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

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

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

Spondylolisthesis, frequently encountered problems with increasing incidence, has been recognizid as an important clinical entity in orthopaedic field. Several methods were applicated as operative treatment of spondylolisthesis; posterior fusion or H-graft, posterolateral fusion, anterior fusion, fixation with internal devices and etc. During the past 12 years from March 1972 to February 1984, 34 patients among the 42 patients were treated surgically at Department of Orthopaedic Surgery of Ewha Womans University Hospital and following results were obtained. 1. The average age was 45.2 years(19 ~ 64 years) and female was predominent(64.7%). Isthmic type was 17 patients(50.0%), degenerative type was 13 patients(38.2%) and dysplastic type was 4 patients(11.8%). Below 40 year old, dysplastic and isthmic type were predominent and degenerative type was more common in the age group above forties. 2. The most prevalent site was L5-Sl; 21 cases(61.8%) and L4-5; 13 cases(38.2%) in orders. In isthmic type L5-Sl was 13 cases and in degenerative type, L4-L5 was 9 cases. By Meyerding classification, grade I was most common(26 patients, 76.5%). 3. The clinical pictures were low back pain only and little improvement with conservative treatment(type I: 9 patients), low back pain with sciatica(type II: 13), type II plus neurologic signs such as motor weakness, sensory change or change of D.T.R(type III, 10) and little low back pain with mainly sciatica(type IV, 2). 4. Of 34 patients, anterior interbody fusion were done in 10 patients ; posterior and posterolateral fusion with decompression were done in 22 patients. Only laminectomy were done in 2 patients(type IV). 5. Fusion rate was observed in 21 patients(95.5%) among 22 patients with posterior or posterolateral fusion and 8(80%) among the 10 patients with anterior fusion. Postopertive functional results by Gill's criteria were excellent or good in 31 patients(91%). 6. There were no difference in fusion rate and functional results in operative methods.
Classification ; Clinical Study ; Decompression ; Female ; Humans ; Incidence ; Laminectomy ; Low Back Pain ; Neurologic Manifestations ; Spondylolisthesis

Fractures of both forearm bones present specific therapeutic preoblems encountered infrequently in the fractures of other shafts of long bones. Although some of these fractures can be treated conservatively, majority of fractures are treated by open reduction and internal fixation for accurate anatomic reduction and rigid fixation. From January 1979 to December 1986, seventy two cases of both forearm bone fractures had been treated by four different methods at the Department of Orthopaedic Surgery, College of Medicine, Ewha Womans University and results were obtained as follows : 1. The most common fractures site was middle third of radius and ulna. 2. Comminuted fx was most common in radius and oblique fracture was most frequent. 3. Eleven cases were treated conservatively and 61 cases were treated by open reduction. Among them, 2 cases were fixed with intramedullary nailing, 36 cases by plating and 23 cases by combined method. 4. The time required for bony union was shorter in group of open reduction and plating than in groups of the other treatment. 5. The functional result was satisfactory in 53 cases(74%) and was best in group of open reduction and plating. 6. Among 5 cases of nonunion, 3 cases were developed in open fractures.
Adult ; Female ; Forearm ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Fractures, Open ; Humans ; Methods ; Radius ; Ulna

While benign tumors of tendons and aponeuroses are observed commonly and have been defined adequately, malignant tumors originating from these tissues are rare. Among those reported most had been classified as synovial sarcoma or fibrosarcoma until Ezinger in 1965 described a new type that he called “clear cell sarcoma” of tendon and aponeurosis. Recently, Ultrastructural and histochemical analysis has revealed that the tumor cells contain melanin in the form of melanosomes in varying stages of development and currently, the neoplasm is considered a primary malignant melanoma of the soft tissue. A csse of clear cell sarcoma of flexor tendon in the wrist is reported, with an emphasis on its electron microscopic description.
Fibrosarcoma ; Melanins ; Melanoma ; Melanosomes ; Sarcoma, Clear Cell ; Sarcoma, Synovial ; Tendons ; Wrist

Calcaneus is more frequently fractured than any other tarsal bones. Because of complex contour of calcaneus, it is difficult to evaluate the type of fracture exactyly. Futhermore fractures involving subtalar joint give rise to chronic pain and functional incapacity. Many different methods have been tried for treatment, but there was no aggrement of its methods and results. From January 1981 to December 1986, calcaneal fractures of 62 cases in 52 patients were analyzed and the results obtained from this study were as follows :l. Of 52 patients, 41 patients were male and 11 female. 2. The cause of fractures was a falling down in 38 patients (76%), traffic accident in 8 patients (15%) and direct blow in 6 patients (12%) 3. According to Rowe;s classfication, Type I fracture was in 5 cases, Type II in 6 cases, Type lll in 5 cases, Type IV in 12 cases and Type V in 34 cases (55%). Of these Type V fracture, tongue type was in 21 cases and joint depression type in 13 cases. 4. The treatment was as follows : cast immobilization in 33 cases, closed reduction and pin fixation in 24 cases and open reduction in 5 cases. 5. The functional result was satisfactory in 44 cases (71%). The result was better in fractures not involving subtalar joint and among type V fractures, the result was better in fractures of tongue type treated with open reduction. 6. So, we recommended compressive bandage and early mobilization for fractures without displacement, axial fixation for tongue type fractures and open reduction for joint depression type fracture.
Accidental Falls ; Accidents, Traffic ; Bandages ; Calcaneus ; Chronic Pain ; Depression ; Early Ambulation ; Female ; Humans ; Immobilization ; Joints ; Male ; Subtalar Joint ; Tarsal Bones ; Tongue