The aims of free tissue transplantation to the injured foot are to cover the exposed blood vessels, nerves, muscles, tendons and bones, to clear up infection, to lessen the morbidity, to shorten the hospitalization, and to prepare for further surgical procedures when no local or transpositioning flaps are available. Authors have carried out free flap transplantation in 13 cases of crushing injury, osteomyelitis and electrical burn in the foot at Chonbuk National University Hospital from June 1992 through May 1996. The results were as follows : 1. 9 cases of 13 (69%) were sustained from the traffic accident. 2. The dorsalis pedis free flap transplantation has been performed most frequently in 5 cases (38.5%), followed gracilis muscle flap in 4 cases(30.7%), rectus abdominis muscle flap in 2 cases(15.4%), latissimus dorsi muscle flap and upper arm flap in 1 each. 3. 6 muscle flaps were covered with split thickness skin graft 20 days after microsurgical anastomosis. 4. All of 13 cases were survived after microsurgical procedure and showed excellent coverage in the foot.
The Journal of the Korean bone and joint tumor society
/
v.1
no.1
/
pp.68-76
/
1995
To evaluate the clinical result of surgical treatment of malignant tumors in shoulder girdle, nine patients who were treated in Department of Orthopedics, Catholic University Medical College between January 1991 and December 1993, were evaluated. There were 5 men, 4 women. The mean age at operation was 47 years(range from 22 to 64 years). Of 9 patiens, 2 were soft tissue tumors(1 MFH, 1 dermatofibrosarcoma protuberance); one was treated with forequarter amputation, and the other with wide excision, Seven were bone tumor(2 chondrosarcoma, 1 osteosarcoma, 1 MFH, 1 plasmacytoma, 1 thyroid carcinoma metastasis, 1 malignant schwannoma); one patient was treated with segmental excision of proximal humerus, 4 with Malawer type I-A resection and arthroplasty or arthrodesis, 1 with Malawer type V-B resection and arthrodesis. Five patients received adjuvant chemotherapy, with or without local radiation therapy, and one patient received radiation therapy alone. All patients have survived now, but I had local recurrence. Functional results of arthrodesis and arthroplasty were similar.
The Journal of the Korean bone and joint tumor society
/
v.17
no.1
/
pp.11-16
/
2011
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 (${\geq}$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 $10.7^{\circ}$, $13.8^{\circ}$, 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.
Journal of the Korean Society of Food Science and Nutrition
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v.39
no.1
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pp.78-84
/
2010
This study was to designed to investigate the effects of nutrition education and exercise program for overweight or obese female adults, and also emphasize the necessity of a proper nutrition education. The anthropometric characteristics, nutritional intake, eating habit, and hematological index, physical examination were measured before and after program. Considering the time schedule of the subjects, the exercise program was divided into 3 sessions (morning, afternoon, and evening) and the subjects performed swimming and weight training for 4 weeks. The subjects were overweight or obese women, with an average age and height of each 46.1 and 156.3 cm. The weight and BMI were decreased significantly after nutrition education and exercise program. The back region of front arm (p<0.001), infrascapular region (p<0.001), body fat (p<0.001) were significantly decreased, and grasping power (p<0.01), back muscle power (p<0.001) were significantly increased after nutritional and exercise program. Total triglyceride level and fasting blood glucose (p<0.001) were decreased significantly after program. The intakes of vitamin D and vitamin $B_1$ were significantly changed after nutrition and exercise program. As for eating behavior and nutritional knowledge evaluation after program, the average score increased significantly (p<0.001). The results of this study show that this nutrition and exercise program can be an effective approach to improve their hematological index and nutritional and health status.
