One of the most important factors leading to a successful healing of rotator cuff tear is good bone quality to secure the suture anchor in the bone for a stable fixation. However, rotator cuff tear are commonly found in elderly patients, and their proximal humerus often shows osteoporosis or cystic lesions. Especially when the transosseous repair prevails for a torn rotator cuff, a weak metaphyseal cancellous bone is often the case, which associated with difficulty in stable fixation of the lateral row suture anchor. In this situation, we were able to augment the lateral row fixation with polymethylmethacrylate bone cement. Although there is a concern of disturbance in the blood flow and healing potential, our case showed good clinical results with respect to healing. If we suspect a weak fixation of the lateral row suture anchor, bone cement seems to be a good option for augmentation.
Aged ; Bone Cements ; Humans ; Humerus ; Osteoporosis ; Polymethyl Methacrylate ; Rotator Cuff* ; Suture Anchors ; Tears

No abstract available.
Arthroscopy* ; Tibia*

Lichen nitidus is a comparatively rare, asymptomatic, chronic disease displaying small, sharpIy defined, fresh colored papules usually localized on the penis, arms and the abdomen. Waisman found immunoglobulin at the dermo-epidermaI junction in lichen planus, but not in lichen nitidus. This settled the argument whether lichen nitidus is a variant of lichen planus. A 11 year old healthy girI was brought to the clinic because of many flesh colored discrete papules on the cubital fossae and the anterior chest. The papules are skin colored. pinhead sized, round, and flat-topped The lesions appeared first at the age of 8 on the antecubital folds and in the following years, increased in number and extended slowly to the upper arms and the anteior chest.
Abdomen ; Arm ; Child ; Chronic Disease ; Humans ; Immunoglobulins ; Lichen Nitidus* ; Lichen Planus ; Lichens* ; Male ; Penis ; Skin ; Thorax

Fundamental pathologic cianges of secondary syphilid are said to be swelling and proliferation of endothelials and a predominantly parivascular infiltrates composed chiefly of lymphoid cells and plasma cells. But recentIy this theory has heen challenged. We present bistologic observation made on 10 patients who agreed to go through a biopsy, during 2 years period. from 1975 to l977. Male to female ratio was 9: 1 The age of patient ranged from 20 to 33, with a mean of 26. 8. The duration of lesion before the visit to the department ranged frorn 6 weeks to 20 weeks, with a mean of 11.9. The lesions in 2 were classified as macule, 3 as papule (1 as moist papule), and 5 as papulo-squamous lesions. The VDRL titer was higher in papular type. Dark fieId examination was performed on all patient and 6 showed positive result. The edidermal changes consist of hyperkeratosis (in 6 cases), parakeratosis (in 5), acanthosis (in 6), elongation of rete ridges (in 8) and exocytosis (in 3). The dermis showed mild to severe perivascular infiltration consist chiefly of lymphoid cells and histiocytic cells (in 10), plama cells (in 7), eosinophils (in 4), neutrophils (in 2), chromatophores (in 4), extra vasation of RBC (in 5), and dilated bload vessels endothelial swellings (in 8). Of particular interest was the finding that plasma cell infiltration is more pronounced at the lower portion of dermal infiltrate and in 3 cases plasma cell infiltration was totally absent. Vascular changes were seen in 8 cases.
Biopsy ; Chromatophores ; Dermis ; Eosinophils ; Exocytosis ; Female ; Humans ; Lymphocytes ; Male ; Neutrophils ; Parakeratosis ; Plasma Cells ; Syphilis, Cutaneous*

PURPOSE:The project of the neonatal mass screening test for inborn errors of metabolism are just at the beginning in Korea and there was a few reports about the overall incidence and subtypes of congenital hypothyroidism. METHODS:In this study, we analysed the 97 cases of newborns with hyperthyrotropinemia who were detected by neonatal screening test to identify the incidence and early clinical manifestations of each subtypes of congenital hypothyroidism. Thyroid function were measured by thyrotropin(TSH) level, T4, T3, Free T4, Free T3, thyroglobulin, T3 resin uptake, TBII, TBG in serum, thyroid ultrasonography and 99mTc thyroid scan. We reanalysed the thyroid functions 1 week after discontinuance of L-thyroxine treatment for 1 year. RESULTS: 1) The time of neonatal screening test were between 3 and 7 days after birth in 46 cases(47.4%) and 8 and 14 days after birth in 35 cases(36.1%). Two cases (2.1%) were done neonatal screening test at the age of 2 days old. 2) The major cause of thyroid disorders were primary hypothyroidism in 45 cases of the total due to thyroid aplasia(7 cases), thyroid hypoplasia(17 cases), ectopic thyroid gland(12 cases) and dyshormonogenesis(9 cases). Other causes of thyroid disorders were TBG deficiency(11 cases), TBG dysfuction(1 case), transient hyperthyrotropinemia(28 cases) and transient hypothyroidism(12 cases). 3) Serum level of thyrotropin(TSH) at diagnosis were 223.5+/-229.6microU/ml in thyroid aplasia, 41.6+/-42.9microU/ml in thyroid hypoplasia, 52.4+/-55.6microU/ml in ectopic thyroid gland. TSH levels were significantly high in thyroid aplasia. T4 levels in thyroid aplasia are 1.7+/-2.0microg/dl and this is significantly lower than other types of thyroid disorders. T3 levels were within normal range except in thyroid aplasia and TBG deficiency. 4) Prolongation of physiologic jaundice was the most common clinical manifestation(33.3%) in patients with primary hypothyroidism and macroglossia, hypothermia, umbilical hernia and cold skin were the next commom clinical manifestations in order to present. 5) Osseous development was normal in 57 cases(82.6%) out of 69 cases who accomplished roentgenographic examination of knees. Only 12 cases(17.4%) showed retardation of osseous development, but there was no significant differences between types of thyroid disorders. 6) Most of the newborn(93.3%) with primary hypothyroidism started to treatment within 8 weeks of age. 7) Initial dosage of L-thyroxine was 10microg/kg/day and decreased 6 to 12 months after treatment. 8) There was significantly decreased thyroid uptake of 99mTc after 1 year follow-up in 5 cases of dyshormonogenesis. 9) The serum TSH levels returned to normal ranges within 6 month after treatment in transient hypothyroidism and transient hyperthyrotropinemia. CONCLUSIONS:Special attention should be paid to transient hyperthyrotropinemia and transient hypothyroidism because many of the congenital thyroid disorders showed transient type and it is necessary to establish the diagnostic guideline to early detect these transient types of congenital thyroid disorders.
Congenital Hypothyroidism ; Diagnosis ; Follow-Up Studies ; Hernia, Umbilical ; Humans ; Hypothermia ; Hypothyroidism ; Incidence ; Infant, Newborn ; Jaundice ; Knee ; Korea ; Macroglossia ; Mass Screening ; Metabolism, Inborn Errors ; Neonatal Screening* ; Parturition ; Reference Values ; Skin ; Thyroglobulin ; Thyroid Dysgenesis ; Thyroid Gland* ; Thyroxine ; Ultrasonography

