Recent development of maxillofacial surgery has taken an interest in the regeneration of facial bone defects. For the reconstruction of facial bone defects, autogenous bone grafts have been widely used. However, there are some clinical problems : the morbidity of donor sites, resorption of autogenous bone graft and, the availability of the proper form and size. The purpose of this study is to find the effective solutions to above problems. The present study was designed to evaluate the roles and regenerating capacity of fibrin sealant. Fibrin sealant is a newly developed substance for hemostasis, tissue sealing and wound healing. I made the experimental study on the effects and roles of bibrin sealant in sutogenous bone graft procedure to minimize the above complications and problems. Twenty-five adult white rabbits were used as the experimental material. Three trephine defects were made by drilling on the parietal bone of each rabbit. Defect size was 8x8mm. First group consisted of the rabbits which had the artificial defect on the parietal bone as control. The defect in second group was sealed up with autogenous boon chip only. Last group comprised the rabbits autografted by mixing the bone chip with the fibrin sealant. The results were carefully examined grossly and microscopically from the 3rd day to the 28th day postoperatively. The following results were obtained ; 1. The mixture of fibrin sealant and bone chip was useful for regenerating the bone defects. Most of the defects were substituted by new bone. 2. In the case of the graft with bone chip only, most defects were also filled with new bone, but less than fibrin group. 3. In the control group, new bone was formed around the peripheral area only. A mixture of fibrin sealant and autogenous bone chip plays an effective role in forming new bone. find judging from the results of this experiment, it may be expected the much use of the fibrin sealant in maxillofacial orthopedic surgery.
Adult ; Autografts ; Bone Regeneration* ; Facial Bones ; Fibrin Tissue Adhesive* ; Fibrin* ; Hemostasis ; Humans ; Orthopedics ; Parietal Bone ; Rabbits ; Regeneration ; Surgery, Oral ; Tissue Donors ; Transplants ; Wound Healing

Osteochondromadevelop most commonly at distal femur, proximal humerus and proximal tibia, but the rib osteochondroma was reported less commonly. In this report, scapular snapping syndrome complicated by adventitious bursa and soft tissue pseudotumor surrounding the osteochondroma of the 6th rib body was treated successfully by surgical excision of them. We report this rare case with reviewing the relevant literature.
Femur ; Humerus ; Osteochondroma* ; Ribs* ; Shoulder* ; Tibia

No abstract available.
Adenocarcinoma* ; Carcinoma, Squamous Cell*

STUDY DESIGN: A case report. OBJECTIVES: To report a rare case of remote cerebellar hemorrhage (RCH), which was a complication after posterior decompression and lumbar interbody fusion (PILF). SUMMARY OF LITERATURE REVIEW: Remote cerebellar hemorrhage (RCH) after spinal surgery is a rare complication, and its cause is known to be due to a loss of cerebral spinal fluid (CSF) through the dural tear. Most of the literature has disclosed that early diagnosis and treatment of RCH is very important in the patient with suspicious symptoms. MATERIALS AND METHODS: A 57-year-old woman had posterior lumbar decompression and interbody fusion for the severe spinal stenosis at L4-5. During surgery, an accidental dural tear with CSF leakage occurred. The torn dura was sutured. Postoperatively, she developed nausea and a severe headache. Hypotension developed at postoperative 2 hours. A brain CT showed RCH. The patient was conservatively managed with clamping of the wound drainage. RESULTS: The nausea and severe headache were controlled and normal blood pressure could be maintained without dopamine therapy at postoperative day 2. The patient was discharged without any neurological deficit, and her consciousness was clear at postoperative 2 weeks. CONCLUSIONS: Persistent postoperative nausea, headache, and hypotension after repair of the torn dura may suggest that the treating surgeons pay careful attention due to the possibility of RCH, even though the amount of CSF leakage is small.
Blood Pressure ; Brain ; Consciousness ; Constriction ; Decompression* ; Dopamine ; Drainage ; Early Diagnosis ; Female ; Headache ; Hemorrhage* ; Humans ; Hypotension ; Lumbar Vertebrae ; Middle Aged ; Nausea ; Postoperative Nausea and Vomiting ; Spinal Stenosis ; Wounds and Injuries

