Helical Blade versus Lag Screw for Treatment of Intertrochanteric Fracture

PURPOSE: To evaluate the radiographic and functional outcomes between who had unstable intertrochanteric fracture, treated with the ITST (lag screw design) and the PFNA (helical blade design). MATERIALS AND METHODS: We selected each 17 and 13 patients of unstable intertrochanteric fracture which were treated with ITST or PFNA from April 2005 to December 2008. We evaluated the radiographic results by follow-up radiography and the clinical outcomes with the mobility score of Parker and Palmer, Social function scoring system. RESULTS: The mean sliding distance of cervical screw with ITST nails was not shown significant differences than with using PFNA nails. The other factors were not statistically different. Decrease of mobility score of Parker and Palmer, Social function score were similar. 2 cases of cutting out was noted with ITST nails and 1 case of cutting out was noted with PFNA nails. CONCLUSION: Unlike the existed biomechanical reposts, there are no differences that are clinical and radiological results in treatment of unstable intertrochanteric fracture using the ITST nails and PFNA nails.

Comminuted Pilon Fractures: Comparative Outcome Analysis according to Surgical Techniques

PURPOSE: To evaluate the overall surgical outcome of the tibial pilon comminuted fractures and perform the comparative analysis between the limited internal fixation-external fixation group and the delayed open reduction-internal fixation (ORIF) group. MATERIALS AND METHODS: From June 1997 to June 2004, 17 tibial pilon comminuted fractures were treated with the limited internal fixation-external fixation (6 cases) or the delayed open reduction-internal fixation (11 cases). The average age of the patients was 47.7 years (range: 41~63 years), male was fourteen patients, female was three. Follow-up period was average 33.6 months (range: 12~84 months). The clinical outcomes were evaluated by using AOFAS ankle-hindfoot score and patient satisfaction was also evaluated. RESULTS: AOFAS score at final follow-up was 80.4 points, and 88% of the patients were satisfied with the results. AOFAS scores of the external fixation group and the delayed ORIF group were average 77.0 points and 82.2 points respectively, which did not show the statistical difference (p>0.05). Bony union was achieved at average 16.0 weeks. There were 18 complications such as skin necrosis. CONCLUSION: We have achieved relatively encouraging functional results and high patient satisfaction for pilon comminuted fractures, without significant result difference between the two surgical techniques.

Open Intramedullary Nail with Tension Band Sutures & Lock Sutures on Proximal Humeral Three-part Fracture

PURPOSE: To evaluate the results according to the difference of age and bone mineral density (BMD) of the surgical treatments using open intramedullary nail with tension sutures and lock suture on proximal humeral three part fracture. MATERIALS AND METHODS: 30 patients treated by open intramedullary nail with tension band and lock suture technique on proximal humeral fractures were reviewed. After treatment, average follow up periods was 50 months (range; 17~143 month). Postoperative clinical outcome was evaluated using ASES functional score, Neer score and constant score. RESULTS: Bony union were obtained all except one case. Range of motion, mean forward elevation was 142°, mean external rotation was 56°, mean external rotation at 90° abduction was 68°. Average pain score of visual analog scale was 1.5. Average functional score of American Shoulder and Elbow Society was 86. Average Neer score was 89. Constant score was 85. Pain and functional score of group I were better than those of group, however, there was no statistically significant difference (p>0.05). In the comparison between group III and group IV, the results were same (p>0.05). CONCLUSION: The patients treated using open intramedullary nailing, tension band and lock suture could enable early ROM exercise and show good clinical results. This treatment method will be useful in old age osteoprorotic patients.

Genetic diversity of Acanthamoeba isolated from ocean sediments

Genetic diversity of 18 Acanthamoeba isolates from ocean sediments was evaluated by comparing mitochondrial (mt) DNA RFLP, 18S rDNA sequences and by examining their cytopathic effects on human corneal epithelial cells versus reference strains. All isolates belonged to morphologic group II. Total of 16 restriction phenotypes of mtDNA from 18 isolates demonstrated the genetic diversity of Acanthamoeba in ocean sediments. Phylogenetic analysis using 18s rDNA sequences revealed that the 18 isolates were distinct from morphological groups I and III. Fifteen isolates showed close relatedness with 17 clinical isolates and A. castellanii Castellani and formed a lineage equivalent to T4 genotype of Byers' group. Two reference strains from ocean sediment, A. hatchetti BH-2 and A. griffini S-7 clustered unequivocally with these 15 isolates. Diversity among isolates was also evident from their cytopathic effects on human corneal cells. This is the first time describing Acanthamoeba diversity in ocean sediments in Korea.

