No abstract available.
Dental Implants* ; Tissue Engineering*

Osteochondritis dissecans of the femoral head following Legg-Calve-Perthes disease has been considered a rare complication. Catterall, in 1982, reviewed the literature and found only 54 reported cases proving the relative rarity of this condition. Of the 363 hips with Legg-Calve-Perthes disease treated at the Chonnam University Hospital for 15 years from 1973 to 1987, osteochondritis dissecans of the femoral head developed in seven(1.9%). The seven patients with osteochondritis dissecans were male and over seven years old at the time of diagnosis of Legg-Calve-Perthes disease. Since six patients had nearly silent hip, treatment was not advised. In remaining one patient, the lesion was drilled and grafted with bone chips. Spontaneous healing of osteochondritis dissecans was observed in three patients.
Diagnosis ; Head ; Hip ; Humans ; Jeollanam-do ; Legg-Calve-Perthes Disease ; Male ; Osteochondritis Dissecans ; Osteochondritis ; Transplants

The technique of muscle transposition has gained an accepted place in treating the wide skin defect with bony exposure in which conventional palliative care has rarely been successful. The principle of this procedure, popularized by Ralph Ger and significantly contributed by Bakajian, has been approved by many and now been adapted in the care of similar lesion throughout the entire body regions. This report comprises the results of muscle transposition experienced in 28 patients. The results were as follows: 1. Twenty-four cases of antetibial skin defect with bony exposure, resulted from chronic osteomyelitis, open fracture, chronic ulcer, and burn scar, were successfully managed with the transposition of single muscle or combination of them: medial head of the gastroenemius, the soleus, the flexor digitorum longus and the abductor hallucis. The extent and the level of the defect in each case were the sole indication of selection of the appropriate muscle and the number. 2. Four patients with decubitus ulcer in the sacral region were also managed by transposing the upper half of the gluteus maximus. 3. Subsequent skin coverage over the transposed muscle were uniformly successful in all cases and this technique seemed to afford a definite favorable influence upon the healing of fracture and the eradication of infection.
Body Regions ; Burns ; Cicatrix ; Fractures, Open ; Head ; Humans ; Osteomyelitis ; Palliative Care ; Pressure Ulcer ; Sacrococcygeal Region ; Skin ; Transplants ; Ulcer

Partial capital resection (cheilectomy, partial capitectomy, excision of a lip) has gained an accepted place in treating the Legg-Calve-Perthes disease with severely malformed femoral head in which containment surgery has rarely been successful. The clinical experiences in six children aged over 10 years who complained marked limitation of hip motion with severe collapse and subluxation of femoral head are presented. Postoperative results including clinical and radiological findings are quite promising.
Child ; Containment of Biohazards ; Head ; Hip ; Humans ; Legg-Calve-Perthes Disease

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

OBJECTIVE: Our purpose was to compare the expression of endothelial nitric oxide synthase in the placenta and umbilical cord of preeclamptic placenta with that of the normotensive placenta. METHOD: We compared placental endothelial nitric oxide synthase expression in preeclamptic (n=5) with in normal (n=5) pregnancies. Frozen sections of umbilical cords, chorionic plate vessels, and terminal villi were immunostained with a monoclonal endothelial nitric oxide synthase antibody. RESULTS: The age revaled no difference between control (28.1+4.2 years). and study group (26.1+4.7 years). The gestational age was statistically different between control (38.9+1.7 weeks) and study group (34.9+3.5 weeks). The neonatal body weight and placental weight were also statistically different between control (3060+528 g) and study group (2160 417 g). No difference in endothelial nitric oxide synthase immunostaining in the endothelium of the umbilical vessels and stem villous vessels was found between preeclamptic and normotensive pregnancies. In contrast, in the preeclamptic placental endothelial nitric oxide synthase immunostaining was seen in the terminal villous vessels. In the syncytiotrophoblast endothelial niric oxide synthase immunostaining appeared primary basal in location and diffuse in distribution in the preeclamptic placentas but primary apical in the normotensive placentas. CONCLUSION: Differences in endothelial nitric oxide synthase expression in terminal villous vessels and syncytiotrophblast may be a result of vascular alterations or damage that take place in the placenta in preeclampsia.
Body Weight ; Chorion ; Endothelium ; Frozen Sections ; Gestational Age ; Nitric Oxide Synthase Type III ; Nitric Oxide Synthase* ; Nitric Oxide* ; Placenta ; Pre-Eclampsia* ; Pregnancy* ; Trophoblasts ; Umbilical Cord

Chronic osteomyelitis with protracted clinical course and pretibial skin loss imposes on every orthopaedic surgeon as one of the most difficult problems to deal with. All the conservative treatment hitherto reported have left much to be revised and they often accompany, to the despair of both surgeon and patient, recurrence of the lesion. The authors have had the opportunity of treating such four cases, in which the extensive removal of sclerotic bone as well as soft tissue adjacent to the focus was done, and lo cover the defect thus produced, the soleus muscle transferred anteriorly, followed by skin graft. It proves to have been successful and the rationale to meet the wider clinical applicability of this procedure is described.
Humans ; Muscle, Skeletal ; Osteomyelitis ; Recurrence ; Skin ; Transplants

