Polydactyly is one of the most common congenital anomalies of the limb, however its surgical treatment varies from simple excision to reconstruction. The purpose of this study is to present out classification of polydactyly in which the type of surgery was concerned primarily. Two hundred and thirty five digits(134 fingers and 101 toes) in 188 patients were operated from 1980 to 1992. We divided the polydactyly into two types-the simple type, in which the extradigit arises from only one digit, and the complex type in which the extradigit connects more than two adjacent main digits. The simple type was subdivided into joint type(type I), in that the extradigit has its own joint in its origine; epiphyseal type(type II), the extradigit share common epiphysis with main digit; and hypoplastic type(type III), the extradigit is connected only by soft tissue to the main digit. The epiphyseal type(type II) was further divided into subtype A(type IIA), in that the origin seems to be directly derived from the epiphysis; and subtype B(type IIB), which resemble an osteochondroma. Type III and type IIB can be treated by simple excision, however the type I and type IIB can be treated by arthroplasty with or without osteotomy as well as excision of extradigit. Result of surgical treatment in 1 digit of the simple form, which siginifies the extradigit arising from only one digit, are good in 193 digits(91%), fair 14(6.6%), and poor 5(2.4%) after an average follow-up period of 20 months. Our principles in the surgical treatment of polydactyly was treatment according to the type, and early treatment.
Arthroplasty ; Classification ; Epiphyses ; Extremities ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Osteochondroma ; Osteotomy ; Polydactyly

Experimental findings have suggested that the metabolic activities of articular cartilage can be influenced by mechanical stimuli. Our recent mathematical analysis predicted that cyclic compressive loading may create periods of intermittent negative hydrostatic pressure within the cartilage extracellular matrix. Therefore, we hypothesize that intermittent negative hydrostatic pressure, created in the cartilage extracellular matrix during dynamic compression, has a stimulative effect on the biosynthesis of chondrocytes. In order to test this hypothesis, the present study developed a custom designed negative pressure generator to subject a monolayer culture of chondrocytes to an intermittent negative pressure. It was found that the intermittent negative pressure produced a 40% increase in proteoglycan and a l7% increase in non-collagenous protein synthesis during the pressurization period(p (0.05). The collagenous protein synthesis was not affected by the intermittent negative pressure regimen used in this study. After the intermittent negative pressurization, the metabolic activities of the chondrocytes returned to normal(control level). The intermittent negative pressure also produced an increase in the mRNA signals for aggrecan. Therefore, we conclude that intermittent negative pressure may be one of the major mechanical stimulators of chondrocytes in articular cartilage during dynamic compression.
Aggrecans ; Cartilage ; Cartilage, Articular ; Chondrocytes* ; Collagen ; Extracellular Matrix ; Hydrostatic Pressure* ; Metabolism* ; Proteoglycans ; RNA, Messenger

No abstract available.
Congenital Abnormalities*

Spontaneous testicular hemorrhagic necrosis is a rare disease usually associated with testicular torsion. Partially involved and suspicious testis tumor cases are also defined from orchiectomy specimens. Herein, a spontaneous hemorrhagic necrosis, without any testicular torsion, but with involvement of the whole testicle and epididymis, is reported. A 21 year old patient, who presented with a painless left testicular enlargement of several days duration was believed, based on physical examination, ultrasonography and elevation of serum LDH, to have a testicular tumor. Diagnosis was made only after radical orchiectomy and histopathological examination.
Diagnosis ; Epididymis ; Hemorrhage ; Humans ; Male ; Necrosis* ; Orchiectomy ; Physical Examination ; Rare Diseases ; Spermatic Cord Torsion ; Testis* ; Ultrasonography ; Young Adult

No abstract available.

Venous hemangioma is a vascular tumor that has been reported by such diverse names as; "cirsoid aneurysm", "arteriovenous hemangioma", "acral arteriovenous tumor" according to the author's opinions of its origin and histopathologic classification. It is benign and rarely biopsied, and it is also rarely reported in dermatology literature. We present two cases of venous hemangioma. The first case was a 64-year-old man who was presented with an elliptical dark-red plaque with overlying several grouped papules on the left periorbital area which had been present for 7 years. The second case was a 56-year-old man who was presented with a single red papule on the right postauricular area which had been present for 4 months. Histopathologically, there were a well-circumscribed proliferation of thick-walled muscle-containing blood vessels in the dermis. Intermingled with the thick-walled blood vessels, there were also thin-walled dilated blood vessels. In both cases, the thick-walled blood vessels resembled arteries, but they lacked elastic fibers on the Verhoeff van Gieson stain.
Arteries ; Blood Vessels ; Classification ; Dermatology ; Dermis ; Elastic Tissue ; Hemangioma* ; Humans ; Middle Aged

