An experimental study on the effect of the induced avascular necrosis of the femoral head on the femoral anteversion was made in the hips of 74 three to four-week-old rabbits. The results were as follows; l. In 18 of the 74 operated rabbits, a relative increase of anteversion was observed on the operated side, as compared with the nonoperated femur, the differences ranging from 10 to 75°(average increase was 25.9°). 2. Anteversion increase was actually internal rotation of femoral shaft starting from the subtrochanteric level and progressively increasing downward with spiral fashion. 3. The cause of anteversion increase was not proved in this experiment, but anteversion increase was a result of avascular necrosis.
Femur ; Head ; Hip ; Necrosis ; Rabbits

This is a long term follow-up study to clarify whether arthroscopic synovectomy would be able to prevent further destruction of the articular cartilage in rheumatoid joints. Three hundred and eighteen rheumatoid joints of 94 patients who had surgery in the multiple joints(average 3.4 joints per person) and was followed for an average 39.9 months (range, 24-126 months) were selected. Diagnosis of rheumatoid arthritis was made according to the 1987 revised criteria of the American College of Rheumatology. The preoperative roentgenographic narrowing of cartilage space (modified classification of ARA) and the arthroscopic findings (grading of Outerbridge) were recorded. The points of investigation were 1) further destruction of articular cartilage on X-ray, postoperatively, and 2) reaccumulation of effusion. The results were as follows; 1) Knee Joint: Among 103 knee joints there were 92 (89.3%) Stage I, G-0 knees, 8 Stage II (G-2: 1, G-3: 3, G-4: 4 joints), and 3 Stage IIIB, G-4, preoperatively. The 3 Stage IIIB, G-4 knees showed progression of narrowing of joint space and were replaced by artificial joints two years after the synovectomy. 2) Wrist joint: Fifteen joints (28.3%) out of 53 joints were Stage II, G-4, and 2 joints joints (3.8%) were Stage I, G-3, preoperatively. They were progressed to Stage IIIB at final follow-up. 3) Other Joints: There was no further narrowing of the joint space following surgery in 22 fingers, 2 toes, 34 elbows, 34 shoulders and 70 ankles. 4) Prognosis seemed to depend upon postoperative medication. From these results it would be suggested that the rate and severity of recurrence of synovitis and further destruction of articular cartilage can be decreased with early synovectomy so long as proper anti-rheumatic medication is followed, although the surgery can not halt the disease process.
Ankle ; Arthritis, Rheumatoid ; Cartilage ; Cartilage, Articular ; Classification ; Diagnosis ; Elbow ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Knee ; Knee Joint ; Prognosis ; Recurrence ; Rheumatology ; Shoulder ; Synovitis ; Toes ; Wrist Joint

The congenital dislocation. of the hip is a common congenital disease in the orthopedic field. It is well known that the early diagnosis and effective treatment is very important for the patient to provide a favorable function in the whole life. The Pavlik harness made an important contribution to the treatment of children before standing age. The authors report a clinical experience of 34 patients(35 hips) with congenital dislocation of hip who were treated with Pavlik harness at the Department of Orthopedic Surgery of Chonnam University Hospital. There were total 230 patients(237 hips) diagnosed as congenital dislocation of hip for 10 years from 1978 to 1987. Fifty-one patients(52 hips) of them were treated with Pavlik harness. Only 34 patients(35 hips) were included in this study excluding 17 patients(17 hips) because of inappropriate records or follow-up. The follow-up period ranged from 1 year to 6 years with an average of 2 years and 5 months. The results are as follows ; 1. The most patients were girls, comprising 33 girls and 1 boy. 2. The age of children was 124.6days in average ranging from 13 to 201 days. 3. Of the 35 hips treated with Pavlik harness, satisfactory reduction was obtsined in 30 hips(85.7%). For 5 failed cases, the authors performed closed reduction under the general anesthesia in 3 cases and open reduction in 2 cases. 4. The causes of reduction failure were impossible reduction in 3 cases, nonconcentric reduction in 1 case and repeated redislocation in 1 case. 5. The acetabular and metaphyseal-edge angle improved from the average 33 and 5.8 degrees at the first visit to the average 19.9 and 30.6 degree at the final follow-up (20.7 and 29.2 degrees in normal side). 6. When compared with the value of the 30 hips which were reduced successfully, the initial acetabular angle of 5 failed cases was similar but the metaphyseal-edge angle of them was very low. 7. There was no reduction failure in 27 hips which had metaphyseal-edge angle above 10 degrees. But 5 reduction failures were observed in 8 hips with below −11 degrees. 8. An avascular necrosis was observed in only one patient. In conclusion, the Pavlik harness proved to be a successful means in treating patients with congenital dislocation of hip under 7 months of age with particularly above −10 degrees in metaphyseal-edge angle.
Acetabulum ; Anesthesia, General ; Child ; Dislocations ; Early Diagnosis ; Female ; Follow-Up Studies ; Hip ; Humans ; Jeollanam-do ; Male ; Necrosis ; Orthopedics

