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

Over 26 kinds of tablets and capsules, such as Tetracycline, Quinidine and Potassium preparations were reported to cause esopbageal ulcerations, eharacterized in various size, shape and number, ind sually in mid-esophagus, Recently authors experienced 10 cases of drug-induced esophageal ulcerations due to antibiotics and antiinflammatory agents such as Tetracycline, Aspirin, etc. Four cases were men and six were women. Four cases were in third dades, three in fourth cleeades, two in fifth decades and one in sixth decades. Presenting symptoras were odynophagia(4/10), dysphagia(3/10), substernal pain(7/10) and epigastric pain(3/10). Endoscopic examination of the esophgus showed single or multiple, small and shallow ulcers on the mid-esophgeal mucosa at the level of 30cm from the ineisor in eight cases, one Iarge and deep ulcer at the level of 40cm from incisor in one patient and one amall, shallow and one large, deep ulcers at the same time. in one patient The shape of alcers were various from a round to a large horseshoe shaped one. The clinical course was mild without complications. It was suggested that drug-induced esophsgeal ulcers with antibiotics and antiinflammatory agents could be found frequently and they had benign and mild clinicalc ourse,
Anti-Bacterial Agents ; Anti-Inflammatory Agents ; Aspirin ; Capsules ; Female ; Humans ; Incisor ; Male ; Mucous Membrane ; Potassium ; Quinidine ; Tablets ; Tetracycline ; Ulcer*

PURPOSE: One-stage corrective osteotomy of a symptomatic malunion of a distal radius fracture, is not easy because of the contracture of surrounding soft tissues. We have treated these malunions by a one-stage corrective osteotomy procedure that uses an intraoperative gradual distraction method of the osteotomy site. We have analysed the clinical and radiological results of our procedure, retrospectively. MATERIALS AND METHODS: We have operated on 7 wrists of 7 patients who had malunion of a distal radius fracture who complained of both wrist pain and functional impairment. The distal radius was osteotomized and distracted gradually for 20 to 30 minutes using a lamina spreader. Then the gap was filled with a pre-designed iliac bone graft. The results were analysed functionally using the Cooney's wrist score, cosmetically using Ladd's method, and radiologically using Kreder's method. RESULTS: The Cooney's wrist score improved from an average 44 preoperatively to 91 at the latest follow-up. The clinical results were excellent in 4 patients, good in 2 patients and fair in one patient. CONCLUSION: A one-stage corrective osteotomy with iliac bone graft using a laminar spreader is followed by creep phenomenon is an useful method for the treatment of the malunion of distal radius fracture.
Contracture ; Follow-Up Studies ; Humans ; Osteotomy* ; Radius Fractures* ; Radius* ; Retrospective Studies ; Transplants* ; Wrist

BACKGROUND AND OBJECTIVES: The excision of submandibular gland (SMG) has been commonly used for the treatment of calculi in the hilum of SMG, since intraoral removal of the hilar stone has the potential risk of lingual nerve injury and the poor surgical field. However, it would leave loss of remained gland function and external scars after the excision. Therefore, the authors modified the intraoral retrieval techniques as the marsupialization of the Wharton's duct up to the calculi in the hilum. This study reports our clinical experience with the modified intraoral retrieval technique and the advantages of this modality for calculi in the hilum of SMG. SUBJECTS AND METHOD: SMG excision and intraoral removal with marsupialization (IRM) were used from 1994 through 2003 to treat 9 and 16 cases of calculi in the hilum of SMG, respectively. We analyzed the characteristic findings of calculi, surgical morbidities and complications by comparing two different treatment groups. RESULTS: The mean diameter of the calculi was 6.1 mm in patients with SMG excision and 7.8 mm in patients with IRM. The success rate of extraction by IRM of calculi in the hilum were 86.7%. The surgical complications were similar in both groups. The proportion of palpable calculi were significantly increased in the IRM group (92.9% vs 22.2%). We failed to remove the stone by IRM from patients, and stones were impalpable intraorally preoperatively. CONCLUSION: IRM is an excellent alternative method for the removal of palpable calculi located in the hilum of SMG. Furthermore, it would preserve the salivary gland function without external scars and with acceptable surgical complications and morbidities.
Calculi* ; Cicatrix ; Humans ; Lingual Nerve Injuries ; Oral Surgical Procedures ; Salivary Ducts ; Salivary Glands ; Submandibular Gland*

No abstract available.

