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

PURPOSE: To evaluate normal variations and thus to avoid confusion in differentiation from lesions of the accessory structures (rhomboid fossa, foramen for supraclavicular nerve, conold tubercle) of the clavicle in chest radiographs. MATERIALS AND METHODS: We studied the variations of the clavicle in 300 chest radiographs (134 men, 166 women) and 355 dry bones (right 166, left 189; 151 men, 74 women, 130 unknown sex). RESULTS: In chest radiographs, the incidence of the depressed rhomboid fossa was 229 cases (39.5%;male 52.0%, female 29.9%);the flat type was 329 cases (56.9%;male 45.7%, female 65.7%);and the elevated type was 20 cases (3.5%; male 2.4%, female 4.3%). In the dry bones, the incidence of the depressed thombold fossa was 129 cases (57.3%;male 59.6%, female 52.7%);the flat type was 65 cases (28.9%;male 24.5%, female 37. 8%) ;and the elevated type was 31 cases (13.8%;male 15.9%, female 9.5%). The incidence of the foramen for supraclavicular nerve was 0.8% in chest radiographs, and 1.4% in the dry bones. The incidence of the elevated conold tubercle was 65.1% (male 64.0%, female 65.9%) in chest radiographs, and 96.9% (male 95.4%, female 100.0%) in the dry bones. CONCLUSIONS: The incidence of the depressed rhomboid fossa in chest radiographs was higher in men and the right clavicle. The incidence of flat rhombo~d fossa in chest radiographs decreased according to increase of age. The foramen for supraclavicular nerve was occasionally found (0.8% in chest radiographs; 1.4% in the dry bones).
Clavicle* ; Female ; Humans ; Incidence ; Male ; Radiography, Thoracic* ; Thorax*

PURPOSE: To evaluate normal variations and thus to avoid confusion in differentiation from lesions of the accessory structures (rhomboid fossa, foramen for supraclavicular nerve, conold tubercle) of the clavicle in chest radiographs. MATERIALS AND METHODS: We studied the variations of the clavicle in 300 chest radiographs (134 men, 166 women) and 355 dry bones (right 166, left 189; 151 men, 74 women, 130 unknown sex). RESULTS: In chest radiographs, the incidence of the depressed rhomboid fossa was 229 cases (39.5%;male 52.0%, female 29.9%);the flat type was 329 cases (56.9%;male 45.7%, female 65.7%);and the elevated type was 20 cases (3.5%; male 2.4%, female 4.3%). In the dry bones, the incidence of the depressed thombold fossa was 129 cases (57.3%;male 59.6%, female 52.7%);the flat type was 65 cases (28.9%;male 24.5%, female 37. 8%) ;and the elevated type was 31 cases (13.8%;male 15.9%, female 9.5%). The incidence of the foramen for supraclavicular nerve was 0.8% in chest radiographs, and 1.4% in the dry bones. The incidence of the elevated conold tubercle was 65.1% (male 64.0%, female 65.9%) in chest radiographs, and 96.9% (male 95.4%, female 100.0%) in the dry bones. CONCLUSIONS: The incidence of the depressed rhomboid fossa in chest radiographs was higher in men and the right clavicle. The incidence of flat rhombo~d fossa in chest radiographs decreased according to increase of age. The foramen for supraclavicular nerve was occasionally found (0.8% in chest radiographs; 1.4% in the dry bones).
Clavicle* ; Female ; Humans ; Incidence ; Male ; Radiography, Thoracic* ; Thorax*

The purpose of this study was to find the distribution and measurement of compressive and tensile stress when intrusi- on arch wire is forced engage with upper canine and to analysis stress at each section through FEM. And we compare compressive and tensile ratio at each section. The results were as follows. 1. At FA point and cemento-enamel junction of upper canine, compressive and tensile force ratio is about the same. 2. At apex, compressive force is the four times as tensile force. ; In intrusion, we show root resorption at apex. 3. At Cemento-enamel junction, the compressive and tensile force show the maximun value except FA point.
Root Resorption

