No abstract available.

No abstract available.
Child* ; Humans ; Testosterone*

Two cases of old unreduced dislocation of shoulder are reported. One was the posterior dislocation for six months with malunited fracture of humeral shaft in thirty degree lateral angulation. Her shoulder and arm aches with limitation of motion remaining only ten degrees in every direction but abduction in thirty degrees, The malunion of humeral shaft and shoulder were reduced surgically in result of eighty degrees abduction, seventy degrees flexion, sixty degrees extension and twenty degrees of external rotation with free of pain. Another case was an anterior dislocation for one year. Her range of shoulder motions are almost normal degree but brachial plaxus compression symptoms. Open reduction in practically Putti-Platt procedure was performed. She became completely free of brachial plexus symptom and ranges of shoulder motion are normal except about fifteen degrees less external rotation than preoperative condition. The surgical indication and the result of treatment were discussed for the the neglected cases of old unreduced dislocation of the shoulder.
Arm ; Brachial Plexus ; Dislocations ; Fractures, Malunited ; Shoulder

The principle of the tension band technique is to counteract the tensile forces acting across the fracture site and to convert them into compressive forces. We have experienced 37 fractures treated with tension band technique from 1975 to 1978 and the results are as followings; 1. 37 Cases of fracture were treated by tension band technique. Eight cases out of 37 were olecranon fractures. 16 cases were patellar fractures. 10 cases were malleclar fractures. and three cases were trochanteric fractures of the femur. 2. As post-operative immobilization, applied cast splint in almost of the cases except application of hip spica cast in trochanteric fracture. 3. The average duration of immobilization in each cases, 12 days in olecranon, two weeks in patella, four weeks in malleolus and six weeks in greater trochanter respectively. 4. The radiological union was obtained in seven weeks in olecranon, six weeks in patella, eight weeks in malleolus and six weeks in greater trochanter. 5. As complication, one case of nonunion in olecranon, one case of infection and, one case of wire breakage in patella and one case of traumatic arthritis in malleolus were noted, which needed further surgery. 6. In conclusion, tension band wiring is considered as a good method for the fractures involving joing, olecranon, patella, and malleolus because the technique has advantages such as rigid internal fixation, shortening the duration of immobilization and fracture healing and early mobilization of the neighboring joints.
Arthritis ; Early Ambulation ; Femur ; Fracture Healing ; Hip ; Hip Fractures ; Immobilization ; Joints ; Methods ; Olecranon Process ; Patella ; Splints

No abstract available.
Blattellidae* ; Child* ; Humans

Five patients with “definite” or “classical” rheumatoid arthritis who had failed to respond to salicylates, non-steroid anti-inflmmatory agents, steroids, and gold, were treated with D-Penicillamine. In a follow-up ranging from 3 weeks to 4 months, two patients had complete remission and one had major improvement. In one patient penicillamine had to be discontinued because of side effects and in another the time interval is too short at this reporting to assess the results.
Arthritis, Rheumatoid ; Follow-Up Studies ; Humans ; Penicillamine ; Salicylates ; Steroids

