We analyzed 34 cases of large bone defect caused by trauma, infection and tumor resection from July, 1979 to June, 1985. The bony defect were restored by vascularized fibular graft or vascularized fibular transposition. 22 cases were the traumatic segmental loss and 7 cases were infected ones and 5 cases were the loss following tumor resection. Vascularized fibular graft was performed in 19 cases and vascularized fibular transposition was performed in 15 cases. The 33 cases(97%) of 34 cases had obtained sound bony union and average union time had been 18.6 weeks. Even local infection in the bone, vascularized fibular graft or transposition can be performed. Grafted or transposed fibula had been hypertrophied about 1.2 times in anteroposterior and lateral film which had been measured in the center of the fibula. The most common complication was the clawing of first or second toe. If the ipsilateral fibula is intact, the vascularized fibular transposition is better and if not, vascularized fibular graft is preferred. Operation using the vascularized fibula is a excellent method for the restoration of large bone defect in long bone.
Animals ; Fibula ; Hoof and Claw ; Methods ; Toes ; Transplants

BACKGROUND: Osteoporosis results from bone loss due to menopause [estrogen(E) deficiency] and aging. Initial skeletal effect of menopause is accelerated bone resorption with an increase in seurm calcium(Ca) and compensatory but inadequate bone formation. Secretion of parathyroid hormone(PTH) is suppressed at this time. Postmenopausal osteoporosis results in fractures predominantly of trabecular bone, i.e., vertebra. With aging, secondary hyperparathyroidism by low serum Ca and vitamin D deficiency superim poses. Senile osteoporosis produces hip fractures, area of cortical bone. The aim of this study was to- examine the association of vitamin D[25(OH)D] and intact(i) PTH with bone mineral density(BMD) after controlling for suggested confounding factors, and the possibility of low serum vitamin D and high serum iPTH concentration could impact bone loss in Korean postmenopausal women. METHODS: Data from 188 postmenopausal Korean women aged 42 to 69 were analyzed through BMD, serum 25(OH)D, iPTH, Ca, phosphorus(P), alkaline phosphatase(ALP) and clinical characteristics. Factors affecting BMD was determined by Pearson correlation and the relationship between lumbar and femoral neck BMD and vitamin D[25(OH)D] and iPTH was assessed by multiple regression analysis after adjus- ting for suggested confounding factors. RESULTS: Lumbar and femoral neck BMD, serum Ca, P were decresaed and serum iPTH was increased with aging. In Pearson`s correlation, significant contributing factors to lumbar BMD was age, height, weight, menarche, year since menopause(YSM) and ALP. And significant contributing factors to femoral neck BMD was age, height, weight, menarche, YSM and iPTH. No relationship could be demonstrated between serum vitamin D[25(OH)D] and lumbar and femoral neck BMD. How ever, after controlling for potential confounding factors, a correlation was found between vitamin D[25(OH)D] and both of lumbar (p=0.013) and femoral neck BMD(p=0.077). iPTH was inversely related to femoral neck BMD(p=0.004) only in multiple linear regression. CONCLUSION: Serum vitamin D[25(OH)D] was influencing both of vertebral and femoral neck BMD, which suggests a significant role of vitamin D deficiency in the pathogenesis of postmenopausal osteo- porosis. In age related remodeling and loss of bone, increased serum iPTH might have additive role in cortical bone of femur. These findings suggest that vitamin D is very important for optimal bone health and a deleterious effect of increased iPTH on cortical bone loss. Adequate calcium and vitamin D status have to be maintained to prevent osteoporosis in postmenopausal Korean women.
Aging ; Bone Density* ; Bone Resorption ; Calcium ; Female ; Femur ; Femur Neck ; Hip Fractures ; Humans ; Hyperparathyroidism, Secondary ; Linear Models ; Menarche ; Menopause ; Osteogenesis ; Osteoporosis ; Osteoporosis, Postmenopausal ; Parathyroid Hormone* ; Spine ; Tolnaftate ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*

No abstract available.
Gait* ; Humans ; Spinal Cord Diseases*

Three cases of chronic subdural hematoma superimposed on posttraumatic subdural hygroma are presented, with discussion of the development of the chronic subdural hematoma particularly. In all of these three cases the chronic subdural hematoma had occurred consequently to the posttraumatic subdural hygroma, but these diagnoses were done in variable periods of 20 days to 60 days. Therefore, it is suggested that the posttraumatic subdural hygroma have, at least, some relation to the genesis of the chronic subdural hematoma.
Diagnosis ; Hematoma, Subdural, Chronic* ; Subdural Effusion*

