No abstract available in English.
Transplants

Although the primary repair has been recognized so far, the tendon graft is reported as a primary treatment method for tendon injury in no man's land of Bunnel, judging from the state of injured hand, the ability of operator and the environment of medical operation. The 27 cases of tendon graft that were operated for 11 years from June, 1973 to June, 1984 in the Department of Orthopedic Surgery, Hanyang University College of Medicine have been followed up for clinical study. The results were as follows: 1. The Material of this study was composed of 13 males (21 cases) and 5 females (6 cases) whose age were from 8 to 39 years old. 2. The injured fingers were classified with 3 thumbs, 6 index fingers, 7 middle fingers, 8 ring fingers and and 3 little fingers out of 27 cases and all injured parts of fingers were Zone II except that of thumb which was Zone IV of Bunnel. 6 patients were injured more than 2 fingers. 3. The duration from tendon injury to tendon graft which scattered from 1 month to 9 years and averaged out to 28.2 months is supposed to have little relation to post-operative results. 4. The post-operative results showed up 9 excellent, 7 good and 1 fair out of 17 cases in good gmup, 3 good and 6 fair out of 9 cases in cicatrix group, 1 fair out of 1 case in nerve damage group at pre-operative state. 5. The post-operative results of thumb which show up 2 excellent, 1 good out of 3 cases were most successful among those of all fingers. 6. The pre-operative state is supposed to have great relation to post-operative state judging from 94% satisfactory results of good group at pre-operative state. 7. As multiple injury makes little difference from single injury, the injured state of each hand is supposed to an important effect on post-operative results. 8. As all electric bumed injury show up fair except that of thumb, they are supposed to have unsatisfactory results.
Cicatrix ; Clinical Study ; Female ; Fingers ; Hand ; Humans ; Male ; Methods ; Multiple Trauma ; Orthopedics ; Tendon Injuries ; Tendons ; Thumb ; Transplants

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

Fractures of the femur are one of the most frequent injuris which Orthopedic Surgeons are called upon to treat. The incidence of femoral fractures has risen by the results of rapid increase in traffic accident, industrial accident, and prolongation of life expectancy in adults. Two hundred and ninty eight consecutive femur fractures were treated at the Department of Orthopedic Surgery, Hanyang University, during the period of May 1972 to September 1977 were reviewed. The results were as follows; 1. The fractures occured commonly in the 6 to 10 years age group (46.1%) in children and in the 21 to 40 years age group (48.2%) in adults. Males comprised 217 cases (71.1%). 2. Fractures were caused by traffic accident (72.2%) mainly and especially in old aged fractures of the femoral neck and intertrochanter were caused by fell down from a height. 3. Closed fractures were 258 cases (84.7%) and transversefractures were the most common type in, children, and comminuted fractures were the most common type in adults. 4. The freguent fracture site was transcervical fracture of femoral neck, type 3.4 (by Tronzo) of the. intertrochanteric fracture and middle third of femoral shaft. There were no differences between medial and lateral femoral condyle fractures. 5. Associated injuries were common in young adults in 165 cases and in order of frequency, these were fractures of the tibia and fibula, pubics, skulls, patella and ribs etc. 6. Better results were obtained with conservative treatment in children and operative treatment in adults. 7. The period of bony union in children was 7.6 weeks with Bryants traction 9.3 weeks with Russel traction, 8.6 weeks with cast immobilization, 10 weeks with 90-90 skeletal traction and 10.8 weeks with Bohler-braun skeletal traction. 8. The period of bony union in adults was 17 weeks with Kuntscher nail, 13.6 weeks with compression plate and screw fixation, 18 weeks with Bohler-braun skeletal traction and 19weeks with cast brace in femoral shaft fracture. 9. Complications were much more frequent in adults than in children and it were treated well Postoperative infection was occured in 5 cases (1.7%) and they cured well with sequestrectomy, curettage and continuous antibiotics administration. 10. The Bryants traction under 2 years of age, 90-90 skeletal traction over 5 years of age in children and compression plate and screw fixation in adults were further recommended.
Accidents, Occupational ; Accidents, Traffic ; Adult ; Anti-Bacterial Agents ; Braces ; Child ; Clinical Study ; Curettage ; Femoral Fractures ; Femur ; Femur Neck ; Fibula ; Fractures, Closed ; Fractures, Comminuted ; Humans ; Immobilization ; Incidence ; Life Support Care ; Male ; Orthopedics ; Patella ; Ribs ; Skull ; Surgeons ; Tibia ; Traction ; Young Adult

