Since Duhamel (1739), numerous experimental studies on the longitudinal growth of growing long bone have been reported. In Hales(1747) experience, growing long bone showed overgrowth after drilling in the tibia of chickens. David(1924) observed the fact that various degrees of shortening disappeared within 15 months after fracture of the femur in children and he concluded that fractures in children should be treated with the caution that the growing long bone has a tendency to increase in length after injury. Bisgard(1936) concluded that shortening from overriding of fragments in fractured extremities of children will frequently, but not invariablly, become partially or totally eliminated by the acceleration of growth which incidentaIly results from the inflammatory process, incited by trauma and fracture repair. Hass(1926) reported that interstitial proliferation of osseous tissue plays no part in the elongation of a growing bone, either in the mature bone or the young osteoid tissue bordering on the epiphyseal cartilage plate, and length growth of bone is entirely dependant on the purposeful multiplication of cartilage cells of the epiphyseal cartilage plate. Ham(1952) reported that the growth of long bone depends upon the interstitial growth of cartilage. This study was initiated to investigate the effects of fractures in the longitudinal bone growth of growing bone. Artificial fractures were made at two different sites in the diaphysis of the tibia in young rabbits. The operation for artificial fracture was performed under general anesthesia with ether. The type of fracture was an incomplete one, leaving a part of the posterior cortex of the tibia, in order to prevent the displacement of fractured fragments. In all of the cases, no cast immobilization was applied. After the fractures, follow up observations were made weekly till the 4th week, and thereafter at two week intervals, with roentgenographic, lethal measurement and histological examination. The results were as follows; 1) Longitudinal bone growth was increased from fracture of the diaphysis of growing long bone. 2) Compared with the control limb, tendency to overgrowth of growing bone was noted from the first week after the operation. 3) In follow up measurements, no growth inhibition was observed till the 10th week after the operation, but, thereafter, a tendency to reduce the proliferation of cartilage cells was noted. 4) In cases of fracture of the mid 1/3, the gorwing activity in the epiphyseal plate was increased more than from proximal 1/3 fractures. 5) The bony growth, accelerated by fractures in diaphysis of growing long bone without displacement was transient, and the prolonged overgrowth was compensated by the reduction of growing activity and premature closure of the epiphysis.
Acceleration ; Anesthesia, General ; Bone Development ; Cartilage ; Chickens ; Child ; Diaphyses ; Epiphyses ; Ether ; Extremities ; Femur ; Follow-Up Studies ; Growth Plate ; Humans ; Immobilization ; Rabbits ; Tibia

No abstract available.

The area overlying the ischium is the most frequent site for the development and recurrence of pressure sores in the paraplegic patient. This report describes a newly-designed inferior gluteus maximus myocutaneous island flap that is useful for the repair of ischial pressure sores in paraplegic patients. Sacral sore develops a wide and flat ulcer crater. However, ischial sore seems to develop large and deep bursa with relatively small openings. We have used a newly-designed gluteus maximus myocutaneous island flap according to the specific characteristics of ischial sore. The flap is designed in the fashion of a small skin island with a large muscle flap. This flap with its abundant and constant blood supply had proved very reliable in the surgical management of ischial pressure sore. There is also the possible advantage of cushioning with the bulk of muscle for greater long-term durability. Incision could be extended for a complete bursetomy and partial ischiectomy. The reliability, versatility and low morbidity of the inferior gluteus maximus island flap has been demonstrated by its use in our consecutive series of 7 patients with 8 ischial pressure sores. We conclude that this newly-designed inferior gluteus maximus myocutaneous island flap can be applied in deep, infected ischial sore according to the specific characteristics of ischial sore, and it is a very useful method in comparison to other flaps.
Humans ; Ischium ; Pressure Ulcer ; Recurrence ; Skin ; Ulcer

The purpose of this study is to introduce a new method for fingertip coverage for cases of soft tissue only defects and finger tip amputations including bone. 86 lingers in 67 patients haute undergone coverage with a large rotation flap based on digital artery and nerve and Z-plashy after fingertip amputation or finger pulp avulsion from October 1991 to December 1995. There were 53 thumbs, 12 index fingers, 5 long fingers, 3 ring fingers and 13 little fingers. All injured fingers had exposure of the distal phalanx bone. A large volar flap based on either the radial or ulnar aspect including both digital neurovascular bundles was elevated just abode the pulleys and flexor tendon sheath after longitudinal incision along the lateral border of the digit. Then a large Z-plasty was performed at the MP joint crease to release the tension. The volar flap was easily rotated to cover the fingertip and was sutured with slight flexion of the interphalangeal joints. All fingertip defects healed completely. These flaps successfully covered the fingertip, and up 2/3 of the distal phalanx on the volar or lateral aspect. Sensation returned to normal and fingers could be fully extended within 3 months of surgery. All patients only required a single operation for complete fingertip coverage and did not require bony shortening. We conclude that this large rotation, axial pattern, neurovascular flap and Z-plasty provided a durable, completely sensate, well vascularized coverage fort the fingertip with minimal discomfort for the patient.
Amputation ; Arteries ; Fingers ; Humans ; Joints ; Sensation ; Tendons ; Thumb

