Local deposition of antibiotics has become increasing popular in the management of open fractures or osteomyelitis, and several substances have been employed as the vehicle for delivery. Although the elution characteristics of some substances have been documented, a comparative study of the characteristics of the commonly used substances were performed in order to establish the clinical indications for particular vehicles. Carriers were prepared, which were human iliac cancellous bone, bovine cancellous bone matrix(Lubboc?), absorbable gelatin sponge(Gelfoam?), fibrin glue(Beriplast? P) and polymethylmethacrylate(CMW?) for elution characteristics of vancomycin. The each carriers were immersed on the 20 ml of PBS and then obtained the samples for analysis of concentration of vancomycin at first, second, third, fourth, fifth, sixth, fourteenth, twenty-first, twenty-eighth day after immersion. The assay technique was fluorescent polarization immunoassay(Abbott, Dallas, Texas, U.S.A.). Nearly 50% of vancomycin was released from human iliac cancellous bone, Lubboc? and fibrin glue during the first 3 days, and negligible after first week. Gelatin sponge produced high local concentration of vancomycin during the first week. PMMA eluted the only 6% of vancomycin during the first day and trace amount detected as long as 4 weeks. There are significant statistical difference among carriers at second and fourth week(ANOVA test, P < 0.05). The authors considered that human iliac cancellous bone, Lubboc? ,Gelfoam? and fibrin glue may be best employed when brief antibiotic coverage is required, whereas PMMA may be better suited for long-term coverage.
Anti-Bacterial Agents ; Fibrin ; Fibrin Tissue Adhesive ; Fractures, Open ; Gelatin ; Gelatin Sponge, Absorbable ; Humans ; Immersion ; In Vitro Techniques ; Osteomyelitis ; Pharmacokinetics ; Polymethyl Methacrylate ; Porifera ; Texas ; Vancomycin

The lateral compression injury of the pelvis is common in high-speed vehicle accidents, and symphysis pubis disruption can occur with external rotation or anterior compression injury. The most common injury of the symphysis pubis is diastasis. So far, four cases of the locked symphysis pubis have been reported, and two of these were treated by closed reduction. The current case involves a 26-year-old man who experienced a lateral compression force to his pelvis and knees, and suffered a symphysis pubis disruption (locked symphysis pubis, i.e., creeping of the left pubic body below the right pubic body), urethral rupture and bilateral knee dislocation. The locked symphysis pubis was successfully reduced with a closed maneuver.
Adult ; Dislocations* ; Humans ; Knee ; Knee Dislocation ; Pelvis ; Rupture

The term juxta-facet cyst has been used to characterize two types of periarticular cystic alterations, synovial and ganglion, that can occur in the paraspinal region. Synovial cysts arise from synovial outpouchings through the weakened or destroyed capsular tissue.Ganglion cysts are commonly found about the wrist and hand.But theoretically they can occur at any site in the body where periarticular connective tissue is present. In spinal canal these cysts may cause pressure on adjacent nerve root to produce a variety of neurological symptoms. The clinical features indicated an acute onset of symptoms favoring a diagnosis of disc herniation, so differential diagnosis is important.We have experienced two cases of the intraspinal extradural cysts connected to posterior longitudinal ligament by a sheath, causing nerve root compression. those were managed with excision of the cyst, and no recurrence has been identified during follow up evaluation.
Connective Tissue ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Ganglion Cysts ; Longitudinal Ligaments ; Radiculopathy ; Recurrence ; Spinal Canal ; Synovial Cyst ; Wrist

Chronic cavities of the dorsum of the foot often have bare bone and are unsuitable for free skin grafting. Local Flaps are often impossible because of surrounding scar tissue and dead space. A simple method is presented; it consists of the excision of the lesion, filling the cavity by a two staged random-pattern de-epithelialised turn over flap, and skin graft.
Cicatrix ; Foot ; Methods ; Skin ; Skin Transplantation ; Transplants

Phakomatosis pigmentovascularis characterized by the association of cutaneous hemangioma and pigmentary nevi was first recognized as a syndrome by Ota in 1947. We describe herein a case of phakomatosis pigmentovascularis alsoiated with ocular abnormalities in a 22-year-old female. According to Hasegawas criteria, this case is lassified as type lIb.
Female ; Hemangioma ; Humans ; Neurocutaneous Syndromes* ; Nevus ; Stomach Neoplasms ; Young Adult

Bowens disease is a precaicerous lesion and may transform into in asive squamous cell carcinoma. We present a case of a 67 year-old male with Bowens disease on the buttock from which squamous cell carcinoma developed. He had anerythematous, scaly and crusted slaque with a nodule on the left buttock. Skin biopsy specimen taken from the plaque and nodule revealed typical histopathological findings of Bowens disease and squlamous cell carcinoma, respectieels. The patient was treated with excision and skin graft under general anesthesia.
Aged ; Anesthesia, General ; Biopsy ; Bowen's Disease ; Buttocks ; Carcinoma, Squamous Cell ; Humans ; Male ; Skin ; Transplants

