A variety of substitutes and numerous operative procedures have been described to stabilize the anterior cruciate ligament(ACL) deficient knee. OBJECTIVES: The purpose of this study has been to evaluated the remodelling process of bone-patef- lar tendon-bone(B-PTB) allograft(Tutoplast(r)) for ACL reconstruction by means of light microscopic(LM) and electron microscopic(EM) examinations from the biopsy specimens obtained at the time of second-look arthroscopy. The authors also have been grossly observed the width, vascularity, elasticity and stability of B-PTB allograft. MATERIALS AND METHODS: ACL reconstruction using B-PTB allograft was performed on 22 consecutive patients. Among them, 12 patients were reviewed and the average age at time of operation was 22.5 years ranging from 21 to 40 years. The second look arthroscopy was performed at 6 months, 12 months, 24 months in each of the 4 cases. The gross findings of allograft were observed, and biopsy was done by the method of Millonig. Results; The arthroscopic findings of the reconstructed ACL were partially covered with synovium and narrowed in diameter at 6 months follow up. At 12 months follow up after reconstruction, that grafted ligaments were covered with more synovial membrane, and observed the more thickness with normal strength similar to normal anterior cruciate ligament configuration. At 24 months, grafted ligaments were grossly similar to normal ACL. The LM findings demonstrated many fibroblasts with spindle shape nuclei and and hypercellularity at 6 months. At the 12 months, crimp pattern of collagen bundles and decreased hypercellularity observed. At 24 months, grafted ligament were similar to nomal ACL. The EM findings that fibroblasts were showed abundant cytoplasm which contained marked dilated rough endoplasmic reticulum(r-ER) and aggregates of microfilaments at 6 months. At 12 months, fibroblasts with folded nuclei and abundant cytoplasm were observed. At 24 months, demonstrated the fibroblasts with abundant cytoplasm and densely packed collagen fibrils. Collagen fibrils displayed parallel arrangement and characteristic cross striation with a periodicity. Scanning EM findings showed uniformly small diameter of collagen in the transeverse section. CONCLUSIONS: Gross & LM findings of B-PTB allograft were similar to that of normal ACL at 6 months, and at 12 months, postoperatively. But EM findings of B-PTB allograft were compared with the biopsy samples of normal ACLs, the allograft was still undergoing maturation 24 months postoperati vely.
Actin Cytoskeleton ; Allografts* ; Anterior Cruciate Ligament* ; Arthroscopy ; Biopsy ; Collagen ; Cytoplasm ; Elasticity ; Fibroblasts ; Follow-Up Studies ; Humans ; Knee ; Ligaments ; Patella* ; Patellar Ligament* ; Periodicity ; Prospective Studies* ; Surgical Procedures, Operative ; Synovial Membrane ; Transplants

The posterior cruciate ligament in the stoutest ligamentous structure in the knee joint. Kennedy and Hawkins have confirmed its strenght to be about 2 times that of the anterior cruciate ligament or tibial collateral ligament. This would appear to offer the support that this ligament has a vital role to play in knee stabilization. But, in the past, non-surgical management was frequently elected either because of the belief that most kness with posterior cruciate insufficiency are asymptomatic or because it is difficult to access surgically. Recently, Hughston and Trickey reported good results after surgical repair of the rupture of the posterior cruciate ligament. And current trend is to repair it surgically. So, we analyzed the 36 cases of acute posterior cruciate ligament injuries, who were admitted and treated surgically in Severance Hospital between Jan. 1981 to Dec. 1985, and obtained the following results. 1. Single rupture of the posterior cruciate ligament largely results in good outcome. 2. When the rupture site is in the substane, we can obtain relatively good results with the augmentation using the medial head of the gastrocnemius. 3. When combined with medial or lateral compartment injuries, the chance of later instability and reconstruction is high.
Anterior Cruciate Ligament ; Clinical Study ; Head ; Knee ; Knee Joint ; Ligaments ; Medial Collateral Ligament, Knee ; Posterior Cruciate Ligament ; Rupture