Purpose: The purpose of this study was to evaluate the usefullness of polarus nailing in the treatment of proximal humerus fractures including 2 part, 3 part and proximal comminuted fractures. Materials and methods: Fifteen cases of proximal humerus fracture treated with Polarus nailing from March, 2002 to March, 2004 were selected. Man was 3 cases, and woman was 11 cases. There were one case of follow up loss due to decease. Average age was 60 years old (range, 23 to 84), and there were 6 cases of 2 part fracture, 3 cases of proximal segmental fracture, 5 cases of 3 part fracture. We analyzed the outcom results between 2 part fracture and 3 part fracture. The average follow up period after the operation was 1.5(range, 1 to 2) years. Range of motion (ROM), pain and functional outcome were evaluated by visual analogue scale(VAS) and american shoulder and elbow surgery (ASES) activity of daily living (ADL) functional scoring system. Results: All cases showed union on radiologic evaluation, with 2.3 months follow up. In 5 cases of 3 part fracture, average union time was 1.9 months regardless of proximal screw loosening in 4 cases. In 2 part fracture union time was 2.2 months (P>0.05). VAS pain score was 1.3, ROM was $160^{\circ}$ in forward flexion, $40^{\circ}$ in external rotation, L3 level in internal rotation, and ASES, ADL functional score was 21 in 2 part fracture. VAS pain score was 1.25, ROM was $160^{\circ}$, $43^{\circ}$ and L1 level, and ASES, ADL functional score was 21 in 3 part fracture. There were no statistically significant difference between two groups (P>0.05) VAS pain score was 1.6, ROM was $170^{\circ}$, $47^{\circ}$ and L3 level, and ASES, ADL functional score was 23 in proximal comminuted fracture. Conclusion: Polarus nailing could be used as an effective modality in certain cases of proximal humeral fracture including 2 part, proximal segmental and in cases of 3 part fractures with large greater tuberosity fragment.
The rotator cuff is situated in a potential tight subacromial space and undergoes senescent structural changes commonly observed in other joints of the body. When the cuff fails, spontaneous healing of the torn tendon is not expected to occur, and multiple factors may be responsible. Its fibers are under tension and typically retract on tearing. The subacromial bursal inflammation and alterations in normal glenohumeral kinematics have been considered in the development of symptoms. Controversy continues to exist concerning the pathogenesis of rotator cuff disease. The heterogeneity of the disorder, as well as the notion that rotator cuff disease may not actually represent a continuum of the same process, but rather, is a compilation of independent disorders, may partly explain the differing viewpoints on its origin. Two contrasting pathogenetic mechanisms have been extensively described and include vascular, or intrinsic, causes and impingement, or extrinsic, factors. Other etiologies have also been reported that include trauma, congenital or developmental factors, and instability. For successful treatment of the rotator cuff diseases, it is essential to understand the structure and function of rotator cuff and to clarify the pathogenesis and natural history of its disorder.
A flightless brown hawk owl (Ninox scutulata) weighing 180 g was rescued and referred to the teaching veterinary hospital with humerus open fracture. On physical examination and radiography, open fracture of the left humerus was found. After 3 days, orthopedic surgery was operated with intramedullary pins and wires. The bird died 2 days after surgery with anorexia. On necropsy, multiple green nodules with 2-3 mm in diameter were observed at the surface and inside of the left lung. Numerous conidial heads and spores were seen in the center of foci in the histopathological examination. The mycelia penetrated the surrounding pulmonary parenchyma, showing inflammation and necrosis. The fungus was isolated from the lung and cultured on Sabouraud Dextrose Agar at $30^{\circ}C$ for 7 days. The colony was blue-green color with a powdery surface. The fungus was identified as Aspergillus fumigatus by DNA analysis, including the internal transcribed spacer region, partial ${\beta}$-tubulin, and the calmodulin gene. This case was diagnosed as pulmonary aspergillosis secondary to open fracture of pneumatic bone in a brown hawk owl.
