The diagnosis and treatment of avascular necrosis of femoral head advanced, after Freud issued examples of bilateral avascular necrosis of femoral head (AVN) in 1926. But still not fixed in treatment and diagnosis. Recently early diagnosis and treatment produced good result. Whole body bone scan, intraosseous pressure mornitoring, intramedullary venography, C-T, or MRI, Selective femoral angiography also used in early diagnosis. Selective femoral angiography was performed for 56 patients, who has suspected as AVN by sumple X-ray and WBBS in order to estimate. How the femoral angiographic finding exist in AVN. In the control group femoral angiography performed to 5 person with normal stage of clinical and radiologic finding. So the result are as following l. All cases in the control group were not observed terminal branch of superior and inferior capslar branch. 2. In AVN the alteration of vasculature appeared 22 patients among 56 patient. 3. The altered vasculature presented 87.5% in traumatic group and 31.5% in nontraumatic group. 4. Collateral circulation was 22.2% in the cases of patients under 6 moths of the time interual between etiological events and clinical symptoms, 89.5% over 6 months. 5. Collateral circulation received 86.8% from inferior gluteal artery two cases from superior gluteal artery, and three cases form obturator artery. 6. Clinical tolerance was supposed to in well developed collateral circulation. According to the above results, Vascular alteraion were noted very much in traumatic group and development of collateral circulation were related promote clinical tolerance. Selective femoral angiography was not effective to assist early diagnosis and treatment of AVN for it could not detect terminal branch of superior and inferior capsular artery that reflected intraossous vasculsture. We need the new nethod of angoigraphy in order to early diagnosis.
Angiography ; Arteries ; Collateral Circulation ; Diagnosis ; Early Diagnosis ; Head ; Hip ; Humans ; Magnetic Resonance Imaging ; Moths ; Necrosis ; Phlebography

Primary hemangiopericytoma of chest wall is very rate and only a few cases have ever been reported. The tumor aries from the capillary pericyte of Zimmerman. It is a highly vascular slow growing tumor which can be calssified as both malignant and benign varieties. We report a case of a 66 year-old man in whom recurrent hemangiopericytoma was treated by complete surgical excision. In October 1993 he had received surgical excision of hemangiopericytoma on posterior chest wall. For more than 6 years after the operation he was in good condition until a recurrent mass was found on the chest X-ray. The patient was discharged 9 days after the operation and is receiving radiotherapy.
Aged ; Capillaries ; Hemangiopericytoma* ; Humans ; Pericytes ; Radiotherapy ; Thoracic Wall* ; Thorax*

No abstract available.
Acute Kidney Injury* ; Lymphoma*

It is the purpose of this study to determine the benificial effect of treatment with methylprednisolone on the enhancement of Na+, K+-ATPase activity and the increased ATP level during the 4 hours after a 400gm-cm injury to the spinal cord of cat. These results demonstrate that high dose (30mg/kg) of methylprednisolone can benificially enhance the activity of neuronal Na+, K+-ATPase during the first 4 hour after spinal cord injury. But the enhancement of this enzyme activity is not significantly increased with mega dose (60mg/kg) of methylprednisolone. Tissue level of ATP in the high dose-treated cat at 1 hour after trauma was significantly elevated, but those in high dose-treated cat at 4 hour and the 1 and 4 hours with mega dose-treated groups were not significantly increased. The protective effects of methylprednisolone in experimental spinal cord trauma are the enhancement of Na+, K+-ATPase, inhibition of the free-radical reaction and the lipid peroxidation, the increment of neuronal activity and ATP utilization. High dose(30mg/kg) of methylprednisolone is required in order to produce the acute effect in the early phase experimental spinal cord injury.
Adenosine Triphosphate ; Animals ; Cats ; Lipid Peroxidation ; Methylprednisolone* ; Neurons ; Spinal Cord Injuries* ; Spinal Cord*

