Fractures of the distal radius are one of the most common injuries met in the orthopedic field. Once it was thought that good function comes despite of poor anatomic restoration in the distal radius fractures. But now there are wide consensus that more aggressive surgical treatments are needed in such complex fractures to fulfill the better clinical results. We reviewed 56 consecutive distal radius fractures of 54 patients treated surgically in Orthopedic Department of Asan Medical Center between October 1989 and July 1994. The mean length of follow-up was 29.2 months. Clinical end results were statistically analyzed according to each anatomi- cal variables and state of distal ulna, and anatomies and results were analyzed according to different surgical modalities in each fracture classes. Radial length and radial inclination was significantly correlated with clinical results. The clinical results were significantly worse when dorsal tilt exceeded 10. In intraarticular type of fractures, residual articular incongruency seems to be the significantly affecting factor of development of arthritis and the clinical result. The associated fracture of distal end of the ulna did not significantly affect the result. In same type of fracture class, achievement and loss of reduction, arthritis, and Demerit score show no significant differences between groups of different surgical modalities. Probably this is due to proper choice of modalities in each different situations.
Arthritis ; Chungcheongnam-do ; Consensus ; Follow-Up Studies ; Humans ; Orthopedics ; Radius Fractures ; Radius ; Ulna

Periosteal chondroma is a slowly growing cartilage tumor of limited size, which develops within and beneath the periosteal connective tissue and characteristically erodes and induces sclerosis of the contiguous cortical bone. The typical morphology of this tumor consists of an area of outer cortex scalloping involving the metaphyseal lesion of a long bone with slightly overhanging edges and a small amount of cartilage calcified matrix adjacent to the scalloping. Histologically this benign tumor can mimic chondrosarcoma. Awareness of this fact is important in order to avoid overdiagnosis and resultant overtreatment of the benign lesion. We report three cases of periosteal chondromas arising in the phalangeal bones of the hand. All were treated by curettage. No local recurrence was seen following this treatment.
Cartilage ; Chondroma ; Chondrosarcoma ; Connective Tissue ; Curettage ; Cytochrome P-450 CYP1A1 ; Hand ; Medical Overuse ; Pectinidae ; Recurrence ; Sclerosis

Ameloblastic fibrosarcoma is an extremely rare variety of odontogenic tumor. It has not previously been reported in Korea. The tumor is composed of benign odontogenic epithelium with a mesenchymal part which exhibits the histologic features of fibrosarcoma. We have reported a case of amloblastic fibrosarcoma of the mandible in a 26-year-old man with swelling of right mandible for 2 weeks. The tumor showed yellowish ill-demarcated ulcerating mass involving right premolar and molar area. Light microscopy revealed irregularly arranged strands and islands of odontogenic epithelium surrounded by abundant mesenchymal tissue with the feature of fibrosarcoma. The fibrosarcoma cells were strong positive on immunostain for vimentin and ameloblastic cells were weakly positive for cytokeratin. S-100 and CEA were negative in both epithelial and sarcoma cells. The sarcoma cells were corresponding to fibroblasts on the electron microscopy with abundancy of RER and mitochondria and covering of basal lamina. Two types of virus like particles were distributed in the cytoplasm and nuclei of sarcoma cells. We treated the patient with surgery and chemotherapy. The recovery was uneventful and the prognosis is under observation.
Male ; Humans

