Synovectomy of the knee in rheumatoid arthritis has been recommended as an effective procedure which improved symptoms such as pain, swelling, and limitation of motion. But some problems, such as limitation of range of motion, infection, long hospital days, occured in open synovectomy. Arthroscopic synovectomy yields reliable result compatible to open synovectomy with less invasiveness and postoperative morbidity. The authors analyzed 20 knees of 14 patients who has done synovectomy of knee in Kyung Hee University Hospital from September 1989 to October 1992. Of the 14 patients, thirteen were females and only one was male, ten knees were affected on the right and ten on the left respectively. Five knees were operated as open synovectomy and fifteen knees as arthroscopic synovectomy. In six patients, both knees were operated either open or arthroscopic synovectomies. The preoperative diagnosis of 20 knees were rheumatoid arthritis as clinically, serologically and radiologically, 13 knees are confirmed as pathologically. Average hospital days after operation were 19 days in open synevectomy and 11 days in arthroscopic synovectomy. Average operation time were 72 minutes in open synovectomy and 84 minutes in arthroscopic synovectomy. No complication occured as a result of these synovectomies. After average follow up of 19 monthes, 1 knee from 5 knees in open synovectomy and 3 knees from 15 knees in arthroscopic synovectomy had pain and intermittent swelling as postoperatively. And only 1 knee in open synovectomy had loss of range of motion. No other patients lost motion in their knees. Preoperatively 17 knees showed radiographic change of rheumatoid arthritis and 16 knees showed no progressive radiographic deterioration at final follow up. And patients overall showed a significiantly increased functional status postoperatively. In conclusion, the result obtained after arthroscopic synovectomy are comparable with those obtained after open synovectomy. In addition arthroscopic procedure had lessened postoperative morbidity as loss of range of motion, postoperative infection, long hospital days and useful as palliative surgery in advanced rheumatoid arthritis.
Arthritis, Rheumatoid ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Palliative Care ; Range of Motion, Articular

This study was performed to investigate the factors related to tooth wear. For this study, 78 patients with temporomandibular disorders and 76 dental students without any signs and symptoms of temporomandibular disorders were selected as the patients group and as the normal group, respectively. Preferred chewing side, Angle's classification, lateral guidance pattern, head and shoulder posture wee observed clinically. Electromyographic activity of anterior temporalis and masseter muscle were recorded with BioEMG and occlusal status were recorded with T-Scan . Wear facet area of each tooth was measured from working model of upper arch corresponding to the occlusal status from T-Scan, Wear facet area were measured with planimeter in mm2. Total area were divided into incisal, canine, posterior tooth area. Anterior wearfacet area was incisor area plus canine area, and unilateral area was anterior area plus posterior area. The data collected were analyzed by SAS statistical program and the results of this study were as follows: 1. There was no significant difference between the two groups in total werafacet area, and male subjects showed tendency to have larger area in the normal group but female subjects showed tendency vice versa. 2. There was no significant difference related to preferred chewing side and Angle's classification, however, some difference was observed by lateral guidance pattern. Anterior wear facet area in subjects of canine guidance was the largest in the three subgroups. 3. Subjects with head tilting to right side had larger posterior and total area, and subjects with higher shoulder in right side had larger canine and anterior area than any other subgrous. 4. Electromyographic activity of masseter muscle was more correlated with wear facet area than anterior temporalis muscle, and tooth contact number and force were significantly correlated with wear facet area, but the most important factor affecting tooth attrition was age.
Dental Occlusion ; Female ; Head ; Humans ; Incisor ; Male ; Malocclusion ; Masseter Muscle ; Mastication ; Posture ; Shoulder ; Students, Dental ; Temporomandibular Joint Disorders ; Tooth Attrition ; Tooth Wear* ; Tooth*

No abstract available.
Cartilage, Articular* ; Child* ; Finger Joint* ; Fingers* ; Humans ; Transplants*

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

Partial knee ankylosis is a recognized complication of following open operative procedure, trauma and disease processes about the knee. Intraarticular trauma or surgical procedures such as TKR, synovectomy or patellar fracture were main source of intraarticular or extraarticular soft tissue adhesion and contracture were resulted from distal femoral and proximal tibial fractures. The purpose of this study is to report the value of arthroscopic adhesiolysis of partial knee ankylosis and to evaluate the clinical results of its application in various conditions. From October 1982 to December 1992, 56 cases in 54 patients who had severe limitation of motion in the knee joint following open operative procedure or trauma about the knee were treated by fibroarthrolysis under the arthroscopic control. For release of thick fibrous tissue, we used our designed blunt metal bar. The following results were obtained. There were 30 males and 24 females and the age at the time of release ranged from 20 to 69 years old(average 38.7 years old). The interval between last open operative procedure or trauma and arthroscopic adhesiolysis ranged from 3 months to 6 years(average 16 months). The interval between arthroscopic adhesionlyssis and the last follow up evaluation ranged from 1 year to 9 years(average 49 months), The average preoperative range of knee motion was 42.2 and the postoperative range of motion under the anesthesia was 115.5 and the average final knee range of motion at follow up was 101.3. So the average loss of motion between postoperative and final motion was 14.2. Complications were one case of patellar and tibial condylar fracture respectively. In the author's experience, arthroscopic adhesiolysis seems to be applied to the various condition of the partial knee ankylosis and the results are better than the other surgical procedures when it was performed early enough16).
Anesthesia ; Ankylosis ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Male ; Range of Motion, Articular ; Surgical Procedures, Operative ; Tibial Fractures ; Tissue Adhesions

