No abstract available.
Antibodies, Monoclonal* ; Humans*

Pretwisting the patellar tendon graft has been advocated hy many authors. Lambert has described a 90 degrees pretwist to benifit the fat pad vascular supply as well as to "" simulate the helicoid course of the ACL "". This technique has also been recommended to fascilitate fixation. Jackson has recommended a 90 pretwist to decrease the possibility of abrasive wear on the tunnel edge, and also to fascilitate fixation as much as a 180 degrees pretwist has heen recommended. However, in spite of all these recommendations, little work has been done on the effect of such pretwisting on the biomechanical behavior of patellar tendon grafts. The purpose of this study is to discover, by experiment, the effects of a 360 degrees external rotation pretwist on the following tensile mechanical properties of canine central 1/3 patellapatellar tendon-tibia complex : (a) ultimate stress, (b) ultimate strain, (c) average elastic modulus, and (d) strain energy density. Five groups of each S specimens were divided as group 1 (0 degrees external rotation), group 2 (90 degrees external rotation). group 3 (180 degrees external rotation), group 4 (270 degreesexternal rotation), and group 5 (360 degrees external rotation). The direction of pretwist meant the twist of tibia around patella. The effects of pretwist were analyzed using parameter one-way analysis of variance (ANOVA)(P1) and nonparameter Kruskal-Wallis one-way analysis of variance (ANOVA)(P2) with repeated measures followed by Scheff multiple comparison test. A p values of < 0.05 was considered statistically significant. Among each groups ultimate stress (P1=0.059, P2=0.095), ultimate strain(P1=0.154, P2=0. l65), and average elastic modulus(P1=0.814, P2=0.818) were not statistically significant. Only strain energy density was the statistically significant difference between group 2 and group 5(P1=0.008, P2=0.022). As a result, there were observed that the ultimate stress and strain energy density were decreased and ultimate strain was decreased but there were not statistically significant differences hetween groups because of the small number of samples, and there will be advantages for graft to avoid ahrasive wear on the tunnel edge and lateral femoral condyle. But, more studies are needed for human being in the future.
Adipose Tissue ; Elastic Modulus ; Humans ; Patella ; Patellar Ligament* ; Tibia ; Transplants

BACKGROUND: The study aimed to determine the type of capsular insertion and the extent of capsular elongation in anterior shoulder instability by quantitatively evaluating their computed tomography arthrographic (CTA) findings, and to investigate the correlation of these parameters with surgical outcomes. METHODS: We retrospectively reviewed 71 patients who underwent CTA and arthroscopic capsulolabral reconstruction for anterior shoulder instability between April 2004 and August 2008. The control group comprised 72 patients diagnosed as isolated type II superior labrum anterior to posterior (SLAP) lesion during the period. Among the 143 patients, 71 were examined with follow-up CTA at an average 13.8 months after surgery. It was measured the capsular length and cross-sectional area at two distinct capsular regions: the 4 and 5 o'clock position of the capsule. RESULTS: With regards to the incidence of the type of anterior capsular insertion, type I was more common in the control group, whereas type III more common than in the instability group. Anterior capsular length and cross-sectional area were significantly greater in the instability group than in the control group. Among patients of the instability group, the number of dislocations and the presence of anterior labroligamentous periosteal sleeve avulsion lesion were significantly associated with anterior capsular redundancy. Postoperatively, recurrence was found in 3 patients (4.2%) and their postoperative capsular length and cross-sectional area were greater than those of patients without recurrence. CONCLUSIONS: Capsular insertion type and capsular redundancy derived through CTA may serve as important parameters for the management of anterior shoulder instability.
Arthrography* ; Dislocations ; Follow-Up Studies ; Humans ; Incidence ; Joint Instability ; Recurrence ; Retrospective Studies ; Shoulder*

The anterior fusion became the popular measure in the treatment of the tuberculosis of the spine. We analysed the 208 cases of the tuberculosis of the spine (174 anterior fusion) who were treated at our department during the period of 1966 to 1973 and compared these results with that obtained during the period of 1957 to 1966. Following has been observed from this comparison. 1. Spine was the most common site in bone and joint tuberculosis (51.7%) but with decreasing tendency. And it was followed by hip, knee, ankle and sacroiliac joints of order. 2. Common age incidence was below 30 years (72.7%) and most common in below 5 years (20.7%). 3. Average duration of disease was 2 years and 2 months. This value was 6 months lower than in previous study. 4. The most common site was changed from lumbar to thoracic vertebrae. 5. The incidence of sinus, cold abscess formation decreased but paraplegia increased in incedence due to high prevalence in thoracic vertebrae. 6. Anterior fusion was performed in 86.1% of the cases. 7. Postoperative complications was found in 17.2%. Adequate rnanagement of chest tube in thoracic areas and blood vessels in lumbosacral areas may be necessary.
Abscess ; Ankle ; Blood Vessels ; Chest Tubes ; Hip ; Incidence ; Knee ; Paraplegia ; Postoperative Complications ; Prevalence ; Sacroiliac Joint ; Spine ; Thoracic Vertebrae ; Tuberculosis ; Tuberculosis, Osteoarticular