No abstract available.
Glycemic Index ; Humans

From 1981 to 1993, one hundred and thirty eight patients had been treated by free flap or island flap, for the tissue defects of the extremities. Among these 138 patients, vascularized bone graft was 29 cases, soft tissue free flap 40, replantation 22, local island flap 45, and lymphovenous shunt 2. Average age at the time of operation was 27 years(1-66 years), and men were 110, women 28. Average duration of follow-up was 2 years and 8 months(4 months-11 years and 8 months). Twenty nine cases of vascularized bone graft was consisted of fibular graft in 15 patients, ilium 8, joint transplantation 4, thumb reconstruction using big toe 1, and rib 1. Four of them were failed. Among 40 patients of soft tissue free flap, latissimus dorsi flap was 12 cases, dorsalis pedis flap 11, scapular flap 8, wraparound procedure 7 and gracilis flap 2. Seven of them were failed. The levels of replantations were both lower extremities in one patient, leg 1, arm 2, distal forearm 2, and finger(s) 16. In six patients, replantation was nor successful. Among 45 patients of local island flap, lateral supramalleolar island flap was performed in 8 patients, dorsalis pedis flap 2, Chinese flap 10, reverse ulnar artery flap 4, reverse posterior interosseous artery flap 3, neurovascular island flaps for fingers 14, and others 4. Two of them were failed. Two cases of lymphovenous shunt for the treatment of lymphedema were successful. As a whole, 119 cases were successful(86%) among 138 cases including local island flap 45 cases.
Arm ; Arteries ; Asian Continental Ancestry Group ; Extremities ; Female ; Fingers ; Follow-Up Studies ; Forearm ; Free Tissue Flaps ; Hallux ; Humans ; Ilium ; Joints ; Leg ; Lower Extremity ; Lymphedema ; Male ; Replantation ; Ribs ; Superficial Back Muscles ; Surgical Flaps ; Thumb ; Transplants ; Ulnar Artery

PURPOSE: The aim of this study is to examine whether conventional primary closure of the bile duct without routinely inserting a T-tube could be performed after all the surgeries used to treat choldocholithiasis. METHODS: From April 2002 to July 2005, we retrospectively analyzed 125 bile duct stone disease patients who underwent primary closure of the bile duct. RESULTS: Wound infection was the most frequent surgical complications, and it showed a higher trend in the patients who had a history of previous biliary operation, and it showed a trend to be slightly higher in the recurrent biliary stone cases than that in the de novo cases. However, these findings were not statistically significant. In addition, surgical complications developed in 16 of 100 patients who were older that 60 years, whereas there was only 1 of 25 patients who developed complications for the patients younger than 60 years. The development of complications has a tendency to be higher for the older patients, yet the level was not statistically significant. In regard to postsurgical hyperamylasemia, although a statistically significant difference could not be detected, this malady developed in 3 of 12 cases in whom endoscopic nasobiliary drainage (ENBD) tubes were inserted. This showed a trend to be higher than that for 13 cases of 113 patients for whom endoscopic nasobiliary drainage tubes were not inserted. Concerning the postsurgical hospitalization period, it was significantly longer in the cases who developed complications (p=0.018), and there was a tendency for a prolonged hospitalization period for the patients who were older than 60 years, for women, recurrent cases and the cases with a history of the bile duct surgery. Yet these had no statistical significance CONCLUSION: It appears that the primary closure of bile duct is a technique that could be performed safely for all choledocolithotomy patients , and this is regardless of the size of bile duct diameter, history of surgery on the bile duct system, gender, emergency operation, age, recurrent biliary stones, the presence of presurgical nasobiliary drainage tube and the presence of concomitant diseases.
Bile Ducts* ; Bile* ; Choledocholithiasis ; Drainage ; Emergencies ; Female ; Hospitalization ; Humans ; Hyperamylasemia ; Length of Stay ; Retrospective Studies ; Wound Infection

OBJECTIVE: The purpose of this study was to determine the optimal volume of injected cement and its distribution when used to treat vertebral compression fractures, and to identify factors related to subsequent vertebral fractures. METHODS: A retrospective analysis of newly developing vertebral fractures after percutaneous vertebroplasty was done. The inclusion criteria were that the fracture was a single first onset fracture with exclusion of pathologic fractures. Forty-three patients were included in the study with a minimum follow up period of six months. Patients were dichotomized for the analysis by volume of cement, initial vertebral height loss, bone marrow density, and endplate-to-endplate cement augmentation. RESULTS: None of the four study variables was found to be significantly associated with the occurrence of a subsequent vertebral compression fracture. In particular, and injected cement volume of more or less that 3.5 cc was not associated with occurrence (p = 0.2523). No relation was observed between initial vertebral height loss and bone marrow density (p = 0.1652, 0.2064). Furthermore, endplate-to-endplate cement augmentation was also not found to be significantly associated with a subsequent fracture (p = 0.2860) by Fisher's exact test. CONCLUSION: Neither volume of cement, initial vertebral height loss, bone marrow density, or endplate-to-endplate cement augmentation was found to be significantly related to the occurrence of a subsequent vertebral compression fracture. Our findings suggest that as much cement as possible without causing leakage should be used.
Bone Marrow ; Follow-Up Studies ; Fractures, Compression ; Fractures, Spontaneous ; Humans ; Retrospective Studies ; Vertebroplasty

