A follow-up study was made of 26 knees of 21 patients who underwent arthroscopic synovectomy between October 1982 and August 1983 in Catholic Medical College and Center. The patient's ages ranged from 3 to 66 years of age. There were 14 female patients and 7 male patients in this series. The follow-up period of all patients was a minimum of twelve months to a maximum of 20 months. The average follow-up of the whole group was 16.8 months. The abnormal findings were rated from 0 to 4 according to Marmors rating system. Final clinical evaluations of the patients were done according to the modified criteria of Sledge et al. The results were as follows; 1. Rheumatoid Arthritis Of 14 knees, 3 joints(21.4%) were rated “excellent”, 6(42.9%) were “good”, and 5(35.7%) were “fair”. There was no case of “unimproved”. 2. Juvenile Rheumatoid Arthritis The results of all 5 knees were satisfactory. Of 5 knees, 4 joints(80%) were rated excellent and one joint (20%) was good. 3. There were 3 knees of osteoarthritis, 3 knees of chronic synovitis and one knee of pigmented villonodular synovitis. Their final results were all satisfactory. Three joints were rated excellent and the other 3 joints were good. 4. Of 26 knees, as a whole, 10 joints (38.5%) were rated “excellent”, 11 joints (42.3%) were “good”, 5 joints (19.2%) were “fair” and no joint was “unimproved”. There were 5 recurrences of active synovial disease in this series, and these patients all were “classic” rheumatoid arthritis. But surprisingly the average patient in this group of recurrence did well even after recurrence. These patients all had less pain and effusion than before operation. 5. The major cause of unsatisfactory results other than recurrence of synovitis were articular degeneration (joint space narrowing) and patellofemoral osteoarthritis (4 knees). 6. A good range of motion with the shortest rehabilitation period can be expected if alternate flexion and extension splints are applied on alternate days for less than a week following the surgery. In conclusion, one may state that the arthroscopic synovectomy is worth considering for the treatment of various kinds of synovitis of the knee joint and when the rheumatoid process follows a favourahle course.
Arthritis, Juvenile ; Arthritis, Rheumatoid ; Female ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Knee ; Male ; Osteoarthritis ; Range of Motion, Articular ; Recurrence ; Rehabilitation ; Splints ; Synovitis ; Synovitis, Pigmented Villonodular

No abstract available.

No abstract available.
Brain Stem* ; Evoked Potentials* ; Hallucinations* ; Humans

BACKGROUNDS: Percutaneous radiofrequency neurotomy of posterior primary ramus has been in use as a treatment for persistent, mechanical low back pain for two decades. However, there has been limited studies regarding to prognostic factors related to outcome. We report our experience with at least 2-year follow up with special aftention on prognostic factors. METHODS: Of total 228 patients who underwent percutaneous radiofrequency neurotomy (PRN) of posterior primary ramus for refractory low back pain during last 3 years, 128 patients whose pain was considered to be originated from facets joints or their surrounding soft tissue and responded to temporary blocks were assigned to a group II. All patients had more than 6 months of pain. These patients were compared with 100 patients to whom PRN were provided for chronic nonspecific low back pain without all inclusion criteria (Group I). RF procedures were done under local anesthesia with C-arm intensifier guidance. Pain reliefs were estimated at 1week, 1month, 6months and 2 years using visual analog scale(VAS). For patients with more that 50% reduction of previous pain was regarded as positive responder. Various clinical variables such as age, sex, symptom duration, types of pain, bilaterality, and previous surgery were studied for prognostic factors. RESULTS: Positive responders were 56% at 1week, 46% at lmonth, 18% at 6months, and 13% at 2years after PRN in group I, and 78.9% at lweek, 75.4% at lmonth, 62.5% at 6months, and 54.7% at 2years in group II. Some variables were found to be significantly related to outcome including prominent local tenderness, percussion tenderness, combination of symptoms with pain on gefting up, extension, transitional movement, pain radiating to buttock and/or posterior thigh, and good immediate response. Age, sex, symptom duration, bilaterality, imaging study results, previous lumbar surgery, and degrees of pain relief from diagnostic block were not related to outcome. CONCLUSIONS: These results indicate that PRN of posterior primary ramus has a moderate overall long-term beneficial effect, with no morbidity in our series. But, the long-term good results will be anticipated only in properly selected patients with low back pain originating from facet joints and surrounding structures.
Anesthesia, Local ; Buttocks ; Follow-Up Studies ; Humans ; Joints ; Low Back Pain* ; Percussion ; Thigh ; Zygapophyseal Joint

STUDY DESIGN: The lumbar segmental motions were analysed in asymptomatic volunteers. OBJECTIVES: To obtain normative data on flexibility and Graf's instability degree in sagittal plan of the normal lumbar spine. SUMMARY OF LITERATURE REVIEW: Although several clinical and radiological measurement tech niques are available, little is known about the normal range of lumbar spine motion. As a consequence, the diagnostic evaluation of radiographs are frequently based on subject opinions rather than object reality. MATERIALS AND METHODS: The authors have checked lumbar flexion-extension Yiews of 95asymptomatic volunteers who were divided into 5 groups by the age, and then their flexibility and Graf's instability degree were calculated by Graf's method with using Graf/Bar Mark II(digitalizing table) and personal computer program(RachisR). Evaluation of the sexual difference and comparison of the difference of each age group in spine level were done RESULTS: 1. There were significant differences in flexibility among age groups(p<0.05) and highest flexibility was observed in group 1 (age: 15-19yrs) and 15-19 segment 2. Flexibility was not different between male and female(p>0.05). 3. Graf's instability degree was not different among 5 age groups(p>0.05), and between male and female(p>0.05). 4. The mean Craf's instability degree was below 8o in L2-3, L3-4, and L4-5 segment, but above 8 in L5-S1 segment(male: 11.62+/-9.27 , female. 11.11+/-8.70). CONCLUSIONS: Although we observed small subjects, these results are the basic steps toward more objective and careful interpretation of flexibilty and Graf's instability degree.
Female ; Humans ; Male ; Microcomputers ; Pliability* ; Reference Values ; Spine ; Volunteers

We have treated the open tibia shaft fractures, especially Gustilo type II, with unreamed interlocking intramedullary nail. In cases combined with soft tissue damage around fracture site, maintaining rigid internal fixation and preserving endoosteal blood supply is important in union of fracture and soft tissue healing. We have analyzed 18 cases of Gustilo type II open tibial shaft fractures managed with intramedullary nailing without reaming since 1991, the follow-up period was average 22 months. Most of the fractures were the result of moderate to high-energy trauma. In all 18 cases, nails were inserted via closed method. Static interlocking nailing was used in all cases. In 16 cases, union of the fracture was achieved from 16 to 25 weeks(average 23 weeks). In the other 2 cases, union was achieved in 7 months. There was no serious postoperative complication except one skin infection with skin defect managed by skin flap and one failure of the interlocking screw. These results are comparable with those obtained from other forms of fixation, including immobilization with a cast, reamed intramedullary nailing, and external fixation.
Follow-Up Studies ; Fracture Fixation, Intramedullary ; Immobilization ; Methods ; Postoperative Complications ; Skin ; Tibia

No abstract available.

No abstract available.
DiGeorge Syndrome*

No abstract available.
Iron*

Localized pulmonary amyloidosis is a rare disease characterized by a deposition of amyloid limited to the lungs. We report a case of primary tracheobronchial amyloidosis which resulted in collapse of left lung and was confirmed by the Congo-red staining.
Amyloid ; Amyloidosis* ; Lung ; Rare Diseases