Routine use of commercially available antisera against hepatitis B core antigen(HBcAg) has permitted a reevaluation of the histochemical distribution of the antigen in liver tissue. HBcAg, classically described almost exclusively in the nucleus, was found with a very high frequency in the cytoplasm of liver cells as well. To elucidate the biologic significance of HBcAg expression and its relation to the natural course of hepatitis B virus(HBV) infection, the patterns of activity in 33 needle liver biopsies of HBsAg carriers were analysed. A good correlation of liver HBcAg with disease activity was demonstrated. HBcAg was present in the hepatocyte nuclei(nHBcAg) or cytoplasm(cHBcAg), or in both(mixed). Pure nHBcAg was seen mainly in non-aggressive reactive liver tissue and cHBcAg was predominantly associated with chronic active hepatitis(95%). The results suggest that expression of HBcAg correlates with the liver pathology and the possibility of HBcAg to be an immunological target for T cell mediated hepatocyte damage.
Biopsy

Only several stages of conventional operation have been able to treat the open fracture of the limb with extensive bone and soft tissue loss. So we, authors, reviewed 25 cases of vascularized osteocutaneous fibulat transfer which were performed to the extensive bone defect of the limb and associated soft tissue injury(from May 13, 1982 to September 30, 1988). In 25 cases, one case was a chronic osteomyelitis combined pseudocarcinomatous epithelial hyperplasia of surrounding soft tissue, the other(24 cases) were the open comminuted fractures with the extensive bone and soft tissue loss of the limbs. The average size of the skin flap was 12.33 × 5.83cm, the average length of vascularized fibula was 16.5cm in length. The complications were fractures of grafted fibula, partial necrosis of both ends of the skin flap and uncontrolled infection of proximal end of grafted fibula. During postoperative period, the patency of the anastomoses were monitored by observing the color of the skin of buoy skin flap. The average amounts hypertrophied fibula at 12 months after operation were 20.6cm. And the following remarkable result were obtained. 1. With the uncontrolled bone infection, the vascularized osteocutaneous fibular transfer was able to be performed. 2. During the follow up period, the grafted fibula had been hypertrophied. 3. In roentgenogram, as compared with conventional bone graft, grafted bone was not resorbed and early united. 4. In adult, free fibula can be obtained and grafted as 23cm as long and the skin flap with fibula can be obtained and grafted as 21 × 7cm as large in or experience. 5. In the vascularized osteocutaneous fibula transfer, the patency of anastomoses was monitored indirectly by confirming skin flap. 6. The fractured fibula was united early by cast immobilization, and it was hypertrophied at the fracture site. 7. The vascularized osteocutaneous fibula transfer is also useful in application of the other long bones.
Adult ; Extremities ; Fibula ; Follow-Up Studies ; Fractures, Comminuted ; Fractures, Open ; Humans ; Hyperplasia ; Immobilization ; Microsurgery ; Necrosis ; Osteomyelitis ; Postoperative Period ; Skin ; Transplants

No abstract available.
Esophageal Neoplasms*

The purpose of this study was to evaluate the amount and interrelationship of the soft and hard tissue change after mandibular setback surgery in skeletal Class III malocclusion. The sample consisted of 25 adult patient (12 male and 13 female) who had severe anteropostrior skeletal discepancy. These patient had received presurgical orthodontic treatment and surgical treatment which is bilateral sagittal split ramus osteotomy. The presurgical and postsurgical lateral cephalograms were evaluated. The computerized statistical analysis was carried out with SPSS/PC program. The result were as follows: 1. After mandibular bilateral sagittal split ramus osteotomy, lower facial soft tissue horizontal posterior changes were high significance value. but vertical soft tissue changes were low significance value. 2. After mandibular bilateral sagittal split ramus osteotomy, relative upper lip protrusion increased(p<0.01) and relative lower lip protrusion decreased(p<0.01) and lower facial soft tissue thickness increased(p<0.01).
Adult ; Male ; Female ; Humans

No abstract available.

Keratoacanthoma (KA) is a rapidly growing cutaneous tumor and is difficult to distinguish from squamous cell carcinoma (SCC) on histomorphology alone. In the present study, we compared the clinicopathological and immunohistochemical findings using antibodies for p21 (WAF-1/CIP1), p53, laminin, and Ki-67 proteins in 27 cases of KA and 31 cases of well differentiated SCC. KA was characterized by occurrence in sun-exposed skin, shorter duration, and smaller size. Expression of p21 protein was increased according to the maturation and involution of KA, but there was no statistical significance. Expression of Ki-67 was decreased in the involutional stage of KA than in SCC (p<0.05). But p53 protein and Ki-67 were expressed in the cells at the periphery of both KA and SCC. The immunoexpression pattern of p53 and Ki-67 suggests that proliferative activities of the two lesions are similar. Laminin was present in the infiltrative cell nests of fully developed and involutional stages of KA, and it may be related to the healing process of KA. In conclusion, it is suggested that the degree of proliferative activity in the proliferative and fully developed stages of KA is similar to that of SCC and that p21 gene expression represents the differentiation property of KA and may be associated with its regression.
Antibodies ; Carcinoma, Squamous Cell* ; Gene Expression ; Keratoacanthoma* ; Laminin ; Skin