No abstract available in English.
Femur

Since 1957, multiple possible mechanisms have been suggested to explain the production of the osteonecrosis of the femoral head and it is now accepted that steroid medication is one of the etiologic factors producing osteonecrosis of the femoral head. Among the surgical procedures in ischemic osteonercrosis of the femoral head are bone grafting, core decom-pression, rotational osteotomy, angulation osteotomy, hemiarthroplasty and total hip replacement. The choice of surgical procedures in the management of idiopathic osteonecrosis of the femoral head is dependent on several factors. Most important are the etiology and stage of the lesion. Other considerations are the patients age, lifestyle, and demands on his hip, and the surgeons preference and expertise. We reviewed 32 total hip replacements in 22 patients, which had been performed to treat steroid-induced osteonecrosis of the femoral head at Department of Orthopaedic Surgery, National Medical Center from Jan. 1975 to Dec. 1981. The longest follow-up was 7 years and 6 months and the shortest, 1 year, the average being 2 years and 6 months. The results were as follows: 1. There were 13 males and 9 females and more than half were in 5th decade. 2. Principal causes to use oral corticosteroids were rheumatoid arthritis, arthralgia, and low back pain in the order of frequency. 3. Duration of corticosteroid medication was between 2 months and 12 years and 18 patients took more than 12 months. 4. Of 18 patients who had the bilateral involvement, the two also had osteonecrosis of the humeral head. 5. Roentgenographically, 30 hips were in stage IV and 2, in stage III according to the classification of Arlet and Ficat. 6. Types of the implants used were Charnely (28 cases), MQller (2 cases) and Trapezoidal-28 (3 cases). 7. The function of the each hip was evaluated preoperatively and postoperatively by the method of Wilson and Salvati and all improved from average poor to average good.
Adrenal Cortex Hormones ; Arthralgia ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Hip ; Bone Transplantation ; Classification ; Female ; Follow-Up Studies ; Head ; Hemiarthroplasty ; Hip ; Humans ; Humeral Head ; Life Style ; Low Back Pain ; Male ; Methods ; Osteonecrosis ; Osteotomy ; Surgeons

No abstract available.
Fractures, Open* ; Tibia*

PURPOSE: This study was aimed to evaluate the recurrence rate of a giant cell tumor (GCT) of the bone. MATERIALS AND METHODS: The medical records of fifty four patients who were diagnosed with a giant cell tumor of the bone between March 1980 and December 2008 were analysed retrospectively. Among 54 patients, 27 were men, remaining 27 were women with the mean age of 33.1 years (range, 13-67 years). The mean duration of follow-up was 67.1 months. RESULTS: Twenty-one patients (38.9%) had a local recurrence. The mean time to recurrence was 21.5 months (range, 2-59 months). The local recurrence rate of the upper extremities was higher than that of lower extremities. According to Campanacci classification, patients with a grade I diseae had lower recurrence rate than those with grade II or III disease. There was no significant differences in the recurrence rates based on cryotherapy, the filling of bone cement or bone grafts and surgical margin. CONCLUSION: To prevent local recurrence of GCT of bone, curettage of the tumor and elimination of the remaining cells are more important than adjuvant therapy.
Cryotherapy ; Curettage ; Female ; Follow-Up Studies ; Giant Cell Tumors ; Giant Cells ; Humans ; Lower Extremity ; Male ; Medical Records ; Recurrence ; Retrospective Studies ; Transplants ; Upper Extremity

No abstract available.
Pregnancy*

During the reproductive period, human endometrium undergoes a pattern of cyclic change. Human endometrium undergoes a complex pattern of proliferation, secretory activity, and menstruation over an approximately 28 days period. Proliferative activity is highest during late proliferative phase under influence of estrogen, and minimal activity in the late secretory and menstrual phase. To study a possible change of telomerase activity during menstrual cycle, telomerase activities in normal and hormone treated endometrium were tested using telomerase repeat amplification protocol(TRAP) assay. Telomerase activities were detected in 9 of 10 proliferative endometrium(90%), and maximal activity was shown in late proliferative phase. Only 3 of 10 secretory endometrium(30%) revealed weak activity. However telomerase activity was not detected in menstrual phase endometrium(N 2) and senile endometrium(N=3). Four of tamoxifen treated endometrium(N 4) and 1 of provera treated endometrium(N 3) Levels of telomerase activity of treated endometrium(N 4) and late proliferative endometrium(N 6) were as high as them of detected in endometrial cancer and hyperplasia. Above findings reveal that telomerase activity of endometrium is changed according to menstrual cycle, And the level of telomerase activity is related to proliferative activity of endometrium that is dependent on the status of female sex steroid hormone and tamoxifen treatment.
Endometrial Neoplasms* ; Endometrium* ; Estrogens ; Female ; Humans ; Hyperplasia ; Medroxyprogesterone Acetate ; Menstrual Cycle ; Menstruation ; Reproduction ; Tamoxifen ; Telomerase*