Fat can be prominet around the aortic root and within the right atrioventricular (AV) groove (1). At times, the fat can be globular, suggesting a mass especially on echocardiography. Computed tomography (CT) and masnetic resonance (MR) images are well suited for characterization of fat in and around the heart (1, 2). This report illustrates CT and MR findings of a very unusual case of prominent fat lump in the left AV groove.
Echocardiography ; Heart

The CT findings were reviewed in two patients with injuries to the gallbladder following blunt trauma. In one patient high attenuation of intraluminal blood clot within the gallbladder and associated hemoperitoneum were identified. Another patient was represented hemoperitoneum and bile leakage into the peritoneal cavity due to laceration of the fundus of the gallbladder which appeared contrasted.
Bile ; Gallbladder ; Hemoperitoneum ; Humans ; Lacerations ; Peritoneal Cavity

PURPOSE: To evaluate further the right minor and major fissure on thin-section narrow-interval CT scans with particular emphases on orientation, degree of completeness. MATERIALS AND METHODS: Thin section CT scans from 10 mm distal to carina to the proximal basal segmental bronchus were obtained at 5 mm invervals in 50 consectutive subjects. Orientation, degree of completeness, and the relationship of the minor and major fissure on thin-section CTscans were analyzed. RESULTS: Four principal types of the minor fissure could be identified according to the highest point of the upper surface of the middle lobe. At bronchus intermedius level, the major fissure appeared with its medial end anterior to lateral end in 45 subjects. The minor fissure was complete in only 10 subjects (20%). Completely absent minor fissure was noted in four subjects (8%). The major fissure was incomplete in 17 subjects (34%) at bronchus intermedius level. the minor and major fissure intersected each other in only 27 subjects (54%). The hig best point of intersection was variable. CONCLUSION: There are much more variations in the fissural complex in our study than in previous reports and these variations can be visualized well on thin-section CTscans.
Bronchi ; Lung* ; Tomography, X-Ray Computed*

PURPOSE: To analyze the clinical and radiological results of bilateral TKA with and without patellar resurfacing in osteoarthritic patient. MATERIALS AND METHODS: We have prospectively studied 17 patients who had bilateral TKA and whose patella was resurfaced on one side and not on the other. Criteria of patient selection include no preoperative patellofemoral pain and bony eburnation of articular cartilage. The Ortholoc Modular. prosthesis was implanted on both sides by same surgeon using identical technique in all cases. The mean follow-up period was 10.6 years. Evaluation was performed annually using HSS (Hospital for Special Surgery) knee rating score and radiological parameters including tibiofemoral angle, width of patella, length of patella, thickness of patella, tilt of patella and shift of patella. RESULTS: On the basis of long term follow-up results, there was no significant difference between resurfaced and unresurfaced group in clinical and radiological study. According to radiological findings as time passed, tibiofemoral angle and patellar thickness decreased but patellar length and width increased in both groups. There was no relationship between HSS knee score and radiological result in both groups. CONCLUSION: This study showed that long term clinical and radiological results of TKA does not depend on patellar resurfacing. Author can propose that patellar resurfacing is not always required in patients with relatively good condition in articular surface of patella.
Arthroplasty* ; Cartilage, Articular ; Follow-Up Studies ; Humans ; Knee* ; Patella* ; Patient Selection ; Prospective Studies* ; Prostheses and Implants

The Saville's index of the lumbar spine and the Singh's index of the femoral neck is very simple method to measure degree of osteoporosis. Authors compared Singh's index and Savilles index with Dual Photon Absorptiometry(D.P.X.) and studied the reliability and clinical usefulness of two indices. We took the D.P.X. and simple L-spine lateral view in 103 patients in same time and also performed D.P.X. and both hips A-P view in 70 patients, then analyzed and compared each two indices with D.P.X. The Singh's index had less interpersonal difference and intrapersonal difference compared with Saville's spine index. There was some confidence of Singh's index and Saville's spine index compared with the D.P.X., but the relationship between Saville's spine index and D.P.X. was less promising than that of Singh's index. Authors suggest that the Saville's spine index has less clinical usefulness than Singh's index in measurement of osteoporosis.
Femur Neck ; Hip ; Humans ; Methods ; Osteoporosis ; Spine