The purpose of this paper is to compare the results, complications, advantages and disadvantages of treatment by flexible intramedullary nail with those by interlocked intramedullary nail in humeral shaft fractures. The authors analyzed 42 cases of humeral shaft fractures in patients who were treated by intramedullary nailing. Nineteen patients were treated with flexible I-M nail and twenty three patients were treated with interlocked I-M nail. Fourteen cases(74%) treated with flexible I-M nail were obtained primary bone union, and twenty one cases(91%) treated with interlocked I-M nail were obtained primary bone union. Five cases treated with flexible I-M nail and 2 cases treated with interlocked I-M nail failed union and the most common cause of nonunion was distraction. Flexible I-M nailing does not solve rotational deformity and could't obtain a high union rate due to distraction. Therefore, we recommend that adequate external support is considered to prevent distraction using the flexible I-M nail. Although we obtained a satisfactory union rate using by Seidel interlocked I-M nail, we must observe the distal spreading screw loosening during the follow up period. In bones with small diameter, sufficient reaming may be necessary, because the distal spreading screw can't spread well.
Congenital Abnormalities ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans

A survey of the literature on the treatment of ruptures of deltoid ligament associated with fracture of distal part of fibula is controversial. Some authors advocated surgical repair of the ruptured deltoid ligament based on the theoretical consideration, while others advocated non-operative treatment based on the clinical consideration. We studied the results in forty-five patients who were treated for disruption of the deltoid ligament and a distal fibular fracture. The length of follow-up in our series was twelve to twenty-four months, with an average of fifteen months. When the fibular fracture was adequately reduced and medial clear space was returned to its normal width, the 91 percents both of patients of being treated with repair of deltoid ligament and patients of being treated without repair had a good or excellent results.
Clinical Study ; Fibula ; Follow-Up Studies ; Humans ; Ligaments ; Rupture

Benign solitary osteochondroma are the most common benign bone tumor, and often arise in the long bone of the extremities about 80% of lesions, particulary about the knee and the upper extremity. In rare cases, the spine is involved. We describe a case in which a solitary sacral osteochondroma compressed the lumbosacral plexus, producing sensory disturbance. The tumor was removed through the anterior midline approach. The excised mass was round, lobulated, measuring 7. 5cm×6cm, pedunculated type and the cartilage cap is complete and is 4mm in thickness.
Cartilage ; Extremities ; Knee ; Lumbosacral Plexus ; Osteochondroma ; Sacrum ; Spine ; Upper Extremity

Synovial sarcoma is a distinct and generally recognized soft tissue tumor that it’s origin still raises controversy. The synovial origin of synovial sarcoma has not been determined despite the accepted terminology implying synovium as stem cell. Three cases of primary synovial sarcoma (2 fibrous monophasic, 1 biphasic type) were studied with a panel of antibodies against different types of cytokeratin and other markers (EMA, CEA, vimentin, S-100 protein, lysozyme, 1-antichymotrypsin). Spindle shaped-cell in monophasic synovial sarcoma showed reactivity for CK7 and pancytokeratin. Epithelial cells lining of glands in biphasic synovial sarcoma reactive for CK7, pancytokeratin, EMA, and focally CEA but spindle cells only positive for vimentin. By electron microscopy, fibrous monophasic synovial sarcoma showed pseudogland formation with intercellular junctions of paired subplasmalemmal destiny and discontinuous basal lamina. These results indicate that synovial sarcoma showes epithelial differentiation. We believe that synovial sarcoma arises in pluripotential connective tissue cells that is able to be differentiated into both mesenchymal and epithelial components. So, synovial sarcoma have been considered carcinosarcoma of soft tissues depending on the type of differentiation.
Antibodies ; Basement Membrane ; Carcinosarcoma ; Connective Tissue Cells ; Epithelial Cells ; Immunohistochemistry ; Intercellular Junctions ; Keratins ; Microscopy, Electron ; Muramidase ; S100 Proteins ; Sarcoma, Synovial ; Stem Cells ; Synovial Membrane ; Vimentin

