No Abstract Available.
Choroid*

For many years, healing membranous bone fractures have been known to show a persistent lucency at the fracture interface. Radiographic follow-up has proven to be of little value as a guideline for healing of mandibular fractures. Recently, a fracture has been treated by rigid internal fixation by metallic plate and screws rather than closed reduction and wire fixation, we expected that some difference in the radiographic features of fracture healing. To investigate these questions we undertook a retrospective radiographic and clinical analysis of 33 followed patients with fractures of the body and angle of the mandible from 1993 to 1997. There were 26 male and 7 female patients ranging in age between 5 and 74 years, with an average of 29.7 years. All patients were managed by open reduction with metallic plates and screws. The length of follow-up ranged from 9 to 187 weeks. Total 81 radiographic follow-up films were obtained and divided into 3 grades according to the degree of radiolucency of fracture lines; grade 0 radiolucent fracture line and no evidence of fracture interface calcification, grade 1 decreased radiolucent area and evidence of fracture interface calcification, and grade 2 disappearance of fracture line.Until follow-up of 8 weeks, all of the radiographs showed grade 0. From 8 weeks to 16 weeks, 62.5 percent showed grade 0 and 37.5 percent showed grade 1. From 16 weeks to 48 weeks, 38.5 percent showed grade 1 and 61.5 percent showed grade 2. After follow-up of 48 weeks, all showed grade 2.In this study we have shown that the radiographic disappearance of mandibular fracture lines was usually accomplished by 48 weeks. We feel that radiographic union of the mandible is lagging well behind clinical union, but disapperance of the fracture line in rigidly fixated mandibular fracture was occurred earlier than healed by fibrous union. We propose that radiographic union of the mandible by approximately 1 year can be a guideline for the normal mandibular bone healing.
Female ; Follow-Up Studies* ; Fracture Healing ; Fractures, Bone ; Humans ; Male ; Mandible ; Mandibular Fractures* ; Retrospective Studies

Os Subtibiale, inconstant bone over the tip of the medial malleolus, is the very unusual findings and extreme rarity of the condition. We experienced a case of Os subtibiale in a 24 year old man who complained pain and tenderness an the bilateral medial malleolar region. The patient was treated by excision with satisfactory result.
Humans

Diabetes mellitus, obstructive uropathy and urinary infection were considered to be most important in the etiology of renal papillary necrosis in the past literature. However, since 1953, Spuhler and Zollinger reported an association between phenacetin abuse and renal papillary necrosis, the most frequent cause of renal papillary necrosis has been diabetes mellitus, while analgesic abuse (contained phenacetin) has been the second most common factor in recent reports. In the more recent literature, most of the patient have had neither obstructive uropathy nor urinary infection, and it is quite possible that there two condition are of no direct etiological significance. But in this case, we can not suggest definite etiological factor except urinary infection clinically. Only one case is reported showing clinical manifestations laboratory findings, pyelographic findings and pathological changes compare with previous papers.
Diabetes Mellitus ; Humans ; Necrosis* ; Phenacetin

No abstract available in English.
Arthritis, Rheumatoid ; Clinical Study

After developement of antimicrobial chemotherapy, morbidity and mortality from pyogenic arthritis has been reduced dramatically, but still this disease has remained as a serious and life threatening infectious disease of childhood or late sequelae in surviving patients. For the period of 6 years from January 1978 to December 1983, seventy nine patients, eigthy one cases who were treated as pyogenic arthritis at Severance Hospital and Yong Dong Hospital were studied retrospectively and the results are summerized as follows. 1. We thought that the main pathogeny of septic arthritis of knee joint are trauma and direct invasion of microorganism, because the frequency of pyogenic arthritis in knee joint are proportional to the age and history of accupuncture therapy and trauma are common. 2. In thirty three cases (40.7%) underlying causes were found, composed of infectious focus in eleven cases(13.6%) correspondent to hematologic transmission, osteomyelitis in seven cases(8.7%), trauma and accupuncture in six cases(7.4%) and eight cases(9.9%) corresponding to direct invasion. 3. In forty five cases(55.6%) microorganism are identified, among which coagulase positive staphylococci are in forty cases(88.9%) . 4. Tc-99m-MDP(Medronate) whole body bone scan were taken at twelve patients and positive findings were eleven cases. 5. In thirty eight cases(46.9%) the complications were appeared: Osteomyelitis of tibia in ankle joint and periarticular or subarticular bone defects in knee joints were common. 6. There were complications in every cases that the duration was more than eleven days, no exceptional.
Ankle Joint ; Arthritis ; Arthritis, Infectious ; Clinical Study ; Coagulase ; Communicable Diseases ; Drug Therapy ; Humans ; Knee Joint ; Mortality ; Osteomyelitis ; Retrospective Studies ; Tibia

