The deformity of the hip in Legg-Calve
Acetabulum ; Arthrography ; Congenital Abnormalities ; Epiphyses ; Hip ; Humans ; Legg-Calve-Perthes Disease ; Necrosis ; Osteoarthritis ; Risk Factors

Deformities of the leg and ankle may result from growth abnormalities of the tibia and fibula. The appearance of the secondary ossification center and growth plate closure of the tibial and fibular epiphyses, and the pattern of closure of the epiphyses, were observed in a different age. Normal radiographs were reviewed in one hundred and fifty patients at age from two days after birth to 20 years, who were injured on the contralateral leg, at Wonju Medical College, Yonsei University from Feb., 1980 to May, 1984. The results were as follows: 1. The time of the appearance of secondary ossification center and the closure of growth plates; The proximal tibial epiphysis usually forms secondary ossification center at birth to second postnatal months, the physeal closure occurs from 13 year and 11 months to 18 year 3 months in male, from 13 year 4 months to 15 year 5 months in female. The secondary ossification center of the distal tibial epiphysis appears from 8th postnatal months to one year, and physeal closure occurs from 15 years to 17 year and 4 months in male, from 15 year 2 months to 16 year 8 months in female. The secondary ossification center of the tibial tuberosity appears from 9 year 3month to 12 year 2 months, and closure occurs from 16 year 3 months to 18 year 7 months inmale, from 14 year 10 months to 19 year 1 months in female. The proximal fibular epiphysis forms secondary ossification center from 2 year 5 months to 5 year 4 months, closure occurs from 15year 8 months to 17 year 4 months in male, from 14 year 9 months to 16 year 9 months in female. The secondary ossification center of the distal fibular epiphysis appears from 2 year 5 months to 3rd years, and closure occurs from 13 year 11 months to 17 year 6 months in male, from 13 year 4 months to 16 year 7 months in female. 2. The growth and the pattern of the closure of growth plates of the tibia; The proximal tibial epiphysis is elliptic for the first 3 years of life. The epiphysis is slightly conical centrally as it extends toward the tibial spines, and becomes more prominent from 8 years to adolescence. The closure of the proximal tibial growth plate occurs initially along the anteromedial aspect of the tibia and tibial tuberosity during 12 years and proceeds posterolaterally. Complete closure of the proximal tibial physis occurs about from 13 years to 18 years. The secondary ossification center of the distal tibial epiphysis is oval in shape initially, becomes thicken medially by 3rd year of life, then the tibial plafond is valgoid, and becomes horizontal at age 10 approximately. The distal epiphysis of tibia unites first at about 13 years, starting centrally and proceeding toward anteromedial portion. And the posterolateral portion unites finally by about 15 to 17 years. The tibial tuberosity develops a secondary ossification center by 7 to 9 years, usually in the most distal region, and gradually elongates and extends toward the secondary ossification center of the proximal tibia.From about 12 years, the tuberosity epiphyseal center fuses with the proximal tibial center, and the fusion with the tibial metaphysis extends distally, the tuberosity physis closes completely from about 15 to 19 years. 3. The growth and development of the tibia, fibula and ankle; The growth of the proximal tibial and the distal fibular epiphyses play an important role of the growth rate in lower extremities unber ten years. The distal tibial growth plate inclines laterally and distally prior to the first year of life, the inclination is on the decrease and it finally horizontal at about 12 years. The distal tibia talus angle is about 90° prior to the age one year, becomes mildly valgoid by 12 years.
Adolescent ; Ankle ; Congenital Abnormalities ; Epiphyses ; Female ; Fibula ; Gangwon-do ; Growth and Development ; Growth Plate ; Humans ; Leg ; Lower Extremity ; Male ; Parturition ; Spine ; Talus ; Tibia

