No abstract available.
Urinary Bladder*

No abstract available.
Arthritis, Rheumatoid* ; Elbow Prosthesis* ; Elbow*

No abstract available.
Arthroplasty* ; Knee*

When the non-union gap in a long bone is more than half of the diameter of the bone at that level, it presents a significant challenge to traditional bone grafting technique. Even if there are several good ways for this problem, such as shortening, traditional various bone grafting, electrical stimulation and free vascularized bone graft, most of these techniques have some difficulties to maintain the stability of fracture post-operatively, and we have to keep their extremities into a cast or external fixator so long. So we have attempted to treat the large osseus gap non-union in long bone with fixation of heavy duty or condylar plate on one side of fracture for fracture stability, a long tibial corticocancellous strut graft on the other side of fracture for fracture stability and rapid bony union, and extensive cancellous chip bone graft between the plate and tibial graft to enhance the bony union. We have experienced 9 cases of large osseus gap non-union in long bone with this technique from March 1981 to September 1986 at the department of orthopaedic surgery, St. Mary's hospital, Catholic University Medical College. 1. Their, 7 males and 2 females, average age was 38 years old, with a range of 24 to 53 years old. The distribution of the involved bone was 6 femur, 2 humerus, 1 radius and ulna with 1.4 years of average duration of non-union, ranged from 7 months to 2.4 years. The average gap from normal bone to normal bone was 4.8cm, with a range of 2.7cm to 7.4cm. The average number of previous surgical procedures was 4, with a range of 2 to 7. Four of the nine patients had quiescent osteomyelitis. 2. Post-operative immobilization with splint or cast was applied for 6 weeks for upper extremity and 8 weeks for lower extremity followed by active R.O.M. exercise and non-weight bearing crutch walking. 3. Five of the nine cases(55.6%) had completely bony union. This occured on an average 8 months post-operatively and was faster in the forearm bones and femur than in the humerus. An additional cancellous bone graft was done in two. But other two of the patients had subsequent amputation because of recurrent and uneontrollable osteomyelitis stirred up by the surgery. 4. This procedures was proved to be one of valuable adjuvant method in treatmqnt of large osseous gap non-union of long bones.
Amputation ; Bone Transplantation ; Electric Stimulation ; External Fixators ; Extremities ; Female ; Femur ; Forearm ; Humans ; Humerus ; Immobilization ; Lower Extremity ; Male ; Methods ; Osteomyelitis ; Radius ; Splints ; Transplants ; Ulna ; Upper Extremity ; Walking

The authors described a case of male schizophrenia who developed myoclonic jerk repeatedly and one episode of convulsive seizure during the treatment of clozapine. According to literatures and reported cases, myoclonic jerks induced in a small amount of clozapine may precede and predict the development of a convulsive seizure. Therefore clinicians have to pay attention to the development of a myoclonic jerk during the administration of clozapine. They may decrease the dosage of clozapine step by step at first in the convulsive state, and observe EEG changes of patients frequently.
Clozapine* ; Electroencephalography ; Humans ; Male ; Myoclonus ; Schizophrenia ; Seizures*

The patellar tendon is known as the strongest material for the substitution of anterior cruciate ligament. There are many technical difficulties in reconstruction of the ligament with this tendon since patellar aponeurosis is weak, and the length of the tendon is restricted, and the adquate insertion in proper place is difficult. Authors harvested the middle 1/3 of patellar tendon c bone block of tibial tubercle and patella with the superficial layer of the quadriceps tendon left attached. The large triangular tibial tubercle piece was impacted into the femoral tunnel from distally to proximally, of which the orifice is the very place of the middle of the original anterior cruciate ligament. Two bundles of 0-dexon sutures made at the tibial tubercle portion, were pulled through to different outlet of femoral condyle during this procedure and were tied over the cortical bone of lateral supracondylar region. The tendon twisted 180°(clockwise for the right knee and counter-clockwise for the left knee) to adapt to screwhome movement. The patellar piece was fixed at the isometric point in full flexion and extension, which is usually the middle point of original tibial insertion c one or two barbed staples made at the original position of tibial insertion of the ligament. We tried this methods in 26 knees (12 vascularized grafts and 14 free grafts) and was followed for more than one year and the results was compared with those of 12 knees of original McIntosh operation (follow up period: 16-72 months, average 34.3 months). The instability were evaluated c Lachman test and OSI sagittal knee tester. The knee of negative Lachman test & pivot shift test was defined as "normal" The results were as follows;l. In modified McIntosh operation group negative Lachman test was noted only in 6 knees (50.0 % ) and there were 2 knees (16.7% ) of GI, II & III, respectively. 2. In vascularized bone block patellar tendon graft group II out of 12 knees (91.7%) showed negative Lachman test and only one knee (8.3%) revealed G II. 3. In free bone block patellar tendon graft 13 out of 14 knees (92.9%) showed negative Lachman test and the other one knee (7.1%) revealed GI. 4, The overall success rate (normal) of bone block patellar tendon graft was 92.3%. The success rate of patellar tendon bone block operation was significantly higher than that of modified McIntosh operation (χ²=6.48, df=1, P=0.0109) and there was no statististical difference between vascularized and free graft group (χ²=0.39, df=l, P=0.5322).
Anterior Cruciate Ligament ; Knee ; Ligaments ; Patella ; Patellar Ligament ; Sutures ; Tendons ; Transplants

