Isolated avulsion fracture of the tibial attachment of the posterior cruciate ligament has been thought very rare. We also had experienced only nine cases of above injury in our center during 5.5 years from January, 1976 to June, 1981. Eight cases of them were followed for an average of the thirteen months, but one of them was eliminated from the study because follow-up study was impossible for the case. The purposes of this paper are to present eight cases of isolated avulsion fracture of the tibial attachment of the posterior cruciate ligament and to discuss the causes and mechanisms of the injury and the method of screw fixation for the avulsed fracture fragment. Seven were injured by traffic accident and one by fall on the knee. All cases seemed to be injured by the force directed against the flexed knee which violently stroke the anterior surface of the proximal end of the tibia or inferior portion of the knee and drove it backwards. We found the tear of posterior capsule only in one patient who was seeming injured by extensive force. All cases were treated operatively by means of screw fixation, and excellent results were obtained in five cases, good in two, and fair in one case.
Accidents, Traffic ; Follow-Up Studies ; Humans ; Knee ; Methods ; Posterior Cruciate Ligament ; Stroke ; Tears ; Tibia

Normal lymphocyte transfer (NLT) test is composed of two peaks of delaycd. hypersensitivity reaction of erythema and/or induration developed at the site of intradermal inoculatioa of allogenic lymphocyte. It has been suggested that NLT test is a px.siblc homograft raaction, how var tlv exact mecha.nism is remained to be resolved. In leprosy, there has been accumulating evidenc. indicating defective cell mediated. immunity detected by varioua immunological tests. The present study was undertaken to evaluate the immune capability of patients with leprosy using NLT test. A total of 20 hea,lthy volunteers, 20 lepromatous and 22 tuberculoid leprosy patients who were under antileprosy chemotherapy with DDS for varying periods, entered this study. Lymphocytes from hepatitis associati antigen (HAA) negative donor were isolated with Ficoll- Hypaque density gradient method and the cell concentration was adjusted by normal saline so as to give 2, 5 million cells per 0. 1 ml. Each recipient was given 0. 1 ml lymphocyte suspension on the flexor surface of th right forearm intrad.ermally using 1 ml tuberculi n syringe with a 26 gauge needle. The appearance and the size of induration was checked daily for 2 weeks. In this atudy, the NLT reaction pattem was classified as follows: a. normal pattem showing the first peak and second peak of reaction. b. first peak only showing the first peak, but no second peak, of reaction. c. flat pattem showing neitger the first peak nor the second peak of reaction The results were as follows: 1. There were normal pattem in sixteen persons(80%) and first peak only in 4 persons(20%) among twenty healthy human volunteers. 2. There were normal pattem in four patients(20%), first peak only in six patients(30%) and flat pattem in ten patients(50%) among twenty letromatous leprosy patients. 3. There were normal pattem in twelve patients(54.5%), first peak only in eight patients(36.4%) and flat pattem in two patients(9.1%) among twenty-two tuberouloid leprosy patients. These findings suggest that NLT test may be useful in evaluating the immune capability in leprosy and host factor in belived to be important in the development of both first and second peaks of NLT test.
Allografts ; Diatrizoate ; Drug Therapy ; Erythema ; Forearm ; Healthy Volunteers ; Hepatitis ; Humans ; Hypersensitivity ; Immunologic Tests ; Leprosy* ; Leprosy, Tuberculoid ; Lymphocytes* ; Needles ; Syringes ; Tissue Donors ; Volunteers