Two 4-day-old Thoroughbred foals with acute clinical signs of depression, elevated pulse and respiratory rates, anemia, and jaundice were referred to the equine hospital of Korea Racing Authority. The foals were seemingly normal at birth, but showed clinical signs such as abnormal behavior, jaundice and anemia suddenly after ingestion of the mare's colostrum, followed by death at 4 days after birth. According to the results of the hematology, serum chemistry analysis, jaundice foal agglutination test, and blood groups test, the foals were diagnosed as neonatal isoerythrolysis (NI) caused by the mare's antibodies. These results suggested that the pregnant mares have a potential for NI.
Agglutination Tests ; Anemia ; Antibodies ; Blood Group Antigens ; Colostrum ; Continental Population Groups ; Depression ; Eating ; Hematology ; Humans ; Jaundice ; Korea ; Parturition ; Respiratory Rate

OBJECTIVE: To investigate an appropriate depth of needle insertion during trigger point injection into the rhomboid major muscle. METHODS: Sixty-two patients who visited our department with shoulder or upper back pain participated in this study. The distance between the skin and the rhomboid major muscle (SM) and the distance between the skin and rib (SB) were measured using ultrasonography. The subjects were divided into 3 groups according to BMI: BMI less than 23 kg/m2 (underweight or normal group); 23 kg/m2 or more to less than 25 kg/m2 (overweight group); and 25 kg/m2 or more (obese group). The mean+/-standard deviation (SD) of SM and SB of each group were calculated. A range between mean+1 SD of SM and the mean-1 SD of SB was defined as a safe margin. RESULTS: The underweight or normal group's SM, SB, and the safe margin were 1.2+/-0.2, 2.1+/-0.4, and 1.4 to 1.7 cm, respectively. The overweight group's SM and SB were 1.4+/-0.2 and 2.4+/-0.9 cm, respectively. The safe margin could not be calculated for this group. The obese group's SM, SB, and the safe margin were 1.8+/-0.3, 2.7+/-0.5, and 2.1 to 2.2 cm, respectively. CONCLUSION: This study will help us to set the standard depth of safe needle insertion into the rhomboid major muscle in an effective manner without causing any complications.
Back Pain ; Humans ; Muscles ; Needles* ; Overweight ; Pneumothorax ; Ribs ; Shoulder ; Skin ; Superficial Back Muscles* ; Thinness ; Trigger Points* ; Ultrasonography

Serum specimens from leprosy patients, their contacts and controls were examined for the presence of phenolic glycolipid I (PGL-I), a Mycobacterium leprae specific antigen, and antibodies to the antigen using enzyme-linked immunosorbent assays. Of 12 lepromatous patients with less than 2 years of therapy, 11(91.7%) were seropositive to PGL-l, thus indicating that new lepromatous cases can be identified by detecting anti-PGL-l antibodies. In contrast 88(56.4%) of 156 lepromatous patiens treated more than 2 years were positve. Moreover, only 69(40.8%) were seropositve among 169 lepromatous patients in the leprosy resettlement villages. The mean antibody level also declined significantly in proportion to the duration of chemotherapy. This may suggest the possibility of monitoring chemotherapy by detecting anti-PGL-l antibodies. The prevalence of anti-PGL-l antibodies among 200 controls from a high endemic area for leprosy was 5.5% and was significantly higher than that(1.5%) among 200 controls from a low endemic area. Of 103 household contacts in the resettlement villages, 10(9.7%) were seropositive, reflecting the frequent chance of exposure to M. leprae. However, PGL-l was not detected many in any of the sera from controls, contacts, and inactive lepromatous patients having the anti-PGL-l antibodies; on the other hand, 6(50%) of 12 lepromatous patients treated less than 2 years had detectable PGL-l in their sera. The results thus indicate that PGL-l detection may be more suitable for monitoring the effectiveness of chemotherapy and that it may be necessary to examine for the presence of PGL-l in sera from contacts and normal populations for confirming M. leprae infection.
Antibodies, Bacterial/*analysis ; Glycolipids/*blood ; Human ; Leprosy/*blood/diagnosis ; Serologic Tests ; Support, Non-U.S. Gov't

The authors analyzed 17 cases of os odontoideum. a very rare condition and one of the causes of atlantoaxial instability. We investigated the radiographic findings of os odontoideum and classified the patients according to clinical grade, radiographic findings and direction of atlantoaxial instability. Their mean age was 33.4 years, and the male to female ratio was. 7: 10. Thirteen patients(76.5%) were classified as clinical grade 3, indicating fixed or progressive myelopathy. They were classified as one of two types, according to the location of the os, five were dystopic and ten were orthotopic. In remaining two patients, it was difficult to classify. We measured SAC(space available for cord) laterally, using plain film, and sagittally, using MR imaging, and compared the results with clinical symptoms. SAC as seen on cervical MRI, correlated more closely with severity of cord compression than did SAC seen on plain film. The 15 patients underwent various operative methods including C1/2 fixation, occipito-cervical fusion, and transoral decompression; because of postoperative hardware failure, two required further surgery. Postoperatively, twelve patients showed excellent or good neurologic improvement. In this retrospective study, SAC seen on cervical MRI was a very good indicator of the need for surgery, and surgery should be considered in patients whose clinical grade is higher than 2.
Decompression ; Diagnosis* ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Spinal Cord Diseases