From Jan. 1987 to May 1994, we carried out cementless total hip arthroplasties using hydroxyapatite-coated Omnifit system, and among these, 63 cases in 49 patients were followed up more than 24 months. The average Harris Hip Score was 46.3 points preoperatively, 95.4 points at POD 1 year and 96.2 points at POD 2 years. Two patients (3%) complained thigh pain at POD 2 years. On the radiologic findings, endosteal bone formation was noted in 34 cases (53,9 %), radiolucent lines were seen at the non-coating region of distal stem in 41 cases (65.3%), which were less than 2mm and not progressive. Cortical hypertrophy was noted in 5 cases (8.4%), and calcar atrophy was observed in 31 cases (49 %).
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Atrophy ; Durapatite* ; Hip ; Humans ; Hypertrophy ; Osteogenesis ; Thigh

STUDY DESIGN: In a prospective study of 38 patients undergoing lumbar pedicle screw instrumentation 200 pedicle hole were tested intraoperatively using electrical stimulation. OBJECTIVES: To evaluate the searching stimulus intensity at pedicle in Korean and to identify the most vulnerable root in transpedicular screw fixation of lumbosacral spine. MATERIALS AND METHOD: Electromyelogram(EMG) was monitored from eight lower extremity muscles bilaterally. Constant current stimulation pulses(0.2msec duration) were delivered through a ball-tipped nasopharyngeal probe used to evaluate each pedicle hole, and evaluated for searching stimulus intensity, the current necessary to evoked EMG RESULTS: The searching stimulus intensity above 5 mA were 194 cases(97.0%), above 7mA 151cases(75.5%), above 10 mA 107 cases(53.5%) and below 5 mA were 6 cases(3.0%). The vastus medialis muscle is most sensitive in L2(100%), L3(83.3%), tibialis anterior is in L4(68.4%), peroneus longus is in L5(44.2%) and gastrocnemious is in S1(64.5%). CONCLUSIONS: Stimulus-evoked EMG monitoring is a valuable and efficacious adjunct to lumbar pedicle screw instrumentation. A stimulation threshold greater than 5 mA reliably indicates adequate screw position and the root located at infero-medial side of pedicle is most vulnerab18 in transpedicular screw fixation.
Electric Stimulation ; Humans ; Lower Extremity ; Muscles ; Prospective Studies ; Quadriceps Muscle ; Spine

The chondrogenic potential of free autogenous periosteal grafts for osteochondral defects was investigated at the Department of Orthopaedic Surgery, Yonsei University, Wonju College of Medicine. Five millimeter diameter of circular full-thickness defects were made in patellar groove of both femur in 64 adolescent rabbits and the rectangular periostei, prepared from the proximal tibiae, were placed over the defects of patellar groove and sutured(cambium layer, facing joint surface) and the rabbits were allowed to move actively. A serial gross and histologic examinations of neochondrogenesis were done during 8 weeks. The results were as follows. l. At 2 weeks after operation, neochondrogenesis was hardly seen either in the graft group or in the control group. The defects were partially filled with some fibrous tissue. 2. After 6 weeks of operation, all defects in the graft group(postop 6 weeks and 8 weeks) were filled with hyaline cartilage cells but only 38% (postop 6 weeks) and 44% (postop 8 weeks) of the control group were filled with hyaline cartilage cells. 3. The cartilages, formed at 6 and 8 weeks, were more mature and better than those formed at 4 weeks. 4. The newly formed hyaline cartilage of the graft group filled the defect earlier and were better than those of the control group. 5. The chondrocytes in the newly formed tissue were originated from the cambium layer of periosteal grafts. 6. Free autogenous periosteal grafts can repair a full-thickness defect in a joint surface by producing tissue that resembles articular cartilage grossly and histologically.
Adolescent ; Cambium ; Cartilage ; Cartilage, Articular ; Chondrocytes ; Femur ; Gangwon-do ; Humans ; Hyaline Cartilage ; Joints ; Rabbits ; Tibia ; Transplants

We performed 15 cases of modified Bristow procedures for recurrent anterior instability of shoulder from january, 1987 to december, 1992 and the following results were obtained. 1. The patient's age at initial dislocation varied from 15 years to 29 years of age. 2. The most common cause of the recurrent anterior instability of shoulder was sport injury(6 cases) and next were traffic accident, hanging with one hand. 3. The average loss of external rotation of shoulder after operation were 10 degrees and internal rotation were 7 degrees. 4. The post-operative complication and recurrence were not observed. 5. End results were excellent in 7 and good in 5 by Rowe's grading system. 6. Strict attention to bone block placement was mandatory and decreased the risk of screw malpo-sition.
Accidents, Traffic ; Dislocations ; Hand ; Recurrence ; Shoulder ; Sports