No abstract available in English.
Arthropathy, Neurogenic

Complete decompression is very important for the surgical treatment of the spinal stenosis. But it may produce the segmental instability or spondylolisthesis as postoperative complications. So rigid internal fixation is mandatory to reduce this problem. Authors treated 16 cases of spinal stenosis by complete decompression and pedicale screw fixation and posterolateral fusion, analyzed 11 cases which were followed more than 9 months. The results were as follows: 1. Among the 11 cases, the mean age was 49 years old and there were 5 males and 6 females. 2. The most common cause was degenerative type, 7 cases. The most frequent level of involvement was L4–L5, 10 cases and two level involvement was 3 cases. 3. Among the 11 cases, 6 cases were excellent and 4 cases were good, and 1 case was fair, in Hanley's criteria. 4. In spondylolisthetic stenosis, the average percentage of slippage was changed from 22% pre-operatively to 2.7% postoperatively and 3.8% after 9 months follow up. 5. The complications were relatively few(1 case of hematoma and 3 cases of pain on the bone graft donor site).
Constriction, Pathologic ; Decompression ; Female ; Follow-Up Studies ; Hematoma ; Humans ; Male ; Pedicle Screws ; Postoperative Complications ; Spinal Stenosis ; Spondylolisthesis ; Tissue Donors ; Transplants

The talus is a bone with unique biomechanical features and vascular supply. Although fractures of the talus are not common, the complications of the displaced fractures or dislocation are frequent and resulting disabilities are so severe that the importance of proper management is emphasized. Authors analyzed 17 cases of fracture-dislocation of the talus, treated at Soon Chun Hyang University Hospital from January 1983 to December 1988. The results were as follows:l. Among the 17 cases, there were 15 males and 2 females and the average age was 28 years old, ranged from 21 years to 58 years. 2. The causes were fall from height in 10 cases, traffic accident in 6 and others in one. 3. According to Marti-Weber classification, 2 cases were type I, 5 in type II, 7 in type III and 3 type IV. 4. Among the 17 cases, 9 cases in type I and II were treated conservatively, and 8 cases in thpe III and IV were treated operatively. 5. Complications were avascular necrosis in 3 cases, degenerative arthritis in 4 and nonunion in 1. 6. Final results, evaluated by the criteria of Mindell et al., were as follows: excellent in 7 cases, good in 5, fair in 3 and poor in 2.
Accidents, Traffic ; Classification ; Clinical Study ; Dislocations ; Female ; Humans ; Male ; Necrosis ; Osteoarthritis ; Talus

Serum specimens from leprosy patients, their contacts and controls were examined for the presence of phenolic glycolipid I (PGL-I), a Mycobacterium leprae specific antigen, and antibodies to the antigen using enzyme-linked immunosorbent assays. Of 12 lepromatous patients with less than 2 years of therapy, 11(91.7%) were seropositive to PGL-l, thus indicating that new lepromatous cases can be identified by detecting anti-PGL-l antibodies. In contrast 88(56.4%) of 156 lepromatous patiens treated more than 2 years were positve. Moreover, only 69(40.8%) were seropositve among 169 lepromatous patients in the leprosy resettlement villages. The mean antibody level also declined significantly in proportion to the duration of chemotherapy. This may suggest the possibility of monitoring chemotherapy by detecting anti-PGL-l antibodies. The prevalence of anti-PGL-l antibodies among 200 controls from a high endemic area for leprosy was 5.5% and was significantly higher than that(1.5%) among 200 controls from a low endemic area. Of 103 household contacts in the resettlement villages, 10(9.7%) were seropositive, reflecting the frequent chance of exposure to M. leprae. However, PGL-l was not detected many in any of the sera from controls, contacts, and inactive lepromatous patients having the anti-PGL-l antibodies; on the other hand, 6(50%) of 12 lepromatous patients treated less than 2 years had detectable PGL-l in their sera. The results thus indicate that PGL-l detection may be more suitable for monitoring the effectiveness of chemotherapy and that it may be necessary to examine for the presence of PGL-l in sera from contacts and normal populations for confirming M. leprae infection.
Antibodies, Bacterial/*analysis ; Glycolipids/*blood ; Human ; Leprosy/*blood/diagnosis ; Serologic Tests ; Support, Non-U.S. Gov't

