The bone formation of periarticular connective tissue after head injury and total hip arthroplasty is included in the category of heterotopic ossification. Induction of a new bone formation in the soft tissue is related to various materials such as bone morphogenic protein. The alkaline phosphatase and acid phosphatase act as important factors in the formation and absorption of the bone. The acid phospatase has the important function of acting as the control with specific activity of phosphatase in vivo. Cholecalciferol induces absorption of the calcium in the alimentary tract and bone resorption and increment of bone calcification, whereas disodium etidronate inhibits the deposition and dissolution of calcium salt and formation of heterotopic bone. This paper reports on the relationship of alkaline phosphatase and various phosphoaminoacid phosphatase which affect the cellular differentiation and remodelling in the heterotopic ossification, with the effect of cholecalciferol and disodium etidronate on the heterotopic bone induction in rats. The following results were obtained: 1. The contents of the calcium in the implanted bone matrix increased markedly from two to five weeks. There was no changes in the calcium content by cholecalciferol or in the administration of small doses of disodium etidronate (5mg/kg). However, in the administration of large dose of disodium etidronate (25mg/kg), calcium mobilization was totally suppressed for the whole period of the experiment. 2. The protein content in the implanted bone matrix did not much change for the whole period of the experiment and the administratinn of cholecalciferol or disodium etidronate also had no effect on the protein content. 3. The activities of alkaline phosphatase in the implanted bone matrix peaked at two weeks in control or cholecalciferol group, whereas disodium etidronate admninstration caused the highest activity in the third week. 4. The activity of acid phosphatase in the implanted bone matrix increased in first and third weeks by cholecalciferol treatment. Disoidum etidronate inhibited the activity of the acid phosphatase in the first, fourth & sixth weeks of implantation. 5. The activity of phosphoserine phosphatase increased due to cholecalciferol treatment, but was significantly inhibited by disodium etidronate (25mg/kg) treatment. 6. The activity of phosphothreonine phosphatase in the implanted bone matrix slightly increased due to cholecalciferol treatment, whereas the activity decreased significantly for the whole period of the experiment by disodium etidronate (25mg/kg) treatment. 7. The activity of phosphotyrosine phosphatase in the implanted bone matrix was not change much for the whole period of the experiment and the administration of cholecalciferol or disodium etidronate had no effect on the activity of phosphotyrosine phosphatase. In conclusion, the disodium etidronate (25mg/kg) almost completely inhibited the molilization of calcium and the activities of acid phosphatase, phosphoserine and phosphothreonine phosphatases. Therefore, it can be suggested that the above phosphatases are closely related to the action mechanism of disodium etidronate.
Absorption ; Acid Phosphatase ; Alkaline Phosphatase ; Animals ; Arthroplasty, Replacement, Hip ; Bone Matrix ; Bone Resorption ; Calcium ; Cholecalciferol ; Connective Tissue ; Craniocerebral Trauma ; Etidronic Acid ; Ossification, Heterotopic ; Osteogenesis ; Phosphoric Monoester Hydrolases ; Phosphoserine ; Phosphothreonine ; Protein Tyrosine Phosphatases ; Rats

With the aging process, the senile lids are manifested by the excessive skin, decreased height of palpebral fissures with interference of the vision. Sometimes these patients often complained the blepharitis on the lateral canthal area and phtophobia. But there are many diseases to differentiate from senile lids such as dermatochalasia, blepharochalasia, hypertrophy of orbicularis oculi, herniation of orbital fat, myasthenia gravis, and blepharoptosis. Blepharospasm must also be differentiated because of sysmptoms similar to the above described senile lids. Essential blepharospam is an idiopathic progressively debilitating desease which involve bilateral spasm of the orbicularis oculi. So just only an conventional blepharoplasty could not get an improvement of symptoms and some times it makes the symptoms worsen. This case report is about blepharospasm patients visiting for blepharoplasty. And the patients got relatively the satisfied results with the injection of botulinum A toxin, aided by neurologist, instead of blepharoplasty. In conslutions, The blepharospasm in required to detect in preoperative evaluation for blepharoplasty. Once the blepharospasm is diagnosed, it is better to cooperate with neurologist and to do the blepharoplasty.
Aging ; Blepharitis ; Blepharoplasty* ; Blepharoptosis ; Blepharospasm* ; Botulinum Toxins ; Botulinum Toxins, Type A ; Humans ; Hypertrophy ; Myasthenia Gravis ; Orbit ; Skin ; Spasm

