Fifty four consecutive total knee arthroplasties were reviewed to compare the accuracy of extramedullary versus intramedullary tibial resection guides. An extramedullary guide ( Group I ) was used in 25 cases and an intramedullary guide ( Group 2 ) was used in 29 cases. Group 1 system included the LCS knee system and Group 2 system included the Whiteside Ortholoc Advantim total condylar knee system. Preoperatively, the two groups were similar, with no statistical significant differences observed in diagnosis, alignment, and patient age. Postoperative tibial component alignment angles were similar in both group (Group 1, 0.8degrees varus; Group 2, 1.1degrees varus ). In group 1, 84% of tibial components were aligned within 2degrees of the 90degrees goal and in group 2, 83% of tibial components were aligned within the same range ( p > 0.05 ). In all cases, an intramedullary guide was used to prepare the distal femur. In femorotibial angles, with group 1 averaging 4.2degrees valgus versus 4.7degrees valgus in group 2 (p > 0.05). If the optimal femorotibial angle was defined by the range from 5+/-2, it was achieved in 76% in Group 1 and 72% in Group 2 ( p > 0.05 ). This study demonstrates no significant differences between the extramedullary and intramedullary group not only in optimal tibial component alignment angle but also in optimal femorotibial angle. This means that each system is satisfactory for the tibial side, but it is more important for the surgeon to appreciate that the indications, potential limitations and sources of errors are unique to each system and to decide which system to use according to the particular case in question.
Arthroplasty* ; Diagnosis ; Femur ; Humans ; Knee*

BACKGROUND: The elderly is known to have many different clinical laboratory data compared with the young adults. But, in Korea, such study is lacking. METHODS: We gathered 98 healthy elderly cases and 98 healthy young adult controls who have taken periodic health examination from January 1993 to May 1996 at one hospital and we compared the mean of various clinical laboratory data between the two groups. RESULTS: In both sexes, cholesterol, ESR, glucose were significantly higher in the elderly t,han in the controls and direct bilirubin was significantly lower in the elderly than in the controls(P<0.05). In men, albumin, calcium, hemoglobin were significantly lower in the elderly than in the controls and MCV was significantly higher in the elderly than in the controls(P<0.05). In women, alkaline phosphatase, LDH, triglyceride, GOT, GPT, T3,TSH, phosphate were significantly higher in the elderly than in the controls and total bilirubin, protein, uric acid were significantly lower in the elderly than in the controls(P<0.05). WBC count, platelet count, neutrophil count(%), lymphocyte count(%), eosinophil count (%), monocyte count(%), MCH, MCHC, BUN, creatinine, HDL were not significantly different between two groups. CONCLUSIONS: Many clinical laboratory data are different between the elderly and the young adults, and some clinical laboratory data have sexual differences.
Aged* ; Alkaline Phosphatase ; Bilirubin ; Calcium ; Cholesterol ; Creatinine ; Eosinophils ; Female ; Glucose ; Humans ; Korea ; Lymphocytes ; Male ; Monocytes ; Neutrophils ; Platelet Count ; Triglycerides ; Uric Acid ; Young Adult*

The primitive erythroblasts in 21 cases of embryonic hearts from 4 to 9 weeks of gestation were studied with a light microscope. The nuclear diameter, the motosis, and the loss of nuclei of the primitive erythoblasts were analyzed quantitatively. The results obtained were as follows. 1. At 4 weeks of gestation, the blood cells consisted of proerythroblasts, along with basophilic polychromatophilic primitive erythroblasts. The nuclear diameter ranged from 3.20 µm to 9.20 µm, but the main range was from 4.20 µm to 6.00 µm. It was revealed that 9.50% had diameter of more than 6 µm. 2. At the fist half of the 7 week gestation when hepatic hemopoiesis developed, the blood cells consisted of basophilic, polychromatophilic, and eosinophilic erythroblasts. Cells of more than 6 µm in nuclear diameter were about 1.10% and thereafter gradually disappeared. The range of the nuclear diameters was from 2.60 µm to 7.00 µm, while a range from 3.40 µm to 5.20 µm wqs the main. The proportion of cells less than 4 µm in nuclear diameter was 39.58% and thereafter rapidly increased. 3. From the second half of 7 weeks to 9 weeks of gestation, the erythrocytes originating from hepatic hemopoiesis increasingly replaced the circulating primitive erythroblasts, which became mature during this time. The erythrocytes showed 72.88% at 9 weeks of gestation. The proportions of cells less than 4 µm in nuclear diameter in the first and second haIves of 8 weeks and 9 weeks were 52.73%, 80.02%, and 89.09%, which represented the rapid destruction of nuclei. 4. Mitosis in the primitive erythroblasts occurred principally up to the early 6th weeks, and very weakly at 8 weeks. 5. As the crown-rump length increased, the average nuclear diameter decreased very significantly (P<0.01, y=-0.2811X + 0.3171). The results suggest that distrilbution of the nuclear diameter, the maturity, the rate of nuclear loss, and the mitotic figure offer credible data for estimating embryonic age.
Basophils ; Blood Cells ; Crown-Rump Length ; Embryonic Structures* ; Eosinophils ; Erythroblasts* ; Erythrocytes ; Heart ; Humans* ; Mitosis ; Pregnancy

