Avascular necrosis of the femoral head is generally localized in the anterosuperior aspect of the head. The posterior part of the head often retains a normal, smooth contour containing healthy cartilage even in much advanced cases. Because of this anatomical localization of the lesion, Y. Sugioka has devised a transtrochanteric rotational osteotomy in young and middle-aged person, which reduces the weight-bearing force on the necrotic area, and transfers shearing forces to the healthy posterior cartilage of the femoral head to prevent progressive collapse of the articular surface and improve alignment when articular collapse followed femoral head subluxiation. The authors reviewed 13 cases of Sugioka operation, performed at the Department of Orthopedic Surgery, Seoul National University Hospital during the period from December 1983 to Feburary 1986 and the following results were obtained. 1. There were 11 males and 1 female. The average age of the 13 cases was 33.3 years. 2. In all the cases of Grade I and Grade II hips, there was not progressiveness of necroticarea of femur heads. 3. By U.C.L.A. hip rating system, preoperative mean scores of pain, walking ability, function and activity were 2.5, 5.7, 4.8 and 4.3, respectively, while postoperative scores of these were increased to 7.7, 9.5, 8.4 and 7.8, respectively. 4. Average ranges of motion of hip joint were increased more postoperatively than preoperatively.
Cartilage ; Female ; Femur Head ; Head ; Hip ; Hip Joint ; Humans ; Male ; Necrosis ; Orthopedics ; Osteotomy ; Seoul ; Walking ; Weight-Bearing

INTRODUCTION: In this study, we compared sleep structure, EEG characteristic of pediatric obstructive sleep apnea (OSA) and normal controls which were matched in sex and age. METHODS: Fifteen children (male:female=4:11) who complained snoring and were suspected to have sleep apnea and their age and sex matched normal controls (male:female=5:10) have been done nocturnal polysomnography (NPSG). Sleep parameters, sleep apnea variables and relative spectral components of EEG from NPSG have been compared between both groups. RESULTS: Pediatric OSA group were distinguished from normal controls in terms of apnea index, respiratory disturbance index and nadir of oxyhemoglobulin desaturation. Pediatric OSA group showed increased percent of sleep stage 1, decreased rapid eye movement sleep percent and increased delta power in O1 EEG channel. However other sleep parameters and spectral powers were not different between two groups. CONCLUSION: In pediatric OSA group, sleep structure parameter disruption may be not prominent as the previous studies for adult OSA group because of including mild OSA data in diagnostic criteria. In addition, EEG changes might not be distinct due to low arousal index compared to adult OSA patients. We can observe general characteristics and particularity of pediatric OSA through this study.
Adult ; Apnea ; Arousal ; Child ; Electroencephalography ; Humans ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Sleep Stages ; Sleep, REM ; Snoring

No abstract available.
Pregnancy*

The most commonly used graft source for anterior cruciate ligament reconstruction is the autogenous bone- patellar tendon-bone graft unit. Despite a good success record, intraoperative technical errors and postoperative complications have been known. Author analyzed intraoperative technical errors and postoperative complications, in 44 patients who were treated at the department of orthopaedic surgery, chosun university hospital from Jan. 1994 to Jun. 1996. The most common intraoperative technical errors was screw graft divergency in 5 cases. Other intraoperative technical errors were too anteriorly location of femoral tunnel in 1 case, too anteriorly location of tibial k femora) tunne.l both in 1 case, graft tunnel mismatching in 1 case, graft pullout in 1 case and partial destruction of posterior cortex of femoral tunnel in 1 case, fracture of the bone plug in 1 case. The most common postoperative complication was patellar tendinitis in 20 cases (45.5%). Other postoperative complications were anterior knee pain in 14 case. (31.8%), patellar crepitation in 12 cases (27.3%), quadriceps atrophy in 9 cases (20.5%), arthrofibrosis in 3 cases and graft failure in 2 cases. Author concluded the causes of intraoperative complications were technical errors, and anteriorly location of graft tunnel is most influenced factor to final fuctional results. To eliminate the postoperative complications, intraoperative technical errors should be avoided and also accelerated rehabilitation should be done.
Anterior Cruciate Ligament Reconstruction ; Atrophy ; Humans ; Intraoperative Complications ; Knee ; Patellar Ligament* ; Postoperative Complications* ; Rehabilitation ; Tendinopathy ; Transplants