Osteochondritis dissecans occurs most commonly in knee joint and often in elbow, ankle, shoulder, hip than in other joint. In osteochondiritis dissecans, an area of subchondral bone undergoes avascular necrosis and degenerative change ususlly occurs in cartilage overlying it. During the course of disease, unless interrupted by treatment or spontaneous healing, the necrotic bone and cartilage seperates from adjacent bone and cartilage and together becomes loose body. To promote healing, the proper treatment is necessary before degenerative change developes. The authors reviewed 11 cases of osteochondritis dissecans which recieved treatment at Severance hospital from January 1972 to December 1981. The results were obtained as follows: 1. The incidence of osteochondritis dissecans in male was a little more frequent than that of female and 50% were observed in the age of 16 to 30 years. 2. The most common symptom and sign was pain and limitation of motion, instability senastion, tenderness, snapping sound in order of frequency. 3. The most common area involved was the knee in 9 cases, 5 cases involved the medial femoral condyle, 4 cases involved the lateral femoral condyle. The ankle and elbow was 1 case for each. 4. Eight(72.7%) of 11 cases had history of trauma. 5. Among 9 cases of knee inlovement, 5 (55.6%) cases were associated with rupture of meniscus. 6. The methods of treatment were as follows. Conservative..................................................................1 Operative Curettage and drilling........................................................6 Excision......................................................................3 Curettage and bone graft.......................................................1 Internal fixation..............................................................1 7. Conservative treatment was performed in one case, but failed. So, all 11 cases recieved operative treatment and obtained satisfactory results in 72.8%.
Ankle ; Cartilage ; Curettage ; Elbow ; Female ; Hip ; Humans ; Incidence ; Joints ; Knee ; Knee Joint ; Male ; Necrosis ; Osteochondritis Dissecans ; Osteochondritis ; Rupture ; Shoulder

Acute pyogenic osteomyelitis is frequent in infants and children, usually hematogenous, and predominant in male. The etiology of acute osteomyelitis is of 3 types: hematogenous, direct innoculation, or postoperative. Acute pyogenic hematogenous osteomyelitis is the most frequent type in children. This study consisted of 119 cases of acute pyogenic osteomyelitis which were studied at the department of orthopedic surgery, Yonsei university, Severance hospital and Youngdong hospital for 10 years from Jan. 1974 to Dec. 1983. The result were as follows. 1. There were tendency to decrease the frequency of this disease graduaUy since 1973 except 1978. 2. 20 patient (16.8%) had the history of trauma and 43 patients (36.1%) had the entry site of infecting organism. 3. The most frequent involved sites were femur and tibia. 4. E.S.R. was definitely increased in 90.4% of male, in 100% of female. 5. 59.6% of patients revealed the definite bone change at admission on X-ray findings. 6. Staphylococcus coagulase positive was the most frequent organism isolated (95%). 7. The most sensitive antibiotics was cephalosporin and the most resistant was penicillin (90.2%). 8. The antibiotics treatment with immobilization of involved site was initially tried, if there was no symptomatic improvement, the various surgical process was performed with satisfactory result.
Anti-Bacterial Agents ; Child ; Clinical Study ; Coagulase ; Female ; Femur ; Humans ; Immobilization ; Infant ; Male ; Orthopedics ; Osteomyelitis ; Penicillins ; Staphylococcus ; Tibia

