No abstract available.
Posterior Cruciate Ligament*

The authors report two cases of successful reconstruction in infected nonunion of the femur involving marked shortening by compression and gradual distraction at the nonunion site using Ilizarov external fixator. At first, infection was controlled by radical excision & the administration of systemic antibiotics for four weeks and we also started compression at the nonunion site 3 days after operation. Autogenous iliac bone graft was added to strengthen the site of new bone formation lastly. In this report, the role of the compression seems to provide a good environment for distraction osteogenesis by focal necrosis and triggering inflammation. Compression and gradual distraction may be one of the treatment mordalities for nonunion of a long bone with massive bone loss or shortening, even infected.
Anti-Bacterial Agents ; External Fixators ; Femur* ; Inflammation ; Necrosis ; Osteogenesis ; Osteogenesis, Distraction ; Transplants

The tibial pilon fracture has been described as difficult fracture to manage. We have reviewed 23 cases of tibial pilon fractures from Mar. 1987 to Feb. 1993 at our hospital. 1. The fractures were classified into five types according to the system of Ovadia and Beals and the methods of treatment were divided into two groups; 9 cases were treated with Ilizarov device(Group I). 6 cases out of Group I were type 3, 4 and 5. Other methods were performed in 14 cases(Group II). 8 cases out of Group II were type 3, 4, and 5. 2. In type 3, 4 and 5 fractures, there were 86 per cent good and fair radiographic results in Group I and 63 per cent good and fair results in Group II. 3. Satisfactory results were obtained by the treatment of Ilizarov method especially in type 3, 4 and 5 fractures. The advantages of Ilizarov device were its primary reduction with ligamentotaxis, easy open reduction due to proximal and distal stabilization, minimal soft tissue injury and minimal internal fixation.
Ilizarov Technique ; Methods ; Soft Tissue Injuries

Thirteen cases of lengthening of short tubular bone by gradual axial distraction using an unilateral external fixator(Orthofix M-100, Orthofix CP0089) are reported. This study aims to prove effective- ness of gradual distraction for lengthening of short tubular bone and usefulness of the newly designed external fixator. Nine patients had brachymetatarsia and four brachymetacarpia. The etiology was consisted of post-traumatic physeal injury in two and congenital in eleven cases. The average amount of lengthening was 14.5mm(37.0%) in metacarpal bone, and 17.3mm(37.5%) in metatarsal. Complications were angular deformity in 3, pin loosening in 2 cases, and premature consolidation, nonunion and pin site infection in one case, respectively. Cosmetical and functional satisfactory results were obtained in all cases. We believe that callotasis is effective for short tubular bone lengthening. Also we confirmed the newly designed external fixa- tor(Orthofix CP0089) useful.
Bone Lengthening ; Congenital Abnormalities ; External Fixators ; Humans ; Metatarsal Bones ; Osteogenesis, Distraction

Cauda equina syndrome(CES) and disc rupture have been implicated as a potential complication of spinal manipulation. A review of the literature from 1911 to 1996 received 61 reported cases of cauda equina syndrome or disc rupture in patients undergoing manipulation. This article presents four new cases, where a temporal association was found between the onset of cauda equina symptoms or disc rupture and lumbar manipulation. The type of manipulation administered and the relationship between the treatment and symptoms is reviewed. Our patients symptoms suggest that acute herniation was caused, or at least precipitated by spinal manipulation. In each of these cases the chiropractitioner failed to comprehend the nature of the problem and take appropriate action. As a consequence, the patient went untreated for several days. Many chiropractic therapists assumed the incidence of CES caused by manipulation to be approximately one in many millions of treatments. However, we assumed that CES or disc rupture is far more common than the literature would reflect. It is therefore essential that persons practicing or prescribing manipulation would be aware of these complications.
Cauda Equina ; Chiropractic ; Humans ; Incidence ; Manipulation, Spinal ; Polyradiculopathy ; Rupture ; Spine*

Epiphyseal fractures in neonates are rare and difficult to diagnose on simple radiographic images and objective guidelines for treatment have not yet been established. Authors performed conservative treatment for displaced distal femoral epiphyseal fracture detected on 5th day after cesarean section delivery. At 10 years of follow-up, satisfactory functional recovery was observed. Herein, we report on a case of displaced distal femoral epiphyseal birth fracture with literature reviews.
Cesarean Section ; Epiphyses* ; Female ; Femur* ; Follow-Up Studies* ; Humans ; Infant, Newborn ; Parturition* ; Pregnancy

