The orthopaedic treatment regarding to the residual deformity secondary to epiphyseal plate injury is the most important thing. Author particularily interested in the microscopic finding upon the repair of damaged transepiphyseal fracture of the distal femoral end of growing rabbits. Experimentally this type of fracture is produced surgically and fixation is achieved by two Kirshner wires; one Kirshner wire is inserted obliquely through the metaphysis. A total of 10 growing rabbits were fed with normal diet, and each 5 rabbits were psacrified by 8 and 10 weeks after the surgical procedure respectively and histological change is examined. No rabbit had infection for those experiment. The results of observation were summarized as follows:1. The ruptured epiphyseal plate due to osteotomy through epiphyseal plate was found to be healed by new bone and fibrotic tissue, not by cartilage regeneration. 2. The epiphyseal plate in the small part of fracture fragments revealed as follows; a. The arrangement of cartilage zones revealed marked irregularity. b. The form and the character of cartilage cells revealed an abnormality such as the hyperophy or the atrophy of cells or both. c. The necrotic area revealed at the several places. d. The thickness of epiphyseal plate revealed more narrowing and irregularity. 3. The effect on the kirschner wires were seen as follows; a. There was no evidence of cartilage regeneration on the margin of the damaged epiphyseal plate. due to Kirschner-wire insertion b. The adjacent tissues around the both kirschner Wires revealed pretty heavy new bone formation.
Atrophy ; Bone Wires ; Cartilage ; Congenital Abnormalities ; Diet ; Femur ; Growth Plate ; Osteogenesis ; Osteotomy ; Rabbits ; Regeneration

The presence of cartilage in a glial tumor is exceptional. It frequently occurs in ependymoma of midline location in young child nuder 5 years of age. The mechanism of cartilage and bone formation in ependymoma is thought to be either metaplastic transformation from mesenchymal tissue or direct transformation from the neoplastic glial cells. A case of ependymoma containing cartilage and bone is reported. The patient is a 4 year-old girl, having calcified mass in the 4the ventricle and cerebellar vermis. The pathogenesis of cartilage formation in this ependymoma is more likely to support the mataplastic theory.
Child ; Male ; Female ; Humans

No abstract available.
Tuberculosis*

Neurilemoma is benign never-sheath tumor which has been described as painless mass and is usually discovered incidentally. It is the most common tumor of peripheral nerve origin and may arise in any nerve where Schwann cells occur. There are few domestic reports which were clinically evaluated in tens of cases of neurilemoma so far. We evaluated on the 56 cases of neurilemoma confined to the trunk and extremities, in the aspect of clinical characteristics, radiology, pathology, EMG, surgical treatment and postoperative results, who were surgically treated at the Department of Orthopedic Surgery of Seoul National University from 1984 to 1994. Among 56 patients, male were 29 and female were 27, and there was no sexual difference. The average age at surgical intervention was 46.4 years (16–83yrs) and 46.4% of patients were in the age of fourties and fifties. The anatomical locations of the tumors were as followed: upper extremities in 22(39%) cases, neck and supraclavicular area in 15(27%) cases, sacrum and lower extremities in 14(25%) cases and trunk in 5(9%) cases. Symptoms were palpable mass in 55 cases, local tenderness in 14, radiating pain in 11, pain in 10, paresthesia in 11, motor weakness in 2 cases. The average follow up period was 19.1 months(13–56 month). Median nerve was involved most frequently(14%), then ulnar nerve(11%). There was no cases which occurred in multiplicity or associated with neurofibromatosis. Marginal excision was done in 51 cases(91%), incisional biopsy only in 4 cases(7%), wide excision in 1 case. The size of the tumors in the longest axis was smaller than 2cm in 9 cases, between 2 and 4cm in 31 cases, between 4 and 6cm in 13 cases and more than 6cm in 3 cases. Malignant change or recurrence was not found in all cases.
Biopsy ; Extremities ; Female ; Follow-Up Studies ; Humans ; Lower Extremity ; Male ; Median Nerve ; Neck ; Neurilemmoma ; Neurofibromatoses ; Orthopedics ; Paresthesia ; Pathology ; Peripheral Nerves ; Recurrence ; Sacrum ; Schwann Cells ; Seoul ; Transcutaneous Electric Nerve Stimulation ; Upper Extremity

