In the treatment of malleolar fracture, anatomical reduction and rigid internal fixation are essential to prevent the complications such as infection, malunion or nonunion, traumatic arthritis, skin necrosis and joint contracture. But it is often difficult to obtain rigid fixation for medial malleolar fracture because of its comminution or thin cortex with osteoporosis. Generally, two operative methods are available for medial malleolar fracture, which are malleolar lag screw fixation and tension band wiring. The purpose of this paper is to analyze which operative method is better for anatomical reduction and rigid fixation and has less postoperative complications for medial malleolar fractures. From March 1992 through March 1995, 88 patients had undergone surgical intervention for medial malleolar fractures. The patients were divided into 2 groups according to operative method for medial malleolar fracture. For one group, malleolar lag screw together with or without a K-wire was used in 48 patients, and for the other group, tension band wiring was used in 40 patients. The average follow-up periods were 14 months in screw fixation group and 13 months in tension band wiring group. The average union time were 15.4 weeks (8-17 weeks) in screw fixation group and 12.2 weeks (6-15 weeks) in tension band wiring group. 27 cases (56%) showed excellent result in screw fixation group and 30 cases (75%) in tension band wiring group. In the patient over 50 years old, 2 (15%) in 13 cases showed excellent result of screw fixation group, while 5 (45%) in 11 cases of tension band wiring group. We concluded that tension band wiring is a better method for medial malleolar fracture to obtain early union and to prevent postoperative complications, especially in the elderly patient.
Aged ; Arthritis ; Contracture ; Follow-Up Studies ; Humans ; Joints ; Middle Aged ; Necrosis ; Osteoporosis ; Postoperative Complications ; Skin

No abstract available.
Anesthetics*

Twenty five patients (twenty seven hips) who had Chiari osteotomy at Kang Nam St. Marys Hospital between 1980 and 1995 were reviewed to evaluate the factors in the operative technique that contribute to successful outcome and assess the clinical results in various conditions. The length of follow-up ranged from one to fourteen years and the age of at operation ranged from four to twentythree years. Eighteen patients had developmental dysplasia of the hip: four, septic hip: three had another disorders, Prior to the Chiari osteotomy, fourteen hips had an femoral osteotomy and four, trochanteric arthroplasty. We used to the standard osteotomy as described by Chiari with certain modification. A pneumatic saw and osteotome are used instead of Gigli saw. This technique is simple procedure to make the correct level and angle. Bone graft was not performed in all cases even the osteotomy was displaced more than 50 percent of the iliac width. The overall results were 12 excellent, eight good, five fair, and two poor. In eleven patients, the osteotomy had to be displaced more than 50 percent to provide good coverage of the femoral head. Their results were good or excellent. A good result will be obtained if enough attention is paid to displacing the osteotomy. The osteotomy using the pneumatic saw provides accurate level and direction of osteotomy and it is an simple procedure also.
Adolescent* ; Arthroplasty ; Child* ; Femur ; Follow-Up Studies ; Head ; Hip ; Humans ; Osteotomy* ; Transplants

No abstract available.
Dislocations* ; Elbow*

Although many reports have been published about Legg-Calve-Perthes disease, developmental dysplasia of hip, it is difficult to gain a satisfactory results in treatment. We experienced 9 year-old girl with ipsilateral neglected DDH combined with contralateral LCPD, and treated with Klisic operation for DDH and femoral valgus osteotomy for hinged abduction of LCPD. We gained satisfactory results and report this rare case.
Child ; Female ; Hip ; Humans ; Legg-Calve-Perthes Disease ; Osteotomy

PURPOSE: To assess the clinical and pathologic features of each type of intrahepatic cholangiocarcinoma,which is divided into three types according to gross appearance, and to determine the efficacy of CT in detectingthis tumor. MATERIALS AND METHODS: The pathologic and CT features of 53 surgically proven cases of intrahepaticcholangio-carcinoma were reviewed. On the basis of their gross appearance, the tumors were divided into threetypes, as follows: mass forming (n=33), periductal infiltrating (n=6), and intraductal growth type (n=14). CTscans were analyzed for sensitivity of detection and correlation between a tumors appearance and itshistopathology. RESULTS: The most common histopathologic feature of mass forming and periductal infiltrating typewas tubu-lar adenocarcinoma, while in the intraductal growth type, papillary adenocarcinoma (100%) was common.With regard to pattern of tumor spread, intrahepatic and lymph node metastasis were more common in the massforming and periductal infiltrating type than in the intraductal growth type. CT findings including intra-hepaticmass, ductal wall thickening or intraductal mass associated with segmental dilatation of intrahepataic bile ducts,corresponded with these morphologic types. CONCLUSION: This classification according to gross appearance is ofconsiderable value when interpreting the pathologic features of intrahepatic cholangiocarcinoma. CT seems to be auseful modality for the detection of tumors and may be consistent with their gross morphologic findings.
Adenocarcinoma ; Adenocarcinoma, Papillary ; Bile ; Cholangiocarcinoma* ; Classification ; Dilatation ; Lymph Nodes ; Neoplasm Metastasis

