The author studied the validity of bone scintigraphy in the assessment of viability and anastomotic patency of free bone grafts revascularized by microvascular anastomoses and also compared them with conventional free devascularized bone grafts and osteotomies. Sixty rabbits were divided into three different groups, and scintigraphy was carried out using technetium labeled methylene diphosphonate on revascularized living bone grafts, conventional devascularized bone grafts and osteotomies. Of these, 38 rabbits could be followed up to 6 weeks. Analyzing the histologic, radiographic and scintigraphic data, the following results were obtained. 1. Free living bone grafts, revascularized by periosteal blood supply from the posterior tibial artery, revealed incomplete bone cell survival on histologic sections taken at 6 weeks after operation. In the osteotomy group the distal fragments were completely viable. Living bone grafts with failed anastomosis and dead bone grafts were almost completely necrotic. 2. Radionuclide uptake in dead bone grafts and living bone grafts with failed anastomosis increased gradually up to 6 weeks after operation. Radionuclide uptake in living bone grafts with patent anastomosis increased rapidly during the first 2 weeks, and increased gradually thereafter up to 6 weeks. In the osteotomy group radionuclide uptake also increased rapidly during the first 2 weeks but decreased slowly thereafter up to 6 weeks. 3. Radionuclide uptake at 6 weeks after operation became comparable to that of the adjacent host bone and there was no significant difference among the various groups. On the basis of the experimental results, the author derived following conclusions. 1. The differences of radionuclide uptake among the various living and dead bone grafts were most remarkable at 2 weeks following the grafting procedure. The radioactivity was highest following osteotomy which preserved blood supply, and it was lower in the living bone grafts with patent anastomosis, while that in the dead bone grafts and living bone grafts with failed anastomosis was lowest. 2. The time factor in performing scintigraphy was most important in assessing the viability of bone grafts and anastomotic patency. The optimal time to assess the viability and anastomotic patency appeared to be 2 weeks after grafting.
Cell Survival ; Osteotomy ; Rabbits ; Radioactivity ; Radionuclide Imaging ; Technetium ; Tibia ; Tibial Arteries ; Time Factors ; Transplants

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

From 1963 to 198I, we have performed Colonna's capsular arthroplasty on 7 children. Three of the hips had congenital dislocations and four hips had pathologic dislocation. The results on these cases, including some long term follow-up were satisfactory. Since Colonna first published his technique in 1932 ideal indications for the classical arthroplasty have largely been replaced by those of more recently developed procedures such as Salter's innominate osteotomy, Chiaris osteotomy and etc. We feel, however, that there still seems today a narrower, but distinct domain of usefulness left for the capsular arthroplasty, and that new indications need to be redefined. We propose the following criteria for such purpose. First, congenital dislocations of the hip in children beyond 6 years of age, which is the upper age limit of Salter's innominate osteotomy, and below 8 years of age, which is the upper age limit o original Colonna's capsular arthroplasty. Second, teratogenic congenital dislocations in which the shallow and slanted acetabulum renders otherwise stable, deeply seated acetabulum with a prospect for a concentric remodelling unlikely. Third, pathologic dislocations secondary to septic hip in children 3 to 8 years of age in which a pain-free, stable and reasonably mobile hip often betrays rentgenographic imaginations and renders reconstructive procedures in adult life feasible.
Acetabulum ; Adult ; Arthroplasty ; Child ; Dislocations ; Follow-Up Studies ; Hip ; Humans ; Imagination ; Osteotomy ; Retrospective Studies

No abstract available.

