In children, snapping knee syndrome and joint pain with the loss of physiological hyperextension strongly suggests a diagnosis of a torn discoid meniscus. We performed arthroscopic meniscectomy to treat torn discoid lateral meniscus on 19 knees and open meniscectomy on 9 knees of 26 children(average age: 10.9 yrs) from September, 1983 to October, 1993 at Guro hospital. According to Ikeuchi's grading system', excellent results were obtained in 14, good in 11, fair in 2 knees and poor in 1 knee which was associated with osteochondritis dissecans. The knees treated by partial meniscectomy showed less Fairbank's radiologic changes than those by total meniscectomy during the average follow-up 4.2 years(minimum 1 year, maximum 7 year 11 months).
Arthralgia ; Child ; Diagnosis ; Follow-Up Studies ; Humans ; Knee ; Menisci, Tibial ; Osteochondritis Dissecans

The purpose of this study is to evaluate the results of bone graft or cement fill for tibial bone defect in total knee arthroplasty. 51 knee in 45 patients which had bone graft or cement fill for tibial bone defect of more than 1cm3 in total knee arthroplasty, between March, 1990 and July, 1994 at the department of Orthopedic Surgery in Hanyang University Hospital were followed for average 30 months. Bone grafts were performed in 33 knees and cement fills in 18 knees. The size of tibial defect was measured after removal of sclerotic and dense bone in the tibial plateau. The average size of tibial defect treated by bone graft was 4.9 cm3 in volume, 11 mm in height and the average size of tibial defects treated by cement fills was 1.5cm3 in volume, 6.8 mm in height. The results were as follows ; 1. In true A-P and lateral x-ray checked by fluoroscopic guide, trabecular union was seen in all 33 knees of bone grafts without collapse, loosening and bone resorption. In one of 18 knees of cement fill, radiolucent line was detected 2 mm in width between cement mantle and the adjacent tibial bone. In other 17 knees, radiolucent was seen 1 mm or less in width. 2. According to the system of Knee Society Score, average knee rating score was improved from 23.2 points preoperatively to 90 points postoperatively in bone graft cases, from 23.4 points preoperatively to 93.2 points postoperatively in cement fill cases. Average functional score was improved from 14.8 points preoperatively to 81.5 points postoperatively in bone graft cases, from 13.3 points preoperatively to 81.4 points postoperatively in cement fill cases. 3. Finally, we obtained the good results by cement fill during cement fixation of tibial component or bone graft without cement fixation of tibial component for small tibial bone defect and by bone graft for large tibial bone defect.
Arthroplasty, Replacement, Knee ; Bone Resorption ; Humans ; Knee ; Orthopedics ; Transplants

PURPOSE: The purpose of this study is to investigate the relative surgical risk and problems in hip hemiarthroplasty for treatment of an unstable intertrochanteric fracture in elderly patients over 80 years old. MATERIALS AND METHODS: Between April 2005 and May 2010, 58 patients whose age was over 80 years were available for inclusion in this study. They were divided into two groups: group 1 included 30 patients with femoral neck fracture and group 2 included 28 patients with intertrochanteric fracture. No significant differences in average age, concomitant disease, and walking ability before development of fracture were noted between the two groups. The following factors, including interval from development of fracture to operation, operation time, amount of blood loss, start time of walking after operation, duration of hospital stay, complications, revision rate, and walking ability were compared between the two groups. RESULTS: Operation time was an average of 85.2 minutes in group 1 and 97.5 minutes in group 2(P=0.03). The amount of bleeding was an average of 483 cc in group 1 and 695 cc in group 2(P=0.006). Similar results for walking start and recovery of walking ability after operation were observed in the two groups. No significant differences were observed in duration of hospital stay, complications, and revision rate. While 25 patients in group 1(83.3%) showed restoration of walking ability after operation to the same level of walking before injury, 19 patients in group 2(67.8%) showed restoration of walking ability postoperatively. CONCLUSION: Even though patients in group 2 showed a longer operation time and a higher amount of blood loss, compared with those in group 1, patients in group 2 had similar surgical risk and complications, compared with those in group 1. Therefore, primary hip hemiarthropalsty could be a good treatment option for intertrochanteric fracture in elderly.
Aged ; Femoral Neck Fractures ; Femur Neck ; Hemiarthroplasty ; Hemorrhage ; Hip ; Hip Fractures ; Humans ; Length of Stay ; Walking

We found an error in this article.

