From May, 1971 to June, 1984, we performed extensive saucerization on the chronic osteomyelitis of long bones eradicating all pathologic foci; not only sequestra but sclerotic involocurum and necrotic original cortex embeded by new bone, which was different from the conventional methods such as sequestrectomy or guttering in its extensiveness. Clinical analysis on the base of radiologic evaluation after saucerization was done on the 16 patients; for average 5 years of follow-up. The results obtained were as follows; 1. The angulatory deformity of the long bones after pathologic fracture complicated by the chronic osteomyelitis was not corrected satisfactorily due to the bony sclerosis or hyperostosis at the fracture site, especially in cases of posterior or medial angulation. 2. The recurrence was closely related to the persisting non-sequestered original cortical lesion after incomplete saucerization, which was embeded by the new bone. So to prevent the recurrence the non-sequestered original cortical lesion must be removed completely. 3. The cortical defect after saucerization was restored completely in patients under the age of 14, but which was not the way in patients over the age of 16.
Congenital Abnormalities ; Follow-Up Studies ; Fractures, Spontaneous ; Humans ; Hyperostosis ; Osteomyelitis ; Recurrence ; Sclerosis

No abstract available.
Pressure Ulcer*

Insulin autoimmune syndrome (IAS) includes fasting or reactive hypoglycemia, hyperinsulinemia and the presence of insulin-binding antibodies in patients who have never been exposed to exogenous insulin. This report concems a 29-year-old male patient with Graves disease who had history of having taken methimazole for two months, without any consequence, 6 months previously. However, when methimazole was administered again for three weeks, the patient suffered hypoglycemia during the next fourth week. He denied history of diabetes mellitus (DM), of taking any oral hypoglycemic agent or of having received insulin injection. Laboratory data showed total serum insulin level > 300 pu/mL, C-peptide reactivity (CPR) 8.0ng/mL and insulin antibody 89%. After stopping methimazole, he was treated with radioiodine (131I). There was no episode of hypoglycemic attack during 8 months of follow-up.
Adult ; Antibodies ; C-Peptide ; Diabetes Mellitus ; Fasting ; Follow-Up Studies ; Graves Disease* ; Humans ; Hyperinsulinism ; Hypoglycemia ; Insulin ; Male ; Methimazole

In evaluation of head trauma, simple skull examinations have been almost routinely requested in emergency room, regardless of historical, physical or neurologic findings, for fear of an unexpected fracture and medicolegal problem. Considering the low yield rate of positive radiologic findings for skull fracture and poor correlation of skull fracture with intracranial sequelae, simple skull examinations in head trauma patients, especially in those with minor trauma, is overutilized without reasonable clinical criteria of application. A retrospective review of 1,101 patients was performed to evaluate the efficacy of simple skull examination at the point of diagnosis and treatment, and to predict the risk for skull fracture and significant intracranial sequelae by clinical findings. Eighty-six patients(7.8%) had skull fractures including two basilar fractures and 12 depressed fractures. 116 patients(10.5%) had significant intracranial sequelae and 62 of these had skull fractures. Of 1,101 patients, 237 had the clinical findings of "high-yield" features and 70 of these had skull fractures and 99 had intracranial sequelae, so high-yield fractures are very indicative for the skull fracture and intracramal sequelae. Only in nine patients(0.08%0 the managements were altered after simple skull examination in that two with basilar fractures were treated with antibiotics and seven with depressed fractures were undergone neurosurgical precedures. Patients who were not admitted nor required further study or treatment because of minor head traumadidn't have any skull fractures or intracranial sequelae in our series, and 62 of 116 patients with intracranial sequelae showed normal skull findings indicating that normal findings can create false sense of security.
Anti-Bacterial Agents ; Craniocerebral Trauma* ; Diagnosis ; Emergency Service, Hospital ; Head* ; Humans ; Neurologic Manifestations ; Retrospective Studies ; Skull Fractures ; Skull*

