Together with review of literatures, authors reported a case of fatigue fracture of right 3rd metatarsal bone in an A-K amputee of lefe side, and added an amputation of contralateral lower extremity as a predisposing factor of fatigue fracture of metatarsal bone.
Amputation ; Amputees ; Causality ; Fatigue ; Fractures, Stress ; Humans ; Lower Extremity ; Metatarsal Bones

Isolated dorsal dislocation of the trapezoid is an unusual injury. In 1990 Ostroski found only 15 cases of dorsal dislocation of the trapezoid in the world literature. The trapezoid is a wedge-shaped bone with the larger dorsal and smaller volar surface area, and stabilized by strong palmar ligaments. Therefore the dislocation of the trapezoid is produced hy a violent force against the dorsum of the hand on a rigid object and often associated with other injuries of the hand. The diagnosis is often missed or delayed perhaps secondary to the difficulty in interpreting the X-ray if you have not kept in mind. Several therapeutic modalities are performed from the collected experience of the authors reporting this injury. A rare example of an isolated dorsal dislocation of the trapezoid bone is described.
Diagnosis ; Dislocations* ; Hand ; Ligaments ; Trapezoid Bone

It has been known that osseous stability of the hip is dependent upon the inclination, anteversion and depth of acetabulum and also upon neck-shaft angle and anteversion of femur. Acetabulum enlarges from two different growth centers; one from the concave articular surface cartilage and the other from the triradiate cartilage. The former contributes primarily to the thickness of acetabular wall, where as, the latter to the central enlargement of the acetabular socket. Additionally the shape of acetabulum can be changed by deformity of the femoral head and neck, which can be explained by Wolff's and Hueter-Volkmann's laws. Yet there are still many factors to be clarified by clinical researchers in the future Authors in this experiment tried to clarify the role of triradiate cartilage and greater trochanteric growth plate upon the development of acetabulum. The material used for this study consiated of 30 rabbits of both sexes, aged 8 weeks. Animals were divided into 3 groups, and each group consisted of 10 rabbits In group I. hip was not injured and used as a Control: in group II, right greater trochanter with its growth plate was destructed completely; in group III, triradiate cartilage of right side was destructed. Subsequent to injury of Y cartilage ot greater trochanter with its growth plate, radiographs of the pelvis including hips were obtained weekly on each rabbit over 6 weeks period. and to evaluate the effect of injury upon the hip development acetatular angle, C-E angle, and acetabular depth and width were measured. The following results were obtained; 1. The shape of acetabulum of rabbits have showe remarable developmental changes until the 10 weeks of age after birth, but the changes became less remarkable by age of the 14 weeks. Thereafter it remained unchanged. 2. In group II, at the age of 14 weeks, compared with the values of the normal hip, the acetabular angle showed an increase of 1.9 degrees, and the center dege angle and acetabular depth showed a decrease of 3.21 degrees and 0.43mm respectirely. 3. In group III, at the age of 14 weeks, compared with the values of the normal hip, the acetabular angle increased by 18.9 degress while the center-edge angle decreased by 22.8 degrees. The acetabular depth showed a decrease of 1.81mm and the acetabular width showed an increase of 0.73mm. These observations suggest that the development of acetabulum depends largely upon the growth of triradiate cartilage, and also is affected secondarily by valgalization of femoral neck which is resulted by destruction of greater trochanteric growth cartilage.
Acetabulum ; Animals ; Cartilage ; Congenital Abnormalities ; Femur Neck ; Femur ; Growth Plate ; Head ; Hip ; Jurisprudence ; Neck ; Parturition ; Pelvis ; Rabbits