Triceps-Sparing Posterior Approach for Intra-articular Fracture of Distal Humerus

PURPOSE: To evaluate the therapeutic results of intra-articular fracture of distal humerus treated through triceps sparing posterior approach. MATERIALS AND METHODS: From February 2001 to December 2003, we reviewed total 9 cases of intra-articular fracture of distal humerus, which were treated by surgical treatment and were followed more than for 12 months. According to the OTA classification, nine cases were classified as type A; two, as type C1; five, as type C2; two. Triceps sparing posterior approach was used in all nine patients. An extensile posterior incision was used over the olecranon without triceps muscle injury. Exposure of the fracture site was done by obtaining medial-lateral mobility through dissection of medial and lateral edge of triceps muscle. Therapeutic results were assessed by bone union, duration for fracture union, complication. and for functional estimation, Mayo elbow performance score was checked and analysed. RESULTS: The range of the elbow joint motion was flexion contracture 5.2 degree to further flexion 135.5 degree on average. Clinical results using Mayo elbow performance score were as follows; six excellent, three good. Compressive neuropathy of ulnar nerve which has been done anterior transposition was observed in one patient. CONCLUSION: Triceps sparing posterior approach is useful surgical technique that provides sufficient exposure of medial and lateral condyle without injury of triceps muscle in intra-articular fracture of distal humerus to the extent of OTA type C2.

Necrotizing Fasciitis of the Low Extremity / 대한정형외과학회잡지

PURPOSE: To describe the clinical presentation and course of necrotizing fasciitis of low extremity and to analyze the factors affecting the clinical result of necrotizing fasciitis. MATERIALS AND METHODS: The medical records and MRI of 26 patient who had suffered from necrotizing fasciitis were reviewed retrospectively. RESULTS: There were 18 men and 8 women with a mean age of 43.8 years. Twenty two of 26 patients had a medical disease and the most common comorbidity was diabetes mellitus. Exquisite pain, erythema, warm skin were the most consistent clinical feature at the time of admission. Only six patients had a diagnosis of necrotizing fasciitis initially. The interval between onset of symptom and operative treatment was average 5.4 days in 20 patients who didn't have a diagnosis of necrotizing fasciitis initially, and among them, 2 patients died. There were limited range motion of knee joint in 3 cases, sacral osteomyelitis in 1 case, and sciatic nerve palsy in 1 case as a complication. CONCLUSION: We think that the diagnosis of necrotizing fasciitis should be considered with a high index of suspicion in patients who present with unexplained limb pain, and delay in operative treatment and wide involvement of the necrosis is associated with poor results of necrotizing fasciits.

Elbow Dislocation Combined with Coronoid Process and Radial Head Fracture

PURPOSE: To evaluate the clinical outcome for terrible triad injury of the elbow joint. MATERIAL AND METHODS: We reviewed consecutive 10 cases retrospectively among 12 terrible triad injuries, which had been followed up for a minimum 1 year. The average age at the time of injury was 45 years (range, 32~72). All cases were dislocated posteriorly. The 3 cases had fracture of olecranon. Combined medial and lateral approach was performed in 3 cases, medial and lateral approach after extensile posterior approach in 4 cases, transolecranon approach using existed olecranon fracture in 2 cases, and transolecranon approach in 1 case were done. RESULTS: The average Mayo elbow performance score was 87, with 5 excellent, 4 good, and 1 poor results. Results by Riseborough and Radin's rating criteria include 9 good and 1 fair. The 8 cases were stable. But 2 cases were classified with moderate and severe instability; these cases had been performed by radial head allograft and excision respectively. CONCLUSION: A stable, functional elbow can be restored in terrible triad injury by early active rehabilitation after anatomic reduction and firm internal fixation.

