A tumor of the neuromyoarterial apparatus, the glomus, was described by Masson : the epitheloid cell of glomus was derived from the pericyte of Ziemmermann and these cells were widely distributed in the body. From Jan. 1987 to Oct. 1993, six patients (male 1, female 5), who were diagnosed as a glomus tumor in the hand were operated. The lesions were distributed in the distal phalanges of thumb (3 cases), index (1 case), ring finger (1 case) and little finger (1 case). The average duration of clinical manifestation was 6.3 year. Nail extraction was performed because of pain in 2 cases, but symptom was not improved. The clinial symptoms were severe lancinating pain, tenderness and cold induced pain in all 6 cases, palpable mass in 2 cases, bluish purple discoloration of skin in 4 cases, subcutaneous hemorrhage in 1 case, swelling in 2 case. On the reontgenography, bone changes were detected in 2 cases, soft tissue change was detected in 1 case and 3 cases showed unremarkable findings. The treatments were simple excision in 5 cases,curettage and bone graft in 1 case and symptoms were improved in the 6 case with the remnant mild pain and there was no recurrence. The aim of this study was to report the rare cases of glomus tumor in the hand.
Female ; Fingers ; Glomus Tumor ; Hand ; Hemorrhage ; Humans ; Pericytes ; Recurrence ; Skin ; Thumb ; Transplants

A study on the ultrastructures of the prostate gland of Clonorchis sinensis was conducted. The presence of the prostate gland in this fluke has not been known up to present time. Authors observed the ejaculatory duct epithelium including its surrounding parenchyma and found the prostate gland with the help of the electron microscope. The prostate gland was consisted of numerous unicellular glands grouped around the ejaculatory duct. The individual cell was lobulated, tapering in the direction of the ejaculatory duct. The secreting ducts of the gland penetrated into the ejaculatory duct through the muscular layer and the basement membrane, and finally opened to the lumen of the ejaculatory duct. The secreting duct had single layered microtubules along the inner wall of the duct. The secretory bodies produced by the prostate gland seemed to be moved to the lumen of the ejaculatory duct through the secreting duct. The prostate gland of this fluke was less developed than that of Fasciola hepatica but the basic structures were quite similar. There were well-developed lamellae in the epithelia of all ducts concerning passage of spermatozoa from the testes to the male genital opening.
parasitology-helminth-trematoda ; Clonorchis sinensis ; electronmicroscopy ; prostatic gland ; rat ; liver

No abstract available.
Humans ; Infant, Newborn*

Soft-tissue defects over the plantar forefoot, plantar heel, Achilles tendon and distal parts of lower leg are often troublesome to cover with a simple graft or local flap due to limited mobility of surrounding skin and poor circulation in these area. Soft-tissue reconstruction in these regions should provide tissue components similar to the original lost tissue, supply durability and minimal protective pressure sensation and result in a donor site that is well tolerated. We analysed 14 cases that were treated with the instep flap due to soft-tissue defects over these regions from JuL 1990 to Oct. 1995. All flaps were viable and successful at follow-up. 1. The age ranged from 5 years to 70 years, and 13 cases were male and 1 case was female. 2. The sites of soft-tissue loss were the plantar forefoot (l case), plantar heel (9 cases), Achilles tendon (3 cases), and distal part of lower leg (1 case). 3. The causes of soft-tissue loss were simple soft-tissue injury (l case), crushing injury of the 1st toe (1 case), post-traumatic infection and necrosis (11 cases) and traction sore (1 case). 4. The associated injury were open distal tibio-fibular fractures (2 cases), medial malleolar fracture of the ankle (1 case), Achilles tendon ruptures (4 cases) and 1st metatarsophalangeal disarticulation (1 case), open calcaneus fracture (1 case) and femur shaft fracture (1 case). 5. The size of flap was from 3 1 cm to 5 10 cm (average 4 5 cm). 6. We could not find post-operative necrosis and infection, non-viability and gait disturbance caused by the instep flap surgery except limitation of the ankle joint in 1 case. In conclusion, this study demonstrates that the instep flap should be considered as another valuable technique in the reconstruction of these regions.
Achilles Tendon ; Ankle ; Ankle Joint ; Calcaneus ; Disarticulation ; Female ; Femur ; Follow-Up Studies ; Gait ; Heel ; Humans ; Leg ; Male ; Necrosis ; Rupture ; Sensation ; Skin ; Tissue Donors ; Toes ; Traction ; Transplants