The stature, span, lower limb length, sitting height, head length and head breadth of 411 Korean elementary school girls ranging from 7 to 10 years of age were measured biometrically and the indices among all of the items were calculated to investigate the physical growth status. The following conclusion have been obtained. 1. The average statures were 117.40cm in 7, 122.72cm in 8, 126.76cm in 9 and 132.92cm in 10 years of age groups, and the annual average stature growth was 5.17cm. 2. The average spans were 113.12cm in 7, 118.70cm in 8, 124.26cm in 9, 130.46cm in 10 years of age groups, and the annual average span growth was 5.78cm. 3. The average lower limb lengths were 62.96cm in 7, 66.80cm in 8, 69.09cm in 9 and 73.13cm in 10 years of age groups, and the annual average lower length growth was 3.39cm 4. The average sitting heights were 65.82cm in 7, 68.56cm in 8, 70.18cm in 9 and 73.13cm in 10 years of age groups, and the annual average sitting height growth was 2.43cm. 5. The average body weights were 21.22kg in 7, 24.13kg in 8, 25.54kg in 9 and 29.27kg in 10 years of age groups, and the annual average body weight growth was 2.68kg. 6. The average head lengths were 16.29cm in 7, 16.38cm in 8, 16.47cm in 9 and 16.60cm in 10 yeras of age groups, and the annual average head length growth was 0.10cm. 7. The average head breadth were 14.50cm in 7, 14.65cm in 8, 14.67cm in 9 and 14.81cm in 10 years of age groups, and the annual average head breadth growth was 0.10cm. 8. While both relative span and lower limb length increased with age and the relative sitting height slightly decreased with age. 9. The relative body weight increased with age. 10. The head type depended on cephalic index was belonged to hyperbrachycephaly, and showed no differrences with age in all of the groups. 11. The relative span was over 96 in all age groups, and the value increased slightly with age. 12. The average annual growth showed remarkable high value between 9 to 10 years of age in the items of stature, span, lower limb length, sitting height and body weight.
Body Weight ; Female* ; Head ; Humans ; Lower Extremity

No abstract available.
Animals ; Cerebral Cortex* ; Glutamic Acid* ; Glycine* ; Kynurenic Acid* ; Perfusion* ; Rats*

Giant cell tumor is an uncommon primary bone tumor of young adults with the highest incidence in patients 20 to 40 years of age. These tumors are most frequently found in the metaphyseal-epiphyseal region of the long bones, especially around the knee joint and the distal end of the radius. So the normal life expectancy and an active life style of the patient necessitate a reliable and durable surgical remedy for eradicating the tumor and preserving joint function. Furthermore, these have an unpredictable clinical behavior. Although almost always benign, these tumors are locally agressive and tend to have a high rate of rerurrence, and malignant transfomation is well known to be 6 15%. Thus the lesions produce a practically difficult therapeutic problem for the orthopaedic surgeon, and a satisfactory method of treatment has not yet been found. Clinical observations were carried out on 33 cases of giant cell tumor of bone in the Department of Orthopaedic Surgery, Yonsei University College of Medicine from May 1975 through May 1985, and the following results were obtained. 1. The highest incidence, 23 cases (70%), accurred in the 21 40 year old age group, and the sex distribution was 18 males and 15 females. 2. The most frequent locations were the distal feuiur, proximal tibia and distal radius. Twenty four cases(73%) occurred around the knee joint. 3. The pathologic grading according to Jaffes criteria showed 10 cases(30.3%) in grade I, 20 cases (60.6%) in grade II and 3 cases(9.1%) in grade III. 4. As the primary treatment modality, currettage and bone graft were performed in 9 cases, currettage and bone cementing in 9 cases, amputation or disarticulation in 7 cases, enbloc excision with or without other procedures in 6 cases and currettage and radiotherpy in 2 cases. 5. Eight cases(24.2%) recurred after primary treatment and 6 cases of the 8 recurrences appeared within 2 years after primary treatment. 6. Four of the 9 tumors treated by currettage and bone graft recurred, as did two of the 9 tumors treated by currettage and bone cementing. No recurrence occurred in the 7 tumors treated by amputation or disarticulation. 7. As the secondary treatment modality for 8 recurrences, amputation or disarticulation was performed in 5 cases.
Amputation ; Disarticulation ; Female ; Giant Cell Tumor of Bone ; Giant Cell Tumors ; Giant Cells ; Humans ; Incidence ; Joints ; Knee Joint ; Life Expectancy ; Life Style ; Male ; Methods ; Radius ; Recurrence ; Sex Distribution ; Tibia ; Transplants ; Young Adult

