BACKGROUND: Standard treatments may provide adequate containment in mild to moderate Legg-Calve-Perthes disease (LCPD), but they can be problematic in more severe cases. The purpose of this study was to report the results of combined shelf acetabuloplasty with femoral varus osteotomy in severe LCPD. METHODS: We reviewed 12 patients who had undergone combined shelf acetabuloplasty with femoral varus osteotomy. The indications for this type of operation were: (1) above 8 years of age at clinical onset; (2) massive femoral epiphysis involvement (Catterall group 4, lateral pillar C); (3) femoral head lateral subluxation on the anteroposterior radiograph; and (4) impending hinged abduction on preoperative magnetic resonance imaging or arthrography. The mean age was 9.3 years (range, 8 to 10.8 years). The patients were clinically evaluated with Iowa hip score and leg length discrepancy at the final follow-up. Radiographic outcome was assessed using the Stulberg classification to evaluate femoral head sphericity. The presence of osteoarthritis was evaluated by the Tonnis classification. Correlation analysis was conducted to analyze the preoperative factors that were strongly associated with patients' outcomes. RESULTS: The mean follow-up period was 10.1 years (range, 7.1 to 13.2 years). Functional grade was excellent in all patients at last follow-up (mean, 92; range, 82 to 99). The mean leg length discrepancy after skeletal maturity was 0.9 cm (range, 0 to 1.7 cm). There were no significant complications or need for additional surgery. Radiographically, 92% of patients reached satisfactory outcomes: Stulberg grade I, 0 cases; Stulberg grade II, 4 cases (34%); Stulberg III, 7 cases (58%), Stulberg IV, 1 case (8%); and Stulberg V, 0 cases. There was no osteoarthritis by Tonnis classification. CONCLUSIONS: The surgical outcomes for combined shelf acetabuloplasty with femoral varus osteotomy in severe LCPD patients over 8 years old are comparable with other advanced surgical methods. In the cases of severe disease that match our inclusion criteria, our containment method could be another treatment option.
Acetabuloplasty/adverse effects/*methods ; Child ; Female ; Humans ; Leg Length Inequality ; Legg-Calve-Perthes Disease/radiography/*surgery ; Male ; Osteotomy/adverse effects/*methods ; Pain ; Postoperative Complications ; Retrospective Studies ; Treatment Outcome

No abstract available.
Hemorrhage*

No abstract available.
Hemorrhage*

Prospective study of gallbladder wall thickness by utrasonography was performed in 38 patients of acute viral hepatitis and 50 normal subjects as a control group from June 1983 to April 1984. The results were as follows; 1.In normal population, the range of gallbladder wall thickness is from 1mm to 3mm with peak incidence in 2mm(66%,33 case). Mean thickness of gallbladder wall is about 1.9±0.6mm. 2. In acute viral hepatitis, the range of gallbladder wall thickness is from 2mm to 8mm with peak incidence in 3mm(34%, 13 case), second peak in 4mm (29%,11 case). Mean thickness of gallbladder wall is about 3.6±1.6mm, which is thicker than normal with statistical signifiance. (p<0.005) 3, In acute viral hepatitis , the mean thickness of glabladder wall is about 4.4±1.8mm in the group of SGOT/ SGPT level above 400 IU, and 2.8±0.8mm in the group of SGOT/SGPT level below 400 IU. This difference is significant statistically. (p<0.05).
Alanine Transaminase ; Gallbladder ; Hepatitis ; Humans ; Incidence ; Prospective Studies