No abstract available.
Amnion* ; Hydrocortisone* ; Pregnancy*

STUDY DESIGN: Immunohistologic staining of Intervertebral discs at surgery was performed using CD68, matrix metallopro-teinase-1(MMP-1) and matrix metalloproteinase-3(MMP-3). OBJECTIVES: 1. To investigate the histologic characteristics of the macrophage infiltrations in herniated discs and degenerative discs. 2. To investigate the difference of immumoexpression of MMP-1 and MMP-3 activity to herniated discs and degenerative discs. 3. To investigate the possible correlation between the macrophage infiltrations, MMP-1 and MMP-3 in herniated discs and degenerative discs. SUMMARY OF LITERATURE REVIEW: Spontaneous absorption of herniated disc is associated with infiltrating macrophages and matrix metalloproteinases. Matrix metalloproteinases(MMP) are main matrix degradative enzymes in intervertebral disc. MATERIALS AND METHODS: Sixty-seven specimens of degenerative disc specimens and one hundred and two specimens of lumbar disc herniation were immunostained with monoclonal antibodies to CD68, anti-MMP-1, and anti-MMP-3. RESULTS: The granulation tissue containing many CD68-positive macrophages was commonly observed in herniated disc and not in degenerative disc. The immunoexpression of MMP-1 and MMP-3 were observed in herniated and degenerative disc and there were the differences of intensity and localization of MMP-1 and MMP-3 expression in herniated disc and not in degenerative disc. There was no correlation between the macrophage infiltrations, MMP-1 and MMP-3 expression. CONCLUSIONS: The macrophage infiltrations were specific in the granulation tissue of herniated discs. The differents patterns of immunoexpressions of MMP-1 and MMP-3 were observed in herniated and degenerative discs.
Absorption ; Antibodies, Monoclonal ; Granulation Tissue ; Intervertebral Disc Displacement ; Intervertebral Disc* ; Macrophages* ; Matrix Metalloproteinases

The ryanodine receptor/channel (RyR) mediates the release of calcium from the sarcoplasmic reticulum (SR) in both skeletal and cardiac muscle cells. There are three isoforms of the RyR: RyR1, RyR2, and RyR3. RyR1 is specifically expressed in skeletal muscles and RyR2 in cardiac muscles. RyR3 is yet another isoform found in non-muscle cells such as neuronal cells. Single channel recordings of RyR1 and RyR2 reconstituted in artificial lipid bilayer show that the characteristics of two isoforms are very distinct. RyR1 has a shorter mean open time and is activated at a higher concentration of Ca2+ than RyR2. In this study, we isolated the heavy SR membranes from canine latissimus dorsi muscles and investigated the single channel activities from the heavy SR membrane fraction using Cs+ as a charge carrier. Two different types of activities were observed. The fast-gating type (FG) with the mean open time of 0.9 ms was more frequently recorded (n = 12) than the slow-gating type (SG) with the mean open time of 269.2 ms. From the I-V relation, the slope conductance of the FG was calculated to be 514.7 pS and the SG, to 625.6 pS. The activity of the fast gating type increased by raising the concentration of Ca2+ in the cis-solution up to 100 microM. The appearance of the SG in the canine heavy SR membrane fraction suggests a possibility that two types of RyR isoform are co-expressed in mammalian skeletal muscle as well as in avian, amphibian and piscine fast twitch muscles.
Animal ; Calcium Channels/*metabolism ; Dogs ; *Ion Channel Gating ; Lipid Bilayers ; Microsomes/metabolism ; Muscle Proteins/*metabolism ; Muscle, Skeletal/*metabolism ; Ryanodine Receptor Calcium Release Channel ; Sarcoplasmic Reticulum/*metabolism ; Support, Non-U.S. Gov't ; Thorax ; Time Factors

PURPOSE: To determine whether correlation exists between anxiety/depression and the advent/ progression of the disease in glaucoma patients. We compared the degree of anxiety and depression among 3 groups which consist of glaucoma patients, cataract patients, and healthy individuals. METHODS: Between July 1, 1999 and December 31, 1999, a written survey was conducted on three groups of people-glaucoma patients, cataract patients, and healthy individuals, who visited Dankook University Hospital's Ophthalmology Outpatient Depatment. Each group consists of 25 people. The Spielberg's State-Trait Anxiety Inventory (STAI) was employed to quantify the degree of anxiety. STAI consists of 40 questions; 20 questions were designed to measure State Anxiety (STAI-S) and 20 questions to measure Trait Anxiety (STAI-T). In each question, the participants were asked to give scores of 1 to 4. In order to measure the degree of depression, Beck Depression Inventory (BDI) was employed which consists of 21 questions with a 0 to 3 scoring scale for each question. RESULTS: In glaucoma patient group, the average STAI-S score was 44.76+/-13.64, STAI-T score 43.92+/-11.66, and BDI score 15.72+/-10.16. The obtained score was significantly higher compared to cataract patient group (34.64+/-9.17, 34.84+/-10.76, 8.44+/-6.80) and normal group (35.56+/-7.30, 34.52+/-7.70, 8.76+/-4.92) and such findings implied that the degree of anxiety and depression was significantly higher in glaucoma patient group. The severity of intraocular pressure, visual field, visual acuity, and cup to disc ratio did not seem to be correlated with anxiety and depression. DISCUSSIONS: In glaucoma patients, a psychological self training in daily life, in addition to surgical or medical treatment, which can help reduce anxiety and depression can be a useful complement to the conventional treatment modalities.
Anxiety* ; Cataract ; Complement System Proteins ; Depression* ; Glaucoma* ; Humans ; Intraocular Pressure ; Ophthalmology ; Outpatients ; Visual Acuity ; Visual Fields