PURPOSE: To report the results of acetabular revisions performed with the cementless, hemi-spherical porous coated component supported by viable host bone and minimal allobone graft for acetabular deficiencies. MATERIALS AND METHODS: A retrospective study was completed for 22-revision acetabular components, using the cementless hemispherical porous coated prosthesis and minimal femoral head allograft. There was an average follow up of 48 months, with a range of 24 to 84 months. Radiographic measurements were performed in several aspects; cup-allograft contact, inclination, vertical and horizontal migration of acetabular cup, and acetabular zone by modified zone of DeLee and Charnley, in which location, size and progression or non-progression of radiolucent zone were recorded. The acetabular deficiencies were classified by the American Academy of Orthopaedic Surgeons Committee and were type I in 2 hips (9%), type II in 12 hips (55%), and type III in 8 hips (36%). Twenty acetabular cup cases of Harris-Galante II were used in this study, 1 case of Harris- Galante I, and 1 case of Duraloc. The average size of the cup was 57(44-66) mm. RESULTS: The average cup-allograft contact was 72.5% in 19 cases and we could not differentiate the margin between the host bone and the allograft in 3 cases. There was no significant vertical or horizontal migration of acetabular cup. Radiolucent zones in follow-up radiographs were 8 cases in zone IA, 4 cases in zone IB, 4 cases in zone IIB, 9 cases in zone IIC, 8 cases in zone IIIA, and 7 cases in zone IIIB. One case showed 2 mm radiolucent area in zone IIC and another case showed 3 mm radiolucent area in zone IIB, but the radiolucencies were not progressive. The remaining cases showed less than 0.5 mm radiolucent area or no radiolucent zone. The average period of bony incorporation was 13.1 months. CONCLUSIONS: We suppose that acetabular revision with the cementless hemispherical porous coated cup supported by viable host bone and minimal bone graft produces good results.
Acetabulum* ; Allografts ; Follow-Up Studies ; Head ; Hip ; Prostheses and Implants* ; Retrospective Studies ; Transplants

No abstract available.
Animals ; Liver* ; Rats*

No abstract available.
Animals ; Hypokinesia* ; Immobilization* ; Muscle, Skeletal* ; Rats*

PURPOSE: The enhanced cytotoxic effect of combined treatement of hyperthermia and chemotherapy by increasing intracellular acidify with HMA was investigated. MATERIALS AND METHODS: Fsall tumor cells were injected on the hindlegs of female C3H mice. When the tumor volume reached about 200mm3 , experiments were performed on the groups classified as follows : Group I : Control Group II : Melphalan alone (2.5 mg/kg, 5 mg/kg, 10 mg/kg, 15 mg/kg). Group III : Heat alone (42.5degree C for 1 hour) Group IV : Melphalan + Heat (42.5degree C for 1 hour) Group V : HMA(10 mg/kg) + Melphalan (5.0 mg/kg) + Heat (42.5degree C for 1 hour) Each group included 8-12 mice on each experiment. HMA (3-amino-6-chloro-5(1-homopiperidyl)-N-(diaminomethylene)-c-pyrazinecarboxamide), an analog of amiloride which increases intracellular pH(pHi) was dissolved in dimethyl sulfoxide(DMS) and injected into the tumor-bearing mice through the tail vein. 10mg/kg of HMA and each dose of melphalan were injected into peritoneum of the tumor-bearing mice 30 minutes before heating. Tumor growth delay was calculated when the tumor vlme reached at 1500mm3 . Excision assay was performed on each group and repeated 2-4 times. RESULTS: Tumor growth delay of each experimental groups at 1500 mm3 were 9, 10, 13 and 19 days respectively. In vivo-in vitro excision assay using Fsall tumor cells, the cytotoxicity of each experimental groups was 1.2 X 107 , 1 X 107 , 6 X 106 , 1.7 X 106 and 1 X 105 clonogenic cells/gm respectively. When HMA was added to the combined treatment of heat and chemotherapy, the tumor growth ws delayed more than combined treatment without HMA i.e., 6 days tumor growth delay at 1500 mm3 of tumor volume. CONCLUSION: he combined effect of cytotoxicity by heat and chemotherapy can be much more enhanced by HMA.
Amiloride ; Animals ; Drug Therapy* ; Female ; Fever* ; Heating ; Hot Temperature ; Humans ; Hydrogen-Ion Concentration* ; Melphalan ; Mice ; Mice, Inbred C3H ; Peritoneum ; Tumor Burden ; Veins