OBJECTIVE: To document the outcome of the conservative treatment in plantar heel pain patients. Specific objectives included the evaluation the difference of outcome between patients, who revealed the different clinical menifestation, and the evaluation of prognostic factors. METHOD: We devided the plantar heel pain patients to two groups by the location of maximal tenderness on the heel(Group A - localized severe tenderness over the medial calcaneal tuberosity, Group B - diffuse tenderness over the central heel) and performed the conservative treatment according to a standard protocol(relative rest,nonsteroidal anti-inflammatory medications and stretching exercise during initial 2 weeks. And then viscoelastic polymer heel cushion, functional custom-made insole for all patients. Steroid injections were used for the patients of Group A who suffer from pain despite of standard treatment. In order to evaluate the results, we reviewed all charts and conducted the follow-up survey by questionnairs. 21 patients(8 males, 13 females; 26 heels; average age, 47.9 years; 15 group A, 6 group B) were available for review. RESULTS: The average follow-up was 9 months. Clinical results were classified as good(resolution of symptoms) for 3 patients, fair(continued symptoms but no limitation of activity) for 13 patients, poor(continued symptoms limiting activity) for 5 patients. The overall successful improvement(including good and fair) were 76.2% within 2.6 months. There were no significant difference of the successful improvement between two groups, which were 73.3% in group A, 83.3% in group B. The overweight was the only predictive factor of poor result. CONCLUSION: The outcome of a conservative treatment in patients with plantar heel pain is successful. But it is not different in spite of difference of clinical menifestation.
Female ; Follow-Up Studies ; Heel* ; Humans ; Male ; Overweight ; Polymers

PURPOSE: To analyze the results of cementless total hip arthroplasty with a F2L Multineck femoral stem. MATERIALS AND METHODS: A total of 64 patients (73 hips), who underwent cementless total hip arthroplasty with a F2L Multineck femoral stem, SPH acetabular cup and a ceramic liner from December of 1998 to October of 2001 were followed up for at least 4 years, were selected for the clinical and radiological evaluations. RESULTS: At the final evaluation, 63 patients had an improved average Harris hip score ranging from 51.4 preoperatively to 95.1. None of the patients had any significant leg length inequality. Thigh or inguinal pain was observed in 3 hips (1 hip of femoral stem subsidence and 2 hips of damaged ceramic parts), for which revision total hip arthroplasty was performed. Hip dislocation occurred in 2 hips within 2 weeks after surgery and conservative management was performed after a closed reduction. CONCLUSION: Total hip arthroplasty with a F2L Multineck femoral stem produced satisfactory results. Postoperative complications such as hip dislocation and leg length inequality could be minimized by modulating the anteversion angle, femoral offset and leg length with multineck femoral stem.
Acetabulum ; Arthroplasty, Replacement, Hip* ; Ceramics ; Hip ; Hip Dislocation ; Humans ; Leg ; Leg Length Inequality ; Postoperative Complications ; Thigh

PURPOSE: Large rearrangements in the dystrophin gene is detected in about 65-70% of patients by multiplex PCR or Southern blot, although detection of point mutations and microlesions is currently in progress. The purpose of this study is to carry out mutation analysis of the dystrophin gene by application of PCR-related molecular diagnostic methods in Duchenne muscular dystrophy (DMD). METHODS: Five patients diagnosed as a DMD by muscle biopsy, and their first-degree relatives and mothers were enrolled in this study. The genomic DNA was extracted from the peripheral blood lymphocyte. We used a total of 28 pairs of primers including Beggs' and Chamberlain's primers. The multiplex PCR was performed in 4 groups; 5'Rxn2, 3'Rxn2, Rxn2, and CRxn2. For exon duplication analysis, multiplex PCR and gel densitometry were carried out by comparing the band intensities among individual bands. For groups with no detectable deletion, single strand conformation polymorphism (SSCP) analysis and direct DNA sequencing method were performed with individual PCR of candidate exons. RESULTS: About 12-20microg of genomic DNA was extracted from 1mL of blood, and the size of DNA was over 50kb. Up to 9 PCR products were made from multiplex PCR using the genomic DNA. Among 5 families with DMD, No. 6 had about 240kb DNA deletion from exon 45 and 47-53, and No. 11 had about 130kb deletion from exon 47-49 and 53. No. 1 showed duplication of exon 43 when the multiplex PCR products were analyzed by a densitometer. When the deletion/duplication negative No. 3 was analyzed by SSCP method, exon 43 and 49 showed abnormal band patterns. The abnormal band pattern of exon 43 was caused by deletion mutation of A residue, which resulted in pretermination of dystrophin synthesis, meanwhile exon 49 showed transversion mutation of C G at intron 49. CONCLUSION: Based on the results of this study, the methods of multiplex PCR, SSCP and direct DNA sequencing of PCR products made it possible to analyze several types of mutation of DMD.
Biopsy ; Blotting, Southern ; Densitometry ; DNA ; Dystrophin* ; Exons ; Humans ; Introns ; Lymphocytes ; Mothers ; Multiplex Polymerase Chain Reaction ; Muscular Dystrophy, Duchenne* ; Pathology, Molecular ; Point Mutation ; Polymerase Chain Reaction* ; Polymorphism, Single-Stranded Conformational ; Sequence Analysis, DNA ; Sequence Deletion