PURPOSE: We investigated the direct labeling method of antibody with 99mTc and 188Re and examined the stability and function of these labeled compounds in in vitro and in vivo. MATERIALS AND METHODS: Disulfide bond of nonspecific human IgG was reduced to -SH group by 2-mercaptoethanol. Stannous ion was used to reduce 99mTc and 188Re. The stability of 99mTc-IgG and 188Re-IgG was estimated upto 24 hrs. Biodistribution was evaluated in abscess bearing rats at 4 and 24 hr post-injection of 99mTc or 188Re labeled IgG. RESULTS: The number of -SH group per reduced IgG molecule was 2.34. The labeling yield of 99mTc-IgG and 188Re-IgG were 90% and 95%, respectively. The stability of 99mTc-IgG at 1, 4, 6 and 24 hr was 91%, 83%, 78%, 7% and that of 188Re-IgG, high uptake was found on kidney, blood, stomach and abscess (9.42+/-0.68, 1.43+/-0.24, 0.86+/-0.18, 0.72+/-0.10 %ID/g, respectively). The uptakes at 24 hr were kidney, abscess, stomach, and blood in descending order. In case of 188Re-IgG, high uptake at 4 hr post injection appeared on kidney, blood, abscess and stomach (3.92+/-0.62, 1.32+/-0.08, 0.88+/-0.01, 0.26+/-0.06, respectively). The upatkes at 24 hr were kidney, abscess, blood abd stomach in descending order. The abscess to blood uptake ratio of 99mTc-IgG was 0.5 at 4 hr and 2.02 at 24 hr and that of 188Re-IgG was 0.67 and 1.29. CONCLUSION: 99mTc-IgG and 188Re-IgG and 188Re-IgG canbe labeled efficiently with direct labeling method. However, 99mTc-IgG and 188Re-IgG, labeled with direct method, was unstable. Further study in needed to enhance the stability of the antibody labeling.
Abscess ; Animals ; Humans ; Immunoglobulin G ; Kidney ; Mercaptoethanol ; Rats ; Stomach

The need for a relaparotomy shortly after an initial abdominal operation indicates a serious complication and may frequently constitute a surgical failure. Many of the postoperative symptoms that might indicate the onset of complications may be masked by the usual postoperative course. Reported findings vary widely. Thus there is no clear picture for a surgeon to use as a guide. In an attempt to obtain more definite guidelines regarding the indications for and the timing of reintervention a retrospective study based on a 7-year survey was undertaken to assess the problem of reoperation after abdominal surgery. This study consisted of a retrospective clinical analysis made an 95 patients who required reoperation due to postoperative complications and planned stage operations during 7 years from January 1990 to December 1996. The number of reoperations was 95 cases (24%) among 3932 patients who had undergone abdominal operations at our department. The sex distribution for the reoperations was 58 males and 37 cases in females. The peak age incidence was the 6th decade in 25 cases(26.3%). The most common physical findings of the patient who required reoperations were abdominal pain and tenderness (56.8%). The main cause necessitating reoperation was intestinal obstruction (25.3%). The most common types of reoperations were common bile duct exploration with T-tube insertion(24.2%). The time interval between initial operation and reoperation was within 10 days in 10 cases (10.5%) and 25 months grouped in separate admission in 36 cases (37.9%). The most frequent complication was wound infection(15.8%) and the mortality rate was 4 cases (4.2%). Conservative treatment cannot be recommended for severe complications, such as postoperative bleeding or peritonitis, due to free anastomotic leakage. However, in doubtful cases, when there is mild peritonitis of an undetermined origin, ileus, well-controlled billiary or duodenal leaks, and the like, the high mortality associated with reintervention should be borne in mind. In these cases, conservative treatment with close supervision of the patient may prove the most prudent course.
Abdomen ; Abdominal Pain ; Anastomotic Leak ; Common Bile Duct ; Female ; Hemorrhage ; Humans ; Ileus ; Incidence ; Intestinal Obstruction ; Male ; Masks ; Mortality ; Organization and Administration ; Peritonitis ; Postoperative Complications ; Reoperation* ; Retrospective Studies ; Sex Distribution ; Wounds and Injuries

Identification of patients with combined valvular prolapse has important clinical imlications, because such patients appear to be early surgical candidates. Detection of combined valvular prolapse became more feasible with development of 2-dimentional echocardiography and the incidence of combained mitral and valve prolapse is reported to be variable from 3% to 24%. The authors found a case of combined mitral and aortic valve prolapse detected by 2-dimensional echocardiography. This 30-years-old male patient who admitted because of peptic ulcer bleeding revealed a prolapse of anterior mitral leaflet with regurgitation and also a prolapse of the right coronary cusp into the left ventricular outflow tract but without evidence of aortic regurgutation by Doppler echocardiogram. he discharged without surgical intervention and needs further observation.
Aortic Valve Prolapse* ; Aortic Valve* ; Echocardiography ; Hemorrhage ; Humans ; Incidence ; Male ; Mitral Valve ; Peptic Ulcer ; Prolapse