Cytokines are produced during the effector phases of natural and specific immunity and serve to mediate and regulate immune and inflammatory responses. In natural immunity,endotoxin directly stimulates mononuclear phagocytes to secrete their cytokines and cytokines which were produced by one cell type often regulate the synthesis of cytokined by other cells. To gain effects on the role of pro-inflammatoy cytokines(TNF, IL-1, IL-6) in the endotoxin induced uveitis, author investigated the cell counts of infilterating inflammatory cells, IL-6 bioassay in aqueous humor, mRNA analysis in the transgenic endotoxin induced uveitic mice(TNF-R(-), IL-1R(-), TNF-R(-)/IL-1R(-)). In this study, there was no significant difference in the number of infiltering cells in TNF-R(-) mice compared to congenic controls, but significant diffetence in the unmber of infiltering cells was found in IL-1R(-) and TNF-R(-)/IL-1R(-) mice. IL-6(-) levels in aqueous humor were reduced in IL-1R(-) and TNF-R(-)/IL-1R(-) mice. TNF-alpha, IL-1alpha, IL-6 mRNA were detected in all experimental mice after endotoxin injection. IL-1alpha and IL-1Ralpha mRNA were detected in noninjected TNR-R(-) mice. IL-1beta mRNA was not detected in all experimental mice without or with endotoxin injection. In conlclusion, IL-1 appears to have a more important role in endotoxin induced uveits than TNF. Though IL-6 is detected in endotoxin induced uveitis, it is not an indicator for the enhenceing inflammation and may not be essential for the endotoxin induced uveitis.
Animals ; Aqueous Humor ; Biological Assay ; Cell Count ; Cytokines* ; Inflammation ; Interleukin-1 ; Interleukin-6 ; Mice ; Phagocytes ; RNA, Messenger ; Tumor Necrosis Factor-alpha ; Uveitis*

PURPOSE: To evaluate the usefulness and safety of unified technique of vascular control before renal exposure in reconstructive surgery of renal trauma. MATERIALS AND METHODS: From July 1995 to June 1997, 10 patients with major renal trauma who operated by unified approach technique were included in this study. Blunt trauma was the mechanism of injury in 8 patients and 2 were resulted from penetrating(stab) injury. Of the injuries 2 were grade 3, 7 grade 4, 1 grade 5. RESULTS: Of the 10 patients, 8(80%) were performed kidney preserving surgery and 2(20%) resulted in nephrectomy. Partial nephrectomy was underwent in 6 patients(with vascular repair in 2 cases) and renorrhaphy in 2 patients. Pedicle flap of omentum was used mainly and polyglycolic acid mesh also used in 2 cases as coverage material of parenchymal defect. Complications occurred in 2 cases(20%) but none resulted in renal loss with the mean followup of 10 months(1 to 15 months). CONCLUSIONS: Unified approach technique of vascular control before renal exposure seems to be a safe and effective method for reconstructive surgery in renal trauma. To confirm this result, studies with more cases and longer followup are needed.
Follow-Up Studies ; Humans ; Kidney* ; Nephrectomy ; Omentum ; Polyglycolic Acid

No abstract available.
Myelitis, Transverse*

BACKGROUND: Antihypertensive effect and safety of the newer, long acting, nonsulfhydryl angiotensin converting enzyme inhibitor, lisinopril, were studied. METHODS: Twenty eight patients of mild to moderate essential hypertension were administered 10-20mg of lisinopril once daily for ten weeks. Patients were evaluated every two weeks concerning the changes of blood pressure and pulse rate in the sitting position and also any untoward sumptoms and signs attributable to the side effect. Chest X-rey, ECG and laboratory examination were performed in principle two times before and after the completion of medication. RESULTS: The blood pressure declined from 165.4/107.6mmHg to 141.3/92.4mmHg at the end of ten weeks of medication, thus the reduction of 24.1mmHg of systolic pressure and 15.2mmHg of diastolic pressure were observed and the overall effective rate was 85.7%. The pulse rate and laboratory findings were not sigificantly changed before and after the administration of lisinopril. The side effects were observed in 2 cases(7.1%) of mild dry cough and in 2 cases(7.1%) of transitory mild headache and in 1 case(3.6%) of dizziness but no one discontinued medication due to adverse effects. CONCLUSION: Lisinopril proved effective and safe in the treatment of mild to moderate essential hypertension.
Blood Pressure ; Cough ; Dizziness ; Electrocardiography ; Headache ; Heart Rate ; Humans ; Hypertension* ; Lisinopril* ; Peptidyl-Dipeptidase A ; Thorax