The effects of a fermentation filtrate of Ganoderma lucidum (FGL) on carbon tetrachloride (CCl4)-induced hepatic fibrosis were investigated in rats. Male Sprague-Dawley rats were orally administered with FGL (20 or 100 mg/kg) for 33 days, and orally administered with CCl4 (1.0 mL/kg; 2 mL/kg of 50% in corn oil) at 3-day intervals 1 h after FGL treatment. Body and liver weights, blood and histopathological findings in accordance with hydroxyproline concentrations were analyzed. Chronic exposure to CCl4 reduced the body weight gain, but increased liver weights and fibrosis, resulting in 3.35-fold increase in hydroxyproline level. Although FGL did not significantly reduce the CCl4-induced body and liver weight changes, it attenuated the increases in the hepatic fibrosis and hydroxyproline contents. Taken together, it is suggested that FGL might prevent hepatic fibrosis, and that FGL or its ingredient could be a potential candidate for the prevention of chronic hepatic disorders.
Animals ; Body Weight ; Carbon Tetrachloride ; Fermentation ; Fibrosis ; Ganoderma ; Humans ; Hydroxyproline ; Liver ; Male ; Rats ; Rats, Sprague-Dawley ; Reishi ; Weights and Measures ; Zea mays

Antioxidative and aldose reductase (AR)-inhibitory effects of a fermentation filtrate of Rubus coreanus (FRC) were investigated using corneal/retinal homogenate and lens cytosol, respectively. Rat corneal/retinal homogenate was treated with 50 microM FeCl3 in the presence of FRC (3.2-100 microg/mL) for 30 min at 37degrees C, and thiobarbituric acid-reactive substances (TBARS) was quantified as a lipid peroxidation parameter. FRC markedly suppressed the TBARS production in a concentration-dependent manner, leading to 50% (IC50) and 100% (IC100) inhibitory concentrations of 20 and 95 microg/mL, respectively, which was similar to the effect of butylated hydroxyanisole. Activity of AR from rat lens was assayed in the presence of FRC (1-31.6 microg/mL) at 25degrees C using glyceraldehyde as a substrate. FRC inhibited lens AR by 50% (IC50) and 90% (IC90) at approximately 2 and 31.6 microg/mL, respectively, comparable to the effect of quercetin. The results indicate that ERC could be a promising candidate for the improvement of eye injury and visual dysfunction of dry eye and diabetic patients.
Aldehyde Reductase ; Animals ; Butylated Hydroxyanisole ; Cytosol ; Eye ; Eye Injuries ; Fermentation ; Glyceraldehyde ; Humans ; Lipid Peroxidation ; Quercetin ; Rats ; Thiobarbituric Acid Reactive Substances

The authors report 16 cases of mediastinal fine-needle aspiration cytology from Jan. 1985 to Mar. 1988 at the Seoul National University Hospital. Among them, diagnostic material were obtained in fifteen cases, establishing the dia- gnosis of 7 thymomas, 2 germinomas, 2 neurogenic tumosr, 1 lymphoma, and 3 meastatic carcinomas. The 9 cytologic diagnoses could be confirmed by histologic examination in 8 patients and by another cytologic method in one patient, allowing concordance rate of 77%.
Biopsy, Fine-Needle ; Diagnosis ; Germinoma ; Humans ; Kidney* ; Lymphoma ; Mediastinum ; Seoul ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Thymoma

Tourniquet is usually used for total knee arthroplasty to provide s bloodless surgical field. However, there is a possibility that sustained inflation of tourniquet can cause hypertension, while deflation can cause hypotension. In 31 patients who received total knee artroplasty under spinal anesthesia in Seoul National University Hospital, we examined the changes of systolic blood pressure (SBP) and heart rate (HR) (1) before induction (2) just before inflation of tourniquet, (3) at 10 minutes after inflation of it, and (4) just before deflation of tourniquet. We also checked (5) the maximsl change of SBP and HR within 5 minutes after deflation of it. The results were as follows: 1) As time went, inflation did not bring any remarkable change of SBP and HR. 2) SBP decreased by 19 mmHg (p < 0.05) after release of tourniquet. But HR did not change significantly. In conclusion, it is suggested that we have to pay special attention to the patients who underwent total knee arthroplasty operation under spinal anesthesia, because tourniquet deflation might cause significant lowering of blood pressure.
Anesthesia, Spinal* ; Arthroplasty* ; Blood Pressure ; Heart Rate ; Humans ; Hypertension ; Hypotension ; Inflation, Economic ; Knee* ; Seoul ; Tourniquets* ; Vital Signs*

No abstract available.

An analysis and CT findings in 21 adult patients of spontaneous intracerebral hematoma(SICH) mixed with CSF who were admitted to the Fatima Hospital from December 1986 to May 1989. The following results were obtained; 1) We could differentiated SICH that have inhomogenous density and thought that it is composed of blood, CSF and blood-CSF mixture. 2) Previously reported pathways that intracerebral hematoma rupture into the ventricle are caudate nucleus and thalamus but intracerebral hematoma can be mixed with CSF through the subarachnoid space of Sylvian fissure as an another route. 3) Intracerebral hematoma mixed with CSF was removed easily, safely and enoughly with simple aspiration method as like resoluted hematoma in subacute or chronic phase. 4) The prognosis of patients with SICH mixed with CSF was very good unlike to that of patients with pure intracerebral hematoma and/or ventricular hemorrhage.
Adult ; Caudate Nucleus ; Hematoma* ; Hemorrhage ; Humans ; Prognosis ; Rupture ; Subarachnoid Space ; Thalamus