• Archives of Reconstructive Microsurgery
• /
• v.8 no.1
• /
• pp.77-83
• /
• 1999

The skin on the dorsum of the foot is a source of the reliable thin and sensory cutaneous free tissue transplantation with or without tendon, bone and joint. A composite flap with attached vascularized tendon grafts for the combined loss of skin and tendon on the dorsum of the hand and foot offers an immediate one stage solution to this problem. The flap provides a very durable innervated tissue cover for the heel of the foot and the dorsum of the hand and an osteocutaneous transfer combined with the second metatarsal. The major dorsalis pedis artery is constant in size, but the first dorsal metatarsal artery is variable in size and location. The dorsal surface of the foot receives sensory innervation through the superficial peroneal nerve and the first web through the deep peroneal nerve. Authors had performed 5 dorsalis pedis free flap transplantation in the foot and hand at Department of Orthopedic Surgery, Chonbuk National University Hospital from August 1993 through August 1997 and followed up for the period of between 19 and 67 months until March 1999. The results were as follows 1. 5 cases dorsalis pedis free flap transfer to the foot(4 cases) and the hand(1 case) were performed and the recipient was foot dorsum and heel 2 cases each and hand dorsum 1 case. 2 All of 5 cases(100%) were survived from free flap transfer and recipient artery was dorsalis pedis artery(2 cases), anterior tibial artery(1 case), posterior tibial artery(1 case) and ulnar artery(1 case) and recipient veins were 2 in number except in the hand. 3. Long term follow up of the exterior and maceration was good and sensory recovery was poor 4. Donor site was covered with full thickness skin graft obtained from one or both inguinal areas at postoperative 3rd week and skin graft was taken good and no morbidity was showed.

• Journal of Life Science
• /
• v.20 no.12
• /
• pp.1758-1763
• /
• 2010

Osteoporosis is a complex systemic skeletal disease and a major public health concern worldwide. It is a heritable disorder characterized mainly by low bone density and/or low trauma osteoporotic fractures, both of which have strong genetic determination. However, the specific genetic variants determining risk for low bone density are still largely unknown. Here, we performed association analysis to elucidate the possible relationship between genetic polymorphisms in the SQSTM1 gene and low bone density. By examining a total of 7225 (men: 3622, women: 3603) subjects from the Korean population in the Korean Association REsource (KARE) study, we discovered that SQSTM1 gene polymorphisms were associated with bone density. The results of the BD-RT (bone density estimated by T-score at distal radius) showed that three SNPs (rs513235, rs3734007, and rs11249661) within the SQSTM1 gene were significantly associated with bone density. The results of the BD-TT (bone density estimated by T-score at midshaft tibia) showed that four SNPs (rs513235, rs3734007, rs2241349, and rs11249661) were significantly associated with bone density. The three SNPs (rs513235, rs3734007, and rs11249661) had common significance in both BD-RT and BD-TT. In summary, we found statistically significant SNPs in the SQSTM1 gene that are associated with bone density traits. Therefore, our findings suggest SQSTM1 gene could be related to pathogenesis of osteoporosis.

• Clinics in Shoulder and Elbow
• /
• v.9 no.1
• /
• pp.50-59
• /
• 2006

Purpose: The nonoperative outcome of elbow dislocations with associated radial head and coronoid fractures are often unsatisfactory because of chronic instability and stiffness from proloned immobilization, Therefore we managed these injuries with well programed surgical appproaches. Method: Ten patients with this injury were evaluated retrospectively from May 1998 to June 2004 after a minimum of 12 months. These injuries include elbow dislocation and associated fractures of both the radial head and the coronoid process. All ten patients were treated by one clinic operatively with similar scheduled surgical methods which started on the lateral side and terminated on the medial side of the elbow. Radial head and neck fractures were classified Mason types, as two and three types respectively with six and four cases and six cases were fixated. Coronoid process were fixated with screws anteroposterior directly or anchor suture in all cases, each type was classified one, two and three. where were three type one, four type two, and three type three were according to Regan and Morrey classification. Results: The outcome was three resulting in excellent, four good, two normaland and the remaining case was one poor according to the Mayo Elbow Performance score. At a terminal follow up, the range of motion of the elbow averaged flection contracture, $6^{\circ}(0{\sim}20^{\circ})$ and further flection, $129^{\circ}(115{\sim}140^{\circ})$. Two patients had complications requiring additional care. One, displaced coronoid process which was repaired with capsule and the other patient experienced, palsy of ulnar nerve and contracted elbow joint. Conclusions: Usage of early operation as the minimum injury of medial ligaments complex and the rigid fixation of fractures to prompt motion with our scheduled management for elbow dislocations with associated radial head and coracoid fractures provided excellent results.

