High Resolution Computerized Tomographic and Pathologic Findings of Pulmonary Fat Embolism after Long Bone Fracture of Rabbit / 대한정형외과학회잡지

PURPOSE: Fat embolism syndrome is caused by traumatic and nontraumatic conditions, and most commonly associated with fractures of long bones of the lower extremity. Clinical manifestation of the fat embolism syndrome occurs in a minority of patients with fat emboli. The incidence of fat emboilsm has been reported 5-10%. The pulmonary symptoms of fat embolism are clinically important but hard to diagnose, so treatment was often delayed. The purpose of this study is to search for the development of fat embolism after long bone fracture of rabbit, and to demonstrate pulmonary fat embolism by high resolution computerized tomograhy (HRCT) and pathologic findings. MATERIALS AND METHODS: Twelve rabbits (Newzealand, 2.5-3 Kg) were divided into 2, 24, 72 hours and control groups after closed tibiofibular fracture. The presence of involvement was classified by high resolution computerized tomography with ground glass opacity, consolidation and focal hyperlucency. The extent was measured by 10% grading scale. Gross inspection, histologic examination and histochemistry (Oil red 0) were performed in removed lungs. RESULTS: Ground glass opacity was found in 100% of test subjects, consolidation was found in 89%, bronchovascular bundle thickening was found in 78% and focal hyperlucency was found in 33%. Fat embolism was developed in all groups with the 24-hour group showing maximal changes. Microscopically the vessel was occluded with fat globule which was stained with Oil red 0 stain. CONCLUSIONS: The abnormal density lesion on HRCT was correlated with pathologic finding and was induced by fat emboli after long bone fracture of the rabbit

Anterior Knee Pain after Tibia Intramedullary Nailing

Treatments of tibia shaft fracture are closed reduction followed by cast immobilization, external fixation, intramedullary nailing and internal fixation with plate and screws. Among these, intramedullary nailing is commonly used method today. The tibia nailing has high rate of union, but malunion, infection, the joint stiffness and anterior knee pain develops frequently. We reviewed the clinical and radiological result of anterior knee pain retrospectively after tibia nailing. The result were as follows: l. Age distribution of tibia shaft fracture was 17 to 76, and mean age was 40 male patients were 35 and female 13. 2. The open fractures were 17 and the closed fractures were 34. 3. The causes of' tibia shaft fracture were traffic accidents(30cases), fall down injuries(6 cases), slip down injuries(1 1 cases) and other injuries(4 cases) Among the these, 19 cases were cornbined with other fractures or neuri.isurgical injuries. 4. The incision methods were recorded as follows: parapatella tendon incision were 9 cases, patella splitting incision were 25 cases and unrecorded were 17cases. 5. According to the radiological analysis, the average nail plateau distance was 10.3mm and the extent of nail protrusion beyond the anterior cortex was -1.73mm. Among these, protrusion of proximal targeting screws were 8 cases. 6. Insertion of nail through the patella tendon was associated with a hipher incidence of knee pain compared to paratendon site of insertion. The extent of nail protrusion were related to anterior knee pain after tibia intramedullary nailing.

The Effects of TGF-beta1 & TGF-beta2 on the Proliferation of the Lumbar Facet Joint Capsule in Tissue Culture / 대한척추외과학회지

STUDY DESIGN: This study was undertaken to document the effect of TGF-beta 1 and TGF-beta2 on the proliferation of lumbar facet joint capsule. OBJECTIVES: To study the effect of TGF-beta1 and TGF-beta2 on the proliferation of lumbar facet joint capsule and their proliferation mechanism. SUMMARY OF LITERATURE REVIEW: TGF-beta1 and TGF-beta proliferated mesenchymal tissue . This proliferatine mechanism was involved of PLC-gamma- 1 and tyrosine kinase in signalling. MATERIAL AND METHODS: Three lumbar facet joint capsule was cultured in DMEM-20 media. Its proliferatine and inhibited effect was studied under the metabolic inhibitors and trasnsforming growth factors . RESULTS: TGF-beta1, and TGF-beta2, increased cell proliferation dependent on time and dosage. Both of TGF-beta1, and TGF-beta 2, specific antisense oligonucleotide blocked tile autoc.me effect of growth factor, PLC-gamma-1 specific antisense oligonucleotide inhibited the effect of TGF-beta 1, and TGF-beta2, Genistin inhibited the effect of TGF-beta 1, and TGF-beta2, in time and dosage dependent manner. CONCLUSION: The cell proliferation of lumbar facet joint capsule was involved in PLC- gamma-1 and tyrosine kinase in signalling.