PURPOSE: To assess the clinical difference between cubital tunnel syndrome with anconeus epitrochlearis (AE) and idiopathic cubital tunnel syndrome without known other causes. METHODS: This cross-sectional study included the 326 patients who were subjected to surgery because of cubital tunnel syndrome from 2008 to 2014. After exclusion of patients with other known causes of cubital tunnel syndrome, a total of 107 patients were divided into two groups; patients with and without AE. The clinical differences between two groups were analyzed retrospectively; age, sex, presence of intrinsic muscle atrophy, interval from symptom development to surgery, pinch power, the disabilities of the arm, shoulder and hand score and the nerve conduction velocity (NCV). RESULTS: Thirty four (10.4%) patients, being subjected to surgery had the AE. Among 107 patients who had no other known causes, 26 patients had AE. 19 out of 26 patients with AE was male. Average age of patients with AE was significantly younger. The interval from symptom development to surgery in AE patients was significantly shorter. Motor NCV of ulnar nerve at above elbow joint in comparison with that at below elbow joint in AE patient was more significantly decreased (14.3 m/sec vs. 8.3 m/sec). CONCLUSION: The AE in cubital tunnel syndrome is no more rare structure. In younger male patients with rapidly progressive worsening cubital tunnel symptoms, and if there is significant decrease of ulnar motor nerve velocity at above elbow in comparison with at below elbow, the AE should be considered as cause of ulnar neuropathy.
Arm ; Cross-Sectional Studies ; Cubital Tunnel Syndrome* ; Elbow ; Elbow Joint ; Hand ; Humans ; Male ; Muscular Atrophy ; Neural Conduction ; Retrospective Studies ; Shoulder ; Ulnar Nerve ; Ulnar Neuropathies

STUDY DESIGN: Cervical spine radiograms of 460 Jeju islanders. PURPOSE: To investigate the age-matched incidences and severity of the cervical disc degeneration and associated pathologic findings. OVERVIEW OF LITERATURE: Several related studies on the incidences of disc and Luschka's and facet joint degeneration have provided some basic data for clinicians. METHODS: Cervical radiographs of 460 (220 males and 240 females) patients in their fourth to ninth decade were analyzed. Ninety patients in their third decade were excluded because of absence of spondylotic findings. RESULTS: Overall incidence of cervical spondylosis was 47.8% (220 of 460 patients). The percentile incidences of spondylosis in the fourth, fifth, sixth, seventh, eighth and ninth decade was 13.2% (10 of 76 patients), 34.6% (37 of 107 patients), 58.9% (66 of 112 patients), 58.8% (50 of 85 patients), 70.3% (45 of 64 patients) and 75.0% (12 of 16 patients), respectively. The percentile incidences of one, two, three, four and five level spondylosis among 220 spondylosis patients was 45.5% (n=100), 34.1% (n=75), 15.0% (n=33), 4.5% (n=10), and 0.9% (n=2). Severity of disc degeneration ranged from ± to ++++, and was ± in 6.0% (24 segments), + in 49.6% (198 segments), ++ in 35.3% (141 segments), +++ in 9.0% (36 segments) and ++++ in 0.25% (one segment). Spurs and anterior ligament ossicle formed at the spondylotic segments, mostly at C4~6. The rate of posterior corporal spurs formation was very low. Olisthesis and ossification of the posterior longitudinal ligament were rarely combined with spondylosis. Cervical lordotic curve decreased gradually according to the progress of severity of spondylosis. CONCLUSIONS: The incidence of cervical spondylosis and number of spondylotic segments increase, and degeneration gradually becomes more severe with age.
Humans ; Incidence* ; Intervertebral Disc Degeneration ; Ligaments ; Longitudinal Ligaments ; Male ; Spine ; Spondylosis* ; Zygapophyseal Joint

PURPOSE: Nevus sebaceus is a congenital hamartomatous lesion, typically involving head and neck. Various benign and malignant neoplasms can develop in association with nevus sebaceus. We report a case of simultaneous occurrence of squamous cell carcinoma and basal cell carcinoma in nevus sebaceus. METHODS: A 73-year-old man presented with erythematous to black verrucous nodules on the right subauricular area. The upper part was accompanied with inflammation and ulceration, and no specific findings suspicious for malignant degeneration were found in the lower part preoperatively. The mass was totally excised and the defect was directly closed. Lymph nodes were not involved on concomitant neck dissection. RESULTS: Histopathologic examination confirmed the presence of squamous cell carcinoma in the upper part and basal cell carcinoma in the lower part of a nevus sebaceus. Negative margins were achieved on resection. No clinical problems were found during the 3-month follow-up period. CONCLUSION: We experienced a rare case of simultaneous occurrence of squamous cell carcinoma and basal cell carcinoma within the same nevus sebaceus. Because patients with nevus sebaceus have risk of malignant changes, surgical excision and work-up for recurrence and metastasis should be considered in suspicious cases. And even in a totally asymptomatic case, the possibility of occult secondary cancer should be informed before surgery in aged patients.
Aged ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Follow-Up Studies ; Head ; Humans ; Inflammation ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Nevus ; Recurrence ; Ulcer