BACKGROUND: Reperfusion of ischemic myocardium has been postulated to result in a specific oxygen radical mediated tissue injury. Iron may liberate during ischemia and we hypothesized that administration of the iron chelator, deferoxamine during ischemia would result in improved recovery after postischemic reperfusion. PURPOSE: To test whether iron-catalyzed processes contribute to myocardial necrosis during ischemia and reperfusion, deferoxamine was administered to block iron catalyzed hydroxyl radical formation in rabbits. METHODS: Eleven rabbits were divided into two groups: control group (n=5) and deferoxamine pretreatment group (n=6). the left circumflex coronay artery was ligated for 30 minutes and reperfused for 180 minutes. Area at risk (AR) was measured by non-stained area with ethylene blue injection into left atrium after left circumflex coronary artery ligation. Infarct size was measured by weighing after tripheyltetrazolium chloride staining. Heart rate was measured using electrocardiographic recording and systemic blood pressure was monitored by pressure transducer connected to the catheter in the left ventricle. RESULTS: 1. There was no significant difference of heart rate and blood pressure in deferoxamine pretreatment group compared with control group. 2. There was significant decrease of serum iron concentration after continuous infusion of deferoxamine compared with serum iron concentration before ligation of coronary artery (P<0.05). 3. There was no significant difference of area at risk between control and deferoxamine pretreatment group. 4. Area at necrosis to area at risk was significantly reduced in deferoxamine pretreatment group compared with control group (P<0.05) The results suggest that deferoxamine infusion prior to coronary artery occlusion has a significant benefit in reducing infarct size in this model.
Arteries ; Blood Pressure ; Catheters ; Coronary Vessels ; Deferoxamine* ; Electrocardiography ; Heart Atria ; Heart Rate ; Heart Ventricles ; Hydroxyl Radical ; Iron ; Ischemia ; Ligation ; Myocardial Infarction* ; Myocardium ; Necrosis ; Oxygen ; Rabbits ; Reperfusion ; Transducers, Pressure

No abstract available.
Adenocarcinoma*

BACKGROUND: NCAM plays an important role in the peripheral innervation of the spinal neurons as well as in the development of the CNS. Although expression of NCAM is down-regulated in most areas of adult brain and spinal cord, it could be reexpressed after neuronal damages induced by various physical or chemical insults including peripheral nerve transection. METHOD: To investigate alterations of the NCAM immunoreactivity in the dorsal and ventral horns of the spinal cord induced by peripheral neurotomy and reconnection, the unilateral sciatic nerve of the rats were transected and immediately reconnected. Experimental animals were sacrificed at 1 week and 3 weeks after operation, and the alteration of NCAM immunoreactivity in the ventral and the dorsal horns of the lower lumbar spinal cord were examined. RESULTS: NCAM-immunoreactive astrocytes in the ipsilateral dorsal horn was increased at 1 week after operation. Neurons with NCAM?immunoreactive membranes and processes were increased in ipsilateral dorsal horns, and in large motor neurons of ventral horns of both sides at 3 weeks after unilateral sciatic neurotomy and reconnection. CONCLUSIONS: It is consequently suggested that unilateral sciatic neurotomy and reconnection induce the increase of the NCAM-immunoreactive neurons and glial cells in the spinal cord, and increase of NCAM immunoreactivity in the spinal cord may reflect the neuronal damage and healing process induced by peripheral nerve injury.
Adult ; Animals ; Astrocytes ; Brain ; Horns ; Humans ; Immunohistochemistry ; Membranes ; Motor Neurons ; Neural Cell Adhesion Molecules* ; Neuroglia ; Neurons ; Peripheral Nerve Injuries ; Peripheral Nerves ; Rats* ; Sciatic Nerve ; Spinal Cord*