There is a great difference of opinion regarding the treatment of intraarticular fractures of the calcaneus. Many authors suggested that there are essentially four basic methods of treatment, but the choice of treatment depends on the surgeons preference, the type of fracture, and the age of the patient. We obtained the following results in 11 cases of calcaneal fractures involving subtalar joint which were treated by axial fixation at our hospital from 1977 to 1981. 1. The favourable results were obtained in 5 cases of 6 feet of tongue type fractures and in 3 cases of 5 feet of joint depression fractures. 2. Even if the joint depression type fracture which is not severely comminuted, the treatment with axial fixation is thought to be good method. 3. Axial fixation must be tried in three faces of reduction which are reestablishment of Bohler angle and subtalar joint and reduction of lateral bulging of calcaneus. The results were more excellent in which reduction is achieved near anatomical position.
Calcaneus ; Clinical Study ; Depression ; Foot ; Humans ; Intra-Articular Fractures ; Joints ; Methods ; Subtalar Joint ; Surgeons ; Tongue

The purpose of this study is to investigate the effect of plasma sprayed hydroxyapatite(HA) coating on bone ingrowth into fiber-mesh coated titanium implant. The shear strength of the HA coatings on interface attachment, the degree of osseointegration of HA coated implants and bone ingrowth of fiber-mesh coated titanium implants were evaluated. The implants were placed transcortically in the femora of mature dogs and evaluated after six weeks. The pushout test showed 33.58±10.87 MPa in HA-coated fiber meshed implants and 20.53±4.91 MPa in fiber-mesh coated implants. In histologic observations, similar quantitative results in the amount of bone ingrowth and osseointegration on both systems. The HA coatings showed direct osseointegration and bone ingrowth on its surface and fiber-mesh without fibrous layer, but the fiber-mesh only coatings showed thin fibrous layer between the ingrown bone and titanium surface. In conclusion, HA-coating on fiber-mesh coated implant provided earlier and stronger osseointegration and bone ingrowth than fiber-mesh only coated implant.
Animals ; Dogs ; Durapatite ; Osseointegration ; Plasma ; Shear Strength ; Titanium

An unequivocal diagnosis of mesothelioma during life, on the basis of limited biopsy tissue or cytological specimens, is frequently difficult and requires distinction from inflammatory mesothelial hyperplasia on the one hand and secondary neoplasms, especially adenocarcinoma on the other. Although some studies have produced conflicting results, it is generally believed that immunohistochemical methods can aid in this distinction. To obtain comparable and reproducible results, 23 metastatic carcinoma of the pleura and 2 unequivocal malignant epiehtlial mesotheliomas were studied by the peroxidase-antiperoxedase method on paraffin-embedded cell blocks, and commercially available antibodies to carcinoembryonic antigen (CEA), keratin and epithelial membrane antigen (EMA) were used. Nineteen metastaic adenocarcinoma (73%) and two mesotheliomas (100%) reacted with keratin and EMA antibodies. Nineteen matastatic adenocarcinomas (73%) reacted with EMA antibodies. Nineteen metastatic adenocarcinoma (73%) reacted with CEA antibody; no mesotheliomas stained for CEA. Two cases of reactive mesothlial hyperplasia showed positive for keratin, but negative reaction for EMA and CEA. Noen of the antibodies used in this study was specific for mesothelioma, but CEA was found to be the most useful marker for differentiating between mesothelioma and metastatic carcinoma.
Adenocarcinoma ; Biopsy ; Neoplasm Metastasis

An unequivocal diagnosis of mesothelioma during life, on the basis of limited biopsy tissue or cytological specimens, is frequently difficult and requires distinction from inflammatory mesothelial hyperplasia on the one hand and secondary neoplasms, especially adenocarcinoma on the other. Although some studies have produced conflicting results, it is generally believed that immunohistochemical methods can aid in this distinction. To obtain comparable and reproducible results, 23 metastatic carcinoma of the pleura and 2 unequivocal malignant epiehtlial mesotheliomas were studied by the peroxidase-antiperoxedase method on paraffin-embedded cell blocks, and commercially available antibodies to carcinoembryonic antigen (CEA), keratin and epithelial membrane antigen (EMA) were used. Nineteen metastaic adenocarcinoma (73%) and two mesotheliomas (100%) reacted with keratin and EMA antibodies. Nineteen matastatic adenocarcinomas (73%) reacted with EMA antibodies. Nineteen metastatic adenocarcinoma (73%) reacted with CEA antibody; no mesotheliomas stained for CEA. Two cases of reactive mesothlial hyperplasia showed positive for keratin, but negative reaction for EMA and CEA. Noen of the antibodies used in this study was specific for mesothelioma, but CEA was found to be the most useful marker for differentiating between mesothelioma and metastatic carcinoma.
Adenocarcinoma ; Biopsy ; Neoplasm Metastasis