Seven patients with average age of 15years and 6 months (range: 8 years and 11 months 25 years and 6 months) underwent forearm lengthening by callotasis. The indications for lengthening were shortening and/or deformity of the forearm due to exostosis of the distal ulna in three cases, growth disturbance due to physeal injury of the distal radius in three, congenital radial dislocation in one. Three had lengthening of the radius, three of the ulna and one of both the radius and the ulna. The average lengthening achieved was 3.8 cm (3.5 - 4.0) in radius, 2.7 cm (2.3 - 3.0) in ulna. Complications encountered were pin tract infection in two cases, nonunion in one and temporary nerve palsy in one. All of these complications were recovered completely without any residua. Retrospective review after average 41 months of follow-up (range: 36 to 78) showed satisfactory improvement in appearance and function. Callotasis was considered as one of the safe and reliable treatment methods for bone lengthening and deformity correction of the forearm.
Bone Lengthening ; Congenital Abnormalities* ; Dislocations ; Exostoses ; Follow-Up Studies ; Forearm* ; Humans ; Osteogenesis, Distraction* ; Paralysis ; Radius ; Retrospective Studies ; Ulna

Between 1984 and 1996, 8 patients who were suffered from stage g Kienbock's disease underwent interpositional arthroplasty using pronator quadratus pedicled bone. Patients comprised 2 males and 6 females, with an average age of 33 years(range 19-47). Range of motion of the wrist, residual pain, grip strength, and carpal height ratio of the patients were analyzed. The follow-up period was between 1.5 years and 12.5 years(average 5.5 years). The arc of flexion-extension of the wrist was increased from average 74 degrees preoperatively to 96 degrees postoperatively. Among eight patients, five were free of pain and three had intermittent pain during heavy work. None of eight patients had any discomfort in daily work and changed his or her occupation. The grip strength was average 83% of the normal side. Carpal height ratio was average 0.48 preoperatively and was not changed postoperatively. Clinical results, assessed by Lichtman-Evans criteria, showed 4 good and 4 fair. The interpositional arthroplasty using pronator quadratus pedicled bone was considered as a very effective method for the treatment of stage III Kienbock's disease.
Arthroplasty* ; Female ; Follow-Up Studies ; Hand Strength ; Humans ; Male ; Occupations ; Osteonecrosis* ; Range of Motion, Articular ; Wrist

OBJECTIVE: The purpose of this study is to evaluate the efficacy of ferritin-folate-cyanocobalamin supplementation for prevention of anemia during pregnancy. METHODS: The authors conducted a clinical investigation on 50 pregnant women from 20th to 36th gestational weeks. The cobination of cyanocobalamin coenzyme 500mg, folic coenzyme 800mcg, and ferritin 20mg constituted the supplementation. The parameters examined in first trimester as baseline, before treatment(at 20th weeks), and after treatment(at 36th weeks) were : hemoglobin, hematocrit, ferritin, mean corpuscular hemoglobin(MCH), mean corpuscular hemoglobin concentration(MCHC), mean corpuscular volume(MCV), red blood cell count(RDW), folic acid, and vit. BPaired sample t-test was used for comparison. RESULTS: The results indicated a significant increase in the value of hemoglobin(p<0.05) and hematocrit(p<0.01) in comparison to before and after the treatment. The values of serum ferritin, folic acid, vitamin Bwere increased after the treatment compared to those of before the treatment, though there was no statistical significance. The results of MCV, MCH, MCHC, and RDW showed no statistically significant in comparison to before and after the treatment. CONCLUSIONS: These data indicate that supplementing ferritin 20mg-folate 800mcg-cyanocobalamine 500mcg per day from 20th to 36th weeks' gestation can increase values of hemoglobin, hematocrit, and ferritin concentration and can be cosidered as an appropriate method to prevent iron deficient anemia. It also might increase the value of folic acid and vitamin B12, concentration, but further study is stiU needed to determine whether the supplementation of folate and cyanocobalamine in combination with iron can have better eflicacy than iron alone in prevention of iron deficiency anemia.
Anemia* ; Anemia, Iron-Deficiency ; Erythrocyte Indices ; Erythrocytes ; Female ; Ferritins* ; Folic Acid* ; Hematocrit ; Humans ; Iron ; Pregnancy Trimester, First ; Pregnancy* ; Pregnant Women ; Vitamin B 12* ; Vitamins

BACKGROUND: The aim of this study was to evaluate the contribution of the proximal nerve stump, in end-to-side nerve repair, to functional recovery, by modifying the classic end-to-side neurorrhaphy and suturing the proximal nerve stump to a donor nerve in a rat model of a severed median nerve. METHODS: Three experimental groups were studied: a modified end-to-side neurorrhaphy with suturing of the proximal nerve stump (double end-to-side neurorrhaphy, Group I), a classic end-to-side neurorrhaphy (Group II) and a control group without neurorrhaphy (Group III). Twenty weeks after surgery, grasping testing, muscle contractility testing, and histological studies were performed. RESULTS: The grasping strength, muscle contraction force and nerve fiber count were significantly higher in group I than in group II, and there was no evidence of nerve recovery in group III. CONCLUSIONS: The contribution from the proximal nerve stump in double end-to-side nerve repair might improve axonal sprouting from the donor nerve and help achieve a better functional recovery in an end-to-side coaptation model.
Anastomosis, Surgical/methods ; Animals ; Axons/pathology ; Forelimb ; Hand Strength ; Male ; Median Nerve/pathology/*surgery ; Muscle Contraction ; Muscle, Skeletal/physiopathology ; Nerve Regeneration ; Nerve Transfer/*methods ; Rats ; Rats, Sprague-Dawley ; Recovery of Function ; Ulnar Nerve/pathology/*surgery