Iatrogenic damage of the rotator cuff followed by postoperative shoulder function loss is a potential complication after antegrade intramedullary nailing (AIN) for a humeral fracture. The authors present a case of arthroscopic rotator cuff repair and subacromial decompression of a non-healed rotator cuff tendon (mainly supraspinatus) and secondary impingement syndrome caused either by the tear or a proud nail after AIN for a mid-shaft humeral fracture. At presentation, the patient complained of right shoulder pain and 'snapping', especially during forward elevation and abduction of the shoulder, of 4 years duration. Right shoulder pain started sometime after pain due to the humeral shaft fracture, operation had subsided, and persisted after nail removal. Arthroscopic findings showed a longitudinal rotator cuff tear at the nail entry point that had not healed and severe fibrous hypertrophy on the acromion underspace, which is a unique finding since most longitudinal splits of tendon fibers are more likely to heal than conventional rotator cuff tears detached from bone. The torn rotator cuff was repaired after debridement and placing side-to-side sutures. At his 34-month follow-up after rotator cuff repair, the patient showed complete recovery and had excellent clinical scores.
Acromion ; Arthroscopy ; Debridement ; Decompression ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Humans ; Humeral Fractures ; Hypertrophy ; Rotator Cuff ; Shoulder ; Shoulder Pain ; Sutures ; Tendons

Due to the great deal of effort that has gone into the study of osteoclastic differentiation and activation over the last few decades, the mechanisms of these two events have been discovered gradually. Nitric oxide(NO-), which is produced from arginine by a nitric oxide synthase, opened up a new area of biological research. Recently, it has been reported that NO- is produced by osteoblasts stimulated by lipopolysaccharide and several other cytokines. In this study, the effect of sodium nitroprusside(SNP), a donor of nitric oxide(NO-), on osteoclast-like cell formation and on mature osteoclast function was examined. To determine the mechanism of the inhibitory effects of SNP decreased not only the basal 45Ca release but also thee bone resorption induced by PTH and l,25-dihydroxyvitamin D3 (I ,25[OH]2D3). The inhibitory effect of SNP on bone resorption induced by PTH appeared 2 days after treatment, whereas SNP effect on inhibiting bone resorption induced by l,25[OH]2D3 appeared at the third days. When chicken and rat osteoclasts were cultured on dentin slices, treatment of 300micronM SNP resulted in a significant decrease in dentin resorption by osteoclasts in terms of total resorption area and average individual area. We also examined the effect of SNP on formation of osteoclast-like cells that is TRAP-positive multinucleated cells from chicken and rat bone marrow cells in the presence or absence of 10(-8)M l,25[OH]2D3. The addition of 300 micronM SNP inhibited the formation of TRAP-positive multinucleated cells. The present data suggest that SNP, possibly as a NO- donor, inhibits the osteoclastic differentiation and osteoclastic activity.
Animals ; Arginine ; Bone Marrow Cells ; Bone Resorption ; Chickens ; Cytokines ; Dentin ; Humans ; Nitric Oxide Synthase ; Nitroprusside* ; Osteoblasts ; Osteoclasts* ; Rats ; Sodium* ; Tissue Donors

Supracondylar fracture of the humerus is the most common fracture of the elbow in children and it can also be one of the most difficult fractures to be treated. A number of methods to manage supracondylar fracture of the humerus in children, have been being practiced and the ideal one is generally agreed with prompt, accurate and anatomical. reduction performed with the least possible trauma, and, it will prevent most complications. It is essential to minimize additional trauma to the already traumatized joint and pericapsular tissues including blood vessles and nerves. 105 patients with supracondylar fracture of the humerus managed at the Department of Orthopedic Surgery, Busan National University from January, 1971 to June, 1976 were reviewed and the following results were obtained. 1. The age of the patients ranged from 2 years to 14 years; the average age was 7. 0 year. 70 patients were boys. 2. The left side was involved in 62 patients; The distal fragment was displaced posterioly in 102 patients and anteriorly in 3 patients The medial displacement in the posteriorly displaced distal fragment was 60 patients. 3. 20 fractures were treated by open reduction and internal fixation. The indications for open reduction were failure to obtain accurate reduction after a few attempts of closed reduction in 15, an open fracture in 2, acute vascular embarrassment in 2, and redisplacement after open reduction in 1. 4. 15 of the 20 fractures treated by open reduction were re-examine 1 to 5 years; The results were normal elbow motion in 10, loss of extension (average 24 degree) in 5, loss of flexion in 2 and neuro-vascular complication in 2.
Busan ; Child ; Elbow ; Fractures, Open ; Humans ; Humerus ; Joints ; Orthopedics

