The authors have treated 30 cases of trochanteric fracture of the femur from June 1987, to July 1988 at Dong Suwon General Hospital. The 30 cases included, 8 Condylocephalic Kuentscher nailing, 9 Ender nailing, 7 Multiple pinning, 5 Antegrade Kuentscher nailing and 1 Row plating. 1. The shape of condylocephalic Kuentscher nail should be designed differently, contoured circular arc in anteroposterior and angled in lateral plane. In the anteroposterior plane : The length of the radius of the arc is measured by following way. 1) Design the shape of the nail on the X-ray film of the normal femur which was taken in full internal rotation of the leg. 2) Make three points in the femoral film. One is A, midcentral point of the femoral canal of the isthmus. Point B is center of upper lateral quadrant of the femoral head. Point C is apart from medial cortex 5-7mm at the level of entry portal of the nail. 3) Make point D: Draw the perpendicular lines from the right middle of the AB and AC. These lines meet at the point D. AD is radius of the arc of nail. Draw an arc measuring by the length of AD and mold the nail following the arc. In the lsteral plane ; The nail is bent into three or four segments and the length of the longest segment should not be exceeded the permissible length of straight nail, the latter is distance from entry portal of the nail to anterior cortex of the femur where the tip of the inserted nail is impinged, about 15cm. 2. Two different types of the Ender nailings are used depend on the type of the fracture. In intertrochanteric fracture, the trochanter is remained in the distal fragment and acts as the crane post to fix the proximal fragment(interfragmental compression screw fixation) by horizontal screw inserted through the lateral cortex of the distal fragment into medial cortex of the proximal fragment and fixed with another screw inserted into the distal fragment by tension band wiring. In transtrochanteric frscture, the proximal fragment is fixed by two different kinds of the nails, prior to the nailing medial displacement of the distal fragment is not reduced. The first nail is driven along the medial wall of the medullary canal of the distal fragment, the tip of the nail comes out of the fracture site and impinges to the inferomedeial aspect of the head along the out side of the neck. The nail is inserted into the head after correction of nail direction. The second and third nails are inserted through the medullary canal of the fragments. The proximal fragment is fixed between two nail groups. 3. Antegrade Kuentscher nailing is used for undisplaced trochanteric fracture with segmental fracture or comminuted, segmental subtrochanteric fracture. The open reduction and fixation is preferable in comminuted segmental subtrochanteric fracture for its accurate reduction. The authors msde additional several holes, transverse, sagittal (at the dorsum of the nail) oblique holes around the nail, so the interlocking screw can be easily inserted to the nail when the insertion of the screw through the transverse holes are difficult. 4. It's extremely important to study the fracture carefully when the surgeon plans to use the multiple pinning for trochanteric fracture. The fracture configuration has to be determined in regard to expect stability after local pinning especially in lateral plane. The fracture is fixed by horizontal pin, low angle pin, curved buttress pin(or screw) solidly, not parallel as in neck fracture. The curved buttress rush pin should be inserted as acting as the anteromedial or posteromedial buttress.
Femur ; Fungi ; Gyeonggi-do ; Head ; Hospitals, General ; Leg ; Neck ; Radius ; X-Ray Film

This study was undertaken to investigate the characterization and distribution patterns of MHC class II positive dendritic cells[DCs] and ED2 positive tissue macrophages throughout the estrous cycle and during pregnancy in the rat ovary. The immunohistochemical characterization of the cells was carried out using the monoclonal antibodies OX6 and ED2 in cryostat-cut sections. DCs were distributed in the theca cell layer of the growing and mature follicles,stroma and corpus luteum. Tissue macrophages were distributed in the theca externa of the growing and mature follicles, stroma and corpus luteum but they were smaller in number than DCs. None of DC and tissue macrophage was found in the ovum, granulosa layer and follicular cavity of the ovarian follicle. However, DCs and tissue macrophages were present in the granulosa layer and follicular cavity in the atretic follicles. Degenerating corpus luteum contained a vast number of OX6 positive cells. On the contrary, fewer tissue macrophages were founcl in the degenerating corpus luteum. More macrophages tended to be observed in the former follicular cavity and theca lutein cell layer than in the granulosa lutein cell layer of the corpus luteum. In stroma,DCs and tissue macrophages were more frequently found around the blood vessels than in the other region, however, DCs were relatively greater in number than tissue macrophages. There was no estrous cycle and pregnancy dependent variation in the numbers and distribution patterns of DCs and tissue macrophages. In conclusion, the rat ovary contains rich networks of MHC class II positive dendritic cells and ED2 positive tissue macrophages. These findings suggest the existence of a well-developed system of immunological surveillance in the rat ovary. The results of this study have potentially important implications for the understanding not only of the ovarian immune system and the pathogenesis of various ovarian diseases but also of various physiologic functions of the ovary.
Animals ; Antibodies, Monoclonal ; Blood Vessels ; Corpus Luteum ; Dendritic Cells* ; Estrous Cycle ; Female ; Immune System ; Immunologic Surveillance ; Luteal Cells ; Macrophages* ; Ovarian Diseases ; Ovarian Follicle ; Ovary* ; Ovum ; Pregnancy ; Rats* ; Theca Cells