No abstract available.
Tooth, Artificial*

The correlation of metaplasia to dysplasia and carcinoma in the gallbladder has attracted the attention of many investigators. We mapped and examined a total of 263 cholecystectomized gallbladders to analyze the mucosal changes in the carcinogenesis of the gallbladder. Stones were present in 59.7%, hyperplasia in 28.5%, metaplasia in 55.5% (gastric 37.6%, intestinal 17.9%), dysplasia in 17.1% (low grade 9.1%, high grade 8%) and carcinoma in 7.6%. Metaplasia was more frequently identified in the stone-positive group (62.4%) than in the stone-negative group (45.3%) (P<0.05). Especially, the incidence of intestinal metaplasia was significantly higher in the stone-positive group. Dysplasia and carcinoma were more frequent in the metaplasia-positive group (dysplasia 26.7%, carcinoma 11%) than in the metaplasia-negative group (dysplasia 5.1%, carcinoma 3.4%) (P<0.05). Their incidences were significantly higher in the intestinal metaplasia than in the gastric metaplasia. Forty four percent of the dysplasia-positive cases were associated with carcinoma in the adjacent mucosa but carcinoma was absent in the dysplasia-negative cases. Hyperplasia did not reveal any significant correlation with metaplasia, dysplasia and carcinoma. These results suggest that gallstone is causally related to the metaplasia in the gallbladder and the metaplasia-dysplasia- carcinoma sequence exists in the gallbladder.
Adenocarcinoma* ; Carcinogenesis ; Gallbladder* ; Gallstones ; Humans ; Hyperplasia* ; Incidence ; Metaplasia* ; Mucous Membrane ; Research Personnel

No abstract available.
Education* ; Informatics*

Nasal congestion is one of the most common symptoms of medical complaints. Snoring is caused by vibration of the uvula and the soft palate. Nasal obstruction may contribute not only to snoring and obstructive sleep apnea (OSA) but also impair application of continuous nasal positive airway pressure (CPAP), which is the most widely employed treatment for OSA. Total or near-total nasal obstruction leads to mouth breathing and has been shown to cause increased airway resistance. However, the exact role of the nasal airway in the pathogenesis of OSA is not clear and there is no consensus about the role of nasal obstruction in snoring and sleep apnea. Some reports have failed to demonstrate any correlation between snoring and nasal obstruction. On the other hand, opposing reports suggest that nasal disease may cause sleep disorders and that snoring can be improved after nasoseptal surgery. Reduced cross-sectional area causes increased nasal resistance and predisposes the patient to inspiratory collapse of the oropharynx, hypopharynx, or both. Discrete abnormalities of the nasal airway, such as septal deformities, nasal polyps, and choanal atresia and with certain mucosal conditions such as sinusitis, allergic rhinitis and inferior turbinate hypertrophy can cause snoring or OSA. Thus, these sources of nasal obstruction should be corrected medically or surgically for the effective management of OSA and adjunctive for CPAP.
Airway Resistance ; Choanal Atresia ; Congenital Abnormalities ; Consensus ; Estrogens, Conjugated (USP) ; Hand ; Humans ; Hypertrophy ; Hypopharynx ; Mouth Breathing ; Nasal Obstruction ; Nasal Polyps ; Nose ; Nose Diseases* ; Oropharynx ; Palate, Soft ; Rhinitis ; Sinusitis ; Sleep Apnea Syndromes* ; Sleep Apnea, Obstructive ; Sleep Wake Disorders ; Snoring* ; Turbinates ; Uvula ; Vibration

No abstract available.

To observe whether the measurement of enzyme activity has any critical role in assesment of diagnostic value, beta-glucuronidase and lactic dehydrogenase activities in neoplastic tissue of stomach were compared with those in the stomach at the stomach mucosa at the antrum and body which was uninvolved by tumor. And then activities of those enzymes were also compared with differentiated and undifferentiated carcinomas. The stomach tested were obtained by gastrectomy in Pusan National University Hospital during the months from March to June in 1983. The results were summarized as follows: 1) beta-glucuronidase activity in the neoplastic tissue of stomach was higher than that in the antral and body mucosa, and this enzyme activity in the antral mucosa with intestinal metaplasia was higher than that in the body mucosa of stomach. 2) Lactic dehydrogenase activity in the neoplastic tissue of stomach was similar to that in the antral mucosa with intestinal metaplasia, and was higher than that in the body mucosa of stomach. 3) Acitivities of both enzymes in the neoplastic tissue of differentiated carcinoma were slightly higher than that of undifferentiated one, but did not found statistically significant difference. 4) In the neoplastic tissue of the stomach there was no significant correlation between beta-glucuronidase and latic dehydrogenase activities. Above results support that the measurement of gastric juice enzymes is useful in the diagnosis of stomach carcinoma and may be of value in the identification of high-risk groups.