The bone mineral density (BMD) has been measured for evaluation of the osteoporosis. Of the various methods of measuring the BMD, dual energy X-ray absorptiometry (DEXA) has been known to be an accurate, objective, and easily reproducible method. The authors measured BMD in patients with intertrochanteric fracture of the femur for comparison with results in the normal control. The BMD was measured in thirty-two patients with intertrochanteric fracture by dual energy X-ray absorptiometry from March 1993 to March 1995. And the relationship between the severity of osteoporosis and intertrochanteric fracture of the femur was studied. The comparison of BMD between fracture patients and normal control was done in the population below 79 years old of age (23 fracture patients and 90 normal controls). The average BMD in the intertrochanteric fracture group was 0.558g/cm2 in the neck, 0.425g/cm2 in Ward's triangle and 0.568g/cm2 in the trochanter, while in the normal control group it was 0.870g/cm2 in the neck, 0.681g/cm2 in Ward s triangle and 0.772g/cm2 in the trochanter. In comparison with the normal control group, the BMD in fracture group was about 79% of the normal control group. The BMD in the proximal femur was decreased by about 14% with the age increasing decennially after 50 years. The BMD at Ward s triangle and trochanter was much lower in type III and IV of Tronzo classification than in type I and II .The BMD did not show significant correlation with the height and weight of the patients.
Absorptiometry, Photon ; Aged ; Bone Density* ; Classification ; Femur* ; Humans ; Neck ; Osteoporosis

To clarify the developmental characteristics of fetal esophageal epithelium especially ciliated cell, expressions of epidermal growth factor receptor (EGFR) and cytokeratin (CK) in fetal esophageal mucosa (16-24 weeks of gestation) were studied immunohistochemically, and ultrastructure of the ciliated cells was also observed. The expressions of EGFR and CK were identified in labelled streptoavidine biotin immunohistochemical method. Primary antibodies used were EGFR (Ab-4) which is affinity-purified from hyperimmune rabbit sera (Oncogene Science) and monoclonal mouse anti-human cytokeratin (DAK0-CK, MNFl16). The esophageal lumen was lined with stratified ciliated columnar epithelium between 16 and 24 weeks of gestation. The pattern of expression Of EGFR was different with gestational age and epithelial layer. The ciliated cell exhibited variable staining intensity for EGFR at 16 weeks. Some were stained intensively, and others were stained faintly. Number of ciliated cells stained intensively were gradually increased, and most of them were strongly stained at 24 weeks. The superficial non-ciliated cells, however, showed relatively constant staining property of moderate to intense between 16 and 24 weeks. EGFR immunoreactivity was minimal in the basal and intermediate cells at 16 weeks, but became more intense at 24 weeks. CK immunoreactivity in the ciliated cells between 16 and 24 weeks was similar to that of EGFR immunoreactivity. On the other hand, superficial non-ciliated cells were intense for CK staining at 16 weeks, but were very weak to negative at 24 weeks. CK immunoreactivity was intense in basal and intermediate cells between 16 and 24 weeks, but it was almost negative in the some cells of intermediate layer, especially beneath negatively stained non-ciliated cells, at 24 weeks. In electron microscopy, ciliated cells had well organized cilia and dense granules close to Golgi apparatus between 16 and 24 weeks. The cells apparently active in ciliogenesis were also observed. These cells had short microvilli, many centrioles, and dense granules close to Golgi apparatus. The non-ciliated cells contained numerous clear vesicles adluminally clustered at 16 weeks, while they had many dense vesicles of about same size of clear vesicles at 24 weeks. These results demonstrate the expressions of EGFR and CK in esophageal epithelium of human fetus between 16 and 24 weeks of gestational ages, and suggest that the ciliated cells are still proliferative at 24 weeks.
Animals ; Antibodies ; Biotin ; Centrioles ; Cilia ; Epithelium* ; Fetus* ; Gestational Age ; Golgi Apparatus ; Hand ; Humans* ; Keratins ; Methods ; Mice ; Microscopy, Electron ; Microvilli ; Mucous Membrane ; Pregnancy ; Receptor, Epidermal Growth Factor

