2.Lowe's syndrome in a female child: A case report
Sung Keun SOHN ; Sung Soo KIM ; Bum Ho JUNG
The Journal of the Korean Orthopaedic Association 1994;29(2):440-445
Lowe et al. have described a disease characterized by organic aciduria, decreased renal ammonia production, hydrophthalmos, and mental retardation, this disease is now called as Lowe's syndrome or oculo-cerebro-renal syndrome which manifests growth plates, metabolic acidosis, and characteristic eye changes, including bilateral cataract, glaucoma and nystagmus. It is a congenital hereditary affectation. Most of the patients with this syndrome are male sex. We report a new case of Lowe's syndrome in a 5-year old girl.
Acidosis
;
Ammonia
;
Cataract
;
Child
;
Female
;
Glaucoma
;
Growth Plate
;
Humans
;
Hydrophthalmos
;
Intellectual Disability
;
Male
3.Phenotypic Changes of Intermediate Filament Proteins during Degeneration and Regeneration of Rat Leg Muscles following Sciatic Nerve Injury.
Byeong Hwan KIM ; Ki Soo YOO ; Sung Keun SOHN
Journal of Korean Orthopaedic Research Society 2000;3(2):167-181
PURPOSE: The intermediate filament proteins, desmin and vimentin, are specific components of the cytoskeleton of striated muscle fibers and of mononuclear cells of mesenchymal origin including myoblasts, respectively. Desmin has also been found in presumptive myoblasts of mammals. The aim of this experiment was attempted to observe the phenotypic changes of intermediate filaments in skeletal muscle fibers during early stages of sciatic nerve crushing injury. MATERIALS AND METHODS: The sciatic nerves of rats were surgically crushed by hemostat and serial cryosections of soleus and extensor digitorum longus(EDL) muscles were prepared at 2, 4, 6, 8, 10, 15, 20 and 27 days after nerve injury. Serial cryosections were immunolabelled with desmin, vimentin and laminin and were histochemically reacted with NADH-TR. RESULTS: 1) Firstly, desmin positive fibers were appeared in fast-twitch type C fibers of both muscles at 6 days after nerve crushing, but were not reacted for vimentin. 2) Co-expressions of desmin and vimentin were firstly detected in fast-twitch type A fibers of EDL muscles at 8 days after nerve injury. In soleus muscles, co-expressions of desmin and vimentin were firstly seen in slow-twitch type B fibers at 10 days after nerve injury. Many atrophic fibers, that contained several central nuclei like myotubes and co-expressed desmin and vimentin, were appeared in EDL muscles at 10 days after nerve injury. Although whole regions of fibers were regenerated in EDL muscles, only peripheral regions of fibers were regenerated in soleus muscles at 15 days after nerve injury. Many atrophic fibers, co-expressed of desmin and vimentin, were appeared in EDL muscles at 20 days after nerve injury. These whole fibers represented various degrees of regenerating stages. Most of mature fibers containing several central nuclei, only expressed vimentin slightly, were seen in soleus muscles at 20 days after nerve injury. Most fibers of both muscles were matured at 27 days after nerve injury, but some fibers in EDL muscles were still in processing of degeneration and regeneration. No expressions of desmin and vimentin indicated that muscle fibers were almostly matured in soleus muscles at 27 days after nerve injury. 3) Targetoid or target fibers which informed reinnervation, were appeared firstly in soleus muscles at 20 days and were seen in both muscles at 27 days after nerve injury. All targetoid and target fibers were type B fibers. CONCLUSION: Desmin was revealed in processes of degeneration and regeneration and vimentin was appealed in regeneration process. At the same time, positive immunoreactivity of desmin and vimentin showed specific differences in degree of degeneration and regeneration according to different muscles and muscle fibers.
Animals
;
Cytoskeleton
;
Desmin
;
Intermediate Filament Proteins*
;
Intermediate Filaments*
;
Laminin
;
Leg*
;
Mammals
;
Muscle Fibers, Skeletal
;
Muscle, Striated
;
Muscles*
;
Myoblasts
;
Nerve Crush
;
Nerve Fibers, Myelinated
;
Nerve Fibers, Unmyelinated
;
Rats*
;
Regeneration*
;
Sciatic Nerve*
;
Vimentin
4.Phenotypic Changes of Intermediate Filament Proteins during Degeneration and Regeneration of Rat Leg Muscles following Sciatic Nerve Injury.
