Approximately 15% of all fractures in children involve the physis. Although the majority heal without impairment of the growth mechanism, epiphyseal growth plate fracture-seperation can lead to shortening and angulation. The physiologic events in epiphyseal growth fracture seperation that lead to growth disorders relate to 1) destruction of the epiphyseal circulation and 2) communication between the epiphyseal circulation with its osteoprogenitor cells, thus forming a bony bridge. Although the classic procedure of osreotomy, epitphysiodesis, leg shortening and leg lengthening have not lost their importance in the treatment of the sequeales of partial closure of an epiphyseal plate, the possibility of regaining growth in the affected region should be considered before other measures are taken. Simple excision of the bone bridge is ineffective, since the large cancellous surface thus produced will allow for rapid reformation of the bridge. Thus, a material has to be interposed into the defect created by removal of such a bridge in order to prevent its reformation. Langenskiold first demonstrated that a bone bridge could be effectively resected and its reformation prevented by utilizing fat as an interposition material. Other investigators have used a variety of different interposition materials to prevent bone bridge recurrence following operative removal including cartilage, Silastic, Methymethacrylate, bone wax, muscle flap, Gelfoam as well as fat. Thus it is the purpose of this study to analysis and comparing shortening and angulation by resection of a bone bridge and its replacement with different interposition materials. For this study, a total of 32 rabbits with an initial weight of about 600 to 800 gm was used. Control group comprised 4 rabbits and after appmpriate preparation, the medial condyle of the pmximal tibia was exposed surgically. One plug of bone was removed at the level of the epiphyseal plate using a small curet to a depth of 5 mm. and in the other groups, we made a defect with the same curet and filled it with an interposition material directly. The following experimental groups were created. Group 1 (N-4) Control group: no interposition material Group 2 (N-4) Gelfoam interposition material Group 3 (N-4) Bone was interposition material Group 4 (N-4) Muscle flap interposition material Group 5 (N-4) Fat interposition material Group 6 (N-4) Bone cement interposition material Group 7 (N-4) Silastic interposition material Postoperatively the anirnals were sacrificed 15wks following operation. As sacrifice, tibia including fibular is removed, examined grossly and radiographed. Tibia length and angular deformity were determined by measurement of radiographs. Specimens stained with H-E stain were observed during 15 wks after operation. Through these examination, following results were obtained. l. In control group, coronal histological sections of each curetted proxirnal tibial growth plate revealed osseous bridging as early as 3 wks, and this bridging was found consistently in all control groups for the duration of the study. 2. The groups using gel foam, muscle flap and bone wax as interposition material were found effective for the prevention of the formation of epiphyseometaphyseal bone bridge to some extent. 3. The groups using Silastic or bone cement diminished both the angular deformity and growth retradation to a highly significant degree. Although the use of fat did reduce somewhat the amount of shortening and angular deformity when used as an interposition material, it was not effective as Silastic or bone cement. 4. Coronal histological section of the traumatized, margin of the growth plate, with an interposition material revealed thin fibrous layer and lose columnar orientation, foam rounded clone-like structures and randomness to growth. The injured portion of the cartilage may originate from the regeneration of the adjacent part of the growth plate. From these morphological and radiological results, it is suggested that Silastic or bone cement is better interposition material in the elimination of trahsphyseal closure after physeal damage.
Cartilage ; Child ; Congenital Abnormalities ; Gelatin Sponge, Absorbable ; Growth Disorders ; Growth Plate ; Humans ; Leg ; Rabbits ; Recurrence ; Regeneration ; Research Personnel ; Tibia

The incidental observation of periosteal new bone formation on long bones is common in pediatric radiology without any symptoms in extremities : for example, the humeri on chest examination and the femora on abdominal roentgenograms. The purposes of the author is to report the results of a roentgenologic study of the long bones in 100 normal infants and 100 chilren between 1 and 2 years old who had no symptoms refereble to the skeleton to determine the incidence, roentgen characteristics, pathogenesis and significance of this type of periosteal new bone. The results obtained were as follows : 1. Periosteal new bone occured in 28% in normal infants group but did not occured in children group between 1 and 2 years. 2. The site in order of decreasing frequency were femur, tibia, and humerus. 3. Periosteal new bone is always on the diaphysis and usually extended onto the metaphysis to a variable extent, but it has not been observed to reach the end of metaphysis. 4. It seems most logical that the periosteal new bone found in these infants is simply a roentgen manifestation of normal periosteal bone growth in the period of greatest activity. 5. It is not an indication for treatment unless a definite relationship with a specific disease is proven.
Bone Development ; Child ; Diaphyses ; Extremities ; Femur ; Humans ; Humerus ; Incidence ; Infant ; Logic ; Osteogenesis ; Skeleton ; Thorax ; Tibia

The antihypertensive effects of once-daily 15mg dose of tripamide(Normonal(R)) were observed in 30 cases of essential hypertension, and the results were as follows; 1) Mean drop in systolic and diastolic pressure were 30 mmHg and 16 mmHg, respectively. 2) In 76.7% of cases, good or fair control of blood pressure was resulted. 3) There was no significant difference in heart rate before and after treatment. 4) There was no significant difference in serum K, BUN, and FBS before and after treatment. 5) There was no any other side effect which required discontinuing the treatment.
Blood Pressure ; Heart Rate ; Hypertension