BACKGROUND: Angina with normal coronary angiogram has been called syndrome X or microvasclar angina. Pathophysiologic mechanisms for chest pain in this group of patients are not known exactly. This study was performed to compare the insulin level of the patients with syndrome X with that of the healthy asymptomatic volunteers. METHODS: The syndrome X group was consisted of 18 patients(11 men and 7 women). All patients had typical chest pain and positive exercise test with a completely normal coronary andgiogram. Patients with hypertension, diabetes mellitus, and there taking any drug known to affect the insulin secretion were excluded. The control group was consisted of 38 healthy subjects(25 men and 11 women) who were not taking any medications. We measured the plasma glucose insulin and C-peptide concentration during oral glucose tolerance test in both groups. RESULTS: Fasting plasma glucose was normal in all patients in both groups. There were no significant differences in plasma glucose level, during the oral grucose tolerance test. There were no significant differences between control and wyndrome X group in the fasting plasma insulin concentration(5.1+/-2.4 vs 5.9+/-2.7 microg/ml, p>0.05). However, the insulin levels at 60min(47.6+/-20.0 vs 84.0+/-68.0 microg/ml) and 120 min(31.4+/-18.2 vs 92.9+/-83.8 microg/ml)were significantly higher in the syndrome X group(p<0.05). THere were no significant differences in the C-peptide concentrations at fasting, 60 min and 120 min after oral glucose tolerance test between control and syndrome X group(p>0.05). CONCLUSION: As shown in above results, there were significant differences in insulin concentrations, but nor in C-peptide concentrations between control and syndrome X group. Thus it can be suggested that the increased dinsulin level in these patients is resulted from the altered insulin action to the target tissues, not from the pancreatic overproduction of insulin. We suggest that this hyperinsulinemia resulted from the insulin resistance play a possible role in the abnormality of microvascular circulation as a mechanism of Syndrome X.
Blood Glucose ; C-Peptide ; Chest Pain* ; Diabetes Mellitus ; Exercise Test ; Fasting ; Glucose Tolerance Test ; Humans ; Hyperinsulinism* ; Hypertension ; Insulin ; Insulin Resistance ; Male ; Plasma ; Thorax* ; Volunteers

Cystic parathyroid adenoma is one of the rare causes of hyperparathyroidism, and is usually located in neck and mediastinum. This type of adenoma tends to cause increased serum level of parathyroid hormone and alkaline phosphatase, similar serum calcium level when compared to those of solid adenoma. Thanks to current radioimmunoassay and easy accessibility to serum autoanalyzer, serum calcium level and parathyroid hormone level are more easily measured, which in turn lead to more easier diagnosis of hyperparathyroidism. Also improvement in imaging and nuclear diagnostic method of parathyroid lesion are suggested to enable easy diagnosis of cystic parathyroid adenoma. A 35-year-old male presented with easy fatigability for 12 months. The serum calcium, phosphate, alkaline phosphotase were 11.5mg/dL, 1.4mg/dL, 194IU/L respectively and his parathyroid hormone level in serum was 126.42pg/mL. Neck CT showed enlargement of right lobe of thyroid gland with well defined inhomogenously enhanced density inside the right thyroid gland. The patient was diagnosed of hyperparathyroidim due to parathyroid adenoma and was surgically removed. The surgical biopsy showed cystic parathyroid adenoma. After operation his general condition was improved and serum calcium, phosphate, parathyroid hormone level were normalizd. We report a case of hyperparathyroidism caused by cystic parathyroid adenoma with brief review of literature.
Adenoma ; Adult ; Alkaline Phosphatase ; Biopsy ; Calcium ; Diagnosis ; Humans ; Hyperparathyroidism* ; Male ; Mediastinum ; Neck ; Parathyroid Hormone ; Parathyroid Neoplasms* ; Radioimmunoassay ; Thyroid Gland