Comminuted fracture of the acetabulum in association with dislocation of the hip has aiways been a serious injury because of its protracted convalescent period and the permanent disability. Conventional open reduction, however, has contained much technical difficulties and its end result has usually been disappointing to both the patient and the surgeon. Recent concept is that total hip replacemet can be the primary choice of treatment in the management of such complicated injuries. In contemplating THR in this occasion, however, the acetabular defect secondary to its fracture-dislocation stands out as a primary source af cup loosening atter operation. A special consideration has been given in this respect and in five clinical cases the TMR with our modification was carried out with the following results. 1. In three cases of comminuted central fracture-dislocation of the hip, the gap and deformity of the fractured acetabulum was successfully corrected by inserting two pieces of T-shaped bone graft taken from the removed femoral head. 2. In another two cases of comminuted posterior fracture-dislocation of the hip, the posterior wall defect of the acetabulum was prepared by reduction of the fragments displaced and then temporary fixation with two Steinmann pins during the operative step of cup insertion. The pins could easily be removed after setting of the bone cement. 3. By applying this new modification, the THR surgery was successful and uneventful in all five cases with smooth postoperative courses.
Acetabulum ; Arthroplasty, Replacement, Hip ; Congenital Abnormalities ; Dislocations ; Fractures, Comminuted ; Head ; Hip ; Humans ; Transplants

The purpose of this study was to evaluate the effect of estrogen receptor on the degenerative change of articular cartilage by observation of different changes of histology, matrix glycosaminoglycan and chondrocyte proliferation. In sixty-four Newzealand rabbits, experimental instability was made to induce degenerative changes by sectioning the anterior cruciate ligament, medial collateral ligament and medial meniscus of the left knees. In the oophorectomy group (32 rabbits), knee surgery was performed at 6 weeks following bilateral oophorectomy. In the non-oophorectomy group (32 rabbits), knee surgery was performed without oophorectomy. Four rabbits were killed at 0, 1, 2, 4, 8, 12, 16, 20 weeks, respectively, after the knee operation. Total immunohistochemical scores of estrogen receptor were evaluated between the two groups. Histologic evaluation of H-E staining was conducted by alcian blue staining. Evaluation of chondrocyte proliferation was carried out by immunohistochemistry using monoclonal antibody to 5-bromo-2 -deoxyuridine. The stainability of each staining was calculated using semi-quantitative analysis and statistical differences were evaluat- ed by ANOVA test and LSD multiple comparison test. Total immunohistochemical scores of estrogen receptor in the non-oophorectomy group were higher than the oophorectomy group (P<0.05). In the non-oophorectomy group, the histologic scores and the histochemical scores of glycosaminoglycan were lower than the oophorectomy group after 4 weeks and 8 weeks respectively (P<0.05). The immunohistochemical score of BrdU was the highest at 2 week and then decreased after 4weeks in both groups. The immunohistologic scores of non-oophorectomy group was significant higher than oophorectomy group between 1 and 4 weeks (P<0.05). Our results suggested that the estrogen might aggravate the degenerative change of the knee joint in rabbits by decreasing matrix glycosaminoglycan and increasing chondrocyte proliferation.
Adult* ; Alcian Blue ; Anterior Cruciate Ligament ; Bromodeoxyuridine ; Cartilage, Articular* ; Chondrocytes ; Collateral Ligaments ; Estrogens* ; Female ; Humans ; Immunohistochemistry ; Knee Joint ; Knee* ; Lysergic Acid Diethylamide ; Menisci, Tibial ; Ovariectomy ; Rabbits

This is to report the histo-pathologic findings of the degenerated inferior alveolar nerves(IAN) causing uncontrollable neuralgia persisted for over 3 years. The patients had sufferred from frequent attack of unbearable pain along the mandibular branches of the Vth nerve. The pain arised spontaneously 5-10 times a day and lasted for 2-5 minutes. The medications including Tegretol were neither so effective to alleviate the pain level, nor enough to keep free from pain all days. The peripheral neurectomies were preceded by diagnostic nerve block, and partial resection of the IAN in the mandibular canals were approached by sagittal split osteomy of the ramus. The histopathologic findings of the resected IAN were as follows ; 1. Special staining with Luxol Fast Blue (LFB) and Masson Trichrome (MT) disclosed marked degeneration of the axons, decreased in number and fibrosis between the nerve fibers. 2. EM study revealed destruction of myelin continuity surrounding axons, degeneration of Schwann cell and endoneureal sheath, and coarse collagen between the destructed axons. 3. The 3 of 6 patients presented again with recurred pain in 2-3 years after the peripheral neurectomies. Excisional biopsy of the retromolarpterygomandibular softtissues disclosed the collateralization neuropathy beside the long-buccal nerves and their neuromatous findings.
Axons ; Biopsy ; Carbamazepine ; Collagen ; Fibrosis ; Humans ; Mandibular Nerve* ; Myelin Sheath ; Nerve Block ; Nerve Fibers ; Neuralgia ; Trigeminal Neuralgia*