Allografts or autografts of bone-tendon unit have been used for ligament injuries or deficiencies after limb salvage operation for malignant bone tumors around joints. While the remodeling process of the ligament or tendon of the allograftor autograft and the microscopic and biomechanical changes of tendon-bone graft interface have been widely investigated, little is known about the ultrastructural and biochemical changes of the transitionall zone in tendon-bone junction. This study was performed to analyzed the ultrastructural and biochemical changes of the transitional zone after tendon-bone auto-and allo-grafting. A total of twenty four rabbits were divided into two group. In 12 animals(allograft group), two Achilles ten-don-bone unit per each animal were taken and transplanted to another rabbit after preservation below -70degrees C for 2 weeks. In the other 12 animals(autograft group), the Achilles tendon-bone unit was harvested from one side and transplanted to the other side of the rabbit. After operation, their legs were immobilized with short leg cast for 4 weeks, and then mobilized freely. Four animals in each group were sacrificed at four, eight and sixteen-weeks after the transplantation, and their grafted Achilles tendon-bone interfaces were used for analysis of the ultrasturctural and biochemical changes. The following results were obtained. 1. Histologically new cartilage cells were observed at postoperative 16 weeks with local presence of faint tidemark in the autograft group but not in the allograft group. Complete remodeling of the transitional zone had not observed histologically in both groups. 2. Ultrasturctural analysis revealed no definite differences between both groups. However, the slightly rapid appearance of parallelism and cross-striation of microfibrils in the autograft group and time-related restoration of fibers and fibroblasts were observed. 3. From biochemical analysis, type I collagen concentratin was increased, and an early rapid increase of type III collagen and glycosaminoglycan were also observed. In conclusion, these data suggested that type III collagen and glycosaminoglycan are important in stabilization of grafted tendon-bone unit, especially in the transitional zone. The histological and biochemical changes in allograft group were relatively similar to that of autograft group although the allograft group showed the delayed pattern of remodeling. Therefore, the tendon- allograft could be used as a good substitute for the autograft for tendon or ligament reconstruction when no suitable autograft is available.
Allografts ; Animals ; Autografts ; Cartilage ; Collagen Type I ; Collagen Type III ; Fibroblasts ; Joints ; Leg ; Ligaments ; Limb Salvage ; Microfibrils ; Rabbits* ; Tendons ; Transplants*

No abstract available.
Dental Porcelain* ; Hardness* ; Resin Cements*

No abstract available.
Leukemia*

BACKGROUND AND OBJECTIVES: Dizziness is the most common symptom of vertebrobasilar insufficiency (VBI), occurring in at least two-thirds of patients. The aim of our study is to document the clinical features and the treatment outcomes in the dizzy patients with VBI. SUBJECTS AND METHOD: A retrospective review of 36 patients suffering dizziness associated with VBI was performed at a tertiary referral center. RESULTS: The most frequent type and duration of dizziness were rotational (52.8%) and minute (55.6%). Sixteen patients (44.4%) reported that their episodes of dizziness occurred several times per a month. Half of the patients had at least one isolated episode of dizziness and in 25% VBI began with an isolated episode of vertigo. Twenty-three patients (63.9%) had risk factors for cerebrovascular diseases. Benign paroxysmal positional vertigo occurred in 27.8%, and 38.9% had a significantly decreased or absent response to caloric stimulation. On the dynamic posturography, visual dysfunction (33.4%) and vestibular dysfunction (19.4%) were observed. Thirty-two patients (88.9%) had abnormal finding on the pure tone audiometry. Nineteen (61.3%) of 31 patients experienced resolution or significant reduction of their episodes of dizziness with treatment. But one patient progressed to acute infarction. CONCLUSION: VBI-associated dizziness cause various clinical manifestations and there should be relevant differential diagnosis for episodic vertigo that last only minutes. We should pay special attention to the VBI in patients with isolated, transient dizziness and the risk factor of the cerebrovascular disease.
Audiometry ; Diagnosis, Differential ; Dizziness ; Humans ; Infarction ; Retrospective Studies ; Risk Factors ; Tertiary Care Centers ; Vertebrobasilar Insufficiency* ; Vertigo

No abstract available.
Hemarthrosis* ; Knee*

Osteoid osteoma is a relatively common benign tumor that most commonly affect the cortex of the long bone, Adolescent and young adult males are most frequently affected. It causes aching pain that worsens at night and commonly is relieved by aspirin. The typical radiographic appearance is a lucent nidus with surrounding dense cortical thickening. If the lesion is located in intra-articular cancellous bone, an osteoid osteoma may present with clinical findings that are more indicative of an inflammatory synovitis, and with atypical radiographic findings such as lack of both surrounding sclerosis and a lucent nidus. Therefore intra-articular osteoid osteoma may pose a diagnostic difficulty. Recently, we experienced 3 cases of intra-articular osteoid osteoma(2 humeral haed, 1 femoral head) and present them in detail.
Adolescent ; Aspirin ; Humans ; Male ; Osteoma, Osteoid ; Sclerosis ; Synovitis ; Young Adult