No abstract available.
Cell Count* ; HIV* ; Humans ; Panax*

To date, various clinical procedures have been used to restore periodontal apparatus destroyed by periodontal disease. And then, many experimental approaches have been proceeded to develop treatment methods to promote periodontal regeneration. Mechanical, chemical treatments to enhance the attachment of periodontal tissue cells as changing the physical properties of root surfaces, bone graft procedure, and treatments for guided tissue regeneration have been used for periodontal regeneration. However, recent studies have revealed that biologic factors such as growth factors promote biologic mechanism associated with periodontal regeneration. This study was done to enucleate how ELF stimulus affect the periodontal regeneration. We can have following conclusions from this experimental results. The influence of low frequency(ELF) electric stimulus (30HZ at 10micronA) known to promote bone formation in vivo, was evaluated for its ability to affect bone cell function in vitro. After 12 hour exposure of ELF stimulus at most appropriate densities (5x10(4) cells/cm2) to increase osteoblastic cells normally, rat calvarial cells were incubated for 60 hours were used in this study. We have found ELF stimulus suppress calvarial cell proliferation and the ability of protein synthesis, enhance the alkaline phosphatase activity significantly.
Alkaline Phosphatase ; Animals ; Biological Factors ; Cell Proliferation ; Guided Tissue Regeneration ; Intercellular Signaling Peptides and Proteins ; Osteoblasts ; Osteogenesis ; Periodontal Diseases ; Rats ; Regeneration ; Skull* ; Transplants

Patients with medullary spongy kidney(MSK) who recurrently form and pass stones are in danger of developing obstructive nephropathy. Since extracorporeal shock wave lithotripsy (ESWL) was introduced to treat urinary tract stones, the shock wave application to MSK with stones has been performed. Between February, 1990 and August, 1992, 11 renal units in 7 patients were diagnosed as stones in MSK on intravenous urography. These patients were all symptomatic with hematuria and/or flank pain, and then treated by ESWL. The number of stone-burden minor calyces was 1 to3 in 2 cases( 18.2%), 4 to 6 in 8 cases ( 72.7% ) and 7 or more in 1 case(9.1%). The average numbers of treatment for these stones were 8.5, 13.4 and 4 sessions, respectively and the average storage was 386, 470 and 115, respectively. Reduction in the number and size of the stones on plain films was more than ?5% in 5 cases( 45.4%), 25 to 75% in 4 cases( 36.4%), and less than 25% in 2 cases( 13.2%). Serum creatinine, blood urea nitrogen, and creatinine clearance rate did not show any change after the treatments. The post-ESWL complication was only persistent gross hematuria for 4 days in 1 case( 14.3% ) In conclusion, although ESWL does not clear the stones completely, the ESWL is considered to be an effective procedure to prevent an obstructive nephropathy and to reduce the frequency of symptomatic stone passage in medullary spongy kidney with stones.
Blood Urea Nitrogen ; Creatinine ; Flank Pain ; Hematuria ; Humans ; Kidney* ; Lithotripsy* ; Nephrocalcinosis* ; Shock* ; Urinary Calculi ; Urography

Anesthesia, General ; Animals ; Brain ; Child, Preschool ; Depression ; Dogs ; Female ; Head ; Hematoma ; Humans ; Lateral Ventricles ; Magnetic Resonance Imaging ; Parietal Bone ; Radiography ; Sialorrhea ; Skull ; Skull Fractures

It was attempted to clarify the participation of K+ channels in the post-receptor mechanisms of the muscarinic and A1-adenosine receptor-mediated control of acetylcholine (ACh) release in the present study. Slices from the rat hippocampus were equilibrated with (3H)choline and the release of the labelled products was evoked by electrical stimulation (3 Hz, 5 V/cm, 2 ms, rectangular pulses), and the influence of various agents on the evoked tritium-outflow was investigated. Oxotremorine (Oxo, 0.1~10 micrometer), a muscarinic agonist, and N6-cyclopentyladenosine (CPA, 1~30 micrometer), a specific A1-adenosine agonist, decreased the ACh release in a dose-dependent manner, without affecting the basal rate of release. 4-aminopyridine (4AP), a specific A-type K+-channel blocker (1~100 micrometer), increased the evoked ACh release in a dose-related fashion, and the basal rate of release is increased by 3 and 100 micrometer. Tetraethylammonium (TEA), a non-specific K+-channel blocker (0.1~10 mM), increased the evoked ACh release in a dose-dependent manner without affecting the basal release. The effects of Oxo and CPA were not affected by 3 micrometer 4AP co-treatment, but 10 mM TEA significantly inhibited the effects of Oxo and CPA. 4AP (10 micrometer- and TEA (10 mM)-induced increments of evoked ACh release were completely abolished in Ca2+-free medium, but these were recovered in low Ca2+ medium. And the effects of K+-channel blockers in low Ca2+ medium were inhibited by Mg2+ (4 mM) and abolished by 0.3 micrometer tetrodotoxin (TTX). These results suggest that the changes in TEA-sensitive potassium channel permeability and the consequent limitation of Ca2+ influx are partly involved in the presynaptic modulation of the evoked ACh-release by muscarinic and A1-adenosine receptors of the rat hippocampus.
4-Aminopyridine ; Acetylcholine* ; Animals ; Electric Stimulation ; Hippocampus* ; Muscarinic Agonists ; Oxotremorine ; Permeability ; Potassium Channels ; Rats* ; Receptors, Muscarinic ; Tea ; Tetraethylammonium ; Tetrodotoxin

