Metallosis has been reported in the setting of weight-bearing joint arthroplasties, like the hip and knee joints. However, the prevalence of metallosis in non-articular portions is very uncommon. We report a rare case of a patient who had metallosis secondary by fibular nonunion after fixation with plate and screw. In addition, we discuss the clinical and the operative findings, as well as the outcome of this uncommon complication.
Arthroplasty ; Hip ; Humans ; Joints ; Knee Joint ; Prevalence ; Weight-Bearing

STUDY DESIGN: Retrospective study of 72 patients treated for the acute lower cervical spinal injury with or without spinal cord injury. OBJECTIVES: We designed this study to evaluate the determining factors in the prognosis of the acute cervical spinal cord injury. We hypothesized as the prognosis is dependent on the severity of injury, not by time-related for the initiation of the treatment. SUMMARY OF BACKGROUND DATA: There is still controversies in the management of the acute cervical spinal cord injury. And the prognosis is generally considered to depend on the severity of trauma to the spinal cord. METHODS: We divided neurologic status into 4 groups; complete, incomplete, root injury and no neurologic deficit group. And there were complete cord injury in 12, incomplete cord injury in 34, single root injury in 14 and no neurologic deficit in 12 patients. The time to operation since injury was 24 hours in 7, 7 days in 32, 3 weeks in 15, 6 weeks in 8, and more than 6 weeks in 5 cases. The operation was indicated mainly for the patients with irreducible fracture-dislocation or for the patients with bony fragments, and disc materials impinging on the spinal cord. Surgical treatment were done in 67 cases with anterior cervical discectomy and fusion(ACDF), ACDF with anterior stabilizaiton, posterior wiring, and circumferential fusion. We statistically analyzed the relationship hetween the time to surgery after injury and the degree of neurologic recovery after surgical treatment by chi square test. RESULTS: There were no neurologic recovery in complete cord injury. There were incomplete cord injury in 34 patients, 8 anterior cord syndrome had no neurologic recovery, among 24 patients with central cord syndrome(CCS) 18(22/24 operated) had neurologic recovery in various degrees and 2 of Brown-Sequard syndrome showed significant neurologic recovery. In nerve root injury, all except l (1/12) patient had complete neurologic recovery. There were neurologic recovery in 2/2 CCS when operated within 24 hours, 8/10 CCS when operated between 2-7 days and 4/5 CCS when operated between 2-3 weeks. There were neurologic recovery in 3/3 CCS when operated between 4-6 weeks and 1/2 CCS when operated more than 7 weeks after injury. There was no significant difference in the relationship between the time to surgery after injury and the degree of neurologic recovery after operation(X2=2.48, df=4, P=0.65). CONCLUSION: Spinai cord injury is directly related with the magnitude of injury at the time of trauma, and the prognosis is determined entirely at the time of injury, And the prognosis is not altered hy time of the treatment.
Brown-Sequard Syndrome ; Diskectomy ; Humans ; Neurologic Manifestations ; Prognosis* ; Retrospective Studies ; Spinal Cord Injuries* ; Spinal Cord* ; Spinal Injuries

The dysplastic hip presents problems to the orthopedic surgeon in the reconstruction of hip using total hip prosthesis. The use of bone grafts to reconstruct the lateral acetabular bone deficiency is very popular. We investigated in 23 patients(5 cemented cup and 18 cementless cup). Sixteen patients were women and seven were men, whose average age was 42.4 years old; their average followup was 4.6 years. The average Harris hip score improved from a preoperative value of 48 points to a postoperative value of 87 points. Five cases showed radiographic loosening, in which 3 cases loosening from five cemented cup and 2 cases from cementless cup arthroplasty. Radiolucent lines were observed more frequently with cemented cups at last follow-up. Of the 23 cases, 18(78%) was successful. Postoperatively limping was a major problem because most patients in this series had unilateal disease. The grafted bone was incoporated by an average time of 7.4 months, and minor resorption was showed at last follow-up. In our series, cementless cups with autogenous bone graft noted good results than cemented cup arthroplasty.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Female ; Follow-Up Studies ; Hip Prosthesis ; Hip* ; Humans ; Male ; Orthopedics ; Transplants

A 52-year-old woman with a history of at least 5 attacks of benign recurrent aseptic meningitis for the past 2 years is presented. Three of 5 attacks were afrebrile. In cerebrospinal fluid examinations, there was increased protein, normal or reduced glucose, and pleocytosis including endothelial cells, lymphocytes or leukocytes. Brain computed tomography revealed slight ventricular dilatation. No causative organism was found with available techniques. This is believed to be the first reported case of Mollaret's meningitis in Korea.
Brain ; Cerebrospinal Fluid ; Dilatation ; Endothelial Cells ; Female ; Glucose ; Humans ; Korea ; Leukocytes ; Leukocytosis ; Lymphocytes ; Meningitis ; Meningitis, Aseptic ; Middle Aged

Both spindle cell variant of squamous cell carcinoma and atypical fibroxanthoma are most commonly presented as a solitary, often ulcerated nodule, occurring on sun-exposed skin of the elderly. These lesions also share the histologic features of diffuse or indistinct fascicular arrangement of polygonal or pulmp spindle cells. Therefore it is not easy to differentiate immunohistochemistry is done. A case of 73 year old woman with squamous cell carcinoma of the skin resembling atypical fibroxanthoma is presented.
Female ; Humans

