Most studies of limb lengthening have concentrated on the osteotomy. In the present study, the response of soft tissue (muscle, artery, nerve) to different length, rates or rhythms of distraction have been investigated to define the nature of any damage and to see whether new muscle is created. The purposes of the this study are to evaluate the optimum condition for soft tissue during limb lengthening and to study the effect of different rates & rhythms of tibial lengthening on the soft tissue in rabbits hy observing the changes of muscle, artery and nerve. We lengthened the right tihiae of fifty-four growing New Zealand white rabbits by callotasis. The left tibiae were used as control. The rabbits were divided into three different rates & rhythms groups: Group 1 (increments of 0.5mm /day, divided 2 times/day), Group II (increments of 0.5mm/day, divided 3 times/day), Group III (increments of 10mm/day, divided 2 times/day). Each Group was subdivided into three lengthening groups: 1 ( 10% lengthening), 2 (20% lengthening), 3 (30% lengthening). At the end of lengthening, histopathologic & histomorphometric studies were done on the medial heads of gastrocnemius muscles, the posterior tibial artery and the posterior tibial nerve. In the histopathological study, these were stained by hematoxylin eosin, PAS and observed by light microscopy. Electron microscopic examination was done in all samples. In light microscopic findings, the sum of scores of the following five suhjects, each counted from 0 to 3, were analysed for individual groups between the experimental side and the control by the Mann-Whitney test and the kruskal-Wallis test. The following conclusions were made hased on the above observations; 1. There was no significant difference between groups I, II and III, but there was a significant dif-ference between the 10%, 20% and 30% lengthening groups by histopathologic study. And the predominant responses of muscle to the lengthening were atrophy and endomysial fibrosis. 2. There was no change in the proportion of the muscle fiber types by histomophomeric study. 3.ln the initial phase, the muscle adaptation to the gradual lengthening was attained by sliding in Jess than 20% distraction but finally the muscle was regenerated by new muscle formation. 4. Major soft tissue complication to the gradual lengthening was induced by muscle. But arteries & nerves were well adapted to the gradual lengthening up to 30% Iengthening.
Arteries ; Atrophy ; Eosine Yellowish-(YS) ; Extremities ; Fibrosis ; Head ; Hematoxylin ; Microscopy ; Muscles ; Osteogenesis, Distraction ; Osteotomy ; Rabbits* ; Tibia ; Tibial Arteries ; Tibial Nerve

The diagnosis and treatment of avascular necrosis of femoral head advanced, after Freud issued examples of bilateral avascular necrosis of femoral head (AVN) in 1926. But still not fixed in treatment and diagnosis. Recently early diagnosis and treatment produced good result. Whole body bone scan, intraosseous pressure mornitoring, intramedullary venography, C-T, or MRI, Selective femoral angiography also used in early diagnosis. Selective femoral angiography was performed for 56 patients, who has suspected as AVN by sumple X-ray and WBBS in order to estimate. How the femoral angiographic finding exist in AVN. In the control group femoral angiography performed to 5 person with normal stage of clinical and radiologic finding. So the result are as following l. All cases in the control group were not observed terminal branch of superior and inferior capslar branch. 2. In AVN the alteration of vasculature appeared 22 patients among 56 patient. 3. The altered vasculature presented 87.5% in traumatic group and 31.5% in nontraumatic group. 4. Collateral circulation was 22.2% in the cases of patients under 6 moths of the time interual between etiological events and clinical symptoms, 89.5% over 6 months. 5. Collateral circulation received 86.8% from inferior gluteal artery two cases from superior gluteal artery, and three cases form obturator artery. 6. Clinical tolerance was supposed to in well developed collateral circulation. According to the above results, Vascular alteraion were noted very much in traumatic group and development of collateral circulation were related promote clinical tolerance. Selective femoral angiography was not effective to assist early diagnosis and treatment of AVN for it could not detect terminal branch of superior and inferior capsular artery that reflected intraossous vasculsture. We need the new nethod of angoigraphy in order to early diagnosis.
Angiography ; Arteries ; Collateral Circulation ; Diagnosis ; Early Diagnosis ; Head ; Hip ; Humans ; Magnetic Resonance Imaging ; Moths ; Necrosis ; Phlebography