PURPOSE: The purpose of this study was to evaluate the safety and efficacy of intravenous patient-controlled analgesia (PCA) with fentanyl and ketorolac for postoperative pain management in patients with cerebral palsy. MATERIALS AND METHODS: Sixty patients were categorized based on operation complexity into either a minor operation group or a major operation group, and then subdivided based on the analgesic methods used, i.e., intravenous PCA with fentanyl and ketorolac or intravenous pethidine injection. Pain intensity was assessed using the Wong-Baker's faces pain scale. RESULTS: In the major operation group, patients that received PCA had significantly lower pain scores than those who received intravenous pethidine injection, while no significant differences in pain scores were observed in the minor operation group. Moreover, the side effects of these two analgesic methods did not differ significantly. CONCLUSION: Intravenous PCA with fentanyl and ketorolac is effective and safe for moderate to severe postoperative pain control in pediatric patients with cerebral palsy.
Analgesia, Patient-Controlled* ; Cerebral Palsy* ; Fentanyl ; Humans ; Ketorolac ; Meperidine ; Pain, Postoperative* ; Passive Cutaneous Anaphylaxis

Background: The adverse effects of particulate matter (PM) on the skin have been concerning recently. Objective: We investigated PM induced inflammation on barrier-interrupted skin and relieving effects of plant extracts on PM-induced skin irritation. Methods: A total of 20 participants were enrolled for the induction of skin irritation. Sodium lauryl sulfate (SLS) patch was affixed to the forearm for 24 hours. After patch removal, total suspended particulates (TSPs) were applied. After inducing skin irritation using SLS and TSP, cream containing 0.1% mixture of plant extracts (Citrus sunki, Sceptridium ternatum (Botrychium ternatum), and Korthalsella japonica) was applied. The a* value, erythema index (EI), and transepidermal water loss (TEWL) were measured. Results: The a* value was significantly higher at the site where TSPs were applied than that at the site where TSPs were not applied at 1 and 2 days after SLS patch removal. The a* value, EI, and TEWL were significantly low in the cream-applied area 7 days after the introduction of the SLS patch and TSPs. Conclusion PM induced skin irritation in a previously disrupted skin barrier. Topical application of plant extracts alleviated skin irritation symptoms caused by dust exposure.

Background: The adverse effects of particulate matter (PM) on the skin have been concerning recently. Objective: We investigated PM induced inflammation on barrier-interrupted skin and relieving effects of plant extracts on PM-induced skin irritation. Methods: A total of 20 participants were enrolled for the induction of skin irritation. Sodium lauryl sulfate (SLS) patch was affixed to the forearm for 24 hours. After patch removal, total suspended particulates (TSPs) were applied. After inducing skin irritation using SLS and TSP, cream containing 0.1% mixture of plant extracts (Citrus sunki, Sceptridium ternatum (Botrychium ternatum), and Korthalsella japonica) was applied. The a* value, erythema index (EI), and transepidermal water loss (TEWL) were measured. Results: The a* value was significantly higher at the site where TSPs were applied than that at the site where TSPs were not applied at 1 and 2 days after SLS patch removal. The a* value, EI, and TEWL were significantly low in the cream-applied area 7 days after the introduction of the SLS patch and TSPs. Conclusion PM induced skin irritation in a previously disrupted skin barrier. Topical application of plant extracts alleviated skin irritation symptoms caused by dust exposure.