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

There are many controversies in ability of articular cartilage to heal full thickness defect. Generally, it is reported that full thickness defects of articular cartilage filled with organizing hematoma and granulation tissues, which converted to chondroid tissues. It is clear that the size of defect was related to the repair of articular cartilage. Though cartilagenous material fills the defect and restores the surface continuity, it may undergo degeneration, and lead to localized focus of osteoarthritis. Multiple drilling through subchondral bone could be a kind of treatment in articular cartilage defect. Author conducted an experiment for the full thickness defect of articular cartilage in rabbit. After multiple drilling of articular cartilage, the repair of defect was examined histologically until eighth week. Results were as followings ; l. At lst. week, the defect was repaired by fibrovascular proliferation and granulation tissue. 2. At 3rd. week, hyaline cartilage consisted of normal chondrocyte was formed. 3. At 8th. week, subchondral plste was regenerated completely. 4. All defects that were less than 3 mm. in diameter were healed. More repairs were observed in case with the wider defects if the defects were within 3mm. in diameter. 5. The metachromasia was observed with toluidine blue stain. The reformed cartilage shows slight purple(Grade II) to moderate purple(Grade III) at third week and near normal (Grade IV) at fourth week. In conclusion, multiple drilling may be an effective method of treatment in articular cartilage defect. It is considered that multiple drilling with a 3mm. Steinmann pin may be the most convenient and effective method of the cartilage healing.
Cartilage ; Cartilage, Articular ; Chondrocytes ; Granulation Tissue ; Hematoma ; Hyaline Cartilage ; Methods ; Osteoarthritis ; Regeneration ; Tolonium Chloride

The blow-out fracture can be reconstructed by various autogeneous and alloplastic material. Particulate, nonresorbable hydroxyapatite is currently one of the choice of implant material available for reconstruction of blow-out fracture. Hydroxyapatite is radiopaque ceramic, physically and chemically similar to enamel and cortical bone. It is a biomaterial derived from natural corals to use as a bone graft substitute. And we looked into the clinical usefulness of 2 type of hydroxyapatite with their advantages and disadvantages in reconstruction of blow-out fracture. 183 patients with blow-out fracture who underwent surgical reconstruction with two types of hydroxyapatite from March 1933 to July 1977 have been analyzed the results of surgical reconstructions, and have been followed up for more than a year. And the condition of formerly inserted hydroxyapatite was observed in the patients who needed 2nd surgical reconstruction due to the enophthalmos. The disadvantages of hydroxyapatite are fragility, size and contour limitations. In spite of these demerits, hydroxyapatite can be one of the prospective materials to reconstruct orbital floor. Through the clinical experiences for 5 years, we have not found any of complications of exposure, infection, and foreign body reaction. Low rates of diplopia, limitation of ocular movement, and enophtalmos was observed. Hydroxyapatite was well adherent to adjacent orbital bone in most patients who needed secondary reconstruction for enopthalmos. In conclusion, our study shows that the availability of hydroxyapattite in reconstruction of blow-out fracture is recommendable, with low complication rates. Hydroxyapatite important appears to be well tolerated, and provides useful alloplastic prosthesis with few problems in reconstruction of blow-out fracture.
Anthozoa ; Ceramics ; Dental Enamel ; Diplopia ; Durapatite* ; Enophthalmos ; Foreign-Body Reaction ; Humans ; Orbit* ; Orbital Fractures* ; Prostheses and Implants ; Transplants

No abstract available.
Enophthalmos* ; Orbit*

Cavernous hemangioma is the most common primary tumor occurred in adults' orbit. This tumor has symptoms characteristically developing over several years with slowly progressive proptosis, eyeball deviation, hyperopia, diplopia and optic nerve compression. It's removal, necessary when there is progressive exophthalmos and visual deficit, is best performed en bloc to avoid intraoperative vleeding, the risk of residue, and potential further growth. In principle, surgical approach to the orbit must provide maximum safety and optimal visualization. The noncompressibility of the globe imposes greater demand on the need for some removal of the osseous orbit for surgical approach. This also must permit immediate functional and aesthetic reconstruction. The authors have experienced a case of large cavernous hemangioma in the orbit inferomedially. The surgical treatment of tumor was achieved by inferomedial approach combined with inferolateral orbitotomy. This surgical approach allows better visualization of the tumor and greater protection of essential anatomic structures. This also permits immediate functional and aesthetic reconstruction. So we present our case with a brief review of the literature related to orbital cavernous hemangioma.
Diplopia ; Exophthalmos ; Hemangioma, Cavernous* ; Hyperopia ; Optic Nerve ; Orbit*

No abstract available.

