Extensor pollicis longus tendon rupture is well known as a complication of fracture of the distal radius. There is a higher risk that the tendon of extensor pollicis longus will rupture in undisplaced distal radius fracture than in those which are displaced. We have experienced three cases of rupture of the extensor pollicis longus tendon after undisplaced distal radius fracture. Those were treated by tendon graft and tendon transfers. The results were satisfactory without complications. The patients with undisplaced distal radius fracture should be careful concerned about possibility of rupture of extensar pollicis tendon.
Humans ; Radius Fractures ; Radius* ; Rupture* ; Tendon Transfer ; Tendons ; Transplants

Cutaneous horn is a clinical diagnosis based upon the presence of a large protuberant mass of keratin. We report a case of cutaneous horn arising from dermatofibroma in a 31-year old woman. A silver whitish colored comical hyperkeratotic protruding lesion (1.0  0.7 cm size) from the red brown colored nodule was observed. Histopathologic findings showed characteristic findings of dermatofibroma and cutaneous horn. The lesion was removed by surgical excision.
Animals ; Diagnosis ; Female ; Histiocytoma, Benign Fibrous* ; Horns* ; Humans ; Silver

BACKGROUND: A definition of granuloma is a focal chronic inflammatory response to tissue injury evolved by a poorly soluble substwice characterized by the accumulation and proliferation of the mono-nuclear histiocytic cells. The accuracy with which rnononuclear cells may be identified in skir. is much improved by the use of both heteroantisera and monoclonal antibodies directed against selected cellular antigens, OBJECTIVE: Our purpose was to examine the staining patterns of anti-lysozyme, anti-a-1-antitrypsin, anti-S-100 protein antibodies, and MAC-387 monoclonal anibody in granulomatous skin diseases. METHOD: We performed imminoperoxidase staining(the labelled str prvidin-biotin peroxidase complex method on the formalin-fixed, paraffin-embedded tissue specimens of granulomatous skin diseases. RESULTS: S-100 protein positive dendritic cells were demonstrated in the granulomatous infiltrates as scattered pattern and MAC-387 positive cells were predominantly found in the center of granulomas, The staining pattern and percentage of positively stained cells of a--antitrypsin were similar to those of lysozyme. A1Pha-1-antitrypsin and lysozyme positive cells w re present in the center as well as lymphohistiocytic infiltrates of granulomas. CONCLUSION: These data sugget that histiocytes are composed of heter igeneous groups of cells such as the mononuclear-phagocyte system and dendritic cell system.
Antibodies ; Antibodies, Monoclonal ; Dendritic Cells ; Granuloma ; Histiocytes ; Muramidase ; Peroxidase ; S100 Proteins ; Skin Diseases ; Skin*

Fractures of the capitellum humeri are rare and the recommendations for treatment vary. It can involve a significant portion of the articular surface, rendering the elbow joint unstable. In this situation, it is desirable to reduce and internally fix the capitellar fragment, because this restores the articular surface and augments joint stability. We experienced two cases of capitellar fractures which one case was spontaneously anatomical reduced and the other case was treated by open reduction. In one case the capitellar fragment was spontaneous reduced to a stable position although it was noticed radiographically as an unstable displaced fracture preoperatively. The other case was treated by open reduction and internal fixation with 3.5mm, small, AO, cannulated screw and K-wire. Both cases are reported here with references.
Elbow Joint ; Joints

PURPOSE: To compare the pullout strength and insertion torque of proximally tapered screw (PT) with fully tapered screw (FT) and to investigate the correlation between the pullout strength and bone mineral density, morphology of pedicle, and insertion torque of the screw in osteoporotic lumbar spine. MATERIALS AND METHODS: Fifteen osteoporotic lumbar vertebrae from four white human cadavers were used. Bone mineral density, pullout strength and insertion torque were measured by dual energy x-ray absorptiometry, MTS and torque screw driver individually. RESULTS: The FT screw provided greater pullout force and insertion torque than the PT screw in 12 of 15 vertebrae tested (p<0.01). Pullout strength was correlated with insertion torque in PT (r=0.666, P=0.0006) and FT (r=0.464, P=0.19) screws. CONCLUSIONS: Results of this study indicate that the FT screws provide higher pullout strength and insertion torque than PT screws in osteoporotic lumbar spine and suggest that the development of tapered minor diameter may lead to an improved pedicle screw with high pullout strength and insertion torque. Nevertheless, further study is needed to investigate the effect of tapering the minor diameter on the mechanical bending strength of the screw.
Absorptiometry, Photon ; Bone Density ; Cadaver ; Humans ; Lumbar Vertebrae ; Spine* ; Torque

The arthroscopic procedure has been one of the useful treatment modalitis in osteoarthritis of the knee, which does not respond to conservative treatment. Authors reviewed the resuJts of 61cases of 61 patients(18 males and 43 females) that had been treated with arthroscopic procedures including arthroscopic simple )avage, partial menisectomy, removal of the loose bodies, synovectomy and chondroplasty. The purpose of this study is to evaluate indication and effectiveness of arthroscopic surgery for osteoarthritic knee. 1. Seventy-one percent of sixty-one patients had relief of pain and other clinical symptoms after arthroscopic procedures. 2. Sixty-one pereent were still good at last follow-up more, than one year. 3. The favorable results were obtained after removal of loose bodies or partial menisectomy in association with osteoarthritic knee cornpared with the other procedures. And the poor results were obtained in patients with severe degenerative changes and severe cartilage defects of both femoral condyles. 4. The normal-alignment knees had much better results after arthroscopic surgery compared with valgus or varus knees. Our results suggest that arthroscopic surgery can be one of the good alternative treatment methods for osteoarthritic knee and a time-saving procedure before arthroplastic surgery.
Arthroscopy ; Cartilage ; Follow-Up Studies ; Humans ; Knee* ; Male ; Osteoarthritis