There is still discussion concerning the methods for treating Tossy type 3 dislocations of the acromioclavicular joint. Since 1995, the authors have treated 10 patients of type 3 dislocations by arthroscope-assisted modified Weaver and Dunn operation with favorable results. The operation consisted of diagnostic shoulder arthroscopy, arthroscopic resection of acromial end of coracoacromial ligament with bone block, excision of distal end of clavicle, bone block transfer of coracoacromial ligament into the medullary canal of clavicle, and augmentation between coracoid process and resected distal end of clavicle with the Mersilene tape. The advantages of this arthroscope-assisted modified Weaver and Dunn operation are as follows: (1) Using the shoulder arthroscope, associated patholgy in the shoulder joint can be found and treated appropriately. (2) Arthroscopic resection of the acromial end of coracoacromial ligament can give the small incision and least damage to the deltoid muscle so that immediate post-operative range of motion exercise can be possible. (3) Bone block transfer of coracoacromial ligament and augmentation between coracoid process and resected clavicular end can prevent displacement of the resected clavicular end.
Acromioclavicular Joint ; Arthroscopes* ; Arthroscopy ; Clavicle ; Deltoid Muscle ; Dislocations* ; Humans ; Ligaments ; Range of Motion, Articular ; Shoulder ; Shoulder Joint

OBJECTIVE: The conventional methods to determine fetal genetic status, such as amniocentesis or chorionic villi sampling(CVS) have small procedure-related risk of abortion. Recently, several researchers reported that fetal genetic status, such as sex, can be confirmed by fetal nucleated erythrocytes in maternal blood and this method might reduce such risk. Therefore, in this study, we attempted to determine the basic fetal genetic status, sex, with fetal nucleated erythrocytes. METHODS: In twelve pregnant women who undertook amniocentesis or CVS, 20 ml of venous blood was drawn immediately before the procedure and the nucleated erythrocytes were recovered by magnetic activated cell sorting(MACS). After MACS, DNA was extracted from 200 microliter of sample and single nucleated erythrocyte was obtained by additional procedure, immunostaining, and microdissection. After recovery of nucleated erythrocytes by microdissection, nested polymerase chain reaction(PCR) and fluorescent PCR of amelogenin gene were performed to identify the fetal gender. RESULTS: The DNA of enriched erythrocytes after MACS could identify the fetal gender in the 58.3% of the samples by nested PCR. After the recovery of single nucleated erythrocyte by MACS, immunostaining and microdissection, the minute DNA in a single cell could be amplified by primer extension preamplification(PEP), nested PCR, and fluorescent PCR. Fetal genders were correctly identified in 8 out of 12 (66.7 %). CONCLUSION: Through this study, we could conclude that fetal nucleated erythrocytes in maternal blood might be sufficient sample to determine fetal sex. And single cell isolation by microdissection could get the better results than nested PCR after MACS only. However, in spite of the pregnancy of male fetus, female specific bands were obtained after nested PCR of amelogenin in several cells, which might suggest that part of nucleated erythrocytes in maternal blood might be maternal origin. Therefore, to determine fetal genetic condition by nucleated erythrocytes in maternal blood, further improvements of methods to identify the nucleated erythrocytes of fetal origin are needed.
Amelogenin ; Amniocentesis ; Cell Separation ; Chorionic Villi ; Diagnosis* ; DNA ; Erythroblasts* ; Erythrocytes ; Female ; Fetus ; Humans ; Male ; Microdissection ; Polymerase Chain Reaction ; Pregnancy ; Pregnant Women

Segmental fracture of the femoral shaft is known as an unusual injury, usually caused by severe force and associated with marked damage to the soft tissue, and is difficult to treat due to these causes it is a controversal topic in regard to the treatment. Authors analysed 14 cases of segmental fracture of the femoral shaft, except cases associated with hip fracture, which had received operative treatment at Dept. of Orthopaedic Surgery, College of Medicine, Chosun University, from Jan. 1985 to Dec. 1990. The results are summarized as follows; 1. Of 14 cases, there were 12 cases of male and 2 cases of female: male was predominant. Most cases were at their 3rd and 6th decades of age. 2. Traffic accidents were the main causes of injury(11 out of 14 cases.) 3. There were 13 closed fracture and 1 open fracture. 4. In most cases, they accompanied injuries to other vital organ. Among 14 cases, 5 cases accompanied head injury. 5. We treated these fracture by flexible intramedullary nailing in 7 cases, open reduction and internal fixation with plate in 5 cases, locked intramedullary nailing in 2 cases. Bony union was more rapid in the distal fracture than in the proximal fracture. 6. Among 14 cases, primary bone grafting was done in 2 cases. In the group where primary bone grafting had not been done, dealyed union appeared but nonunion was not seen. 7. We could obtain rapid bony union and decreased operation time in the cases which were treated with intramedullary fixation, and thought that intramedullary fixation was a relatively good method in type of this fracture.
Accidents, Traffic ; Bone Transplantation ; Craniocerebral Trauma ; Female ; Fracture Fixation, Intramedullary ; Fractures, Closed ; Fractures, Open ; Hip ; Humans ; Male ; Methods