No abstract available.
Arthroplasty* ; Knee*

Many plastic surgeons have been tried to attain ultimate goal lies in restoring the original shape and function of the facial aesthetics, in reconstruction of deformities resulting from facial hypertrophic scar and skin defects. This would require consideration in terms of hanmony in color match, skin texture and thickness. Various forms of skin graft, local flap, distant flaps, free flap and tissue expander have been employed in restoring skin defects and deformities of the cheek and submental area, and the use of large local flaps utilizing the cervicofacial skin flaps or tissue expander have brought about improved aesthetic results. the authers have obtained satisfactory results in treating 2 cases of wide hypertrophic scar of the cheek and submental area with combination of wide cervical flap and intraoperative tissue expansion using foley catheter. the merits of this combined operative methods are as follows : 1. It is not necessory to keep tissue expander for a long period. 2. This technique is able to diminish the cost of multistage operation and using of tissue expander. 3. There is no psychologic problems due to undesirable facial appearance during tissue expansion period. 4. Rapid intraoperative tissue expansion by foley catheter during elevating wide cervical flap can allow to dissect one, preserving the perforators without bleeding in a short time. 5. Wide cervical flap and additional expanded tissue by means of intraoperative tissue expansion could brought into suturing avoiding tension of oral commissure and lip eversion. 6. Preservation of perforators of cervical flap above the platysma muscle raised flap's survival rate and then this result could prevent distal ischemic necrosis after flap coverage.
Catheters ; Cheek ; Cicatrix, Hypertrophic* ; Congenital Abnormalities ; Esthetics ; Free Tissue Flaps ; Hemorrhage ; Lip ; Necrosis ; Skin ; Survival Rate ; Tissue Expansion Devices ; Tissue Expansion* ; Transplants

Gangweon-do is known to be highly endemic area of sparganosis more than other provinces in Korea. A seroepidmiologic examination for the detection of anti-Spirometra erinacei plerocercoid IgG in serum was carried out in normal inhabitants in Hongcheon-gun, Gangweon-do. Sere were tested by enzyme-linked immunosrobent assay (ELISA) for the anti-sparganum antibodies. Positive rate for anti-sparganum antibody in 719 adults was 3.3%. Data of the questionnaire for 24 ELISA positive inhabitants revealed that 20 had a history of eating raw meat of snakes, 24 had a history of eating frogs, and 24 had a history of drinking stream water. Two positive cases had a past history of sparganosis. Two positive cases showed current symptoms of sparganosis. The data revealed that ELISA would be useful to find infected cases among normal inhabitants at sparganosis-endemic areas.
Adult ; Aged ; Aged, 80 and over ; Animals ; Antibodies, Helminth/*blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Human ; Immunoglobulin G/*blood ; Korea/epidemiology ; Male ; Middle Aged ; Seroepidemiologic Studies ; Sparganosis/*epidemiology ; Spirometra/*immunology

Mucormycosis is an opportunistic fungal infection caused by the mucorales, which consist of the Rhizophus, Absidia, Mortierella, and Mucor. The diverse clinical forms of mucormycosis can be categorized as rhinocerebral, pulmonary, disseminated, gastrointestinal, cutaneous and miscellaneous. Although it can cause disease in healthy people, it most commonly affects patients who are diabetic or immunosup-pressed. Rarely, mucormycosis develops confined to the subcutaneous tissue. We experienced a case of cutaneous mucormycosis developed in a well-controlled diabetic patient who had previously injected foreign material on her face for an aesthetic purpose at the behest of an unlicensed physician. The patient had tissue necrosis and purulent discharge on her left cheek. Following histologic examination, we diagnosed the condition as cutaneous mucormycosis and treated it by wide excision combined with amphotericin B therapy. The disease was cured without any significant sequelae within 6 months of follow up. Cutaneous mucormycosis is rarely reported but it can cause facial deformity due to tissue necrosis, so that early diagnosis and appropriate treatment are important. Currently, foreign material injection for aesthetic purposes is still performed by unlicensed physicians. We present a case report concluding that one should consider the possibility of fungal infection in skin lesion in diabetic or other immunosup-pressed patients. We also emphasize the seriousness of illegal injection of foreign material.
Absidia ; Amphotericin B ; Cheek ; Congenital Abnormalities ; Early Diagnosis ; Follow-Up Studies ; Humans ; Mortierella ; Mucor ; Mucorales ; Mucormycosis* ; Necrosis ; Paraffin* ; Skin ; Subcutaneous Tissue