No abstract available.
Child* ; Endoscopy* ; Gastrointestinal Diseases* ; Humans

A case of carcinoma of the parathyroid gland causing hyperparathyroidism was experienced at the department of orthopaedic surgery, C.A.F.G.H. This patient, a 23 years old male, had complained of a left shoulder pain during the past 3months. And weakness of the lower extremities causing walking disturbance, multiple bone pain, and polyuria had occurred sinoe one month before admission. Physical examination revealed a hard palpable mass in the right anterior region of the neck. Radiologic examination revealed subperiosteal bone resorption in phalanges of the hands and feet, generalized osteoporosis and cystic lesions, and pathologic fracture of the ribs, left humerus, and left femur. Laboratory studies demonstrated hypercalcemia, hypophosphatemia, increased alkaline phosphatase and PTH, hypercalciuria, and hyperphophaturia. Sonogram and C-T scan of the neck revealed a mass in the right inferior portion of the thyroid. Rib biopsy revealed the findings of ostitis fibrosa cystica, and parathyroid gland and regional lymph node biopsy revealed a parathyroid carcinoma with regional lymph node metastasis.
Alkaline Phosphatase ; Biopsy ; Bone Resorption ; Femur ; Foot ; Fractures, Spontaneous ; Hand ; Humans ; Humerus ; Hypercalcemia ; Hypercalciuria ; Hyperparathyroidism ; Hypophosphatemia ; Lower Extremity ; Lymph Nodes ; Male ; Neck ; Neoplasm Metastasis ; Osteoporosis ; Parathyroid Glands ; Parathyroid Neoplasms ; Physical Examination ; Polyuria ; Ribs ; Shoulder Pain ; Thyroid Gland ; Walking

The recent introduction of chemotherapy in the treatment of the gynecologic malignancies has gained wide acceptance along with preoperative and postoperative adjuvant therapy and with preradiation and concurrent chemoradiaton therapy. But, the side effects of chemotherapy including bleeding and infection due to bone marrow suppression have resulted in increased morbidity and mortality of the patients and delayed treatment and a reduction in the chemotherapeutic agents used. In spite of the development of antibiotics and the supportive care of infection, sustained leukopenia in the patients during chemotherapy accounts for the high mortality rate due to sepsis. The early detection of the leukopenia during chemotherapy may enable clinicians to overcome infection problems by timely use of prophylactic broad spectrum antibiotics and G-CSF or GM-CSF. The author investigated the grade, duration, time of onset and other clinical features of the leukopenia and the effects of the age (> or =60 years vs <60 years), the number of the cycle of chemotherapy (> or =3 cycles vs < 3 cycles), fever and performance scale on the leukopenia. 79 cases (32 patients) of the leukopenia during chemotherapy of various gynecologic malignancies at the Department of Obstetrics and Gynecology at Hanyang University between January, 1996 and December, 1998 entered to this study. The results were as follows; 1. Leukopenia occurred at 14.2+/-6.1 day from the first day of chemotherapy, 2. The duration of leukopenia was 2.5+/-1.6 days 3. No significant difference was found between eldely patients ( > or =60 years, n=13) and younger patients ( <60 years, n=66) about the severity, duration and time of onset of leukopenia. 4. No significant difference was found between the patients with more than 3 cycles of chemotherapy (n=40) and less than 3 cycles (n=39) about the severity, duration and time of onset of leukopenia. 5. Febrile leukopenic cases (n=6) had significantly lower granulocyte count, longer leukopenic period and earlier onset of leukopenia than afebrile (n=73). 6. It is thought that performance status scale does not affect the grade of leukopenia, onset of leukopenia and the leukopenic period.
Anti-Bacterial Agents ; Bone Marrow ; Drug Therapy* ; Fever ; Granulocyte Colony-Stimulating Factor ; Granulocyte-Macrophage Colony-Stimulating Factor ; Granulocytes ; Gynecology ; Hemorrhage ; Humans ; Leukopenia* ; Mortality ; Obstetrics ; Sepsis