Posteroanterior radiographs of normal wrist were taken in seventeen volunteers, and analysed to determine the dynamic relationships between the radiocarpal and midcarpal joint during radioulnar deviation. The total arc of radioulnar deviation was 59 degrees, and the motion was 44% radiocarpal and 56% midcarpal. During radioulnar deviation, the motion at the midcarpal joint was more than that at the radiocarpal joint. It is suggested thst dorsoradial and palmar-ulnar flexion as it occurs at the midcarpal joint can be correlated in radio-ulnar deviation of the wrist more than the coronal sliding motions as it occurs mainly at the radiocarpal joint.
Joints ; Volunteers ; Wrist

The main problem in peripheral nerve repair is adhesion, axonal escape, and the ingrowth of extraneurial tissue into the wound. Meticulous microsurgical neurorrhaphy is one of possible answer for these problem. Shielding of nerve suture is another attractive practice. But the results are still unpredictable. We compared the results of nerve repair between microsurgical epineurial neurorrhaphy plus silastic cuff shielding group and epineurial neurorrhaphy group in the sciatic nerve of white rat. The reasults we obtained are as follows; 1. Silastic cuff shielding method was effective for reducing abnormal neurial growth and neuroma formation into the surrounding soft tissue. 2. Some adhesion was formed over the silastic cuff, but there was no adhesion at the inner space of the cuff. 3. Silastic cuff could prevent fibrous tissue ingrowth into the nerve. 4. The slit of the silastic cuff provided vascular ingrowth between surrounding connective tissue and nerve tissue. 5. No evidence of foreign body reaction was observed in and out of the silastic cuff. 6. Nerve conduction test showed a little supperior results in the silastic cuff shielding group. Silastic cuff shielding method in nerve suture might be recommanded to prevent axonal escape, fibrous scar tissue ingrowth to the nerve, and fibrous adhesion in clinical practice. But, it seemed that the final evaluation of the functional recovery of the nerve needed long term follow-up and nerve conduction study.
Animals ; Axons ; Cicatrix ; Connective Tissue ; Follow-Up Studies ; Foreign-Body Reaction ; Methods ; Nerve Tissue ; Neural Conduction ; Neuroma ; Peripheral Nerves ; Rats ; Sciatic Nerve ; Sutures ; United Nations ; Wounds and Injuries

No abstract available.

Synthetic hydroxyapatite is a safe, nontoxic, biocompatible, and osteoconductive material. Hydroxyapatite-coated implants have the property of achieving a very strong bond with living bone in a relatively short period. From March 1992 to June 1994, 140 hydroxyapatite-coated primary total hip prostheses were implanted. This study included 60 cases that could follow up minimum 3 years. At the time of mean follow up, 45 months after operation, the mean Harris hip score was 92 points. Only two patients complained of thigh pain at last follow up. On radiographic evaluation, radiolucent lines were seen around the uncoated distal part of the stem in 46 percents of the implants. No radiolucent line was observed around the coated area of the prosthesis. Cancellous condensation was seen in 95 per cents of the implants at the Gruen zone 2 and 6 area. Cortical hypertrophy was present in 32 percents. Fourteen cases had the gaps at the bone to acetabular cup interface in the immediate postoperative period. The gaps disappeared in 12 months after operation. Five implants were revised because of polyethylene wear, cup migration and periprosthetic fracture. The clinical outcome was excellent. But this result was obtained in the relatively short-term follow up. Longer-term data will be the only true test of the value of hydroxyapatite coated implant.
Acetabulum ; Arthroplasty, Replacement, Hip ; Durapatite* ; Follow-Up Studies ; Hip Prosthesis* ; Hip* ; Humans ; Hypertrophy ; Periprosthetic Fractures ; Polyethylene ; Postoperative Period ; Prostheses and Implants ; Thigh