Byeong Hwan KIM ; Ki Soo YOO ; Sung Keun SOHN
Journal of Korean Orthopaedic Research Society 2000;3(2):167-181
PURPOSE: The intermediate filament proteins, desmin and vimentin, are specific components of the cytoskeleton of striated muscle fibers and of mononuclear cells of mesenchymal origin including myoblasts, respectively. Desmin has also been found in presumptive myoblasts of mammals. The aim of this experiment was attempted to observe the phenotypic changes of intermediate filaments in skeletal muscle fibers during early stages of sciatic nerve crushing injury. MATERIALS AND METHODS: The sciatic nerves of rats were surgically crushed by hemostat and serial cryosections of soleus and extensor digitorum longus(EDL) muscles were prepared at 2, 4, 6, 8, 10, 15, 20 and 27 days after nerve injury. Serial cryosections were immunolabelled with desmin, vimentin and laminin and were histochemically reacted with NADH-TR. RESULTS: 1) Firstly, desmin positive fibers were appeared in fast-twitch type C fibers of both muscles at 6 days after nerve crushing, but were not reacted for vimentin. 2) Co-expressions of desmin and vimentin were firstly detected in fast-twitch type A fibers of EDL muscles at 8 days after nerve injury. In soleus muscles, co-expressions of desmin and vimentin were firstly seen in slow-twitch type B fibers at 10 days after nerve injury. Many atrophic fibers, that contained several central nuclei like myotubes and co-expressed desmin and vimentin, were appeared in EDL muscles at 10 days after nerve injury. Although whole regions of fibers were regenerated in EDL muscles, only peripheral regions of fibers were regenerated in soleus muscles at 15 days after nerve injury. Many atrophic fibers, co-expressed of desmin and vimentin, were appeared in EDL muscles at 20 days after nerve injury. These whole fibers represented various degrees of regenerating stages. Most of mature fibers containing several central nuclei, only expressed vimentin slightly, were seen in soleus muscles at 20 days after nerve injury. Most fibers of both muscles were matured at 27 days after nerve injury, but some fibers in EDL muscles were still in processing of degeneration and regeneration. No expressions of desmin and vimentin indicated that muscle fibers were almostly matured in soleus muscles at 27 days after nerve injury. 3) Targetoid or target fibers which informed reinnervation, were appeared firstly in soleus muscles at 20 days and were seen in both muscles at 27 days after nerve injury. All targetoid and target fibers were type B fibers. CONCLUSION: Desmin was revealed in processes of degeneration and regeneration and vimentin was appealed in regeneration process. At the same time, positive immunoreactivity of desmin and vimentin showed specific differences in degree of degeneration and regeneration according to different muscles and muscle fibers.
Animals
;
Cytoskeleton
;
Desmin
;
Intermediate Filament Proteins*
;
Intermediate Filaments*
;
Laminin
;
Leg*
;
Mammals
;
Muscle Fibers, Skeletal
;
Muscle, Striated
;
Muscles*
;
Myoblasts
;
Nerve Crush
;
Nerve Fibers, Myelinated
;
Nerve Fibers, Unmyelinated
;
Rats*
;
Regeneration*
;
Sciatic Nerve*
;
Vimentin
5.A Clinical Study of Spinal Tuberculosis
Sung Keun SOHN ; Seung Rim PARK ; Chang Il PARK ; Kyung Soo CHOI
The Journal of the Korean Orthopaedic Association 1982;17(3):415-422
The incidence of spinal tuberculosis has been decreased because of the development of anti-tuberculosis drugs, the use of radical surgical procedures and the improvement in the nations general hygiene. The anterior fusion is the most frequently used surgical measure in the treatment of spinal tuberculosis. One-hundred-eighty cases of spinal tuberculosis were treated by surgery during the 5 years from 1976 to 1980 at Presbyterian Medical Center with the following results: 1. The age distribution showed the peak incidence to be in the third decade. 2. The predilection site was the lumbar area and the percentage was 43.3. 3. In 17.2% of the cases, anti-tuberculosis drug was ingested before surgery. 4. Paraplegia was present in 16.1% of spinal tuberculosis. 5. In paraplegia, most of the location of the involved bodies was in the thoracic and the thoracolumbar vertebrae and the percentage was 79.3. 6. In paraplegia, complete recovery was 82.8%, and incomplete recovery was 10.3%. 7. In 90% of the patients, anterior fusion was done and the union rate was 91%. 8. Kyphosis was the most common in late complication.
