Controversy persists regarding the abnormality of the bone metabolism in various bone diseases. Osteocalcin, the vitamin K-dependent protein synthesized in bone, has been shown to be a specific and sensitive marker of bone turnover in metabolic bone diseases. The author measured the serum osteocalcin level using newly developed radioimmunoassay (RIA) in the patients with osteogenesis imperfecta, metastatic bone tumor, postmenopausal osteoporosis and rheumatoid arthritis, which can be the causes of osteoporosis, and ankylosing spondylitis. The aim of this paper is to demonstrate the value of the osteocalcin measurement comparing the each data of disease group with the normal control group. The results were as followings ; 1. The mean of osteocalcin in normal Korean was 4.43±1.04 ng/ml. (4.45±1.08 ng/ml in male, 4.41±1.01 ng/ml in female). The difference between male and female was not significant statistically. 2. The osteocalcin of osteogenesis imperfects was 9.14±2.21 ng/ml, which was significant statistically, And it was thought to be the result of increasing bone turnover rate and the osteocalcin was useful as biochemical marker. 3. In metastatic bone tumor, osteocalcin was under the normal level in both untreated and treated groups, which meant low bone turnover rate or low osteoblastic activity. Osteocalcin was not a useful marker for the assessment of the effect of treatment in this study, but if the radioimmunoassay was done in the same tumor group, a valuable results could be expected. 4. Osteocalcin level in the patients with postmenopausal osteoporosis and rheumatoid arthritis was not different with normal control group and osteocalcin was not useful marker for the evaluation of the degree of osteoporosis and bone turnover. 5. Osteocalcin didn't play a role in the pathologic ossification of ankylosing spondylitis. In conclusion, the osteocalcin by radioimmunoassay can be used as a biochemical marker in metabolic bone diseases and metastatic cancer for the disgnosis and the assessment of prognosis or the effect of treatment.
Arthritis, Rheumatoid ; Biomarkers ; Bone Diseases ; Bone Diseases, Metabolic ; Bone Remodeling ; Female ; Humans ; Male ; Metabolism ; Ossification, Heterotopic ; Osteoblasts ; Osteocalcin ; Osteogenesis ; Osteogenesis Imperfecta ; Osteoporosis ; Osteoporosis, Postmenopausal ; Prognosis ; Radioimmunoassay ; Spondylitis, Ankylosing ; Vitamins

Iatrogenic damage of the rotator cuff followed by postoperative shoulder function loss is a potential complication after antegrade intramedullary nailing (AIN) for a humeral fracture. The authors present a case of arthroscopic rotator cuff repair and subacromial decompression of a non-healed rotator cuff tendon (mainly supraspinatus) and secondary impingement syndrome caused either by the tear or a proud nail after AIN for a mid-shaft humeral fracture. At presentation, the patient complained of right shoulder pain and 'snapping', especially during forward elevation and abduction of the shoulder, of 4 years duration. Right shoulder pain started sometime after pain due to the humeral shaft fracture, operation had subsided, and persisted after nail removal. Arthroscopic findings showed a longitudinal rotator cuff tear at the nail entry point that had not healed and severe fibrous hypertrophy on the acromion underspace, which is a unique finding since most longitudinal splits of tendon fibers are more likely to heal than conventional rotator cuff tears detached from bone. The torn rotator cuff was repaired after debridement and placing side-to-side sutures. At his 34-month follow-up after rotator cuff repair, the patient showed complete recovery and had excellent clinical scores.
Acromion ; Arthroscopy ; Debridement ; Decompression ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Humans ; Humeral Fractures ; Hypertrophy ; Rotator Cuff ; Shoulder ; Shoulder Pain ; Sutures ; Tendons

No abstract available.
Cerebral Hemorrhage* ; Eclampsia* ; Female ; Pregnancy

The knee joint is one of the most susceptable joint to ligamentous injury. For good results, it is very important to make an early diagnosis and to give prompt management. The aim of treatment is to restore the ligaments to their previous anatomic position and tension. The authors reviewed 420 cases of ligamentous injuries in 400 patients who were admitted and managed for 6 years from March, 1981 to February, 1987. The results were as follows : 1. The athletic injury was the most commcn cause of injury(55%), and fall-down was next(26%). 2. The most common ruptured individual ligament was the medial collateral ligament. Combined ligament rupture was more common in medial collateral ligament and anterior cruciate ligament. 3. The ruptured sites of the individual ligament were found to be the following ; a) the medial collateral ligament was ruptured most frequently at the femoral attachment(43%), with the superficial layer ruptured in the midsubstance and the deep layer at the femoral attachment; b) the lateral collateral ligament torn at the fibular attachment(51%); c) the anterior cruciate ligament torn at the femoral attachment(39%); d) the posterior cruciate ligament torn at the femoral attachment(64%). 4. Many ligamentous injuries were associated with fracture(44%) and tear of meniscus- (42%). 5. In stress-radiogram, the significance of ligament injuries was present in more than 10 and 10 mm. 6. Excellent and good results were obtained in 94% by non-surgical treatment and in 92% by surgical treatment. 7. Early surgical repair of the ligament within 2 weeks after injury, gave much better result than later repairs.
Anterior Cruciate Ligament ; Athletic Injuries ; Clinical Study ; Collateral Ligaments ; Early Diagnosis ; Humans ; Joints ; Knee Joint ; Knee ; Lateral Ligament, Ankle ; Ligaments ; Posterior Cruciate Ligament ; Rupture ; Tears