No abstract available.
Arthroplasty* ; Arthroplasty, Replacement, Hip*

No abstract available.
Vulva*

Parkinson's disease most consistently involves pathologic changes in the substantia nigra, which is the major source of dopamine to the striatum. It has been shown that either fetal substantia nigra or adrenal medulla tissue implanted to the rat brain survives, produces dopamine, and improves behavioral abnormalities induced by deprivaion of the caudate nucleus of its dopaminergic innervation. Thus, grafts containing dopamine could be potential replacement for destroyed or damaged dopaminergic neurons in patients with Parkinson's disease. In the present study, authors administrated 6-hydroxydopamine into the right substantia nigra, and produced unilateral dopamine denervated Parkinson's experimental model using solid graft method and cell suspension implant, the results of these grafts were examined behaviorally, biochemically, immunohistochemically 3 months after grafting. In this study, a total of forty-five young(4 to 5 week old) rats were used and divided into three experimental groups-control group which underwent dopamine denervation without any grafting(15), solid graft group which was grafted fetal mesencephalon to the caudate-putamien(n=15) and cell suspension implant group which was grafted cell suspension fetal mesencephalon to the caudate-putamen(n=15). The apomorphine induced rotation test was performed at four weeks, eight weeks, twelve weeks after grafting. The dopamine concentration in the caudate-putamen was biochemically measured by High Performance Liquid Chromatography(HPLC) and immunohistochemically these grafts containing dopamine granules were stained by Avidin-Biotin immunoperoxidase staining with dopamine monoclonal antibody. The results were as follows ; 1) Behavioral testing was performed by apomorphine induced rotational test. A mean rotation number during the first five minutes following apomorphine injection was 40.0+/-.5 in control and 18.3+/-.9 in cell suspension implanted group at one month after grafting and these was more reduction of turning than that in solid graft group. The both graft groups demonstrated explicit reduction of turning by 58% and 55.3% when compared to the control group respectively 3 months after grafting. However the difference in reduction of turning between the two grafted groups was statistically not significant. 2) Biochemical measurements of dopamine concentration was done in pathologic and normal caudate-putamen. The concentration of dopamine was 13.5+/-3.1ng/mg of protein in normal subject and 0.6+/-0.2ng/mg of protein in the dopamine denervated caudate-putamen of the control group which was markedly reduced by 4.4% of dopamine concentration in the normal caudate-putamen. The concentration of dopamine in the cell suspension implant group was 3.2+/-1.2ng/mg of protein at three months after grafting and 3.0+/-1.1ng/mg of protein in the solid group and these values were increased in the concentration give 5 times more than those of pregrafting state. 3) In the results of immunohistochemical examination cells containing granules of dopamine were exclusively found in the grafted groups. In experimental Parkinson's disease model of Sprague-Dawley rats, it was found that the grafts of fetal mesencephalon to the caudate nucleus induced an elevation of dopamine concentration and symptomatic improvement. In the method of graft, cell suspension implant method brings faster effect, leaves less amount of damage to the host brain, and can be used in any area of the brain for the transplantation. Therefore graft of fetal mesencephalon using cell suspension grafting method might be effective treatment of patients with Parkinson's disease.
Adrenal Medulla ; Animals ; Apomorphine ; Brain ; Caudate Nucleus ; Denervation ; Dopamine ; Dopaminergic Neurons ; Humans ; Mesencephalon* ; Models, Theoretical ; Oxidopamine* ; Parkinson Disease ; Rats* ; Rats, Sprague-Dawley ; Substantia Nigra ; Transplantation ; Transplants

In order to study the effects of stereotaxic destruction of distinct epileptogenic focus, the amygdala was destroyed with radiofrequency coagulator. A total of twenty Sprague-Dawley rats were divided into two group : the control group which underwent craniectomy on the biparietal area and was instilled crytal penicillin solution into the right amygdala on the basis of stereotaxic coordinates(n=10), and the amygdalectomy group which was performed selective amygdalectomy with radiofrequency coagulator after confirmation of clinical and electroencephalographic epileptic features after proceeding same methods of control group(n=10). The experimental epileptic models in rats were obtained by selective instillation of crystal penicillin solution into the right amygdala. The effects of amygdalectomy were investigated by observation of the changes in behavior and electroencephalographic recordings. The results were as follows ; 1) A typical behavioral seizure was shown in the control group and epilepticform discharge was prominent in crystal penicillin soultion instilled side, but there was no bilateral synchronous epileptic discharges during ictal stages. 2) In comparision to two groups, the severity and the frequency of behavioral seizure were more decreased in the stereotaxic amygdalectomy group. 3) The amygdalectomy group was shwon a significant decrease in amplitude and frequency of spikes, especially during interictal stages, compared to the control group. From the results of electroencephalographic and behavioral analysis, selective amygdalectomy with radiofrequency coagulator seemed to be an effective method to treat the crystal penicillin soulution induced epileptic rats.
Amygdala ; Animals ; Penicillins ; Rats* ; Rats, Sprague-Dawley ; Seizures