The fabella, a sesamoid bone that occasionally is found in humans on the gliding surface of the lateral head of the gastrocnemius, is a sign of an atavistjc pattern. The authors examined radiograph of knees of 817 patients for the presence of fabella and determined the incidence of fabella in traumatic patients as compared with non-traumatic patients with primary osteoarthrosis or vague pain in that knees. The results were as followes: l. 31.0% of 626 adult patients had at least a unilateral fabella. 2. There was no difference in the incidence of fabella according to sex (p<0.01). 3. The youngest boy showing the fabella was aged 12 years & 8 months, the youngest girl 15 years & 2 months. 4. 87.1% of the patients who had a fabella had one bilaterally. 5. Fabellae were more common in the patients with primary osteoarthrosis or vague pain in that knees. 6. It is our opinion that the presence of fabella is more important in the clinical aspect in Korea.
Adult ; Female ; Head ; Humans ; Incidence ; Knee ; Korea ; Male ; Osteoarthritis ; Sesamoid Bones

Subtrochanteric fractures of the femur are difficult to manage successfully. Two factors, involvement of cortical bone tissue and concentration of stress, frequently have been mentioned as reasons for the high incidence of failure in the treatment of these fractures. We studied 37 patients with 38 subtrochanteric fractures treated at the Seoul Red Cross Hospital from Feb. 1978 to Nov. 1983. The results were obtained as follows: 1. Of the 37 patients studied, 29 were male and 8 female. The majority of male patients (representing 62.1%) were between 21 and 50 years of age, while 7 of 8 female patients were after 50years of age. 2. In 27 (73.0%) of our patients, the fracture resulted from high-energy trauma, traffic accident or fall from height. 3. Many fractures in the present series could not be classified in the manners described by Fielding, Zickel or Seinsheimer. So, we could not find any correlation between fracture type and used fixation device or its prognosis. 4. The associated injuries, which were relatively common in lower limb (10 cases) and pelvis (8 cases), made the fractures more difficult to treat. 5. Of the 38 fractures, 35 (92.1%) were treated by operative means. The Jewett nail was the device most commonly used, with a total of 11(31.4%) fractures being so treated. 6. The average time from operation to partial weight bearing was 12.9 weeks. 7. The average time untill clinical union was about 14 weeks and radiographic union about 24 weeks. 8. From these series, it was considered that, although early weight bearing is frequently impossihle, Jewett nail, plate and screw, compression hip screw, Judet plate or blade plate can be applied successfully to the treatment of subtrochanteric fractures of the femur if the most proper one which can stabilize the lesion effectively is selected and weight bearing is delayed for a sufficient period.
Accidents, Traffic ; Bone and Bones ; Clinical Study ; Female ; Femur ; Hip ; Hip Fractures ; Humans ; Incidence ; Lower Extremity ; Male ; Pelvis ; Prognosis ; Red Cross ; Seoul ; Weight-Bearing

No abstract available.
Female ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Renal Dialysis*

Mitral valvular heart diseases are known to be one of the easily detectable and the hemodynamic chane to the severity and duration of diseases can directly be described by echocardiography. The objective of this study was to determine the echocardiographic characteristics in 3 groups of mitral valvular diseases, that is mitral stenosis(112 cases), mitral stenoinsufficiency (66 cases). and mitral insufficiency(20 cases). 1) In mitral valve study, closing velocity of anterior leaflet reduced in mitral stenosis than other two groups and DE amplitude was greater in mitral insufficiency but there were no significant differences in 3 groups of mitral valvular diseases. DE and AC slope were slightly more rapid in mitral stenosis group and left ventricular outflow tract was much increased in mitral insufficiency group. 2) In aorta and left atrium study, aortic cusps separation was much increased in mitral insufficiency and left atrium was slightly more dilated in mitral stenoinsufficiency than other two groups. But left atrial dimension in mitral insufficiency was more diminished than that in mitral, stenosis, which is probably due to the short durationn of diseases and small range of materials in mitral insufficiency group. 3) In left ventricle study, thickness of interventricular septem, LSa, Ena, left ventricular dimension, LVPW, LV volume. and stroke volume were more increased in mitral insufficiency than mitral stenosis, because of the left ventricular volume overloading. Vcf and PEP/LVET were higher in mitral insufficiency than other two groups. Ejection fraction and fractional shortening were more diminished in mitral stenoinsufficiency but no significant difference was found. 4) In right ventricle study, there were no remarkable changes in right ventricular dimension and right ventricular internal dimension index in all 3 groups of mitral valvular diseases. 5) Calcification of mitral leaflets was observed in 85.7% of mitral stenosis, 90.9% of mitral stenoinsufficiency and 10% of mitral insufficiency, but heavy calcification was more remarkable in mitral stenosis group(25%). 6) Atrial fibrillation was observed in 47% of total mitral valvular diseases, mitral stenosis being 43.8%, mitral stenoinsufficiency 60.6% and mitral insufficiency 20%. In cases of atrial fibrillation, left atrial dimension was significantly enlarged compared with the group without atrial fibrillation.
Aorta ; Atrial Fibrillation ; Constriction, Pathologic ; Echocardiography* ; Heart Atria ; Heart Valve Diseases* ; Heart Ventricles ; Hemodynamics ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Stroke Volume

