The femoral neck fractures in children remain an unsolved problem because of lack of the optimal treatment followed by unpredictable, serious complications. Since the first trial of muscle pedicle bone graft by Judet(1962), Meyers et al(1973) refined and promoted this method for nonunion and as a primary procedure, and Baksi(1983, 1986) expanded its indication to post-traumatic avascular necrosis of the femoral head. Two cases of avascular necrosis and Two nonunion cases treated by quadratus femoris muscle pedicle bone graft at the Chonbuk National University Hospital from Jan. 1986 to Jun. 1988 were reported. The age of the patients varied from 6 to 16 years ; Follow-up ranged 6 to 29 months ; all cases were displaced transcervical fracture. In according to Ratliffs assessment, three cases showed satisfsctory results and one poor.
Child ; Femoral Neck Fractures ; Femur Neck ; Follow-Up Studies ; Head ; Humans ; Jeollabuk-do ; Methods ; Necrosis ; Transplants

Purpose: The goal of study was to evaluate the clinical and radiographic performance of the proximal modular cementless femoral stem for use in revision total hip arthroplasty. Material and method: Fifty seven patients (57 hips) were followed for longer than 24 months or up to 8.4 years after performing revision total hip arthroplasty with using the proximal modular cementless femoral stem between January 1997 and December 2002. The preoperative diagnosis included 45 cases of aseptic loosening, 5 cases of septic loosening (re-revision operation), 6 cases of periprosthetic fracture and 1 case of recurrent dislocation. The bone deficiencies were classified according to the Paprosky classification: there were 27 cases of Type I and II, 19 cases of Type IIIA, 9 cases of Type IIIB and 2 cases of Type IV. Results: The average Harris hip score improved from 47 to 87.6. Clinically satisfactory results were noted in 50 patients (87.7%). Radiographically, distal stable fixation was observed in 54 patients (94.7%). Intraoperative complications included two greater trochanteric fractures and two proximal femur fractures. Postoperative complications included 5 femoral stem subsidences (2hips< 5mm, 3 hips>20mm), 4 deep infections, 2 non-unions of the greater trochanter and the osteotomy site and set screw dissociation was noted in 1 case. 5 proximal component changes were done due to progressive subsidence in two cases, non-union at the osteotomy site and trochanteric displacement in two cases and set screw dissociation in one hip. For the infection cases, the proximal segment was removed and re-revised with a 2nd stage operation. (Ed note: check this.) The subsidence of the femoral stems was showed in 3 Paprosky grade IIIA cases and in 2 cases of grade IIIB or more. There was no postoperative periprosthetic fracture observed at the last follow-up. Conclusion: Revision total hip arthroplasty using the proximal modular cementless femoral stem showed good results in the face of the infection of the proximal component and deficient proximal bony support. This procedure appears to be convenient for the surgeon to correct anteversion of the femoral head and leg length discrepancy.
Arthroplasty, Replacement, Hip ; Classification ; Diagnosis ; Dislocations ; Femur ; Follow-Up Studies ; Head ; Hip ; Hip Fractures ; Humans ; Intraoperative Complications ; Leg ; Osteotomy ; Periprosthetic Fractures ; Postoperative Complications ; Prostheses and Implants*

Despite the continually improving results of total knee arthroplasty, infection remains the most debilitating complication. The treatments of infected total knee arthroplasty were variable, but initially we removed infected implants and inserted antibiotic containing cemented spacer. Postoperatively, patients were mobilized in a 30 knee flexion state and treated with parenteral antibiotics. After control of infection was clinically and radiologically determined, we inserted PCL substitute total knee prosthesis. Five days postoperatively, patient began touch down standing exercise. We observed two cases in whom infected total knee arthroplasty had been salvaged successfully with two-stage implantation using cement spacers containing antibiotics.
Anti-Bacterial Agents* ; Arthroplasty* ; Humans ; Knee Prosthesis ; Knee* ; Replantation*

Despite continually improving results of total hip arthroplasty, infection remains the major debilitating complication. The treatments of infected total hip arthroplasty were variable. but initially we removed infected implants and inserted antibiotic containing cemented spacer so called PRSTALAC to prevent scar contracture and disuse osteoporosis. After 6 weeks later, control of infection was clinically and radiologically determined, we inserted new prosthesis with cement. Three weeks postoperatively, patient began touch down standing exercise. We observed infected total hip patient in whom hip had been salvaged successfuily with twostage implantation using so called "" PROSTALAC "" which was made with Moore stem.
Arthroplasty, Replacement, Hip* ; Cicatrix ; Contracture ; Hip ; Humans ; Osteoporosis ; Prostheses and Implants ; Replantation*

