Average anteversion of the femur is 15.3 degree. Ultrasound, computerized tomogram, and three dimensional reconstruction from CT or MRI have been used for more accurate measurement of the anteversion. There are two methods in measuing anteversion angle from CT scan:one is by drawing a mid line through long axis of the femoral neck (conventional method). Another is by drawing a line from the center of the head to that of the neck at the base of the trochanter using several cut slices (Murphy’s method). We compared these methods with fluoroscopic measurement of the Anteversion. We traced the change of the anteversion before and after closed femoral intramedullary (IMO) nailing to evaluate the origin of malrotation of the femur. 1. Normal anteversion angles were measured in 15 cases. Average anteversion angle was 6.9 degrees by conventional method, 12.3 degrees by Murphy’s method, and 12.2 degrees by fluoroscope. 2. Anteversion angles were measured after IM nailing in 18 cases. Average was 17 degrees by Murphy’s method and 15.2 degrees by fluoroscope. Mean of difference between these two methods sea 6.3 degrees. That was 1.7 degrees in normal side. 3. Change of the anteversion angle between before and after IM nailing was measured in 17 cases by fluoroscope. Average anteversion angle before the operation was 11.9 degrees and it was change to 15.8 degrees after operation. Mean of these change was 7.1 degrees. 4. Pereperative traction provides important information on change of anteversion. Reduction excessive flexion of proximal fragment was a origin of change of anteversion during nailing procedure. Conclusion : Malrotation of the femur after IM nailing must be keep in mind and it may be preventable by fluoroscopic control of the rotation in nailing procedure.
Femur ; Femur Neck ; Fracture Fixation, Intramedullary ; Head ; Magnetic Resonance Imaging ; Methods ; Neck ; Traction ; Ultrasonography

PURPOSE:Ghrelin is an endogenous ligand of the growth hormone secretagogue receptor, and stomach is the major site of ghrelin secretion. The purpose of this study is to compare the serum ghrelin concentrations between patients with type 2 diabetes mellitus (DM) and normal adults. We studied also whether serum ghrelin levels in the patients with type 2 DM are correlated with body mass index (BMI), serum insulin, lipid profiles, and creatinine levels. METHODS:Forty patients with type 2 DM and forty normal adults were included in this study. We measured heights and weights of the subjects and calculated their BMIs. Blood samples were obtained to measure the ghrelin concentration and their sera were stored at -20degreeC until used. In all subjects, serum ghrelin levels were measured using the commercially available Ghrelin(human) EIA kit. RESULTS:No differences of mean values were detected between the control group and the type 2 diabetic group for age, body weight, BMI, and the levels of serum total cholesterol, triglyceride, HDL cholesterol, and creatinine. But ghrelin level of the type 2 diabetic group (71.1+/-30.5 ng/L) was significantly lower than the control group (139.7+/-36.9 ng/L). In the control group, the ghrelin level showed positive correlation with HDL cholesterol (Pearson's correlation coefficient=0.37, P<0.05). In the diabetic group, the ghrelin level showed weakly positive correlation with insulin concentration. However, there was no significant relationship between serum ghrelin and various parameters in the diabetic patients group. CONCLUSION: In this study, ghrelin concentration in type 2 diabetic patients was lower than that in the control group. In the control group, serum ghrelin concentrations were positively correlated with HDL cholesterol. In the type 2 diabetic group, there was no significant correlation between insulin and ghrelin concentrations.
Adult ; Body Mass Index ; Body Weight ; Cholesterol ; Cholesterol, HDL ; Creatinine ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Ghrelin* ; Humans ; Insulin ; Receptors, Ghrelin ; Stomach ; Triglycerides ; Weights and Measures

No abstract available.
Female ; Ovary*

Severely comminuted tibial condylar fracture is a major threat to the structures and function of the knee joint. Recently, anterior approach with Z-tenotomy of the patellar tendon was introduced for these complicated fractures. It provides wide exposure of the tibial articular surface for maximum joint reconstruction. The purpose of this study was to describe the operative technique and to evaluate the clinical results of this method. We had performed operative treatment in 13 cases (12 patients) of severely comminuted Schatzkers type II, V, and VI tibial condylar fractures through anterior approach from December 1993 to April 1996. Twelve cases out of 13 (92%) showed acceptable results according to Blokkers criteria. There was no superficial or deep infection. On the basis of these results, we suggest that the anterior approach is a valuable aid in the operative treatment of severely comminuted tibial condylar fractures.
Joints ; Knee Joint ; Patella* ; Patellar Ligament* ; Tenotomy* ; Tibia

