The purpose of this paper was to report clinical results and complications of high tibial osteotomy with fibular shaft osteotomy for medial unicompartmental osteoarthritis with varus deformity of the knee. Especially, the complications related to fibular shaft osteotomy were surveyed and analysed. Among one hundred and thirty-one cases which underwent high tibial osteotomy from Nov 1993 to May 1999, twenty-five cases underwent it combined with fibular shaft osteotomy and followed up at least more than 2 years. Average follow-up period were 47 months. Hospital for special surgery(HSS) knee score and femorotibial angle from weight bearing anteroposterior roentgenography of the knee were evaluated and measured. HSS knee score was improved from average 69 points preoperatively to 93 points in average at the final follow-up. Femorotibial angle was varus 2.9 degrees in average preoperatively and improved to valgus 8.1 degrees in average postoperatively and valgus 6.6 degrees at the final follow-up. Complications were tender- ness near to fibular shaft osteotomy in 9 cases, superficial peroneal nerve injury in 8 cases, non-union of fibu- lar osteotomy in 7 cases, non-union or delayed union of tibia osteotomy in 3 cases. High tibial osteotomy with fibular shaft osteotomy was a effective procedure in improving clinical results of osteoarthritis of the knee. However care must be taken to avoid complications rel#ated to fibular osteotomy
Congenital Abnormalities ; Follow-Up Studies ; Knee ; Osteoarthritis ; Osteotomy* ; Peroneal Nerve ; Radiography ; Tibia ; Weight-Bearing

PURPOSE: This study was performed to describe the ultrastructure of stromal nerve fibers in central, mid-peripheral, and peripheral parts of the human cornea by flat serial corneal section. METHODS: Seven samples from fresh normal cornea, derived from eyes with retinoblastoma and eyes from eye bank, were processed for transmission electron microscopic examinations. Flat serial sections reaching from mid-epithelium to the anterior stroma were observed. RESULTS: The myelinated and unmyelinated nerve fibers are alternately arranged and run parallel to the stromal collagen fibers at the periphery of the cornea. The main difference between the limbal and the central cornea is the presence of myelinated nerve fibers in the anterior peripheral stroma. The diameter of the unmyelinated nerve fiber measures between 0.25 and 0.63 micrometer in size. The corneal nerve fibers contain vesicles, mitochondria, and glycogen particles. The peripheral nerve fibers contain both clear and dense vesicles. The nerve fiber is separated by an interval of 0.3 micrometer from the cytoplasmic wall of keratocyte at the center of the cornea. CONCLUSIONS: The majority of the corneal nerve fibers can be classified as C-fibers due to their size. The presence of both clear and dense vesicles within the cytoplasm of the periphery of the cornea suggest that a small portion in the peripheral corneal nerve may be originated from the sympathetic nervous system. A close vicinity between the nerve fibers and keratocyte supports that nerve fibers might modulate the release of growth factors in the regulation of stromal and epithelial metabolism.
Collagen ; Cornea ; Cytoplasm ; Eye Banks ; Glycogen ; Humans ; Intercellular Signaling Peptides and Proteins ; Metabolism ; Mitochondria ; Myelin Sheath ; Nerve Fibers ; Nerve Fibers, Myelinated ; Nerve Fibers, Unmyelinated ; Peripheral Nerves ; Retinoblastoma ; Sympathetic Nervous System

Orthofix, a unilateral external fixator is simple and easy to use and it's design is also convenient to reduce and maintain the fracture site. In addition, wide range of application is an another advantage because compression and distraction is possible in the central body. Authors reviewed 56 operations in 50 patients for whom Orthofix was applied for 4 years from march 1988 to february 1992 in Chonnam University Hospital. There were 46 males and 4 females. Twenty five patients(50%) were between 20 to 40 years of age. The indication was open fracture of the long bone in 27 cases, infected nonunion in 17 cases, bony defect in 4 cases, arthrodiastasis in 3 cases, arthrodesis in 2 cases and others in 3 cases. 1. There were 23 cases treated with Orthofix only until completion of treatment, 17 cases necessary to another methods of treatment, 14 cases maintaining Orthofix until now and 2 cases miscellaneous. 2. The duration of maintenance of Orthofix until completion of treatment in 20 cases of open fracture of long bone or infected nonunion was 9.5 months in average. 3. The bone union time averaged 9.5 months in above 20 cases and there was a little difference of bone union time between open fractures and infected nonunions. 4. Result of long term follow-up in 20 cases open fracture of long bone or infected are as follows; 12 cases(60%) have angulation less than 10° or length inequality less than 10mm, 14 cases(70%) have showed no limitation in range of motion or mild limitation of joint above and below the fracture site. 5. Complications, directly related to Orthofix, developed in 17 cases. There were 15 cases of pin tract infection and 2 cases of fixation loosening. Orthofix was considered as one of the excellent external fixation system, for it is simple and easy to use and could provide rigid fixation for difficult conditions in Orthopedic field such as open fracture, infected nonunion, bony defect and arthrodiatasis.
Arthrodesis ; External Fixators ; Female ; Follow-Up Studies ; Fractures, Open ; Humans ; Jeollanam-do ; Joints ; Male ; Orthopedics ; Range of Motion, Articular ; Socioeconomic Factors

