Two cases report on osteogenesis imperfecta tarda and review of literature has been made. The rare genetic disorder, osteogenesis imperfecta tarda is familiar to most orthopedic surgeons because of management of fracture and skeletal deformities, espicially bowing of long bone. Its clinical manifestations are known as bony fragility, blue sclera and deafness less frequently ligamentous laxity but its etiological factor is obscure; The basic defect is thought to involvement some abnormality of collagen. Recently the bony weakness caused by increased bony turnover rate. One case of osteogenesis imberrfecta tarda in 8 year old male was belonged to tarda type 1. (Falvo-classification), who could not walk due to marked anterolateral bowing of right tibia and the another to tarda type II. in 13 year old male with fresh fracture of right femoral shaft. The former was performed corrective multible osteotomy, realignment and intramedullary rod fixation for correction of bowing deformity of right tibia, and the later was managed the fracture of right femoral shaft with Russels traction and hip spica cast. The result of reported therapeutic mesure was good.
Collagen ; Congenital Abnormalities ; Deafness ; Fibrinogen ; Hip ; Humans ; Ligaments ; Male ; Orthopedics ; Osteogenesis Imperfecta ; Osteogenesis ; Osteotomy ; Sclera ; Surgeons ; Tibia ; Traction

The tibial plateau fracture is a common fracture in the knee joint. Tibial plateau fracture involves most always the articulating cartilage and produce the disability of the knee joint oftenly. The 25 cases of tibial fractures have been classified by Hohls method and analysed their clinical courses more than three month period. The 13 cases out of 25 had treated in conservative method such as plaster of Paris with or without closed reduction. Remaining 12 cases were treated operatively due to the failure of closed reduction or associated injury of major ligaments. More than 8 mm of depression or 5 mm split of the plateau fragment is classified as failure of closed reduction. Excellent end result is obtained in 21 cases with free of pain on walking and full range of joint motion without instability and muscle weakness, Three cases were classified as Good result with occasional pain on walking, range of joint motion is available more than 0~90 degree and good grade of muscle power without instability. One case was poor in result with instability of joint and pain on walking. The radiological end result of accurate reduction of fragment is not closely correlated with functional result in the treatment of tibial plateau fracture. The most important factor in the treatment of tibial plateau fracture is the exercises of the joint as early as possible.
Calcium Sulfate ; Cartilage ; Depression ; Exercise ; Joints ; Knee Joint ; Ligaments ; Methods ; Muscle Weakness ; Tibial Fractures ; Walking

Congenital mesoblastic nephroma(CMN) is an important differential diagnosis of a renal mass occurring in the newborn or in early childhood. It was first described by Bolande as a separate disease entity distinct form Wilms' tumor. In 1974, Beckwith has predicted that this tumor has a pathologic spectrum with classic congenital mesoblastic nephroma at one extreme, unequivocally mallignant spindle cell sarcomas at the other, and intermediate "gray zone" lesions of indeterminate biologic significanse. In 1986, Joshi has described "atypical mesoblastic nephroma" as a potentially aggressive variant of CMN, which shows atypical gross and microscopic features such as hemorrhage, necrosis, high cellularity, and mitotic index. We report of a case of atypical mesoblastic nephroma presenting in a 38 days-old male infant. Grossly, the tumor involved the upper and midportion of the left kidney. On section, the cut surface was fleshy, grayish-white, and homogeneous. Microscopically, the tumorshowed high degree of cellularity and arrangement of fusiform cells in sheets and vague interlacing bundles. The individual tumor cells showed fusiform to oval nuclei, indistinct scanty pale-eosinophilic cytoplasm and many mitotic figures.
Infant ; Child ; Male ; Female ; Infant, Newborn ; Humans ; Diagnosis, Differential

Among multple injured patients, the incidence of head injuries combined with long bone fracture is high. In adults who present with long bone fracture and concomitant head injury, the exuberant callus at fracture site was formed. The authors analyzed 26 cases of lower extremity fracure with severe head injury from January 1987 to December 1988. For the control group, we analyzed each 20 patients of only femur and tibia fractures. The results of this study are as follows:1. The mean age of experimental and control group were 38.4 yrs old and 40.1 yrs old, respectively. The sex ratio between male and female of experimental and control group were 2.3:1 and 2.7:1, respectively. 2. The initial level of consciousness by Glasgow coma scale was mild impairement 12%, moderate impairement 65% and severe impairement 23%. 3. Serum calium and phosphate level were no specific difference between the head injury with lower extremity fractured patients and only lower extremity fractured patients, but there was increment of serum alkaline phosphatase level on post-trauma 1 month in head injury cases. 4. The pattern of callus formation in experimental group was different compared with control group. 5. The formation of callus was exuberant in the severe head iniury with femur fracture. 6. In experimental group, there was evidence of early bony union time compared with control group, but there was no statistical significance (p<0.05). In conclusion, the callus formation was exuberant in the head injury with femur fractured patient, there was different healing response compared with control group.
Adult ; Alkaline Phosphatase ; Bony Callus ; Consciousness ; Craniocerebral Trauma ; Extremities ; Female ; Femur ; Fractures, Bone ; Glasgow Coma Scale ; Head ; Humans ; Incidence ; Lower Extremity ; Male ; Sex Ratio ; Tibia