Age Distribution
;
Clinical Study
;
Humans
;
Hygiene
;
Incidence
;
Kyphosis
;
Paraplegia
;
Protestantism
;
Spine
;
Tuberculosis, Spinal
6.Treatment of Metastatic Carcinoma Involvign Cervical Spine by Using Bone Cement
Sung Keun SOHN ; Seung Rim PARK ; Chang Il PARK ; Kyung Soo CHOI
The Journal of the Korean Orthopaedic Association 1982;17(5):854-858
Metastatic malignant tumors involving the spine cause destruction of vertebral body, kyphosis and neural deficit. Irradiation relieves the pain and decreases the tumor mass, but sometimes the spine is progressively destroyed and becomes unstable. Traeatment of metastatic tumor involving the spine is difficult. Replacement of the vertebral body with bone cement and high dosage of radiation therapy was recommended by Harrington. The advantages are excision of the tumor mass, firm immobilization and enough irradiation not to recur. Two cases of metastatic carcinoma involving cervical spine were treated by anterior decompression, bone cement fixation and irradiation. One case died seventeen days after surgery due to severe pleural effusion. Another case was treated with irradiation (6,000 rads) after surgery and the pain was relieved. The spine is stable one year after surgery. There is no local recurrence.
Decompression
;
Immobilization
;
Kyphosis
;
Pleural Effusion
;
Recurrence
;
Spine
7.Problems after Interlocking Intramedullary nailing for Long Bone Fracture
Sung Keun SOHN ; Seong Soo KIM ; Jung Yoon LEE ; Nam Jo BAE
The Journal of the Korean Orthopaedic Association 1994;29(3):745-753
Interlocking intramedullary nailing has many advantages for long bone fracture. However, we can meet many problems during the operative procedure. Among the patients who were treated with interlocking intramedullary nailing from March, 1990 to December, 1991, forty-eight patients(49 cases) of femur and tibia fracture who were followed up more than twelve months(average 14months: 12months 18months) were included in this study. 1) Forty-nine cases consisted of 20 cases(41%) of femur fracture and 29 cases(59%) of tibia fracture. 2) Two cases of proximal protrusion were developed because of inadequate implant length. 3) Operative complications were encountered with 3 cases of new fracture line, 1 case of new fragmentation, 1 case of reduction loss, 2 cases of failure of proximal targeting, 3 cases of failure of distal targeting, 2 cases of distraction of fracture site more than 3 mm, 1 case of sciatic nerve injury due to excessive traction and 1 case of tibial inlet error. 4) Postoperative complications were encountered with 1 case of distal targeting screw failure, 4 cases of infection and 8 cases of delayed union. 5) According to the result, sufficient planning and confirmations(preoperatively, intraoperatively and postoperatively) can diminish the complications. And then the interlocking intramedullary nailing will be useful method in the case of long bone fracture when the operator has extensive experiences.
Bays
;
Femur
;
Fracture Fixation, Intramedullary
;
Fractures, Bone
;
Humans
;
Methods
;
Postoperative Complications
;
Sciatic Nerve
;
Surgical Procedures, Operative
;
Tibia
;
Traction
8.Clinical Study of Gout
Sung Keun SOHN ; Seong Soo KIM ; Jung Yoon LEE ; Hyung Jin KIM ; Chul Hong KIM
The Journal of the Korean Orthopaedic Association 1995;30(1):132-137
Primary gout is a metabolic disease that has its basis in an inborn error in the intermediary metabolism of purines and related compounds. It is characterized by hyperuricemia, recurrent attacks of acute arthritis, deposition of monosodium urate crystals in and around the joints of the extremities, urolithiasis, renal and cardiovascular disease. Thirty-eight patients with gout managed at the department of orthopaedic surgery, Dong-A University Hospital, from April, 1990 to November 1993, had been reviewed retrospectively and the following results were obtained. 1. Most of cases were male(95%) and the mean age was 55.4 years old. 2. The case of first attack was 8 cases(21%), the most common age of first attack was fifth decade and mean duration of disease was 7.4 years. 3. The most common precipitating factor was overindulgence in food and alcohol. 4. The avarage uric acid level of serum and that 24-hour urine collection in acute attacks were 11.2 mg/dl and 24.5mg/D. Respectively all of the cases except four revealed increased ESR (average 43 mm/hr). 5. When the acute attack was developed, the most common involved joint was the first M-P joint (83%) of the foot, but as the acute gout was progressed to the chronic form, multiple joints were affected. 6, The punched out lesion in the radiograph was found in 7 cases(25 joints), among them 6 cases had suffered from the disease for longer than 3 years. 7. The most common complication was nephropathy(18 cases). 8. In case of acute gouty attack, we administered colchicine in the 22 cases. The therapeutic method of colchicine usually consisted of oral administration of 2 tablets(1.3mg) initially, followed by 1 tablet(0.65mg) every hour untill the relief of joint pain or the development of gastointestinal symptoms. We rocomended 6-8 tablets of colchicine for the management of acute gouty attack with safety. 9. Colchicine in small daily dose(0.65mg qd or bid) could be effective to prevent the recurrent attacks of high risk gouty arthritis.
