To clarify the developmental characteristics of fetal esophageal epithelium especially ciliated cell, expressions of epidermal growth factor receptor (EGFR) and cytokeratin (CK) in fetal esophageal mucosa (16-24 weeks of gestation) were studied immunohistochemically, and ultrastructure of the ciliated cells was also observed. The expressions of EGFR and CK were identified in labelled streptoavidine biotin immunohistochemical method. Primary antibodies used were EGFR (Ab-4) which is affinity-purified from hyperimmune rabbit sera (Oncogene Science) and monoclonal mouse anti-human cytokeratin (DAK0-CK, MNFl16). The esophageal lumen was lined with stratified ciliated columnar epithelium between 16 and 24 weeks of gestation. The pattern of expression Of EGFR was different with gestational age and epithelial layer. The ciliated cell exhibited variable staining intensity for EGFR at 16 weeks. Some were stained intensively, and others were stained faintly. Number of ciliated cells stained intensively were gradually increased, and most of them were strongly stained at 24 weeks. The superficial non-ciliated cells, however, showed relatively constant staining property of moderate to intense between 16 and 24 weeks. EGFR immunoreactivity was minimal in the basal and intermediate cells at 16 weeks, but became more intense at 24 weeks. CK immunoreactivity in the ciliated cells between 16 and 24 weeks was similar to that of EGFR immunoreactivity. On the other hand, superficial non-ciliated cells were intense for CK staining at 16 weeks, but were very weak to negative at 24 weeks. CK immunoreactivity was intense in basal and intermediate cells between 16 and 24 weeks, but it was almost negative in the some cells of intermediate layer, especially beneath negatively stained non-ciliated cells, at 24 weeks. In electron microscopy, ciliated cells had well organized cilia and dense granules close to Golgi apparatus between 16 and 24 weeks. The cells apparently active in ciliogenesis were also observed. These cells had short microvilli, many centrioles, and dense granules close to Golgi apparatus. The non-ciliated cells contained numerous clear vesicles adluminally clustered at 16 weeks, while they had many dense vesicles of about same size of clear vesicles at 24 weeks. These results demonstrate the expressions of EGFR and CK in esophageal epithelium of human fetus between 16 and 24 weeks of gestational ages, and suggest that the ciliated cells are still proliferative at 24 weeks.
Animals ; Antibodies ; Biotin ; Centrioles ; Cilia ; Epithelium* ; Fetus* ; Gestational Age ; Golgi Apparatus ; Hand ; Humans* ; Keratins ; Methods ; Mice ; Microscopy, Electron ; Microvilli ; Mucous Membrane ; Pregnancy ; Receptor, Epidermal Growth Factor

The bone mineral density (BMD) has been measured for evaluation of the osteoporosis. Of the various methods of measuring the BMD, dual energy X-ray absorptiometry (DEXA) has been known to be an accurate, objective, and easily reproducible method. The authors measured BMD in patients with intertrochanteric fracture of the femur for comparison with results in the normal control. The BMD was measured in thirty-two patients with intertrochanteric fracture by dual energy X-ray absorptiometry from March 1993 to March 1995. And the relationship between the severity of osteoporosis and intertrochanteric fracture of the femur was studied. The comparison of BMD between fracture patients and normal control was done in the population below 79 years old of age (23 fracture patients and 90 normal controls). The average BMD in the intertrochanteric fracture group was 0.558g/cm2 in the neck, 0.425g/cm2 in Ward's triangle and 0.568g/cm2 in the trochanter, while in the normal control group it was 0.870g/cm2 in the neck, 0.681g/cm2 in Ward s triangle and 0.772g/cm2 in the trochanter. In comparison with the normal control group, the BMD in fracture group was about 79% of the normal control group. The BMD in the proximal femur was decreased by about 14% with the age increasing decennially after 50 years. The BMD at Ward s triangle and trochanter was much lower in type III and IV of Tronzo classification than in type I and II .The BMD did not show significant correlation with the height and weight of the patients.
Absorptiometry, Photon ; Aged ; Bone Density* ; Classification ; Femur* ; Humans ; Neck ; Osteoporosis

