Three cases of human embryo of Carnegie stage 13 were described. The CR length of these embryos were 3.0-5.3mm. The authors made a reconstruction model using photograph, photocopy and computer. These embryos were characterized externally by 4 limb buds and 4 pairs of branchial arches, and internally closed otic pits, appearance of venous valves, septum primum and foramen primum in the heart, beginning of the right and left lung buds, appearance of lens disk.
Branchial Region ; Embryonic Structures* ; Heart ; Humans* ; Limb Buds ; Lung ; Venous Valves

No abstract available.

Total hip replacement for adults with severe acetabular dysplasia presents a difficult problem because deficient bone stock and soft tissue contractures usually prevent sitting at the normal anatomic level. The rationales of high hip center are due to high failure rate of bulk structural weight bearing graft, good short-term result of hemispherical cementless acetabular component in revision surgery, high hip center but not lateral which does not adversely affect the biomechanics of the hip, and intimate apposition with viable host bone. We represented the short-term results of 21 total hip replacements with proximal placement of the acetabular cup than the anatomical position that is normally used. The mean duration of follow up was 18 months(range, 12-58 months) and the mean age of the patient was fifty-one years(range, thirty to sixty-seven years). Most of these hips had a major deficiency or defect of the acetabular bone stock. They had an aver- age Harris hip score of 47 points preoperatively and 90 points postoperatively. Roentgenographic measurements showed that the mean change in the height of the center of the hip postoperatively was only +6.6 millimeters and the mean change of horizontal location of them was 10 millimeters medial to the preoperative position. Postoperative complications included calcar fracture(1 case), trochanteric bursitis(1 case), postop- erative dislocation(1 case) and one case of radiological loosening of the acetabular component. The center of the hip in THR is not a crucial parameter with regard to the long-term stability of acetabular component, so our recommendation is to place the acetabular component at a more proximal but not lateral position if strong bone stock is available. But future studies of high hip center need to address femoral component longevity.
Acetabulum ; Adult ; Arthroplasty, Replacement, Hip ; Contracture ; Femur ; Follow-Up Studies ; Hip Joint ; Hip ; Humans ; Longevity ; Osteoarthritis ; Postoperative Complications ; Transplants ; Weight-Bearing

Enlargement of bone tunnels has been noted on plain X-rays following arthroscopic ACL reconstruction. The cause of this widening is unclear, but it has been hypothesized that it may be due to either mechanical or biological cases. Ishibashi et al. reported anatomical proximal fixation resulted in the most stable reconstructed knee, with increasing instability as the level of fixation moved away from the tibial plateau. The purpose of this study is to determine if any difference exists in the amount of enlargement of the femoral tunnel following arhotoscopic ACL reconstruction with position of interference screw fixation and instability, and to know the factors which affected to the enlargement of the femoral tunnels. Total 39 patients were retrospectively reviewed for tunnel measurements radiologically at one year post-operation. (27 patients received bone-patellar tendon-bone autograft, 12 patients received bone-patellar tendon-bone autograft and Kennedy LAD-ligament augmentation device). The surgery was performed using an arthroscopic single and double incision technique. AP and lateral X-rays were obtained and the tunnels were measured by two independent observers using a digital caplper. The measurements were made at the widest part of the tunnel. Correction for magnification was performed by comparing the measured width of the interference screw used for fixation of the graft with its actual width. Statistical analysis was performed using a one-way analysis of variance(ANOVA) and t-test. 1. Radiographic tunnel enlargement of femoral side was average 2.42 mm (bone-patellar tendon-bone autograft : 2.36 mm, Kennedy-LAD and autograft : 2.56 mm)(p>0.05). 2. According to the position of the interference screw, the femoral tunnel enlargement were 2.25 mm in anatomical fixation, 2.40 mm in mid-tunnel fixation, 2.62 mm in mid-tunnel fixation, 2.62 mm in outer-tunnel fixation(p < 0.05). 3. The femoral enlargement according to the overall results(Clancy, 1982) were 2.39 mm in above good result group and 2.50 mm in below fair result group(p < 0.05). Tunnel enlargement group of femoral side was related to a distance between femoral articular surface and the position of interference screw. We conclude that femoral tunnel enlargement following arthoscopic bone tendon-bone ACL reconstruction is related to the mechanical effect rather than the properties of grafts and the clinical results.
Autografts ; Humans ; Knee ; Retrospective Studies ; Transplants

Rotor syndrome is a rare disease of hereditary hyperbilirubinemia transmitted with autosomal recessive trait. In general, Rotor syndrome shows direct hyperbilirubinemia and there has been several reports since Sons's report in 1966, in Korea. A 34-year-old female was admitted with the chief complaint of intermittent icteric sclera for 24 years. There was no family history of jaundice. Rotor syndrome was diagnosed by oral cholecystogram, BSP retention test, 99mTc-DISIDA scan, liver biopsy and electron microscopy study of liver biopsy specimen. We report this case with brief review of the literature.
Adult ; Biopsy ; Female ; Humans ; Hyperbilirubinemia ; Hyperbilirubinemia, Hereditary* ; Jaundice ; Korea ; Liver ; Microscopy, Electron ; Rare Diseases ; Sclera ; Technetium Tc 99m Disofenin

