No abstract available.
Dexamethasone* ; Psychotic Disorders*

BACKGROUND: We investigated the effectiveness of fibular strut allograft augmentation of proximal humerus fractures to prevent varus deformity in patients over the age of 65 years with insufficient medial support. METHODS: We analyzed the clinical and radiological outcomes of locking plate fixation with adjunct fibular strut allograft augmentation in 21 patients with proximal humeral fractures. The inclusion criteria were age (65-year-old or older); presence of severe medial comminution; inadequate medial support; and those who could participate in at least a one year follow-up. The average age was 76.4 years. We analyzed each patient's Constant score, our indicator of clinical outcome. As radiological parameters, we analyzed time-to-bone union; restoration of the medial hinge; difference between the immediately postoperative and the last follow-up humeral neck-shaft angles;; and anatomical reduction status, which was assessed using the Paavolainen method. RESULTS: A successful bone union was achieved in all patients at an average of 11.4 weeks. We found that the average Constant score was 74.2, showing a satisfactory outcome. The average difference in the humeral neck-shaft angles between the immediately postoperative time-point and at the final follow-up was 3.09°. According to the Paavolainen method, the anatomical reduction was rated excellent. The medial hinge was restored in 14 of 21 patients. Although we did not find evidence for osteonecrosis, we found that a single patient had a postoperative complication of screw cut-out. CONCLUSIONS: Fibular strut allografting as an adjunct treatment of proximal humeral fractures may reduce varus deformity in patients with severe medial comminution.
Allografts ; Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Humerus* ; Methods ; Osteonecrosis ; Postoperative Complications ; Shoulder Fractures ; Transplantation, Homologous

The superior volume maintenance of membranous over endochondral bone grafts, which was shown in several studies has provided the basis for its preferred clinical use as an onlay grafting material on the craniofacial skeleton. The scientific rationale for this seeming embryological advantage, however, has never been proven, Since the cortical component of membranous bone is proportionally greater than that of endochondral bone, it follows that membranous grafts would show greater volume maintenance over time. Our hypothesis is that the pattern of onlay bone graft resorption is primarily determined by a graft's micro-architecture (relative cortical and cancellous composition) rather than its embryololgical origin(membranous versus endochondral). Fourty adult New Zealand white rabbits were used for this study. There were 8 animals in each of 4 groups. The rabbits of each group were sacrificed at 3, 8, and 16 weeks. Four types of grafts were placed subperosteally, onto each rabbit's cranium: a hydroxyapatite, a cortical bone graft of membranous origin, a cortical bone graft of endochondral origin and a cancellous bone graft of endochondral origin. Membranous bone grafts were obtained from the lateral mandible and endochondral bone grafts were obtained from the ileum. In order to determine post-sacrifice volume and density of the bone grafts, a caliper technique and bone densitometry(bone densitometer: LUNAR, DPX-L, U.S.A.) were performed on all of the bone grafts. Bone graft specimens were histologically examined at 3, 8, and 16 weeks.The measurement of volume and density show that there is a statistically greater resumption in the cancellous endochondral bone grafts for all parameter, compared to either the endochondral or membranous cortical bone grafts or hydroxyapatite at all time points(p< 0.05). In addition, there is no significant difference in the resorption rates between the endochondral and membranous cortical bone grafts for all parameters at all time points. By placing cortical bone grafts and cancellous bone grafts on the recipient sites separately, we have shown that the former grafts maintain their volumes, widths and projections significantly better than the latter grafts. Futhermore, we found no statistical difference in resorption rates between the two cortical bone grafts of different embryologic origins, a finding which has never been previously shown. Bone volume fraction, measured with bone densitometry, was shown to be higher in cortical bone than in cancellous bone at all time points, further illustrating the differences between cortical and cancellous bone.From our results, we believe cortical bone to be a superior onlay-graftiong material, independent of its embryololgic origin.
Adult ; Animals ; Biological Factors* ; Densitometry ; Durapatite ; Humans ; Ileum ; Inlays* ; Mandible ; Rabbits ; Skeleton* ; Skull ; Transplants*