• The Journal of the Acoustical Society of Korea
• /
• v.41 no.5
• /
• pp.557-563
• /
• 2022

The cortical bone thickness of the tibia is related to fracture risk and overall bone status. The present study aims to investigate the feasibility of two different ultrasonic methods for measuring the cortical bone thickness in bovine tibia in vitro. In the reflection technique, the tibial cortical thickness was determined from ultrasonic reflections from the periosteum and the endosteum producing specific peaks in the signal envelope. In the axial transmission technique, the tibial cortical thickness was determined from ultrasonic guided wave velocities measured along the axial direction of the tibia. The cortical bone thickness determined by using the reflection technique correlated significantly with that measured by using a caliper, with a Pearson's correlation coefficient of r = 0.97 (p < 0.0001). In contrast, the correlation coefficients for the axial transmission technique were r = 0.92 (p < 0.0001) for the first arriving signal method and r = 0.89 (p < 0.0001) for the slow guided wave method. Clinical feasibility should be demonstrated with an in vivo application to address the question whether the ultrasonic methods presented here could be useful as a screening tool for osteoporosis and potentially could be applied to other skeletal sites such as the femur and the radius.

• The Journal of the Korean bone and joint tumor society
• /
• v.6 no.1
• /
• pp.10-16
• /
• 2000

Object : The aim of the current study is to assess the results of segmental resection and replantation for primary malignant or aggressive tumors of the upper limb. Materials and Methods : From 1986 to 1994, ten patients who had primary malignant or aggressive tumors of the upper limb were managed with segmental resection and replantation method. The average duration of follow-up was 7 years and 7 months. Primary indication of this method is stage II B tumors which, because of their extend, could otherwise be adequately treated only by amputation. Three patients had chondrosarcoma, two had osteosarcoma, two had giant cell tumors with pathologic fracture, one had extensive chondroblastoma, one had Ewings sarcoma, and one had leiomyosarcoma. The location of the tumor was humerus in 6 patients, scapula in 3 patients, and soft tissue of forearm in 1 patient. Wide resection margins were achieved in 7 patients and marginal margin in three. Results : One patient died on 40 months after surgery due to systemic metastasis. Nine patients have remained disease free without local recurrence or metastasis. The average overall functional rating was 65% (43~90%) for ten patients on the last follow-up by the functional rating system of Enneking. The mean grasping power and pinching power of operative hand was 75%(28~95%) and 65%(43~90%) of the opposite hand, respectively. Complications associated with this surgical method included three wound dehiscences and one nerve injury that resolved with proper wound care and time. Conclusion : It was concluded that segmental resection and replantation might be used for partial limb salvage in selected cases for the treatment of primary malignant or aggressive tumors of the upper limb.

• The Journal of the Korean bone and joint tumor society
• /
• v.13 no.1
• /
• pp.22-30
• /
• 2007

Purpose: We describe clinical, radiographic, MRI and pathologic findings as well as final outcome after simple curettage and bone graft of cystic fibrous dysplasia (FD) in the long bone, which has been rarely documented in the literature. Materials and Methods: Clinical records, radiographs, MRI and histologic slides of 11 patients with cystic FD in the long bone were retrospectively analyzed. Results: Six patients complained pain for several months, 4 patients presented pain after trivial injury event, and 1 patient suffered pathologic fracture. The mode of involvement was monostotic in 10 patients and polyostotic in l patient. The femur was affected in 7 patients, the humerus in 3, and the radius in 1. Radiography showed prominent, expansive lysis associated with ground-glass density of FD. MRI revealed 2 different signals of FD and cyst. Microscopic examination revealed classic findings of FD and non-specific cystic degeneration. The final outcome was satisfactory in every patient. Local recurrence was not observed. Conclusion: Cystic FD in the long bone seems not as rare as the scarcity of reported cases would indicate. MRI features provide a basis for differential diagnosis between benign cystic change and malignant transformation. Cystic FD would be an indication for surgery and simple curettage with allo-chip-bone graft is effective.