No abstract available.

PURPOSE: We intended to check the growth rates and phenotypic markers of chondrocytes in the dedifferentiated cells cultivated in various conditions in order to establish the ideal culture system for implantation. MATERIALS AND METHODS: Culturing rabbit chondrocytes from proximal tibia, we checked the phenotypes at first, second, and third week. Then we cultured the chondrocytes in different circumstances such as monolayer or three dimensional gel in the presence or abscence of TGF-B1, and checked the growth rates and phenotypic markers. RESULTS: There was no difference in growth rates and mRNA level of type I, type II collagen and aggrecan between the cells cultured in monolayer and three dimensional gel of collagen. However, the responses of the cells to TGF-B1, were quite different between these two groups. In monolayer culture, the expression of type I collagen was depressed by TGF-B1 while the growth rate was markedly increased. Oppositely in three dimensional culture, the mRNA level of type I collagen was markedly increased and the growth rate was completely suppressed by TGF-B1. The expression of type II collagen could be detected only in TGF-B1-treated cells cultured in three dimensional gel for 4 or more days. The mRNA level of aggrecan was also increased by TGF-B1, in the cells cultured in three dimensional gel. CONCLUSIONS: These results suggest that the number of chondrocytes can be efficiently expanded by culturing the cells in monolayer and the phenotypes of chondrocyte can be restored by culturing the cells in three dimensional gel containing TGF-B1. The application of semi-solid gel containing differentiated chondrocytes in physeal implantation should be further evaluated
Aggrecans ; Chondrocytes* ; Collagen ; Collagen Type I ; Collagen Type II ; Phenotype ; RNA, Messenger ; Tibia ; Transforming Growth Factor beta1*

BACKGROUND: We investigated the risk factors for the recurrence of anterior shoulder instability after arthroscopic surgery with suture anchors and the clinical outcomes after reoperation. METHODS: A total of 281 patients (February 2001 to December 2012) were enrolled into our study, and postoperative subluxation and dislocation were considered as recurrence of the condition. We analyzed radiologic results and functional outcome including the American Shoulder and Elbow Surgeons Evaluation Form, the Korean Shoulder Society Score, and the Rowe scores. RESULTS: Of the 281 patients, instability recurred in 51 patients (18.1%). Sixteen out of 51 patients (31.4%) received a reoperation. In terms of the functional outcome, we found that the intact group, comprising patients without recurrence, had a significantly better functional outcome than those in the recurrent group. The size of glenoid defect at the time of initial surgery significantly differed between intact and recurrent group (p<0.05). We found that the number of dislocations, the time from the initial presentation of symptoms to surgery, and the number of anchor points significantly differed between initial operation and revision group (p<0.05). The functional outcome after revision surgery was comparable to intact group after initial operation. CONCLUSIONS: Eighteen percent of recurrence occurred after arthroscopic instability surgery, and 5.6% received reoperation surgery. Risk factors for recurrence was the initial size of glenoid defect. In cases of revision surgery, good clinical outcomes could be achieved using additional suture anchor.
Arthroscopy* ; Dislocations ; Elbow ; Humans ; Joint Instability ; Recurrence* ; Reoperation ; Risk Factors* ; Shoulder* ; Surgeons ; Suture Anchors* ; Sutures*

In the published article by Choi et al., a part of expression of the Abstract and the Conclusion section in the main body text have been corrected. Underlined text should be read carefully.

STUDY DESIGN: The authors retrospectively analysed the difference of clinical natures in contained vs. ruptured HIVD. OBJECTIVE: To compare contained HIVD with ruptured HIVD in respect of clinical symptoms, signs and the result after surgery. SUMMARY OF LITERATURE REVIEW: In contained disc herniation, the disc material remains beneath tile intact outer annulus. But, once disc material penetrates through the limit of posterior annulus, it is a ruptured herniation or disc extrusion/sequestration. There is few report concerning the clinical characteristics related to type of herniation. MATERIALS AND METHODS: Forty-six patients, treated by open discectomy from March 1990 to December 1994, were followed up for minimum two years. The clinical symptoms and signs including SLR, motor deficit, sensory deficit, change of DTR, and severity of radiating pain were periodically followed up on the predesigned protocol. Result: Twenty patients had contained disc and remaining 26 had ruptured disc. The mean age of contained disc was 31.4 years and that of ruptured disc was 43.3 years. In preoperative examination, 18/26 cases of patients with ruptured discs, developed pain in less than 3 months, compared with 7/20 cases of does with contained ones. Motor deficit was positive in 25/26 cases (96.2%) of ruptured discs and 12/20 cases (60%) of contained ones. 23/26 cases (80.8%) of patients with ruptured discs, had sensory deficit compared with 12/20 cases (60%) of those with contained ones. There was no significant difference in SLR and DTR change between ruptured and contained disc. CONCLUSIONS: Factors such as age, motor and sensory deficits and duration of symptoms had correlation with the type of herniation, but SLR and DTR change showed no statistical difference in this study. Clinical outcome showed no significant difference between two groups, but in ruptured group, the results were getting worse with the time goes. On the basis of this study, we concluded that the clinical symptoms and signs were different between the two groups, but surgical results showed no statistical difference.
Diskectomy ; Humans ; Retrospective Studies

