One of the most difficult problems confronting the orthopedic surgeon today is what to do when faced with a large defect in a peripheral nerve. Recent advances in engineering and neurophysiology have improved our technical ability to understand the consequences of severing a nerve. We have treated a large traumatic ulnar nerve defect with microsurgical nerve graft technique. In a follow-up study of twehre monthes post surgery, the results were satisfactory.
Follow-Up Studies ; Neurophysiology ; Orthopedics ; Peripheral Nerves ; Transplants ; Ulnar Nerve

In recent years the rate of the spine Injury tends to be on the increase year by year as the rate of traffic and industrial accidents are increased. During industrial, sports and automobile accidents are occurred, the various forces were exerted by the mechanism, “flexion, extension, flexlon-rotation, vertlcal compression and shearing.” These exercise their effects on the vertebral bodies, the neural arches and intervertebral disc and the contents of the spinal cord, depending on direction and intensity of the trauma, and the posture and muscular attitude existent at the movement. Once the neurological Iesion has been diagnosised and the type of vertebral injury has been established and particularly after a decision has been made as to whether the spinal injury is stable or unstable, a rational method of treatment can be decised upon: Our treatment consists of providing the best condition for recovery from the spine injury, preventlng further neurologlcal damage in the unstable area, achieving stable bone and llgament heallng ln satisfactory position, preventing metabolic compllcations from being fatal, mobllizing the patient early, and rehabilitating to provide maximum fuctlonal independence with the remaining-muscle power avallablc to the cord injury patient. One hundred and fifty seven spine fracture and dislocation patients were clinically observed and evaluated from Jan. 1972 to Dec. 1978 in our study. The result of this study may be summerized as follows: 1. Out of the patients, there were 135 male and 22 female cases. The ratio between male and female was 6.1:1. The majority (84.7%) of the spine injuries was found in the age of 20 to 50 years. Fifty-two percent of the cases was caused by industrial accidents. 2. The most common site of the lesion occurred between T-11 and L-2 vertebrae (71.8%). 3. In cervical injury, fracture dislocation type was most common (50%), and especially, pure dislocation by extension mechanism was 12.5% but in thoracolumbar iniury, simple anterior wedge compression fracture was most common (66.6%) and there were no pure dislocations just like cervical spine injury cases. 4. Fifty seven cases of the total were complicated by paraplegia, of which 62.5% in cervical region and 31.6% in thoracolumbar region were noticed. The most frequent type of the injury in which paraplegia developed was the fracture dislocation (73.8%) and the most common site of the lesion was between the T-12 and the L-2 vertebrae. 5. Open reduction was performed in 9 cases out of 24 cervical spine injury patients and in 41 cases out of 133 thoracolumbar injury patients. 6. Prognosis of neurologic recovery in initially complete lesion was poor, regardness of treatment. In the cervical lesion cases there were no patients who were recovered. But in the other sites about 10.5% of initially complete lesion showed partial neural recovery comparing to 62.5% of initially incomplete lesions. 7. Progressive deformity is often noted as a complication of spine fracture or dislocation when solid fusion fails to develop. The increment of kyphosis after treatment is as follows: Simple wedge fracture
Accidents, Occupational ; Automobiles ; Catheterization ; Catheters ; Clinical Study ; Congenital Abnormalities ; Diagnosis ; Dislocations ; Female ; Fractures, Compression ; Humans ; Intervertebral Disc ; Kyphosis ; Laminectomy ; Male ; Methods ; Paraplegia ; Posture ; Prognosis ; Spinal Cord ; Spinal Injuries ; Spine ; Sports ; Urinary Bladder

No abstract available.
Dislocations*

No abstract available.
Cystadenocarcinoma*

No abstract available.
Neural Conduction*

No abstract available.
Follow-Up Studies* ; Magnetic Resonance Imaging* ; Radiculopathy*