Most of the peripheral nerve injuries from crushing or compressive forces are accompanied by surrounding soft tissue injuries. As a result, poor vascularity due to fibrosis and sacr formation compromises regeneration of the grafted nerve. Vascularized nerve graft shows superior regeneration to that of a non-vascularized one. However, the human body provides few donor sites of vascularized nerve graft clinically. We presumed that the prefabricated myoneural or adiponeural flap, which include fabricated nerves wrapped with surrounding vascularized muscle or adipose tissue flap, influences superiorly on the regeneration of grafted nerve because that surrounding vasculatity indirectly enhances the vascularity of the grafted nerve itself. Thirty adult male Sprague-Dawley rats were divided into three groups: 1) conventional reversed autogenous graft of the femoral nerve alone(n=10); 2) nerve graft entubulated with abdominal adipose tissue flap with a pedicle of inferior epigastric artery(n=10); 3) nerve graft entubulated with adductor muscle flap with a pedicle of the first muscular branch of the femoral artery(n=10). At three months postoperatively, grafted nerves were examined by electrophysiologic study to check amplitudes and motor nerve conduction velocities, as well as histopathologic study for evaluation of regenerated nerve cells, fibrosis and neo-vascularization. Consquently, nerve regeneration was found in all three groups. Both the myoneural and adiponeural flap groups had better improved results of nerve regeneration compared to that of the conventional nerve graft group. The result of myoneural flap group was superior to that of the adiponeural flap group. The myoneural flap group showed minimal fibrosis and less prominent neovascularization around moderately regenerated nerves. The adiponeural flap group showed more severe perineural and endoneural fibrosis, as well as vascular proliferation around focal regenerated nerves. The results of myoneural flap group proved to be statistically significant. We concluded that it is possible to use nerve graft entubulated with a vascularized muscle flap (myoneural flap) as a substitute for vascularized nerve graft.
Abdominal Fat ; Adipose Tissue ; Adult ; Femoral Nerve ; Fibrosis ; Human Body ; Humans ; Male ; Nerve Regeneration* ; Neural Conduction ; Neurons ; Peripheral Nerve Injuries ; Rats, Sprague-Dawley ; Regeneration ; Soft Tissue Injuries ; Tissue Donors ; Transplants*

OBJECTIVES: Anticardiolipin antibody (ACA) and lupus anticoagulant (LA) are acquired antiphospholipid antibodies (APAs), which are regarded as important risk factors far vascular thrombosis and recurrent fetal loss. Although the clinical relevance of APAs in dialysis patients is uncertain, recent studies have suggested that APAs are involved in bioincompatibility and thrombogenic complications in hemadialysis (HD) patients. METHOD: We performed a cross sectional study of ACA and LA in 50 stable HD patients and their 68 vascular accesses (52 native arteriovenous fistulae and 16 synthetic arterovenous grafts), with the analysis of factors associated with the presence of APAs and the retrospective evaluation of vascular access occlusion (VAO). LA was assessed by platelet neutralization method whereas IgG-ACA was measured by a solid phase ELISA. Values higher than 23GPLU/ml (IgG phospholipid units) were considered to be positive for IgG-ACA and positive values for LA was more than 8 seconds in prolongation of the clotting time with human platelet lysate. Vascular access survival was assessed by Kaplan- Meier method, RESULTS: The mean age of the subject (M:F 21:29) was 46 years and the mean duration of hemodialysis was 49 months. The frequency of VAO in entire subjects was 0.45+/-0.98 episodes/patient year. The median value of IgG-ACA was 16.0 GPLU/ml with a distribution from 2.7 to 46.1GPLU/ ml. The median titer of I.A was 4.5 (3.1-45.6) seconds. Fourteen patients (28%) were found to have at least one episode of VAO. In spite of comparable clinical and biochemical data according to the presence of VAO, the titers of IgG-ACA (13.6+/-7.7 vs, 20.3+/-8.7GPLIJ/ml, P<0.05) and LA (4.5+/-2.9 vs. 11.7 +/-12.6sec, P<0.05) were significantly higher in VAO group. Six out of 50 patients(12%) had an increased titer of IgG-ACA and LA was found in 11 patients(22%). No patients were positive for ACA and LA simultaneously. There was no significant difference in sex, etiology of ESRD, diabetic status, the dosage of heparin during HD or the amount of erythropoietin administered according to the presence of APAs. We could not find any significant correlation between the titer of APAs and age, duration of dialysis, blood pressure, platelet count and biochemical parameters. In the patients with positive ACA, the frequency of VAO was 1.05+/-0.12 episodes/patient year, which was significantly higher than patients without ACA (0.33+/-0.17 episodes/ patient year, P<0.05). In the patients with the presence of LA(1.06+/-0.43 vs. 0.12+/-0.06 episodes/ patients year, P<0.01). The median vascular access survival time in IgG-ACA positive patients (32.7 months) was significantly decreased compared to 66.8 months in IgG-ACA negative group. CONCLUSION: Our data suggest that the presence of APAs (ACA and/or LA) affects the event-free vascular access survival in HD patients. Therefore the evaluation of APAs status have to be included in the diagnostic strategies for the patients with recurrent VAO. Further studies are necessary to explore the pharmacologic intervention method to decrease APAs and prevent VAO in HD patients.
Antibodies, Anticardiolipin* ; Antibodies, Antiphospholipid ; Arteriovenous Fistula ; Blood Platelets ; Blood Pressure ; Dialysis ; Enzyme-Linked Immunosorbent Assay ; Erythropoietin ; Heparin ; Humans ; Kidney Failure, Chronic ; Lupus Coagulation Inhibitor* ; Platelet Count ; Renal Dialysis* ; Retrospective Studies ; Risk Factors ; Thrombosis