The optimal treatment of primary or metastatic liver cancer is the complete surgical excision of the tumors. Hepatoma has a poor prognosis, especially in the case of unresectable hepatoma. In such cases, variable therapeutic modalities have been tried in attempts to improve the prognosis of the hepatoma patients. One of these modalities is hepatic cryosurgery, which has received increased attention recently. We have experienced four cases of hepatic cryosurgery on unresectable hepatomas at the ChungAng University Hospital in Korea, the first such cases, from September 1995 to December 1995. There was an excellent therapeutic outcome in one case. We expect that hepatic cryosurgery will serve as a new and effective therapeutic modality for unresectable hepatoma.
Carcinoma, Hepatocellular ; Cryosurgery* ; Humans ; Korea ; Liver Neoplasms ; Prognosis

PURPOSE: Since children under two years with suspected urinary tract infections (UTIs) cannot control urination, urine cultures in such children are usually performed via urine bags. This method is noninvasive but has a high contamination rate. We studied the contamination rate of bag urine culture in diagnosing UTIs in infants under two years and the factors responsible for contamination. METHODS: We examined patients under 2 years in whom urine culture through the urine bag method yielded over 105 colonies of a single pathogen. We defined UTIs by referring to the guidelines of The Korean Society of Pediatric Nephrology, 2005. We examined the factors responsible for contamination according to sex, duration of urine collection, and whether diarrhea took place with contamination rate. RESULTS: We examined 717 patients (412 males and 305 females). The contamination rate of one bag urine culture was 37.9%. Gender was not related to the contamination rate (P>0.05). Duration of urine collection showed an association with the contamination rate. The longer the duration of collecting urine, the higher was the contamination rate. Duration of urine collection was divided into three groups: first group, <2 hours; second group, 2-4 hours; and third group, > or =4 hours. The contamination rates were 30.0%, 42.2%, and 43.7% for the first, second, and third groups, respectively, with statistical significance (P=0 .001). Diarrhea at admission had no impact on the contamination rate (P>0.05). CONCLUSION: The contamination rate of urine culture in the examined patients was 37.9%. Gender and diarrhea symptoms were not responsible for contamination. In infants with a suspected UTIs, urine should be collected within 2 hours through the urine bag method. If urine collection takes over 2 hours, the urine bag should be resterilized and reattached to the patient.
Child ; Diarrhea ; Humans ; Hypogonadism ; Infant ; Male ; Mitochondrial Diseases ; Nephrology ; Ophthalmoplegia ; Urinary Tract Infections ; Urination ; Urine Specimen Collection

In single atrial and ventricular cells isolated from the guinea-pig and the rabbit heart, action potentials and membrane currents were recorded by using the whole cell voltage clamp technique. In rabbit atrial cells the repolarization showed two distinctive phases, referred as the early and late phases(early and late plateau phase), but in guinea-pig atrial cells there was a maintained plateau and less distinctive two phases of repolartization. Increasing intracellular sodium or reducing external sodium by replacement with lithium suppressed the late phase of the action potential in rabbit atrial cells and shortened the plateau of action potential in rabbit ventricle and guinea-pig atrial cells. Reducing external sodium decreased Ca-current and late inward current in voltage clamp. Ouabain in the concentration of 10(-5)M shortened the duration of action potential and shifted the holding current level to outward direction, decreased Ca-current and moved late inward current to outward direction. Ryanodine 10(-6)M which is known to be an inhibitor of Ca-release in the intracellular store, suppressed the late phase of action potential in rabbit atrial cells and shortened the plateau of action potential in rabbit ventricular cells. Ryanodine also decreased Ca-current and shifted late inward current to outward direction. It is concluded that an inward current activated by intracellular calcium contributes to the late Phase of the action potential in rabbit atrial cells and to the late plateau in rabbit ventricular cells and in guinea-pig atrial cells. It may be carried by the Na-Ca exchange precess and/or by calcium-activated non-specific channels but preferably Na-Ca exchange machanism.
Action Potentials* ; Calcium ; Heart* ; Lithium ; Membranes* ; Myocytes, Cardiac ; Ouabain ; Ryanodine ; Sodium