Infantile myofibromatosis is the most common of the juvenile fibromatoses and an unusual mesenchymal disorder characterized by the proliferation of tumors in the skin, muscle, bone and viscera. There are two forms of the disease: solitary and multicentric. A benign course with spontaneous regression is seen in most patients, but poor prognosis can be associated with the multicentric form, in which visceral organs may be involved. It usually presents in early childhood. We report a case of infantile myofibromatosis arising in the left sole of a female new born. Physical examination showed a firm, red colored 2x4cm sized tumor. Histological examination revealed a spindle cell tumor in the dermis with fascicles of plump spindle cells with a whorled arrangement.
Dermis ; Female ; Fibroma ; Humans ; Myofibromatosis* ; Physical Examination ; Prognosis ; Skin ; Viscera

OBJECTIVE: The purpose of this study was to determine the effect of bone cement augmentation of pedicular screwing in severe osteoporotic spondylolisthetic patients. METHODS: Twenty patients with spondylolisthesis (8 : spondylolytic spondylolisthesis 12 : degenerative spondylolisthesis) who had undergone pedicular screwing and interbody fusion for osteoporotic lumbar spine (T-score on bone mineral density<-3.0) from 2002 to 2005 were reviewed. Mean age was 62.3 years with 3 male and 17 female patients. Average follow-up period was 14 months. Average T-score on bone mineral density (BMD) was -3.62. After decompression of neural elements, about 6cc of polymethylmethacrylate (PMMA) was injected into the each vertebral body through transpedicular route. All patients underwent one level interbody fusion and pedicular screw fixation. Clinical outcome was assessed using Oswestry Disability Index (ODI) on the last clinical follow-up. In addition, a modified MacNab's grading criteria was used to objectively assess patient's outcome postoperatively. Radiographic analysis of sagittal contour was assessed preoperatively, immediately postoperatively, and at final follow-up including fusion rate. RESULTS: Eighteen of 20 patients were graded as excellent or good according to the modified MacNab's criteria. An significant improvement of ODI was achieved in both groups. Mean sagittal angle at the preoperative state, postoperative state and at the last follow-up state was 11.0 degrees, 20.1 degrees and 18.3 degrees, respectively, with mean sagittal angle correction gain 7.3 degrees. Firm fusion was achieved in all patients. There were one compression fracture above the fused segment after 6 months follow-up and one case of seroma. But, there were no postoperative complications related to bone cement leakage and pedicular screwings such as screw pullout or screw cut-up. CONCLUSION: Bone cement augmentation of pedicular screwing can be an effective procedure for osteoporotic lumbar spine in spondylolisthetic patients.
Bone Density ; Decompression ; Female ; Follow-Up Studies ; Fractures, Compression ; Humans ; Male ; Polymethyl Methacrylate ; Postoperative Complications ; Seroma ; Spine ; Spondylolisthesis

Generalized pustular psoriasis(GPP) is an uncommon and severe form of psoriasis. The possible provocative factors such as steroid therapy, infection, stress, drugs, pregnancy, sun exposure, and metabolic disorders were reported. Among them, corticosteroid therapy is thought to be the most common factor. Although the cause of psoriasis remain obscure, the coexistence of psoriasis and autoimmune disease and cyclosporin accepted for the treament of psoriasis emphasize the importance of immunologic mechanism in the pathogenesis of psoriasis. We present a case of GPP in a 48-year-old male, who has had a history of myasthenia gravis since the age of 34 years and managed with long-term corticosteroid therapy. With the administration of acitretin and cyclosporin, generalized pustular eruptions nearly cleared and clinical improvement was achieved.
Acitretin ; Autoimmune Diseases ; Cyclosporine ; Humans ; Male ; Middle Aged ; Myasthenia Gravis* ; Pregnancy ; Psoriasis* ; Solar System

Dermatomyositis is an idiopathic inflammatory myopathy characterized by progressive symmetric proximal muscle weakness and typical cutaneous lesions. Recently the association of adult dermatomyositis and malignancy has generated much attention. A 56-year-old male presented with skin eruptions, proximal muscle weakness, and a neck mass on the right side. Diagnosis of dermatomyositis was established by clinical investigation, muscle enzyme study, electromyogram, and histological findings of the skin and muscle. A computerized tomography scan and histologic finding of right neck mass showed nasopharyngeal carcinoma. The patient was treated with chemotherapy and radiotherapy, and showed partial remission of nasopharyngeal carcinoma, with some improvement of the skin eruptions. But muscle weakness and myalgia were aggravated. He was then treated with systemic steroids (prednisolone) and azathioprine.
Adult ; Azathioprine ; Dermatomyositis* ; Diagnosis ; Drug Therapy ; Humans ; Male ; Middle Aged ; Muscle Weakness ; Myalgia ; Myositis ; Neck ; Radiotherapy ; Skin ; Steroids