For the nonunion of humeral shaft, there have been many methods of treatment. We are aimed to analyse the causes of nonunion of humeral shaft fracture and present the direction of treatment. We reviewed total 21 cases which were diagnosed as delayed or nonunion of humeral shaft and analysed the causes. l. Initial method of treatment was surgical in 19 out of 21 cases. Among these 19 cases, 14 cases were operated with internal fixation with plate and screw. 2. The most common cause of nonunion was inadequate internal fixation in 26 cases(81%) in which were unstable fixation in 13 cases, choice of inadequate internal fixator in 11 cases, and failure of operative technique in 2 cases. Other causes were distraction between fracture fragments in 4 cases(13%) and open comminuted fracture in 2 cases. 3. Eighteen cases of established nonunion due to inadequate internal fixation were treated by rigid fixation with longer and broader plate and bone graft, and 1 case interlocking IM nailing, 1 case Ender nailing and 1 case bone graft only. 4. Union was obtained in all cases at least in 5 months. And there were no specific complications. In conclusion, surgeons should contemplate the operative indication and principles in primary treatment. In treatment of nonunion, surgeons should treat by more longer and broder internal fixator and additional bone graft.
Fractures, Comminuted ; Humerus ; Internal Fixators ; Methods ; Surgeons ; Transplants

No abstract available.
Child* ; Hip* ; Humans ; Osteoma, Osteoid*

Tretinoin(all-trans retinoic acid) is a metabolite of vitamin A and it is useful in the treatment of photoaging skin. Photoaging skin is characterized by wrinkles, mottled pigmentation, dry and rough skin, and loss of skin tone. Current use of topical tretinoin mainly acts on the epidermis, requires a long period to obtain the desired results and may cause skin hyperpigmentation. A combination of topical and injectable tretinoin has been used to reduce the treatment period as a result of its potentialized effect on the dermis when compared to graditional topical cream use. in this study, we observed histologic alterations in 5 white rabbits after using 0.05% topical tretinoin cream and 0.1% injectable tretinoin. Tretinoin was treated on the rabbits ears-group 1 and 2 on the right ear for study 1, and group A and B on the left ear for study 2. Study 1 was done to differentiate whether the dermal thickening is due to the simple physical stretching of dermis by intradermal injection, or whether it is duer to the histologic change by tretinoin. In group 1, saline was injected intradermally and in group 2, tretinoin was injected intradermally. Study 2 was done to compare the dermal thickening between the topical tretinoin cream treatment group (group A) and the combined topical and injectable tretinoin group (group B). Injection was done once a week immediately followed by 340nm blue light skin exposure. These treatment were done for 12 weeks. We harvested skin stripe from all group, group 1 and 2, and group A and B respectively, after 2, 6, and 12 weeks after treatment. Histologic differences were observed and measured. Dermal thickening was observed in group 2 and in group B(p<0.05). The results showed that intradermal injection of tretinoin mainly acts on the dermis and potentialtes the effect on photo-aging skin and fine wrinkles.
Dermis ; Ear ; Epidermis ; Hyperpigmentation ; Injections, Intradermal* ; Pigmentation ; Rabbits ; Skin ; Tretinoin* ; Vitamin A

A 69-year old female, complaining of severe ocular pain, marked proptosis, and severe congestion of one eye, was found to have an extensive thrombophlebitis of the orbit. The cause and pathogenesis of this process were undetermined. Authors report a case of idiopathic thrombosis of orbital veins. A review of literature related to this disease was added.
Aged ; Estrogens, Conjugated (USP) ; Exophthalmos ; Female ; Humans ; Orbit* ; Thrombophlebitis ; Thrombosis* ; Veins*