Superoxide dismutase(SOD), catalase and glutathione peroxidase and the levels of lipid peroxide were assayed in erythrocytes and synovial fluid isolated from 17 patients with osteoarthritis of the knee joints and 7 with healthy knee joints as a control groups. In the erythrocytes, SOD, catalase and glutathione peroxidase activities were significantly increased in osteoarthritis compared with normal control groups, but the changes of malonyldialdehyde level was not significant. The activity of SOD in synovial fluid was significantly decreased in osteoarthritis compared with normal control groups, but catalase activity was significantly increased in synovial fluid of osteoarthritis. This result suggested that the increament of antioxidant enzymes in erythrocytes were probably due to increased production of oxygen radicals in osteoarthritis. In osteoarthritis, knee joints might be injured more easily by oxygen radicals because of decreased activity of SOD in synovial fluid of osteoarthritis.
Catalase ; Erythrocytes ; Glutathione Peroxidase ; Glutathione ; Humans ; Joints ; Knee Joint ; Knee ; Malondialdehyde ; Osteoarthritis ; Osteoarthritis, Knee ; Reactive Oxygen Species ; Superoxide Dismutase ; Superoxides ; Synovial Fluid

This is a retrospective review of our experience with endoscopic extraction of 20 cases of foreign body on the upper gastrointestinal tract at sanggye paik hospital from Oct. 1989 to Nov. 1993. Among 20 cases, 3 cases were under 5years of age and 17 cases were over 27years of age. 9 cases (45%) were located in the esophagus, 8 cases (40%) were in the stomach and 3 cases (15%) were in the duodenum. All children (100%) have true foreign body, almost of all adults (82%) have food-related foreign body. Dysphagia with chest pain or vomiting was the most common symptom in the esophageal foreign body. Epigastric pain and vomiting or hematemesis were common symptoms in the stomach or duodenal foreign body, All of the esophageal foreign body (100%) were extracted within 72 hours, most of all (91%) stomach and duodenal foreign body were extracted after 72 hours.
Adult ; Chest Pain ; Child ; Deglutition Disorders ; Duodenum ; Esophagus ; Foreign Bodies* ; Hematemesis ; Humans ; Retrospective Studies ; Stomach ; Upper Gastrointestinal Tract* ; Vomiting

Since Green et al has introduced a new technique of retrograde intramedullary nail, the use of retrograde interlocking intramedullary nails has been recommended as one of the treatment options for the distal femoral fracture. However there are some disadvantages that an arthrotomy is required for insertion and the knee joint could often be violated. Authors present a simple, arthroscopically assisted method using the retrograde intramedullary nailing for distal femoral fractures with minimal invasiveness to the knee. From March 1995 to March 1997, the retrograde intramedullary nail was used to treat 9 distal femoral fractures. Five of 9 patients were fractured at the distal shaft of the femur and others were fractured at the supracondylar region of the femur. Only one of the fractures was open injury(Gustilo-Anderson grade II). Significant concomitant knee joint injuries were revealed through the arthroscopy in 3 patients. Eight of 9 fractures healed by 5 months, but one fracture was not healed and required bone grafting. Average knee range of motion was 130. Complications included 1 nonunion and 1 hardware failure. There were no patellofemoral problems and no posttraumatic arthritis of the knee joint. This arthroscope-assisted method have some potential benefits that include decreased risk of damage to the knee joint, early evaluation and treatment of the associated knee joint injuries, and accurate placement of the nail.
Arthritis ; Arthroscopy* ; Bone Transplantation ; Femoral Fractures* ; Femur ; Fracture Fixation, Intramedullary ; Humans ; Knee ; Knee Joint ; Range of Motion, Articular