BACKGROUND: Although pedobarographic measurement is increasingly used for clinical and research purposes, relatively few published studies have investigated normative data. This study examined pedobarographic findings in young healthy adults with regard to sex-related differences and correlations among measurement indices. METHODS: Twenty young healthy adults (mean age, 22.4 years; standard deviation, 1.2 years; and 10 males and 10 females) were included. Weight bearing anteroposterior (AP) and lateral foot radiographs were taken, and dynamic pedobarographic data during treadmill walking and maximum ankle dorsiflexion were obtained. AP talo-first metatarsal angle, naviculocuboid overlap, lateral talo-first metatarsal angle, and plantar soft tissue thickness were measured on foot radiographs. Pedobarographic data including peak pressure and pressure-time integral were measured on five plantar segments: medial forefoot (MFF), lateral forefoot (LFF), medial midfoot (MMF), lateral midfoot (LMF), and heel. RESULTS: Male and female subjects significantly differed in body mass index (BMI, p < 0.001), AP talo-first metatarsal angle (p = 0.018), soft tissue thickness under the metatarsal head (p = 0.040) and calcaneal tuberosity (p < 0.001), maximum dorsiflexion during stance phase (p = 0.041), peak pressure on the MFF (p = 0.005) and LFF (p = 0.004), and pressure-time integral on the MFF (p = 0.018) and heel (p = 0.001). BMI was significantly correlated with soft tissue thickness under the metatarsal head (r = 0.521, p = 0.018) and calcaneal tuberosity (r = 0.585, p = 0.007), peak pressure on the MFF (r = 0.601, p = 0.005) and LFF (r = 0.487, p = 0.029), pressure-time integral on the heel (r = 0.552, p = 0.012), and total pressure-time integral (r = 0.755, p < 0.001). Maximum dorsiflexion demonstrated significant negative correlations with pressure-time integral on the MFF (r = −0.595, p = 0.007) and total pressure-time integral (r = −0.492, p = 0.032). Pressure-time integral varus/valgus index was significantly correlated with pressuretime integral forefoot/heel index (r = 0.472, p = 0.036). CONCLUSIONS: Sex-related differences in pedobarographic examination were observed, which could provide useful information in setting appropriate treatment goals and obtaining appropriate control data. The effects of subtalar motion in distributing plantar pressure should be investigated in a future study.
Adult* ; Ankle ; Body Mass Index ; Female ; Foot ; Head ; Heel ; Humans ; Male ; Metatarsal Bones ; Sex Characteristics* ; Walking ; Weight-Bearing

Hypercalcemia is a relatively common complication of cancer that is clinically important because, left unattended, it is associated with symptomatic deterioration and even death. So hypercalcemia can afflict the quality of life and complicate management of the cancer patients with anorexia, lethargic, stuporous mentality, and severely dehydrated. Nonetheless, most cancers are at an advanced stage by the time hyperclacemia develops, many clinicians share doubts about the role of antihypercalcemic therapy in this situation. Furthermore, because the symptoms of hypercalcemia may mimic that of progressive malignant disease or the toxic effects of chemotherapy and radiation therapy, this may not always be recognized. So concerns are needed for active management of patients with malignant hypercalcemia. The authors reviewed the morbidity and mortality in 20 patients with malignant hypercalcemia out of 219 patients with bone metastasis, who were treated at the department of orthopaedic surgery, Catholic University Medical College from January 1989 through December 1992. The results were as follows. 1. The overall incidence of malignant hypercalcemia was 8.6% of bone metastases (20 out of 219 cases).: lung cancer 11.2% (10 out of 89 cases), breast cancer 22.5% (7 out of 31 cases), stomach cancer 6.3% (3 out of 47 cases). 2. The underlying diseases associated with hyprecalcemia were 10 cases of lung cancer(50%), 7 cases of breast cancer(35%) and 3 cases of stomach cancer(15%). Out of lung cancers, 8 cases were squamous cell cancers, the other 2 cases were oat cell cancers. 3. Only 7 out of 20 patients were treated with hydration, diuretics, steroid, calcitonin and mithramycin. And the mean survival duration after recognition of hypercalcemia was 11.3 weeks independent of treatment. In conclusion, the authors emphasize that inspite of grave prognosis, when treated actively, calcium lowering therapy may allow patients to be discharged during terminal period of their illness.
Anorexia ; Avena ; Breast ; Breast Neoplasms ; Calcitonin ; Calcium ; Diuretics ; Drug Therapy ; Humans ; Hypercalcemia ; Incidence ; Lung ; Lung Neoplasms ; Mortality ; Neoplasm Metastasis ; Neoplasms, Squamous Cell ; Plicamycin ; Prognosis ; Quality of Life ; Stomach ; Stomach Neoplasms ; Stupor