Eosinophilic granuloma, Hand-Schuller-Christian and Abt-Letterer-Siewe syndrome are known to be the same disease entity involving the reticulohistiocytic system of the body, although their clinical manifestations are different. So they were included under the term of Histiocytosis X and this concept has been generally accepted. The authors have experienced one case of Hand-Schuller-Christian disease and that of eosinophilic granuloma. The former was a 23 years old man with complaints of exophthalmos, polyuria and a tender palpable mass on the right parietal area and in the latter a soft pulastile mase located on the left parietal area in a 3 year old boy. There was no neurological deficits on their admission. We managed them with radiation and steroid therapy following surgical curettage.
Child, Preschool ; Curettage ; Eosinophilic Granuloma ; Exophthalmos ; Histiocytosis* ; Histiocytosis, Langerhans-Cell* ; Humans ; Male ; Polyuria ; Rabeprazole ; Young Adult

BACKGROUND: Thyroid cancer is the most common tumor with a endocrine gland origin, and it has a gradually increasing incidence rate. An operative procedure is useful to obtain good results for this disease. Howevers, the selection of operation method remains controversial. Thus, we reviewed the variable prognostic factors which influence thyroid cancer recurrence in order to determine the treatment methods which reduce the recurrence rate. METHODS: We retrospectively reviewed the cases of 383 thyroid cancer patients who had received operations from January 1988 to December 1993. The review looked at age, sex, operation methods, lymph-node metastasis, histologic types, mass size and capsular invasions, and the correlations between these factors and recurrence were analyzed by using Chi-square and SAS trend tests. Complications which developed after various operation methods were also reviewed. RESULTS: Thyroid cancer recurred in 33 (8.6%) patients. Age, sex, lymph-node metastasis, histologic types and capsular invasions did not influence the cancer recurrence rate significantly. However, mass size and operation method were potential factors for recurrence. CONCLUSIONS: If thyroid cancer is diagnosed, a total thyroidectomy with lymph-node dissection is the best method for reducing the cancer recurrence rate. By careful management, complications can be prevented after a total thyroidectomy.
Endocrine Glands ; Humans ; Incidence ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Surgical Procedures, Operative ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

No abstract available.
Anemia, Aplastic*

OBJECTIVE: Our present studies were conducted to examine more effective isolating method of preantral follicles from mouse ovaries. METHODS: ICR mice (3-6 weeks old) were sacrificed through cervical dislocation and their ovaries were removed and put into watch glasses containing Hams F-10 supplemented with 10% fetal bovine serum (FBS). Preantral follicles were isolated by three different methods; 1) enzymatical method and 2) mincing method, and 3) scraping method. Enzymatical method was carried out as following. Ovaries were bisected with a pair of fine 30G needles. Bisected ovaries were incubated at 37degrees C and 5% CO2 incubator in 2-well dish containing Hams F-10 supplemented with collagenase 600 IU/ml. After 20 min.,follicles were isolated by repeated pipetting. Isolated preantral follicles were collected, and the remnant of tissues was placed in incubator and previous procedure was repeated. Mincing method was carried out with a pair of fine 30G needles attached to 1 ml syringes and mined ovary. Scraping method was carried out wit a pair of fine 30G needles and scratched to surface of ovary. The differences between isolating methods were analyzed using Student's t-test and Chi-square. Results were considered statistically significant when P value was less than 0.05. RESULTS:In handling time, mincing or scraping method (28+/-3.42 min or 16+/-1.58 min) were significantly (p<0.00001) shorter than enzymatical method (72+/-1.69 min), and scraping method was significantly (p<0.01) shorter than mincing method. Total number of isolated follicles was significantly (p<0.0001) higher in enzymatical method (49.8+/-3.91) than in mincing or scraping method (25.3+/-2.33 or 20.5+/-1.75). Isolated follicles in < or =90 micrometer were significantly (p<0.005) higher in enzymatical method (15+/-1.71) than in mincing or scraping method (7.8+/-0.98 or 8.1+/-1.31). In 91~130 micrometer, isolated follicles were significantly (p<0.0005) higher in enzymatical method (33+/-3.27) than in mincing or scraping method (16.3+/-1.82 or 10.7+/-1.38). In > or =131 micrometer, isolated follicles were not significantly differences between all groups. In equal sizes, the rate of isolated follicles in < or =90 micrometer was highest in scraping method (39.6% vs. enzymatical method:30.1%, p<0.05; mincing method: 30.9%, p=0.11719, NS). Rate of follicles in 91~130 micrometer was significantly (p<0.05) lower in scraping method (52.7%) than in emzymatical or mincing method (66.3% or 64.5%). Rate of follicles in > or =131 micrometer was highest in scraping method (8.3% vs. enzymatical or scraping method: 3.6%, p<0.05)or 4.6%, p=0.19053, NS). CONCLUSIONS: This study suggests that scraping method is simple and useful for isolation of preantral follicles, because this method reduced handling time and recovered enough follicles. The recovered rate of isolated follicles in diameter of 91~130 micrometer was highest in all methods.
Animals ; Collagenases ; Dislocations ; Eyeglasses ; Female ; Glass ; Incubators ; Mice* ; Mice, Inbred ICR ; Needles ; Ovary* ; Syringes