We report a pigmented follicular cyst (PFC) in a 40-year-old male manifestated clinically as pigmented nevus. Histopathologic findings revealed an infundibular cyst in the mid dermis containing a small amount of keratinous material. The cystic wall consisted of four or five layers of squamous epithelium with a granular layer with abundant keratohyaline granules and the cyst wall contained one hair follicle. It must be differentiated from other pigmented lesions of over-lying skin such as eruptive vellus hair cyst, apocrine hydrocystoma and melanocytic nevus coexistance of an epidermoid cyst. Surgical excision and histopathological examination are necessary for an accurate diagnosis in pigmented lesions.
Adult ; Dermis ; Diagnosis ; Epidermal Cyst ; Epithelium ; Follicular Cyst* ; Hair ; Hair Follicle ; Humans ; Male ; Nevus, Pigmented ; Skin

STUDY DESIGN: The treatment of a stable fracture around thoracolumbarjunction is a controversial subject. OBJECTIVES: To evaluate the result from long term follow-up of the stable spinal fracture around thoracolumbar junction according to the operation, osteoporosis and in situ extension bar, respectively. SUMMARY OF BACKGROUND DATA: The thoracolumbar junction is a transitional zone in which the kyphotic angle of thoracic spine is continued to the lordotic angle of lumbar splne. So it is prone to be injured biomechanically, and the stability of the spine around thoracolumbar junction is not determined yet. METHODS: We studied retrospectively 105 cases of the stable fracture around thoracolumbar junction from January 1985 to December 1995. The criteria of the stability were a compression fracture by Denis F., a bursting fracture without involvement of posterior column, a neural enchroachment of bony fragment below 30%, fracture without subluxation or dislocation in spinal junction. RESULTS: The most common cause was traffic accident and, the first lumbar vertebrate was common site. Below 30% of initial compression, the progression was not exceded 5% in operative group. But in nonoperative group, anterior compression was more progressed than initial compression over 5%. The degree of anterior compression was affected by osteoporosis and in situ extension bar just after injury. CONCLUSIONS: We suggest an anterior compression abode 30% in spinal body of thoracolumbar junction for an additional operative indication. The prognosis may be affected by osteoporosis and in situ extension bar.
Accidents, Traffic ; Dislocations ; Follow-Up Studies* ; Fractures, Compression ; Osteoporosis ; Prognosis ; Retrospective Studies ; Spinal Fractures ; Spine ; Vertebrates

We report a case of a morphologic variant of dermatofibroma. A coin sized, brownish, shinny, somewhat fibrotic pedunculated tumor in a 39-year-old male was diagnosed as a sclerosing hemangioma, a type of dermatofibroma histopathologically. Its dome shape morphology was unusual in comparison with the typical morphology of dermatofibroma that we know.
Adult ; Histiocytoma, Benign Fibrous* ; Humans ; Male ; Numismatics

No abstract available.
Knee Joint* ; Knee*

No abstract available.

The superficial palmar arch of the hand is formed by the anastomosis of the palmar branch of the radial artery and the distal part of the ulnar artery. The variation of the superficial palmar arch and its branches have been known to occur frequently. There are many reports about the formation of the arch and the branches of it and the incidence of the median artery. These variations of the arch are considerablly valuable in the surgical management of the hand injuries, especially in vascular injury. This study deals with the Korean hands. The author observed the pattern of the superficial palmar arch, the presence of the median artery and the pattern of the common palmar digital arteries and the results are as followings; 1. The superficial palmar arch was complete type in 97.2% and incomplete type in 2.8%, The majority of the complete arch was type 1 and type 2. 2. The median artery was present in 2.8%. 3. The common palmar digital artery was present as type 1 in 65.3% type 2 in 13.9% type 3 in 4.2%, type 4 in 5.5%, type 5 in 6.9% and type 7 in 1.4%.
Arteries ; Hand ; Hand Injuries ; Incidence ; Radial Artery ; Ulnar Artery ; Vascular System Injuries

Tibia valga has been described as a consequence of non-displaced fractures of the proximal metaphysis of the tibia in children. There has been considerable speculation about the cause of this deformity. Four cases of estabilished valgus deformity following injury to the proximal tibia metaphysis in children are presented. In one case of them, it was showed that an infolding of a portion of the periosteum of the tibiain medial opening of this fracture. It was treated by surgical clearence of the infolding periosteum and varus osteotomy with slight over-correction and partial fibulectomy. The recurrence of valgus deformity was absent during post operative one year. In another case, roentgenogram showed an asymmetrical growth arrest line of the pmximal tibia. The presence of asymmetrical growth arrest lines in the pmximal metaphysis of the tibia demonstrates that the valgus deformity in this patient was caused by overgrowth of the medial portion of the proximal tibial epiphyseal plate. In the remainder, we observed the deformity developed without any specific cause.
Child ; Congenital Abnormalities ; Growth Plate ; Humans ; Osteotomy ; Periosteum ; Recurrence ; Tibia