In the treament of the non-union or delayed union of the long bone, it is very difficult to achieve union. We have experienced 15 cases of non-union or delayed union of the tibia who were treated by sliding inlay bone graft with cancellous chip bone graft from June, 1979 to April, 1984. The results were as follows: l. In all cases cancellous iliac bone graft were performed, and additionally internal fixation or simple cast immobilization were done for stabilization of the fracture site. 2. The average bone union time was 2.8 months in delayed union and 4.4 months in non-union. 3. 1n 5 failed cases there were reactivation of previous infections. 4. In 5 cases of postoperative infection, sliding grafts were sequestrated in all. 5. The advantage of this procedure in the cases without infection were: 1) In the anteromedial cortex of tibia, such a surgical intervention permits easy skin closure and prevents skin necrosis. 2) Such a procedure can recanalize the obliterated medullary cavity without disturbance of the fracture ends during operation. 6. This procedure was proved to be one of valuable adjuvant method in the treatment of uninfected non or delayed union of the tibiae.
Immobilization ; Inlays ; Methods ; Necrosis ; Skin ; Tibia ; Transplants

We have experienced 7 cases of resurfacing prosthesis in comminuted patellar fracture in 5 patients, The follow up time was from 1 year and 6 months to 3 years and 6 months. The dome-shaped plastic patellar prosthesis was used after fracture healing. Each case was evaluated by Levitt's method of evaluation and we compared with patellectomy in “End results of patellectomy” reported by West, F. E. in 1962 in quadriceps power, range of motion, appearance and pain on the knee. The results were as follows: 1. By Levitt's method of evaluation, 6 cases were satisfactory, but 1 case was unsatisfactory. 2. The resurfacing prosthesis was better than patellectomy in quadriceps power, range of motion and appearance, but it was a little more painful.
Follow-Up Studies ; Fracture Healing ; Fractures, Comminuted ; Humans ; Knee ; Methods ; Patella ; Plastics ; Prostheses and Implants ; Range of Motion, Articular

No abstract available.

No abstract available.
Humans ; Magnetic Resonance Imaging, Cine* ; Spinal Cord Diseases*

A case is presented in which left-sided hemiparesis was caused by a fibromuscular dysplasia of the right internal carotid artery in the neck, and it used as a basis for discussion of the angiographic features. The 24-year-old woman was admitted to our Department of Neurosurgery, Korea University hospital, with the complaints of headache and left-sided hemiparesis which developed abruptly about one month before this admission. The carotid angiography was performed by puncture of the right common carotid artery under the clinical impression of cerebral thrombosis, which showed no gross intracranial abnormalities. But the characteristic findings were observed under and widening of the arterial lumen which are so-called loose stocking appearance or 'string of beads' appearance and are the typical feature of fibromuscular dysplasia. No surgical interventions such as arterial reconstruction and grafting, or arterial dilatation with bougies were applied on the patient, and she was discharged from the hospital three days after the admission. Fibromuscular dysplasia is a rare sclerotic, noninflammatory lesion of unknown etiology involving the wall of large arteries. This disease is found most frequently in early adult life and women are afflicted more often than men, This condition has been described most often in the renal arteries, where it has been found to be a cause of hypertension. Among the involvement of carotid system, the cervical portion of the internal carotid artery is most often affected, and the involvements are often bilateral. When localized to the internal carotid arteries, it can give symptoms of intermittent or permanent cerebral ischemia, but is usually asymptomatic. The typical angiographic appearance is the main parameter for diagnosis of fibromuscular dysplasia.
Adult ; Angiography ; Arteries ; Brain Ischemia ; Carotid Artery, Common ; Carotid Artery, Internal* ; Diagnosis ; Dilatation ; Female ; Fibromuscular Dysplasia* ; Headache ; Humans ; Hypertension ; Intracranial Thrombosis ; Korea ; Male ; Neck ; Neurosurgery ; Paresis ; Punctures ; Renal Artery ; Transplants ; Young Adult

BACKGROUND: Traditional visual reading of patch-test reactions is a rather subjective method, lacking the sensitivity and reproducibility needed in experimental studies. Recently the laser Doppler perfusion imaging (LDPI) has been used to measure objectively the increase in superficial blood flow which results in the appearance of erythema. OBJECTIVE: We designed this study to examine the relationship between the LDPI measurement and visual reading after patch test to several different irritants. METHODS: In this study, reading of erythema in experimentally-induced irritant contact dermatitis was performed visually and by laser Doppler perfusion imaging (LDPI). In addition, we investigated whether the LDPI measurement was appropriate in the routine patch test clinic. RESULTS: A close correlation was shown between the 2 methods (r=0.9046, p<0.001) and the LDPI producing mean adjusted perfusion values (APVs) was able to discriminate between the different visual grades. CONCLUSION: LDPI is a valuable instrument to objectively assess intensity of irritant patch-test reaction, and is indeed one of the few methods which overcomes the inter-individual variations in visual reading, but this instrument is not appropriate to use routinely in patch test clinic because of unacceptably long measurement time.
Dermatitis, Contact ; Erythema ; Irritants ; Methods ; Patch Tests ; Perfusion Imaging* ; Perfusion*