Fifteen shoulders in 15 patients with traumatic recurrent anterior dislocation were performed from Sept. 1993 to April 1994. The position in which the dislocation occurred were abduction and external rotation in 10 cases, but most likely direct injuries in the 13 cases. The average interval between the initial and second dislocation was 5.4 months, and the average frequency of dislocation was 15 times per year. Physically, crank test in 13, fulcrum test in 12, sulcus test in 4, and jerk test in 3 cases were positive. The classic Bankart lesions were 4 cases, the bony Bankart lesions in 11 cases, so all of them had an abnormal tension on the inferior glenohumeral ligament. The Hill-Sachs lesions were associated in 14 cases, the Superior Labrum Anterior Posterior lesion in 1 case. Traditional Bankart procedure in 12 cases, traditional method and shift surgery simultaneously for inferior laxity in 3 cases were performed. In 4 cases of bony Bankart lesion with large bone fragment, anterior capsule and subscapularis muslce was splitted during exposure. Velpeau sling was applied in a daytime for postoperative immobilization, exercise with 90° of flexion but no external rotation was permitted during 3 weeks after operation. After than 140° of flexion and 40° of flexion and averag 57° of external rotation. There was no recurrence in our series. The result at follow up were exellent in 9 cases, good in 6 cases.
Dislocations ; Follow-Up Studies ; Humans ; Immobilization ; Ligaments ; Methods ; Recurrence ; Shoulder

Pedicled bone flap raised from the volar aspect of lower end of the radius, pedicled by the pronator quadratus has been used for the treatment of scaphoid nonunion and Kienbock's disease. From July 1991 to Jan. 1992, authors performed this procedures for 3 cases of Kienbock's disease. Patients were 2 cases in the left hand, l case in the right hand. There was no critial trauma history. Age at operation were 25, 37 and 57 years. All patients were in Stage I in 2 cases and stage II-A in 1 case of Lichtman's radiologic classification. Preoperative grip powers were 11%, 38%, 63% and pinch powers were 20%, 41%, 61% of that of normal opposite hand. Follow up periods were 28, 31 and 33 months. At last follow up roentgenographic finding shows no progression of necrosis of lunate, new bone formation, decreased sclerosis, and joint space were preserved in all cases. The fuctional results at the last follow up were as follows. Pain during motion was markedly diminished in all patients. Grip power were 57%, 89% and 96% and pinch powers were 68%, 83% and 100% of that of normal opposite hand with use of calibrated Jamar dynamometer which showes significant increase than preoperative state. The ranges of motion of wrist were as follows. Volar flexion were 40, 45 and 80 degree. Dorsiflexion were 10, 20 and 45 degree. Ulnar deviation were 10, 20 and 30 degree. Radial deviation were 10, 25 and 30 degree. This viable bone graft with blood supply gives very satisfactory clinical results.
Classification ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Joints ; Necrosis ; Osteogenesis ; Osteonecrosis ; Radius ; Sclerosis ; Transplants ; Wrist

Indications for bone lengthening in the hand are less common than for the lower extremity. From 1991 to 1993 authors had performed nine hand bone lengthenings in the eight patients, based on callotasis and chondrodiastasis, Average age at the time of surgery was 18 years old(from 4 to 31 years old). Diagnoses included traumatic amputations in 7 cases and congenital syndactyly of both hand with hypoplastic digits in 2 cases. Sites of lengthening were metacarpal bone in 7 cases, phalangeal bone in 2 cases. Eight of 9 lengthening procedures resulted in complete consolidation of the bone gap after the single stage procedure. In one case secondary bone graft was required for the bone defect. Average consolidation period was 16 weeks(from 10 weeks to 22 weeks). Average gained length was 14.6mm (from 6 to 30mm) and average percent of gained digital bone length was 48%. There were minimal complications including marginal necrosis of skin, numbness and bone tip exposure and were responsed to conservative manage, but stump revision for bone tip exposure was performed in one case. In all cases followed to completion and for 1 to 3 years postoperatively, there was improvement of function with key pinch. The callotasis lengthening is one of the useful method of short hand bone lengthening to improve function of hand and cosmetic demand.
Amputation, Traumatic ; Bone Lengthening ; Diagnosis ; Fingers ; Hand ; Humans ; Hypesthesia ; Lower Extremity ; Methods ; Necrosis ; Osteogenesis, Distraction ; Skin ; Syndactyly ; Transplants