The present study was intended to examine the effect of sodium vanadate on contractility of vascular smooth muscle. Aortic ring preparations were made from the rabbit thoracic aorta and endothelial cells were removed from the ring. The contractility of the aortic ring was measured under various conditions. The results were summarized as follows; 1) Sodium vanadate induced contraction of vascular smooth muscle in a dose-dependent fashion. 2) The contractile effects were not blocked by treatments with adrenergic blocking agent(phentolamine) and indomethacin, indicating the direct action of the drug on vascular smooth muscle. 3) In the presence of ouabain, Na(+)-K(+)-ATPase inhibitor, sodium vanadate still increased the contractility of vascular smooth muscle. 4) Treatment with 4.4'-diisothiocyanostilbene-2.2'-disulfonic acid(DIDS) blocked completely the contractile effects of sodium vanadate. 5) In the presence of verapamil, lanthanum and ryanodine, the contractility of the vascular smooth muscle by sodium vanadate was decreased. From the above results. it was suggested that sodium vanadate acts directly on vascular smooth muscle and causes contraction. It was probably due to inhibition of Ca(++)-ATPase in plasma membrane as well as increasing the release of Ca(++) from sarcoplasmic reticulum and Ca(++) influx across the plasma membrane, but not inhibition of Na(+)-K(+)-ATPase.
Aorta, Thoracic ; Cell Membrane ; Endothelial Cells ; Indomethacin ; Lanthanum ; Muscle, Smooth, Vascular* ; Ouabain ; Ryanodine ; Sarcoplasmic Reticulum ; Sodium* ; Vanadates* ; Verapamil

Acute cervical myelopathy is usually caused by fracture or fracture-dislocation of vertebra due to high energy trauma, not ruptured disc material. However, in this report, we present an unusual case that lead to severe neurological symptom such as motor weakness of upper and lower extremity during leisure sports activity in adjacent segment of previous anterior cervical fusion.
Leisure Activities ; Lower Extremity ; Spinal Cord Diseases ; Spine ; Sports

No abstract available.
Infant, Newborn ; Jaundice, Neonatal* ; Radionuclide Imaging* ; Technetium Tc 99m Disofenin*

Teramethylammonium(TMA) in one of the synthetic compounds of nicotine that act at ganglionic site. The major action of TMA consists of initial stimulation followed by a more persistent depression of all autonomic ganglia by binding to a cholinergic receptor. It is well believed that the level of membrane potential in arterial smooth muscle is an important regulator of tension development. Depolarization and hyperpolarization by only few millivolts results in significant changes in tension. In general, the agents of vascular smooth muscle induce vascular relaxaion. The present study was undertaken to elucidate the effect of TMA on vascular contractility in the isolated rabbit thoracic aorta with or without endothelial cell, and mechanisms involved in the change of vascular contractility by TMA. The results obtained are summarized as follows ; 1) In the presence of endothelial cell, TMA induced a relaxtion of the aorta precontracted with norepinephrine but induced a contraction in the aorta without endothelial cells, indicating that in the rabbit aorta, relaxations produced by TMA were the endothelium-dependent. 2) The addition of inhibitor such as methylene blue, hemoglobin, hydroquinone and p-bromophenacyl bromide during the TMA-induced relaxation reversed the contractile tension to a level similar to or higher than that before the addition of TMA in rabbit thoracic aorta.This relaxation effect of TMA suggest that the TMA-inducdd relaxation in rabbit aorta is due to the release of endotheline derived relaxing factor(EDRF). 3) Relaxation induced by TMA was antagonized by atropine and thus the TMA does seem to act on the muscarinic receptors. 4) TMA reduced the norepinephrine-induced Ca++ influx into rabbit smooth muscle membrane. From the above results, it may be concluded that TMA-induced vacular relaxation in rabbit aorta is due to the release of EDRF. Mechanism involved in the relaxation induced by TMA may be the stimulation of soluble guanylate cyclase and increased tissue cGMP concentrations.
Aorta ; Aorta, Thoracic* ; Atropine ; Depression ; Endothelial Cells ; Endothelins ; Endothelium ; Endothelium-Dependent Relaxing Factors* ; Ganglia, Autonomic ; Ganglion Cysts ; Guanylate Cyclase ; Membrane Potentials ; Membranes ; Methylene Blue ; Muscle, Smooth ; Muscle, Smooth, Vascular ; Nicotine ; Norepinephrine ; Receptors, Muscarinic ; Relaxation

The clinical observation on hematuria was done who were admitted to the Department of Urology, from January, 1979 to December, 1981. The following results were obtained. 1. The total numbers of admission with hematuria were 262 cases (60.7%) 2. The incidences of hematuria were calculus, trauma and BPH in frequence. 3. The most frequent incidences of hematuria were calculus and trauma under the age of 50 and BPH and tumor over the age of 50. 4. The site of hematuria were in the ureter (35.1%), prostate (18.7%), Bladder (18%), Kidney (13.4%). 5. The cases of asymptomatic hematuria were 20.7 %, and their common causes were renal lesions and the cases of symptomatic hematuria were 79.3% and their common causes were ureteral lesions.
Calculi ; Hematuria* ; Humans ; Incidence ; Kidney ; Prostate ; Ureter ; Urinary Bladder ; Urology