Spontaneous rupture of the quadriceps tendon has heen rarely reported. We experienced four knees of 3 patients. Two patients with chronic renal failure(CRF) had been treated with peritoneal dialysis and the other patient was healthy without significant medical problem. In the CRF patients, laboratory studies were coincided with secondary hyperparathyoidism. Radiologic and operative findings suggested that the repeated minor trauma caused avulsion fracture of the bone near the insertion site of the tendon. Histologic findings revealed no elastosis of the tendon and no deposit of amyloid in the quadriceps tendon. In the non-CRF case, there was normal lahoratory data, and the rupture occurred at the musculotendinous junction, suggesting sudden contracture of the muscle causing failure without trauma history. All cases were treated successfully with open repair of the quadriceps tendon. It could be summarized that the site of spontaneous rupture in the CRF and normal patient were different.
Amyloid ; Contracture ; Humans ; Kidney Failure, Chronic ; Knee* ; Peritoneal Dialysis ; Rupture ; Rupture, Spontaneous* ; Tendons*

The purpose of this study was to evaluate the effect of estrogen receptor on the degenerative change of articular cartilage by observation of different changes of histology, matrix glycosaminoglycan and chondrocyte proliferation. In sixty-four Newzealand rabbits, experimental instability was made to induce degenerative changes by sectioning the anterior cruciate ligament, medial collateral ligament and medial meniscus of the left knees. In the oophorectomy group (32 rabbits), knee surgery was performed at 6 weeks following bilateral oophorectomy. In the non-oophorectomy group (32 rabbits), knee surgery was performed without oophorectomy. Four rabbits were killed at 0, 1, 2, 4, 8, 12, 16, 20 weeks, respectively, after the knee operation. Total immunohistochemical scores of estrogen receptor were evaluated between the two groups. Histologic evaluation of H-E staining was conducted by alcian blue staining. Evaluation of chondrocyte proliferation was carried out by immunohistochemistry using monoclonal antibody to 5-bromo-2 -deoxyuridine. The stainability of each staining was calculated using semi-quantitative analysis and statistical differences were evaluat- ed by ANOVA test and LSD multiple comparison test. Total immunohistochemical scores of estrogen receptor in the non-oophorectomy group were higher than the oophorectomy group (P<0.05). In the non-oophorectomy group, the histologic scores and the histochemical scores of glycosaminoglycan were lower than the oophorectomy group after 4 weeks and 8 weeks respectively (P<0.05). The immunohistochemical score of BrdU was the highest at 2 week and then decreased after 4weeks in both groups. The immunohistologic scores of non-oophorectomy group was significant higher than oophorectomy group between 1 and 4 weeks (P<0.05). Our results suggested that the estrogen might aggravate the degenerative change of the knee joint in rabbits by decreasing matrix glycosaminoglycan and increasing chondrocyte proliferation.
Adult* ; Alcian Blue ; Anterior Cruciate Ligament ; Bromodeoxyuridine ; Cartilage, Articular* ; Chondrocytes ; Collateral Ligaments ; Estrogens* ; Female ; Humans ; Immunohistochemistry ; Knee Joint ; Knee* ; Lysergic Acid Diethylamide ; Menisci, Tibial ; Ovariectomy ; Rabbits

This is to report the histo-pathologic findings of the degenerated inferior alveolar nerves(IAN) causing uncontrollable neuralgia persisted for over 3 years. The patients had sufferred from frequent attack of unbearable pain along the mandibular branches of the Vth nerve. The pain arised spontaneously 5-10 times a day and lasted for 2-5 minutes. The medications including Tegretol were neither so effective to alleviate the pain level, nor enough to keep free from pain all days. The peripheral neurectomies were preceded by diagnostic nerve block, and partial resection of the IAN in the mandibular canals were approached by sagittal split osteomy of the ramus. The histopathologic findings of the resected IAN were as follows ; 1. Special staining with Luxol Fast Blue (LFB) and Masson Trichrome (MT) disclosed marked degeneration of the axons, decreased in number and fibrosis between the nerve fibers. 2. EM study revealed destruction of myelin continuity surrounding axons, degeneration of Schwann cell and endoneureal sheath, and coarse collagen between the destructed axons. 3. The 3 of 6 patients presented again with recurred pain in 2-3 years after the peripheral neurectomies. Excisional biopsy of the retromolarpterygomandibular softtissues disclosed the collateralization neuropathy beside the long-buccal nerves and their neuromatous findings.
Axons ; Biopsy ; Carbamazepine ; Collagen ; Fibrosis ; Humans ; Mandibular Nerve* ; Myelin Sheath ; Nerve Block ; Nerve Fibers ; Neuralgia ; Trigeminal Neuralgia*

No abstract available.