No abstract available.
Animals ; Rats* ; Sepsis*

The main problem in peripheral nerve repair is adhesion, axonal escape, and the ingrowth of extraneurial tissue into the wound. Meticulous microsurgical neurorrhaphy is one of possible answer for these problem. Shielding of nerve suture is another attractive practice. But the results are still unpredictable. We compared the results of nerve repair between microsurgical epineurial neurorrhaphy plus silastic cuff shielding group and epineurial neurorrhaphy group in the sciatic nerve of white rat. The reasults we obtained are as follows; 1. Silastic cuff shielding method was effective for reducing abnormal neurial growth and neuroma formation into the surrounding soft tissue. 2. Some adhesion was formed over the silastic cuff, but there was no adhesion at the inner space of the cuff. 3. Silastic cuff could prevent fibrous tissue ingrowth into the nerve. 4. The slit of the silastic cuff provided vascular ingrowth between surrounding connective tissue and nerve tissue. 5. No evidence of foreign body reaction was observed in and out of the silastic cuff. 6. Nerve conduction test showed a little supperior results in the silastic cuff shielding group. Silastic cuff shielding method in nerve suture might be recommanded to prevent axonal escape, fibrous scar tissue ingrowth to the nerve, and fibrous adhesion in clinical practice. But, it seemed that the final evaluation of the functional recovery of the nerve needed long term follow-up and nerve conduction study.
Animals ; Axons ; Cicatrix ; Connective Tissue ; Follow-Up Studies ; Foreign-Body Reaction ; Methods ; Nerve Tissue ; Neural Conduction ; Neuroma ; Peripheral Nerves ; Rats ; Sciatic Nerve ; Sutures ; United Nations ; Wounds and Injuries

Urinary cytology has become an essential element in the diagnosis and management of transitional cell carcinoma(TCC) of the urinary tract. It has the advantage of being noninvasive, inexpensive, and easily accessible. Besides that it can even detect malignancy when unsuspected at cystoscopy. We report a retrospective review of urine cytology in the diagnosis of 83 TCC cases that underwent 295 cytologic evaluation. All patients had biopsy-proven TCC of the bladder, ureter and renal pelvis. The overall inci- dence of the positive cytology cases was 66.2%. To define the cytologic features of tumor cells, we tried to use three cytologic gradings such as "grade 1", "grade 2", and "grade 3" according to the cytologic degree of anaplastic neoplastic cells. These cytologic gades of TCC were relatively well correlated with the histologic grade and tumor invasiveness. This result suggests that the recognition of characteristic cellular features of TCC can suspect the histologic grade and tumor stage. The false negative TCC cases were 78.9%. They showed severe inflammatory or bloody background and a few neoplastic cells. Therefore, a cautious approach for accurate interpretation, personal experience, and proper fixation and processing could expand the role of urinary cytology.
Cystoscopy ; Diagnosis ; Humans ; Kidney Pelvis ; Nocturnal Enuresis* ; Retrospective Studies ; Risk Factors* ; Thyroid Gland ; Ureter ; Urinary Bladder ; Urinary Tract

No abstract available.
Leydig Cell Tumor*

PURPOSE: To evaluate the value of fast field echo(FE) technique in accesing temporOmandibular joint(TMJ) dynamics. MATERIALS AND METHODS: A series of 120 TMJ MRI examinations of 60 symptomatic patients was performed. The fast FE technique was used to provide dynamic images of the TMJs in various phase of mouth opening with a step-bite-block. RESULTS: Among 120 cases, there were 30 cases which were normal, 21 cases of anterior displacement with reduction, 66 cases of anterior displacement without reduction, 11 cases of deformity of menisci, 23 cases of bony deformity, and 3 cases of medial displacement. The menisci and condyles were clearly delineated and the motions of the menisci during jaw opening were well evaluated in both normal and pathologic conditions. CONCLUSION: The dynamic TMJ MRI scan using fast FE technique permits both fast scanning and study of joint dynamics as well as TMJ anatomy.
Congenital Abnormalities ; Humans ; Jaw ; Joints ; Magnetic Resonance Imaging* ; Mouth ; Temporomandibular Joint*

No abstract available.
Fistula* ; Pyriform Sinus* ; Thyroiditis, Suppurative*