Calcific Amyloidoma of Tibialis Anterior Muscle: Case Report / 대한정형외과학회잡지

Calcific amyloidoma of the soft tissue is quite rare and it is difficult to make a differential diagnosis from other lesions such as osteomyelitis or bone tumor. We encountered a case of a calcified amyloidoma found in the anterior tibial muscle that occurred more than 20 years after a proximal tibial fracture adjacent to the origin of the muscle. The features of the lesion resembled osteomyelitis. Satisfactory result was obtained by a thorough mass excision. We report this case with review of the relevant literature.

Shape and Motion of Each Lumbar Segment in Normal Korean Adults / 대한정형외과학회잡지

PURPOSE: By achieving informations about sagittal shape and motion of each lumbar segment in normal subjects, we tried to get the standards useful in management of spinal disorders and fractures. MATERIALS AND METHODS: Thirty normal adults without any disorder on their back were adopted. L3 centered thoracolumbar (T-L) X-ray's including standing lateral, AP's in righ-tleft bending, and flexion- extension lateral were checked for each person. Cobb angles of each segment were measured. Statistical analysis was done for comparison by gender and correlation of each factors. RESULTS: Body shape of upper lumbar vertebrae was kyphotic but caudal bodies are changed into lordotic gradually. Disc angle was lordotic in all the discs. Segmetal motion in sagittal plane was greatest at L4-L5 (18.6degrees). However, segmental motion at coronal plane was largest at L3-L4 (12.6degrees). CONCLUSION: We achieved Korean standard of shape and motion of each lumbar segment. Proportion of each factor contributing to total lumbar lordosis was evaluated also.

Syphilitic Osteomyelitis of the Clavicular Shaft Mimickinga Malignant Bone Tumor: A Case Report / 대한정형외과학회잡지

Skeletal lesions such as osteomyelitis induced by acquired syphilis are rarely encountered except in the neuropathic joints of tertiary syphilis. The authors experienced syphilitic osteomyelitis of the clavicle in a 51 year-old lady. The lesion seemed to be a malignant tumor radiologically, but diagnosis was not achieved even by biopsy. However, thorough serologic examinations enabled an accurate diagnosis and the disease was controlled effectively by antibiotics, including penicillin injections. The authors report this case and include a review of the literature, which describes the rarity and clinical significance of this condition.

Synergistic Effect of Isoflavones on the BMP-4 MediatedOsteoblastic Differentiation of C2C12 Myoblast / 대한정형외과학회잡지

PURPOSE: Isoflavones are rich in soybean and are known to affect bone formation. This study examined the effects and modes of action of isoflavones on the differentiation of C2C12 myoblasts in the presence of the bone morphogenetic protein (BMP)-4. MATERIALS AND METHODS: The isoflavones, daidzein, genistein or equol, and/or BMP-4 were added alone or in combination to C2C12 myoblasts. After 72 hours culture, the cells were stained for the early osteoblastic differentiation marker, alkaline phosphatase (ALP). The ALP activity was determined by comparing the color of the stained images as well as by spectrophotometry. The expression profiles of the extracellular matrix (ECM) genes responsible for the extensive remodeling at the cell surface were analyzed using agene expression microarray after treating thesamples with daidzein. RESULTS: ALP staining of BMP-4 or the isoflavones-treated cells showed that BMP-4 increased the activity of ALP in a dose dependent manner, whereas the isoflavones alone did not induced any remarkable increase. However, the ALP activity increased when the cells were treated with BMP-4 and any of the three isoflavones. The macrogen mouse MAC array data showed that the ECM genes, Mmp13 and Mmp3, were up-regulated by daidzein, whereas Col4a2, Col5a1 and Mmp9 were down-regulated. CONCLUSION: Isoflavones induce osteoblastic differentiation when combined with BMP-4, which is possibly achieved by modulating the expressional levels of various ECM genes.

Results of Non-fusion Method in Thoracolumbar and Lumbar Spinal Fractures / 대한척추외과학회지

STUDY DESIGN: A retrospective study of surgically managed patients. OBJECTIVES: To evaluate the results of posterior stabilization of a thoracolumbar fracture, without fusion, followed by the removal of metal implants within an appropriate period. Changes in the sagittal alignment and the restoration of segmental motion were also investigated. SUMMARY OF LITERATURE REVIEW: In managing unstable thoracolumbar and lumbar fractures, posterior fusion, using a transpedicular screw system, has been the treatment of choice, but results in the permanent loss of segmental motion. MATERIALS AND METHODS: Twelve patients with thoracolumbar and lumbar spine fractures, under 40 years of age (mean 28.4 years), were managed using this non-fusion method. Implants were removed at mean 9.2 months after the initial fixation of the fracture. For metal-fixed segments, the sagittal alignment, such as the angle of kyphosis, height of body, recovered motion range in flexion-extension and right-left bending view, were measured radiologically and compared with a control group. Clinical aspects, such as gross deformity and functional ability, were also investigated. RESULTS: The average sagittal angle at the time of injury was average 17.2 degrees, but became 1.7 degrees post-fixation, which increased after removal of the implants, reaching 9.8 degrees at the final follow up. The height of the fractured body was maintained until the final follow-up. The mean segmental motion measured in the sagittal and coronal planes were 11.7 and 9.5 degrees, respectively. Most patients were satisfied with the final gross appearance and functional outcomes. Only one patient showed considerable development of kyphotic angulation, but the functional outcome was good. CONCLUSION: The author's non-fusion method seems to be effective in achieving stability and sagittal alignment, as well as in regaining segmental motion of the fixed segments. The non-fusion method seems to be an effective method for managing thoracolumbar fractures, especially for young active persons.