We studied about 437 patients(620 hips) who were diagnosed osteoncrosis of the femoral head in Kyung Hee University Hospital during last 15 years and analysed the epidemiologic distribution and relation with other diseases. In 437 patietns, nontraumatic femoral head necrosis(NTFHN) were 340 patients(77.8%) and traumatic femoral head necrosis(TFHN) were 97 patients(22.2%). The male was more affected in ratio of 4:1, especially higher in NTFH about 4.6:1. The peak incidence of age distribution was 4th and 5th decades. The most frequent probable etiologic factors in NTFN was idiopathic(137 patients, 40.3%) and followed by alcoholic(124 patients, 36.5%), steroid induced(53 patients, 15.6%). The cases of bilateral involvement in NTFHN were 182 patient(53.5%). The steroid induced cases(69.8%) were higher than other cases in bilaterality. Liver disease was the most frequent associated disease and it was followed by diabetes mellitus and renal disease. In steroid induced cases, the underlying causes of its medication were nephrotic syndrome(12 patients), arthralgia(8 patients) and dermatologic diseases(7 patients), etc. The abnormal findings of selologic studies in NTFN were hyperlipidemia(28.1%), hyperuricemia (17.0%) and increased transmainase(18.5%) and there was contact relationship between hyperilipidemia and increased transmainase. Marked declination of Harris score was found between stage II and stage III in the course progression of NTFHN. The annual incidence of femoral head osteoncerosis increased gradually
Age Distribution ; Diabetes Mellitus ; Epidemiology ; Head ; Humans ; Hyperuricemia ; Incidence ; Liver Diseases ; Male ; Osteonecrosis

The early diagnosis of osteonecrosis of the femoral head is difficult because the radiologic change usually appears after some pregression of the disease process. The value of bone marrow pressure measurement for esily detection of the osteonecrosis has been studied by many authors. We measured bone marrow pressure in avascular femoral head and compared with patient's age, stage of osteonecrosis and radiological types. And also we measured bone marrow pressure in osteoarthritic hip. The results were following:l. In 95% of osteonecrosis of the femoral head, BMP is increased. 2. There is no correlative change between BMP and radiological stage. 3. In steroid induced osteonecrosis, BMP increase is predominent after provocative test. 4. Radiological type seems to influence more significant BMP change than radiological stage. 5. The diagnostic accuracy of the early stage of osteonecrosis of the femoral head is 97% in average. 6. Osteoarthritic hip also shows increased BMP. 7. Baseline pressure is highest in greater trochanteric area, but subchondral area shows most sensitive change. 8. The provocative pressure is lower than baseline pressure in the necrotic center of the head. The increase of the BMP of the femoral head osteonecrosis not specific butvery sensitive. But the measurement of BMP of the femoral head is very useful method for early detection of AVN of the femoral head.
Bone Marrow ; Early Diagnosis ; Femur ; Head ; Hip ; Methods ; Osteonecrosis

A review of sixteen cases of the modified Bristow operation for recurrent anterior dislocation of the shoulder from Feb. 1987 to Feb. 1989 was presented and the following results were obtained. 1. The age of initial dislocation varied from 12 years to 27 years of age with the average of 17.3 years. 2. The age at operation varied from 21 years to 30 years of age with the average of 23.3 years. 3. The times of dislocation vaaried form 7 to 40 times with the average 23.8 times. 4. The average loss of abduction and external rotation were 5.9 and 12.5 degree respectively. 5. The complications and recurrence were not observed in this period
Dislocations ; Recurrence ; Shoulder

No abstract available.
Arthroplasty, Replacement, Hip*

The authors report a case of multiple spinal metastasis from a meningeal hemangiopericytoma. A 35-year-old man who had undergone radical resection of temporal hemangiopericytoma presented with a two-month history of worsening low back pain and severe radiating pain on the left leg. Radiologic examination demonstrated a tumor involving body, pedicle and facet joint on the left side of L4 compressing dural sac with large paraspinal extension. Also there was a small tumor on left side pedicle and posterior body of T10. Satisfactory results were obtained after gross total resection of tumors on both regions with posterior lumbar instrumented fusion. Unlike a well differentiated tumor on temporal lesion, the metastatic spinal lesions were anaplastic histologically. Multiple spinal metastasis should be considered after surgical treatment of cranial hemangiopericytoma.
Adult ; Hemangiopericytoma* ; Humans ; Leg ; Low Back Pain ; Neoplasm Metastasis* ; Zygapophyseal Joint

PURPOSE: To analyze the general characteristics of isolated SLAP (superior labrum anterior to posterior) lesions of shoulder and to evaluate efficacy of arthroscopic treatment. MATERIALS AND METHODS: We retrospectively reviewed 43 athletic patients with 46 isolated SLAP lesions. The mean follow-up period was 21 months, and mean patient age was 25 years. Twenty seven patients presented with injury to the dominant shoulder, and 3 had bilateral involvement. RESULTS: Pain and clicking were the most common symptoms. The mechanism of injury was assumed to be chafing in 27 cases, compression in 9 cases. Type 2 lesion was commonest (30 cases). The single most sensitive test was the compression-rotation test, which was positive in 92% of patients. The average UCLA score at the last follow-up was 31.6 points; 18 cases ranked as excellent and 21 as good.Postoperative performance data was obtained for in 27 athletes, 19 were able to return to their sports. CONCLUSION: Arthroscopic surgery for an isolated SLAP lesion resulted in 85% of patients being rated good or above, and 70% of athletic patients were able to resume sporting activity.
Arthroscopy ; Athletes ; Follow-Up Studies ; Humans ; Retrospective Studies ; Shoulder* ; Sports