No Abstract Available.
Child* ; Humans ; Spine*

In infected uncemented hip arthroplasty, 4 cases which showed well-fixed femoral stem were managed by staged procedure. Thorough debridement, removal of acetabular socket and insertion of antibiotics impregnated cement spacer was done without removal of femoral stem. No recurrence of infection or loosening was developed after staged procedure and revisoin was performed after infection evidence disappeared. The interval between the two procedures was 4 months (3-6) on average. In Weber's criteria, all 4 cases were graded as having definitive cure of infection on both clinical and radiological criteria (Grade I) .
Acetabulum ; Anti-Bacterial Agents ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Debridement ; Hip ; Recurrence

We present a case of severe intracranial hypotension syndrome following lumbar drainage. A 60-year-old woman developed recurrent attacks of vertigo, nausea and vomiting a week prior to admission. Brain MRI revealed a homogeneously well-enhanced mass in the right frontal lobe ; this was found to be a meningioma, and was totally removed. Dural defect was covered with fat and fascia, and postoperative cerebrospinal fluid(CSF) leakage through the frontal sinus was noted. Lumbar drainage was initiated, and about 36 hours later, the patient complained of bouts of headache, nausea and vomiting. Her mental state then gradually deteriorated, and she became stuporous. Brain CT was performed immediately and revealed bifrontal subdural fluid collection and signs of severe brain edema including obliteration of ventricles and basal cisterns. The lumbar drain was then clamped and she regained consciousness 12 hours later. This case clearly demonstrates that to avoid complications such as severe intracranial hypotension syndrome in a patient who has undergone lumbar drainage, the rate and amount of CSF drainage should be closely monitored.
Brain ; Brain Edema ; Consciousness ; Drainage* ; Fascia ; Female ; Frontal Lobe ; Frontal Sinus ; Headache ; Humans ; Intracranial Hypotension* ; Magnetic Resonance Imaging ; Meningioma ; Middle Aged ; Nausea ; Stupor ; Vertigo ; Vomiting

Four cases of retinal detachment with macular hole and no posterior vitreoretinal connections were treated successfully by draining subretinal fluid externally, injecting sulfur hexafluoride gas into the vitreous cavity, and then keeping the patient in a prone position. And in all four cases, the retina remained attached during follow-up periods of 6 months or longer. This approach is simple, easy, and safe. Moreover, it brings good functional success because the macula is preserved. This approach must be the treatment of choice in retinal detachments with macular hole but without other breaks or vitreous adhesion.
Drainage* ; Follow-Up Studies ; Humans ; Prone Position ; Retina ; Retinal Detachment* ; Retinal Perforations* ; Retinaldehyde* ; Subretinal Fluid* ; Sulfur Hexafluoride

High-dose methylprednisolone (MP) has been shown to play an important role in traumatic optic nerve injury. The purpose of this study was to investigate histopathologic changes of the injured optic nerve with time course after experimental trauma to the optic nerve had been induced. The optic nerve trauma was made by rotating the eyeball in rabbits. Twelve rabbits were divided into three groups (Group 1; 2 weeks, Group 2; 1 month, and Group 3; 2 months) according to time course after MP administration. Each group comprised of control group and treatment group. MP significantly reduced damage of the myelinated nerve and gliosis in comparision with the control group, when MP was administered IV immediately after trauma in the treatment group at a bolus of 30mg/kg, two times for 3 days, with a subsequent continuous MP infusion at 30mg/kg for 4 days. And massive gliosis and damage of the myelinated nerve in the control group were oberserved on electron microscopy. However, we could not find PMNLs, macrophages, and proliferation of fibroblast in both the control group and treatment group. It is possible that high-dose MP protects further damage of the injured optic nerve and that the beneficial effect is partially due to its antioxidant rather than its anti-inflammatory effect. This histopathologic study indicated that high-dose MP might improve the neurological outcome in the injured optic nerve.
Fibroblasts ; Gliosis ; Macrophages ; Methylprednisolone* ; Microscopy, Electron ; Myelin Sheath ; Optic Nerve Injuries ; Optic Nerve* ; Rabbits

No abstract available.
Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia, Mycoplasma*