Background:Eutropin is a recombinant human growth hormone preparation and has been used in patients with growth hormone deficiency. Short stature is a characteristic feature of Turner syndrome, which is caused by sexual chromosomal anomalies. Growth hormone therapy would increase growth velocity and increase the ultimate final height in patients with Turner syndrome. The purpose of this study was to evaluate the clinical effects and safety in patients with Turner syndrome with Eutropin treatment. Subjects and METHODS:60 patients with Turner syndrome,who were diagnosed by chromosome study,were treated with Eutropin 1IU/kg/week for 12 months and followed up every 3 month. The height and weight were evaluate at 0, 3, 6, 9, 12 months. A complete blood count, ESR, urinary analysis and chemistry studies were done every 3 month. IGF- I , T4, TSH & anti-GH antibody were measured at 6 months and 12 months. Chest X-ray was checked at 0, 6 ,12 months. RESULTS:60 patients were enrolled but 10 patients were lost or treated irregularly and excluded in the study of growth effect. but included all cases in safety analysis. At the onset of Eutropin therapy,their mean age was 10.8+/-2.9 years old(range 4.2- 14.9yr)and the height was 121.1+/-13.7cm(-3.1+/-0.9 SDS) and yearly growth velociy was 3.4+/-1.5cm. Their weight was 30.5+/-10.6kg and bone age 9.1+/-3.0 yrs. After Eutropin treatment, mean height was increased to 123.2+/-13.5cm at 3 months, 125.2+/-13.1cm at 6 months, 127.5+/-12.4cm at 9 months, 128.3+/-12.8cm at 12 months. Height velocity were increased to 8.3+/-3.1cm at 3 months, 8.1+/-2.6cm at 6 months, 7.6+/-1.9cm at 9 months and 7.1+/-1.9cm at 12 months(P<0.001). Height SDS at 0, 3, 6, 9, 12 months were -3.1+/-0.9, -2.9+/-1.0, -2.7+/-0.9, -2.7+/-0.9 respectively(P>0.001).Their bone age were 9.1+/-3.0yr, 9.6+/-2.9yr, 10.2+/-2.7yr before and 6 & 12 months after treatment respectively. HA/BA were 0.84+/-0.15, 0.87+/-0.13, 0.88+/-0.12 at before and 6 & 12 months after treatment respectively(P<0.05). Growth velocity of 4-8 yrs group was most prominent compared to other groups. Serum IGF- I concentration was increased from 167.4+/-85.8ng/ml to 368.4+/-158.1ng/ml at 6 months and 423.2+/-181.0ng/ml at 12 month(P<0.001) after treatment. No significant changes were observed in thyroid function, CBC, ESR, Blood chemistry and urinalysis. Anti-hGH antibody were positive in 2 patients, but these didnot attenualte the growth velocity. CONCLUSION: Treatment with Eutropin increased significantly height velocity in patients with Turner syndrome. No specific adverse events were observed during Eutropin therapy.
Blood Cell Count ; Chemistry ; Growth Hormone ; Human Growth Hormone ; Humans* ; Thorax ; Thyroid Gland ; Turner Syndrome* ; Urinalysis

Most of the peripheral nerve injuries from crushing or compressive forces are accompanied by surrounding soft tissue injuries. As a result, poor vascularity due to fibrosis and sacr formation compromises regeneration of the grafted nerve. Vascularized nerve graft shows superior regeneration to that of a non-vascularized one. However, the human body provides few donor sites of vascularized nerve graft clinically. We presumed that the prefabricated myoneural or adiponeural flap, which include fabricated nerves wrapped with surrounding vascularized muscle or adipose tissue flap, influences superiorly on the regeneration of grafted nerve because that surrounding vasculatity indirectly enhances the vascularity of the grafted nerve itself. Thirty adult male Sprague-Dawley rats were divided into three groups: 1) conventional reversed autogenous graft of the femoral nerve alone(n=10); 2) nerve graft entubulated with abdominal adipose tissue flap with a pedicle of inferior epigastric artery(n=10); 3) nerve graft entubulated with adductor muscle flap with a pedicle of the first muscular branch of the femoral artery(n=10). At three months postoperatively, grafted nerves were examined by electrophysiologic study to check amplitudes and motor nerve conduction velocities, as well as histopathologic study for evaluation of regenerated nerve cells, fibrosis and neo-vascularization. Consquently, nerve regeneration was found in all three groups. Both the myoneural and adiponeural flap groups had better improved results of nerve regeneration compared to that of the conventional nerve graft group. The result of myoneural flap group was superior to that of the adiponeural flap group. The myoneural flap group showed minimal fibrosis and less prominent neovascularization around moderately regenerated nerves. The adiponeural flap group showed more severe perineural and endoneural fibrosis, as well as vascular proliferation around focal regenerated nerves. The results of myoneural flap group proved to be statistically significant. We concluded that it is possible to use nerve graft entubulated with a vascularized muscle flap (myoneural flap) as a substitute for vascularized nerve graft.
Abdominal Fat ; Adipose Tissue ; Adult ; Femoral Nerve ; Fibrosis ; Human Body ; Humans ; Male ; Nerve Regeneration* ; Neural Conduction ; Neurons ; Peripheral Nerve Injuries ; Rats, Sprague-Dawley ; Regeneration ; Soft Tissue Injuries ; Tissue Donors ; Transplants*