Remodelling of Angular Deformity in Birth-Associated Femoral Shaft Fracture

PURPOSE: To find out the process of bone remodelling and risk factors in birth-associated femoral fracture. MATERIALS AND METHOD: We evaluated the four femoral fractures in three neonates about the obstetric and family history, and measured the angulation at the fracture site and the angle between the proximal and distal epiphysis of the femur on the radiographies taken at regular intervals. RESULTS: The incidence of birth-associated femoral fracture was 0.06%. In two cases, fracture angulation and interepiphyseal angle had been decreased. However the angular deformity was worsened in two cases, but the interepiphyseal angle had been decreased regardless to the change of fracture angulation. So the alignment of epiphyseal plate came to normal alignment of joint surface. CONCLUSION: The underlying disorder should be searched, because of its rarity. The physeal reorientation that makes joint alignment near normal irrespective of amount of angular deformity is assumed as the predominant mechanism in remodelling process of the angular deformity.

Radiologic Result of Treatment of Intertrochanteric Fracture Using Compression Hip Screw: Involvement of Lateral Cortex

PURPOSE: To assess the meaning of the unstable intertrochanteric fracture of femur with involvement of lateral cortex by analysing the radiologic result of the surgical treatment using a compression hip screw. MATERIALS AND METHODS: Classifing patients (who has taken the surgical treatment for intertrochanteric fracture of femur using compression hip screw from January 1999 to June 2002) in our hospital with 24 patients who had not much difference statistically in the compression screw located within the femur, Tip-Apex distance (TAD) the Singh Numerical Value of osteoporosis. The results were divided into two groups, group A (without fracture extends through lateral cortex of femur: 16 cases) and B (fracture extends through lateral cortex of femur: 8 cases), when analyzing it. And then analyzed the final examination in the evaluation of electrical potential level by radiology, change of the inside and outside of neck-shaft angle, descent level of the screw and the change of the neck-shaft angle. RESULTS: In the latest follow up, the sliding amount of the screw in group B, the average was 14.9+/-9.3 mm, and 6.7+/-3.6 mm in group A. There was no difference statistically (p value>0.05). In the varus change in group B, the average was 8.00+/-8.12degrees and in group A it ws 2.75+/-2.63degrees There was statistical difference(p value<0.05). In displacement after operation, it was 7.60+/-2.61 mm in group B and 0.5+/-1.80 mm in group A. There was statistical difference (p value<0.05). CONCLUSION: The intertrochanteric fracture with involvement of lateral cortex of femur have to be considered as unstable fracture having tendency of displacement.

Transforaminal Lumbar Interbody Fusion for the Treatment of Nonunion after Posterolateral Lumbar Fusion / 대한척추외과학회지

STUDY DESIGN: A retrospective study OBJECTIVES: To evaluate the clinical and radiological results of a transforaminal lumbar interbody fusion for the treatment of non-union after a posterolateral spinal fusion. LITERATURE REVIEW SUMMARY: In the case of nonunion after a posterolateral spinal fusion, the anterior column should be reconstructed. However, due to epidural scarring and fibrosis, the approach to the anterior column by conventional posterior lumbar interbody fusion (PLIF) is difficult. The authors have modified the original transforaminal lumbar interbody fusion (TLIF) developed by Dr. Harms, which offers potential advantages and provides a surgical alternative to the traditional methods. MATERIALS AND METHODS: Between January 2002 and August 2003, 10 cases of TLIF for the treatment of non-unions after a posterolateral spinal fusion were performed. There were 8 male and 2 female cases. The mean age of the patient was 63.3 years, ranging from 53 to 75 years. The levels of the TLIF were the L4-5 and L5-S1 in 9 and 1 cases, respectively. The mean interval between the revision and previous operations was 21.3 months, ranging 12 to 48 months. In the preoperative radiography, bony defect in posterolateral fusion mass, halos around screws and abnormal motions in the stress view were observed. Using the previous midline approach, exposure of the bilateral articular and transverse processes were performed. With a small osteotome, the superior articular process was removed along a line parallel to the superior margins of the pedicular screw head, to allow access to the neural foramen and lateral aspect of the disc space. The TLIF was performed through this space by inserting cages. The loosened screw was replaced by one that was thicker, coupled with a cancellous bone graft in the foramen. RESULTS: The average operation time and blood loss were 224 min. and 727 cc, respectively. Using Kirkaldy-Willis categories, the results were excellent in 1 case, good in 7, fair in 1 and poor in a further 1 case, with 1 case of nonunion was observed postoperatively. CONCLUSIONS: The transforaminal lumbar interbody fusion for the treatment of nonunion after a posterolateral spinal fusion is a reliable and safe technique, which seems to have the merit of less morbidity.

