Supracondylar osteotomy was performed on 78 knees in 65 patients with poliomyelitis for correction of deformities of the knee at the Department of Orthopedic Surgery, Seoui National Unlversity Hospital, during the 16 years from January 1963 to December 1978. Following observations were made from the review of statistics, technical problems, and complications of the operation. 1. The ages of the patients ranged from 4 years to 28 years, the average being 15 years. Two thirds of the patients were in the second decade. 2. 37 knees (47.4%) had flexion deformity, 19 knees (24.4%) flexion-valgus deformity, and 13 knees (16.7%) flexion-valgus-external rotation deformity. The amount of flexion deformity ranged from 7 degrees to 90 degrees, the average being 22 degrees. Valgus deformity ranged from 3 degrees to 25 degrees, the average being 12 degrees. External rotation deformity ranged from 5 degrees to 30 degrees, the average being 18 degrees. 3. The operative techniques employed were categorized into 5 types. The most common type was a closed wedge hinged osteotomy (Technique I), which was employed on 50 knees (64.1%). Satisfactory results were obtained by combining other procedures, when necessary, i.e. pre-operative skeletal traction, Yount fasciotomy, high tibial rotation osteotomy hamstring transfer and epiphysiodesis. 4. The time required for union was the shortests in the Technique 1 group, and longest in the Technique III group, a complete osteotomy with bone shortening. 5. The most common complication was stiff knee, which was encountered in 10 knees. Residual or recurrent deformity was observed in 4 knees, in 3 of which hamstring transfer was recommended but was not consumated. Delayed union was observed in 3 knees in the Technique II group (closed wedge complete osteotomy) and in 1 knee in the Technique III group. Nonunion occured in 1 knee in the Technique II group. The incidence of complications were higher in the Technique II and III groups, and lowest in the Technique I group.
Congenital Abnormalities ; Humans ; Incidence ; Knee ; Orthopedics ; Osteotomy ; Poliomyelitis ; Traction

No abstract available.
Humans ; Infant, Newborn*

It remains a problem that successful revascularization and reperfusion after ischemia are associated with high systemic complication rates and severe local tissue injuries. With prolonged ischemia, there is damage to tissue from anoxia, but further injury may occur after reperfusion. The activation of leukocytes and endothelial cells during reperfusion causes neutrophil adhesion in capillaries, resulting in plugging and further ischemia, Alternativety, neutrophil adhesion to endothelium leads to the migration of neutrophil with local edema formation, hemorrhage and thrombosis. Some chemotactic and activating factors are needed to propel neutrophils to the site of local inflammation. The chief cytikines that induce a pro-adhesive state in endothelium are tumor necrosis factor-alpha(TNF-alpha), interleukin-1 beta(IL-1 beta) and endotoxin or lipopolysaccharide(LPS). Similarly, TNF-alpha,and to a lesser extent interleukin-8(IL-8), is the important stimulus that acts on neutrophils and other leukocytes to alter their adhesion. The purpose of this study was to evaluate the pathogenetic role of IL-8 after perfusion with CDl8 monoclonal antibody(CDl8 mAb), the blocking antibody of neutrophil adherence, on reperfusion injury in rat epigastric island skin flap. A 6 X 3 cm-sized island skin flap was made on the abdomen. The epigastric pedicle was occluded for six hours with ambient temperature. Fifteen minutes before reperfusion, the flap was perfused with saline and CDl8 mAb(1 mg/kg). For evaluation of IL-8 levels, tissue fluid and serum were obtained at 4, 8, 12 and 24 hours after reperfusion. IL-8 concentrations of the CDl8 mAb group in the tissue fluid were significantly decreased at 8, 12 and 24 hours compared to the control group(P > 0.01), but the difference between the two groups was not significant at 4 hours after reperfusion IL-8 concentrations of the CDl8 mAb group in the serum were significantly decreased over time compared to the control group(P > 0.05, p > 0.01). Form the above results, we concluded that blocking neutrophil adherence using CD18 mAb within the peak level of IL-8 at 4 hours after reperfusion may be a better method of reducing reperfusion injury to the island skin flap.
Abdomen ; Animals ; Anoxia ; Capillaries ; Edema ; Endothelial Cells ; Endothelium ; Hemorrhage ; Inflammation ; Interleukin-1 ; Interleukin-8* ; Ischemia ; Leukocytes ; Necrosis ; Neutrophils ; Perfusion ; Rats ; Reperfusion Injury* ; Reperfusion* ; Skin ; Thrombosis

Entrapment neuropathy of the suprascapular nerve is rare and frequently overlooked in the differential diagnosis of shoulder pain. There have been few published reports on a ganglion compressing the suprascapular nerve. We experienced a case of entrapment neuropathy of the suprascapular nerve by a ganglion that compressed the inferior branch of suprascapular nerve at the spinoglenoid notch.
Diagnosis, Differential ; Ganglion Cysts ; Shoulder Pain