OBJECTIVE: To investigate the patterns of the temperature effect on motor nerve conduction parameters according to various warming methods and to obtain the most valuable method of warming in clinical setting. METHOD: Twenty normal subjects were studied. After limb cooling in cold water, the cooled hands were warmed by hot pack, fan heater, and whirl pool. The median motor responses were recorded at abdnctor pollicis brevis after the stimulation at the wrist during warming at 1 min interval until the temperature increment reached plateau. We measured the temperature changes and conduction parameters were measured at each examination. RESULTS: The time constants for temperature increment and distal motor latency, duration, area of compound muscle action potentials showed shorter tendency by hot pack and whirl pool than by fan heater (p<0.05). For the measurement of distal motor latency, time constant of whirl pool (2.49 1.21 min) was shorter than that of fan heater (7.12 3.12 min) or hot pack (5.96 1.98 min) (p<0.05). CONCLUSION: These findings suggest that the use of whirl pool is the most effective method for warming of the cooled limb.
Action Potentials ; Extremities ; Hand ; Neural Conduction* ; Water ; Wrist

This study was performed to compare and analyzed the mode of tooth movement according to the timing of orthodontic force application after extraction. The upper right and left third incisors were carefully extracted at three-week interval in four adult dogs. Both canines were used as an anchorage for the bodily movement of the upper second incisors. Orthodontic force of 100gm was simultaneously applied at one week after extraction on one side four weeks after extraction on the other side using NiTi closed coil spring. While orthodontic force was applied for twelve weeks, the amount of tooth movement was measured at every second week with calipers. The animals were sacrificed at twelve weeks and histologic examination was executed to reveal any difference between both sides. The results were obtained as follows: 1. The tooth movement was likely to be faster in four-week side for the first two seeks while faster in one-week side during next two weeks 2. The rate of tooth movement was fastest during four to six weeks period, then decreased gradually. 3. The total amount of tooth movement was likely to be larger in one-week side compared to four-week side. 4 Any damage to tooth and periodontal tissue could not be seen in the histologic section of one-week side. These results suggest that earlier application of orthodontic force is better than later after extraction in terms of the rate of tooth movement.
Adult ; Animals ; Dogs ; Humans ; Incisor ; Tooth Movement* ; Tooth*

No abstract available.
Adenocarcinoma* ; Optic Nerve*

OBJECTIVE: To systematically review previous studies and to assess, via a subgroup meta-analysis, the combined odds ratio (OR) of prognostic factors affecting the success of miniscrew implants (MIs) inserted into the buccal posterior region. METHODS: Three electronic searches that were limited to articles on clinical human studies using MIs that were published in English prior to March 2015 were conducted. The outcome measure was the success of MIs. Patient factors included age, sex, and jaw of insertion (maxilla vs. mandible), while the MI factors included length and diameter. A meta-analysis was performed on 17 individual studies. The quality of each study was assessed for non-randomized studies and quantified using the Newcastle-Ottawa Scale. The meta-analysis outcome was a combined OR. Subgroup and sensitivity analyses based on the study design, study quality, and sample size of miniscrews implanted were performed. RESULTS: Significantly higher success rates were revealed for MIs inserted in the maxilla, for patients ≥ 20 years of age, and for long MIs (≥ 8 mm) and MIs with a large diameter (> 1.4 mm). All subgroups acquired homogeneity, and the combined OR of the prospective studies (OR, 3.67; 95% confidence interval [CI], 2.10-6.44) was significantly higher in the maxilla than that in the retrospective studies (OR, 2.10; 95% CI, 1.60-2.74). CONCLUSIONS: When a treatment plan is made, these risk factors, i.e. jaw of insertion, age, MI length, and MI diameter, should be taken into account, while sex is not critical to the success of MIs.
Humans ; Jaw ; Maxilla ; Odds Ratio ; Outcome Assessment (Health Care) ; Prospective Studies ; Retrospective Studies ; Risk Factors ; Sample Size