PURPOSE: We report clinical and radiologic outcomes after metacarpal extension osteotomy for mild osteoarthritis of the thumb carpometacarpal joint. MATERIALS AND METHODS: From 1999 to 2008, 11 patients were diagnosed with mild thumb carpometacarpal arthritis (Eaton stage I, II), and extension osteotomies were performed. Of these, seven patients with at least 6 years follow-up were analyzed retrospectively. Male to female ratio was 2:5, and mean age at time of surgery was 38.9 years old. Symptom onset period was a mean of 11.2 months. Two patients were I, and five patients were II in Eaton stage. Preoperative visual analogue scale (VAS) and disabilities of the arm, shoulder and hand scale (DASH) scores were 3.7 points (3-4 points), and 40.1 points (32-51 points). Radial abduction was 38.5degrees (30degrees-45degrees), and volar abduction was 42.1degrees (40degrees-45degrees). Grip strengths and pinch powers, compared with the normal contralateral side were 82% (64%-90%) and 72% (40%-100%), respectively. RESULTS: The mean follow-up period was 8.5 years, and all patients except one maintained their occupational activity during the follow-up period. Final VAS and DASH scores were 0.7 points (0-2 points) and 11.7 points (8-16 points), respectively, and were statistically significant. Volar abduction, grip strengths, and pinch power were improved to 45degrees (40degrees-50degrees), 92.3% (73%-117%), and 94.4% (75%-117%) with statistical significances. In five patients, Eaton stages did not change, and two patients advanced to the next stage (stage I to II in one patient, stage II to III in one patient). CONCLUSION: Among the various treatment options for mild thumb carpometacarpal arthritis, metacarpal extension osteotomy may be considered as an effective treatment.
Arm ; Arthritis* ; Carpometacarpal Joints ; Female ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Male ; Osteoarthritis ; Osteotomy* ; Retrospective Studies* ; Shoulder ; Thumb*

Cubitus varus deformity is the late complication of the supracondylar fracture of humerus which is common in growing children. If the deformity is severe it causes tunctional problems as well as cosmetic ones necessitating conective osteotomy. Though many authors devised different methods of corrective osteotomy, the cosmetic results are not always satisfactory because of the development of the lazy S deformity hy the lateral prominence. Technically. the initial stahility of the osteotomy is also poor due to the poor contact of the osteotomy site. So we have devised a new quadrilateral displacement osteotomy to increase the initial stability of the osteotomy by creating a wedge on the osteotomy site & also to prevent the development of the lazy S deformity hy elimination of the Interal prominence. We treated 9 cases of cubitus varus deformity with the new quadrilateral displacement osteotomy. The correction technique was not difficult & the initial stahility of the osteotomy is rather good & the osteotomy is fixed by the conventional methods, & all of the cases were healed uneventfully. There developed no the lazy & deformity after osteotomy. We would like to report the details ot the supracondylnrquadrilateral displacemenl osteotomy.
Child ; Congenital Abnormalities* ; Humans ; Humerus ; Osteotomy*

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

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

Sixteen patients who had radial head fractures were treated with open reduction and internal fixation using Herbert screws (10 patients), and with silastic prosthetic replacement (6 patients) from March, 1992 to December, 1994 in Chungnam National University hospital. The average duration of follow up was 19.5 months. The purpose of this study is to examine the role of Herbert screw fixation and silicone replacement arthroplasty and to asscess the clinical results of two groups functionally, radiologically in raidial head fractures. By functional rating index (modified After B.F. Morrey et al), the results were classified as excellent (9 patients), good (6 patients), fair (No patient) and poor (1 patient). Nine of the ten patients treated by open reduction and internal fixation using Herbert screws had resulted in excellent or good. All patients were inserted silastic implants were showed excellent or good results. Especially, in Mason Type III radial head fractures, three of four patients treated by Herbert screws and all 5 patients treated by silastic prosthesis were considered to excellent or good results. We concluded that Herbert screw fixation or silastic prosthetic replacement had satisfactorily appeared to be the alternative treatment option for Mason Type III radial head fractures.
Arthroplasty, Replacement ; Chungcheongnam-do ; Follow-Up Studies ; Head* ; Humans ; Prostheses and Implants ; Silicones

The Clufoot is still controversial in the etiology, the pathology, and the method of the treatment. Turco issued one stage posteromedial soft tissue release in 1971, which is still widely used. But the Turco's procedure is not satisfactory results in forefoot adduction and ankle motion. McKay and Simon were performed one stage complete subtalar soft tissue release and reported better results compared with those who had posteromedial release. So we performed Turco's posteromedial release with lateral release by Cincinnati incision in 12 patients (20 feet) and analysis the results from Oct. 1987 to Jul. 1989 at the department of orthopaedic surgery of CNUH. The results were as followings ; 1. The mean age of the patient at first examination was 1 year 9 months (range from at birth to 5 year 10 months) and the mean age at operation was 2 year 1 month (range from 4 months to 5 year 10 months). 2. The clinical results were excellent in 2 feet, good in 14 feet, fair in 3 feet and unsatisfactory in 1 foot. 3. The radiological results were satisfactory in 18 feet and unsatisfactory in 2 feet. 4. Forefoot adduction was corrected in 14 feet (70%) as normal range, 3 feet as acceptable, and 3 feet as unacceptable 10' over the normal range. 5. Two feet of hind foot overcorrection result was operation as McKay's method. 6. The Clincinnati incision was favorable to visulization and release of the posteromedial, anteromedial and posterolateral structure of the foot.
Ankle ; Clubfoot ; Foot ; Humans ; Methods ; Parturition ; Pathology ; Reference Values