No abstract available.
Absorptiometry, Photon* ; Bone Density*

The first myelography with air was carried out by Walter Dandy in 1919, and the myelography with positive contrast medium was done by Sicard and Forestier in 1922. Since Pantopaque was adopted as a contrast material by University of Rochester group in 1944, it has been rapidly popularized. Although higher diagnostic accuracy has been made with a development of the diagnostic aids such as electromyography, discography, epidural venography and computerized tomography, myelography has been popularized in our country with electromyography. The authars have seen and studied 107 cases of herniated lumbar disc with respect to the diagnostic accuracy of myelographic examination from January, 1976 to December, 1981 at the department of Orthopedic Surgery, Yonsei University College of Medicine. The results were as follows: l. Of the 107 cases, 59 were found in the age of 20 to 40 years and the ratio of male and female was 2:l. 2. Fifty eight cases (54.2%) had no history of back injury, but 40 cases (37.4%) had sprain of the back and 9 cases had direct trauma history. 3. In all cases, plain X-ray and myelogram were taken. Among them 55 cases showed narrowing of intervertebral space in plain film, and 100 cases showed positive myelographic findings such as lateral indentation of dural sac (41 cases), hour-glass defect (30 cases), root sleeve defect (12 cases), block defect (10 cases) and combined defects (7 cases). 4. Sixty one cases which confirmed by operation, the most frequent level of disc herniation was in L4-5 space. Clinical diagnosis was correct in 57.4%, and myelographic accuracy was coincided with operative finding in 80.3%. 5. Twelve (19.7%) of the 61 cases showed discrepancy between myelographic and operative findings, and these 12 cases consisted of 5 cases of level discrepancy, 3 cases of false positive and 4 cases of false negative.
Back Injuries ; Clinical Study ; Diagnosis ; Electromyography ; Female ; Humans ; Iophendylate ; Male ; Myelography ; Orthopedics ; Phlebography ; Sprains and Strains

Bone formation by osteoblast may be closely related to the increase in intracellular Ca2+ activity of osteoblast. In order to study the effects of changes in Ca2+ activity of osteoblast-like cell on fracture healing, we changed intracellular Ca2+ activity of osteoblast-like cells by vanadate and verapamil. And the process of fracture healing was observed after injection of the treatment osteoblast-like cells into the fracture site by hematoxylin-eosin (H-E) stain and bromodeoxyuridine (BrdU) stain. The results were as follow: 1) The most effective range of concentration which could facilitate bone formation was 10-6 to 10-5 M. 2) H-E stain showed more abundant osteoblast and osteoid tissues, more active mitotic division of osteoblast, and earlier appearance of chondroblast and chondroid tissue, making the maturation of woven bone faster in the vanadate-treated group than in the control group. The opposite was true in the verapamil-treated group compared with the control group. 3) BrdU labeling index showed more active osteoblastic proliferation in the vanadate-treated than in the control group. The opposite was observed in the verapamil-treated group compared with the control group. From these results, the fracture healing appears to be facilitated and decelerated by vanadate which apparently increase intracellular Ca2+ activity of osteoblast and verapamil which decreases it, repectively. Therefore the change of intracellular Ca2+ activity of osteoblast can be considered to be one of fracture healing mechanisms and expected to be applied for clinical purpose.
Bromodeoxyuridine ; Chondrocytes ; Fracture Healing ; Osteoblasts ; Osteogenesis ; Vanadates ; Verapamil

Twenty four hyperlipidemic patients, consist of 13 males and 11 females, were administration a new hypolipidemic agents, Pantethine, and blood lipid level were checked sereally for 16 weeks. The following results are obtained. 1. The serum high density lipoprotein-cholesterol are markedly increased by 11.8%. 2. The serum cholesterol level are reduced mildly by 4.8% & it seems to be insignificant. 3. The serum triglyceride level are moderately reduced by 10.7%. 4. In 11 female patients, pantethine are more than effect on male patients. 5. Pantethine has been well tolerated in most patients. With a consideration of remakable safety, it is promising that pantethine are effective in reducing cholesterol, Triglyceride and increasing high density lipoprotein-cholesterol level.
Cholesterol ; Female ; Humans ; Hypolipidemic Agents ; Male ; Triglycerides