In the orthopaedic field, some elective surgeries such as joint replacement, spinal surgery and limb salvage procedures for musculoskeletal tumors frequently need various amounts of blood transfusions. However, homologous transfusion occasionally results in various side effects, such as allergic reaction, febrile reaction, and the transmission of infectious diseases such as syphilis, hepatitis and AIDS, ctc. Recently, these complications especially in elective surgery might result in medicolegal or social problems. Risks from transfusions in elective surgery can be minimized with prebanked autologous transfusion. To evaluate the necessity of prehanked autogenous transfusion, fifty five patients who had unilateral hybrid total knee arthroplasty (noncemented at the femoral side and cemented at the tibial and patellar sides) were operated on by the same surgeon from April 199S to July 1997 and had autogenous shed blood transfusion were evaluated for postoperative blood loss, amount of autogenous shed blood, amount of transfusion, hemoglobin and hematocrit. The results were as follows: 1. The distribution of preoperative hemoglobin was from 9.6g/dL to 16.5g/dL (average: 1.8g/dL). 2. The distribution of the amount of blood loss for three days postoperatively was from 156ml to 2001 ml (average: 798ml). 3. The distrihution of the amount of transfusion of autogenous shed blood was from 30ml to 600ml (average: 448ml). 4. There were two patients who had febrile reactions above 38 after transfusion of autogenous shed blood. 5. Forty-six patient(84%) had a homologous transfusion and the average amount of transfusion was 1.9 pint. 6. Total amount of homologous transfusion was decreased according to the increased amount of hemoglobin and the amount of transfusion was statistically decreased above the level of I 3g/dL(Students t-test, P=0.0005). 7. There were no significant differences in the amount of homologous transfusion between age, sex, type of disease, type of implants. In conclusion, most of our patients(84%) needed homologous blood transfusion in unilateral hyhrid total knee arthroplasty and the amount of transfusion decreased in patients who had hemoglobin above 13.0g/dL. So we recommend preparing banked autogenous hlood preoperatively in patients who have a lower hemoglobin level in unilateral hyhrid total knee arthroplasty.
Arthroplasty* ; Blood Transfusion* ; Communicable Diseases ; Hematocrit ; Hepatitis ; Humans ; Hypersensitivity ; Joints ; Knee* ; Limb Salvage ; Postoperative Hemorrhage ; Social Problems ; Syphilis

The purpose of this study was to find the distribution and measurement of compressive and tensile stress when intrusi- on arch wire is forced engage with upper canine and to analysis stress at each section through FEM. And we compare compressive and tensile ratio at each section. The results were as follows. 1. At FA point and cemento-enamel junction of upper canine, compressive and tensile force ratio is about the same. 2. At apex, compressive force is the four times as tensile force. ; In intrusion, we show root resorption at apex. 3. At Cemento-enamel junction, the compressive and tensile force show the maximun value except FA point.
Root Resorption

No abstract available.
Diagnosis* ; Endoscopy* ; Stomach Neoplasms*

Most gastrointestinal stromal tumors (GISTs) arise from the proper muscle layer of the upper gastrointestinal (GI) tract and have a low malignant potential. They are sometimes accompanied by symptoms, but in most cases are detected by chance. Endoscopic surgery of subepithelial tumors in the upper GI tract has been actively performed, and its merits include the need for fewer medical devices compared with other surgical procedures and post-resection organ preservation. However, because endoscopic procedures are still limited to small or pilot studies, a multidisciplinary approach combining laparoscopy and endoscopy is needed for more effective and pathologically acceptable management of GISTs. Many new endoscopic surgeries have been developed, and this review describes the current status of and the new approaches for endoscopic surgery of GISTs in the upper GI tract.
Endoscopy ; Gastrointestinal Stromal Tumors* ; Laparoscopy ; Organ Preservation ; Pilot Projects ; Upper Gastrointestinal Tract*

Slipped capital femoral epiphysis is a rare disease in Korea, but the incidence has being increased according to the changes of body contour and life style. Now we have more concern about slipped capital femoral epiphysis, especially the factors which contribute to the final result of treatment. Many factors such as severity of slip, stability of slipped epiphysis, whether closed reduction was done or not, whether severe complication like avascular necrosis or chondrolysis has occurred or not have effect on the result. We analyzed 20 cases of slipped capital femoral epiphysis, which occurred in 16 adolescence in view of which factors contributed to the final satisfactory result. In our study, the difference in the duration of symptoms, instability of slipped epiphysis, patients age, association with obesity or acute trauma and the number of pins had much effect on the final results and whether the reduction was done or not, the kinds of pins and association with endocrinopathy made a little difference. But further studies are necessary because the number of cases is not sufficient and the length of follow up period is not long.
Adolescent ; Epiphyses ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Life Style ; Necrosis ; Obesity ; Rare Diseases ; Slipped Capital Femoral Epiphyses*