The tracheostomy is increasingly being performed. In most cases, the tracheostomy sites are left to heal by secondary intention, so it leaves a depressed and wide scar that is cosmetically disfigured. Another problem os that the scar is also attached directly to the trachea itself and will move vertically with the trachea during the act of swallowing. Even though the tracheostomy scar is cosmetically acceptable, the mobility and retraction of the scar is a continual nuisance to the patient. We performed a retrospective study on 9 patients who had undergone revision of the depressed thracheostomy scar by the Renner Method from June, 1997 to February, 1999. The method includes transverse fusiform incision of the original scar and excision of the depressed portion of the scar to the level of the trachea itself. To prevent attachment of the skin and trachea, a bilateral subcutaneous flap and muscle flap were simply advanced to the midline and overlapped. Then the rest of scar that was not depressed was deepithelized and flipped to augment the soft tissue volume in the central depressed area. Satisfactory results were achieved in all patients without hematoma, infection, hypertrophic scar, and keloid formation. We believe this simple Renner method is one of the best ways of performing posttracheostomy scar revision.
Cicatrix* ; Cicatrix, Hypertrophic ; Deglutition ; Hematoma ; Humans ; Intention ; Keloid ; Retrospective Studies ; Skin ; Trachea ; Tracheostomy

Sebaceous carcinoma is an uncommon neoplasm usually associated with ocular adnexa. This malignancy may occur at any anatomic site that contains sebaceous glands. Despite the widespread anatomic distribution of sebaceous glands, extraocular sebaceous carcinoma occurs with far less frequency. We report a case of an 87-year-old Korean woman with extraocular sebaceous carcinoma treated with total excision.
Aged, 80 and over ; Female ; Humans ; Sebaceous Glands

No abstract available.
Female ; Meigs Syndrome*

Fractures of the capitellum humeri are rare and the recommendations for treatment vary. It can involve a significant portion of the articular surface, rendering the elbow joint unstable. In this situation, it is desirable to reduce and internally fix the capitellar fragment, because this restores the articular surface and augments joint stability. We experienced two cases of capitellar fractures which one case was spontaneously anatomical reduced and the other case was treated by open reduction. In one case the capitellar fragment was spontaneous reduced to a stable position although it was noticed radiographically as an unstable displaced fracture preoperatively. The other case was treated by open reduction and internal fixation with 3.5mm, small, AO, cannulated screw and K-wire. Both cases are reported here with references.
Elbow Joint ; Joints

No abstract available.
Cytomegalovirus* ; DNA* ; Glomerulonephritis* ; Polymerase Chain Reaction*

In this study, the feasibility of identification and genotypic differentiation of enteroviruses was investigated by using nested reverse transcription-polymerase chain reaction (nested RT-PCR), single-stranded conformation polymorphism (SSCP), and restriction fragment length polymorphism (RFLP) techniques. Two hundred seventy-four clinical samples were assayed by both nested RT-PCR and tube culture method using MRC-5 and MK cells; 58 (86.6%) out of 67 enterovirus culture-positive samples contained enteroviral RNA. In addition, 114 (55.1%) of 207 samples from patients with suspected enteroviral CNS disease with negative viral cultures were positive by the nested RT-PCR. The nested RT-PCR products were genotyped by the SSCP method and the results were compared with serotypes. We could differentiate 6 subtypes, 3 of which are similar to coxsackievirus B3, B5, echovirus 11, plus 3 other subtypes. RFLP cleaved with Sty I, Bgl I, and Xmn I yielded characteristic patterns for each laboratory strains. This study demonstrates the usefulness of the RT-PCR for the rapid diagnosis of enterovirus infection and the potentials of the SSCP method for differentiation of enterovirus strains.
Central Nervous System Diseases ; Diagnosis ; Enterovirus B, Human ; Enterovirus Infections ; Enterovirus* ; Genotype* ; Humans ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single-Stranded Conformational ; RNA

In order to extract useful tumor cell-specific information. DNA contents and other morphological parameters were measured by image analysis. Single cell preparation was made from archived paraffin blocks of 14 cases of bronchogenic squamous cell carcinoma, poorly differentiated, by protease treatment. The cells were Feulgen stained, and DNA content, area, perimeter, and major axis of the tumor cell nuclei were measured. Inflammatory lymphocytes concurrent with the tumor cells were used as an internal standard. DNA ploidies of the lymphocytes and 2C tumor cells showed simple peaks with Gaussian distribution and mean coefficients of variation of 10% and 14% respectively. By the location and proportion of the tumor cells other than 2C cells, DNA ploidies could be classified into diploidy(1 case), polyploidy(2 cases), and aneuploidy(11 cases). The mean proportion of DNA aneuploidal tumor cells relative to the total tumor cells was 82.8%. In 8 cases, nuclear areas showed more or less overlapped distribution, whereas DNA contents showed discrete peaks. THes results suggest that many bronchogenic squamous cell carcinomas, poorly differentiated, have DNA aneuploidy and high proportion of aneuploidal cells, and that nuclear size and DNA content are more or less independent parameters.