Partial meniscectomy was a common method of treatment for a meniscal injury and currently available instruments were scalpel, punch, electrocautery, CO2, laser, Nd: YAG laser, etc. However some methods could cause injuries to adjacent meniscal tissue after meniscectomy. An experimental study was conducted in order to examine the depth of injury to adjacent meniscal tissue according to above 5 different methods of meniscectomy. 25 medial menisci were harvested from Yorkshire pig knee immediately after the death of pig. Meniscal injury, 1.5cm long and 0.5cm wide, was made by using 5 different methods and was analysed macroscopically and microscopically. Average depth of injury was 237 in Nd: YAG laser group. 258um in electrocautery group, 307um in CO2, laser group, and nil in scalpel and punch group. The depth of meniscal injury of Nd: YAG laser and electrocautery group were less than that of CO2, laser group. Scalpel and punch were the most safe methods to adjacent meniscal tissue. CO2, laser, Nd: YAG laser and electrocautery should be carefully applied because they could cause the significant depth of injury in the adjacent meniscal tissue.
Electrocoagulation ; Knee ; Lasers, Solid-State ; Menisci, Tibial ; Methods

STUDY DESIGN: Thirteen patients with cervical interlocked facets dislocation in whom closed reduction by skull traction was failed were evaluated about the patterns of ruptured disc fragment. Objects : To evaluate the causes of failure at closed reduction, and the relation between ruptured discs and interlocked facets, and the treatment results through an anterior approach. SUMMARY OF LITERATURE REVIEW: In traumatic dislocation of the cervical facet joints, spinal cord or nerve roots injury associated with the ruptured disc fragment has been reported. However, there is few report evaluating the patterns of ruptured disc fragment as a cause of reduction failure. MATERIALS AND METHODS: Between 1988 and 1997, thirteen patients were treated by anterior fusion with plate after complete removal of the intervertebral disc through anterior approach and reduction of interlocked facets by O1iveira method. They have been followed for an average of 36 months(range : 12-96 months). The interlocking was bilateral in seven cases and unilateral in six cases. We assessed the types of ruptured disc fragment by preoperative MRI and CT and the clinical and radiological results. RESULTS: Ruptured disc fragment was found in all thirteen patients with interlocked facets dislocation. The patterns of ruptured discs were within the uncovertebral joints in 5 cases, posterioly under the posterior longitudinal ligament in 3 cases, anteriorly under intact anterior longitudinal ligament in 3 cases and combined under the anterior and posterior longitudinal ligament in 2 cases. The displacement of ruptured disc fragment were seemed to be the cause of failure in closed reduction. CONCLUSIONS: Intervertebral disc injury should be evaluated carefully with MRI and CT in the lower cervical interlocked facet dislocations before trial of reduction or decision makings of treatment.
Dislocations* ; Humans ; Intervertebral Disc ; Joints ; Longitudinal Ligaments ; Magnetic Resonance Imaging ; Skull ; Spinal Cord ; Spine* ; Traction ; Zygapophyseal Joint

The anterior discectomy is widely accepted method for removal of the herniated disc material of cervical spine due to direct visualization of the lesion site. In addition, it is believed to prevent recurrence of herniation, progression of degenerative change, and to preserve normal cervical lordosis after the fusion. For more effective anterior fusion and early postoperative ambulation without prolonged external support, internal fixation technique was introducsuspected to influence the result of operation, the type of bone graft and age of the patient may be the effective factors to the late result. ed. Authors reviewed 36 patients with cervical disc herniation and evaluated the result of anteior discectomy and fusion with plate fixation. With a mean follow up of 34 months, there were remarkable symptomatic improvement at most instances and bony union in situ within 3 months in all cases after the operation. Disclosed complications were 2 cases of hoarseness which was improved spontaneously, and 1 case of dysphagia. At the comparison of the effect of the factors which were suspected to influence the result of operation , the type of bone graft and age of the patient may be the effective factors to the late result.
Animals ; Deglutition Disorders ; Diskectomy* ; Follow-Up Studies ; Hoarseness ; Humans ; Intervertebral Disc Displacement ; Lordosis ; Recurrence ; Spine ; Transplants ; Walking