No abstract available.
Lymphoma*

Though the primary carcinoma of the vermiform appendix is rare, the secondary carcinoma of the vermiform appendix is extremely rare. About fourty cases have been reported through the world. The breast is most common primary site, and adenocarcinoma is most common form. The metastatic carcinoma of the vermiform appendix, from squamous cell carcinoma of the uterine cervix, were extremely rare. The authors experienced a case of metastatic squamous cell carcinoma of the vermiform appendix, in thirty-two years old housewife. She was diagnosed with carcinoma of the uterine cervix on December, 1983, and treated with a radical hysterectomy on February, 1984, at Chicago, and with a radiation therapy. She had been suffered from palpable masses on left axilla and left neck region, and and coughing and chest pain. After an excision biopsy, on August, 1984, she showed intestinal obstruction sign including abdominal distension with abdominal pain. A right-sided hemicolectomy was performed on November, 1984. During gross examination, the wall of the distal portion of the vermiform appendix was moderatery thickened, and showed homogeneous light yellow cut surface. On microscopic examination, there were clusters of tumors that had negative stained preparations. On electron microscopic examination, the secretory granules were not found, and the characteristics of squamous cells, including intercellular spaces, desmosomes and tonofibrils, were noted.
Adenocarcinoma ; Neoplasm Metastasis

Sarcomatoid carcinomas are malignant epithelial neoplasms in which the tumor cells assume a partial or complete spindle cell pattern of growth, leading to the erroneous classification of some true carcinomas as sarcomas. These spindle cells are malignant and manifest various amount of both vimentin and cytokeratin. Positive reaction of some of the spindle cells for cytokeratin antibodies is confirmatory. Clinical features do not differ significantly from those of patients with high-grade transitional cell carcinoma. So far, 13 cases of sarcomatoid transitional cell carcinoma of the renal pelvis have been reported in English and Korean literature. In this report, we describe clinicopathologic features of recently observed two cases of sarcomatoid transitional cell carcinoma of the renal pelvis and summarize the pathologic findings of previously reported cases with review of the literature.
Antibodies ; Carcinoma ; Carcinoma, Transitional Cell* ; Carcinosarcoma ; Classification ; Humans ; Keratins ; Kidney Pelvis* ; Sarcoma ; Vimentin

Polymorphic reticulosis(PMR) is a unique clinicopathological entity of unknown etiology, which commonly present as an aggressive, necrotizing lesion of the upper respiratory tract. It is a separate nosologic entity from Wegener's granulomatosis and idiopathic mildine destructive disease. The origin of the cells composing polymorphic reticulosis has been controversial. We reviewed 15 cases of polymorphic reticulosis with respect to clinical and histologic bases, and immunohistochemical studies were done using UCHLI (CD45RO), as a T cell marker, CD-20 as a B cell marker and alpha- I -antichymotrypsin as a histiocytic marker. Almost all cases showed characteristic histologic and immunohistochemical features similar to those of peripheral T cell lymphoma. Thus, this study indidcated that polymorphic reticulosis is a type of malignant lymphoma of T cell lineage.

Sixty-three patients with permanent sigmoid colostomy were surveyed to evaluate their satisfaction and complications with the "irrigation technique" and the "atural evacuation" of the colostomy management (irrigation technique; 32 patients, natural evacuation; 31 patients). All patients had colostomy for at least 12 months without disease recurrence. Each patient was interviewed in addition to standard questionnaire. The irrigation was not associated with any major complication including colonic perforation. The irrigation was used younger age group than the natural evacuation (53+/-10 vs. 62+/-12, P=0.01). The frequency of bowel movement was lower in the irrigation than in the natural evacuation (5.1+/-2.5/wk vs. 10.8+/-9.0/wk, P=0.04). Five patients (16%) of the irrigation experienced spontaneous bowel action but only one patient suffered from it. The time spent for managing irrigation was 59+/-13 minutes. Twenty-three patients (74%) of the natural evacuation suffered from one or moreproblems such as expensive apparatus, leakage, skin irritation or odor. Sixteen patients (52%) of the natural evacuation and 2 patients (6%) of the irrigation were restricted in social activity (P=0.0001). Thirteen patients (42%) of the natural evacuation and 1 patient (3%) of the irrigation were dissatisfied with colostomy management (P=0.002). Thus, the irrigation technique seems to be more effective and satisfactory method for managing colostomy without compromising patient's social activity when it is performed in appropriately selected patients.
Colon ; Colon, Sigmoid ; Colostomy* ; Humans ; Odors ; Surveys and Questionnaires ; Rectal Neoplasms ; Recurrence ; Skin

No abstract available.
Kidney Transplantation*