Administration, Oral
;
Arthralgia
;
Arthritis
;
Arthritis, Gouty
;
Cardiovascular Diseases
;
Clinical Study
;
Colchicine
;
Extremities
;
Foot
;
Gout
;
Humans
;
Hyperuricemia
;
Joints
;
Metabolic Diseases
;
Metabolism
;
Methods
;
Precipitating Factors
;
Purines
;
Retrospective Studies
;
Tablets
;
Uric Acid
;
Urine Specimen Collection
;
Urolithiasis
9.Surgical Treatment for Unstable Intra-articular Fracture of Distal Radius
Sung Keun SOHN ; Seong Soo KIM ; Jung Yoon LEE ; Sung Wan KIM
The Journal of the Korean Orthopaedic Association 1995;30(4):1033-1040
Authors reviewed 21 cases of unstable intra-articular fractures of the distal radius treated with open reduction and internal fixation to improve anatomical and functional results during March 1990 to May 1993 at Dong-A University Hospital. The following results were obtained; 1. The most common injury type was type VIII(9 cases) according to Frykman's classification, type C,(8 cases) according to AO classification, and open fractures were 4 cases. 2. Twelve cases were treated with open reduction and internal fixation with external fixator and 9 cases were treated with open reduction and internal fixation with cast. 3. According to demerit point rating system, excellent to good results were obtaned in 76.2%. In cases of external fixator application, excellent and good results were 88.3%, compared to 66.7% in cases of cast application. 4. In last follow-up examination, the mean loss of radial length was 0.9mm(10.0%) in cases of cast, but 0.3mm(3.3%) in cases of external fixator, the mean loss of radial inclination was 2.7° (16.7%) and 1.8° (11.0%) respectively, the mean loss of volar tilt was 2.9° (19.6%) and 2.4° (16.4%) respectively, and there were statistical significances in all three parameters between the external fixator group and the cast group(p < 0.05). 5. Open reduction and internal fixation, combined with external fixation was thought to be a better method than open reduction and internal fixation with cast for the treatment of unstable comminuted fractures of the distal radius, because that was more comfortable and convenient to patients and useful to prevent late displacement or collapse of fractures.
Classification
;
External Fixators
;
Follow-Up Studies
;
Fractures, Comminuted
;
Fractures, Open
;
Humans
;
Intra-Articular Fractures
;
Methods
;
Radius
10.Comparision of Gamma nail and Compression Hip Screw on Femur Intertrochanteric Fracture
Sung Keun SOHN ; Seong Soo KIM ; Jung Yoon LEE ; Chul Hong KIM
The Journal of the Korean Orthopaedic Association 1995;30(4):939-943
Most of femur intertrochanteric fractures occured in elderly patients with predisposing osteoporotic bone change and general weakness. This group is exposed to the high postoperative morbidity and mortality. Many devices were developed for these purposes, Gamma nail is relatively acceptable on above considerations because of some benefits; lower blood loss, lower risk of infection, shorter operation time, early weight bearing and rigid internal fixation. We reviewed 19 cases of compression hip screw fixation(group 1) from March 1990 to October 1991 and 19 cases of unreamed type Gamma nail (group 2) from March 1990 to May 1993. The following results were obtained; 1. The mean union time was 15.1 weeks on group 1 and 15.4 weeks on group 2. 2. The mean amount of intraoperative bleeding was 511ml on group 1 and 303ml on group 2. 3. The mean timing of nonweight bearing ambulation was at postoprative 5.3 days on group 1 and at 2.2 days on group 2. 4. The complications were 4 cases on group 1 and 3 cases on group 2. 5. We obtained satisfactory results in femur intertrochanteric fracture using unreamed type Gamma nail. So, We suggest application of this method for treatment of femur intertrochaneric fracture if skilled technique is used.
Aged
;
Femur
;
Hemorrhage
;
Hip Fractures
;
Hip
;
Humans
;
Methods
;
Mortality
;
Walking
;
Weight-Bearing