OBJECTIVE : Mammalian embryos undergo changes of energy environment for transfer from oviduct to uterus. Also, the human reproductive organ (oviduct, uterus) contains energy sources of different concentration (oviduct - glucose: 0.5 mM, pyruvate: 0.32mM, lactate: 10.5 mM; uterus - goucose: 3.15 mM, pyruvate: 0.1mM, lactate: 5.87 mM, respectively). This study was conducted to examine the effect of these energy sources added in DMEM with glutamine on the mouse embryo development. METHODS: There was used ICR female mouse. Two cell embryos of mouse are collected by method of 'flushing'. Flushing fluid was used Ham's F-10 added to 20% FBS. The collected 2 cell embryos were cultured in media such as Control (only DMEM), group A and B (DMEM supplemented with 0.5 mM and 3.15 mM glucose), and group C and D (DMEM supplemented with 0.1 mM and 0.32 mM pyruvate), and group E and F (DMEM supplemented with 5.87 mM and 10.5 mM lactate). All experimental media supplemented with 20% hFF, respectively. Pattern of embryo development was observed to interval at 24hr during 96hr. RESULTS : The media with glutamine added glucose (group A: 51.0%; group B: 48.4%) was significantly (p<0.05) higher than other experimental group in development into the morula stage after 24 hr in culture, but not significantly different compared with control and the rate of development into the blastocyst was significantly (p<0.05) low in the both of pyruvate (group C: 7.9% group D: 6.8%) and lactate (group E: 7.1%, group F: 7.1%) treatment group after 48 hr in culture. Development into the hatched and attached balstocyst after 96hr in culture revealed similarly in control (81.9%) and glucose treatment group (group A: 83.3%, group B: 82.8%). However, development into the hatched and attached blastocyst after 96hr in culture revealed significantly (p<0.05) development in the glucose treatment group (group A: 82.3%, group B: 78.5%) than control (63.2%), and its of pyruvate (group C: 34.1%, group D: 34.1%) and lactate (group E: 25.9%, group F: 33.3%) treatment group were significantly (p<0.05) lower than control similar to previous observations. CONCLUSION : The glucose added to the DMEM with only glutamine, as energy source, was highly to the rate of development compared with control, but the other energy sources were not, synthetically. Above refer to, the human reproductive organ (oviduct, uterus) contains energy sources of different concentration. Thus, further studies are will examine continuously to effects by interaction of different energy sources in the mouse embryo culture.
Animals ; Blastocyst ; Eagles* ; Embryo, Mammalian ; Embryonic Development* ; Embryonic Structures* ; Female ; Flushing ; Glucose ; Glutamine ; Humans ; Lactic Acid ; Mice* ; Morula ; Oviducts ; Pregnancy ; Pyruvic Acid* ; Uterus

PURPOSE: Intestinal atresia is a well-recognized cause of bowel obstruction in the newborn. The management of neonates with intestinal atresia has improved in recent decades due to refinements in neonatal intensive care, operative techniques, use of total parenteral nutrition (TPN), and neonatal anesthesia. More recently, the survival rate has risen rapidly up to 90%. METHODS: Twenty-five (25) cases of intestinal atresia were encountered at Kwangju-Christian Hospital between January 1985 and December 1998. We reviewed sex, gestational age, body weight, clinical manifestations, associated ano malies, causes, interval to operation, preoperative complications, operative methods, and postoperative complications. RESULTS: Sites involved were the duodenum (n=10; 40%), the jejunum (n=5; 20%), and the ileum (n=10; 40%). The sex distribution was male predominant (1.8:1). The overall survival rate in our hospital was 76%. CONCLUSION: Refinements in neonatal intensive care and perioperative management were important in decreasing postoperative mortality.
Anesthesia ; Body Weight ; Duodenum ; Gestational Age ; Humans ; Ileum ; Infant, Newborn ; Intensive Care, Neonatal ; Intestinal Atresia* ; Jejunum ; Male ; Mali ; Mortality ; Parenteral Nutrition, Total ; Postoperative Complications ; Sex Distribution ; Survival Rate