No abstract available.
Depression*

Endotheline-1 (ET-1) is a potent vasoconstrictor peptide with 21 amino acid residues. ET-1 is thought to have a key role in vasoconstriction, and cardiac, renal, and endocrine actions of the peptide. Creatine Kinase(CK), also referred to as ATP-creatine-N-phosphotransferase, consists of either the B or M type. CK is found almost exclusively in muscle(MM), myocardium(MB), and brain(BB). It is to be an almost specific index of injury of myocardium and brain in hypoxic damage. I measured the ET-1, CK isoenzyme in neonates among asphyxia group (14 cases), as a control devide into two group. 1st group(birth weight (2500 g, n=9) and 2nd group (body weight 2500g, n=11). 1) There was no significant difference between asphyxia and control 1st, 2nd group during postnatal 24 hrs include cord blood on irET-1(p< 0.05). 2) There was significant difference between asphyxia and control 1 st, 2nd group during postnatal 24 hrs include cord blood on CK and CK and CK isoenzyme (p<0.001). 3) There was significant difference between asphyxia and control 1st, 2nd group on CK-MB and CK-BB proportion (p< 0.001). 4) There was significant difference between cord blood and postnatal 24 hrs on total CK level (P< 0.001).
Asphyxia* ; Brain ; Creatine Kinase* ; Creatine* ; Fetal Blood ; Humans ; Infant, Newborn* ; Myocardium ; Plasma* ; Vasoconstriction

The medial collateral ligament(MCL) of the knee is the well established secondary restraint to the anterior displacement of the knee joint. However, there has been no report about the estimation of the anterior displacement in combined ACL(anterior collateral ligament) and MCL injures according to period when they were treated with conservative measures. This prospective study evaluated the changes of anterior displacement over time in combined ACL/MCL injury as the MCL injury heals after initial conservative measures. 19 patients who had combined ACL/MCL injury were followed during twelve months after injury. All patient had a positive Lachman test and were evaluated the side to side differences on KT-2000 knee arthrometer(Medmetric, San Diego, California) testing under 20 Ibs anterior tibial loading at 30 degree knee flexion. The stability of the knee was assessed using KT-2000 knee arthrometer every 8 weeks with clinical examination prospectively. They were treated with CI (Combined instability) brace (Smith & Nephew, Carlsbad, California) as conservative measures. Overall, Initial side to side difference of the anterior displacement was averaged 5.21mm (range,4.0-7.0mm) and 3.30mm (range,2.0-5.5mm) finally. According to the classification of MCL injury, in Grade III groups, they had the greatest initial anterior displacement about 6.4mm, but tight- ened the most to 3.08mm finally. In Grade II and Grade I groups they showed 2.97mm and 2.13mm side to side difference (p>0.01). However in Grade I, the anterior displacement were decreased by 4 months after injury but, it were increased at 6 months after injury. In Grade II and III, the decrement of the anterior displacement were continued by 6 months after injury, but they were not changed after that. The data was analyzed by General Linear Model Procedure method. Conclusively, the anterior displacement of knee in patients with combined ACL/MCL injury was diminished with the time in the majority of patients as the MCL healed. It means that the MCL was the stabilizer to the anterior displacement of the knee under the anterior tibial loading.
Braces ; Classification ; Humans ; Knee Joint ; Knee* ; Linear Models ; Prospective Studies

Controversies about the posterior cruciate ligament continue with regards to total knee arthroplasty. There has been a long debate regarding PLC and its importance seems to be overrated in total knee arthroplasty. Twenty four patients had twenty six total knee replacements with insertion of the PCL substituting Press Fit Condylar modular total knee system with cement, and they were enrolled in a prospective study to assess the clinicoradiological results and measure the femoral roll-back postoperatively. Follow-up ranged from twenty four months to fifty months with an average of thirty two months. The mean HSS score was 92.1 points and the mean range of motion was 122.7 degrees. Twenty five cases(96.1%) showed excellent and good clinical results. The radiologic evaluation based on Knee Society roentgenographic system revealed proper alignment of all components and one significant radiolucent area. The mean femoral roll-back was 2.3mm posteriorly. In the present series, total knee arthroplasties with the Press Fit Condylar modular knee system resulted in excellent relief of pain, excellent range of motion and restoration of function.
Arthroplasty* ; Arthroplasty, Replacement, Knee* ; Follow-Up Studies ; Humans ; Knee ; Posterior Cruciate Ligament ; Prospective Studies ; Range of Motion, Articular

The femoral neck fracture in children are extremely rare and occur secondary to severe trauma. Many authors recommend early anatomical reduction and firm internal fixation because of many complications after treatment. Eleven displaced femoral neck fractures in children who were treated at the Keimyung University Dong San Medical Center from February, 1989 to February, 1993. Following results were obtained, after clinical and radiological evaluations. 1. Fractures of the femoral neck in children occurred from five to sixteen years, the highest inci dence was between ten and thirteen years of age. 2. The main causes of the fracture were traffic accident in 9 cases. 3. 10 cases were treated by arthrotomy, open reduction and internal fixation and one by closed reduction and internal fixation. 4. Operation were performed within 24 hrs after trauma in 5 cases, within 5 days in 4 cases, and 2 cases were performed within 10 days after trauma. 5. According to the classification of Delbet and Colonna(12), cervicotrochanteric fracture(type III) was the most common type(7 cases). 6. The degrees of displacement were 4 cases totally displaced, one case more than two third dis placed, 4 cases 1/3 to 2/3 displaced, and 2 cases less than one third displaced. 7. Complications were transient AVN confirmed by bone scan(1 case) and coxa vara due to nonunion(1 case). 8. According to the Ratliffs assessment(22) the results were good in 9 cases, fair in one, and poor in one.
Accidents, Traffic ; Child ; Classification ; Coxa Vara ; Decompression ; Femoral Neck Fractures ; Femur Neck ; Humans