PURPOSE: LASEK is a newly developed refractive surgery technique that can make up for the complications from PRK and LASIK. The most unique procedures in LASEK is covering of the cornea with epithelial flap after keratectomy. We examined the effect of corneal epithelial flap on the wound healing of canine cornea. METHODS: Operation was performed in eyes from 12 dogs, and the 12 eyes were recovered with epithelial flap and the remaining 12 eyes were recovered without epithelial flap. Wound healing process was compared using fluorescein staining, light and transmission electron microscopic examination. RESULTS: Fluorescein stained area of the cornea was reduced with time in both groups, and from 9 hours after the operation, it was significantly reduced in the group with epithelial flap compared with those of the group without epithelial flap (p< 0.05). On light microscopic examination of the group with epithelial flap, and normal epithelial structure was found at 24 and 48 hours, respectively. However, in the group without epithelial flap, no complete reepithelialization had occurred on center at 48 hours after the operation. On transmission electron microscopic examination, eyes of the group with epithelial flap showed hemidesmosomes in the area where epithelial flap was closely contacted with the stroma at 24 hours, and they were completely developed at 48 hours. On the other hand, in the group without epithelial flap, hemidesmosomes developed only in the proximal portion but not at the leading edge even at 48 hours. CONCLUSIONS: These results suggest that corneal epithelial flap accelerate the wound healing process of the cornea and the wound healing process depend on the vitality of the epithelial flap.
Animals ; Cornea ; Dogs ; Fluorescein ; Hand ; Hemidesmosomes ; Keratectomy, Subepithelial, Laser-Assisted ; Keratomileusis, Laser In Situ ; Refractive Surgical Procedures ; Wound Healing* ; Wounds and Injuries*

The author attempted to clarify the nature of alpha-adrenoceptors in relation to the pressor response to the increased intracranial pressure(ICP) in urethane-anesthetized rabbits, using the epidural balloon method. 1) The blood pressure increased in parallel with the raised ICP which was made by gradual inflation of the balloon. 2) B-HT 920, an alpha2-agonist, which elicited depressor and bradycardiac responses in normal rabbits inhibited markedly the pressor response to the raised ICP. 3) Piperoxan, an alpha2-antagonist, potentiated the pressor response to the raised ICP. 4) Piperoxan antagonized the depressor and bradycardiac responses by B-HT 920 as well as the inhibitory effect of B-HT 920 on the pressor response to the raised ICP. 5) The pressor response to the raised ICP were not affected at all by prazosin, an alpha1-antagonist. 6) Neither the depressor and bradycardiac responses by B-HT 920 itself nor the inhibitory effect of B-HT 920 on the pressor response to the raised ICP were significantly affected by prazosin. It is inferred from these observations that the central alpha-adrenoceptors play an important role in producing the pressor response to the raised ICP and that the receptors involved here seems to be of alpha2-type.
Blood Pressure ; Inflation, Economic ; Intracranial Pressure* ; Piperoxan ; Prazosin ; Rabbits

The author attempted to clarify the nature of alpha-adrenoceptors in relation to the pressor response to the increased intracranial pressure(ICP) in urethane-anesthetized rabbits, using the epidural balloon method. 1) The blood pressure increased in parallel with the raised ICP which was made by gradual inflation of the balloon. 2) B-HT 920, an alpha2-agonist, which elicited depressor and bradycardiac responses in normal rabbits inhibited markedly the pressor response to the raised ICP. 3) Piperoxan, an alpha2-antagonist, potentiated the pressor response to the raised ICP. 4) Piperoxan antagonized the depressor and bradycardiac responses by B-HT 920 as well as the inhibitory effect of B-HT 920 on the pressor response to the raised ICP. 5) The pressor response to the raised ICP were not affected at all by prazosin, an alpha1-antagonist. 6) Neither the depressor and bradycardiac responses by B-HT 920 itself nor the inhibitory effect of B-HT 920 on the pressor response to the raised ICP were significantly affected by prazosin. It is inferred from these observations that the central alpha-adrenoceptors play an important role in producing the pressor response to the raised ICP and that the receptors involved here seems to be of alpha2-type.
Blood Pressure ; Inflation, Economic ; Intracranial Pressure* ; Piperoxan ; Prazosin ; Rabbits