We report upon our experiences of 4 cases of reconstruction using the palmaris longus tendon for medial instability of the elbow joint. All patients were male and preoperatively the average age was 22 (19-25) years old; the average follow up period was 21 (17-28) months. Three patients were pitchers who had pain and instability during the late cocking and acceleration phase. One patient had been hit directly on the medial side of the elbow and experienced instability during normal activities. The provocation test for medial instability of the elbow was positive in all patients, and magnetic resonance imaging showed complete disruption of the ulnar collateral ligament. The three baseball pitchers could throw well without symptoms at the last follow up. One patient was comfortable during the normal and sports-related activities. No ulnar nerve symptom was evident in any patient postoperatively. The results of reconstructive surgery for medial instability of the elbow were excellent or good. The surgical approach between the palmaris longus and the flexor carpi ulnaris muscles provided a good operative field without damage of the common flexor group. In the absence of a history of ulnar neuropathy preoperatively, it was found not to be necessary to transport the ulnar nerve anteriorly.
Acceleration ; Baseball ; Collateral Ligaments ; Elbow Joint* ; Elbow* ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Muscles ; Tendons* ; Ulnar Nerve ; Ulnar Neuropathies

BACKGROUND: Isolated heterotopic gastric mucosa of the upper esophagus(HGME), often referred to as inlet patch, is an asyptomatic benign lesion. It may, however, cause retrosternal chest pain and dysphagea, and rarely produce complications such as ulceration and stricture. It may be suspected on characteristic finding of endoscopy, and the diagnosis is usually proved by biposy. We studied several characteristics of HGME. METHOD: From January 1996 to May 1997, endoscopy was performed on 2000 consecutive patients (1068 male, 932 female). HGME was seen 25 patients(12 male, 13 female) among 2000 patients. RESULT: Prevalence of HGME is 1.25%. There was no significant difference of the prevalence of HGME between male and female. HGME was presented as a velvety and salmon-pink patch with a distict border from the normally pale squamous cell mucosa of the esophagus, and was seen as multiple lesions in 8 patients among 25 patients. Thirty three locailzed gastric mucosal patches, varying in size 3 mm to 30 mm in the longest diameter, were detected within or just below of upper esophageal spincter in all the twenty five patients. Biopsy specimens taken from the miucosal patches demonstrated gastric mucosa. Among 25 patients with HGME, four patients complained foreign body sensation on throat or heartburn, without other diseases such as GERD, gastritis or peptic ulcer. CONCLUSION: Further studies of a large scale about pathogenesis, prevalence, and complication of HGME will be required.
Bays ; Biopsy ; Chest Pain ; Constriction, Pathologic ; Diagnosis ; Endoscopy ; Esophagus* ; Female ; Foreign Bodies ; Gastric Mucosa* ; Gastritis ; Gastroesophageal Reflux ; Heartburn ; Humans ; Male ; Mucous Membrane ; Peptic Ulcer ; Pharynx ; Prevalence ; Sensation ; Ulcer

BACKGROUND AND OBJECTIVES: We evaluated which plaque components are associated with long-term clinical events in patients who underwent primary percutaneous coronary intervention (PCI). SUBJECTS AND METHODS: The study subjects consisted of 57 consecutive patients (mean age, 58.5+/-14.5 years; 45 males) who underwent primary PCI and a virtual histology-intravascular ultrasound examination. Major adverse cardiac events (MACEs) including death, acute myocardial infarction, stroke, and revascularization were evaluated during the mean 28 month follow-up period. RESULTS: Patients with high fibro-fatty volume (FFV >13.4 mm3, n=29; mean age, 61.3 years) had a lower ejection fraction (52.7% vs. 59.4%, p=0.022), a higher incidence of multi-vessel disease (69.0% vs. 28.6%, p=0.002), larger plaque area (25.7 mm2 vs. 15.9 mm2, p<0.001), and larger plaque volume (315 mm3 vs. 142 mm3, p<0.001) than those with a low FFV (< or =13.4 mm3, n=28; mean age, 55.6 years). Patients with high FFV had a significantly higher incidence (32.1% vs. 8.3%, p=0.036) of MACE than those with low FFV. When we divided the study population according to the necrotic core volume (NCV), fibrous volume, or dense calcified volume, no significant findings in terms of demographics and MACE rates were observed. A Cox regression analysis revealed that the independent factor for MACE was FFV (hazard ratio, 6.748; 95% confidence interval, 1.168-38.971, p=0.033) in this study population. CONCLUSION: The coronary plaque component, particularly FFV, but not NCV, was important in long-term clinical outcomes in patients who underwent primary PCI.
Demography ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Stroke ; Ultrasonography, Interventional

Vertebral artery injury is a rare complication of anterior cervical approach. We report two patients who suffered injury to vertebral artery during anterior cervical spine surgery. The mechanism of injury, their operative management, and the subsequent outcome were assessed and relevant literatures reviewed. The awareness of the possibility of vertebral artery injury is most important to prevent and it's occurrence is best avoided by a thorough understanding of the anatomical relationships of the artery, the spinal canal, and the vertebral body and careful use of surgical instruments.
Arteries ; Humans ; Spinal Canal ; Spine* ; Surgical Instruments ; Vertebral Artery*