In order to develop questionnaire estimating vinyl chloride monomer(VCM) exposure levels, to reset selection criteria for detailed tests, to measure current VCM exposure levels, to evaluate the mutagenic effects of VCM exposures and to develop multiphasic screening method of PVC- or VCM-handling workers, VCM concentrations of work environments were measured and tentative self-administrative questionnaire, physical examination, sister chromatid exchange(SCE) test and some clinical chemical test were applied to 195 men who had been handling VCM or PVC(Exposed Group) and 37, in the same factories without exposure to VCM or in polyethylene- or polypropylene-related factories(Control Group). Mean VCM concentrations of work environments were 0.268+/-0.183 ppm under PVC synthesis processes, 0.160+/-0.200 ppm under VCM synthesis process, 0.076+/-0.111 ppm under PVC pipe producing processes, 0.090+/-0.108 ppm under PVC wall paper, sheet, or film producing processes, 0.071+/-0.051 ppm under PVC floor producing processes, 0.243+/-0.250 ppm under PVC sash producing processes, and 0.020+/-0.031 ppm under triming process. VCM levels of work environments under manual resin mixing processes (0.209+/-0.168 ppm)were higher than those of the others (0.209+/-0.168 ppm) (p-value<0.05). There was no VCM-related symptoms, the positive response rates of which were higher in the Exposed Group. Overall abnormal rate in clinical chemistry test of the Exposed Group was higher than that of the Control Group, but due to extermely low exposure level of exposure group and to small sample size of the Control Group, no statistical significance was found(p-value>0.05). SCE frequencies of the Exposed Group were significantly higher than those of Contorl Group(p-value<0.05) and those of test-abnormal persons were higher than those of test-normal persons. SCE frequencies linearly increased with not only current but also cumulative VCM exposure levels(p-value<0.05). These results suggest that adverse health effect may ensue from VCM exposure to as low as 1 ppm. But SCE frequencies had no statistically significant correlation with drinking amounts, smoking amoutns, or radiation dose equivalents. Questionnaire was revised by referring to these results and formula estimating cumulative VCM exposure levels based on occupational history in questionnaire were made. In addition, were presented methods evaluating work environments and multiphasic screening test for PVC workers.
Chromatids ; Clinical Chemistry Tests ; Drinking ; Humans ; Male ; Multiphasic Screening* ; Patient Selection ; Physical Examination ; Polyvinyl Chloride* ; Polyvinyls* ; Questionnaires ; Sample Size ; Siblings ; Sister Chromatid Exchange ; Smoke ; Smoking ; Vinyl Chloride*

BACKGROUND: Intravenous injection of mesenchymal and hematopoietic stem cells (MSCs, HSCs) has the disadvantages of low delivery rate to bone marrow and sequestration of cells in the lung and liver. This study was designed to determine whether there is a relationship between the administration route and dosage of stem cells and GVHD and survival. METHODS: MSCs were retrieved from five subcultured C3H/10T1/2, cell lines from C3H/He mice. HSCs were transplanted by injecting 1 x 10(7) of bone marrow mononuclear cells and 5 x 10(6) of spleen cells from six to eight week old female C3H/He mice into six week old irradiated female BALB/c mice. The groups were divided into intravenous injection (IV) and intra-marrow (IM) injection groups. IV and IM+MSC groups consisted of mice transplanted with the same bone marrow mononuclear cells and SP, IV and IM groups, with the additional co-injection of 1 x 10(6) MSCs. RESULTS: Evaluation of all mice, in both groups, showed no difference in GVHD and survival. However, high dose injection with 1 x 10(6) MSCs led to a decreased incidence of GVHD (P<0.05) and improved survival (P<0.01) in both groups. CONCLUSION: The results of this study showed that the positive effects of MSC on GVHD and survival were primarily dependent on the number of injected cells.
Animals ; Bone Marrow ; Cell Line ; Female ; Graft vs Host Disease* ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Incidence ; Injections, Intravenous ; Liver ; Lung ; Mesenchymal Stromal Cells* ; Mice ; Spleen ; Stem Cells ; Transplants*