No Abstract Available.
Humans

Generally the clinical results of Legg-Calvé-Perthes disease were evaluated until the time of disease healing. However, it is well known that the deformities of the proximal femur progress to the period of skeletal maturity. The purpose of this study was to evaluate the progression of the deformities in the proximal femur. In a retrospective study of 60 patients with Legg-Calvé-Perthes disease, who visited Chonnam National University Hosipital 1974 and 1995 and who were followed until the skeletal maturity, the bony changes of the proximal femur were compared between disease healing stage and skeletal maturity. The results were as follow; 1. More bony deformities were identified in skeletal maturity than in disease healing. 2. The quotient of inferior border of medial femoral neck decreased from 60% in disease healing to 45% in skeletal maturity (P < 0.001). 3. The femoral shortening increased from 4.9mm in disease healing to 10mm in skeletal maturity (P < 0.001). 4. The femoral neck-shaft angle decreased from 128 degrees in disease healing to 125 degrees in skeletal maturity (P < 0.001). 5. The proximal migration of greater trochanter increased from 13.8mm in disease healing to 21.3mm in skeletal maturity (P < 0.001). 6. There were no significant statistical differences in clinical results between operative and conservative treatment groups. 7. The spherical quotient of femoral head and Stulberg rate revealed no differences between disease healing and skeletal maturity. These results revealed that there were considerable differences of the deformities in the proximal femur at the time of disease healing and skeletal maturity.
Congenital Abnormalities ; Femur Neck ; Femur ; Head ; Humans ; Jeollanam-do ; Legg-Calve-Perthes Disease ; Retrospective Studies

No abstract available.
Breast Neoplasms* ; Breast*

The main goals of treatment of malignant bone tumor are the prolongation of life survival and the improvement of quality of life. In growing children, however, leg length discrepancy (LLD) is one of major problem in the treatment of malignant bone tumors. Therefore, the precise understanding of growth in children is essential, and the prediction of LLD is critical in deciding the time and options of surgery. In addition, to use the adequate method of growth expectation, periodic follow-up and collaboration with patient's parents are needed.
Child ; Cooperative Behavior ; Humans ; Leg ; Life Support Care ; Parents ; Quality of Life

STUDY DESIGN: We report two cases of symptomatic spinal epidural lipomatosis (SEL) associated with long-term use of steroid medication OBJECTIVES: The purpose of this study was to assess the clinical characteristics, diagnosis and treatment of symptomatic spinal epidural lipomatosis. SUMMARY OF LITERATURE REVIEW: Spinal epidural lipomatosis is a condition in which excess adipose tissue is deposited circumferentially about the spinal cord in the epidural space. It can present neurologic symptoms including back pain, radiculopathy or cauda equina. Magnetic resonance imaging is the most helpful dignostic means and should be used initially if suspected. Treatment is decompressive laminectomy and debulking of fat. MATERIALS AND METHODS: Two cases of lumbar epidural lipomatosis with neurologic symptoms were discussed and evaluated by physical examination, postmyelography CT and MRI. RESULTS: Two cases were treated with decompressive laminectomy and debulking of fat. Increased accumulation of the fatty tissue was seen predominently in posterior and posterolateral epidural space of the spinal canal, displacing and compressing the lumbar spinal cord anteriorly. Both gross and histologic evaluation revealed overgrowth of unencapsulated normal appearing fat consistent with spinal epidural lipomatosis. One case was demonstrated gradual improvement in symtoms after operation but the other was died due to medical problems. CONCLUSION: The authors reviewed the literature and reported the results of operative treatment of patients with lumbago, radicular pain and intermitent claudication caused by epidural lipomatosis of lumbar spine and degenerative spinal stenosis.
Adipose Tissue ; Back Pain ; Cauda Equina ; Diagnosis ; Epidural Space ; Humans ; Laminectomy ; Lipomatosis* ; Low Back Pain ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Physical Examination ; Radiculopathy ; Spinal Canal ; Spinal Cord ; Spinal Stenosis ; Spine