The purpose of this study was to assess the results of passive release of the pulley with needle under local anesthesia performed at the out patient department. There were 68 fingers of 54 patients. Fifteen patients(27.8 %) were male and 39 patients(72.2 %) were female. Involved fingers were 28 thumbs(41.2 %), 7(10.3 %) index fingers, 14(20.6 %) middle fingers, and 19(27.9 %) ring fingers. Ages were varied-between 41 years and 61 years old. Rheumatoid fingers were 12(17.6 %). The others had no underlying disease. An 18 gauge needle was introduced distal to the palpable nodule. The pulley was released passively when the PIP joint was extended. The follow-up period was 4.5 years on average(range; 1-8 years). At final follow-up local recurrence was noted in 1-2 weeks in 7 cases(10.3 %), which was due to technical fault in early trial cases. The patients complained of pain for a few days and mild tenderness for less than 2 weeks. In three cases adhesion occurred, which was resolved in a week by maniqulation. There was no difference between rheumatoid arthritis and the other underlying diseases as far as rate of recurrence was concerned. From these results it would be suggested that the passive release of pulley with needle is an effective method for the treatment of adult trigger finger.
Adult ; Anesthesia, Local ; Arthritis, Rheumatoid ; Female ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Male ; Methods ; Needles ; Recurrence

No abstract available.
Orthognathic Surgery

Fracture of the metal base of tihial components of total knee arthroplasty has heen occasionally reportecl. The most common cause of the failure of the metal hase plate was known to be a fatigue fracture around the screw hole where the strength of the metal hase plate was the weakest. We experienced a case of the fracture of the metal hase plate secondary to the t'racture of the posteromedial corner of the metal tihial condyle which was weakened due to the shoil peg hole for the base plate of MG II implant. Since the proximal portion of the posterior tihial condyle was normally thin, cutting the hone for the base plate made it thinner and wcaker than normal. Therefore stress fracture of the bone occurred and the overlying metal plate was subsequently hroken. From this experience. we concluded that the posterior peg hole may cause unwanted failure of the posteromedial corner of the tibial base plate.
Arthroplasty* ; Fractures, Stress ; Knee*

No abstract available.
Arthritis* ; Knee*

BACKGROUND: The analgesic properties of the nonsteroidal antiinflammatory drugs (NSAIDs) have been attributed to their effects on the peripheral synthesis of prostaglandins. Although the preoperative use of NSAIDs has been increasing because of concerns regarding the side effects of opioid analgesics but results of clinical preemptive analgesia studies remain inconclusive. So, we studied the efficacy of preemptive analgesic effects of tenoxicam, new NSAID, on postoperative continuous intravenous analgesia with morphine. METHODS: We studied 40 parturients, undergoing cesarean section, ASA class I or II, randomly divided into two groups. Tenoxicam group were injected tenoxicam 0.3 mg/kg and control group were injected normal saline 3 ml at ten min. before induction. For both groups morphine 0.1 mg/kg was administered as loading dose and 0.015 mg/kg/hr as maintenance dose. We examined verbal quantitative score (VQS) at postoperative 30 min, 1, 6, 12, 24 and 48 hr. Maternal satisfaction, side effects, hepatic and renal function also evaluated after pain control. RESULTS: The values of VQS showed no significant differences between two groups 30 min, 1 and 6hr after start of morphine infusion, but there was significant decrease in tenoxicam group compared to control group 12, 24 and 48 hr after start of morphine infusion (p<0.05). There was no significant difference in maternal satisfaction between two groups and also there were no significant differences in the overall incidences of side effects between two groups. CONCLUSIONS: Preoperative single injection of tenoxicam showed incomplete preemptive analgesic effects on postoperative pain control after cesarean section.
Analgesia* ; Analgesics, Opioid ; Anti-Inflammatory Agents, Non-Steroidal ; Cesarean Section* ; Female ; Incidence ; Morphine* ; Pain, Postoperative ; Pregnancy ; Prostaglandins

No abstract available.
Child* ; Humans ; Infant*