BACKGROUND: Cardiovascular mortality is high in patients with end-stage renal disease (ESRD). Although the factors contributing to ESRD-related vascular disease are incompletely understood, recent studies suggest that inflammatory reaction or chronic infectious disease may play an important role as new risk factors. The aim of present study was to measure coronary artery calcification score (CACs) and to investigate the association with various markers of systemic inflammatory reaction. METHODS: We conducted a cross-sectional study in 33 patients (M: F=23: 10, age=57+/-2 years) on maintenance hemodialysis. Multirow spiral CT (MSCT) was performed in all patients to measure CACs utilizing area and volume calculations. We measured high sensitivity C-reactive protein (hs- CRP) and interleukin-6 (IL-6) as indicators of inflammatory reaction, and measured IgA and IgG antibodies to C. pneumoniae, and IgG antibodies to H. pylori, cytomegalo virus, and herpes simplex. RESULTS: Median CACs equaled 379 (range, 0- 3, 662) by area and 338 (range, 0-2, 968) by volume. CACs more than 100 was present in 24 (73%) patients. Log (hs-CRP) was positively correlated with log (CACs) (area: r=0.37, p<0.05, volume: r=0.39, p< 0.05), but log (IL-6) was not. There was no significant relationship between CACs and antibody titers to C. pneumoniae, H. pylori, cytomegalovirus, and herpes simplex. Age was positively correlated with log (CACs) (area: r=0.39, p<0.05, volume: r=0.39, p< 0.05), but the presence of diabetes, smoking history, the duration of dialysis, body mass index, blood pressure, and serum cholesterol, albumin, PTH, calcium, and phosphorous levels were not. CONCIUSION: Coronary artery calcification was common in ESRD patients on hemodialysis, and associated with increased hs-CRP, an indicator of the presence of inflammatory reaction. There was no significant relationship between antibodies to chronic infections such as C. pneumoniae, but large-scale longitudinal studies are needed to evaluate fully that.
Antibodies* ; Blood Pressure ; Body Mass Index ; C-Reactive Protein* ; Calcium ; Cholesterol ; Communicable Diseases* ; Coronary Disease ; Coronary Vessels* ; Cross-Sectional Studies ; Cytomegalovirus ; Dialysis ; Herpes Simplex ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Interleukin-6 ; Kidney Failure, Chronic ; Mortality ; Pneumonia ; Renal Dialysis* ; Risk Factors ; Smoke ; Smoking ; Tomography, Spiral Computed ; Vascular Diseases

BACKGROUND: Cardiovascular mortality is high in patients with end-stage renal disease (ESRD). Although the factors contributing to ESRD-related vascular disease are incompletely understood, recent studies suggest that inflammatory reaction or chronic infectious disease may play an important role as new risk factors. The aim of present study was to measure coronary artery calcification score (CACs) and to investigate the association with various markers of systemic inflammatory reaction. METHODS: We conducted a cross-sectional study in 33 patients (M: F=23: 10, age=57+/-2 years) on maintenance hemodialysis. Multirow spiral CT (MSCT) was performed in all patients to measure CACs utilizing area and volume calculations. We measured high sensitivity C-reactive protein (hs- CRP) and interleukin-6 (IL-6) as indicators of inflammatory reaction, and measured IgA and IgG antibodies to C. pneumoniae, and IgG antibodies to H. pylori, cytomegalo virus, and herpes simplex. RESULTS: Median CACs equaled 379 (range, 0- 3, 662) by area and 338 (range, 0-2, 968) by volume. CACs more than 100 was present in 24 (73%) patients. Log (hs-CRP) was positively correlated with log (CACs) (area: r=0.37, p<0.05, volume: r=0.39, p< 0.05), but log (IL-6) was not. There was no significant relationship between CACs and antibody titers to C. pneumoniae, H. pylori, cytomegalovirus, and herpes simplex. Age was positively correlated with log (CACs) (area: r=0.39, p<0.05, volume: r=0.39, p< 0.05), but the presence of diabetes, smoking history, the duration of dialysis, body mass index, blood pressure, and serum cholesterol, albumin, PTH, calcium, and phosphorous levels were not. CONCIUSION: Coronary artery calcification was common in ESRD patients on hemodialysis, and associated with increased hs-CRP, an indicator of the presence of inflammatory reaction. There was no significant relationship between antibodies to chronic infections such as C. pneumoniae, but large-scale longitudinal studies are needed to evaluate fully that.
Antibodies* ; Blood Pressure ; Body Mass Index ; C-Reactive Protein* ; Calcium ; Cholesterol ; Communicable Diseases* ; Coronary Disease ; Coronary Vessels* ; Cross-Sectional Studies ; Cytomegalovirus ; Dialysis ; Herpes Simplex ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Interleukin-6 ; Kidney Failure, Chronic ; Mortality ; Pneumonia ; Renal Dialysis* ; Risk Factors ; Smoke ; Smoking ; Tomography, Spiral Computed ; Vascular Diseases