The exact etiologies and mechanisms of ischemia in avascular necrosis of femoral head are still under investigation. But this condition seems to be increasing during a few decades with increasing use of steroid and alcohol abuse in Korea. The treatment modalities have been based on the stages of the disease by simple radiographic findings that do not describe the accurate pathological extent or localization. Therefore more sophisticated study is needed to treat the AVN of the femoral head well. Magnetic resonance images, simple radiographs, scintigraphs of 13 patients(22 femoral heads), who were admitted and treated at Seoul National University Hospital from April, 1989 to December, 1989 were correlated, to characterize the type of AVN by extent and location regardless of its stage and reveal the relationship between types and stages. It is the result of this study that the type of AVN as well as stage should be considered in determining the treatment modality.
Alcoholism ; Classification ; Head ; Ischemia ; Korea ; Magnetic Resonance Imaging ; Necrosis ; Seoul

Of 29 scoliotic patients treated by Harrington and Dwyer instrumentation, fourteen patients were taken of preoperative cnrrection by halo-femoral skeletal traction for the last two years from June 1974 to June 1976 at the Department of Orthopedic Surgery, Seoul National University Hospital. The correctability of scoliosis by the use of halo-femoral traction was evaluated with roentgenogram study and the following result was obtained. 1. Of the 14 cases, five cases were male and eight were female, and they were between the age of 13 and 29. 2. The etiology of the 14 scoliosis was idiopathic in three, paralytic in eight, congenital in one, and associated with neurofibromatosis in two. 3. The average initial curve was 108 degress with the flexibility of 32.1% on side bending. 4. The average preoperative curve with halo-femoral traction for one week was 75. 1 (30.5% correction), and the end of two week was 68 (37% correction). 5. The average immediate postoperative curve was 58.5 (46.5% correction). 6. The result of traction in the different etiologic type showes no significant difference.
Female ; Humans ; Male ; Neurofibromatoses ; Orthopedics ; Pliability ; Scoliosis ; Seoul ; Traction

No abstract available.

No abstract available.
Peripheral Vascular Diseases*

No abstract available.
Extremities* ; Limb Salvage* ; Tendons*

We performed ERCP manometry of Sphincter of Oddi(SO) before and after endoscopic sphincterotomy(EST) for evaluation of the effect af EST on the SO. The subjects were postcholecystectomized common bile duct stone patients(n=l2) and EST was performed by major incision. The pressure gradient between common bile duct and duodenum before EST (8.6 + 3.9 mmHg) decreased significantly after EST(2.4 +1.7 mmHg). The length of SO before EST(8.8 + 0.8mmHg) decreased significantly after EST(2.5 + 0.8mm). But in each patient, the pressure gradient between common bile duct and duodenum remained in spite of the major incision. In conclusion, EST alters the function of the sphincter of the Oddi, but does not destroy its all protective function. The positive pressure in the bile duct is preserved in contrast to the absolute loss of pressure following surgical transduodenal sphincteroplasty.
Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Duodenum ; Humans ; Manometry* ; Sphincter of Oddi* ; Sphincterotomy, Endoscopic* ; Sphincterotomy, Transhepatic

From July 1989 to August 1991, we performed 146 cases of endoscopic sphincterotomy(EST). In our series, 9 early complications occurred in 146 cases(morbidity rate: 6.2%), and no fatalities were recognized(mortality rate:0). Four cases with late complications consisted of 2 cases of acute cholecystitis, one case of chalaagitis and restenosis. There were 36 with the gallbladder with stone(11 cases) or without stone(25 cases). Two cases with chalecystitis after EST occurred in the patients with gallbladder stones. EST gives the sufficient result in diagnosis and treatment for various disease of biliary tract. Furthermore, EST was found to be a safe procedure from low rates of complications and fatalities.
Biliary Tract ; Cholecystitis, Acute ; Diagnosis ; Gallbladder ; Humans ; Sphincterotomy, Endoscopic*

The dynamic blood flow is regulated by the numerous complex mechanisms. Since blood flow varies directly with the radius of the vessel, blood flow is markedly affected by small changes in the caliber of the vessels. Using the hotoplethysmography, we assessed the relative changes of blood flow after topical application of the vasoactive drugs to the femoral arteries of the rabbits. It is the purpose of this study to evaluate the immediate and delayed effects of the vasoactive drugs such as epinephrine, methylergonovine, chymopapain, and lidocaine in course of time when the drugs applied topically to the vessel. 60 rabbits were divided into 6 experimental groups. In group I, the femoral artery was surgically exposed only. In Group g-A, epinephrine was applied to the femoral artery after surgical exposure. In Group Il-B, after spplication of epinephrine, the effect of epiniphrine was reversed with lidocaine. Another drugs were applied as follows methylergonovine in Group Hl-A, methylergonovine and lidocaine in Group Ill-B as in group Il-B, Chymopapain in Group lV. The relstive changes of blood flow were measured by the photoplethymograph for 3 weeks. The results are as follows ; 1. The amplitude of the photoplethysmographic wave decreased immediately after the topical application of epinephrine, methylergonovine and chymopapain. Such an effect could be observed until the 3rd week after the topical application of the drugs, 2. The delayed dffect of reducing the amplitude could be seen during the 1st week in the epinephrine and methylergonovine treated groups. However, it was seen after 1st week in the chymopapain treated group. 3. The delayed effect of epinephrine and methylergonovine could be reversed with lidocaine. 4. It seems that lidocaine can be used clinically to preyent the delayed effect of epinephrine and methylergonovine.
Blood Vessels ; Chymopapain ; Epinephrine ; Femoral Artery ; Lidocaine ; Methylergonovine ; Photoplethysmography ; Rabbits ; Radius

A choledochocele is a benign cyst-like herniation of the intramural segment of the distal common bile duct protruding into the duodenal lumen. Cholangiography is essential to demonstrate a choledochocele. Because choledochoceles are often associated with characteristic structual alterations of the papilla of Vater and the peripapillary area, ERCP is helpful in demonstrating a choledochocele. We present the clinical, endoscopic and radiographic (ERCP) findings in a patient with choledochocele.
Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst* ; Common Bile Duct ; Humans

A choledochocele is a benign cyst-like herniation of the intramural segment of the distal common bile duct protruding into the duodenal lumen. Cholangiography is essential to demonstrate a choledochocele. Because choledochoceles are often associated with characteristic structual alterations of the papilla of Vater and the peripapillary area, ERCP is helpful in demonstrating a choledochocele. We present the clinical, endoscopic and radiographic (ERCP) findings in a patient with choledochocele.
Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst* ; Common Bile Duct ; Humans