To investigate the effects of fibronectin (FN), hyaluronic acid (HA), epidermal growth factor (EGF), fibroblast growth factor (FGF), and transforming growth factor-beta(TGF-beta) on the healing of the corneal endothelial cells, the rabbit corneal endothelial cells were cultured from the outgrowth of Descemet's membrane explants. After making a wound at the center of the monolayer of confluent corneal endothelial cells using a rotating silicone tip, three different concentrations of testing agents were added. Then, the wound healing area and healing rate were measured. In addition, the effects of agents on the DNA synthesis by corneal endothelial cells were determined by measuring the incorporation of 3H-thymidine into cold acid-insoluble material. FN and EGF increased the wound healing area at all concentrations tested, and HA only at 1.0mg/ml showed a stimulatory effect. However, FGF showed little effect at all concentrations. TGF-beta promoted wound healing at 1.0 and 10.0 ng/ml. The combined treatment of FN and HA caused a more potent effect on corneal endothelial wound healing than single treatment. Neither the combined treatment of EGF and TGF-beta, nor the combined treatment of FGF and TGF-beta caused any significant effect. Wound healing rate was highest during the first 12 hours in all agents. EGF stimulated DNA synthesis while other agents studied did not, and TGF-beta suppressed EGF-induced DNA synthesis. These results indicate that FN, HA and TGF-beta stimulate the endothelial wound healing by probably enhancing cell migration, and EGF by enhancing cell migration and cell proliferation.
Cell Movement ; Cell Proliferation ; Descemet Membrane ; DNA ; Endothelial Cells* ; Epidermal Growth Factor ; Fibroblast Growth Factors ; Fibronectins* ; Hyaluronic Acid* ; Intercellular Signaling Peptides and Proteins* ; Silicones ; Transforming Growth Factor beta ; Wound Healing* ; Wounds and Injuries*

PURPOSE: To evaluate the precision of measurements of distances and angle in the cross-sectional views of linear tomogram of panorama and to assess the technique for visualizing the mandibular canal. METHODS: Ten dry mandibles were radiographically examined with 3 continuous cross-sectional views of linear tomogram of panorama and 4 continuous computed tomograms. The distance between the superior border of canal and alveolar crest and the bucco-lingual width of alveolar bone at the level of the superior border of canal and the angle between the two lines above were measured. Measurements were performed by radiologist and implantologist group and compared with measurements on computed radiograms of the same areas. RESULTS: The measurements differences for the distance of alveolar bone height between in panorama and in CT showed 0.9mm+/-0.6mm by radiologists and 1.3mm+/-0.8mm by implantologists. There was no statistically significant difference between two groups' measurements. The differences in measurements for the distance of alveolar bone width between in panorama and in CT showed 0.5mm+/-0.8mm by radiologists and 2.5mm+/-1.4 mm by implantologists. There was significant difference (p<0.05) between two groups' measurements. The average bucco-lingual inclination of alveolar bone above mandibular canal was average 95.8degrees in CT. The difference of measurements between two groups was average 1+/-0.9degrees. Three cross-sectional views of panorama could show that the mandibular canal crosses antero-lingually and slopes inferiorly from the posterior segment of the mandible. Conclusions : The measurements in the linear tomogram of panorama by radiologists gave the accurate values of the distances and the angle compared with the values in computed tomograms.
Mandible*