No abstract available.
Osteogenesis Imperfecta* ; Osteogenesis*

Alpha-interferon is a drug of proven effect in both hepatitis B and C infection. But, the interferons are associated with numerous adverse reactions including various neurologic syndromes. We report a case of Bell's palsy during interferon therapy. The patient commenced on alpha 2b-interferon therapy for chronic hepatitis C infection. He developed Bell's palsy fifth months after commencing therapy. Although Bell's palsy in our patient may have occurred by chance, a neuropathic effect of alpha 2b-interfeon on the facial nerve cannot be excluded.
Bell Palsy* ; Facial Nerve ; Hepatitis B ; Hepatitis C, Chronic ; Humans ; Interferon-alpha ; Interferons*

BACKGROUND: Cerebral venous thrombosis (CVT) is a distinct disorder with highly variable symptoms and courses. Malignancy is known to be one of the predisposing factors of CVT. CASE REPORT: We present the case of a 69-year-old man with sudden behavioral changes. Brain MRI, magnetic resonance venography, and positive D-dimer assay confirmed the presence of CVT. The work-up for detecting the cause of the CVT revealed occult prostate cancer. CONCLUSIONS: Occult malignancy including prostate cancer should be strongly suspected in older patients with idiopathic CVT.
Aged ; Brain ; Fibrin Fibrinogen Degradation Products ; Humans ; Magnetic Resonance Spectroscopy ; Phlebography ; Prostate ; Prostatic Neoplasms ; Venous Thrombosis

Spontaneous cervical epidural hematoma (SCEH) is a rare condition that causes paraparesis or quadriparesis. As spontaneous resolution is seldom expected, it usually requires surgical treatment for relieve symptoms. Even if spontaneous resolution occurs, relief from symptoms usually requires several hours to days. In contrast, hemiparesis is the most common symptom of a transient ischemic attack (TIA), and usually resolves over minutes to hours. We report here two patients with SCEH who presented with hemiparesis with severe neck pain. Both patients were taking antiplatelet drugs. Their neurological symptoms recovered spontaneously over a very short time. They were initially misdiagnosed as TIA. These cases show that patients with transient hemiparesis may have SCEH if there is severe neck pain and no cranial nerve involvement.

Background & Objective: EGB 761 is a standardized natural extract used to treat impaired cerebral perfusion and nutrition (cerebrovascular insufficiency) in Korea. Although several animal studies have been conducted, few studies have investigated the clinical effects of EGB 761 in acute stroke. This study assessed the clinical benefit of intravenous EGB 761 in patients with acute ischemic stroke. Methods: This retrospective study examined a prospectively collected stroke database. We evaluated 232 patients with acute ischemic stroke within 48 hours of symptom onset. All patients were treated with antiplatelet or anticoagulation agents. We compared baseline characteristics between the EGB 761-treated and non-treated groups. The functional outcome measure was the modified Rankin Scale (mRS) score 90 days after stroke onset. Results: Of the 232 patients, 170 received EGB 761 during the first 3 days after arrival in the emergency department. We found no significant differences in baseline characteristics between the groups, with the exception of atrial fibrillation (p=0.032). After adjusting for baseline factors, intravenous administration of EGB 761 was associated with an improved 90-day functional outcome (mRS ≤2) compared with the control group (odds ratio, 2.56; p<0.05). Conclusions: Our results showed a clinical benefit of intravenous EGB 761 in patients with acute ischemic stroke
Stroke

A 41-year-old man was admitted due to altered mentality and confusion. He had showed progressive cerebellar ataxia, dysarthria, gait disturbance from his age of 33 years old. Brain MRI revealed high signal lesions in periaqueductal gray matter, mammillary bodies, median thalami and postcentral gyri bilaterally on T2-weighted images. Severe cerebellar atrophy was noted, too. We report a case of Wernicke's encephalopathy in a patient with probable multiple system atrophy. As far as we know, there have been no published report on this kind of case.
Adult ; Atrophy ; Brain ; Cerebellar Ataxia ; Dysarthria ; Gait ; Humans ; Magnetic Resonance Imaging ; Mamillary Bodies ; Multiple System Atrophy* ; Periaqueductal Gray ; Wernicke Encephalopathy*