No abstract available.

No abstract available.

No abstract available.

Allografts or autografts of bone-tendon unit have been used for ligament injuries or deficiencies after limb salvage operation for malignant bone tumors around joints. While the remodeling process of the ligament or tendon of the allograftor autograft and the microscopic and biomechanical changes of tendon-bone graft interface have been widely investigated, little is known about the ultrastructural and biochemical changes of the transitionall zone in tendon-bone junction. This study was performed to analyzed the ultrastructural and biochemical changes of the transitional zone after tendon-bone auto-and allo-grafting. A total of twenty four rabbits were divided into two group. In 12 animals(allograft group), two Achilles ten-don-bone unit per each animal were taken and transplanted to another rabbit after preservation below -70degrees C for 2 weeks. In the other 12 animals(autograft group), the Achilles tendon-bone unit was harvested from one side and transplanted to the other side of the rabbit. After operation, their legs were immobilized with short leg cast for 4 weeks, and then mobilized freely. Four animals in each group were sacrificed at four, eight and sixteen-weeks after the transplantation, and their grafted Achilles tendon-bone interfaces were used for analysis of the ultrasturctural and biochemical changes. The following results were obtained. 1. Histologically new cartilage cells were observed at postoperative 16 weeks with local presence of faint tidemark in the autograft group but not in the allograft group. Complete remodeling of the transitional zone had not observed histologically in both groups. 2. Ultrasturctural analysis revealed no definite differences between both groups. However, the slightly rapid appearance of parallelism and cross-striation of microfibrils in the autograft group and time-related restoration of fibers and fibroblasts were observed. 3. From biochemical analysis, type I collagen concentratin was increased, and an early rapid increase of type III collagen and glycosaminoglycan were also observed. In conclusion, these data suggested that type III collagen and glycosaminoglycan are important in stabilization of grafted tendon-bone unit, especially in the transitional zone. The histological and biochemical changes in allograft group were relatively similar to that of autograft group although the allograft group showed the delayed pattern of remodeling. Therefore, the tendon- allograft could be used as a good substitute for the autograft for tendon or ligament reconstruction when no suitable autograft is available.
Allografts ; Animals ; Autografts ; Cartilage ; Collagen Type I ; Collagen Type III ; Fibroblasts ; Joints ; Leg ; Ligaments ; Limb Salvage ; Microfibrils ; Rabbits* ; Tendons ; Transplants*

No abstract available.
Hyperostosis, Cortical, Congenital*

No abstract available.
Spine*

Osteoid osteoma is a relatively common benign tumor that most commonly affect the cortex of the long bone, Adolescent and young adult males are most frequently affected. It causes aching pain that worsens at night and commonly is relieved by aspirin. The typical radiographic appearance is a lucent nidus with surrounding dense cortical thickening. If the lesion is located in intra-articular cancellous bone, an osteoid osteoma may present with clinical findings that are more indicative of an inflammatory synovitis, and with atypical radiographic findings such as lack of both surrounding sclerosis and a lucent nidus. Therefore intra-articular osteoid osteoma may pose a diagnostic difficulty. Recently, we experienced 3 cases of intra-articular osteoid osteoma(2 humeral haed, 1 femoral head) and present them in detail.
Adolescent ; Aspirin ; Humans ; Male ; Osteoma, Osteoid ; Sclerosis ; Synovitis ; Young Adult

Purpose: To evaluate the risk factors for the development of osteonecrosis in civilian professional divers by an epidemiologic study and to determine the correlation between osteonecrosis in divers and coagulopathy by analysis of serologic markers that are related to thrombophilia and hypofibrinolysis. Materials and Methods: Forty-two divers, who collected pen shells (Atrina pinnata), and among whom 10 had osteonecrosis (group 1), were compared with 32 divers without osteonecrosis (group 2). Both groups were evaluated based on the number of years of diving experience, number of dives per year, mean number of dives per day, mean diving time and depth, and diving methods. We determined any statistically significant differences among these variables. We measured the levels of serologic markers that were related to hyperlipidemia, thrombophilia, and hypofibrinolysis from the divers and a control group of 20 physicians (group 3). The levels of the serologic markers were compared between groups 1 and 2 and between the divers and the control group, in order to determine the relationship between the serologic markers and the development of dysbaric osteonecrosis. Results: None of the variables demonstrated any statistically significant differences, except for the mean diving time, in which group 1 had a mean diving time of 124 minutes and group 2 had a mean diving time of 62.1 minutes (P<0.05). In the analysis of the serologic markers, there were no statistically significant differences between groups 1 and 2; however, in comparison with the group 3, the divers demonstrated significantly decreased activity levels of proteins C and S (Protein C: P<0.05; Protein S: P<0.05), and an increase in the levels of plasminogen activator inhibitor-1 (PAI-1) (P<0.05). Conclusion: The divers with osteonecrosis had a longer mean diving time than did those divers without osteonecrosis. In the serologic marker analysis, the divers with osteonecrosis demonstrated significantly decreased activity levels of Proteins C, S and a significant increase in the levels of PAI-1, compared with the control group.
Biomarkers* ; Diving ; Epidemiologic Studies* ; Epidemiology ; Hyperlipidemias ; Osteonecrosis* ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Protein S ; Risk Factors ; Thrombophilia

