Results of 170 total knee arthroplasties(TKAs) performed from 1986 to 1995, followed up for at least one year, were reviewed. Lateral retinacular release was performed in 76 knees(45%) and not performed in 94 knees(55%). We compared the results of TKAs combined with lateral retinacular release with those without lateral retinacular release. The clinical results of TKAs were evaluated by the Knee Scoring System of Hospital for Special Surgery(HSS). The average follow-up period was 34 months. The clinical results assessed by HSS score, pain score and range of motion improved postoperatively in both groups, but there was no significant difference between the two groups. There were 8(4.7%) with patellar subluxations in 170 TKAs, one(1.3%) in the group with lateral retinacular release and 7(7.5%) in the group without lateral retinacular release(t-test; p<0.05). Analysis of lateral tilt of patella on roentgenographs also showed a significant difference between the two groups. 7 knees(9.2%) with lateral tilt were observed in the group with lateral retinacular release and 22 knees(23.4%) with lateral tilt in the group without lateral retinacular release(t-test; p<0.05). There was no osteonecrosis or fracture of patella in either group. In summary, lateral retinacular release might improve the patellar tracking and lower the incidence of patellar subluxation and lateral tilt of patella. Lateral retinacular release alone did not seem to cause patellar osteonecrosis and subsequent patellar fracture which were detectable in plain roentgenographs. So, we suggest that lateral retinacular release can be performed without great risk of potential patellar complications in TKAs requiring lateral retinacular release for proper patellar tracking.
Arthroplasty* ; Follow-Up Studies ; Incidence ; Knee* ; Osteonecrosis ; Patella ; Range of Motion, Articular

No abstract available.
Ankle*

In order to assess the biocompatibility of domestic dynamic compression plates and screws manufactured at KAIST (Korea Advanced Institute of Science and Technclogy), hematological, serological, histological, and metallurgical studies were carried out on sixty rabbits through thirty-two weeks. The rabbits were divided into two groups, group I: thirty rabbits for KAIST plates and screws, group II: thirty rabbits for Osteo plates and screws. The plate and screws were fixed on the fixed tibial shaft. All the resulg of hematological, serological, histological, and metallurgical study revealed that there were no meaningful differences between the two groups. This, in fact, enco.urages us to use domestic KAIST plates and screws clinically and to develop more complicated designs including total joint replacement system.
Animal Experimentation ; Animals ; Joints ; Rabbits ; Stainless Steel

It has been reported that the maintenance of proper ligament balance around the knee joint and the proper location of tibio-femoral joint line position are very important factors for obtaining good knee joint function after the total knee replacement arthroplasty. but, yet the exact effect of the change of joint line on the result of total knee replacement arthroplasty has not been elucidated. The purpose of this study is to evaluate the effect of the change of joint line on the patellar position and the postoperative knee joint function as well as the effect of antero-posterior offset of tibial component on the clinical result. The authors performed the clinical and radiological analysis of 85 knees, in which total knee replacement arthroplasty was performed and followed over 1 year. Tibio-femoral joint line changed from -7mm to +6.8mm (average -0.07) and in this range, the change of joint line did not influence the clinical result and the patellar position. As tibio-femoral joint line migrated proximally, the patella migrated distally and as tibio-femoral joint line migrated distally, the patella migrated proximally. Postoperative pain decreased as the patella and patellar articular surface moved proximally. As the patellar bone height from tibial tuberosity decreased postoperatively. The range of motion decreased. Antero-ppsterior offset of tibial component distributed from -4.2mm to +4.5mm (average 0.62mm) and no effect on cllinical result in this range. In conclusion, it may be suggested that the change of joint line in total knee replacement arthroplasty must be changed as little as possible for the good postoperative range of motion and relief of pain.
Arthroplasty* ; Arthroplasty, Replacement, Knee* ; Joints* ; Knee ; Knee Joint ; Ligaments ; Pain, Postoperative ; Patella ; Range of Motion, Articular

Malignant esophago-bronchial fistula is an incurable and distressing condition. The passage of swallowed saliva and solid or liquid food into the bronchial tree causes coqghing and frequent pulmonary infection and collapse. Most patients are unfit for major surgery, but intubation offers a quick, simple and effective treatment with improved length and quality of life. However, intubation with simple esophageal tubes are liable to result in failure to occlude the fistela, migration of the tube, erosion, and in the case of latex tubes, disintegration. To overcome these problems, the fistula is intubated perorally with a prosthesis surrounded by a foam rubber cuff contained ia silicone sheath, in which vacuum can be created. This cuffed prosthesis is the most satisfactory design for the treatment of malignant esophago-bronchial fistula with effiective and gentle occlusion of the fistula without risk of pressure necrosis. We experienced a case of the endoscopic treatment with a cuffed prosthesis for malignant esophago-bronchial fistula. So we report this case with brief review of the previous literatures.
Bronchial Fistula* ; Esophageal Neoplasms ; Fistula ; Humans ; Intubation ; Latex ; Necrosis ; Prostheses and Implants* ; Quality of Life ; Rubber ; Saliva ; Silicones ; Vacuum