Metastasis to bone with destruction of the skeletal system is a common problem in old patients with malignancy. Destruction of the musculoskeletal system poses major problems for the patients, including uncontrollable pain, forced immmobilization, pathologic fracture and hypercalcemia. The purpose of this study is to evaluate the effectiveness of surgical treatment and to suggest treatment guidelines for impending or established pathologic fractures due to metastasis of the femur. Between 1985 and 1995, thirty six patients who had pathologic or impending fractures in the femur underwent surgical treatment. The indications of surgery for pathologic fractures are 1) the possibility of survival time more than three months, 2) more benefits of sungical treatment than those of conservative treatment, 3) the possibility of rigid internal fixation, 4) patient s general condition allowing surgery, and those in impending fractures are 1) cortical destruction more than 50% or lytic lesion more than 2.5cm. The method of surgery was excision of the tumor and rigid internal fixation to allow early ambulation with or without bone cement augmentation. The results were analyzed by three criteria, the performance status, pain relief and survival time. Pain relief more than Lots was achieved in 80.6% of patients according to the Kaiko's criteria. The performance status improved more than one grade in all patients except one who died of acute respiratory failure and the mean improvement was 1.8 grade by the Functional Classification of the New York Heart Association. Postoperatively, most of the patients had only slight to moderate limitation of physical activities and felt comfortable at rest and ordinary activities. The survival time was 20.9 months in patients with single metastasis and 10.2 months in patients with multiple metastases. But there was no statistical significance due to large deviation of survival time in each case. In summary, surgical stabilization of the pathologic lesion involving the femur provided definite improvement of quality of life including pain relief and early ambulation. In selected patients with single metastasis, low grade malignancy, or good performance status, postoperative survival time may be expected to be prolonged. More aggressive treatment for the metastatic lesion of the femur is suggested.
Classification ; Early Ambulation ; Femur* ; Fractures, Spontaneous ; Heart ; Humans ; Hypercalcemia ; Motor Activity ; Musculoskeletal System ; Neoplasm Metastasis ; Quality of Life ; Respiratory Insufficiency

BACKGROUND: Recently, the molecular pathologic investigation for clonality in lymphomas has been introduced and has gained a role in the diagnosis of lymphomas. In fact, the clonality test using TCRGR phenomenon has been done by Southern blot analysis (SBA) and polymerase chain reaction (PCR) for molecular pathologic diagnosis of T cell lymphomas. However, it is difficult to perform SBA with paraffin embedded specimens or with samples of small skin biopsies. OBJECTIVE: We investigated the efficacy of PCR amplification of TCR gene in paraffin em-bedded cutaneous T cell lymphomas. METHODS: Iii this study, the clonality was assessed by polymerase chain reaction (PCR) analysis of T cell receptor gamma (TCR) gene from the DNA extracts obtained from paraffin em-bedded tissues (PET) of malignant T cells, B cell lymphomas, and benign cutaneous T cell proliferative disorders. Heteroduple-x-analyses were also performed to rule out the false positives. RESULTS: Among the total of 62 cases analyzed, monoclonality was observed in 4 out of 10 mycosis fungoides, 7 out of 9 cutaneous T cell lymphomas excluding mycosis fungoides, 1 out of 3 angiocentric lymphomas, 2 out of 2 lymphomatosis papulosis, 1 out of 7 large plaque parapsoriasis, and 1 out of 2 T cell lymphomas in other organs. No monoclonality was observed in 9 inflammatory cutaneous diseases, 5 small plaque parapsoriasis, 4 cutaneous B cell lymphomas, and 11 B cell lymphomas in lymph nodes. CONCLUSION: The results suggest that the PCR method and heteroduplex analysis used in this study were not only practical but also efficacious for the diagnosis of cutaneous T cell lymphomas using tissues embedded in paraffins.
Biopsy ; Blotting, Southern ; Diagnosis ; DNA ; Gene Rearrangement* ; Genes, T-Cell Receptor ; Heteroduplex Analysis* ; Lymph Nodes ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Cutaneous ; Mycosis Fungoides ; Paraffin ; Parapsoriasis ; Polymerase Chain Reaction* ; Receptors, Antigen, T-Cell* ; Skin ; T-Lymphocytes