We evaluated the muscle fiber characteristics, the mean proportion of muscle fiber types and its range of individual difference in human vertebral muscle. Muscle samples used were from subjects who had a relatively brief history of spinal dysfunction such as compression fracture, disc hernia etc., and obtained from precisely defined superficial and deep sites on both sides of the vertebral column. In particular, samples were collected from three different levels of the column and flash-frozen sections of biopsied adult vertebral muscles were stained for H–E, trichrome, PAS, regular and reversed myosin ATPase, and SDH. Discrimination of muscle fiber types in H–E and trichrome stained sections was not evident. Three types of muscle fibers were, however, evident in PAS-stained sections according to the degree of positivity in observed vertebral muscles. The mean proportion of musele fiber types was different in regular and reversed myosin ATPase, and SDH stains and the majority of fiber types in human vertebral muscles was type I in three different levels of vertebral clumn. There was a decreasing tendency in percentage of type I fibers at both superficial and deep levels as the vertebral column descended. The size of muscle fibers was relatively larger in deep levels than in superficial levels of vertebral muscles. The human vertebral muscle showed moderately individual and regional differences in the mean size of fiber types. The evaluation for the combination patterns of various enzyme histochemical activities showed that the common musele fiber types(type I, II A and II B) were moderately reduced in the mean proportions and unusual rare muscle fiber types increased in number. And the decreasing tendency in the mean proportion of type as the vertebral column descended was not evident in the combination patterns of histochemical activities
Adult ; Coloring Agents ; Discrimination (Psychology) ; Fractures, Compression ; Hernia ; Humans ; Individuality ; Muscles ; Myosins ; Spine

Vesicovaginal fistula is a distressing complication which may follow total hysterectomy, prolonged labor, chemical cauterization due to uterine prolapse. radiation therapy, and cervix cancer. The management of vesicovaginal fistula still remains controversial in regard to the type of approach and timing of repair. A review of experiences with vesicovaginal fistula repair was done on 39 cases admitted to the Department of Urology, Chonnam University Hospital, during the period from January, 1977 to December. 1991. The most prevalent age group was the forties to fifties (25/39 cases, 64.1%). The most common location of vesicovaginal fistula was the trigone (19/39 cases, 48.7%). The highest range of size of vesicovaginal fistula was that below 1.0 cm (24,39 cases, 61.5%).Of 39 cases. 14 occurred after total hysterectomy (35.9%). 13 chemical cauterization (33.3%). 8 prolonged labor(20.5%). 2 radiation therapy (5.1%). 1 Cesarean section (2.6%), and 1 Dilatation & Curettage (2.6%). The success rate of the initial repair was 88.5% (23,26 cases) by transvaginal repair. 83.3% (5/6 cases) by transperineal transvesical repair. 60.0% (3,5 cases) by suprapubic transvesical repair. 100.0% (1/1 case) by colpotleisis, and l00.0% (1/1 case) by ileal conduit, respectively. The transvaginal repair was most simple, and required the least time of average 96 minutes. Of six cases failed in the initial repair, one case was cured with the second repair and two cases with the third repair, with overall cure rate of 92.3% (36/39 cases).
Cautery ; Cesarean Section ; Dilatation and Curettage ; Female ; Humans ; Hysterectomy ; Jeollanam-do ; Pregnancy ; Urinary Diversion ; Urology ; Uterine Cervical Neoplasms ; Uterine Prolapse ; Vesicovaginal Fistula*