Distal radioulnar dislocation is commonly associated with radius fracture. Most common dislocation pattern is the dorsal dislocation. We present the unique case of volar dislocation of the distal radioulnar joint blocked by displaced dorsal Barton fracture of distal radius and discuss the injury mechanism and anatomic lesions.
Dislocations* ; Joints* ; Radius ; Radius Fractures

Ulnar tunnel syndrome (UTS) is a compressive neuropathy of the upper extremity that shows various clinical symptoms according to the anatomic region of the compression site. Numerous factors may cause UTS, and most publications are case reports describing various etiologies; thus, obtaining a correct diagnosis is often challenging. Giant cell tumor of the tendon sheath (GCTTS) is well described to be a common benign soft tissue tumor of the hand; however, it is rarely reported to cause UTS. We report a case of GCTTS in Guyon's canal causing UTS that was misdiagnosed as handlebar palsy.
Diagnosis ; Giant Cell Tumors* ; Giant Cells* ; Hand ; Paralysis* ; Tendons* ; Ulnar Nerve Compression Syndromes ; Ulnar Neuropathies ; Upper Extremity

Case Report: We report a case of bicipitoradial bursitis, which is a rare mass lesion in cubital fossa. A 54-year-old woman visited our clinic with onemonth history of anterior elbow discomfort and mass lesion. She had a movable and hard mass lesion in cubital fossa. We checked imaging study with simple radiography and MRI. There was a 3.4x2.6x2.7 cm sized cystic mass lesion between biceps tendon and radial tuberosity with inflammatory change in the adjacent tissue on MRI. Enlarged bursa wrapping around the distal biceps tendon was excised and bursitis was confirmed by histologic examination. Bicipitoradial bursitis is a rare disease condition and must be differentiated with other neoplasm in cubital fossa.
Bursitis ; Elbow ; Female ; Humans ; Middle Aged ; Rare Diseases ; Tendons

PURPOSE: The androgen receptor (AR) plays a central role in prostate cancer. Evidence from several groups indicates that epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 2 (HER2) may enhance AR activity in prostate cancer cell lines. This study was designed to investigate the protein expression of AR, EGFR, and HER2 and to determine whether the EGFR and HER2 genes are amplified in prostate cancer tissues. MATERIALS AND METHODS: The protein expression levels of AR, EGFR, and HER2 in a tissue microarray block of 66 prostate cancer samples were investigated by immunohistochemical analysis and chromogenic in situ hybridization was used to determine whether the EGFR and HER2 genes were amplified in these tissues. RESULTS: The AR and EGFR proteins were expressed in 59.1% and 40.9% of prostate cancers, respectively, but their expression levels were not significantly associated with clinicopathologic factors. Of the cases in which tissues were negative for EGFR protein expression, 69.2% were positive for AR protein expression; however, AR protein expression was significantly reduced (44.4%) in tissues in which EGFR protein was expressed. HER2 expression was detected in only 1 case (1.5%). No amplification of the EGFR or HER2 genes was found in prostate cancer specimens. CONCLUSION: This study was limited by small number of subjects, but it can still be inferred that the expression levels of the AR and EGFR proteins are inversely correlated in prostate cancer patients. The potential utility of EGFR and HER2 as prognostic factors or therapeutic targets warrants further study.
Cell Line ; Genes, erbB-2 ; Humans ; In Situ Hybridization ; Prostate ; Prostatic Neoplasms ; Proteins ; Receptor, Epidermal Growth Factor ; Receptor, erbB-2 ; Receptors, Androgen

Anterior interosseous nerve is purely a motor nerve and supplies flexor pollicis longus, flexor digitorum profundus to the index finger, and pronator quadratus. The etiology and treatment option of anterior interosseous nerve syndrome remain controversial. Bilateral involvement of the anterior interosseous nerve have been described rarely; however, we found no reported case of nonsimultaneous bilateral anterior interosseous nerve palsy associated with the entrapment neuropathy. We present the unique case of delayed anterior interosseous nerve syndrome, 3 years 5 months following an identical event in the opposite extremity and literature review.
Equipment and Supplies ; Extremities ; Fingers ; Paralysis