Transforaminal Lumbar Interbody Fusion for the Treatment of Nonunion after Posterolateral Lumbar Fusion / 대한척추외과학회지

STUDY DESIGN: A retrospective study OBJECTIVES: To evaluate the clinical and radiological results of a transforaminal lumbar interbody fusion for the treatment of non-union after a posterolateral spinal fusion. LITERATURE REVIEW SUMMARY: In the case of nonunion after a posterolateral spinal fusion, the anterior column should be reconstructed. However, due to epidural scarring and fibrosis, the approach to the anterior column by conventional posterior lumbar interbody fusion (PLIF) is difficult. The authors have modified the original transforaminal lumbar interbody fusion (TLIF) developed by Dr. Harms, which offers potential advantages and provides a surgical alternative to the traditional methods. MATERIALS AND METHODS: Between January 2002 and August 2003, 10 cases of TLIF for the treatment of non-unions after a posterolateral spinal fusion were performed. There were 8 male and 2 female cases. The mean age of the patient was 63.3 years, ranging from 53 to 75 years. The levels of the TLIF were the L4-5 and L5-S1 in 9 and 1 cases, respectively. The mean interval between the revision and previous operations was 21.3 months, ranging 12 to 48 months. In the preoperative radiography, bony defect in posterolateral fusion mass, halos around screws and abnormal motions in the stress view were observed. Using the previous midline approach, exposure of the bilateral articular and transverse processes were performed. With a small osteotome, the superior articular process was removed along a line parallel to the superior margins of the pedicular screw head, to allow access to the neural foramen and lateral aspect of the disc space. The TLIF was performed through this space by inserting cages. The loosened screw was replaced by one that was thicker, coupled with a cancellous bone graft in the foramen. RESULTS: The average operation time and blood loss were 224 min. and 727 cc, respectively. Using Kirkaldy-Willis categories, the results were excellent in 1 case, good in 7, fair in 1 and poor in a further 1 case, with 1 case of nonunion was observed postoperatively. CONCLUSIONS: The transforaminal lumbar interbody fusion for the treatment of nonunion after a posterolateral spinal fusion is a reliable and safe technique, which seems to have the merit of less morbidity.

Effects of Taping Therapy on the Deformed Angle of the Foot and Pain in Hallux Valgus Patients / 간호학회지

PURPOSE: This study was to examine the effects of Taping therapy on the deformed angle of the foot and pain in hallux valgus patients. METHOD: The subjects were 24 feet from 15 patients who were diagnosed withhallus valgus at the orthopedic department of K University Hospital in Seoul. Taping therapy was conducted 15 times overall during a four-week period. Data was analyzed using descriptive statistics and t-test. RESULT: The deformed angle of the foot of the hallus valgus patients significantly improved from 21.95(4.38) to 18.75(4.80) after Taping therapy. Pain significantly decreased from 4.73(1.56) to 3.45(2.21) after Taping therapy. CONCLUSION: The result shows that Taping therapy is effective in improving the deformed angle of the foot and in decreasing pain in the hallux valgus patients.

Treatment of Osteoporotic Vertebral Collapses of the Thoracolumbar Spine with Neurologic Deficits using Anterior Approach / 대한척추외과학회지