In order to investigate wheter or not elastic dynamization by axial micromotion enhanced regenerate bone healing in distraction osteogenesis(callotasis), a unilateral external fixator, with which the magnitude of dynamization could be controlled, was applied to the tibiae of 12 Korean adult mongrel dogs, weighting approximately 35kg. Tibiae and fibulae of both sides were osteotomized at the proximal metaphysio-diaphyseal junction and fixed with unilateral external fixators. Distraction was started from the third postoperative day until 2 cm (10% of tibial length) of length gian was achived, at the rate of 0. mm twice a day. When 1 cm (5%) of lengthening was achieved, controlled elastic dynamization of 1 mm (group I), 2 mm (group II), and 3 mm (group III) in magnitude was allowed on left tibia. Right tibia was not dynamized until sacrifice, and served as a control for each group. Plain anteroposterior radiographs and measurements of bone mineral density(BMD) by dual x-ray absorptiometry(DXA) were obtained pre- and post-operatively. Relative ratio of BMD was calculated, dividing the BMD value measured in each period by the BMD value measured at the beginning of dynamization. Mechanical test was performed in uniaxial compression on an Instron machine. Following observations were made: 1. Plain anteroposterior radiography showed that at mid-consolidation phase (postoperative 50th day) the width of callus in the distraction gap increased significantly in all dynamization groups, as compared to their control groups(p < 0.05). However, there were no significant differences among the dynamization groups. 2. Both BMD and the relative BMD ratio of the distraction gap were higher in the dynamization groups than those in the their control groups throughout the study period(p < 0.05). However, there was no significant difference among the dynamizaion subgroup(p>0.05). 3. Axial Compression test revealed that the dynamization group had significantly increased stiffness, maximal load, elastic modulus, and strength, as compared to those of the control group(p < 0.05). In conclusion, controlled elastic dynamization effectively enhances regenerate bone healing in distraction osteogenesis of canine tibia, at 1 mm to 3 mm of magnitude.
Adult ; Animals ; Bony Callus ; Dogs ; Elastic Modulus ; External Fixators ; Fibula ; Humans ; Miners ; Osteogenesis, Distraction ; Radiography ; Tibia

Many of the thoracolumbar spine fracture may be managed conservatively by postural reduction. But postural reduction alone cannot treat all the patient with thoracolumbar spine fracture properly. Recently, more patients with thoracolumbar spine fracture are managed surgically with the advance of surgical technique and instrument. Surgery may be performed by either anterior or posterior approach according to many factors. Generally initial management of patient with thoracolumbar spine fracture is conservative and surgery is delayed for spinal fusion, but early surgery with decompression of spinal cord and fusion of the vertebral body seems to be more proper in unstable fracture with compression of spinal cord by bony fragment and incomplete neurological deficit. Authors analyzed 52 cases of thoracolumbar spine fracture and made a proper management plan and proper surgical approach.
Decompression ; Humans ; Spinal Cord ; Spinal Fusion ; Spine*

Purpose: To evaluate set-up error for head and neck cancer (HNC) patients according to each neck lymph node (LN) level. And clinical factors affecting set-up error were analyzed. Materials and Methods: Reference points (RP1, RP2, RP3, and RP4) representing neck LN levels I to IV were designated. These RP were contoured on simulation computed tomography (CT) and cone-beam CT of 89 HNC patients with the same standard. After image registration was performed, movement of each RP was measured. Univariable logistic regression analyses were performed to analyze clinical factors related to measured movements. Results: The mean value of deviation of all axes was 1.6 mm, 1.3 mm, 1.8 mm, and 1.5 mm for RP1, RP2, RP3, and RP4, respectively. Deviation was over 3 mm in 24 patients. Movement of more than 3 mm was observed only in RP1 and RP3. In RP1, it was related to bite block use. Movement exceeding 3 mm was most frequently observed in RP3. Primary tumor and metastatic LN volume change were clinical factors related to the RP3 movement. Conclusion Planning target volume margin of 4 mm for neck LN level I, 3 mm for neck LN level II, 5 mm for neck LN level III, and 3 mm for neck LN level IV was required to include all movements of each LN level. In patients using bite block, changes in primary tumor volume, and metastatic LN volume were related to significant movement.