Chronic osteomyelitis with protracted clinical course and pretibial skin loss imposes on every orthopaedic surgeon as one of the most difficult problems to deal with. All the conservative treatment hitherto reported have left much to be revised and they often accompany, to the despair of both surgeon and patient, recurrence of the lesion. The authors have had the opportunity of treating such four cases, in which the extensive removal of sclerotic bone as well as soft tissue adjacent to the focus was done, and lo cover the defect thus produced, the soleus muscle transferred anteriorly, followed by skin graft. It proves to have been successful and the rationale to meet the wider clinical applicability of this procedure is described.
Humans ; Muscle, Skeletal ; Osteomyelitis ; Recurrence ; Skin ; Transplants

No abstract available.
Fractures, Open*

Recently posterior stabilization with various instrumentation and fusion has been used for fractures of the thoracolumbar spine involving anterior and middle columns. However, these methods are sometimes inadequate to gain anatomical reduction and complete decompression especially in burst fractures. So anterior decompression and interbody fusion were frequently added as a second operation. Biomechanically a rigid anterior spinal instrument such as kaneda device can provide enough anterior decompression through partial or total corpectomy and adequate correction of kyphosis as an one stage operation. We have experienced 27 cases of Kaneda instrumentation via anterior approach for thoracolumbar fracture, most of them were burst fractures, from Jan. 1989 to June 1990. Of there 27 cases, 12 were followed up at least 1 year and reviewed. The results were as followed: l. Anterior spinal approach using Kaneda instrumentation provided sufficient anterior neural decompression and adequate correction of kyphotic deformity. It eliminates the second posterior procedure in most cases and enhances early solid union. Simultaneously, it allows early mobilization of patient with an application of brace. 2. Post-operative courses were eventful in most cases except a case of pathological fracture. 3. This procedure seemed to be one of the most suitable method for the treatment of burst fractures of the thoracolumber region. 4. Complications by Kaneda device itself were not developed in the early evaluation stage. However, on longer follow-up study over 1 year revealed some complications including 2 cases of screw breakage and one lateral wedging deformity.
Braces ; Congenital Abnormalities ; Decompression ; Early Ambulation ; Follow-Up Studies ; Fractures, Spontaneous ; Humans ; Kyphosis ; Methods ; Spine

No abstract available.
Spine*

No abstract available.

No abstract available.

No abstract available.
Constriction, Pathologic*

No abstract available.
Fractures, Spontaneous* ; Prostheses and Implants*

The ultrasonographic findings of 49 ovarian cystadenomas were analized. The results were as follows: 1. Themost common age group was 3rd decade and most patients(83%) belong to active reproductive period. 2. In 80% ofserous cystadenoma the size of the tumor was ranged in 6–10cm in diameter. The large tumors of 16–20 cm indiameter were mostly mucinous cystadenomas. 3. Purely cystic appearance was the most common finding(40%) of serouscystadenoma and thick linear septation with and without solid component was the most common finding (38%) ofmucious cystadenoma. 4. Thick linear septation with solid component was not found inserous cystadenoma. 5. Welldefined nodular projection was found in 3 cases of serous cystadenoma but not identified in mucinous cystadenoma.
Cystadenoma ; Cystadenoma, Mucinous ; Cystadenoma, Serous ; Humans ; Reproduction

Purpose: In retinal endothelial cells, homocysteine (Hcy) activates matrix metalloproteinase (MMP)-9, which results in apoptosis. This study investigated these effects of Hcy in human trabecular meshwork cells (HTMC). Methods: HTMC cultures using 5 mM low or 20 mM high glucose (HG)-containing media were exposed to 100 μM Hcy for 3 days. Cell viability was assessed with the MTT (3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide) assay. The MMP-9 and tissue inhibitor of MMP (TIMP)-1 levels were measured by western blotting and the degree of apoptosis was analyzed with flow cytometry using Annexin-propidium iodide double staining. Results: Exposure to Hcy in HG decreased cell viability compared to HG alone (p = 0.036). Compared to HG alone, co-exposure to Hcy with HG decreased the TIMP-1 levels, albeit not significantly (p = 0.094), and did not affect the MMP-9 levels (p = 0.413). In addition, co-exposure to Hcy with HG produced no difference in the degree of apoptosis compared to HG alone (p = 0.437). Conclusions Unlike in retinal endothelial cells, Hcy did not affect the activities of TIMP-1, MMP-9, or the degrees of apoptosis significantly in HTMC. Thus, the effects Hcy may be limited in HTMC.