Although osteltis fibrosa cystica was the clinical manifestation originally recognized as a feature of the primary hyperparathyroidism, its frequency in diagnosed cases currently has decreased. Affected patients are now being detected in earlier stages of the disease. We have experienced a case of primary hyperparathyroldism with the typical bony changes and the pathologic, subtrochanteric fracture of left femur. We have treated the fracture with Zickel nalling and parathyroidectomy was performed. Four months after the removal of parathyoid adenoma the fractured femur healed well.
Adenoma ; Femur ; Fractures, Spontaneous ; Humans ; Hyperparathyroidism, Primary ; Parathyroidectomy

More than 100 surgical methods were described as the treatment of recurrent patella dislocation. These can be divided into two categories, the proximal, dynamic reconstruction and the distal, static reconstruction. We treated a case of recurrent patella dislocation with a new method, using gracilis. The tendon of gracilis was dissected and cut at the point about 7cm proximal to the insertion. A 'H' shaped slot was made subperiosteally in the anterior surface of patella. The both ends of cut gracilis tendon were imbedded into the 'H' shaped slot of patella and sutured. So the gracilis tendon could act as a static and dynamic stabilizer. The result was excellent at 1 year follow up.
Dislocations ; Follow-Up Studies ; Methods ; Patella ; Tendons

No abstract available in English.
Orthopedics

Experiences of 26 cases of electrical bone stimulation on normal adult rabbits was documented in this paper. The cathodic electrode was introduced longitudinally into the medullary cavity of the proximal tibia and the anodic electrode was introduced transversely in the distal femur of the same side. The contralateral tibia was used as the control, of which the Teflon coated Kirschner wire was introduced longitudinally into the medullary cavity. 10uA of direct current was passed continuously through the fixed wires between the proximal tibia and distal femur. At the second, fourth and sixth week, random bone scan with 99m-Tc was performed and the animals were sacrificed. The specimen X-rays of the tibia and femur were taken and the specimens were prepared for the microscopic study. The followings are obtained from this experimental study. 1. The rate of new bone formation is 69.2% in the stimulated group and 7.7% in the control group. There were also fibrosis and cartilage formation as well as the new bone formation. The fibrosis and cartrilage formation are observed only in the electrically stimulated side and their occurances are 69.2% and 11.1% respectively. So The new bone formation and fibrosis are definitely increased in the bones of the cathodic electrical stimulation than those of the control side. 2. The intramembraneous ossification is the predominent feature of this electrically stimulated new bone formation. 3. Bone and soft tissue necrosis was the main microscopic feature in the anode side. 4. Since new bone, fibrous tissue and sometimes new cartilage were observed in this study, it seems that the cathodic electrical stimulation is not specific for the new bone formation, but induce crude tissues such as bone, cartilage, fibrous tissue or vessels. Furthermore, it can be postulated that the 10uA electrical stimulation is only one of the best electrical environment for the formation of the crude tissues, especially for bone and fibrous tissue.
Adult ; Animals ; Cartilage ; Electric Stimulation ; Electrodes ; Femur ; Fibrosis ; Humans ; Necrosis ; Osteogenesis ; Polytetrafluoroethylene ; Rabbits ; Tibia

No abstract available.
Cell Line* ; Cisplatin* ; Doxorubicin* ; Osteosarcoma*

It has been known that right ACA occlusions can cause callosal disconnection syndrome. A 61-year old right-handed man was admitted because of a left ACA occlusion. MRI showed infarction of the medial frontal cortex and the anterior two-thirds of the corpus callosum. He presented with weakness and gait initiation failure in the right leg with grasp reflex, suspicious alien hand sign, and tactile anomia in the right hand. He was diagnosed with transcortical motor aphasia. He was unable to successfully complete written tasks in response to dictations and writing down spontaneous answers. He wrote down incorrect words and demonstrated paragraphism with his left hand. He could copy simple items but not written words and complex items with his left hand. Finally, he had difficulties in writing answers in response to complex verbal and written commands with his left hand, but preserved the ability to simple verbal commands, somato-sensory, and visually guided tasks. We attribute these results to the anterior callosal disconnection of the right sensorimotor cortex from the left language area.
Anomia ; Anterior Cerebral Artery ; Aphasia, Broca ; Corpus Callosum ; Emigrants and Immigrants ; Gait ; Hand ; Hand Strength ; Humans ; Infarction ; Leg ; Magnetic Resonance Imaging ; Middle Aged ; Reflex ; Writing