We report a case of unilateral nevoid telangiectasia associated with acanthosis nigricans in a 20-year old male patient. Unilateral nevoid telangiectasia may be congenital or acquired. The unilateral and dermatomal distribution suggests that distribution of target vessels is fixed and that they are sensitive to estrogen. Estrogens are mainly produced by the ovaries, but they are also produced by peripheral cirornatization of androgen. Because a major site of this conversion is adipose tissue, estrogen can increase in an obese person. Obesity also reverses the metabolism of estrogen and increases the serum insulin level. Therefore it seems that obesity in our patient induces the development of unilateral nevoid telangiectasia and acanthosis nigricans.
Acanthosis Nigricans* ; Adipose Tissue ; Estrogens ; Female ; Humans ; Insulin ; Male ; Metabolism ; Obesity ; Ovary ; Telangiectasis* ; Young Adult

BACKGROUND: A fully automated enzyme-immunoassay (EIA) analyzer, Enzymun System, ES-300 (Boehringer Mannheim, Germany) uses streptavidin technology and performs single test or panels of up to 12 tests per run. We evaluated the results of ES-300 for anti-HCV by comparing the results with microplate-EIA, radioimmunoassay (RIA), and confirmatory test. METHODS: Total 79 sera (51 positive, 24 negative, 4 indeterminate results confirmed by Lucky HCD Confirm) were analysed. ES-300 with Enzymun-Test(R) Anti-HCV (Boehringer Mannheim, Germany) and microplate-EIA (Green Cross Center Innotest HCV 3.0(R)) were used. Fifty one sera were examined additionally by 2nd-generation RIA method, NANBDINE 125C(General Biologicals Corp., R.O.C.). And all results were compared to the results of Lucky HCD Confirm. RESULTS: The overall concordance rate of ES-300 and Innotest(R) was 72/79 (91.1%). The results of Lucky HCD Confirm on seven discrepant samples were five negative and two indeterminate. The results of ES-300 and NANBDINE 125C showed concordance rate of 90.2%. The sensitivity and specificity of ES-300 with regard to Lucky HCD Confirm were 94.5%, and 87.5%, respectively, and that of Innotest(R) were 98.2% and 66.7%, respectively. Clear distinction of positive and negative results by signal/cut off ratio was available in both EIAs. The positive predictive values of ES-300 and Innotest(R) were 94.5%, and 87.1%, respectively. CONCLUSIONS: ES-300 showed relatively good results in sensitivity and positive predictive value with regard to confirmatory test. In EIA-positive persons, however, follow-up study would be necessary for reliable evaluation of HCV infection.
Humans ; Radioimmunoassay ; Sensitivity and Specificity ; Streptavidin

No abstract available.
Leg* ; Myocutaneous Flap* ; Superficial Back Muscles*

Neuroblastoma originate in neural crest and is one of the most frequent tumor next to leukemia and brain tumor in child. The tumor is most highly malignant tumor due to early metastasis at diagnosis. It could be diagnosed by various diagnostic modalities such as roentgenologic examination, laboratory data and confirmed by pathologic diagnosis. Management of neuroblastoma is surgery, radiotherapy and chemotherapy. We experienced a case of adrenal neuroblastoma at age of 20-month male child and report with a brief review of literature
Adrenal Glands ; Brain Neoplasms ; Child ; Diagnosis ; Drug Therapy ; Humans ; Leukemia ; Male ; Neoplasm Metastasis ; Neural Crest ; Neuroblastoma* ; Radiotherapy

No abstract available.
Leg*