No abstract available.
Arthroplasty, Replacement, Hip* ; Ceramics*

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

Acetabular erosion, intrusion of the prosthesis into the pelvis, is the most serious late complication of hemiarthroplasty. For the detailed observation on this lesion, the authors reviewed 55 patients who underwent femoral head replacement and were followed up to at least 1 year after operation. The acetabular erosion were present in 18 patients(32.7%) out of the total 55 patients. Based on the results of this study, the authors presented a new classification of acetabular eorsion: Stage I(erosion of the cartilage only) was seen in 11 patients, stage II (evidence of the initial bony erosion) in 4 patients,and stage III(intraosseous intrusion of the metallic head) in 3 patients. Revision arthroplasty was obligatory in two of the three stage III patients. The severity of symptoms did not always correspond with the radiological changes. The acetabular erosion was more common in younger patients, in male patients and in patients with avascular necrosis of femoral head than in older patients, in female patients, and in patients with femoral neck fracture. The tendency of acetabular erosion occurring mainly in younger and male patients is probably attributed to their better survival and greater activity.
Acetabulum ; Arthroplasty ; Cartilage ; Classification ; Female ; Femoral Neck Fractures ; Head ; Hemiarthroplasty ; Humans ; Male ; Necrosis ; Pelvis ; Prostheses and Implants

Generally the clinical results of Legg-Calvé-Perthes disease were evaluated until the time of disease healing. However, it is well known that the deformities of the proximal femur progress to the period of skeletal maturity. The purpose of this study was to evaluate the progression of the deformities in the proximal femur. In a retrospective study of 60 patients with Legg-Calvé-Perthes disease, who visited Chonnam National University Hosipital 1974 and 1995 and who were followed until the skeletal maturity, the bony changes of the proximal femur were compared between disease healing stage and skeletal maturity. The results were as follow; 1. More bony deformities were identified in skeletal maturity than in disease healing. 2. The quotient of inferior border of medial femoral neck decreased from 60% in disease healing to 45% in skeletal maturity (P < 0.001). 3. The femoral shortening increased from 4.9mm in disease healing to 10mm in skeletal maturity (P < 0.001). 4. The femoral neck-shaft angle decreased from 128 degrees in disease healing to 125 degrees in skeletal maturity (P < 0.001). 5. The proximal migration of greater trochanter increased from 13.8mm in disease healing to 21.3mm in skeletal maturity (P < 0.001). 6. There were no significant statistical differences in clinical results between operative and conservative treatment groups. 7. The spherical quotient of femoral head and Stulberg rate revealed no differences between disease healing and skeletal maturity. These results revealed that there were considerable differences of the deformities in the proximal femur at the time of disease healing and skeletal maturity.
Congenital Abnormalities ; Femur Neck ; Femur ; Head ; Humans ; Jeollanam-do ; Legg-Calve-Perthes Disease ; Retrospective Studies

There have been a few repots that serum immunoglobulins are increased in Perthes' disease suggesting possible immunological involvement in the pathophysiology of the disease. Joseph(1991) suggested that the raised IgM concentrations might be related to complications of Perthes' disease such as striking reduction of movement, fixed deformities and striking reduction of movement, fixed deformities and chondrolysis and that immunological mechanisms might be implicated in the mediation of some of the changes in Perthes' disease. More studies are necessary to prove the results. The purpose of this study is to detect if there is a true increase of serum immunoglobulins in Perthes' disease.
Congenital Abnormalities ; Immunoglobulin M ; Immunoglobulins ; Negotiating ; Strikes, Employee

Total hip arthroplasty (THA) can be a good treatment option for avascular necrosis (AVN) of the femoral head. However, because dislocation can frequently occur after surgery, THA is a concern in patients with a neuromuscular disease, such as cerebral palsy or poliomyelitis. In patients with poliomyelitis, only one case of AVN of the femoral head in the affected limb has been reported in the English literature. Here, the authors report on a case of AVN of the femoral head in a patient with poliomyelitis, who was treated with a large diameter femoral head metal-on-metal THA using a modified minimally invasive-2-incision technique.
Arthroplasty ; Cerebral Palsy ; Dislocations ; Extremities ; Head ; Hip ; Humans ; Necrosis ; Neuromuscular Diseases ; Poliomyelitis ; Tacrine

No Abstract Available.
Arthroplasty* ; Knee*

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