Neurilemoma is benign never-sheath tumor which has been described as painless mass and is usually discovered incidentally. It is the most common tumor of peripheral nerve origin and may arise in any nerve where Schwann cells occur. There are few domestic reports which were clinically evaluated in tens of cases of neurilemoma so far. We evaluated on the 56 cases of neurilemoma confined to the trunk and extremities, in the aspect of clinical characteristics, radiology, pathology, EMG, surgical treatment and postoperative results, who were surgically treated at the Department of Orthopedic Surgery of Seoul National University from 1984 to 1994. Among 56 patients, male were 29 and female were 27, and there was no sexual difference. The average age at surgical intervention was 46.4 years (16–83yrs) and 46.4% of patients were in the age of fourties and fifties. The anatomical locations of the tumors were as followed: upper extremities in 22(39%) cases, neck and supraclavicular area in 15(27%) cases, sacrum and lower extremities in 14(25%) cases and trunk in 5(9%) cases. Symptoms were palpable mass in 55 cases, local tenderness in 14, radiating pain in 11, pain in 10, paresthesia in 11, motor weakness in 2 cases. The average follow up period was 19.1 months(13–56 month). Median nerve was involved most frequently(14%), then ulnar nerve(11%). There was no cases which occurred in multiplicity or associated with neurofibromatosis. Marginal excision was done in 51 cases(91%), incisional biopsy only in 4 cases(7%), wide excision in 1 case. The size of the tumors in the longest axis was smaller than 2cm in 9 cases, between 2 and 4cm in 31 cases, between 4 and 6cm in 13 cases and more than 6cm in 3 cases. Malignant change or recurrence was not found in all cases.
Biopsy ; Extremities ; Female ; Follow-Up Studies ; Humans ; Lower Extremity ; Male ; Median Nerve ; Neck ; Neurilemmoma ; Neurofibromatoses ; Orthopedics ; Paresthesia ; Pathology ; Peripheral Nerves ; Recurrence ; Sacrum ; Schwann Cells ; Seoul ; Transcutaneous Electric Nerve Stimulation ; Upper Extremity

No abstract available.
Compliance* ; Humans

No abstract available.
Compliance* ; Humans

Increased melanin pigmentation following ultraviolet irradiat.ion is due to increasing tyrosinase activity and multiplicatian of functioning melanocytes. After UV-irradiation, the size of melanocytes increases, and melanocyte dendrites elongatc, and branch. In this experiment, we induced the activation of melanocyts in the epidermis of C57BL black mice by ultraviolet-B(UVB) irradiation and observcd ihe effect of azelaic acid and retinoic acid on the UVB activated epidermal melanocytes. Sixty C57BL black mice were irradiated by UVB 100mJ/cm daily for 10 days, and then azeiaic acid and retinoic acid were topically applied daily for 7 weeks. For the estimation of morphologic change of epidermal melanocytes, light microscopic observation with split DOPA stain was performed at the end of the 1st, 3rd, 5th and 7th week of topical application. The results are summerized as follows : 1. The number, size and circumference of DOPA-positive epidermal melanocytes were significantly decreased in 20% azelaic acid applied group and 30% azelaic acid and 0.05% retinoic acid applied group. 2. In 20% azelaic;i.cid and 0.05% retinoic acid applied group, the number, size and circumference of DOPA-positive epidermal melanocytes were nore significantly decreased than in 20% azelaic acid applied group. In summary, the present study suggets that azelaic acid act as a depigmenting agent on epidermal melanocyte; and such depigmenting effect of azelaic acid was increased by addition of retinoic acid.
Animals ; Dendrites ; Dihydroxyphenylalanine ; Epidermis ; Melanins ; Melanocytes* ; Mice* ; Monophenol Monooxygenase ; Pigmentation ; Tretinoin*