Obesity is associated with an impairment of the growth hormone secretion elicited by all stimuli known to date, but the basic mechanism of the alteration is unknown to date, but the basic mechanism of this alteration is unknown. To determine whether obesity is associated with a chronic state of tonic somatostatin secretion, several tests with growth hormone stimuli such as GHRH(1 microgram/kg), clonidine(150 microgram/m(2))and Regular insulin (0.1U/kg, subcutaneously), to obese subjects and normal control with or without pyridostigmine were undertaken, and the Somatomedin-c levels were measured in both obese subjects and matched controls. 1) The peak GH levels and AUC-GH after administration of GHRH, Clonidine or Regular insulin in obese group is less than those in control group. 2) Pretreatment with pyridostigmine increased the peak GH levels and AUC-GH significantly in obese group but the absolute values are less than those of normal group. 3) The Somatomedin-c levels are significantly higher in obese group than control. Our results lend support to the view that chronically high level of somatostatin decreases the responsiveness to GHRH and secretion itself.
Child* ; Clonidine ; Growth Hormone* ; Humans ; Insulin ; Obesity* ; Pyridostigmine Bromide ; Somatostatin

Cutaneous metastases from internal carcinomas are relatively rare, especially from pancreatic carcinoma. Pancreatic carcinomas are usually adenocarcinomas which arise in the head of the gland, and are known to rapidly metastasize to the lymphatic system by permeation and embolization. We report a case of cutaneous metastasis from pancreatic adenocarcinoma. in 74-year-old male patient who have two pea sized, slight erythematous nodules on the lower abdomen and posterior side of the neck.
Abdomen ; Adenocarcinoma* ; Aged ; Head ; Humans ; Lymphatic System ; Male ; Neck ; Neoplasm Metastasis* ; Peas

No abstract available.
Child* ; Epilepsy* ; Humans

BACKGROUND: The regurgitative valvular heart diseases are important underlying diseases that result in congestive heart failure, and the prevalence increase with the increasing age. Early detection and management of the regurgitative valvular heart disease could decrease the morbidity and mortality rate of the elderly. METHODS: We reviewed medical records of 425 patients who visited KonKuk University Medical Center ChungJu Hospital for the echocardiography between April 1994 to September 2000. 281 out of 425 patients were diagnosed with regurgitative valvular heart disease, and they were analyzed according to their age, sex, underlying disease, and accompaniment of congestive heart failure. Also the relationships between the regurgitative valvular heart disease and fractional shortening(FS), and also with ejection fraction(EP) were analyzed. RESULTS: There were 281 patients diagnosed with regurgitative valvular heart disease. Greatest number of patients was diagnosed with MR, followed by AR, TR and PR, accordingly. The prevalence of regurgitative valvular heart disease increased as the age increased. The prevalence of regurgitative valvular heart disease in male patients were 74% and for female patients, 62%. For patients with hypertension, it was 59%, and for DM patients it was 60%. For patients with past history of ischemic heart disease, or congestive heart failure, the prevalences of regurgitative valvular heart disease were high. FS for the patients with regurgitative valvular heart disease was 28.91% compared 32.69% for the patients without regurgitative valvular heart disease. EF for the patients with regurgitative valvular heart disease was 54% compared to the 60% for without regurgitative valvular heart disease. The FS for patients with symptomatic regurgitative valvular heart disease was 23.86% compared to 27.7% for asymptomatic group. The EF for symptomatic regurgitative valvular heart disease was 46.2% compared to 52.3% for asymptomatic group. CONCLUSION: When 2D-echocardiography was performed on elderly patients who were older than 65 years of age, most of them featured degenerative structural changes in valves and deterioration of valvular functions resulting in regurgitative valvular heart disease. When patients had any symptoms or underlying diseases, the decrease in cardiac function and high prevalence of regurgitative valvular heart disease were apparent. Therefore in elderly patients, even if they are asymptomatic or without any underlying diseases, aggressive diagnostic approaches and early intervention may delay the progress of valvular heart disease.
Academic Medical Centers ; Aged* ; Chungcheongbuk-do ; Early Intervention (Education) ; Echocardiography ; Female ; Heart Failure ; Heart Valve Diseases* ; Humans ; Hypertension ; Male ; Medical Records ; Mortality ; Myocardial Ischemia ; Prevalence

PURPOSE: Unilateral testicular torsion is usually associated with damage to both the affected and the contralateral testis and thus with diminished fertility. This study was preformed to evaluate whether the capsaicin prevents contralateral testicular damage and how long the protection lasts. MATERIALS AND METHODS: Eight groups of 8 male Sprague-Dawley rats(5 weeks old; 150~180 g) were studied. Groups 1 and 5 were sham-operated controls, groups 2 and 6 were testicular torsion controls, groups 3 and 7 underwent sham operation 24 hours after intraperitoneal administration of 0.5 cm3 of capsaicin, and groups 4 and 8 had testicular torsion performed 24 hours after the intraperitoneal administration of 0.5 cm3 capsaicin. The contralateral testis of each animal was harvested at 24 hours after the operation(groups 1~4) or at 4 weeks(groups 5~8). The weight, histologic findings, and extent of apoptosis were evaluated. RESULTS: At 4 weeks, the weight of the contralateral testis and the diameter of the seminiferous tubules were decreased in the testicular torsion groups. The histologic grade and spermatogenesis was significantly lower in groups 6 and 8. The apoptosis index was significantly higher in groups 2, 6, and 8. CONCLUSIONS: Capsaicin prevents early contralateral testicular damage from unilateral torsion(within 24 hours). However, these effects are not sustained at 4 weeks.
Animals ; Apoptosis ; Capsaicin* ; Fertility ; Humans ; Male ; Rats* ; Rats, Sprague-Dawley ; Seminiferous Tubules ; Spermatic Cord Torsion* ; Spermatogenesis ; Testis*