It is generally accepted that fractures should be treated by closed methods, however for certain femoral fractures in adults, closed methods yields an unacceptable high incidence of nounlon, malunion, delayed unlon, and disability. For these fractures various methods of open reduction and internal fixation have been recommended, but unfortunately, there are frequent reports of complications and failures. The recently developed association for study of Internal fixation (ASIF) compression plating apparatus, seems to satisfy the basic objectives of internal flxatlons: namely
Adult ; Femoral Fractures ; Femur ; Follow-Up Studies ; Humans ; Incidence ; Joints ; Walking

Histiocytic medullary reticulosis is a rare, uniformly fatal, acute disease of the reticuloendothelial system. The disease is associated with fever, malaise, weakness, weight loss, lymphadenopathy, hepatosplenomegaly, jaundice, and purpura. Common laboratory findings are severe anemia, leukopenia, and thrombocytopenia. A 49-year-old male patient is described who had multiple purple nodules and tumors in the skin. A biopsy taken from a skin lesion showed a diffuse proliferation of atypical histiocytes in the dermis and subcutaneous tissue.However, erythrophagocytosis of these atypical histiocytes was not seen.
Acute Disease ; Anemia ; Biopsy ; Dermis ; Fever ; Histiocytes ; Humans ; Jaundice ; Leukopenia ; Lymphatic Diseases ; Male ; Middle Aged ; Mononuclear Phagocyte System ; Purpura ; Skin ; Thrombocytopenia ; Weight Loss

Leukemia cutis, skin lesions in leukemia, are clinically divided into specific and nonspecific types. Specific skin lesions demonstrate malignant cell infiltrate when the biopsy is done. We have encountered a typical case of specific skin lesions of leukemia cutis associated with acute lymphocytic leukemia in a 18-year-old male patient. There were multiple, pinhead to rice sized, skin colored to lemon yellow colored, discrete papules on the face, neck and trunk. A review of the literature is presented with a brief discussion of this case.
Adolescent ; Biopsy ; Humans ; Leukemia* ; Male ; Neck ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Skin

Electron microscopic examination of specimens from lesions of eight patients with hyperpigmented and six patients with hypopigmented tinea versicolor and from unaffected skin in each patient was performed. The results are summarized as follows; 1. In hyperpigmented lesions, melanosomes are larger and more singly dispersed than in unaffected skin. 2. In hypopigmented lesions, melanosomes are smaller and less singly diepersed than in unaffected skin. 3. Number of total melanosomes in hyperpigmented and hypopigmented lesions was not different from in unaffected skin.
Humans ; Melanosomes* ; Skin ; Tinea Versicolor* ; Tinea*

Cryptococcosis is an acute, subacute or chronic infectian caused by the encap sulated yeast Cryptococcus neoformans. The case of Cryptococcosis is a 2 5/12 year-old boy with involvement of the skin, lungs, liver, spleen, lymph node and central nervous system is reported. He has suffered from fever, nausea., vomiting and multiple skin lesions for a month. Thcre were various cutaneous lesions consisting of papules, pustules, nodules, crusts and ulcers on the scalp, face, back, buttocks and both extremities. Diagnosis was confirmed by the clinical characteristics, histopathologic findings and culture of the C. neoformans from cerebrospinal fluid and marcerated skin tissue. He was successfully treated with combination of Amphotericin B and 5-fluorocytosine.
Amphotericin B ; Buttocks ; Central Nervous System ; Cerebrospinal Fluid ; Cryptococcosis* ; Cryptococcus neoformans ; Diagnosis ; Extremities ; Fever ; Flucytosine ; Humans ; Liver ; Lung ; Lymph Nodes ; Male ; Nausea ; Scalp ; Skin ; Spleen ; Ulcer ; Vomiting ; Yeasts

The principle in the treatment of an elderly patient with an intertrochanteric fracture has swung from traction to internal fixation due to complication such as pneumonia, skin ulcer, and throm-boembolic disease, etc. Since the introduction of the Smith-Peterson nail, numerous internal fixation devices such as I-beam nail, Thornton plate, Jewett nail and Holt nail have been developed by gadgeteers and instrument companies. Recently Compression Hip Screw is popular because of rigid internal fixation. The operative management of intertrochanteric fractures of the hip using Compression Hip Screwplate was performed in thirty-three patients who were followed more than 5 months after operation at Department of Orthopedic Surgery, Kyung Hee University Hospital, from Feb. 1974 to 1978. The results were as follows. 1. Of 33 cases of intertrochanteric fractures, 3 cases were stable fracture and 30 cases were unstable fracture. The commonest type was Tronzo type III with 42 percentage. 2. Dimon-Hughston reduction in 13 cases with unstable fracture and anatomical reduction in 20 cases with stable and unstable fracture were achieved. 3. The average time to fracture union was 12 weeks, minimum in 8 weeks (maximum 20 weeks). The average union time in age group over 50 years was 14 weeks and 11 weeks in age group under 50 years. 4. The average union time was 13 weeks in medial displased group and 10 weeks in anatomical reduction group. 5. Complication after internal fixation were 4 cases e.g., two cases of varus deformity, one case of genitourinary tract infection and one transient peroneal nerve palsy. 6. Compression Hip Screw is a good internal fixation device to treat intertrochanteric fracture.
Aged ; Congenital Abnormalities ; Hip Fractures ; Hip ; Humans ; Internal Fixators ; Orthopedics ; Paralysis ; Peroneal Nerve ; Pneumonia ; Skin Ulcer ; Traction