STUDY DESIGN: Retrospective OBJECTIVES: To evaluate the clinical and radiological results of treatment for thoracolumbar spine fractures, with neurological deficits, using an anterior approach in a senile osteoporotic spine. SUMMARY OF BACKGROUND DATA: With osteoporotic vertebral collapses, an operative treatment may be indicated for lesions that are considered unstable, especially if there is spinal canal compromise with neurological deficits. As for the treatment of these cases, a posterior approach destabilizes, and increases, the kyphotic deformity, resulting in the need for a longer fusion period. A combined anterior-posterior approach increases the morbidity. A one stage anterior decompression and anterior reconstructive stabilization is often the most reasonable operative choice. MATERIALS AND METHODS: Between January 1999 and August 2001, 12 cases of thoracolumbar osteoporotic vertebral collapse, with neurological deficits, were performed. There were 10 female and 2 male cases. The mean age for the patient was 69.3 years, ranging from 60 to 79 years. The numbers of each level of fractured vertebrae were; 2, 5, 4 and 1, in eleventh thoracic, twelfth thoracic, first lumbar and second lumbar vertebrae, respectively. All patients reported minor injury or trauma, and the average interval between injury and operation was 8.3 months, ranging from 1 to 36 months. There were 4 and 8 cases of neurological deficits in the Frankel D2 and D3 groups, respectively. The average preoperative local kyphotic angle was 23.8 degrees, ranging from 5 to 35 degrees, with a 66% loss in height, ranging from 42 to 83%). The average T score from the Bone Densitometry was -3.7 S.D, ranging from -3.2 to -4.4. The operations were performed by an extrapleural-retroperitoneal approach. The anterior instrumentation was performed with the Kaneda system and a titanium mesh cage. All cases were followed for more than 12 months. RESULTS: All cases had a solid bony fusion. The immediate postoperative average local kyphotic angle was 10.3 degrees, ranging from -14 to 22 degrees, and the correction loss at the last follow-up was 2.6 degrees, ranging from 0 to 9 degrees. All 12 patients with incomplete preoperative neurological deficits improved, postoperatively, to Frankel group E. CONCLUSIONS: The one stage anterior spinal decompression and reconstruction, with a Kaneda instrument and a titanium mesh cage, afforded enough stability in patient with an osteoporotic vertebral collapse to enable early ambulation and to achieve realignment and solid fusion, and seems to have merit in the neurological recovery following an operation.

Three-level Anterior Cervical Discectomy and Fusion with Cervical Plate / 대한척추외과학회지

STUDY DESIGN: Retrospective study. OBJECTIVES: To evaluate the clinical and radiological outcomes by the method of three-level anterior cervical discectomy and fusion with cervical plate. SUMMARY OF LITERATURE REVIEW: The arthrodesis rate and outcome for patients having three-level anterior cervical discectomy and fusion procedures is disappointing. The success of arthrodesis depends on several factors including bone graft type, size, and additional anterior plate fixation. MATERIALS AND METHODS: Five patients (average age, 69 years; all males) were observed. All had a anterior discectomy, placement of autogenous tricortical iliac bone graft at three-levels and application of a Orion plate. Clinical and radiologic results of bony union, cervical lordosis and intervertebral disc height were assessed. RESULTS: All clinical symptoms of patients had been resolved after operation. The postoperative scores by the criteria of Odom are 2 in excellent and 3 in good. The bony unions were achieved in all cases in the average 12 weeks after surgery (minimum 8 weeks, maximum 20 weeks). The sum of three-level intervertebral disc height in average was increased from 14.8 mm preoperatively to 25.4 mm postoperatively. The average angle of cervical lordosis was corrected from 18o preoperatively to 27o postoperatively. CONCLUSIONS: The three-level anterior cervical discectomy and fusion with Orion plate and autogenous tricortical iliac bone graft results in effective surgical treatment, which produces good clinical outcome, early and solid bony union, restoration of the normal cervical lordosis and disc space height.

The effect of Korean mistletoe extract M11C (non-lectin components) on IL-1beta release and expression from macrophages

BACKGROUND: Korean mistletoe (Viscum album) extract has been found to posses immunostimulatory activity. In this study, Korean mistletoe extract, M11C (non-lectin components), was used to know whether this extract might activate mouse peritoneal macrophages to produce interleukin 1 beta (IL-1 beta). METHODS: Hemagglutination assay was carried out to examine whether M11C contained a lectin or not . To know the effect of M11C on the production of IL-1 beta, the macrophages were treated by the M11C, and then collected the supernatant (M11C stimulated macrophages-conditioned media; MMCM). MMCM was analyzed for the IL-1 beta quantification and mRNA expression by means of ELISA and RT-PCR, respectively. RESULTS: Maximum effective dose and time of M11C on IL-1 beta production from macrophages were 20 micro gram/ml and 8 hours, respectively . This ELISA data was reconfirmed by immunoblotting assay . indicating that M11C is a good candidate for an immunomodulator. The dose and time dependent effect s of M11C on the expression of IL-1 beta mRNA from macrophages was also shown in expression of mRNA detected by RT-PCR. Treatment dose and time for the maximum expression of IL-1 beta mRNA were 20 micro gram/ml and 4 hours, respectively . Maximum gene expression of IL-1 beta was much earlier than maximum production of it. CONCLUSION: As results, Korean mistletoe extract, M11C, may be used for an immunomodulator. This will be able to make up for and solve the problems caused by existent immunoagent with many adverse effects through many other studies in future including one molecule extraction.