Two cases of Castleman's disease (Giant lymph node hyperplasia) are reported. The first case was a multicentric cervical giant lymph node hyperplasia. Excisional biopsy confirmed the diagnosis of Castleman's disease of the plasma-cell type. Despite repeated dissection of the cervical lymph nodes, complete removal of the lymph nodes was impossible, and the type was changed into mixed type, and regrowth of the tumor was noted. Prednisolone was of no benefit. The patient is now living with cervical masses in situ without general symptoms, 4 years after the initial diagnopsis. The second case was a solitary retroperitoneal giant lymph node hyperplasia, incidentally found. Complete excision was performed and biopsy confirmed the diagnosis of Castleman's disease of hyaline-vascular type. No recurrence was found at 2 years after the excision.
Biopsy ; Diagnosis ; Giant Lymph Node Hyperplasia* ; Humans ; Lymph Nodes* ; Neck ; Prednisolone ; Recurrence

The bcl-2 gene is a proto-oncogene which extends cell survival by blocking apoptosis. Bcl-2 expression has been detected in many types of nodal and MALT lymphoma. The p53 gene is a tumor suppressor gene and p53 mutation is the most common genetic alteration in human malignancies. The relationship between the expression of bcl-2 and p53 protein in primary gastric lymphoma has been rarely reported. The authors investigated the expression of bcl-2 and p53 protein in 37 cases of primary gastric lymphoma by immunohistochemical method using bcl-2 and p53 monoclonal antibodies. There were five cases of low grade B-cell MALT lymphomas and thirty two cases of high grade B-cell lymphomas. Fifteen of 37 cases (41%) showed bcl-2 protein expression in the cytoplasm of tumor cells and 26 cases (70%) showed p53 protein expression in the nucleus of tumor cells. Bcl-2 protein was detected in 4 of 5 (80%) low grade MALT lymphomas, and in 11 of 32 (34%) high grade lymphomas. There was no significant correlation between bcl-2 expression and histologic grade of primary gastric lymphomas (p>0.05). p53 protein was positive in 25 of 32 (78%) high grade lymphomas, and in 1 of 5 (20%) low grade MALT lymphomas. The expression of p53 protein is significantly higher in high grade lymphoma than in low grade MALT lymphoma (p<0.05). The p53 expression in the bcl-2 negative cases (86%) was significantly higher than in the bcl-2 positive cases (47%). There was an inverse relationship between bcl-2 and p53 expression in primary gastric lymphoma. These results suggest that bcl-2 and p53 expression in primary gastric lymphoma may be involved in the transition from low grade MALT lymphoma to high grade lymphoma.
Antibodies, Monoclonal ; Apoptosis ; B-Lymphocytes ; Cell Survival ; Cytoplasm ; Genes, bcl-2 ; Genes, p53 ; Genes, Tumor Suppressor ; Humans ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone ; Proto-Oncogenes

The clinical study was made on 38 cases of the congenital megacolon who had been admitted to Dept. of Pediatrics and General surgery, National Medical Center from Jan., 1869 to Dec., 1977 We obtained the following results. 1. The sex ratio was 4.4 : 1, of male preponderance. 2. The onset of symptoms was within 1 week after birth in majority of the cases. 3. All patients were delivered at fullterm and the familial occurrence was not observed. The associated anomalies were a case of mongolism with congenital heart disease and of congenital hypertrophic pyloric stenosis. 4. In about half of the cases, the definitive diagnosis was made before the age of 6months 5. The clinical symptomes were abdominal distension, constipation, vomiting, diarrhea, visible peristalsis and weight loss in order of frequency. 6. Meconium passage was spontaneous in 41.2% and after digital examination or enema in 58.8%. 7. The majority of the cases(79%) were so called short segment type. One male patient was proved to be total aganglionic colon. 8. The definitive operation was performed in 18 cases, in which 14 cases(77.7%) received Swenson's procedure. The early complications were wound infection, leakage, fistula, pelvic abscess and the late complications were stricture, intestinal obstruction, enterocolitis, fecal impaction, malnutrition in order of frequency. 9. The total mortality rate was 23.7% and the operation mortality was 16.7%. 10. The results of one stage operation was somewhat better than two stage operation. 11. The follow up results were good in 83.3% of operated cases.
Abscess ; Colon ; Constipation ; Constriction, Pathologic ; Diagnosis ; Diarrhea ; Down Syndrome ; Enema ; Enterocolitis ; Fecal Impaction ; Fistula ; Follow-Up Studies ; Heart Defects, Congenital ; Hirschsprung Disease* ; Humans ; Intestinal Obstruction ; Male ; Malnutrition ; Meconium ; Mortality ; Parturition ; Pediatrics ; Peristalsis ; Pyloric Stenosis, Hypertrophic ; Sex Ratio ; Vomiting ; Weight Loss ; Wound Infection