This study was conducted to evaluate the relations between alcohol intake and blood lipid level in a group of 1,138 Korean adult men, ages 20 to 69 years. Total number of each of a variety of drinks in the previous two weeks was obtained by questionnaire and converted into grams of alcohol consumed in a week. The levels of blood lipid such as Cholesterol, HDL-Cholesterol, Triglyceride and LDL-Cholesterol were examined by enzyme method. We also observed the effects of various variables such as age, body mass index, smoking, exercise and blood pressure on blood lipid level. The results obtained were as follows; 1. Average weekly alcohol intake was 129.0+/-167.4 gm and that of 30-39 age group was the highest as 149.3+/-170.4gm. 2. Levels of Cholesterol, Triglyceride and LDL-Cholesterol tended to increase with increasing age, but level of HDL-Cholesterol showed no significant relationship with age. 3. The positive linear regressions of alcohol intake on HDL-Cholesterol and Triglyceride were noted statistically significant. 4. Multiple regression analysis demonstrated that the effect of alcohol on HDL-Cholesterol and Triglyceride was statistically significant and the contribution rates were 5.0% and 0.8%, respectively. And, in the case of HDL-Cholesterol, the alcohol intake was the most significant independent variable.
Adult* ; Blood Pressure ; Body Mass Index ; Cholesterol ; Humans ; Linear Models ; Male ; Surveys and Questionnaires ; Smoke ; Smoking ; Triglycerides

Of 29 scoliotic patients treated by Harrington and Dwyer instrumentation, fourteen patients were taken of preoperative cnrrection by halo-femoral skeletal traction for the last two years from June 1974 to June 1976 at the Department of Orthopedic Surgery, Seoul National University Hospital. The correctability of scoliosis by the use of halo-femoral traction was evaluated with roentgenogram study and the following result was obtained. 1. Of the 14 cases, five cases were male and eight were female, and they were between the age of 13 and 29. 2. The etiology of the 14 scoliosis was idiopathic in three, paralytic in eight, congenital in one, and associated with neurofibromatosis in two. 3. The average initial curve was 108 degress with the flexibility of 32.1% on side bending. 4. The average preoperative curve with halo-femoral traction for one week was 75. 1 (30.5% correction), and the end of two week was 68 (37% correction). 5. The average immediate postoperative curve was 58.5 (46.5% correction). 6. The result of traction in the different etiologic type showes no significant difference.
Female ; Humans ; Male ; Neurofibromatoses ; Orthopedics ; Pliability ; Scoliosis ; Seoul ; Traction

Osteoblastoma is a benign lesion somewhat similar to ostoid osteoma histologically but different from it clinically, roentgenologically and grossly. The autors have experienced a case of benign osteoblastoma of the neural arch of the Iumbar spine, and treated the case by total laminectomy and conflrmed with biopsy.
Biopsy ; Laminectomy ; Osteoblastoma ; Osteoma ; Spine

Benign epiepsy of childhood with centrotemporal spikes (BECCT) is an electroclinical syndrome characterized by noctural seizure that remit spontaneoully before adulthood, and belong to idiopathic age and location related epilepsies. We reviewed the medical records to analyse the seizure the seizure pattern, and also inspect the EEG recording to identify topography of the epileptiform discharge of 24 patient who met the following criteria: 1) presence of nocturnal seizure or partial seizure confined to the face, 2) normal intecual and development, 3) normal background EEG feature, 4) monomormhic spikes or sharp wave that increase in the frequency during sleep if those state were achieved. The result as follow: 1) The age of seizure onset were 3 to 11 years old (7.08 1.89) and male to female ratio was 1, 4:1. 2) Past history of birth trauma, CNS infection and other diseases involving CNS, were not found. There was past history of febrile convulsoin 33.3% of patient and epilepsy in 8.3%. One of paient's sister had childhood abscence epilepsy and never a nocturnal partial seizure, also and had centrotemporal spikes in EEG. 3) In 91.7% of Seizures occurred during sleep, especially short after sleep onset and the symptomatology of seizure was shown 66.7% of oropharyngeal sign, such as hypersalivation and gargle sound, and 54.2% of hemifacial involvement, 33.3% of speech arrest, 25.5% of upper limb involement, 18.3% of lower limb involvement, and 45.8% of general seizure. 4) In 91.5% of patients had on location of epileptiform discharge that located central (37.5%) midtemporal (33.3%), parietal and frontal. We could observe tangental dipole in 16.7% of patients.
Child ; Electroencephalography ; Epilepsy ; Epilepsy, Rolandic* ; Female ; Humans ; Lower Extremity ; Male ; Medical Records ; Parturition ; Rabeprazole ; Seizures ; Sialorrhea ; Siblings ; Upper Extremity