The skin defect with sensory impairment of volar aspect of fingers should be reconstructed for the better function of hand. The Neurovascular island graft has been used to provide sensation to volar surface the thumb and to replace pulp tissues avulsed from thumb or index finger. Authors performed neurovascular island graft for defective sensibility of finger tip loss in 14 cases since Jun. 1979 to Mar. 1985. The donor flaps were obtained from the ring finger in 9 cases and middle finger in 5 cases. Among 14 cases, the donor flaps were taken from the ulnar side of 3rd and 4th finger in 11 cases. We followed up the the patients from 7 months to 4 years and 6months and in last follow-up, recovery of protective sensation such as sharp/blunt discrimination, temperature discrimination, and touch/stroke discrimination, was good but two point discrimination and reorientation of sensa-tion were poor. Cold intolerance was developed in 11 cases, and longitudial linear scar band of donor digit was demonstrated in 12 cases.
Cicatrix ; Discrimination (Psychology) ; Fingers ; Follow-Up Studies ; Hand ; Humans ; Sensation ; Skin ; Thumb ; Tissue Donors ; Transplants

No abstract available.
Kidney*

This study was designed to evaluate the expression of heat shock protein in tooth and surrounding tissue during the experimental movement of rat incisors, by LSAB(labelled streptavidine biotin) immunohistochemical staining for heat shock protein. Twenty seven Sprague-Dawley rats were divided into a control group(3 rats), and 6 experimental groups(24 rats), to which 75g of force was applied from helical springs across the maxillary incisors. Rats of experimental groups were sacrificed at 0.5, 1, 4, 7, 14 and 28 days after force application, respectively. And the periodontal tissues of a control group and experimental groups were studied immunohistochemically. The results were as follows : 1. In control group, the expression of HSP47 was rare in gingiva, dentin and cementum, and mild in periodontal ligament and alveolar bone. But it was more evident than that of HSP70. 2. The expression of HSP47 or HSP70 was rare or mild in dentin, cementum and odontoblast of experimental group, regardless of the duration of force application, which was not different from that of control group. 3. In experimental group, the expression of HSP47 got to the highest degree in periodontal ligament and alveolar bone at 4 days after force application, and then decreased. And the expression was more evident in the pressure side than in the tension side of periodontal ligament 4. The expression of HSP70 began to increase at 12 hours after force application and got to the highest degree at 4 days, in the capillary of pulp and periodontal ligament. And the expression was more evident in the pressure side than in the tension side of periodontal ligament 5. The expression of HSP70 in alveolar bone of experimental group was rare, which was similar to that of control group.
Animals ; Capillaries ; Dental Cementum ; Dentin ; Gingiva ; Heat-Shock Proteins* ; Hot Temperature* ; Incisor ; Odontoblasts ; Periodontal Ligament ; Rats* ; Rats, Sprague-Dawley ; Streptavidin ; Tooth Movement* ; Tooth*

BACKGROUND: Even though careful techniques is utilized and proper concentration of local anesthetics are used, tissue toxicity is common. METHOD: The fibroblast cell lines (NUGM) was exposed with each concentration of 10(-6), 10(-5), 10(-4) M lidocaine and bupivacaine in culture media for 24 hours. Glucose consumption rate and LDH activity in cultured media were measured for using as indicator of cellular damage on 0. 24, 48, 72 hours. By using that, we calculated the trend lines of the change of glucose consumption rate and LDH (lactic dehydrogenase) activity. On the trend lines, we searched out for decreasing time to 1/2 of glucose concentration and increasing time to 2 times of LDH activity compared to control. RESULTS: 1) In control group, Decreasing time to 1/2 of glucose concentration was 236.0 hours (p<0.05) and increasing time to 2 times of LDH activity was 1168.6 hours (p<0.05). 2) At each concentration of 10 6, 10 5, 10 4 M lidocaine, decreasing time to 1/2 of glucose concentration was 873.7 (370%), 938.7 (398%), 1101.6 (467%) hours compared with 236.0 (100%) hours of control (p<0.05) and then increasing time to 2 times of LDH activity was 135.1 (12%), 85.6 (7%), 93.9 (8%) hours when compared with 1168.6 (100%) hours of control (p<0.05). 3) At each concentration of 10(-6), 10(-5), 10(-4) M bupivacaine, decreasing time to 1/2 of glucose concentration was 706.7 (299%), 948.1 (402%), 1018.2 (431%) hours when compared with 236.0 (100%) hours of control (p<0.05) and then increasing time to 2 times of LDH activity was 111.6 (10%), 69.5 (6%), 59.1 (5%) hours when compared with 1168.6 (100%) hours of control (p<0.05). 4) On light microscopy, cells are showed destruction in each concentration of 10(-6), 10(-5), 10(-4) M lidocaine and bupivacaine with dose dependent fashion. CONCLUSIONS: 1) Glucose consumption rate and LDH activity in cultured media could be used as a useful index of cellular destruction by toxic effect on cultured cell. 2) Even at any concentration of lidocaine and bupivacaine could be toxic on cell. With all of above results, cell-line on 3 demensional cultured method could be use as another method for determining of cellular toxicity of local anesthetics.
Anesthetics, Local* ; Bupivacaine* ; Cell Line ; Cells, Cultured* ; Culture Media ; Fibroblasts ; Glucose* ; Lidocaine* ; Microscopy ; Oxidoreductases*