No abstract available.
Humans* ; Ligaments*

OBJECTIVE: To examine the stiffness of finger joints with StifMeter among the patients with rheumatoid arthritis and to calculate the absolute value of the stiffness with a unit of power and to compare the values of the StifMeter with visual analog scale about stiffness (VASstiff). METHOD: Subjects were 53 rheumatoid arthritis patients (male 8, female 45) with disease duration at least 6 months. StifMeter was made up of 10 graded springs of a same spring-constant. Stiffness and pain by VAS and StifMeter, finger circumference and pinch strength were measured at outpatient clinic as well as questionaire, prospectively. Laboratory data were reviewed from medical records to verify the state of disease. We compared StifMeter with VASstiff and VASpain. RESULTS: Mean score of StifMeter was 5.59 on the right side and 5.53 on the left. The corrected values of the StifMeter with a unit of power were 0.01684 on the right side and 0.01672 on the left side. VASstiff score was positively correlated with that of StifMeter. The older the age, the higher the score of VASstiff that was positively correlated with that of StifMeter. The longer the duration of disease, the higher the score of VASstiff that was positively correlated with that of StifMeter. CONCLUSION: StifMeter is a semi-objective method which may be of value in the measurement of finger joint stiffness.
Ambulatory Care Facilities ; Arthritis, Rheumatoid ; Female ; Finger Joint* ; Fingers* ; Humans ; Medical Records ; Pinch Strength ; Prospective Studies ; Visual Analog Scale

No abstract available.
Sepsis* ; Yersinia*

PURPOSE: This study was performed to examine the vascular network of the human iris using flat preparation. METHODS: The ciliary body-iris structures were separated from human eyeballs, and a portion of the irises were treated with trypsin to remove the pigment granules. These iris tissues were unfolded and placed onto glass slides using flat preparation, and the vascular network of each iris was examined by fluorescein microscopy. The ciliary body-iris structures separated from the remaining eyes were stained with hematoxylin-eosin without trypsin treatment and were examined by light microscopy. RESULTS: The long posterior ciliary artery formed several branches before entering the iris root, and such branches formed the major arterial circle of the iris with diverse diameters in the vicinity of the iris root and the ciliary process. In the pupillary margin, the iris vasculature network formed a cone shape and then formed an arcade by connecting to adjacent vasculatures. In the vicinity of the collarette, the iris vasculature network formed the minor arterial circle of the iris with diverse diameters perpendicular to the arcade of the iris network located in the pupillary margin. In the pupillary margin, the capillaries were somewhat thick and connected to the irregular traveling iris vein. CONCLUSIONS: The above findings explain the human iris vascular network and provide a theoretical basis for the sectoral filling of the iris vasculature seen in fluorescein iris angiography.
Cadaver ; Cytological Techniques/*methods ; Humans ; Infant ; Infant, Newborn ; Iris/*blood supply ; Microscopy, Fluorescence ; Ophthalmic Artery/*cytology ; Veins/*cytology