A morphological study on the ultrastructures of body wall and the nervous system of Clonorchis sinensis was conducted. For this study, liver flukes were collected from the liver of rabbit six months after the infection with metacercariae obtained from the fresh water fish, Pseudorasbora parva. The collected materials were washed with 0.85 percent saline solution and then immediately moved to cold 2.5 percent glutaraldehyde buffered with 0.1 M Millonig's phosphate buffer (pH 7.4). The materials were dissected into appropriate pieces in the fixative about 30 minutes after beginning of the fixation. Two hours later the materials were rinsed several times with the buffer and were fixed with cold, buffered 1 percent osmium tetroxide(OsO(4)) for 2 hours. The fully fixed tissue blocks were dehydrated in a series of graded concentrations of acetone and were embedded in Epon 812 mixture. Thin sections obtained from Sorvall MT-2 ultramicrotome were stained with uranyl acetate and Reynold's lead citrate. Observations of the sections were carried out with Hitachi HS-7S electron microscope. The following structures are newly identifed in a series of observations. The mid-abdominal integument of the fluke is more thicker(-6 micrometer) than the dorsal side(about 3 micrometer). Although it is so far known that only surface and epithelia of the suckers, pharynx, and the oesophagus are composed of integumental, anuclear layer, it is newly found that epithelium of the excretory pore also consists of integumental, anuclear layer. There are lot of microvilli in the dorsal outer surface of the oral sucker. A kind of ducts accumulated with unknown secretory granules are present within the parenchyrna around both of the oral suckers and the pharynx. The nerve endings are distributed to the integument of the body where sensory hairs are projected outward. The sensory hairs are rarely distributed throughout the whole integument, but a little more in the surroundings of both suckers. The sensory hairs are attached to the base of the sheath by a circular septate desmosome. No rootlet structure is observed but the upper part of the basal body is attached to the peripheral desmosome by transverse fibres. The mitochondria and the vesicles are present within the hair cavity. The nerve fibres are also found to be myelinated at least in main axons.
parasitology-helminth-trematoda ; Clonorchis sinensis ; electronmicroscopy ; mitochondria ; vesicle ; desmosome ; rabbit

No abstract available in English.
Adenocarcinoma, Bronchiolo-Alveolar* ; Pathology*

A morphological study on the ultrastructures of the alimentary tract and the excretory system of Clonorchis sinensis was conducted. The liver flukes were collected from rabbit liver six months after the experimental infection The worms were washed with 0.85 percent saline solution and immediately moved to cold 2.5 percent glutaraldehyde in 0.1 M phosphate buffer pH 7.4. The materials were dissected and fixed for two hours. The blocks were post-fixed in 1 percent osmium tetroxide. The blocks were embedded in Epon 812. Ultra thin sections were cut with Sovall MT-2 ultramicrotome and stained with uranyl acetate and lead citrate. Sections were then observed with Hitachi HS-7S electron microscope. The following results were obtained in a series of observations. The walls of oral cavity and esophagus comprised tegumental syncytium, basement membrane, loose connective tissue, muscular layer and parenchymal cells. The apical surface and the base of the syncytium were covered with a protoplasmic membrane for each forming numerous invaginations. Granular endoplasmic reticulum was developed in the epithelium of the oesophagus. The gastrodermis of Clonorchis sinensis comprised two types of cells in general. The first cell type was numerous one forming a single continuous layer of epithelial cells. Each of the cells had outfolded cytoplasm into the caecal lumen and lamellae along the cell surface. Among the above epithelial cells, no considerable differences in structure reflecting their functional states were identified. The second cell type was less differentiated in nature and lay within the gastrodermis above the basement membrane but not in contact with the caecal lumen, being overlapped by neighboring gastrodermal cells of the type described above. At this portion the gastrodermis seemed to be a pseudostratified epithelium. There were well-developed lamellae along the surface of epithelia of all canals or duct concerning evacuation. The excretory pore was 7.5 micrometer in diameter and dorso-terminally opended. The epithelium of the excretory pore, a syncytial layer, contained many microtubules unlike the other part of tegumental layer of this worm. The epithelium thickness of the excretory pore was very irregular(1.3-5.5 micrometer).
parasitology-helminth-trematoda ; Clonorchis sinensis ; electron microscopy ; alimentary tract ; liver ; rabbit