The Effect of LDL Oxidation Caused an Atherosclerosis in Macrophage Cells * : The Antioxidant Effect of Ganhaungenin / 대한면역학회지

Oxidatively modified low density lipoprotein (LDL) could contribute to one of the atherosclerotic processes through its uptake by the scavenger receptor of macrophage. The aim of the present study was to examine whether ganghaungenin has an antioxidant effect. For the approach of the aim, a lipid peroxidation of LDL, the changes of degradation and negative charge of LDL, and LDL uptake in macrophage were measured after ganghaungenin was treated in the reaction process of LDL oxidation. The effective LDL oxidation was performed with treatment of 20 pM CuSO4 for 5 hours. Quercetin, one of the well-known antioxidant, was used as a positive control. The antioxdant effect of ganghaungenin on the LDL oxidation were examined at concentrations of both 40 p,M and 80 p,M for Sh. Ganghaungenin significantly inhibited the lipid peroxidation of LDL. It inhibited the oxidation-enhanced degradation and negative charge of LDL. Even 100 p,M of it did not have any toxic effects on macrophage. It inhibited the uptake of the oxidized LDL into macrophage. These data revealed that ganghaungenin obtained from Scutellaria Baicalensis Georgi was a potent antioxidant in inhibiting the oxidative modification of LDL. Conclusively, these findings indicate that ganghaungenin in physiologic concentrations could inhibit the oxidative modification of LDL in vivo, and suggest that ganghaungenin could be also used for the atherosclerosis prevention.

The Characterization of T Cell - Derived Neutrophil Survival Factor % / 대한면역학회지

It has been reported that the stimulated T lymphocytes might secret a neutrophil survival factor. Thus the goal of study was to determine which molecules are the neutrophil survival factors secreted from the phytohaemagglutinin (PHA)-stimulated T lymphocytes. Human peripheral blood T lymphocytes and neutrophils were isolated by Ficoll-paque density sedimentation from heparinized blood of healthy adult donors. The purity of T lymphocytes and neutrophils were more than 90% and 95%, respectively. The maximal effective condition for the neutrophil viability-sustaining activity was 1 ug/ml af PHA in 12 hours incubation with T lymphocytes. The effect of PHA-stimulated T lymphocyte conditioned medium (TCM) on the neutrophils were used for the comparison with PHA-nonstimulated TCM or enriched medium alone. Neutrophil viability-sustaining activity with PHA-stimulated TCM for 24 hours incubation was significantly higher than other groups (85+/-11 vs 43+/-5 vs 916%; p<0.01). In the analysis of the primary data, the good candidates for the neutrophil viability-sustaining factor were granulocyte/monocyte colony stimulating factor (GM-CSF) and interleukin-8 (IL-8). They were used in the bioassay and antibody neutralization of cytokine activity. ...continue...

Operative Treatment for Cubital Tunnel Syndrome / 대한정형외과학회잡지

Thirteen patients were operated for cubital tunnel syndrome and followed for an average of 26 months postoperatively. Ten patients had a history of relevant trauma and three patients had degenerative osteoarthritis of the elbow. The average duration of symptoms was 18 months (range, 2 to 96 months). Diagnosis was made by physical examination, electromyography and nerve conduction study. Among these, nerve conduction study was found to be the most valuable diagnostic method for the patients with atypical clinical findings. Most of the operations were performed by anterior transposition of the ulnar nerve. At the most recent follow-up, the result was excellent in two patients, good in eight, and fair in three; thus ten patients(77%) showed satisfactory results. The rating system for ulnar neuropathy based on sensory, motor dysfunction and pain was useful for evaluating the operative results. The postoperative gain of score for pain and sensory function were larger than that of motor function. Factors known to influence the result of the operation (age, duration of symptom, history of trauma, method of operation) did not effect the outcome in this study. For successful operation, the ulnar nerve must be thoroughly examined, all possible levels of compression must be released and new foci of compression must be created.

Rotational acetabular osteotomy in acetabular dysplasia / 대한정형외과학회잡지

No abstract available.

Secondary chodrosarcoma in Maffucci's syndrome: a case report / 대한암학회지

No abstract available.