To study the basic pathological changes of small intestine in metagonimiasis, light- and electron microscopic studies were made, using a total of 21 cats which were experimentally infected with metacercariae of Metagonimus yokogawai. The metacercariae were obtained from naturally infected sweetfish (Plecoglossus altivelis) by digestion technique. The cats were divided in control, light-infection(10,000 metacercariae infected) and heavy-infection(50,000 metacercariae infected) groups. Cats were killed at the 5th, 10th, 15th day, and 4th, 8th and 10th week after the infection. And the small intestine was prepared for the study. Pathological studies comprised gross examination, worm distribution pattern, light microscopic examination and both transmission and scanning electron microscopic examinations. The results obtained were summarized as follows. Gross morphologic changes were the most marked during the first 2 weeks after infection. The gross abnormalities were severer in the heavily infected animals. The changes were dryness and listlessness of serosal surface due to dehydration, mushy and/or watery intestinal content, effacement of transverse nodes and enlargement of mesenteric lymph folds and Peyer's patches. After 4 weeks of infection, these changes became less marked showing a tendency to return to normal. The sectioned flukes were distributed from duodenum to proximal ileum. However, individual variation was marked in distribution. In the heavy-infection group, the locality of parasitism tended to extend more distally. The locality of M. yokogawai in the intervillous space was mostly in the lower-most portion of intervillous space, where they compressed and eroded epithelial cells probably due to mechanical damage to the structure. Very rarely the worms were found in lumen of Lierberkuehn's crypt, and reaching, in two occasions, into proprial lymphoid tissue. Light-microscopically the lesion was restricted in mucosa: Early mucosal changes were shortening, blunting, fusion, and thickening of the villi, crypt hypertrophy with consequent decrease of villus/crypt ratio, as well as stromal changes of edema, capilliary ectasia and marked inflammatory cell infiltration of lymphocytes and plasma cells. Goblet cells were markedly reduced in number as with depletion of its cytoplasmic content. In the later stages of infection, mucosa restored its normal configuration in spite of persistent parasitism of the worms. At the infection stage of 5-15 days, there was significant shortening of the microvillous height with varible destruction of glycocalyx in electron microscopic examination. With lapse of infection time, microvilli became to restore the normal pattern. With these morphological changes, it appears that diarrhea in experimental metagonimiasis would be related to the decrease of absorptive surface of the small intestine particularly in the early phase of infection. The significant changes seen in villi and microvilli might be due to massive intrusion or invasion of Metagonimus worms into the crypts, causing direct mechanical and possible host-immune response to the small bowel mucosa.
parasitology-helminth-trematoda ; metagonimiasis ; Metagonimus yokogawai ; pathology ; cat-intestine ; edema ; lymphocytes ; plasma cells ; goblet cell

In certain low-grade malignant tumors such as chondrosarcoma and giant cell tumor, radical treatments may provide a good chance for cure. And large bony defect after the radical treatment can be filled with the massive bone graft. Recent advances in clinical microsurgery have made free tissue transfer a clinical reality, and Taylor in 1975, first reported the technique of free vascularized fibula graft for the reconstruction of large tibial defects with excellent clinical results. We tried wide excision and free vascularized bone graft in 6 patients with malignant or aggressive bone tumor from April 1981 to November 1985 and followed up for more one year. Mean follow up of free vascularized bone graft is 26.4 months and that of devascularized bone graft is 22.6 months. The results of the free vascularized bone graft were compared with 10 patients who were treated with the wide excision and the devascularized bone graft. In this analysis, free vascularized bone graft is superior to devascularized bone graft in bony union, complications and functional results.
Chondrosarcoma ; Fibula ; Follow-Up Studies ; Giant Cell Tumors ; Humans ; Microsurgery ; Transplants

BACKGROUND: Proximal humerus fracture is considered to be the third most common fracture for patients aged 65 years or older. Conservative treatment has been known to treat most of humerus fracture. However, fractures with severe displacement or dislocation may require surgical treatment. Intramedullary fibular allograft with a locking plate is frequently used in patients accompanying medial metaphyseal disruption. In this study, author intends to evaluate clinical and imaging results based on patients who underwent surgical treatment using fibular allograft with a locking plate. METHODS: This study is conducted prospectively at Wonju Severance Christian Hospital, targeting patients who previously underwent surgical treatment using open reduction and intramedullary fibular allograft with a locking plate between 2011 and 2015. A total of 26 patients were evaluated on the following: postoperational clinical assessment measuring Constant score, American Shoulder and Elbow Society (ASES) score, and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Postoperational imaging assessments are evaluated via measuring the neck-shaft angle. The study subject were Neer classification type 3, 4 proximal humerus fracture cases with disrupted medial hinge and having cortical comminution in the region of the surgical neck. RESULTS: The average period of progression was 22.5 months, and the average age of patients was 72.6 years. At the final follow-up, the average Constant, average ASES, and average DASH scores were 80.1, 78.5, and 20.6 respectively. The average neck-shaft angle was 127.5°. CONCLUSIONS: In conclusion, fibular allograft augmentation with a locking plate showed satisfying results in both clinical and imaging studies.

No abstract available.
Angiogenesis Inducing Agents* ; Intracranial Aneurysm*