PURPOSE: To compare the functional and radiographic results of the treatment in unstable intra-articular fractures of distal radius by closed reduction and external fixation versus open reduction and internal fixation. MATERIALS AND METHODS: Forty cases of unstable intra-articular fractures of distal radius were treated either by application of closed reduction and external fixation (CREF) or by open reduction and internal fixation (ORIF) between March 1989 and June 1997. They were followed up for more than one year. To assess the functional results, we used Green and O' Brien' s score system and for the radiographic results, measured volar tilt, radial inclination and radial length. RESULT: In functional results, excellent to good results were obtained in 19 cases (76%) in the CREF group and 10 cases (80%) in the ORIF group, and the average score was 81.4 and 82.8 by the Green and O' Brien' s score system. In radiographic results, mean loss of volar tilt, radial inclination and radial length were 1.4 degree (13.4%), 2.0 degree (9.0%), 1.3 mm (10.3%) in the CREF group and 1.2 degree (10.8%), 1.6 degree (6.1%) and 1.2 mm (11.5%) in the ORIF group on last follow-up radiographs. There was no evidence of statistical difference between two groups in functional and radiographic results (P>0.05). CONCLUSIONS: If an appropriate operative method is selected according to the presence of several properties, including the pattern of fracture, the general condition and activity of patient and the degree of soft tissue injury, the two operative managements are considered useful to restoring articular congruity and alignment and to allow early postoperative range of motion exercise
Follow-Up Studies ; Humans ; Intra-Articular Fractures* ; Radius* ; Range of Motion, Articular ; Soft Tissue Injuries

Osteochondroma is one of the most common benign tumor. But, intraarticular occurrence is very rare. This tumor have been thought not a true neoplasm hut a developmental malformation or harnartoma. The authors experienced a case of intaarticular osteochondroma arising from inferior pole of pateUa, projecting into the infrapatellar fat pad. The tumor was excised surgically, and symptoms were relieved.
Adipose Tissue ; Knee ; Osteochondroma* ; Patella*

An electron microscopic study was conducted in order to investigate the healing and maturation process of central one third of donor site patellar tendon which was used for endoscopic anterior cruciate ligament reconstruction. 17 patients among 118 consecutive series, which underwent ACL reconstruction from January 1990 to March 1995, were involved in this study according to various followup periods. At 6 months follow-up, hypercullular and randomly arranged fibrohlasts had abundant cytoplasm with marked irregular cytoplasmic borders and short cytoplasmic extensions. Thc, nuclei of fibroblasts had prominent nuclear indentation with chromatin condensation along the nuclear mernbrane and prominent nucleolus. The cytoplasm contained irregularly dilated rough endoplasmic reticulum, Golgi complex, and pinocytic vesicles. Intercellular space were occupied by newly-formed, immature col)agen fibrills without distinct parallel arrangement, and the diameter of collagen fibrils was unifoimly small. At 12 months, fibroblast and collagen fibrils showed a little matured findings except the small diameter of collagen fibrils. At 24 months, irregular-shaped fibroblasts were still present, which contained folded nuclei, ahundant cytoplasm with large amount of rough endoplasmic reticulum and Golgi complex. Collagen fihril showed also a unimodal distribution pattern with small diameter, however had a tendency to have a regular parallel arrangement. These finding suggest that the donor site of a patellar tendon was still quite different from normal patellar tendon in electron microscopic morphology even at 24 months postoperative follow-up regardless of considerable maturation of regular parallel arrangement pattern of collagen fibril.
Anterior Cruciate Ligament Reconstruction ; Chromatin ; Collagen ; Cytoplasm ; Dronabinol ; Endoplasmic Reticulum, Rough ; Extracellular Space ; Fibroblasts ; Follow-Up Studies ; Golgi Apparatus ; Humans ; Patellar Ligament* ; Tissue Donors*