No abstract available.
Fetal Death*

No abstract available.
Humans ; Siblings* ; Thrombasthenia*

No abstract available.
Animals ; Horns* ; Kidney*

The T cell antigen receptor (TcR) in combination with costimulatory signals triggered by accessory molecules present on the surface of the antigen-presenting cells (APC) regulates the activation and growth of T lymphocytes. Calyculin A and Okadaic acid is known to be an inhibitor of serine/threonine phosphatase and RK-682 specifically blocks functions of tyrosine phosphatase. To investigate roles of these inhibitors in TcR-mediated signaling cascade, chimeric molecule CD8-5 which contains the extracellular and transmembrane domains of the human CD8a molecule and the cytoplasmic tail of TcR 5 chain were stably expressed in Jurkat cell line. CD8-5 chimeric protein induced tyrosine phosphorylation of various cytoplasmic substrates and IL-2 gene expression in a NFAT dependent manner by stimulation with anti-CD8 mAb OKT8 as seen in TcR stimulation. When CD8-5 transfectants were preincubated with Okadaic acid, Calyculin or RK682, they differentially affected tyrosine phosphorylation of signaling mediators including CD8-5 molecule. When Jurkat Tag cell line was used where SV40 T antigen is stably expressed and the expression of p-galactosidase is driven by the multiple NFAT binding sites plus minimal IL-2 promoter, these phosphatase inhibitors -RK682, Calyculin A, Okadaic acid- effectively inhibited IL-2 gene expression at the concentration of 1.2832 x 10 ' M, 3.9924 x 10 M, 7.2707 x 10 M respectively. These results suggested that Okadaic acid, Calyculin or RK682 modulate TcR-proximal as well as TcR-distal signaling events during T cell activation.
Antigen-Presenting Cells ; Antigens, Viral, Tumor ; Binding Sites ; Cell Line ; Cytoplasm ; Gene Expression ; Humans ; Interleukin-2 ; Jurkat Cells ; Okadaic Acid* ; Phosphorylation ; Receptors, Antigen, T-Cell ; T-Lymphocytes ; Tyrosine

The aim of our study is to achieve complete periodontal tissue regeneration by the application of BMP and resorbable membrane. Three beagle dogs aged over one and half years and weighed 14 to 16 kg were used in this study. Mandibular 1st, 2nd premolars were extracted bilaterally. Horizontal furcation defects were induced around 3rd, 4th premolars bilaterally. BMP-4 were applied in the right side with resorbable membranes and only resorbable membranes were applied in the left side respectively. Each animal was sacrificed at 2, 4, and 8weeks, after regenerative surgery. Specimens were prepared with Hematoxylin-Eosin stain and Goldner's modified Masson Trichrome stain for light microscopic evaluation. The results were as follows: 1. At 2 weeks after regenerative surgery, downgrowth of junctional epithelium was observed both in the membrane-applied site and BMP-4-and-membrane-applied site. 2. At 4 weeks after regenerative surgery, resorbable membranes were completely resolved, therefore would not prevent downgrowth of junctional epithelium. New bone formation, new cementum formation and Sharpey's fiber were observed in BMP-4-and-membrane-applied site. 3. At 8 weeks after regenerative surgery, downgrowth of junctional epithelium was observed in the membrane-applied site. But, new cementum formation was observed in the same site. The extensive regeneration of new bone, new cementum and remarkable formation of Shapey's fiber were showed in BMP-4-and-membrane-applied site. 4. Resorbable membranes were resolved via the cell-mediated processes. 5. Periodontal tissue regeneration were better achieved in the BMP-4-and-membrane-applied site than in the membrane-applied site. Within the above results, BMP-4 may have the strong capability to form the new bone and resorbable membrane may be able to prevent the bony ankylosis. However, resolution rate of resorbable membrane may not be enough to protect rapid epithelial downgrowth for ideal periodontal regeneration. In conclusion, I suggest BMP-4 may have the strong possibility to be utilized in the clinical periodontal treatments.
Animals ; Ankylosis ; Bicuspid ; Dental Cementum ; Dogs ; Epithelial Attachment ; Furcation Defects ; Membranes* ; Osteogenesis ; Regeneration*

PURPOSE: To evaluate the use of stereotactic navigation during orbital decompression surgery. METHODS: We conducted a retrospective analysis of 27 patients (48 orbits) with thyroid-associated orbitopathy who underwent orbital decompression. Stereotactic navigation was performed on 28 orbits of 15 patients, and orbital decompression surgery without navigation was performed on 20 orbits of 12 patients. The changes in medial wall, lateral wall and inferior wall orbital volume in CT scans and horizontal and vertical eyeball deviation after surgery were analyzed in the 2 patient groups. RESULTS: The mean decompressed volume of orbits was significantly increased in the lateral wall decompression with stereotactic navigation patient group than without stereotactic navigation (p < 0.05, p = 0.025). However, in the inferior wall and the medial wall decompression, there was no significant difference between the 2 groups. The changes of horizontal and vertical deviation were not significant between the 2 groups and no patient experienced neural damage. CONCLUSIONS: The stereotactic navigation during lateral orbital wall decompression is a safe and effective method for inducing greater decompressed volume.
Decompression* ; Humans ; Orbit* ; Retrospective Studies ; Tomography, X-Ray Computed