Differential diagnosis between physiologic bow legs and nonphysiologic bow legs is difficult and still not fixed in diagnosis, especially under 5 years old age. Recently the problem exist in differential diagnosis and treatment method of rickets because of non-specific laberatory finding in rickets. Metaphyseal-Diaphyseal angle in distal femur, Diaphyseal-Diaphyseal angle between femur and tibia, and Metaphyseal-Diaphyseal angle in proximal and distal tibia, and Metaphyseal-Metaphyseal angle in tibia are measured and compared for 30 bow legs children. And divided into rickets group and physiologic bow legs group by clinical and laboratory findings. The results are as following 1. Mean age was 1.91 years old at initail examination, 2.08 years old in rickets group, 1.73 years old in phisiologic bow legs group. 2. Diaphyseal-Disphyseal angle between femur and tibia was 18.12 ±6.80 in rickets group. And 10.17±5.36 in phisiologic bow legs group. Metaphyseal-Diaphyseal angle in distal femur was 10.88±3.62 in rickets group. And 8.42±4.42 in physiologic bow group. 3. Metaphyseal-Diaphyseal angle in proximal tibia was 11.50±2.56 in rickets group. And 7.17±2.01 in phisiologic bow legs group. It's angle in distal tibia was 10.50±3.86 in the former and 9.50 ±3.09 in the later group. Metaphyseal-Metaphyseal angle in tibia was 20.68±3.91 in rickets group and 16.78±4.11 in phisiologic bow legs group. According to the above mentioned results. Metaphyseal-Metaphyseal angle and Metaphyseal- Diaphyseal angle in tibia are comparable to gross appearance of bow legs deformed children rater than Diaphyseal-Diaphysealangle between femur and tibia, and Metaphyseal-Diaphyseal angle in distal femur. All values are high in rchekts, statistically. Therfore measurement of above mentioned angle in simple X-ray is valuable in differential diagnosis between phisiologic bow legs and Rickets.
Child ; Diagnosis ; Diagnosis, Differential ; Femur ; Genu Varum ; Humans ; Methods ; Rickets ; Tibia

We had treated 24 patients who had nonunions of the carpal scaphoid from June 1987 to September 1995. 17 of 24 nonunions of carpal scaphoid were treated by K-wires fixation and autogenous iliac bone grafts. Another 7 cases were treated by Herbert screw fixation and autogenous iliac bone graft. 24 patients were followed up average 42.6 months and obtained following results; l. Among 24 cases, 23 cases were men and 19 cases were the third and fourth decade. Most common injury was the falling accidents (11 cases: 45.8%). 2. Most common pattern of fractures was waist type (20cases: 83.3%) in anatomical site and transverse type (15 cases: 75.0%) in pattern of fracture line. 3. Preoperative scapholunate angles (mean 52.9degrees: K-wires, 69.1degrees: Herbert screw) has been improved after open reduction and internal fixation by K-wires or Herbert screw (mean 46.2degrees: K-wires, 51.1degrees: Herbert screw). 6 cases had DISI deformity preoperatively with scapholunate angles over 70degrees (mean 80.0degrees: K-wires, 84.0degrees: Herbert screw) has been corrected after ORIF (mean 48.0: K-wires, 58.0: Herbert screw). 4. Bony unions were obtained in average 13.2 weeks in K-wires group and 9.8 weeks in Herbert screw group. 5. 13 cases (76.5%) in K-wires group and 6 cases (85.7%) in Herbert screw group were excellent and good result by Maudsley method. 6. The complications and sequalaes were present 4 cases in K-wires group with degenerative arthritis on radioscaphoidal and scapholunate joint and collapse of proximal pole and 1 case in Herbert screw group with screw malposition. So, We were thought that ORIF with K-wires and Herbert screw was effective treatment for nonunions of carpal scaphoid, especially Herbert screw fixation and autogenous iliac bone graft. In comparison of bony union and results of treatment, Herbert screw group was more effective than K- wires group.
Congenital Abnormalities ; Humans ; Joints ; Male ; Osteoarthritis ; Transplants

BACKGROUND: Generalized aggressive periodontitis (GAP) is a destructive periodontal disease that can develop in young age. Only a few cases of full mouth rehabilitation, using dental implants, have been reported in a patient with aggressive periodontitis. CASE DESCRIPTION: This clinical report describes the treatment procedures and results of full mouth rehabilitation in a patient with aggressive periodontitis. After all teeth were extracted, 6 implants were placed in the maxilla and mandible, respectively. Fixed detachable implant prostheses were made. The patient was satisfied with the final results. She was followed for 10 months postloading. CLINICAL IMPLICATION: For a long-term success, continuous maintenance care is critical, as the contributing factors of the disease (such as immune factors or periodontal pathogens) may not be controlled adequately.
Aggressive Periodontitis ; Dental Implants ; Humans ; Immunologic Factors ; Mandible ; Maxilla ; Mouth ; Mouth Rehabilitation ; Periodontal Diseases ; Prostheses and Implants ; Tooth

No abstract available.
Angiocardiography* ; Contrast Media* ; Electrolytes* ; Osmolar Concentration* ; Plasma* ; Renin*

The authors report seven cases of carotid-ophthalmic artery aneurysms who were surgically treated using the combined extradural-intradural or intradural approach from March, 1991, to December, 1993. Carotid-ophthalmic artery aneurysms are of considerably surgical interest because some of these were considered to have technical difficulties of clipping and disastrous surgical results. Removal of the anterior clinoid process and unroofing of the optic canal are the key points to exposure the operative field adequately. On the basis of these experiences, authors concluded that this approach is very useful, because of adequate surgical field and better mobilization of the internal carotid artery and optic nerve for direct clipping of carotid-ophthalmic artery aneurysm and basilar tip aneurysm.
Aneurysm* ; Arteries* ; Carotid Artery, Internal ; Optic Nerve

No abstract available.
Typhoid Fever*

No abstract available.
Immunoglobulins* ; Tetanus Toxoid* ; Tetanus* ; Vaccination*

No abstract available.
Child* ; Humans ; Peritoneal Dialysis, Continuous Ambulatory*