Pleomorphic (undifferentated) carcinoma is a rare histologic type of carcinomas of the gallbladder and an atypical carcinoid is thought to be an intermediated type between carcinoid tumor and small cell carcinoma. Dense core "neurosecretory" granules can be found in the above mentioned tumors. We experienced a case of a double tumor of the gallbladder in a 51-year old male patient. Grossly, a large solid mass, about 5.0 cm in diameter, was found in the fundic portion and the neck portion also had a small 1.5 cm-sized polypoid mass. Microscopically, these lesions had features of pleomorphic carcinoma and atypical carcinoid, respectively. Immunohistochemically, they manifested reactivity for neuron specific enolase. Ultrastructural study revealed neurosecretory granules in the cytoplasms of tumor cells of the fundic and neck masses. Although light microscopic features of these tumor masses are quite different, we consider that these tumors represent a spectrum of neuroendocrine differentiation.
Male ; Humans

No abstract available.
Electrocardiography* ; Heart Septal Defects, Ventricular* ; Hemodynamics*

A statistical analysis was made on the 102 patients of hand injuries and their treatments. The rate of hand injury increases steadily due to the development of industrial activities and traffic accident. The hand has much more delicate functions to be performed and its structural characters should be fully understood to manage them properly. The most important point and to be emphasized is the proper coverage (resurfacing) of the wound as early as possible to avoid infection. For this purpose, early debridement and irrigation of the wound are important previous to the resurfacing. The statistical analysis is concluded as follows: 1. The peak incidence of hand injury was in the age group of 11-20 years (34.3%) and most of all were male in 89.2%. 2. There was no difference rate of dominant side and was almost equal affection of both side. 3. Industrial accident was the main cause and the most cammon type were crushing injuries with open fracture (43.1%). 4. Most of the patient were able to get the chance of early medical care in arriving hospital within six hours in 69.6%. 5. The most common digit of injury was middle finger (25.1%) and 59.8% was monodight involvement. 6. As the final result, the 28.6% (57 out of 199) of finger was amputed at the time of injury or for the purpose of treatment. The most common level of amputation were distal and middle phalanx with the rate of 29.8% each. 7. 46.8% of hand injuries were able to close primarily after debridement including 16.2% with bony amputation. 8. Various complications of hand injuries were observed in 36 case and one of most common complication was the infection in 21 cases (58.3%). About a half (52.4%) of infection were caused by pseudomonas.
Accidents, Occupational ; Accidents, Traffic ; Amputation ; Clinical Study ; Debridement ; Fingers ; Fractures, Open ; Hand Injuries ; Hand ; Humans ; Incidence ; Male ; Pseudomonas ; Wounds and Injuries

In 1868 Charcot described the join in tabes dorsalis, which since then has been designated as Charcot neuroarthropathy. It is characterized by painless swelling and abnormal mobility of the affected joint. Arthropathy of the type described by Charcot has been associated with various other conditions, such as diabetes mellitus, syringomyelia, injury to nerve root, congenital indfference to pain, leprosy, and intra-articular use of steroid, etc. Authors present a case of Charcot joint which involved the left knee joint associated with pathologic fracture of the left tibia and fibula.
Arthropathy, Neurogenic ; Diabetes Mellitus ; Fibula ; Fractures, Spontaneous ; Joints ; Knee Joint ; Knee ; Leprosy ; Syringomyelia ; Tabes Dorsalis ; Tibia

Spondylolisthesis, named by Kilian in 1854, is a major cause of low back pain and numerous methods were designed for its treatment. The 80 cases out of 132 spondylolysis and spondylolisthesis were analysed and evaluated the result cf their treatment. The results are summerized as follows. 1. The most common type of spondylolisthesis was isthmic type (58 cases, 72.5%). 2. The most common site of incidence was L5 and L4, L3 were next to it. 3. All of the dysplastic type were in L5, isthmic type were in L3, L4 and the degenerative type were most common in L4, and followed L5,L3 consecutively. 4. The 67 cases out of 80 were treated conservatively and rest of cases had operative care with six cases of anterior fusion and seven cases of posterior fusion. 5. The results of tretment was evaluated and graded more than good in all cases of operative care and 51 cases (76.2%) in conservative management.
Incidence ; Low Back Pain ; Spondylolisthesis ; Spondylolysis

The mechanism of back pain arising from change in intervertebral disc has not been clearly defined. So that the diagnosis and treatment were variable. The 26 cases of herniated intervertebral discs, treated by surgically, were analysed and evaluated as follows. 1 In 26 cases of herniated intervertebral discs, 18 cases (69%) were male and 8 cases (31%) was female. 2. The most common age group was 30 to 40 years old. 3. The most common site of incidence was L4-5 with 15 cases (57%) and L5-S1 10 cases (38%). 4. The over all followup result to surgical treatment was evaluated as 80% (21 cases) in excellent & good. 5. The end results correlated with myelographic findings was that the lateral indentation and asymmetry of nerve sleeve sleeve groups were better than the hour-glass appearance group.
Back Pain ; Clinical Study ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Incidence ; Intervertebral Disc ; Male