No abstract available.
Anesthesia, Spinal* ; Arthroplasty*

Twenty-seven consecutive patients who had post-traumatic stiffness of the elbow were treated by operative soft tissue release or by soft tissue release and distraction arthroplasty. The purpose of this study was to describe the method of operation and postoperative management and to evaluate the results in the patients who had operative treatment for the post-traumatic stiffness of the elbow. The type of operative procedure was determined by whether the factors limiting motion were extra-articular (extrinsic) or intra-articular (intrinsic) and by pre-operative radiographic evaluation. The soft tissue release was performed by staged adhesiolysis through lateral or combined lateral and medial approaches. And if the factors limiting motion included a severe intraarticular lesions, distraction arthroplasty using the Judet or Oganesian apparatus was added to soft tissue release. The mean pre-operative arc of active motion was 42 degrees. At follow-up examination, nineteen to sixty-six months postoperatively, the mean post-operative arc of active motion was 103 degrees. There were nine complications (33 percent) in twenty-seven patients. All of them was transient ulnar nerve paresthesia. And we analysed the final results with Mayo elbow performance index for the evaluation of clinical outcome. Twenty-five (93%) of twenty-seven patients had satisfactory result according to Mayo elbow performance index. We conclude arthrolysis with or without distraction arthroplasty is useful for the treatment of posttraumatic elbow stiffness. However, the accurate anatomical knowledge, operative skill, and careful postoperative rehabilitation program were needed in the operative treatment of post-traumatic elbow stiffness.
Arthroplasty ; Elbow* ; Follow-Up Studies ; Humans ; Paresthesia ; Rehabilitation ; Surgical Procedures, Operative ; Ulnar Nerve

The main trend moves towards early excision and skin grafting as treatment for the deep second degree burns and the third degree burns. The ability to excision & skin grafting. This study prospectively evaluated the ability of laser doppler flow measurements obtained within 72 hours after burn injury to predict the depth of burn wounds. A Periflux system 4001 laser doppler flowmetry had been used to measure cutaneous microflow circulation of 100 selected points of burn wounds in 44 admitted patients from March 1993 to February 1994. The mean value of superficial second degree burn checked by laser doppler was 194.6 perfusion unit(PU). The deep second degree burn was 59.7 PU and third degree burn was 5.1 PU. The blood flow of more than 100 PU reliably predicted the superficial second degree burn with 90.2 percents accuracy. The blood flow between 100 PU and 10 PU predict the deep second degree dermal burn with 96.2 percents accuracy. That of less than 10 PU predict the third degree burn with 100 percents accuracy. There was also a significant correlation between initial flow measurements and the depth of burn wounds. We conclude that laser doppler flow measurements performed early after burn injury are useful in predicting the depth of burn wounds. The laser doppler flowmetry has the advantage of being easy to use, noninvasive, provide immediate result for early determination of burn depth. The laser doppler flowmetry is useful in selecting patients for early excision and grafting of burn wounds.
Burns* ; Humans ; Laser-Doppler Flowmetry* ; Perfusion ; Prospective Studies ; Skin Transplantation ; Transplants ; Wounds and Injuries

BACKGROUND: Residual and recurrent bile duct stones after biliary surgery cause many difficult problems. and reoperation on biliary tract has limitation due to its high morbidity and mortality. In recent years, various non-operative modalities for management in residual and recurrent stone have been developed. METHODS: We analyzed 69 cases of residual and recurrent bile duct stones which were managed with non-operative modalities at the Department of surgery, Dae Dong Hospital from Jan. 1994 to Dec. 1997, and evaluated the efficacy of these modalities. RESULTS: Female exceeded male with a ratio 1.76:1. and the peak incidence of age group was 6th decade. The most common diagnostic procedure was T-tube cholangiography (53.6%). Interval between previous operation and second procedure for residual or recurrent stones was within 6 months in most cases (82%). Cholecystectomy with T-tube choledochostomy was performed most frequently in previous operation. Residual and recurrent stones were found only at common bile duct in 34 cases (49.3%) most commonly. Common bile duct stones were managed most frequently with endoscopic sphincterotomy (39.5%), but the complete removal rate was heighest in choledochoscopic stone removal (100%). Complete removal rate of intrahepatic duct stone was heighest with interventional radiologic stone removal as well as choledochoscopic stone removal (43.6%), but average number of session was smaller in choledochoscopic stone removal (2.5) than interventional radiologic stone removal (3.5). Associated complication with non-operative management modalities were very low, except three cases of hepaticocutaneous jejunostomy. The latter required reoperation due to continuous bile fistula in two cases, and long jejunal loop in one case. CONCLUSIONS: Choledochoscopic stone removal is most effective method in the management of residual and recurrent bile duct stones.
Bile Ducts* ; Bile* ; Biliary Tract ; Cholangiography ; Cholecystectomy ; Choledochostomy ; Common Bile Duct ; Female ; Fistula ; Humans ; Incidence ; Jejunostomy ; Male ; Methods ; Mortality ; Reoperation ; Sphincterotomy, Endoscopic

The complications of pancreatitis, such as pseudocyst or abscesses, are well known to radiologists. Yet formation of a pseudoaneurysm of the short gastric artery is an uncommon complication of acute pancreatitis. It is also very rare for a psuedoaneurysm of the short gastric artery to cause splenic vein occlusion and the final result is gastric varices. We report here on a case that showed the dramatic effect of embolotherapy for a pseudoaneurysm of the short gastric artery that caused gastric variceal bleeding.
Abscess ; Aneurysm, False ; Arteries ; Embolization, Therapeutic ; Esophageal and Gastric Varices ; Hemorrhage ; Pancreatitis ; Splenic Vein

No abstract available.
Magnetic Resonance Imaging* ; Myelography*