Tumor necrosis factor alpha (TNF-alpha) inhibitors are used widely to treat patients with active rheumatoid arthritis and ankylosing spondylitis (AS). Although various cutaneous reactions can occur as side effects of TNF-alpha inhibitors, systemic vasculitis requiring withdrawal of the agent and immunosuppressive drugs is rare. A 59-year-old male with AS who had been treated with infliximab for 60 months visited us with complaints of palpable purpura on both legs and severe abdominal pain. Abdominal computed tomography showed diffuse wall thickening of the proximal jejunum and ileum and a skin biopsy revealed leukocytoclastic vasculitis. The patient was diagnosed with Henoch-Schonlein purpura (HSP). Infliximab was discontinued and systemic steroid therapy at 0.5 mg/kg resulted in prompt resolution of the HSP. Here, we report the first case of HSP in a patient with AS after infliximab treatment.
Abdominal Pain ; Antibodies, Monoclonal ; Arthritis, Rheumatoid ; Biopsy ; Humans ; Ileum ; Jejunum ; Leg ; Male ; Purpura ; Purpura, Schoenlein-Henoch ; Skin ; Spondylitis, Ankylosing ; Systemic Vasculitis ; Tumor Necrosis Factor-alpha ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous

Pyogenic spondylitis involving only the posterior element of a vertebra is rare. To the best of our knowledge, there have been no reports of osteomyelitis of the transverse process. We report here on a 45-year-old male with a one month history of swelling associated with lower back pain. The magnetic resonance imaging showed a paraspinal soft tissue mass, and computed tomography revealed a fine osteolytic lesion in the right transverse process of the 5th lumbar spine, and this was all consistent with chronic osteomyelitis. A mixed staphylococcal infection was identified. Open drainage, resection of the transverse process and intravenous injection of anti-staphylococcal antibiotics resolved the back pain and reduced the erythrocyte sedimentation rate to normal. Pyogenic osteomyelitis of the transverse process is extremely rare, which can cause a misdiagnosis or a delayed diagnosis. Careful consideration of this disease is needed when evaluating patients who complain of back pain.
Chronic Disease ; Humans ; *Lumbar Vertebrae ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Osteomyelitis/*diagnosis/therapy ; Spinal Diseases/*diagnosis/therapy ; Staphylococcal Infections/*diagnosis/therapy ; Tomography, X-Ray Computed

BACKGROUND: The sacrococcygeal morphology of Arabs and Europeans has been studied using computed tomography (CT) or magnetic resonance imaging to determine the cause of coccydynia. Studies have suggested differences in sacrococcygeal morphology among ethnic groups. However, there are no data on the sacrococcygeal anatomy of Koreans. METHODS: We conducted a retrospective analysis of 606 pelvic CT scans that were taken at Cheju Halla General Hospital between 2008 and 2014. Fractures of the sacrum or coccyx were excluded. Differences in the sacrococcygeal morphology among age groups stratified by decade of life and between genders were analyzed using sagittal plane pelvic CT scans. The morphological parameters studied were the sacral and coccygeal curved indexes, sacrococcygeal angle, intercoccygeal angle, coccygeal type, coccygeal segmental number, and sacrococcygeal fusion. RESULTS: The average sacral and coccygeal curved indexes were 6.15 and 7.41, respectively. The average sacrococcygeal and intercoccygeal angles were 110° and 49°, respectively. Type II coccyx was most common, and the rate of sacrococcygeal fusion was 34%. There was a moderate positive correlation between age and the sacral curved index (r = 0.493, p = 0.000) and a weak negative correlation between age and the coccyx curved index (r = −0.257, p = 0.000). There was a weak negative correlation between age and the intercoccygeal angle (r = −0.187, p = 0.000). The average intercoccygeal angle in males and females was 53.9° and 44.7°, respectively. CONCLUSIONS: The sacrum tended to be more curved and the coccyx straighter with age. The coccyx was straighter in females than males. Knowledge of the sacrococcygeal anatomy of Koreans will promote better understanding of anatomical differences among ethnicities and future studies on coccydynia.
Arabs ; Asian Continental Ancestry Group ; Coccyx ; Ethnic Groups ; Female ; Hospitals, General ; Humans ; Jeju-do ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Sacrum ; Tomography, X-Ray Computed