In recent years the rate of the spine Injury tends to be on the increase year by year as the rate of traffic and industrial accidents are increased. During industrial, sports and automobile accidents are occurred, the various forces were exerted by the mechanism, “flexion, extension, flexlon-rotation, vertlcal compression and shearing.” These exercise their effects on the vertebral bodies, the neural arches and intervertebral disc and the contents of the spinal cord, depending on direction and intensity of the trauma, and the posture and muscular attitude existent at the movement. Once the neurological Iesion has been diagnosised and the type of vertebral injury has been established and particularly after a decision has been made as to whether the spinal injury is stable or unstable, a rational method of treatment can be decised upon: Our treatment consists of providing the best condition for recovery from the spine injury, preventlng further neurologlcal damage in the unstable area, achieving stable bone and llgament heallng ln satisfactory position, preventing metabolic compllcations from being fatal, mobllizing the patient early, and rehabilitating to provide maximum fuctlonal independence with the remaining-muscle power avallablc to the cord injury patient. One hundred and fifty seven spine fracture and dislocation patients were clinically observed and evaluated from Jan. 1972 to Dec. 1978 in our study. The result of this study may be summerized as follows: 1. Out of the patients, there were 135 male and 22 female cases. The ratio between male and female was 6.1:1. The majority (84.7%) of the spine injuries was found in the age of 20 to 50 years. Fifty-two percent of the cases was caused by industrial accidents. 2. The most common site of the lesion occurred between T-11 and L-2 vertebrae (71.8%). 3. In cervical injury, fracture dislocation type was most common (50%), and especially, pure dislocation by extension mechanism was 12.5% but in thoracolumbar iniury, simple anterior wedge compression fracture was most common (66.6%) and there were no pure dislocations just like cervical spine injury cases. 4. Fifty seven cases of the total were complicated by paraplegia, of which 62.5% in cervical region and 31.6% in thoracolumbar region were noticed. The most frequent type of the injury in which paraplegia developed was the fracture dislocation (73.8%) and the most common site of the lesion was between the T-12 and the L-2 vertebrae. 5. Open reduction was performed in 9 cases out of 24 cervical spine injury patients and in 41 cases out of 133 thoracolumbar injury patients. 6. Prognosis of neurologic recovery in initially complete lesion was poor, regardness of treatment. In the cervical lesion cases there were no patients who were recovered. But in the other sites about 10.5% of initially complete lesion showed partial neural recovery comparing to 62.5% of initially incomplete lesions. 7. Progressive deformity is often noted as a complication of spine fracture or dislocation when solid fusion fails to develop. The increment of kyphosis after treatment is as follows: Simple wedge fracture
Accidents, Occupational ; Automobiles ; Catheterization ; Catheters ; Clinical Study ; Congenital Abnormalities ; Diagnosis ; Dislocations ; Female ; Fractures, Compression ; Humans ; Intervertebral Disc ; Kyphosis ; Laminectomy ; Male ; Methods ; Paraplegia ; Posture ; Prognosis ; Spinal Cord ; Spinal Injuries ; Spine ; Sports ; Urinary Bladder

Segmental wiring to treat the unstable fracture and fracture-dislocation of the thoraco-lumbar spine is more effective method than Harrington instrumentation as primary procedure which afforded immediate rigid internal fixation of the spine and permitted mobilization without external support and immediate rehabilitation. A clinical study was made of twenty seven patients who were hospitalized and treated at the Department of Orthopaedic Surgery, Wonju Christian Hospital from Feb. 1979 to Apr. 1983. The following results were obtained: l. Of twenty seven patients, nine(33.3%) had a flexion rotation, eight(29.6%) had a shearing, eight (29. 6%) had a flexion compression and two(7.5%) had a vertical compression by Holdsworths mechanism of injury and by Pauls classification of fracture, thirteen(48. 1%) had a flexion distraction fracture, twelve(44. 4%) had a translation fracture and two(7. 5%,) had a unstable burst fracture. 2. Fifteen(55. 6%) had a complete neural deficit and five(18. 5%,) had an incomplete neural deficit. Six(22.2%) of the fifteen patients with complete neural deficit and one(3. 7%.) of the five patients with incomplete neural deficit showed slight neurological recovery, but eight(29.6%) gained complete recovery. 3. Correction of kyphotic deformity was average 12. 4 degree in Harrington instrumentation and average 18. 0 degree in segmental wiring, and during the follow-up periods, there was a final loss of 6. 3 degrees of kyphotic correction in Harrington instrumentation and 3. 0 degrees in segmental wiring. 4. In external support, fourteen(51.9%) had body jacket cast and four(14.8%) had back brace in Harrington instrumentation, but all patients except one brace had no external support in segmental wiring. 5. In complication, two hook dislocations and two pseudoarthroses were occurred in Harrington instrumentation, but any complication except only one cases of wound infection was not occurred in segmental wiring.
Braces ; Classification ; Clinical Study ; Congenital Abnormalities ; Dislocations ; Follow-Up Studies ; Gangwon-do ; Humans ; Methods ; Pseudarthrosis ; Rehabilitation ; Spine ; Wound Infection