To investigate the earlier cellular alterations(Glucose-6-Pase activity and morphologic features) caused by a hepatotoxin, thioacetamide (TAA), a single dose of the agent (200mg per kg of body weight) was given intraperitoneally to mice, which were sacrificed at intervals of 4, 8 or 16 hours after corresponding treatments. For histochemical study of glucose-6-phosphatase (G6Pase) activity, unfixed frozen sections were incubation of the Wachstein and Meisel medium and stained. The smallest pieces of liver tissue were fixed in glutaraldehyde and osmic acid, and stained by the routine electron-microscopic techniques. Some pieces of liver were fixed in 10% formalin, embedded in paraffin, and stained with hematoxylin and eosin. There was a rapid and progressive loss of G6Pase activity, in an orderly time sequence, in the experimental group. There were also morphologic changes: loss of cytoplasmic basophilia, cell infiltration and necrosis in the centrilobular and intermediate zones, and an increase of sER, small vesicles and ribosomes in the cytoplasm of hepatocytes, the marked changes of nuclei and nucleoli, and a slight increase of lipid droplets in the cytoplasm at 16 hours after intoxication. The correlation between these cellular alterations was discussed in view of mechanisms in the hepatotoxic action.
Acetamides/adverse effects* ; Animal ; Glucose-6-Phosphatase/metabolism* ; Liver/drug effects* ; Liver/enzymology ; Liver/ultrastructure ; Male ; Mice ; Thioacetamide/adverse effects* ; MH - ; Substances: ; Acetamides ; Thioacetamide ; Glucose-6-Phosphatase

To investigate the earlier cellular alterations(Glucose-6-Pase activity and morphologic features) caused by a hepatotoxin, thioacetamide (TAA), a single dose of the agent (200mg per kg of body weight) was given intraperitoneally to mice, which were sacrificed at intervals of 4, 8 or 16 hours after corresponding treatments. For histochemical study of glucose-6-phosphatase (G6Pase) activity, unfixed frozen sections were incubation of the Wachstein and Meisel medium and stained. The smallest pieces of liver tissue were fixed in glutaraldehyde and osmic acid, and stained by the routine electron-microscopic techniques. Some pieces of liver were fixed in 10% formalin, embedded in paraffin, and stained with hematoxylin and eosin. There was a rapid and progressive loss of G6Pase activity, in an orderly time sequence, in the experimental group. There were also morphologic changes: loss of cytoplasmic basophilia, cell infiltration and necrosis in the centrilobular and intermediate zones, and an increase of sER, small vesicles and ribosomes in the cytoplasm of hepatocytes, the marked changes of nuclei and nucleoli, and a slight increase of lipid droplets in the cytoplasm at 16 hours after intoxication. The correlation between these cellular alterations was discussed in view of mechanisms in the hepatotoxic action.
Acetamides/adverse effects* ; Animal ; Glucose-6-Phosphatase/metabolism* ; Liver/drug effects* ; Liver/enzymology ; Liver/ultrastructure ; Male ; Mice ; Thioacetamide/adverse effects* ; MH - ; Substances: ; Acetamides ; Thioacetamide ; Glucose-6-Phosphatase

Closed internal degloving is a significant soft-tissue injury associated with a trauma that results in a tear of the subcutaneous tissue away from the underlying fascia. Although the diagnosis of Morel-Lavallee lesion (MLL) is routinely based on clinical and radiological examinations, in one-third of the cases, there is a possibility that clinicians may fail to diagnose MLL due to its inconsistent clinical manifestations. Additionally, it often involves initial skin bruising due to underlying soft-tissue injury. We present two cases of delayed MLL without a fracture treated using percutaneous drainage and sclerotherapy. Our cases demonstrated successful treatment with a minimally invasive percutaneous approach. The potential advantage of using a percutaneous technique is to preserve the subdermal arterial plexus, which is the only remaining blood supply to the skin in the area of the lesion. Maintaining this blood supply may result in healthier skin at the time of any open procedure.
Diagnosis ; Drainage* ; Fascia ; Sclerotherapy* ; Skin ; Subcutaneous Tissue ; Tears