No abstract available.
Humans ; Male* ; Thyroid Diseases* ; Thyroid Gland*

No abstract available.
Humans ; Moral Development* ; Students, Medical*

Since last August, 29 cases of synovial punch biopsy have been carried out with Franklin-Silverman needle which was used in liver biopsy, instead of the specialized needle for the synovium. Authors report the applicable utility of Franklin-Silverman needle for the synovial biopsy, diagnostic value of this procedure and histopathologic findings of the results. The rate of the technical success to abtain synovial tissue was about 76%. Complications after procedure have been very rarely encountered, consisting of mild transient hemarthrosis. In 17 cases, the histopathologic changes was compatible with their clinical findings. In the remainders, we experienced the failures to get synovial tiasue at all in 7 cases and to give the significant synovial changes in 5 successful specimens. Fortunately, the important diagnostic aid was achieved in 3 cases which were conformed early diagnosis of tuberculous arthritis. This needle biopsy was also thought to contribute to rule out the gouty arthritis from other hyperuricemic conditions. But the histologic changes were non specific inflammatory findings in the synovial mambrane of rheumatoid arthritis, osteoarthritis, traumatic and infectious arthritis.
Arthritis ; Arthritis, Gouty ; Arthritis, Infectious ; Arthritis, Rheumatoid ; Biopsy ; Biopsy, Needle ; Early Diagnosis ; Hemarthrosis ; Liver ; Needles ; Osteoarthritis ; Synovial Membrane

Sixty amputees who had traumatic amputations due to industrial accidents were examined on their phantom limb and phantom pain phenomena and the following results were obtained. 1. Fifty-three (93%) of sixty amputees experienced phantom limb and twenty-four (40%) experienced phantom pain. The incidence of phantom pain in the lower limb amputation (59%) is greater than that of upper limb amputation (29%). 2. Amputees with asthenic body status gave higher incidence (56%) of phantom pain than those with muscular body status (20%). None of amputees with obese body status experienced phantom pain. 3. The sensation of strong current and cramping were most predominant sensations in the phantom pain. 4. Twenty-eight (93%) of thirty amputees had experienced painless phantom limb longer than four months. 5. Six (55%) of eleven upper limb amputees with phantom pain experienced pain sensation at the tips of fingers and nine (69%) of thirteen lower limb amputees with phantom pain experienced pain at the great toe. 6. Fifty-three (88%) of sixty amputees experienced telescoping of the lost limb and twenty-three (38%) of sixty amputees experienced jerking movement of the stump. 7. In fifty-four (90%) of sixty amputees, trigger zones triggering pain in the phantom limb were found in the healthy part of the body. 8. Twenty-two (40%) of fifty-five male amputees experienced burning sensation in the phantom limb associated with urination, defecation or ejaculation. 9. Cold temperature was predominant, aggrevating factor of the phantom pain. Fitting prosthesis and alcohol intake were predominant, relieving factor of the phantom pain.
Accidents, Occupational ; Amputation ; Amputation, Traumatic ; Amputees ; Burns ; Cold Temperature ; Defecation ; Ejaculation ; Extremities ; Fingers ; Humans ; Incidence ; Lower Extremity ; Male ; Muscle Cramp ; Phantom Limb ; Prostheses and Implants ; Sensation ; Toes ; Upper Extremity ; Urination