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

A Epiphyseal injury in children is common following trauma to result in significant and permanent loss of function and growth. We analyzed 24 cases of epiphyseal injuries about the knee inchildren, who were treated in the Department of Orthopaedic Surgery, Yonsei University, Wonju College of Medicine from Jan. 1980 to Dec. 1987. The results were as follows :1. The sex ratio between male and female eas 2.5: 1, and mean age was 11 years old. 2. Large number of cases were by slip-down, traffic accidents or fall. 3. Epiphyseal injuries about the knee occurred in 12% among the 417 cases of childrens epiphyseal injuries. In point of injury patterns, large number of cases were Salter-Harris type 2 and type 3 injuries in the distal femur and the proximal tibia. 4. They were treated with closed reduction and plaster immobilization in 66%, with operative reduction and internal fixation in 34%. 5. Complications occurred in 6 cases : Knee pain and limitation of motion, angular deformity and limb shorteniing.
Accidents, Traffic ; Child ; Clinical Study ; Congenital Abnormalities ; Extremities ; Female ; Femur ; Gangwon-do ; Humans ; Immobilization ; Knee ; Male ; Sex Ratio ; Tibia

We present at least a one-year follow up of the 19 patients(twenty-two hands) of a open release of carpal ligament and external neurolysis in surgery for carpal tunnel syndrome. The transverse carpal ligament is exposed through a three centimeter paJmar incision in line with the axis of the third finger, started at the mid-point of the distal wrist crease and then straightly advanced. We analysed clinical manifestations and the following results were obtained; The average follow-up period was 27 months (12 - 120months). 1. According to the patients satisfaction of results(Cseuz criteria), the large majority of patients(91%) obtained good results. In 9% of the case (two hands) symptoms were siightly improved followed the operation but pain, numbness and paresthesia remained troublesome. 2. The mean grip and pinch strength of the fifteen hands were 23.4kg and 5.97kg respectively. 3. Thirteen(87%) of the fifteen hands that had thenar atrophy regained normal muscle bulk. 4. Six(50%) of the twelve hands that had denervation findings such as fibrillation or sharp wave were disappeared. 5. Twenty(91%) of the twenty-two hands that had increased values for two-point discrimination had normal values at follow-up.
Atrophy ; Axis, Cervical Vertebra ; Carpal Tunnel Syndrome* ; Denervation ; Discrimination (Psychology) ; Fingers ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Hypesthesia ; Ligaments* ; Paresthesia ; Pinch Strength ; Reference Values ; Wrist

PURPOSE: To evaluate the factors affecting foveal threshold measured by blue on yellow perimetry in moderate to severe open angle glaucoma. METHODS: Fourteen eyes of 14 patients who were diagnosed as moderate to severe open angle glaucoma underwent macular threshold test of the Humphrey Field Analyzer using white and blue targets. The foveal threshold using white targets (white threshold) was more than or equal to 18 dB in all cases. The cases of foveal threshold using blue targets (blue threshold) less than or equal to 0 dB were defined as foveal sensitivity loss group (7 eyes) and those more than 0 dB as no foveal sensitivity loss group (7 eyes). Those of age, contrast sensitivity, visual acuity, refraction, mean deviation, pattern standard deviation, corrected pattern standard deviation, vertical and horizontal C/D ratio, foveal white threshold, intraocular pressure, any point within central 5degrees with sensitivity less than or equal to 0 dB in visual field test were statistically analyzed between the two groups. RESULTS: Foveal white threshold and any point within central 5degrees with sensitivity less than or equal to 0 dB in visual field test showed significant difference between the two groups. CONCLUSION: Foveal dysfunction represented as decrease in blue threshold is possibly related to the paracentral scotoma which means any point within central 5degrees with sensitivity less than or equal to 0 dB in moderate to severe open angle glaucoma. However, significant deficits in either visual acuity or white threshold were not presented.
Contrast Sensitivity ; Glaucoma, Open-Angle* ; Humans ; Intraocular Pressure ; Scotoma ; Visual Acuity ; Visual Field Tests*

No abstract available.
Humans ; Nephrotic Syndrome* ; Renal Veins* ; Thrombosis*

Ipratropium bromide (IP) is a new anticholinergic bronchodilator. To evaluate its effect on bronchial asthma which is still unknown in Korea, a double blind and randomized study was done on all patients of bronchial asthma who visit out-patients clinic of out department from June to September 197 and showed 75 to 100% of FEV1/FVC ratio on prebronchodilator spirometry (pre BD). The selected patients were given 2 puffs of Fenoterol (FE) or Ipratropium inhalator blindly and Spirometry. The repeated results are: 1. In both FE and IP groups, there was a significant bronchodilatory effect on 5 and 60 minutes after administration. 2. One 5 minutes, effect of FE was significantly greater than IP (FVC p<0.05, FEV1 p<0.01). 3. One 60 minutes, effect of IP was slightly less than FE but statistically non-significant. On the basis of above results, we concluded that onset of effect of IP is slower than FE, but its effect is significant and nearly comparable to FE.
Asthma* ; Fenoterol ; Humans ; Ipratropium* ; Korea ; Nebulizers and Vaporizers ; Outpatients ; Spirometry