BACKGROUND: Vasopressin has recently been recognized to have greater effect on improving blood flow to myocardium and brain during cardiac resuscitation than epinephrine and also improves rates of ROSC(return of spontaneous circulation) and survival in pre-hospital and in-hospital prolonged refractory cardiac angst patients who did not respond to the standard epinephrine treatment. This study was designed to investigate the effects of vasopressin on ROSC rates and survival rates in rat asphyxia arrest model. METHOD AND MATERIAL: Thirty male Sprague-Dawley rats were used. Anesthesia was induced with halothane and nitrous oxide and ventilatory cairo was maintained. EtCO2 was adjusted to 30-40mmHg and halothane was maintained. Right infernal carotid artery and right femoral vein were cannulated and EKG electrodes were attached. After 10 minutes of asphyxia, group 1 was treated with 1ml of saline, group 2 with 1ml(0.001mg/100g) of epinephrine and group 3 with 1ml(0.16u/100g) of vasopressin for resuscitation. Statistical significance was an analysed by SPSS with ANOVA and chi-square tests. RESULTS: No significant differences were seen in baseline measurements. Three ROSC and eight 60 minutes survivals were found in group 1, whereas nine ROSC and eight 60 minutes survivals were obtained in group 2 and all of the subjects in group 3 showed ROSC and 60 minutes survival, but no statistical differences were seen between group 2 and 3. CONCLUSION: Vasopressin seems to have similar effect on improving ROSC and survival rates compared to epinephrine in rat asphyxia models.
Anesthesia ; Animals ; Asphyxia* ; Brain ; Carotid Arteries ; Electrocardiography ; Electrodes ; Epinephrine* ; Femoral Vein ; Halothane ; Humans ; Male ; Myocardium ; Nitrous Oxide ; Rats* ; Rats, Sprague-Dawley ; Resuscitation* ; Survival Rate ; Vasopressins*

PURPOSE: Portal triad clamping and total or intermittent hepatic vascular exclusion are usually used to reduce blood loss during a major liver resection. Here we report the results of hepatectomy without vascular clamping. METHODS: From January 2003 to December 2005, 143 hepatectomies were performed without vascular clamping. There were 102 men and 41 women, with a mean age of 56.4 years. The indications were 79 hepatocellular carcinomas, 20 intrahepatic duct stones, 13 metastases, 13 gallbladder carcinomas, 7 intrahepatic cholangiocarcinomas, 5 Klatskin's tumors, and 6 others. All procedures were carried out using an ultrasonic dissector and intraoperative ultrasonography. RESULTS: There were 11 complications (7%) including intra-abdominal abscess (3), hyperbilirubinemia (3), postoperative bleeding (2), hepatic failure (1), ARDS (Acute respiratory distress syndrome) (1), and massive ascites (1). Sixty-one patients (42.6%) required a blood transfusion. The mean blood transfusion requirement was 1.4 pints. The liver function test results were similar to those previously reported on days 1,3,5, and 7 postoperatively, with a return to normal values after 1 week. CONCLUSIONS: Hepatectomy without vascular clamping reduces liver injuries, including ischemia of the remnant liver and splanchnic congestion. Reduction of bleeding during hepatectomy, requires accurate knowledge of the vascular anatomy, meticulous dissection of the liver parenchyma and maintenance of a low central venous pressure. Our experience with liver resections showed that hepatectomy without vascular clamping can be safely performed using intraoperative ultrasound and an ultrasonic dissector.
Abdominal Abscess ; Ascites ; Blood Transfusion ; Carcinoma, Hepatocellular ; Central Venous Pressure ; Cholangiocarcinoma ; Constriction* ; Estrogens, Conjugated (USP) ; Female ; Gallbladder ; Hemorrhage ; Hepatectomy* ; Humans ; Hyperbilirubinemia ; Ischemia ; Klatskin's Tumor ; Liver ; Liver Failure ; Liver Function Tests ; Male ; Neoplasm Metastasis ; Reference Values ; Ultrasonics ; Ultrasonography

The purpose of this study was to investigate immediate changes in the mandibular dentition after maxillary molar distalization using headgear in non-growing patients. Sixteen patients (mean age, 18.9 ± 2.0 years) with Class II molar relationship and crowding were included in the present study. To correct the molar relationship, headgear was used for maxillary molar distalization. Cone-beam computed tomography-generated half-cephalograms (CG Cephs) and dental casts were used to evaluate dental changes for each subject before and immediately after molar distalization using headgear. The mean duration that subjects wore the headgear was 6.3 months. CG Cephs showed that the first maxillary molars were distalized 4.2 ± 1.6 mm with 9.7°± 6.1° of distal angulation. The intercanine, interpremolar, and intermolar widths of the mandible increased after maxillary molar distalization. The present study's results suggest that maxillary molar distalization using headgear induces a spontaneous response in the untreated mandibular dentition of non-growing patients.
Dentition* ; Humans ; Malocclusion ; Mandible ; Molar*

No abstract available.
Cardiac Catheterization* ; Cardiac Catheters* ; Echocardiography* ; Exercise Tolerance* ; Humans ; Tetralogy of Fallot*