No abstract available.
Spine

No abstract available.
Oxygen* ; Oxygenators*

At Orthopedic Department of Kyung Hee University Hospital, we performed 20 total knee replacements in 12 patients who had rheumatoid arthritis and 18 total knee replacements in 13 patients who had osteoarthritis during the period from August 1982 to May 1986. All patients were female. Comparative analysis was done between the two groups with a follow-up period ranging from 1 year to 4 years 8 months, average being 2 years and 3 months. The average age of rheumatoid arthritis patients was 10 years younger than osteoarthritis patients. The improvement of range of knee motion after total knee replacement was greater in rheumatoid arthritis comparing to osteoarthritis. Preoperative flexion contracture was more severe in rheumatoid arthritis than osteoarthritis, but after total knee replacement the average degree of flexion conrcacture was no significant difference between two groups. The average of preoperative Hospital Surgery Knee Rating Scale was low in rheumatoid arthritis group than in osteoarthritis group, but postoperative Knee Rating Scale was similar in both groups. It seems that the problem of wound was more frequent in rheumatoid arthritis than in osteoarthritis.
Arthritis, Rheumatoid ; Arthroplasty, Replacement, Knee ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee ; Orthopedics ; Osteoarthritis ; Wounds and Injuries

Approximately 15% of all fractures in children involve the physis. Although the majority heal without impairment of the growth mechanism, epiphyseal growth plate fracture-seperation can lead to shortening and angulation. The physiologic events in epiphyseal growth fracture seperation that lead to growth disorders relate to 1) destruction of the epiphyseal circulation and 2) communication between the epiphyseal circulation with its osteoprogenitor cells, thus forming a bony bridge. Although the classic procedure of osreotomy, epitphysiodesis, leg shortening and leg lengthening have not lost their importance in the treatment of the sequeales of partial closure of an epiphyseal plate, the possibility of regaining growth in the affected region should be considered before other measures are taken. Simple excision of the bone bridge is ineffective, since the large cancellous surface thus produced will allow for rapid reformation of the bridge. Thus, a material has to be interposed into the defect created by removal of such a bridge in order to prevent its reformation. Langenskiold first demonstrated that a bone bridge could be effectively resected and its reformation prevented by utilizing fat as an interposition material. Other investigators have used a variety of different interposition materials to prevent bone bridge recurrence following operative removal including cartilage, Silastic, Methymethacrylate, bone wax, muscle flap, Gelfoam as well as fat. Thus it is the purpose of this study to analysis and comparing shortening and angulation by resection of a bone bridge and its replacement with different interposition materials. For this study, a total of 32 rabbits with an initial weight of about 600 to 800 gm was used. Control group comprised 4 rabbits and after appmpriate preparation, the medial condyle of the pmximal tibia was exposed surgically. One plug of bone was removed at the level of the epiphyseal plate using a small curet to a depth of 5 mm. and in the other groups, we made a defect with the same curet and filled it with an interposition material directly. The following experimental groups were created. Group 1 (N-4) Control group: no interposition material Group 2 (N-4) Gelfoam interposition material Group 3 (N-4) Bone was interposition material Group 4 (N-4) Muscle flap interposition material Group 5 (N-4) Fat interposition material Group 6 (N-4) Bone cement interposition material Group 7 (N-4) Silastic interposition material Postoperatively the anirnals were sacrificed 15wks following operation. As sacrifice, tibia including fibular is removed, examined grossly and radiographed. Tibia length and angular deformity were determined by measurement of radiographs. Specimens stained with H-E stain were observed during 15 wks after operation. Through these examination, following results were obtained. l. In control group, coronal histological sections of each curetted proxirnal tibial growth plate revealed osseous bridging as early as 3 wks, and this bridging was found consistently in all control groups for the duration of the study. 2. The groups using gel foam, muscle flap and bone wax as interposition material were found effective for the prevention of the formation of epiphyseometaphyseal bone bridge to some extent. 3. The groups using Silastic or bone cement diminished both the angular deformity and growth retradation to a highly significant degree. Although the use of fat did reduce somewhat the amount of shortening and angular deformity when used as an interposition material, it was not effective as Silastic or bone cement. 4. Coronal histological section of the traumatized, margin of the growth plate, with an interposition material revealed thin fibrous layer and lose columnar orientation, foam rounded clone-like structures and randomness to growth. The injured portion of the cartilage may originate from the regeneration of the adjacent part of the growth plate. From these morphological and radiological results, it is suggested that Silastic or bone cement is better interposition material in the elimination of trahsphyseal closure after physeal damage.
Cartilage ; Child ; Congenital Abnormalities ; Gelatin Sponge, Absorbable ; Growth Disorders ; Growth Plate ; Humans ; Leg ; Rabbits ; Recurrence ; Regeneration ; Research Personnel ; Tibia

The incidental observation of periosteal new bone formation on long bones is common in pediatric radiology without any symptoms in extremities : for example, the humeri on chest examination and the femora on abdominal roentgenograms. The purposes of the author is to report the results of a roentgenologic study of the long bones in 100 normal infants and 100 chilren between 1 and 2 years old who had no symptoms refereble to the skeleton to determine the incidence, roentgen characteristics, pathogenesis and significance of this type of periosteal new bone. The results obtained were as follows : 1. Periosteal new bone occured in 28% in normal infants group but did not occured in children group between 1 and 2 years. 2. The site in order of decreasing frequency were femur, tibia, and humerus. 3. Periosteal new bone is always on the diaphysis and usually extended onto the metaphysis to a variable extent, but it has not been observed to reach the end of metaphysis. 4. It seems most logical that the periosteal new bone found in these infants is simply a roentgen manifestation of normal periosteal bone growth in the period of greatest activity. 5. It is not an indication for treatment unless a definite relationship with a specific disease is proven.
Bone Development ; Child ; Diaphyses ; Extremities ; Femur ; Humans ; Humerus ; Incidence ; Infant ; Logic ; Osteogenesis ; Skeleton ; Thorax ; Tibia