STUDY DESIGN: A retrospective study OBJECTIVES: To evaluate postoperative muscle damage after microendoscopic discectomy (MED) and open discectomy (OD), using analysis of serum creatine phosphokinase (CPK) levels. SUMMARY OF LITERATURE REVIEW: Paravertebral muscle damage after retraction during posterior lumbar surgery can cause postoperative back pain. Serum CPK level is elevated in these patients and may indicate postoperative muscle damage. MATERIALS AND METHODS: We examined 35 cases with MED (group 1) and 11 cases with OD (group 2). Serum CPK levels were checked preoperatively and postoperatively at day 1 and day 3. We analyzed intra-group and inter-group differences in CPK levels according to sex, age, and operation time. Surgical outcomes were evaluated with a visual analog scale (VAS) preoperatively and 1 year postoperatively. RESULTS: CPK levels at postoperative 1 day were increased significantly and decreased significantly at postoperative 3 day in both groups (p<0.05), with levels in group 1 significantly lower than in group 2 (p<0.05). There were no differences in CPK levels according to sex, age, or operation time, except between the 3rd and 5th decades of age at postoperative 1 day in group 2. VAS was significantly different in intra-group analysis (p<0.05) with no significant differences in intergroup analysis. CONCLUSIONS: MED induced a lower increase in serum CPK than OD with similar VAS outcomes. MED results in less postoperative muscle damage than OD, with similar surgical outcomes.
Back Pain ; Creatine Kinase* ; Creatine* ; Diskectomy* ; Humans ; Retrospective Studies ; Visual Analog Scale

STUDY DESIGN: The authors reviewed the dural tears in the thoracolumbar fractures treated surgically. OBJECTIVES: To evaluate the incidence and the predictive values for the presence of dural tears in the thoracolumbar fractures. SUMMARY OF LITERATURE REVIEW: Many authors reported that the dural tear was usually related to the thoracolumbar fractures especially with laminar fracture and neurologic deficit. The dural tears may lead complications such as the entrapment of spinal nerve root, delayed wound healing, cerebrospinal fluid fistula, and myelomeningocele. Previous reports emphasized posterior approach to confirm and treat the dural tears using laminectomy. So it is very important that surgeons should identify the presence of dural tear preoperatiyely to determine the surgical approach and treatment options. MATERIALS AND METHODS: The authors reviewed 22 patients of thoracolumbar fractures treated with posterior laminectomy, posterior decompression, posterolateral fusion, and instntmentation from August 1993 to August 1996. The follow-up period was minimally 12 months. We checked the canal compromise, the injury of the posterior column including laminar fracture and ligamental injury, and neurologic deficits as the predictive values. The statistical analysis was done to evaluate the relationship between the dural tear and the predictive values. RESULTS: The incidence of dural tear was 54.4% of the thoracolumbar fractures. The canal encroachment, the injury of the posterior column, and the neurologic deficits were not significantly related with the dural tears in statistical analysis. But we could find the tendency that is related to the dural tear and posterior column injury. CONCLUSION: The authors concluded that we could find the possible presence of dural tears in the severe thoracoiumbar which were needed the surgical treatment and we could suggest the injury of posterior column was a possible value that could predict the presence of dural tear.
Cerebrospinal Fluid ; Decompression ; Fistula ; Follow-Up Studies ; Humans ; Incidence ; Laminectomy ; Ligaments ; Meningomyelocele ; Neurologic Manifestations ; Spinal Nerve Roots ; Tears* ; Wound Healing