A large body of evidence indicates that Helicobacter pylori is involved in the pathogenesis of chronic gastritis and peptic ulcers. Several techniques are currently used for detecting H. pylori. Recently the immunohistochemical method was introduced for rapid detection of H. pylori. To compare the result of the immunohistochemical method with those obtained by microbiologic methods, we glean formalin fixed, paraffin embbeded gastric and duodenal biopsy specimens from 85 patients with upper gastrointestinal symptoms. We set fifty cases which H. pylori was cultivated and identified by Gram stain as Group I, and thirty-five cases without H. pylori in Gram stain and culture as Group II. The results were as follows. 1) The sensitivity and the specificity of immunohistochemical method were 94% and 80% compared with the microbiologic method. Positive and negative predictive value of the immunohistochemical method were respectively 87% and 90%. However, in seven cases of Group II, H. pylori were identified by immunohistichemical method. 2) Immunohistochemical staining exhibited bacteria that were present in the mucus layer, the surface of the gastric mucosa and metaplastic gastric epithelium in duodenum. With reference to the distribution and density of H. pylori in Group I and II, a significant correlation existed between microbiologic results and bacterial load of the biopsy specimen (p<0.01). 3) Chronic inflammation of gastric biopsies were seen in all 45 H. pylori-positive cases(100%) and 16 out of 19 H. pylori-negative cases(84%). The degree of chronic inflammation was more severe in positive cases than negative cases. Activity of inflammation was seen 98% of H. pylori-positive cases and 16% of H. pylori-negative cases. Intestinal metaplasia was seen 40% of H. pylori-positive cases and 58% of H. pylori-negative cases. Lymphoid follicles and aggregates were seen in 47%(27 cases) of H. pylori-positive cases. Among 47%, cases with lymphoid follicles were 9%(4 cases) and cases with lymphoid aggregates were 38%(17 cases). In H. pylori-negative cases, lymphoid follicles and aggregates were seen in 16%(3 cases). It is possible to obtain samples from most of the individuals who underwent the endoscopy in Korea. And this method is simple, rapid and sensitive. We conclude that the immunohistochemical method is another useful diagnostic tool for detection of Helicobacter pylori.
Predictive Value of Tests ; Biopsy

Surface ECG findings in 29 patients with left isomerism were reviewed. Among the total 46 wave axis distributions, 25(54%) were abnormal axis, not originated from sinus node. Congenital atrioventricular block was found in 2 children. 6 patients showed the bradycardia and junctional escape rhythm intermittently or persistently. 4 of them, not related with heart surgery, were much older than 2 patients who showed these ECG findings after heart surgery. These ECG findings suggested the possibility of occurrence of sinus node or subsidiary pacemaker dysfunction in the patients with left isomerism, especially in the older patients. So we thought that electrophysiologic evaluation is necessary in some patients with left isomerism.
Atrioventricular Block ; Axis, Cervical Vertebra ; Bradycardia ; Child ; Electrocardiography* ; Humans ; Isomerism* ; Sinoatrial Node ; Thoracic Surgery ; United Nations

No abstract available.
Humans

We report a rare case of primary glomerular disease with both features of IgA nephropathy and membranous glomerulonephritis in a 27 year-old woman with nephrotic syndrome. Histologically, glomeruli showed slight mesangial expansion, proliferation of mesangial cells, and short subepithelial spikes on capillary wall. Direct immunofluorescence demonstrated granular IgG and C3 deposits along the capillary walls, and IgA with C3 deposits in mesangium. Granular subepithelial and rnesangial deposits were observed by electron microscopy. The patient showed complete remission after 6 months therapy with steroid and ACE inhibitor.
Adult ; Capillaries ; Female ; Fluorescent Antibody Technique, Direct ; Glomerulonephritis, IGA* ; Glomerulonephritis, Membranous* ; Humans ; Immunoglobulin A* ; Immunoglobulin G ; Mesangial Cells ; Microscopy, Electron ; Nephrotic Syndrome

The ideal breast reduction should create beautiful breasts with limited scars. Unfortunately, no surgeon has ever been able to produce such a result. Most recent breast reduction techniques tend to produce minimal breast scars and avoid the classic inverted-T incision. The vertical mammaplasty can be used in mild to moderate cases of breast reduction, producing consistently good, stable results with limited scars. This technique uses adjustable preoperative markings, an upper pedicle for the areola, and a central breast reduction with limited skin undermining. The shape of the breast is created by suturing of the gland and does not rely on the skin. The adjunctive use of liposuction in fatty breasts can be considered safe and efficient. We have performed reduction mammaplasty using the vertical mammaplasty technique in 12 patients. Overall number and extent of complications were small, and patient satisfaction was high for this procedures. The advantages of vertical mammaplasty technique compared with other methods are as follows ; 1. The markings are adjustable to nearly all patients. 2. Stable contours are produced because the gland is strongly sutured. 3. Few postoperative complications occur. 4. Limited scars(only vertical scars) are created 5. The procedure is easy to learn and perform.
Breast ; Cicatrix ; Female ; Humans ; Lipectomy ; Mammaplasty* ; Patient Satisfaction ; Postoperative Complications ; Skin

Two cases of vaginal injury due to Coitus are presented. One is the case of the laceration of midportion of posterior vaginal wall with shock and the other one in the laceration of posterior vaginal fornix and pelvic peritoneum. They are all in multiparity. And a review of literature on vaginal injury due to coitus is made briefly.
Coitus* ; Female ; Lacerations ; Parity ; Peritoneum ; Shock