A 6-month-old, intact male Great Pyrenees (35 kg) was referred with 2 weeks continuous left forelimb lameness to the Chonbuk Animal Medical Center, College of Veterinary medicine, Chonbuk National University. The lameness became worse three days before being referred to the hospital. Upon the physical examination, the patient had pain when the left shoulder joint was palpated, and the lameness was visible in the left forelimb during ambulation on gait examination. There were no remarkable findings on radiological and neurological examination. Osteochondritis dissecans (OCD) was suspected based on medical history and gait tests. As a definitive diagnosis could not be made, exploratory arthroscopic surgery was performed to examine the inside of the shoulder joint. During the operation, mild bicipital tenosynovitis, synovitis and OCD which was located on the caudal medial area of humeral head were revealed. Arthroscopic procedures were used for the treating OCD, including the removal of the OCD flap and debriding of the subchondral defect until hemorrhaging by use of an electrical burr. The patient was discharged a day after surgery. After 2 weeks, the patient again presented at the hospital due to complications, including inflammation of the surgical lesion because of licking and seroma within the subcutaneous tissue. Antibiotics were administered and an aseptic bandage was applied. And simple surgical operations were performed for the removal of the cyst and seroma. Eleven weeks following arthroscopy, the lameness was completely resolved. Arthroscopy has the advantage of allowing gross examination inside the joint capsule. Due to this advantage, arthroscopy is one of the best advanced options for diagnosis in dogs with undiagnosed joint pain.
The Journal of the Korean bone and joint tumor society
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v.9
no.1
/
pp.24-30
/
2003
Purpose: To clarify the results of simple bone cyst (SBC) treatment in children by percutaneous autologous bone marrow grafting and xenografting. Materials and Methods: We studied seven cases (4 males, 3 females) of SBC, which were treated by percutaneous autologous marrow and heterograft bone grafting from January 1996 to February 1999. Their mean age at surgery was 10 years (6 to 15), and the mean follow-up period was 35.6 months (20 to 52). Three cases were located in the proximal and middle humerus; three cases were in the proximal femur; and one case occurred in the ilium. Mean volume was 14.7 $cm^2$ (10 to 23). Six cases were active, and one was inactive. Five patients had a history of receiving a mean of 3.2 steroid injections. The mean quantity of bone marrow used in treatment was 14.3 ml (10 to 20), and the mean amount of $Lubboc^{(R)}$ heterograft bone (Transphyto S.A. Clermont Ferrand, France) used was 6.4 blocks (5 to 10). Results were analyzed using the modified Neer classification. Results: Five cases completely healed with obliteration of the cyst cavity (Grade IV). Two cases demonstrated sclerosis around a partially visible cyst (Grade III). All treatment results were satisfactory and without intraoperative or postoperative complications. Conclusione: Percutaneous autologous marrow and heterograft bone grafting is recommended as an effective treatment method for simple bone cyst. It offers ease of operative technique, a high rate of healing, a low recurrence rate, low morbidity, a low incidence of postoperative complications, and free from bone graft donor site problems.
To evaluate the pinhole scintigraphic findings and its significance, authors retrospectively compared the pinhole bone scintigrams and corresponding radiograms of 16 lesions in 14 patients with fibrous dysplasia. They were diagnosed pathologically in 10 lesions and radiologically in 6 lesions. The mean age of patients was 41.1 years. The mean interval between two studies was 1.1 days. Locations were ribs 7, pelvic bone 4, clavicle 1, long bones 4(femur 2, tibia 1, humerus 1). The radiographic findings were as follows : the central portions were radiolucent(n=9), ground-glass opacities(n=5) or sclerotic(n=2) and the peripheral appearance were sclerotic rim(n=5), septation(n=7), cortical perforation (n=10) and invisible cortical thinning(n=9). Pinhole scintigraphic findings were as follows; Central portions showed normal 1+ uptake in 6 cases(radiolucent 5, ground-glass opacity 1), slightly increased 2+ upta- ke in 7 cases(radiolucent 4, ground-glass opacity 3), and marked 3+ uptake in 3 cases(ground-glass opacity 1, sclerotic 2). The 15 of 16 lesions showed more intense uptake in the peripheral portion: slightly increased 2+ uptake corresponding to the sclerotic rim(5/5) and unvisible cortical thinning(1/9), and irregular foci of marked 3 + uptake corresponding to septation(7/7), cortical perforation(10/10) and invisible cortical thinning (8/9). One of 16 lesions showed homogeneous 2+ uptake. In conclusion, pinhole scintigram provides information on regional activity of the fibrous dysplasia, which would be helpful in diagnosis, prediction of prognosis and determination of treatment plan.
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