No abstract available.
Finite Element Analysis*

From September 1992 to April 1994, we reviewed 7 patients after arthroscopic surgery for anterior impingement in the ankle, who complained ankle pain and limitation of motion. All patients were mem and main symptoms were severe pain at full dorsiflexion of ankle and limitation of motion. Bony spur was located on the anterior aspect of tibia, and it was possible to resect the tibial bony spur arthroscopically without distraction devices. Mean operation time was 55 minutes. Pain, swelling and limitation of motion were much improved. There was no postoperative complication. Arthroscopic resection of the anterior tibial bony spur is an effective treatment for anterior impingement in the ankle.
Ankle ; Arthroscopy ; Humans ; Postoperative Complications ; Tibia

In the literature, the scapular neck fracture with ipsilateral acromioclavicluar dislocation(type I), mid-clavicular fracture(type II) or sternoclavicular dislocation(type III) is defined as floating shoulder. Authors managed 4 cases of type II floating shoulder, 3 cases by open reduction and internal fixation for the clavicular fracture only and 1 case by conservative therapy. The final results were excellent in 3 cases of the operative group and good in 1 case of the conservative group, by UCLA shoulder rating scale. There were no complications, including drooping or limited motion in the operative treatment group. However, there was shoulder pain in the case of the conservative treatment. It is thought that internal fixation for the clavicular fracture only may be the simple and sufficient treatment method for type lI floating shoulder.
Neck ; Shoulder Pain ; Shoulder*

BACKGROUND: The electrophysiological effects of purinergic receptor agonists, adenosine triphosphate(ATP) and adenosine were examined using conventional microelectrode technique in rat atrial muscle fibers under superfused with a normal or a simulated ischemic(hypoxic, hyperkalemic and acidotic) physiologic salt solution(PSS) in vitro. METHODS: Action potential parameters, such as maximal diastolic potential(MDP), action potential amplitude(APA), rate of phase 0 depolarization(dv/dtmax) and action potential duration(APD90) were measured in electrically paced, physiologic salt solution(Tyrode's) superfused left rat atrium. In the experiment of ischemic simulation in vitro, normal physiologic salt solutions(NPSS0 were modified(MPSS) and superfused in substitute for normal Tyrode's solution. To investigate the effects of purinergic receptor agonists, ATP or adenosine was added to the superfused tyrode's solutions(NPSS or MPSS) in molar concentration. RESULTS: Under superfused with normal PSS, ATP(10(-3), 10(-4)M) elicited slight hyperpolarization in MDP, and both ATP(10(-6)-10(-3)M) and adenosine(10(-6)-10(-3)M) shortened the duration of normal action potential in a dose-dependent manner. The other paramaters were not affected by the drugs. Superfusion with ischemic PSS caused reductions in MDP as well as APA, dv/dtmax and, especially, APD90. The effects produced by the initial 10 minutes of superfusion with ischemic PSS almost completely disappeared during a subsequent period of continued superfusion with normal PSS, but, those by the initial 20 min lasted in some degree. Both ATP(10(-4)M) and adenosine(10(-4)M) attenuated the reduction in the rate of phase 0 depolarization and the amplitude of the action potential amplitude produced by the ischemic PSS. CONCLUSION: Purinergic receptor agonists, ATP and adensoine, caused a concentration-dependent shortening of the action potential duration in rat atrial muscle fibers and they attenuated the reductions in the rate of phase 0 depolarization and action potential amplitude in fibers superfused with ischemic PSS.
Action Potentials ; Adenosine ; Adenosine Triphosphate ; Animals ; Ischemia ; Microelectrodes ; Molar ; Purinergic Agonists* ; Rats ; Receptors, Purinergic

Authors reviewed 42 fractures of distal tibia fixated with Ender nails(24 cases) or Interlocking nails(18 nails) at the Chosun university Hospital from 1986 to 1992. The purpose of this study is to compare the bony union, the complications and the functional results of two groups(Ender nailing group and Interlocking nailing group). The follow-up period was average 19 months(range, 12 to 36 months). The results were as follows 1. The most common causes of the injury were traffic accidents(36 cases). 2. In the Ender nailing group, 8 cases are closed fractures and 16 cases are open fractures. Among 24 cases, 14 cases are simple fractures and 10 cases comminuted fractures. In interlocking nailing group, 7 cases are closed fracture and 11 cases are open fractures. Among 18 cases, 8 cases are simple fractures and 10 cases are comminuted fractures. 3. The average radiologic union was obtained at 19.3 wks in Ender nailing group, and 18.1 wks in interlocking nailing group. 4. Major complication was a delayed union in both group(5 cases-Ender nailing group, 3 cases-Interlocking group). 5. According to the criteria of functional results by Klemm and Borner, we obtained a 87.5% of Excellent and good results in Ender nailing group(21 out of 24 cases) and 94.4% of Excellent and good results in Interlocking group(17 out of 18 cases). 6. There was no significant difference between the two groups in stable fractures of distal tibia, so we suppose that Ender nailing is a good technique in these cases due to its simplicity and the economic price. But in more unstable fractures such as long oblique, spiral and comminuted fractures, we think that intramedullary interlocking nailing is better due to its stability.
Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Tibia

Freeman-Sheldon Syndrome is one of the very rare genetic diseases which primarily affects face, hands and feet. At first, Freeman and Sheldon described this syndrome as cranio-carpo-tarsal dystrophy in 1938 and later Burian, as "whistling face" syndrome in 1963. There were 60 cases of reports in the world up to now, and only one paper with 5 cases in a family was reported in Korea. The authors report 2 cases of Freeman-Sheldon Syndrome associated with bilateral inguinal hernias and undescended tests in a family, briefly review the literature and alert orthopaedic surgeons to this condition.
Cryptorchidism ; Foot ; Hand ; Hernia, Inguinal ; Humans ; Korea ; Male ; Surgeons

No abstract available.

No abstract available.
Knee*

No abstract available.
Spine*

The polyglandular autoimmune syndrome designates the dysfunction of endocrine and nonendocrine system involving two or more organs on the basis of an autoimmune mechanism. The autoimmune nature of these diseases has been based on the presence of lymphocytic infiltration in the affected gland, organ specific autoantibodies in the serum, cellular immune defects and an association with the HLA DR/DQ genes or immune response genes. This syndrome is usually classified into three classes and their etiology or pathogenesis is still not completely understood. A 28-year-old woman developed vitiligo and insulin dependent diabetes mellitus during the treatment of Graves' disease with antithyroid drug. She had a tendency of spontaneous ketonemia and serum c-peptide levels were low(0.21, 0.16ng/mL: fasting and glucagon stimulated). Thyrotrophin binding inhibitor immunoglobulin and pancreas iIslet cell cytoplasmic antibody were positive. We report here a case of polyglandular autoimmune syndrome, type III manifesting Graves' disease, vitiligo, and insulin dependent diabetes mellitus.
Adult ; Autoantibodies ; Bone Diseases ; C-Peptide ; Cytoplasm ; Diabetes Mellitus ; Fasting ; Female ; Genes, MHC Class II ; Giant Cells ; Glucagon ; Granuloma ; Graves Disease ; Humans ; Immunoglobulins ; Insulin ; Ketosis ; Pancreas ; Pedigree ; Thyrotropin ; Vitiligo