A turret exostosis is a rare complication of minor trauma to the dorsum of the fingers. In 1966, Wissinger reported first and called turret exostosis. Until now any case have not been reported in Korea. A twenty year-old man complained a painful mass on dorsum of the middle phalanx of the left 4th finger. Thirteen months ago, he had deep laceration of the left 4th finger and extensor tendon was ruptured totally with dorsal cortical breakage of the middle phalanx. Radiologically, there is a smooth, dome shaped, and well-defined osseous mass fused to the underlying bony cortex on the earlier injury site. This is a finding that suggest turret exostosis. We report a case and a brief review of literature.
Exostoses ; Fingers ; Korea ; Lacerations ; Rupture ; Tendons

PURPOSE: There are several methods for the reconstruction of partial urethral defect. Split-thickness skin graft, full-thickness skin graft, prepuce flap and free flap are those. Despite partial success using these methods, most results are unsatisfactory due to frequent complications such as postoperative infection, fistula formation, hair growth and stricture. There has been several pioneering experiments in this field using autogenous vein graft, but the results of this procedures were controversial. Therefore, this study was designed to illustrate the possibility of using vein graft for the reconstruction of partial urethral defect. MATERIALS AND METHODS: Two different types of vein graft method were performed in total 20 New Zealand White rabbits with partial urethral defect. Firstly, for the patch graft group, 1x cm rectangular vein graft was sutured at defective area of the same size. Secondly, for the tubed graft group, vein graft segment of 1 cm long was replaced at segmental urethral defect of the same length. Histologic study was performed at 3 and 8 weeks postoperatively in each group. And retrograde urethrogram was checked at eight weeks postoperatively. RESULTS: On histologic study, the process of transitional cell epithelial replacement within grafted vein was uniformly observed in both experimental group at three week postoperatively. At eight weeks postoperatively, the epithelial replacement was almost complete and histologically undistinguishable. In the retrograde urethrogram performed on the day of the 8th week postoperatively, in patch graft group, contrast material was well advanced to the bladder and showed no stricture, and two of five rabbits of tubed graft group showed mild stricture with luminal patency at the graft site. CONCLUSIONS: Natural urethral epithelium was restored in grafted venous segment irrespective of type of graft. Mild stricture was observed in 40% of tubed graft group while complete reconstruction was possible in patch graft group.
Constriction, Pathologic ; Epithelium ; Fistula ; Free Tissue Flaps ; Hair ; Phenobarbital ; Rabbits* ; Skin ; Transplants* ; Urethra ; Urinary Bladder ; Veins*

PURPOSE: We evaluated the clinical and radiological results of arthroscopic ankle fusion using 2 medial screws which had advantages of less morbidity, early weight-bearing and high union rate. MATERIAL AND METHODS: From April, 2002 to March, 2004, 8 patients who had ankle osteoarthritis were treated by ankle fusion using 2 medial screws under arthroscopy; five patients with post-traumatic osteoarthritis, two with post-infectious arthritis and one with paralytic foot. There were 5 male and 3 female. Average age was 67 years old ranging from 57 to 71 years. We evaluated them clinically preoperative and postoperative using AOFAS score, VAS pain scale and patient's satisfaction. In regard to radiological fusion, we checked them by simple AP, lateral and mortise view. Follow up period was average 11 months (range, 6~24 months). RESULTS: All ankles were successfully fused with 2 medial screws under arthroscopy. The mean time of fusion was 10.5 weeks (range, 8~14 weeks). Patient's satisfaction checked at 6 months after operation had favorable results (excellent and good 75%). One case had pain on medial malleolar area because of screw's protrusion. CONCLUSION: Arthroscopic ankle fusion using 2 medial screws was good modality of ankle fusion with less morbidity and early weight-bearing in some cases of ankle arthritis.
Aged ; Ankle* ; Arthritis ; Arthritis, Reactive ; Arthroscopy ; Female ; Follow-Up Studies ; Foot ; Humans ; Male ; Osteoarthritis ; Weight-Bearing

OBJECTIVE: Our previous study demonstrated that the placental GnRH and GnRH mRNA did not parallel the time course of hCG secretion, though it is thought to be one of the potential paracrine regulators of hCG secretion from the trophoblasts. The present study was designed to examine the potential variation in GnRH-receptor mRNA expression in the placenta, which may account for the GnRH-mediated action of hCG secretion during pregnancy. METHODS: Human placentas in firt, second, and third trimester of normal pregnancy were obtained. These placentas were fixed with 4% paraformaldehyde and embedded in OCT compound, and sectioned by cryostat. For in situ hybridization, S labeled RNA probes were used and followed by autoradiography. RESULTS: The GnRH-receptor mRNA signals were present in both cytotrophoblast and syncytiotrophoblast cell layers. Signal intensities varied with gestational ages and were abundant at 6-7 weeks, peaked at 9-12weeks, declined at 14 and 24 weeks, and were barely detectable at term. The present study demonstrates that GnRH-receptor mRNA exhibits changes paralleling the time course of hCG secretion during pregnancy CONCLUSION: These data provide mechanistic understanding that the paracrine/autocrine regulation of hCG secretion by placental GnRH is mediated through an increase followed by a decline in GnRH-receptor mRNA expression from the first trimester to term placenta.
Autoradiography ; Female ; Gestational Age ; Gonadotropin-Releasing Hormone ; Humans ; In Situ Hybridization ; Placenta* ; Pregnancy Trimester, First ; Pregnancy Trimester, Third ; Pregnancy* ; RNA Probes ; RNA, Messenger* ; Trophoblasts