No abstract available.
Phenylketonurias*

Submucosal tumors (SMTs) originate from tissues that constitute the submucosal layer and muscularis propria, and are covered by normal mucosa. Esophageal SMTs are rare, accounting for <1% of all esophageal tumors. However, the recent widespread use of endoscopy has led to a rapid increase in incidental detection of SMTs in Korea. Esophageal SMTs are benign in ≥90% of cases, but the possibility of malignancies such as gastrointestinal stromal tumor and malignant leiomyosarcoma still exists. Therefore, patients undergo resection in the presence of symptoms or the possibility of a malignant tumor. For resection of esophageal SMTs, surgical resection was the only option available in case of possible malignancy, but minimally invasive surgery by endoscopic resection is becoming more preferable to surgical resection with the development of endoscopic ultrasonography, endoscopic techniques, and other devices.
Endoscopy ; Endosonography ; Gastrointestinal Stromal Tumors ; Humans ; Korea ; Leiomyosarcoma ; Minimally Invasive Surgical Procedures ; Mucous Membrane

A hemangioma in the knee joint of a 13-year-old girl was diagnosed by magnetic resonance imaging. There was pain and a tender localized swelling around to the patellar tendon. Arthroscopy verified the diagnosis but did not allow visualization of the full extent of the tumor. After arthroscopic excision of the associated hypertrophic medial plica, a miniarthrotomy was done. The tumor was attached to the periph-ery of the anterior horn of the medial meniscus, the anterior tibial plateau, and the fat pad. Its origin was from the venous plexus just below the anterior lip of the central tibial plateau. The patient was asympto-matic one and a half years after surgery. If the case is not amenable to arthroscopic surgery, open excision through miniarthrotomy ensures complete removal of the hemangiomas without recurrence.
Adipose Tissue ; Adolescent ; Animals ; Arthroscopy ; Diagnosis ; Female ; Hemangioma* ; Horns ; Humans ; Knee Joint ; Knee* ; Lip ; Magnetic Resonance Imaging ; Menisci, Tibial ; Patellar Ligament ; Recurrence

The vascularized fibula flap, first described in 1975, was originally developed as a vascularized bone flap for extremity reconstruction. In 1989, the first experience with fibula free flap for mandibular reconstruction was published by Hidalgo. Vascularized fibula flaps have many advantages in the restoration of the contour and function of mandible. But a potential disvantages is unreliable skin paddle and the limited volume of fibula. So, we were dissected 63 Korean cadaver limbs. The aim of this study was 1) to define more clearly the anatomy of peroneal artery to fibula and lateral leg skin, specially with regard to the fibular osteocutaneous flap 2) to measure the dimensions of fibula available for dental implant placement. The results were as follows: 1. The peroneal artery arised from the posterior tibial artery in 60 cases(95.2%). But in 3 cases(4.8%), it took place of the posterior tibial artery. The peroneal artery branched off the posterior tibial artery 6.3+/-1.3cm(range 2 - 6.5cm) distal to the fibular head. 2. The musculoperiosteal and septocutaneous branches of the peroneal artery were distributed from 4/10 to 8/10 in most cases. 3. The number of nutrient foramen was one in 60 cases(95.2%). The foramen was positioned on the posterior surface in 50 cases(75.8%) The average foraminal index was 42.4+/-0.8% and its range was 30.2 to 73.3%. 4. The total length of fibula was 35.4+/-1.8 cm (range 31.0 - 39.5cm) in males and 31.3+/-1.5cm(range 28.0 - 35.0cm) in females. 5. The bone height from the base(anatomic posterior surface) to the spot at which was reduced to 6.0mm in midpoint of fibula was 12.3+/-1.8mm in males and 8.8+/-1.9mm in females.
Arteries* ; Cadaver ; Dental Implants ; Extremities ; Female ; Fibula* ; Free Tissue Flaps ; Head ; Humans ; Leg ; Male ; Mandible ; Mandibular Reconstruction ; Skin ; Tibial Arteries

As a commensal or a pathogen, Helicobacter pylori can change the balance of a complex interaction that exists among gastric epithelial cells, microbes, and their environment. Therefore, unraveling this complex relationship of these mixtures can be expected to help prevent cancer as well as troublesome unmet medical needs of H. pylori infection. Though gastric carcinogenesis is a multi-step process, precancerous lesion can be reversible in the early phase of mucosal damage before reaching the stage of no return. However, biomarkers to predict rejuvenation of precancerous atrophic gastritis have not been identified yet and gastric cancer prevention is still regarded as an impregnable fortress. However, when we take the journey from H. pylori-associated gastritis to gastric cancer, it provides us with the clue for prevention since there are two main preventive strategies: eradication and anti-inflammation. The evidence supporting the former strategy is now ongoing in Japan through a nation-wide effort to eradicate H. pylori in patients with chronic gastritis, but suboptimal apprehension to increasing H. pylori resistance to antibiotics and patient non-compliance still exists. The latter strategy has been continued in the author's research center under siTRP (short-term intervention to revert premalignant lesion) strategy. By focusing on the role of inflammation in the development of H. pylori-associated gastric carcinogenesis, this review is intended to explain the connection between inflammation and gastric cancer. Strategies on H. pylori eradication, removal of inflammation, and reverting preneoplastic lesion will also be introduced. In the end, we expect to be able to prevent gastric cancer by take a detour from the unpleasant journey, i.e. from H. pylori-associated gastritis to gastric cancer.
Animals ; Anti-Bacterial Agents/pharmacology/therapeutic use ; Biomarkers/metabolism ; Disease Models, Animal ; Gastritis/*etiology ; Helicobacter Infections/*complications/drug therapy ; Helicobacter pylori/drug effects/metabolism/physiology ; Humans ; Stomach Neoplasms/etiology/*prevention & control ; Virulence Factors/metabolism