PURPOSE: The aim of this study was to analyze the osteogenic effect of cultured rabbit mesenchymal stem cells(MSCs). MATERIALS AND METHODS: MSCs were obtained from rabbit femur and were cultured in a Dulbecco's Modified Eagle's Medium(DMEM) with beta-glycerophosphatate, L-ascorbic acid, and dexamethasone to proliferate and differentiate into osteoprogenitor cells until 12 weeks. The expression of osteogenic markers was detected by reverse transcription-polymerase chain reaction(RT-PCR) and the release of osteocalcin was measured by Enzyme-linked Immunosorbent Assay(ELISA). MSCs that were cultured on the porous poly-L-lactic-co-glycolic acid(PLGA) scaffold were implanted into athymic nude mouse to observe the osteogenic activity. RESULTS: As the time, we observed osteoblastic-like cells on the culture flask. Mineralized nodules were observed at 3-4 weeks. Osteogenic markers such as osteopontin, osteonectin, type I collagen, and alkaline phophatase were all identified at 2 weeks. But, expression of osteocalcin was only detected after cells differentiation. The amount of osteocalcin which is a specific protein in osteoblast, increased gradually from 2 weeks until 7 weeks. Scanning electron microscopy revealed that the MSCs were well adhered and proliferated within the PLGA scaffold. Immature bone was identified after 10 weeks in the histological examination of transplanted cell-scaffold composit. CONCLUSION: Our results demonstrate gradual differentiation of MSCs into osteoblastic cells. The adhesion and proliferation of the cells within the biodegradable scaffold represents the possibility of bone formation using cell-scaffold composites.
Animals ; Ascorbic Acid ; Bone Marrow* ; Collagen Type I ; Dexamethasone ; Femur ; Mesenchymal Stromal Cells* ; Mice ; Mice, Nude ; Microscopy, Electron, Scanning ; Osteoblasts ; Osteocalcin ; Osteogenesis ; Osteonectin ; Osteopontin

PURPOSE: Injury to articular cartilage is likely progressive to develop arthritis and dysfunction of joint because its regeneration is limited. Transplantation of cultured autologous chondrocytes was proved to be a satisfactory treatment method and could prevent a dysfunction of joint. However chondrocytes propagated in monolayer culture lose their original characteristics by assuming a morphologic shift to fibroblast like cell and biosynthetic shift to production of collagen type I from type II and to decrease in synthesis of DNA and proteoglycans. A three dimensional culture of articular chondrocytes using microcarrier was performed to overcome disadvantages of phenotypic changes in monolayer culture. MATERIALS & METHODS: Cultured articular chondrocytes, 6 times passed in 13 weeks, were innoculated and propagated in flasks for monolayer culture and spinner flasks for three dimensional culture respectively for 2 weeks. RESULTS: Cells in three dimensional culture proliferated faster and showed more markedly increase in cell number than those in monolayer culture. Expression of type II collagen was observed in three dimensional culture, but was hardly observed in monolayer culture. CONCLUSION: Degree of synthesis of DNA and proteoglycans also more markedly increase in three dimensional culture than in monolayer culture. Our experiments demonstrate that three dimensional culture of articular chondrocyte using microcarrier provides increase in growth and reexpression of phenotype of chondrocytes.
Arthritis ; Cartilage, Articular ; Cell Count ; Chondrocytes* ; Collagen Type I ; Collagen Type II ; DNA ; Fibroblasts ; Joints ; Phenotype ; Proteoglycans ; Regeneration

PURPOSE: Injury to articular cartilage is likely progressive to develop arthritis and dysfunction of joint because its regeneration is limited. Transplantation of cultured autologous chondrocytes was proved to be a satisfactory treatment method and could prevent a dysfunction of joint. However chondrocytes propagated in monolayer culture lose their original characteristics by assuming a morphologic shift to fibroblast like cell and biosynthetic shift to production of collagen type I from type II and to decrease in synthesis of DNA and proteoglycans. A three dimensional culture of articular chondrocytes using microcarrier was performed to overcome disadvantages of phenotypic changes in monolayer culture. MATERIALS & METHODS: Cultured articular chondrocytes, 6 times passed in 13 weeks, were innoculated and propagated in flasks for monolayer culture and spinner flasks for three dimensional culture respectively for 2 weeks. RESULTS: Cells in three dimensional culture proliferated faster and showed more markedly increase in cell number than those in monolayer culture. Expression of type II collagen was observed in three dimensional culture, but was hardly observed in monolayer culture. CONCLUSION: Degree of synthesis of DNA and proteoglycans also more markedly increase in three dimensional culture than in monolayer culture. Our experiments demonstrate that three dimensional culture of articular chondrocyte using microcarrier provides increase in growth and reexpression of phenotype of chondrocytes.
Arthritis ; Cartilage, Articular ; Cell Count ; Chondrocytes* ; Collagen Type I ; Collagen Type II ; DNA ; Fibroblasts ; Joints ; Phenotype ; Proteoglycans ; Regeneration