Primary repair of anterior cruciate ligament is superior to late reconstruction procedures for two reasons; objective stability is more easily restored due to intact secondary restraints not subjected to chronic stress, and the quality of the joint is superior with greater chance of intact menisci and normal articular cartilage not yet damaged through recurrent subluxation. We present the result of thirty-eight kness in thirty-seven patients who had been treated with primary repair of augmented repair for acute ACL rupture from March, 1984 to August, 1990. Twenty-one knees were treated with primary repair and seventeen knees augmented repair. At an average 33 months follow up, the results obtained were as follows: 1. The patients were 23 males and 14 females with an average age of 27.1 years. 2. Twenty four knees were injuried during athletic endeavors, 9 knees by automobile accident, and 5 knees by landing from height. In 18 knees anterior cruciate ligament was ruptured at the proximal attachment, in 17 knees at the midsubstance tear and in 3 at the near distal attachment. 3. The average interval from injury to operation was 7.5 days (ranged from 1 to 14 days). 4. The results were evaluated by Hospital for Special Surgery knee rating scale (modified by Marshall) at an average 33 months (range from 13 months to 7 years and 6 months) follow-up study. 16 (76%) out of 21 knees treated with primary repair were rated as good or excellent. 12 (86%) out of 14 knees treated with augmented repair were rated as good or excellent. As the result of this study, acutely torn anterior cruciate ligaments appear to be successfully treated with primary repair or augmented repair according to torn site and shape of ligaments.
Anterior Cruciate Ligament ; Automobiles ; Cartilage, Articular ; Female ; Follow-Up Studies ; Humans ; Joints ; Knee ; Ligaments ; Male ; Rupture ; Sports ; Tears

No abstract available.
Diagnosis* ; Knee* ; Magnetic Resonance Imaging*

No abstract available.

Incomplete fixation of pancreas, which may be associated with a wide mobility of root of SMA, result in chronic midgut volvulus. Movable pancreas is an uncommon form of incomplete intestnal fixation and rotation. Herein, we present a caae of movable pancreas. A patient was a 32-year-old male with the complaint of colicky intermittent abdomnal pain. The abdominal ultrasonography and CT showed a movable pancreas. The head of pancreas was located in the left of the abdominal aorta during the inspiratory time and left decubitus position. At surgery, pancreas was mobile and the root of mesentery was very weak and fibrotic. Duodenum and mesentery were fixed by 0.7 mm Dacron patch along the right peritoneal gutter and the retroperitoneum from ligament of Treitz to the ileocecal attachment. Duodenojejunostomy was performed for the prevention of SMA syndrome. The symptoms disappeared and recovery was prompt. Following the procedure, the patient remains asymptomatic until 10 months after operation
Adult ; Aorta, Abdominal ; Duodenum ; Head ; Humans ; Intestinal Volvulus* ; Ligaments ; Male ; Mesentery ; Pancreas* ; Polyethylene Terephthalates ; Ultrasonography

Many types of osteotomy have been proposed for the treatment of cubitus varus deformity of the elbow, and various methods for fixation of the osteotomy site have also been described. However, no method has been perfect. We treated two cases of cubitus varus elbow deformity with step-cut osteotomy using a new fixation method with two crossing screws and an anatomically designed locking plate. Active assisted elbow range of motion (ROM) exercise was permitted at postoperative 3 days, after removal of the drainage. Preoperative and postoperative humerus-elbow-wrist angles and ranges of motion of the two patients were compared. At 3 months follow-up, each patient had recovered the preoperative elbow ROM, and achieved the complete bony union of the osteotomy site and proper correction of the cubitus varus deformity. In addition, the appropriate remodeling of the lateral bony protrusion was observed. Therefore, we introduce a new fixation method for achievement of stable fixation allowing immediate postoperative elbow motion after corrective osteotomy for cubitus varus deformity in young adults.
Congenital Abnormalities* ; Drainage ; Elbow* ; Follow-Up Studies ; Humans ; Osteotomy ; Range of Motion, Articular ; Young Adult*