No abstract available.
Animals ; Dogs* ; Lung*

Pelvic actinomycosis is a rare disease, and has variable clinical manifestations and courses, which make it difficult to diagnose the disease initially. We experienced a pelvic actinomycosis in a woman who complained vaginal discharge and lower abdominal pain, and had not been carring a intrauterine contraceptive device. This infection results in tissue destruction, fibrosis, and the formation of draining sinuses. We describe the case with brief review of clinical diagnosis and management.
Abdominal Pain ; Actinomycosis* ; Diagnosis ; Female ; Fibrosis ; Humans ; Intrauterine Devices ; Rare Diseases ; Vaginal Discharge

Isolated stress fracture of the first rib is quite rare cause of uncertain shoulder pain in athletes. These fractures are stress induced and precipitated by repeated traction of muscles acting on the first rib. A prompt diagnosis can shorten the time required for healing and decrease the risk of associated complication as nonunion or pseudoarthrosis. The diagnosis can be made by taking a thorough history and performing chest X-ray, computed tomography, or bone scan. Early recognition and proper management generally lead to successful outcomes and return to normal activities. Typically, they heal with conservative treatment with rest and mild analgesia. This report describes stress fractures of bilateral first rib in a weightlifter, one of which developed into a pseudoarthrosis as a result of persistent overhead activities due to missed diagnosis.
Analgesia ; Athletes ; Diagnosis ; Fractures, Stress* ; Humans ; Muscles ; Pseudarthrosis* ; Ribs* ; Shoulder Pain* ; Shoulder* ; Thorax ; Traction

Seven patients with average age of 15years and 6 months (range: 8 years and 11 months 25 years and 6 months) underwent forearm lengthening by callotasis. The indications for lengthening were shortening and/or deformity of the forearm due to exostosis of the distal ulna in three cases, growth disturbance due to physeal injury of the distal radius in three, congenital radial dislocation in one. Three had lengthening of the radius, three of the ulna and one of both the radius and the ulna. The average lengthening achieved was 3.8 cm (3.5 - 4.0) in radius, 2.7 cm (2.3 - 3.0) in ulna. Complications encountered were pin tract infection in two cases, nonunion in one and temporary nerve palsy in one. All of these complications were recovered completely without any residua. Retrospective review after average 41 months of follow-up (range: 36 to 78) showed satisfactory improvement in appearance and function. Callotasis was considered as one of the safe and reliable treatment methods for bone lengthening and deformity correction of the forearm.
Bone Lengthening ; Congenital Abnormalities* ; Dislocations ; Exostoses ; Follow-Up Studies ; Forearm* ; Humans ; Osteogenesis, Distraction* ; Paralysis ; Radius ; Retrospective Studies ; Ulna

Genu recurvatum deformity of the knee can be due to the deformity of the bone of the proximal end of the tibia or to the changes in the soft tissues, or both. The causes of acquired genu recurvatum include trauma, wire traction of the tibia, operative procedures involving the proximal tibial physis, Osgood-Schlatter's disease, osteomyelitis and prolonged immobilization. The most frequent symptoms of genu recurvatum are weakness, pain and instability of the knee, genu valgus, and shortening of the affected lower extremity. Operative treatment consists of tibial osteotomy and soft tissue procedures performed on the capsule and ligaments, and recently percutaneous corticotomy of the proximal tibia and gradual correction by the Ilizarov external fixator became one of the treatment modalities. From Nov. 1990 to June 1993, the authors have performed gradual correction by the Ilizarov external fixator in 6 patients of genu recurvatum and the results were as follows. 1. The mean age was 14 years ranging from 11 to 21. And there were 2 males and 4 females. 2. In the past history, there were ipsilateral femur fractures in 5 cases in which 4 cases were treated with skeletal pin traction on the proximal tibia, and one case had ipsilateral open tibiofibular fracture. 3. After Ilizarov external fixation, proximal tibial corticotomy just inferior to the tibial tuberosity were performed in all 6 cases. 4. The follow up period was 19 months in average. 5. The results were evaluated according to a scoring system that was suggested by Lecuire et al.: 2 cases were excellent, 3 cases were good and 1 case was fair. 6. Ilizarov gradual correction was very effective not only in the treatment of genu recurvatum but also in the concurrent correction of limb length inequality and mechanical axis deviation of the lower extermity.
Congenital Abnormalities ; External Fixators ; Extremities ; Female ; Femur ; Follow-Up Studies ; Humans ; Immobilization ; Knee ; Ligaments ; Lower Extremity ; Male ; Osteomyelitis ; Osteotomy ; Socioeconomic Factors ; Surgical Procedures, Operative ; Tibia ; Traction