No abstract available in English.
Tibia

It was reported that many adverse effects occurred to the growth areas of the adolescent player due to repititous strain. The injuries mainly involved in the shoulder and elbow, and named as little leaguers Shoulder and Little Leaguers: Elbow in boy baseball player. But the stress fracture of olecranon epiphyseal plate was rare and reported in a few cases. We reported a case observed in an adolescent Judo Player.
Adolescent ; Baseball ; Elbow ; Fractures, Stress ; Growth Plate ; Humans ; Male ; Martial Arts ; Olecranon Process ; Shoulder

Partial knee ankylosis is a recognized complication following open operative procedure, trauma and disease processes about the knee. It can result from the formation of intraarticular adhesion and contracture of the capsule as well as the shortening or adhesion of the quadriceps mechanism. Physical therspy and occasionally manipulation under the anesthesia may improve the results, but performed late, these methods will be useless. This is a review of 30 patients who had severe limitation of motion in the knee joint following open operative procedures or trauma about the knee and who were treated by the percutaneous release of adhesions under the arthroscopic control. The following results were obtained; There were 17 males and 13 females, and the age of release ranged from 23 to 69 years old (av. 42.8years old). The interval between arthroscopic adhesiolysis and the last follow-up evaluation ranged from 6 months to 5 years and 7 months(av. 23 months). The interval between the last open operative procedure or trauma and arthroscopic adhesiolysis ranged from 3 months to 4 years(av. 15 months). The average preoperative knee ROM was 38.8°the postoperative ROM was 121.1°and the average final knee ROM at follow-up was 102.6°So the average loss of ROM was 18.5°The arthroscopic adhesiolysis seems to be applied to the various conditions of the partial knee ankylosis and the results are better than the other surgical procedures when it was performed early enough.
Anesthesia ; Ankylosis ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Male ; Surgical Procedures, Operative

OBJECTIVE: Endometriosis is a disease affecting a large population of women all over the world. A local sterile inflammation occurs in the peritonel cavity of patients with endometriosis. It suggests that immunological events play a major role in the pathogenesis of endometriosis. We have studied the levels of serveral T cell and monocyte derived cytokines, especially IL-6 (promoter of immune response) and IL-10 (inhibitor of immune response), in the peritoneal fluid of patients with endometriosis to characterize the change of immune response that occurs at the site of endometriosis. Method: This study was performed in Hallym university hospital from October, 1997 to October 1998 and enrolled 29 women with gross or microscopic findings of minimal to severe endometriosis in case group, and 28 women without visual evidence of pelvic endometriosis and with benign gynecologic disease in control group. IL-6 and IL-10 levels in the peritoneal fluid were determined using commercial ELISA and compared between endometriosis and controls and between fertile and infertile women with endometriosis and according to the revised American Fertility Society classification. RESULT: IL-6 was higher and IL-10 was lower in the peritoneal fluid of endometriosis group than of control group. Cyclic variations in the IL-6 concentrations were seen in endometriosis group : the concentrations in the secretory phase were significantly higher than those in the proliferative phase. In endometriosis group, IL-6 concentrations of infertile women were higher than fertile women. Both IL-6 and IL-10 in the peritoneal fluid of endomtriosis group did not show significant correlation according to r-AFS stages. CONCLUSION: Increased IL-6 and decreased IL-10 levels in the peritoneal fluid may be related to infertility and pathogenesis in the endometriosis, suggesting that partially contribute to the disturbed immune regulation observed in endometriosis.
Ascitic Fluid* ; Classification ; Cytokines ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Fertility ; Genital Diseases, Female ; Humans ; Infertility ; Inflammation ; Interleukin-10* ; Interleukin-6* ; Monocytes