Chronic ruptures of the patellar tendon are uncommon injuries. They are technically difficult to repair because of scar formation, poor quality of the remaining tendon, and quadriceps muscle atrophy and contracture. We report a case on the reconstruction of a chronic patellar tendon rupture. The reconstruction was performed 18 months after the injury, using an Achilles tendon allograft and reinforcing suprapatellar wire. At four weeks postoperative, the patient had attained 70degrees C flexion and 10degrees C extension lag. Nine months after the index procedure, the patient regained 130degrees C flexion and 5degrees C extension lag, and 85% quadriceps strength. The technique accomplished the preoperative goals of restoring quadriceps function and anatomic position of the patella as well as allowing early mobilization after surgery. Although this reconstructive procedure is technically demanding, the functional results obtained can be excellent. We recommend the use of this technique for chronic patellar tendon ruptures that cannot be primarily repaired.
Achilles Tendon ; Allografts* ; Atrophy ; Cicatrix ; Contracture ; Early Ambulation ; Humans ; Patella ; Patellar Ligament* ; Quadriceps Muscle ; Rupture* ; Tendons

The purpose of this animal study is to evaluate, by histomorphometric analysis, bone regeneration in rabbit's maxillary sinuses with blood clots alone, Bio-Oss, β-tricalcium phosphate (β-TCP), and demineralized tooth dentin (DTD) grafting. Bilateral sinus augmentation procedures were performed in 18 adult male rabbits. Rectangular replaceable bony windows were made with a piezoelectric thin saw insert. In the group 1, blood clots were filled; group 2, anorganic bovine graft (Bio-Oss) was grafted; group 3, β-TCP was grafted; group 4, DTD was grafted, and covered by replaceable bony windows. Animals were sacrificed at 2, 4, and 8 weeks after surgical procedure. The augmented sinuses were evaluated by histomorphometric analysis using hematoxylin and eosin and Masson's trichrome stains. Histologically, new bone formation was revealed along the elevated sinus membrane and all graft materials. The new bone area of the group 2 was significantly greater than the group 1, and of the group 3 was significantly greater than the group 2, and of the group 4 was significantly greater than the group 3 at 8 weeks with P < 0.05. The bone marrow area of group 1 was significantly greater than other groups at 8 weeks. The DTD area was significantly lesser than Bio-Oss or β-TCP particles area at 8 weeks. This present study suggests that DTD can be effective graft materials for bone regeneration of the maxillary sinus augmentation.
Adult ; Animals ; Bone Marrow ; Bone Regeneration ; Coloring Agents ; Dentin ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Male ; Maxillary Sinus* ; Membranes ; Osteogenesis ; Rabbits ; Tooth ; Transplants*

BACKGROUND: IgA nephropathy is the most common type of glomerulonephritis to progress to the end-stage renal disease. The variable course and long natural history of the disease make it difficult to predict prognosis. The aim of the present study was to search for significant predictive factors at the time of biopsy. METHODS: Authors investigated the association between prognosis of IgA nephropathy and clinical (age, sex, hypertension, compliance), laboratory (serum creatinine and uric acid, proteinuria, selective proteinuria index, IgA/C3 ratio), and histologic findings at the time of biopsy from 50 patients who were biopsy-proven IgA nephropathy and followed for more than 5 years at our hospital. Two outcomes were analysed. The first, only 46 cases (initial GFR > or =60) were divided into two groups:group 1 (last GFR > or =60 mL/min), group 2 (<60 mL/min). The second, percent change of GFR (from the time of biopsy to 5 yr follow-up GFR) was calculated at each patients and all patients were divided into two groups: group A (GFR-chage <30%), group B(> or =30% and GFR <90 mL/min). RESULTS: Risk factors for chronic renal failure by multivariate analysis (Cox proportional hazards model) were compliance. And histopathologic classification as Haas has predictive value for rapid deterioration of GFR (p<0.005). CONCLUSION: Compliance may be predictors for renal survival in the patients with IgA nephropathy by multivariate analysis. Histopathologic classification as Haas was related with rapid reduction of renal function. And hyperuricemia seems to be related with prognosis of IgA nephropathy. But these outcome may need further evaluation by long-term and large cohort study.
Biopsy ; Classification ; Cohort Studies ; Compliance ; Creatinine ; Follow-Up Studies ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Humans ; Hypertension ; Hyperuricemia ; Immunoglobulin A* ; Kidney Failure, Chronic ; Multivariate Analysis ; Natural History ; Prognosis ; Proteinuria ; Risk Factors ; Uric Acid