STUDY DESIGN: The authors reviewed 14 patients with neurologic deficits caused by ossification of ligamentum flavum(OLF) of thoracic and thoracolumbar spine. OBJECTIVE: To evaluate the clinical and roentgenographic characteristics and suggest the treatment method of the OLF in the thoracic and thoracolumbar spine. SUMMARY OF LITERATURE REVIEW: The reported OLF mainly developed at the thoracolumbar area. It compressed the spinal cord and resulted to the symptoms of thoracic myelopathy. The methods of treatment were posterior decompression including laminectomy or laminoplasty, and sometimes anterior and posterior decompression, with or without fusion. The OLF was not common disease yet and many surgeons have met a problem in making the decision of the extent of posterior decompression multiple or selective. METHODS: The authors reviewed 14 patients with the OLF using clinical reports and roentgenographic studies. We checked the plain roentgenograms, computed tomograms, and magnetic resonance imagings. We performed the posterior decompression using total laminectomy without fusion. We divided three groups according to the operative methods. Group I included the patients with one or two levels of OLF treated with posterior extensive laminectomy. Group II included the patients with OLF in three or more levels, or combined other cord-compressing diseases. They had been treated with multiple posterior or anterior decompression for the entire cord-compressing levels. Group III included the patients with same conditions as group II but they had been treated with selective decompression for the mainly symptomatic levels of OLF. RESULTS: We found the OLF at 54 segments of 14 patients. The involvement of OLF was 29 segments(53.7%) in thoracolumbar and 25 segments(46.3%) in thoracic area. The most commonly involved segment was T10-11(16.7%) and the second was T11-12(14.8%). Clinically the most common neurologic deficit was motor weakness and sensory deficit. The most symptomatic level of OLF was T10-11 and T12-Ll segment(28.6% at each) and the next was T11-12 segment(21.4%). We got the favorable results in group I and group III. But the final results of group II were not good. CONCLUSION: The OLF was most common at the thoracolumbar area and the symptoms and signs were revealed same as those of the thoracic myelopathy. We obtained favorable clinical results after posterior laminectomy without fusion in cases with the OLF in 1-2 segments. In the cases with multiple OLF in three or more segments, or the cases with other cord-compressing diseases, we could get more favorable results in the patients with the selective decompression than the patients with multiple decompression for the entire cord-compressing diseases.
Decompression ; Humans ; Laminectomy ; Ligamentum Flavum* ; Neurologic Manifestations ; Spinal Cord ; Spinal Cord Diseases ; Spine*

We retrospectively reviewed the sex distribution, age at oepration, chief complaints, peroperative and postoperative refractive errors, and corrected visual acuity in 160 previously operated patients to evaluate the clinical manifestations, reractive error, frequency of amblyopia, age at operation, and the postoperative factors affected by the operation of epiblepharon and congenital entropion itself that influence visual acuity and refractive error. The average age at operation was 7.9 years. The chief complaint was ocular discomfort, followed by visual disturbance, photophobia, eyelid rubbing and epiphora. One hundred thirty-three wyws(41.6%) whose preoperative corrected visual acuity was below 0.6 had a mean visual acuity of 0.7. Ninety-five eyes (29.7%) were preoperative myopes above -1.0D, 77 eyes(24%) were hyperopes above +1.0D, and 163 eyes were astigmatic above -1.0D. Twenty-two out of 76 eyes who were followed up for more than one year had a corrected visual acuity of below 0.6. The difference between the older and less than 7 years groups was significantly not significant. Astigmatic changes were not statistically different at any age group. However, the mean significantly visual acuity at postoperative one year was 0.73, which was significantly different from the preoperative value(P=0.006). In conclusion, concurrent postoperative glasses correction and amblyyopia therapy is indicated because the incidence of refractive errors and amblyopia is higher in epiblepharon and congenital entropion.
Amblyopia ; Entropion* ; Eyeglasses ; Eyelids ; Glass ; Humans ; Incidence ; Lacrimal Apparatus Diseases ; Photophobia ; Refractive Errors ; Retrospective Studies ; Sex Distribution ; Visual Acuity