Thirteen cases of concomitant hip and shaft fractures of the same femur are reported. The hip fractures was initially missed in one case. Osteosynthesis of both fractures was performed in twelve cases. One except was 12-year-old boy who was managed hip with two Knowles pins and shaft conservatively. Both fractures healed in all followed for average 5.3 months or more. Osteosynthesis of both fractures is recommended as soon as the patient is in a stable condition, preferably by early fixation with AO principle or IM nailing in selected cases.
Child ; Femur ; Hip Fractures ; Hip ; Humans ; Male

The anterior cruciate ligament injury is one of the most common ligament injury of the knee joint, and anterior cruciate ligament is as important structure for stabilization as a primary restraint. Noyes reported that the diagnosis of a tek of the anterior cruciate ligament was made by the original treating physician in only 6.8%. And there are many controversies in its treatment. It is certain thatearly diagnosis and treatment are th most important clue. Authors studied 48 patients of isolated anterior cruciate ligament injury who were diagnosed by same physician from Jan. 1983 to Dec. 1985 after follow ups ranging from six mnths to 4 years, average beimng one year and two months. The results were as followings: 1. The most common cause was sports injury. 2. The most common sign and symptom were hemarthrosis in acute injury and giving way in chronic injury. 3. Anterior drawer test without anesthesia had 25% of diagnostic accuracy but pivot shift test under anesthesia 95.8%. 4. 31 cases in 48 cases (64.8) had associated meniscal injury. 5. In acute torn ACL, the primajy repair was preparable but conservative treatment with arthroscopic partial menisectomy was eful in chronic case.
Anesthesia ; Anterior Cruciate Ligament ; Athletic Injuries ; Clinical Study ; Diagnosis ; Follow-Up Studies ; Hemarthrosis ; Humans ; Knee ; Knee Joint ; Ligaments

The purpose of this study is to develop and evaluate the Self Efficacy Promotion and Exercise Training Program to decrease anxiety and depression and to increase the quality of life for kidney transplant recipients. The subjects were selected randomly among the patients who underwent renal transplant at three major transplantation hospitals in Seoul, Korea. The observed subjects in this study consisted of 56 patients who had renal transplantations between one to twelve months prior to this study. The patients did not take any regular physical exercise. This study was carried out between November, 1999 and March, 2000. The study groups were divided into 3 groups; exercise training group (n=16), self efficacy group (n=18) and control group (n=22). The exercise training group received self efficacy promotion and exercise training program for 12 weeks. The self efficacy group received self efficacy promotion education, but no exercise training was given. The control group was not offered any education. The anxiety, depression and quality of life were evaluated 3 times, before the experiment, after 8 weeks and after 12 weeks. The data were analyzed with mean, standard deviation, Chi-square test, ANOVA and Scheff test. The results were as follows: 1. After the experiment, anxiety and depression scores of the exercise training group and self efficacy group were more significantly decreased than those of the control group (p=.05). 2. After the experiment, the quality of life score of the exercise training group and self efficacy group were more significantly increased than those of the control group (p=.05). This study showed that the Self Efficacy and Exercise Training Programs were effective. Therefore, it is expected that the Self Efficacy Promotion and Exercise Training Program could be widely applied as an effective independent nursing intervention to decrease anxiety and depression and to increase quality of life for kidney transplant recipients.
Anxiety* ; Depression* ; Education* ; Exercise ; Humans ; Kidney Transplantation ; Kidney* ; Korea ; Nursing ; Quality of Life* ; Self Efficacy* ; Seoul ; Transplantation*

The purpose of this study was to explore the educational needs of kidney transplant patients and educational importance perceived by their nurses to develop a rehabilitational and educational program. Data were collected from January 29, 1999 to July 30, 1999 with interviews using a structured questionnaire. The subjects for this study were 173, of whom 107 were patients who had had a kidney transplant and had visited the out-patient department and 66 were transplant ward nurses who were taking care of the kidney transplant patients at six general hospitals located in Seoul. The questionnaire used for this study was developed by the investigator through a literature review and collected and modified by 11 professional personnel and 3 kidney transplant patients. The data were analyzed using the SAS program for numbers, percentiles, mean, standard deviation, t-test, ANOVA, and Scheff test. The results were as follows; 1) In the patient group, the total mean score for educational needs was 154.61 and the item mean score was 3.96. In the nurses group, the total mean score for perceived educational importance was 166.26 and the item mean score was 4.26. In the nurses group, perceived educational needs were scored higher than by the patient group. With regard to domains, both patient and nurses group had the highest educational needs and perceived educational importance in the domain of physical condition and the top five items in the educational needs and perceived educational importance were also in the domain of physical condition. 2) In the patient group, women and the divorce/bereavement group had higher educational needs in the domain of nutritional management, those who had been admitted longer than 4 weeks from their kidney transplant time had higher educational needs in the domains of physical condition and those who were less than 4 years from their transplant had higher educational needs in the domain of follow-up care. In the nurses group, those who were married had higher perceived educational importance in the domain of physical condition.
Female ; Hospitals, General ; Humans ; Kidney Transplantation ; Kidney* ; Outpatients ; Research Personnel ; Seoul ; Surveys and Questionnaires

No abstract available.
Fingers* ; Toes*