PURPOSE: This study was aimed to analyze the incidence and the anatomical distributions of HME (Hereditary Multiple Exostoses) on upper limbs and its related change in alignment of the upper limbs in HME patients. MATERIALS AND METHODS: Thirty eight patients who had been diagnosed HME between 2001 and 2009, were categorized into two groups; (1) group A (1-2 involvements); (2) group B (> or =3 involvements). We checked the carrying angle, VAS (Visual Analogue Scale), limitations in daily activities, cosmetic satisfaction according to the number of exostoses invasion. RESULTS: Among the 38 patients, 23 patients (43 cases) had exostoses in the upper limbs. The locations of exostoses in the upper limbs were proximal humerus in 33 cases (30%), distal ulna in 31 cases (28.2%), and distal radius in 24 cases (21.8%). The carrying angle of group A and B was 10.7degrees, 13.8degrees, VAS was 1.3, 3.5, and the limitations in daily activities was 7.3, 6.6 of 8 points. The cosmetic satisfactory cases were 13 and 10 cases, respectively. CONCLUSION: The deformity in upper limbs was observed in 65% of the HME patients. As the number of invasion increases, carrying angle and VAS were increased but limitations in daily activities and cosmetic satisfaction were decreased.
Congenital Abnormalities ; Cosmetics ; Exostoses ; Exostoses, Multiple Hereditary ; Humans ; Humerus ; Incidence ; Lifting ; Radius ; Ulna ; Upper Extremity

Angioedma is a group of disorders with multifactorial etiology but a similar clinical expression, is characterized by swelling of subcutaneous or submucosal tissue. Systemic lupus erythematosus(SLE) is a chronic multi-systemtic disease characterized by inflammation and tissue damage resulting from deposition of auto-antibodies and immune complex. We experienced a case of angioedema which was the first manifestation of SLE in 24-year-old female patient. She had suffered from severe facial edema and multiple lymphadenopathy for six months and she also had pleural effusion, positive anti-nuclear and anti-DNA antibody test. Marked decrease of C3 and C4 levels was noted with normal antigenic level, and activity of Cl esterase inhibitor. The angioedema was not improved with anti-hitamine agents and instead disappeared with use of corticosteroid and non-steroidal anti-inflammatory drugs. Complement levels normalized after corticosteroid treament. We report a case of SLE which initial manifestation was angioedema.
Angioedema ; Antigen-Antibody Complex ; Complement System Proteins ; Edema ; Female ; Humans ; Inflammation ; Lupus Erythematosus, Systemic* ; Lymphatic Diseases ; Pleural Effusion ; Young Adult

The retinal pigment epithelial tear(RPE tear)has been recognized as a complication of the retinal pigment epithelial detachment(PED)in the age-related macular degeneration(AMD)with or without choroidal neovascularization(CNV). CNV was known to play a role in the formation of the RPE tear. However, fluorescein angiographic(FAG) evidence of CNV was hardly observed. A 74-year-old AMD patient with a folded and retracted RPE and associated fibrovascular PED in a subfoveal area was studied with FAG and indocyanine green angiography(ICGA). The area of exposed choroid by the torn RPE showed intense hyperfluorescence on FAG and hypofluores-cence on ICGA. The area of folded and retracted flap of RPE disclosed marked hypofluorescence on FAG and hyperfluorescence on ICGA. ICGA demonstrated the presence of CNV in the RPE tear secondary to AMD.
Aged ; Choroid ; Choroidal Neovascularization ; Fluorescein ; Fluorescein Angiography ; Humans ; Indocyanine Green ; Macular Degeneration* ; Retinaldehyde*