OBJECTIVE: The purpose of this study was to determine whether cyclooxygenase [COX]-1 and COX-2 are expressed in the pregnant human uterine cervix and if they are expressed differentially between preterm and term pregnancies. METHODS: Fourteen patients delivered between 29 and 41 weeks of gestation were matched for obstetrical history and maternal age were divided into a preterm group who delivered between 29 and 36 weeks [n=7], and a term group who delivered between 37 and 41 weeks of gestation [n=7]. Immediately after vaginal delivery cervical biopsy samples were obtained and immunohistochemicaly stained for COX-1 and COX-2 and the degree of staining was evaluated by H-scoring system. RESULTS: Expression of COX-1 and COX-2 was found in all epithelial and stromal cells of uterine cervical tissues of pregnancy. The expression of COX-1 and COX-2 was significantly stronger in the term group compared to the preterm group in epithelial cells [HSCORE : 2.14+/-0.69 vs. 1.14+/-0.38 ; 3.71+/-0.76 vs. 1.86+/-0.90, p<0.05], but there was no significant differences in stromal cells [HSCORE : 3.43+/-0.53 vs. 2.86+/-0.38 ; 2.43+/-0.53 vs. 2.57+/-0.98, p>0.05]. CONCLUSION: In the pregnant human uterine cervix, COX-1 and COX-2 are found to be expressed, and both are strongly expressed in the cervical epithelial cells of term pregnancies compared to preterm pregnancies. It is suggested that the uterine cervix, under the control of prostaglandins, is actively involved in the process of labor, and that the role of COX-2 in epithelium is particularly significant in term pregnancies compared to preterm pregnancies.
Biopsy ; Cervix Uteri* ; Cyclooxygenase 1* ; Cyclooxygenase 2 ; Epithelial Cells ; Epithelium ; Female ; Humans* ; Maternal Age ; Pregnancy* ; Prostaglandin-Endoperoxide Synthases ; Prostaglandins ; Stromal Cells

PURPOSE: To evaluate the expression of the Na(+)-K(+)-2Cl(-)-cotransporter 2 (NKCC2) in the ischemic rat retina. METHODS: Retinal ischemia was induced by pressures 90 to 120 mmHg, above systemic systolic pressure. Immunohistochemistry and western blot analysis were performed. RESULTS: NKCC2 is expressed in the normal retina and its expression is increased by ischemia caused by intraocular pressure elevation. NKCC2 immunoreactivity was observed mainly in axon bundles of ganglion cells and horizontal cell processes in the retina. NKCC2 expression continuously increased with a peak value 3 days (to 415% of normal levels) after ischemic injury, and then gradually decreased to 314% of controls until 2 weeks post injury. The mean density of NKCC2-labeled ganglion cells per mm2 changed from 1,255 +/- 109 in normal retinas to 391 +/- 49 and 185 +/- 37 at 3 days and 2 weeks after ischemia, respectively (p < 0.05), implying cell death of ganglion cells labeled with NKCC2. CONCLUSIONS: Taken together, these results suggest that NKCC2, which is expressed in retinal ganglion and horizontal cells, may contribute to cell death by ischemic injury in the retina, although the molecular mechanisms involved remain to be clarified.
Animals ; Blotting, Western ; Disease Models, Animal ; Immunohistochemistry ; Intraocular Pressure ; Ischemia/etiology/*metabolism ; Male ; Microscopy, Confocal ; Ocular Hypertension/*complications/metabolism/physiopathology ; Rats ; Rats, Sprague-Dawley ; Retinal Diseases/etiology/*metabolism ; Retinal Ganglion Cells/*metabolism/pathology ; Sodium-Potassium-Chloride Symporters/*biosynthesis

Extra-adrenal pheochromocytoma accounts for about 10 to 15 percent of all such tumors and the combination of pheochromocytoma and renal artery stenosis is rare. We report an unusual case of extra-adrenal pheochromocytoma causing renal artery stenosis which was developed in a 11-year-old boy and the literatures were reviewed.
Child ; Humans ; Male ; Pheochromocytoma* ; Renal Artery Obstruction* ; Renal Artery*

Steroid cell tumor of ovary, first described as lipid cell tumor, is rare lesions composed entirely of cells resembling typical steroid hormone - secreting cells, that is lutein cells, Leydig cells, and adrenal cortical cells. Steroid cell tumors oftcn secret androgen and manifest themselves with symptoms of virilization. Other presentations include abdominal swelling or pain, menstrual dysfunction, postmenopausal bleeding, or rarely ascites. We experienced a case of right ovarian steroid cell tumor, not otherwise specified(NOS), manifested hirsuitism and amenorrhea in 49 - year - old patient. The tumor was about 5 cm in size, and associated with huge ascites (l3,000 ml), both pleural effusion, and elevated serum CA 125. We present a case of Meigs syndrome associated with benign ovarian steroid cell tumor with a brief review of the literature.
Amenorrhea ; Ascites* ; Dysmenorrhea ; Female ; Hemorrhage ; Humans ; Leydig Cells ; Luteal Cells ; Male ; Meigs Syndrome ; Ovary ; Pleural Effusion ; Virilism

Twin pregnancy is at increased risk for congenital anomalies. Although twins were relatively infrequent, they accaunted for a disproportionately large portion of adverse pregnancy outcome, primarily as a consequence of preterm delivery, gestational diabetes, and pregnancy induced hypertension. In case of twin pregnancy with a single anomalous fetus, the clinicians are faced with difficult decision-making processes regarding the route of delivery, when to deliver, how aggressively to attempt to prevent delivery. Twin pregnancy discordant for a fetal abnormality can be managed expectantly or by selective fetocide of abnormal twin. Recently we experienced two cases of twin pregnancy with a single anornalous fetus. We reported cases with concerned literatures.
Diabetes, Gestational ; Female ; Fetus* ; Humans ; Hypertension, Pregnancy-Induced ; Pregnancy ; Pregnancy Outcome ; Pregnancy, Twin*

No abstract available.
Kidney Transplantation*