BACKGROUND: Cardiopulmonary bypass during open heart surgery causes systemic inflammatory respose. IL-10 is an anti-inflammatory cytokine that inhibits inflammatory process and protects organ function by down regulation of pro-inflammatory cytokine release and maintenance of blood level balance with pro-inflammatory cytokines. MATERIAL ateial and Method: Plasma IL-10 levels were measured and analyzed in 22 patients who underwent open heart surgery (11 cases of coronary artery bypass graft, 11 cases of valve replacement) under cardiopulmonary bypass since 1988 January to July at Department of Thoracic and Czardiovascular surgery, Yeungnam University Hospital. 1g of methylprednisolone was administrated to thirteen patients randomly. Blood samp.es were taken and collected at the time of induction of anesthesia, 10 min before cardiopulmonary bypass, 10 min after starting of CPB, 10 min aftr aortic cross clamping, 10 min after ACC release, and 10 min, 2 hours, and 5 hours after CPB respectively. The plasma levels of IL-10 were determined by enzyme-linked immunosorbent assays (ELISA). Wilcoxon-Raule Sum test was used for statistical analysis. In all 22 patients, cardiopulmonary bypass time was used for statistical analysis. In all 22 patients, cardiopulmonary bypass time was 171+/-41.4 min and aortic cross clamp time was 118+/-36.5 min. Peak IL-10 level was achieved at 10 min after ACC (361.0+/-52.81pg/ml) and was decreased sharply at 2 hours after CPB. Peak IL-10 level was correlated positively with aortic cross clamp time (p=0.011); however, it did not correlated with bypass time (p=0.181). In valve replacement group, mean IL-10 level at peak point was 567.89+/-107.69 pg/ml and was significantly higher than that of coronary artery bypass group (205.67+/-192.70 pg/ml) (p<0.001). ACC time in valve replacement group was significantly longer than that of coronary artery bypass group (p<0.01), however, bypass time was not (p=0.212). Thirteen patients with steroid pretreatment before starting of CPB showed relatively higher plasma IL-10 level than in control group, however, no statistical significance was noted (p=0.19). CONCLUSION: plasma level of IL-10 was increased in association with cardiopulmonary bypass and revealed peak at 10 min after ACC release. IL-10 level was correlated positively with ACC time. Therefore, systemic inflammatory respeonse in association with cardiopulmonary bypass could be decreased by reducing ACC time during cardiac surgery.
Anesthesia ; Cardiopulmonary Bypass* ; Constriction ; Coronary Artery Bypass ; Cytokines ; Down-Regulation ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-10* ; Methylprednisolone ; Plasma ; Thoracic Surgery ; Transplants

The long QT syndromes have been classified into acquired or inheritary forms, both of which are associated with a characteristic type of life-threatening polymorphic ventricular tachycardia called torsade de points. Beta-adrenergic blocker is the first cholic treatment, but in those whom cardiac events are not prevented by beta - blockade, left thoracic sympathetic ganglionectomy may be useful in selected cases. A 50-year-old woman had an recurrent syncopal attack in which she was unconscious for 1-2 min and 1-2 times a month for 10 years. The EKG revealed that QT & QTc intervals were 744 and 632 msec respectively. Treatment with Beta-adrenergic blocker and calcium channel blocker was ineffective in preventing recurrence of syncopal spell. Therefore, she underwent left thoracic sympathetic ganglionectomy with thoracoscope. During the 9 months after operation, she was free of syncopal episodes and is doing well.
Calcium Channels ; Electrocardiography ; Female ; Ganglionectomy* ; Humans ; Long QT Syndrome* ; Middle Aged ; Recurrence ; Syncope ; Tachycardia, Ventricular ; Thoracoscopes*

Isolated congenital aneurysm of the left atrium with intact pericardium is a rate anomaly, which usually presents with arrhythmia, cerebral embolism or abnormalities on routine chest X-ray. Surgery is indicated in most cases to eliminate a potential source of systemic emboli and arrhythmias. A 42-year-old woman having cervical cancer, she was suspected of having a left atrial aneurysm on review of chest X-ray and confirmed by echocardiography and cardiac catheterization. Surgical resection of Left atrial aneurysm was achieved without complication using median sternotomy with cardiopulmonary bypass. The postoperative course was uneventful.
Adult ; Aneurysm* ; Arrhythmias, Cardiac ; Cardiac Catheterization ; Cardiac Catheters ; Cardiopulmonary Bypass ; Echocardiography ; Female ; Heart Atria* ; Humans ; Intracranial Embolism ; Pericardium ; Sternotomy ; Thorax ; Uterine Cervical Neoplasms

Subcutaneous form of neuromuscular hamartoma is extremely rare and histologically different from the conventional neuromuscular hamartoma of the peripheral nerve or benign Triton tumor by an indistinct nodular growth with ill-defined margin and marked collagen interposition. It is usually not associated with a major nerve. We report a case of subcutaneous neuromuscular hamartoma developed in the forehead of 24-year-old man. The tumor showed proliferation of dense, hyalinized fibrous tissue, in which single or group of mature skeletal muscle fibers and nerve fibers were haphazardly intermixed. Recognition of abnormally arranged muscle and nerve fibers is important not to miss this lesion.
Collagen ; Forehead ; Hamartoma* ; Humans ; Hyalin ; Muscle Fibers, Skeletal ; Neptune ; Nerve Fibers ; Peripheral Nerves ; Skin ; Young Adult

Waardenburg syndrome is a very rare auditory-pigment syndrome with autosomal dominant inheritance. In his first report in 1951, Waardenburg characterized this syndrome as dystopia canthorum, a high broad nasal bridge, synophrys[confluent eyebrows], heterochromia iridid, a white forelock or early graying, and sensory neural deafness. We observed a case of Type 2 Waardenburg syndrome with openangle glaucoma and, therefore report with literature review.
Deafness ; Glaucoma ; Glaucoma, Open-Angle* ; Waardenburg Syndrome* ; Wills

Two cases of suprasellar papillary craniopharyngioma are presented. The tumors are exclusively composed of well-formed papillary squamous epithelium and show morphologic homogeneity. There is no palisading basal layer in squamous epithelium. Clinical and radiologic findings, exclusive occurrence in adult and lack of calcification, are much different from conventional craniopharyngioma. Differences between papillary craniopharyngiom and conventional craniopharyngioma are discussed.
Adult ; Male ; Female ; Humans