Hypercalcemia complicating the treatment of fractures is occasionally seen by the orthopedic surgeon. That this complication can occur in immobilized patients with pre-existing metabolic and bone diseases, such as Pagets disease, hyperparathyroidism, multiple myeloma, and the like is well established. It is less well recognized, however, that hypercalcemia can complicate immobilization in patients with no evidence of pre-existing metabolic and bone diseases. The calcium mobilization from the skeleton following immobilization is reflected clinically hypercalciuria, but significant elevation of serum calcium level does not generally occur in normal persons in complete bed rest or in patients with no pre-existing metabolic or bone diseases who are immobilized in the body cast for treatment of fractures. In order to ascertain the above facts, following experiments were carried out in 24 patients who were immobilized after fracture or operation. In each patient, calcium and phosphate levels in serum and 24-hour urine were determined both before and 20 to 30 days after immobilization. The results obtained are summerized as follows; 1) Calcium levels in both serum and 24-hour urine are increased following immobilization, the mean value being 1.17mg percent and 168. 6mg, respectively, with no concomitant increase of phosphate in serum and 24-hour urine. 2) It is also suggested that the amounts of increase in calcium levels in serum and urine are influenced solely by the extent of immobilization and not dependent upon the presence or abscence of pre-existing bone diseases or age.
Bed Rest ; Bone Diseases ; Calcium ; Humans ; Hypercalcemia ; Hypercalciuria ; Hyperparathyroidism ; Immobilization ; Multiple Myeloma ; Orthopedics ; Skeleton

No abstract available.
Fever*

Mucous gland adenoma, one type of bronchial adenoma, is first introduced by Rosenblum and Klein2) in 1935 and very rare. Only twenty-one cases had been reported in english literature. This tumor must be differentiated from other types of bronchial adenoma because of completely benign clinical course. A case of mucous gland adenoma is presented which showed marked secondary calcification.
Adenoma

No abstract available.
Glomerulonephritis*

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

No abstract available.
Classification* ; Shoulder*

The cruciate ligaments are important in providing the anterior and posterior stability and usually associated with other ligament injury of the knee joint, and there are many controversies in its treatment. In general, the primary repair for the acute cruciate ligament injury was good, but some had opposite opinions in the treatment of the isolated anterior cruciate ligament injury. In acute injury, early repair of ligament and in delayed case, the reconstrution surgery of ligament was recommended. For good results, it is very important to give prompt management. Authors studies 23 cases in 16 patients with acute cruciate ligament proper injury who were treated by multiple pull out technique at the department of orthopaedic surgery, Chungnam National University Hospital from April, 1984 to July, 1988. The results were as followings: 1. The incidence was high in active male patients. 2. The most common injury was the traffic and automobile accident. 3. the tibial and femoral attachment were the most common detachment site in anterior and posterior cruciate ligament injury, respectively. 4. Isolated cruciate ligament injury was rare. 5. The results were good in 11 cases(47.8%), especially treated within one week.
Anterior Cruciate Ligament ; Automobiles ; Chungcheongnam-do ; Humans ; Incidence ; Knee Joint ; Ligaments ; Male ; Posterior Cruciate Ligament

The diagnosis and treatment of avascular necrosis of femoral head advanced, after Freud issued examples of bilateral avascular necrosis of femoral head (AVN) in 1926. But still not fixed in treatment and diagnosis. Recently early diagnosis and treatment produced good result. Whole body bone scan, intraosseous pressure mornitoring, intramedullary venography, C-T, or MRI, Selective femoral angiography also used in early diagnosis. Selective femoral angiography was performed for 56 patients, who has suspected as AVN by sumple X-ray and WBBS in order to estimate. How the femoral angiographic finding exist in AVN. In the control group femoral angiography performed to 5 person with normal stage of clinical and radiologic finding. So the result are as following l. All cases in the control group were not observed terminal branch of superior and inferior capslar branch. 2. In AVN the alteration of vasculature appeared 22 patients among 56 patient. 3. The altered vasculature presented 87.5% in traumatic group and 31.5% in nontraumatic group. 4. Collateral circulation was 22.2% in the cases of patients under 6 moths of the time interual between etiological events and clinical symptoms, 89.5% over 6 months. 5. Collateral circulation received 86.8% from inferior gluteal artery two cases from superior gluteal artery, and three cases form obturator artery. 6. Clinical tolerance was supposed to in well developed collateral circulation. According to the above results, Vascular alteraion were noted very much in traumatic group and development of collateral circulation were related promote clinical tolerance. Selective femoral angiography was not effective to assist early diagnosis and treatment of AVN for it could not detect terminal branch of superior and inferior capsular artery that reflected intraossous vasculsture. We need the new nethod of angoigraphy in order to early diagnosis.
Angiography ; Arteries ; Collateral Circulation ; Diagnosis ; Early Diagnosis ; Head ; Hip ; Humans ; Magnetic Resonance Imaging ; Moths ; Necrosis ; Phlebography

Treatment of a paralysed or flail shoulder falls into two categories; arthrodesis and reconstructive surgery. Of these the latter is preferable in view of mobility. Most authors have tried to reconstruct the paralysed abductor by transferring the trapezius muscle only. The final result of these procedures were poor in severe paralysis of the deltoid muscle or combined paralysis of the deltoid and the rotator cuff muscles. Noting the importance of the action of the rotator cuff muscles in abduction of the shoulder, Saha, in 1967, recommended simultaneous reconstruction of tne paralysed deltoid and rotator cuff muscles. We treated a case of paralysed shoulder that followed poliomyelitis by the Saha meshod, i.e., transfer of the trapezius muscle for the paralysed deltoid, transfer of the levator scapulae muscle for the supraspinatus, transfer of the pectoralis minor muscle for the subscapularis, all in one stage. Duration of the follow up was 3 months and the initial result seemed to be good in view of stability, mobility, and abductor power.
Accidental Falls ; Arthrodesis ; Deltoid Muscle ; Follow-Up Studies ; Methods ; Muscles ; Paralysis ; Poliomyelitis ; Rotator Cuff ; Shoulder ; Superficial Back Muscles

A 26-year-old man presented with a bluish speckled patch on the dorsum of the left hand. It had apperaed at birth as a bluish spot. Since adolescence the lesion extended and at the time of visiting hospital it covered the most part of the dorsum of the left hand and even some palmar aspect. The histopathological and ultrastructural examination revealed numerous dermal melanocytes, mainly in the upper dermis. Clinically and pathologically, the patient was diagnosed as having dermal melanocyte hamartoma, a distinct type of dermal melanocytosis.
Adolescent ; Adult ; Dermis ; Hamartoma* ; Hand ; Humans ; Melanocytes* ; Parturition