This article aims to summarize the development and application of menu engineering technique, 'Menu Engineering Modified by Preference (MEMP)'. The site selected for this project was a foodservice operation in Yonsei University residence hall. Sales and food costs data were collected from the daily sales reports for 1 month, and the survey of food preference was conducted during May, 1999. Statistical data analysis was completed using the SAS/Win 6.12 for descriptive analysis. The calculation for menu analysis were carried out with MS 2000 Excel spreadsheet program. This MEMP technique developed had 6 category criteria and 2 dimensions of the contribution margin (CM) and the menu mix modified% (MMM%). The MMM% was calculated by the sales volumes and also weighted by food preference. The CM and MMM% for each item were compared with a mean menu CM as well as a 70% rule. Four possible classifications by MEMP were turned out as 'STAR', 'PLOWHORSE', 'PUZZLE', 'DOG'. 'STAR' items were the most popular and profitable items and required to maintain rigid specifications for quality. The decision actions for 'PLOWHORSE' menu items which were relatively popular, but yield a low menu average CM included combining a plowhorse item with lower cost products and reducing the frequency of serving or serving size. There was a need for 'PUZZLE' items to be changed in the menu combination, improve recipe, and promote menu. The last 'DOG' items were desired to be deleted. This study demonstrates that menu information can be interpreted more easily with MEMP. The use of MEMP is therefore an effective way to improve management decisions about menu of university residence hall foodservice.
Classification ; Commerce ; Data Interpretation, Statistical ; Food Preferences ; Serving Size

PURPOSE: The authors investigated the process of endochondral ossification quantitatively and objectively in respect to proliferation and apoptosis. MATERIALS AND METHODS: Fractures were made on the left tibiae of 72 male Sprague-Dawley rats. The fracture callus was harvested at the 5th, 7th, 9th, 11th, 14th, and the 21st day after fracture. Cellular DNA content was analyzed with image cytometry, and proliferative index was determined from the data. The Ki-67 antigen expression was semiquantitatively measured by the immunohisto-chemical method. TUNEL was used for in situ localization of apoptotic cells. The expression of cell cycle inhibitors, P21 and P27, was investigated with Northern blotting. RESULTS: The proliferation index was highest on the 5th day, then gradually decreased until the 11th day. The expression of Ki-67 antigen gradually decreased with time. Apoptotic cells increased in accordance with enhanced bone formation within chondroid callus. The expression of p21 and p27 was highest on the 11th and the 14th day. CONCLUSIONS: These findings show that proliferative activity decreased with the reduction of mesenchymal tissue and the appearance of mature chondroid tissue. The apoptosis of hypertrophic chondrocytes occurred in accordance with enhanced bone formation. P21 and P27 had a certain role in the differentiation of chondrocytes.
Apoptosis* ; Blotting, Northern ; Bony Callus ; Cell Cycle ; Cell Proliferation* ; Chondrocytes ; DNA ; Fracture Healing* ; Humans ; Image Cytometry ; In Situ Nick-End Labeling ; Ki-67 Antigen ; Male ; Osteogenesis ; Rats, Sprague-Dawley ; Tibia

Bosworth fracture, fracture-dislocation of ankle with entrapment of fibula behind the tibia, is a rare condition. Diagnosis of this fracture-dislocation may not he easy, and closed reduction of this injury is difficult because of entrapment of fibula by the tieht interosseous membrane. We report a case of Bosworth fracture treated with the anti-glide plate technique.
Ankle ; Diagnosis ; Fibula ; Membranes ; Tibia

Osteoporosis represents reduced amount of bone mass per unit volume as compared with controls of the same age and sex. The purpose of this study was to show how bone mineral densities of spine and intertrochanteric area decrease with aging, to investigate the relationship between the bone mineral densities (BMD) of the two areas, and to obtain fracture threshold values. We measured BMD of lumbar vertebrae and intertrochanteric areas by Dual Energy X-ray Absorptiometry (DEXA) from 241 postmenopausal women. 190 normal postmenopausal women comprised non-fracture group and there were 50 fresh thoracolumbar fracture patient and 31 intertrochanteric fracture patients in whom the fractures were not caused by high energy trauma. The mean bone mineral density values of non-fracture group were significantly higher than those of fracture groups and significant correlation held between bone density of spine and that of intertrochanteric area in non-fracture group and fracture groups. The fracture threshold was 0.837 g/cm3 in spine fracture group and 0.792 g/cm3 in the intertrochanteric fracture group.
Absorptiometry, Photon* ; Aging ; Bone Density* ; Female ; Humans ; Lumbar Vertebrae ; Osteoporosis ; Spine