No abstract available.
Free Tissue Flaps* ; Lower Extremity*

The anterior cruciate ligament integrity is critical to the mechanics, stability, and protection of the joint and its periarticular structure. The insufficiency of the anterior cruciate ligament leads to a disintegration of the rolling/gliding movement, and followed by degenerative changes of the joint cartilage. Numerous surgical procedures have been designed to control the anterior cruciate ligament insufficiency. None has yet been generally accepted as the best procedure. Arthroscopy has added a new dimension to knee surgery and earned a rightful place in the diagnosis and mansgement of the anterior cruciate ligsment problems. In this article, we present the results in twenty two patients who were treated with staple by arthroscopic surgery from January, 1984 to December, 1985. The results obtained were as follows : 1. Type of surgery were 2 cases of primsry repair, 12 cases of pedicle graft, and 8 cases of semitendinosus graft. 2. Associated lesions were 17 cases(77.3%) of meniscal injuries and 3 cases(13.6%) of the injury to the articular cartilage. 3. Clinical results were excellent and good in 12 cases(54.5%) and fair in 8 cases(36.4%) by the Hospital for Special Surgery knee follow up score. 4. Advantages of using the Ligamentous and Cagsular Repair system for anterior cruciate ligament insufficiency were A) Minimal surgical exposure and trauma. B) Less painful. C) Utilized the patients own collagen tissue with vascularity and synovial covering. D) Close approximation of normal anterior cruciate attachment. E) Excellent bony fixation. F) Rapid rehabilitation. G) Minimal morbidity and few complications. On the basis of our findings, we advocate the arthroscopic repair % reconstruction with staple as a reliable and effective method of treating anterior cruciate ligament insufficiency.
Anterior Cruciate Ligament ; Arthroscopy ; Cartilage ; Cartilage, Articular ; Collagen ; Diagnosis ; Follow-Up Studies ; Humans ; Joints ; Knee ; Ligaments ; Mechanics ; Methods ; Rehabilitation ; Transplants

Various methods have been described for sugical management of patients who have recurrent anterior shoulder dislocation. In recent years, great advancements have been made in arthroscopic surgery of anterior shoulder dislocation. From June, 1987 to December, 1989, 10 shoulders in 10 patients who experienced recurrent traumatic anterior dislocation were repaired with the arthroscopic stapling technique. Among them, 6 cases which could be followed for more than 1 year were analyzed. Postoperstive follow-up averaged 21 months (range 1 year to 3 years). The results were summarized as follows: l. Average patient age was 24 years with an age range from 20 to 31 years. All 6 cases were male. 2. The orighinal dislocation involved an injury in all cases. It had occurred between 18 months and 6 years before surgery. Every patients had had 4 or more recurrences. 3. Among the 6 cases, 5 cases were found to have a Bankart lesion and 3 cases, a Hill-Sachs lesion at surgery. 4. There have been no postoperative recurrence up to date. 5. 7 and 10 degrees restriction in external rotation, as compared to the contralateral shoulder, was noted in 2 patients. 6. Clinical results of 6 cases, based on the Rowe shoulder rationg system, were 4 excellent and 2 good. 7. No instances of infection, instrument failure, or major neurovascular complications occurred in this series.
Arthroscopy ; Dislocations ; Follow-Up Studies ; Humans ; Male ; Recurrence ; Shoulder Dislocation ; Shoulder

Bowen's disease may be defined as an intraepidermal squamous cell carcinoma of the skin whieh puraues a slow, relatively benign course but may progress into invasive carcinoma. We have experienced two female patients who had well demarcated, multicentric, brown to black colored flat-topped papules on the vulva with histopathologic features of intraepidermal squamous cell carcinoma but showed entireIy different clinicaI appearance from Bowen's disease. For differentiation from extramammary Paget's disease, PAS stain and mucicarmine stain were done but not reacted to them, Both cases were diagnosed as multicentric pigmented Bowen's disease, and in case 2, regression occured after local appIication of 5-fluorouracil cream. A conservative approach to managment of these lesions is suggested. We have experienced peculiar entities and literatures were reviewed.
Bowen's Disease* ; Carcinoma, Squamous Cell ; Female ; Fluorouracil ; Humans ; Paget Disease, Extramammary ; Skin ; Vulva

Unilateral absence of the articular process at a lumbar vertebra is a rare anomaly. The etiology of the congenital absence of articular process is not precisely determined yet, but it was explained as some of the possible embryologic bases. Absence of the articular process at the level of L5-Sl have been reported a few, but anomaly above L4 is rare. We are reporting a case of absence of articular process at the level of the 4th lumbar vertebra.
Spine

No abstract available.
Nephrotic Syndrome*

BACKGROUND: To investigate the effectiveness of reverse total shoulder arthroplasty (RTSA) in treating irreparable massive rotator cuff tears (RCTs). METHODS: Twenty-nine patients who underwent RTSA for the treatment of irreparable massive RCTs and completed follow-up for at least 1 year were selected. Their mean age was 69.7 years (range, 59-80 years). The mean follow-up was 17.7 months (range, 12-42 months). The shoulder range of motion was measured preoperatively and at final follow-up. The functional result was evaluated using visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeon (ASES) score, and Korean Shoulder Society (KSS) score. Additionally, the shoulders were categorized into two groups depending on prior history of surgery and the clinical outcomes were analyzed between two groups. RESULTS: Mean pain VAS improved, from 6.6+/-1.2 to 2.7+/-0.9 (p=0.001), and the mean functional VAS from 35.7+/-4.2 to 73.3+/-5.4 (p=0.006). The mean ASES score improved from 37.2+/-2.8 to 75.0+/-3.8 (p=0.012). The mean KSS improved from 36.5+/-7.2 to 75.6+/-5.4 (p=0.009), the mean forward elevation from 66.3+/-4.7 to 135.6+/-8.4 (p=0.0001), and the mean abduction from 45.2+/-4.2 to 119.0+/-6.5o (p=0.0001). Internal rotation differed significantly from the first sacral to the third lumbar vertebrae (p=0.036). External rotation did not change significantly (p=0.076). There was also no statistically significant difference between groups (no previous operation versus none). Four complications occurred: one superficial infection, one with anterior dislocation, one acromial fracture, and one clavicle fracture. CONCLUSIONS: RTSA provides reliable pain relief and recovery of shoulder function in patients with massive irreparable RCTs in short-term follow-up.
Arthroplasty* ; Clavicle ; Dislocations ; Elbow ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; Range of Motion, Articular ; Rotator Cuff* ; Shoulder* ; Visual Analog Scale

No abstract available.
Female ; Humans

No abstract available.
Biopsy* ; Nephrotic Syndrome*

No abstract available.
Basement Membrane*