No abstract available.
Dental Arch* ; Humans

No abstract available.
Peritoneal Lavage*

Turner's syndrome results from complete or partial monosomy of the X chromosome and is characterized by hypogonadism or related other congenital anomalies in phenotypic females. In these patients, there are failure to develop normal secondary sex characteristics, amenorrhea, or short stature at puberty and the ovaries are reduced to atrophic fibrous strands devoid of ova and follicles(streak gonads). Individuals with this condition are particularly prone to the development of gonadoblastoma. For this reason, the gonads should be early removed and supplemental estrogen therapy given. We experienced a case of Turner's syndrome, 45, XO/46, XY karyotype in a 20-year-old phenotypic female complained an amenorrhea. On the exploratory laparotomy, the right gonadal mass is sevearly adhered to the adjacent organs and measures 8 x 5 x 5 cm in dimension and 75gm in weight and shows multiple foci of hemorrhage with necrosis. The left streak gonad measures 3.5 x 2 x 1.5 cm in dimension and shows multiple foci of calcification. Microscopically, the right gonadal mass reveals malignant mixed germ cell tumor, composed of endodermal sinus tumor, composed of endodermal sinus tumor with dysgerminoma and gonadoblastoma. The left streak gonad consists of mainly dense fibrous connective tissue and shows some foci of calcification associated with gonadoblastoma. On immunohistochemical and special stainings, the cytoplasm and hyalin droplets of the endodermal sinus tumor component reveal strong positivity to the a-fetoprotein and PAS. After removal of both gonads, the serum level of the a-fetoprotein is markedly down from 1742ng/ml to 2.6 ng/ml.
Female ; Humans

Rectovagianl fistula(RVF) is a congenital or acquired communication between the two epithelial-lined surface of the rectum and the vagina. We present our experience with 62 patients with RVF. There were various etiologies and repair methods of rectovaginal fistula. The purpose of this study was to retospectively review the clinical course of the patients we treated and to evaluate the efficacy of various treatment options. The mean age was 40.5 yr, The type of RVF was classified to one of two(simple and complex), according to their location, size and etiology. RVF was developed most commonly after radiotherapy due to cervical cancer(n=17), then after pelvic surgery due to malignancy(n=16), obstetric trauma after episiotomy at delivery(n=7), congenital malformation(n=4), inflammatory bowel disease(n=1), Bechet's disease(n=1), infections such as perianal fistula or abscess(n=2), direct invasion of carcinoma(n=3), after chemotherapy(n=1), and idiopathic(n=6). Three cases of them associated with rectovesicovaginal fistula. Surgical therapeutic option was divided to local repair, abdominal approach and tissue transposition by the type of RVF. Most simple RVFs were repaired with local approach through the vagina or rectum. Most complex RVFs were repaired through abdominal approach or tissue transposition. With an average follow up of 20 months, the treatment results were as follows: completely healed(n=36, 58.1%), persistent symptom(n=6, 9.7%), recurrence after repair(n=5, 8.1%), loss of search or death(n=15, 24.1%). Therefore we assist that the management of RVF depends on size, location, and cause. anal sphincter function and overall health status of the patient. Careful preoperative assessment of the fistula, surrounding tissues, and anal sphincter and exclusion of associated disease are essential. With through evaluation, thoughtful consideration of treatment options, and meticulous operative technique, patient can be assured of an optimal outcome.
Anal Canal ; Episiotomy ; Female ; Fistula ; Follow-Up Studies ; Humans ; Radiotherapy ; Rectovaginal Fistula* ; Rectum ; Recurrence ; Vagina

Radon is a naturally occurring radioactive material that is formed as the decay product of uranium and thorium, and is estimated to contribute to approximately half of the average annual natural background radiation. When inhaled, it damages the lungs during radioactive decay and affects the human body. Through many epidemiological studies regarding occupational exposure among miners and residential exposure among the general population, radon has been scientifically proven to cause lung cancer, and radon exposure is the second most common cause of lung cancer after cigarette smoking. However, it is unclear whether radon exposure causes diseases other than lung cancer. Media reports have often dealt with radon exposure in relation to health problems, although public attention has been limited to a one-off period. However, recently in Korea, social interest and concern about radon exposure and its health effects have increased greatly due to mass media reports of high concentrations of radon being released from various close-to-life products, such as mattresses and beauty masks. Accordingly, this review article is intended to provide comprehensive scientific information regarding the health effects of radon exposure.
Background Radiation ; Beauty ; Beds ; Epidemiologic Studies ; Human Body ; Inhalation Exposure ; Korea ; Lung ; Lung Neoplasms ; Masks ; Mass Media ; Miners ; Occupational Exposure ; Radon ; Smoking ; Thorium ; Uranium

The authors analized the 98 cases of cervical spine injuries without fracture or dislocation by hyperflexion/hyperextension of the neck. The peak incidence of the age was in the second to fourth decades(69.4%). There was a male preponderance with a sex ratio of. 1.8 : 1. Sources of trauma were motor vehicle accident, object falling on and motorcycle accident in the order of frequency. The common mechanisms of injury were flexion-extension, extension and flexion injury in the order of frequency. There were 10 cases of cervical cord injury without fracture or dislocation and operative management was given in 6 cases of them. The most common preexisting disease was congenital cervical stenosis. Surgical modality such as laminectomy, laminoplasty and anterior decompressive procedure made them improved. The authors discuss the mechanism of injury and surgical management of the patients with cervical cord injury in the absence of concomittent fracture or dislocation.
Constriction, Pathologic ; Dislocations* ; Humans ; Incidence ; Laminectomy ; Male ; Motor Vehicles ; Motorcycles ; Neck ; Preexisting Condition Coverage ; Sex Ratio ; Spine*

No abstract available.
Neck*