Cutaneous metastasis from renal cell carcinoma is unusual and have been reported infrequently. We report a case of metastatic renal cell carcinoma in a 33-year-old man who presented with a 3.5X2.0 cm-sized round, brightly red colored nodule on the scalp for 1 month. A skin biopsy revealed the typical clear cell adenocarcinoma with clear cytoplasm and oval hyperchromatic nuclei arranged in glandular pattern consistent with metastatic renal cell carcinoma. In most instances, once cutaneous involvement is manifested the disease is widespread and has a poor prognosis. But, our case presented only a single cutaneous nodule, and workup showed no evidence of further metastasis for 1 year.
Adenocarcinoma, Clear Cell ; Adult ; Biopsy ; Carcinoma, Renal Cell* ; Cytoplasm ; Humans ; Neoplasm Metastasis ; Prognosis ; Scalp* ; Skin

Glutathione has a key role in several detoxification reactions and in the protection against injury caused by reactive oxygens. Pregnancy-induced hypertension(PIH) is associated with endothelial cell dysfunction. Such dysfunction could be caused by oxidative stress. There is evidence of increased activity of free radicals in PIH, but little is known about the part played by changes in specific antioxidants. In this study, the changes of glutathione levels were investigated in blood of patients with PIH, and cord blood of these patients was also investigated. The glutathione levels in cord blood of neonates from hypertensive pregnant women were significantly higher than in cord blood from normotensive pregnant women. The changes of gamma-glutamuylcysteine synthetase and of glutathione s-transferase in placenta were not significant, but gamma-glutamyl transpeptidase activity increased significantly in placenta of hypertensive pregnant women. These results suggest that the increased glutathione in cord blood of patients with PIH may be due to increased glutathione interorgan transport resulting from incerased activity of the placenta gamma-glutamyl transpeptidase.
Antioxidants ; Endothelial Cells ; Female ; Fetal Blood ; Free Radicals ; gamma-Glutamyltransferase ; Glutathione Transferase ; Glutathione* ; Humans ; Hypertension, Pregnancy-Induced* ; Infant, Newborn ; Ligases ; Oxidative Stress ; Oxygen ; Placenta* ; Pregnancy ; Pregnant Women

Thirty-nine patients with fixed drug eruption who visited the Department of Dermatology in National Medical Center from January 1g7g to December 1982 were selected. Among them, twentyseven patients performed skin biopsy and were evaluated histopathologically on the basis of duration. The results were as follows; ].In the early stage less than 1 week of duration, hydropic degeneration of basal cells, necrotic keratinocytes with eosinophilic cytoplasm and pknotic nucleus in the epidermis, and mixed cell infiltration with eosinophlis in the upper dermis were prominently. In the late stage more than 20 days of duration, acanthosis, an increased amount of melanin in the basal cell layer and presence of melanophages were found more prominent, however, hydropic degeneration of basal cells, papillary dermal ederna, inflammatory infiltration of mononuclear cells were found less prounced or absent.
Biopsy ; Cytoplasm ; Dermatology ; Dermis ; Drug Eruptions* ; Eosinophils ; Epidermis ; Humans ; Keratinocytes ; Melanins ; Skin

Multiple primary tumors are defined as cases involving primary malignant tumors of different histologic origins in one person. The absolute number of reported cases of double primary malignant tumors has increased in recent years diagnostic procedures. Primary adenocarcinoma of duodenum is a rare disease and represents less than 0.5% of all gastrointestinal malignancies. Therefore, synchronous multiple primary cancers of the stomach and duodenum are very rare. Recently, we experienced a case of triple primary malignant tumors of different site originating from the stomach, duodenum and cervix in 71- year-old woman. She had had radiation therapy and chemotherapy for squamous cell carcinoma of the uterine cervix 8 years previously. We performed subtotal gastrectomy and pancreaticoduodenectomy with radical lymph node dissection. She remained healthy without any evidence of recurrence 12 months after the operation.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cervix Uteri ; Drug Therapy ; Duodenal Neoplasms* ; Duodenum ; Female ; Gastrectomy ; Humans ; Lymph Node Excision ; Pancreaticoduodenectomy ; Rare Diseases ; Recurrence ; Stomach ; Stomach Neoplasms* ; Uterine Cervical Neoplasms*