Transhiatal gastric transpositions were performed in two case of long gap esophageal atresia without tracheoesophageal fistula. The patients were a 12 months old female and an 18 months old male. Stamm type gastrostomies were performed at other hospitals in both cases. The stomach was mobilized preserving the right gastric artery, the right gastroepiploic artery and spleen. The proximal and distal esophageal pouches were excised by transcervical and transhiatal route, respectively. The mobilized stomach was pulled up to the neck through esophageal hiatus and posterior mediastinal route. The esophagogastrostomy, the only one anastomosis of this procedure, was performed in the neck. There was no clinical evidence of anastomotic leakage, stricture, regurgitation, difficulty of gastric emptying, hoarseness or respiratory problem. Transhiatal gastric transposition seems to be a safe and easy alternative surgical procedure for esophageal replacement in long gap esophageal atresia.
Anastomotic Leak ; Arteries ; Constriction, Pathologic ; Esophageal Atresia* ; Female ; Gastric Emptying ; Gastroepiploic Artery ; Gastrostomy ; Hoarseness ; Humans ; Infant ; Male ; Neck ; Spleen ; Stomach ; Tracheoesophageal Fistula

No abstract available.
Angiomyoma* ; Mucous Membrane*

No abstract available.
Female ; Fetal Heart* ; Heart Rate, Fetal* ; Meconium* ; Pregnancy

We report a case of eosinophilic pustular folliculitis (EPF) with associated plantar lesions in a 45-year-old man. Exarnination of the skin disclosed an erythematous patch, approximstely 3 x 5cm, on the left cheek, which contained discrete and confluent pspulopustules and scaly circinated vesicular patch on the right foot. Histologic examination of a biopsy specirnen from the left cheek revealed the hair follicles and the sebaceous glands are infiltrated mainly by eosinophils and by some mononuclear and neutrophils. Histologic examination of a biopsy specimen from the right foot revealed a vesicle extending from the subcorneal portion to the lower epidermis, which was filled with neutrophils and a small number of eosinophils.
Biopsy ; Cheek ; Eosinophils* ; Epidermis ; Folliculitis* ; Foot ; Hair Follicle ; Humans ; Middle Aged ; Neutrophils ; Sebaceous Glands ; Skin

Since 1957, multiple possible mechanisms have been suggested to explain the production of the osteonecrosis of the femoral head and it is now accepted that steroid medication is one of the etiologic factors producing osteonecrosis of the femoral head. Among the surgical procedures in ischemic osteonercrosis of the femoral head are bone grafting, core decom-pression, rotational osteotomy, angulation osteotomy, hemiarthroplasty and total hip replacement. The choice of surgical procedures in the management of idiopathic osteonecrosis of the femoral head is dependent on several factors. Most important are the etiology and stage of the lesion. Other considerations are the patients age, lifestyle, and demands on his hip, and the surgeons preference and expertise. We reviewed 32 total hip replacements in 22 patients, which had been performed to treat steroid-induced osteonecrosis of the femoral head at Department of Orthopaedic Surgery, National Medical Center from Jan. 1975 to Dec. 1981. The longest follow-up was 7 years and 6 months and the shortest, 1 year, the average being 2 years and 6 months. The results were as follows: 1. There were 13 males and 9 females and more than half were in 5th decade. 2. Principal causes to use oral corticosteroids were rheumatoid arthritis, arthralgia, and low back pain in the order of frequency. 3. Duration of corticosteroid medication was between 2 months and 12 years and 18 patients took more than 12 months. 4. Of 18 patients who had the bilateral involvement, the two also had osteonecrosis of the humeral head. 5. Roentgenographically, 30 hips were in stage IV and 2, in stage III according to the classification of Arlet and Ficat. 6. Types of the implants used were Charnely (28 cases), MQller (2 cases) and Trapezoidal-28 (3 cases). 7. The function of the each hip was evaluated preoperatively and postoperatively by the method of Wilson and Salvati and all improved from average poor to average good.
Adrenal Cortex Hormones ; Arthralgia ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Hip ; Bone Transplantation ; Classification ; Female ; Follow-Up Studies ; Head ; Hemiarthroplasty ; Hip ; Humans ; Humeral Head ; Life Style ; Low Back Pain ; Male ; Methods ; Osteonecrosis ; Osteotomy ; Surgeons

PURPOSE: To assess the ability of scrotal Doppler ultrasonography to confirm the diagnosis of clinical varicoceles and detect subclinical varicoceles. MATERIALS AND METHOD: Sixty patients with clinically evident varicocele were examined by scrotal doppler ultrasonography(gray scale: 60 patients, spectral Doppler: 35 patients, color Doppler: 22 patients). A control group of 21 patients with no suspected scrotal pathology also were studied. The age range of the varicocele group was 12-49 years. The normal group consisted of 21 subjects aged 19-23 years. Ultrasonographic measurement of scrotal vein diameter of patients before and during Valsalva maneuver, and scrotal vein blood flow reversal with Valsalva maneuver was compared with the findings of varicocele by physical examination. RESULTS: Significant differences were found in scrotal vein diameter before and during Valsalva maneuver between normal and varicocele testicular units. Cut-off points were selected in an arbitrary fashion on the basis of scattergram. Using this cut-off points and blood flow reversal, we found that 12(23%) of 53 patients with a clinically palpable left unilateral varicocele had an ultrasonographically positive subclinical right varicocele. 8(38%) of 21 patients without a clinical varicocele had a positive scrotal ultrasound. CONCLUSIONS: We suggest that scrotal doppler ultrasonography is a reliable means of confirming the clinical varicocele and screening the subclinical varicoceles.
Diagnosis ; Humans ; Mass Screening ; Pathology ; Physical Examination ; Ultrasonography ; Ultrasonography, Doppler* ; Valsalva Maneuver ; Varicocele* ; Veins