No abstract available.
Ameloblastoma*

OBJECTIVES: We investigated the prevalence and functional impairment of premenstrual dysphoric disorder (PMDD) and premenstrual syndrome(PMS) in young women. METHODS: A total of 1063 female college students were recruited from two urban areas(Seoul and Suwon) of Korea. Questionnaires for sociodemographic data and risk factors of PMDD, attitude about menstruation, and the Premenstrual Symptoms Screening Tool(PSST) were applied. RESULTS: The prevalence of severe moderate to severe PMS and PMDD were 16.9% and 11.7%, respectively. There were differences in the alcohol and coffee consumption, severity of menstrual cramp, and family history of PMS among the moderate to severe PMS, PMDD, and no/mild PMS groups. Although some participants did not fulfill diagnostic criteria for PMDD, they showed significant functional impairment. Participants with negative attitude about menstruation reported premenstrual symptoms more frequently than those with positive or ambivalent attitude about menstruation. CONCLUSION: These results suggest that PMS and PMDD were prevalent and associated with functional impairment in young females. Some participants reported significant functional impairments although they did not meet the full DSM-IV diagnostic criteria for PMDD. Negative attitude about menstruation was associated with more premenstrual symptoms experiences.
Coffee ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Korea ; Mass Screening ; Menstruation ; Muscle Cramp ; Premenstrual Syndrome ; Prevalence ; Questionnaires ; Risk Factors

Authors investigated the possible role of intravascular hypercoagulable states on the etiology of Kegg-Clave-Perthes diesease. Forty-five patients with Legg-Clave-Perthes disease(31 avascular stages and 14 reossification stages) and twenty-two normal control patients were subjected to study for evaluation of coagulation and fibrinolysis system by means of the tests which included antiphospholipid antibody(APA), Protein C, Protein S and antithrombin- III (AT- III) for evaluation of coagulation system, and tissue type PIasminogen activator(tPA), Plasminogen activator inhibitor(PAI), D-dimer for fibrinolytic system. APA increased significantly in Legg-Clave-Perthes patients(p=0.016) as compared with control group, while Protein C(p=0.040) and Protein S(P=0.0001) decreased significantly in Legg-Clave- Perthes disease. AT- III increased in Legg-Clave-Perthes disease(p=0.0000). In contrast, there were no statistically significant differences in PAI, tPA, D-dimer between the Legg-Clave-Perthes disease and control group. There were no differences in all parameters between the avascular stage and reossification stage in patients with Legg-Clave-Perthes disease, Suggestive of possible inherent effect in coagulation system(hypercoagulable states) which does not change with time. Based on the above findings authors presumed that hypercoagulable state may contribute to the development of Legg-Calve-Perthes disease. However, to elucidate the etiology of Legg-Calve-Perthes disease, further extensive investigation should be followed, which include the familial tendency of hypercoagulable state, relationship with other multifactorial causes such as alcohol and steroids, and confirmation of intravascular thrombosis or decreased blood perfusion in the femoral head. Also, the significance of abnormally elevated AT-III on the disease should be answered.
Fibrinolysis ; Head ; Humans ; Legg-Calve-Perthes Disease ; Perfusion ; Plasminogen Activators ; Protein C ; Protein S ; Steroids ; Thrombosis

Recently, methionyl-hGH was produced in the E. coil K-12, W3110 by recombinant DNA technology in Korea. In this paper, the clinical efficacy and immunogenicity of this GH were studied in 43 patients with growth hormone deficency.The subjects of this study were aged 4.3-18.5 years and each patient received GH 0.5-0.71U/kg week subcutaneously, 6-7 times a week for 1 year. During treatment, height, body weight and bone age were checked. Blood count, urinalysis, blood chemistry and thyroid hormonal concentrations were checked before and every 3 months. The measurement of IGF-1 was performed and assay of antibody against hGH was performed before and every 6 months.The height velocities significantly increased from 3.7+-3.0 cm/year to 11.0+-4.2 cm/year and 9.9+-3.2 cm/year at 6 and 12 months after GH therapy, respectively. The Height SDS were significantly improved after GH therapy with increasing ratio of bone age to chronological age from 0.60+-0.19 at pretreatment to 0.68+-0.16 at 6 month, 0.69+-0.16 at 12 month of therapy. The plasma IGF-1 levels significantly increased during treatment. Three out of 35 patients(8.3%) showed antibody against hGH after 1 year of treatment. Thoughout study, we could not observe any remarkable side effect with GH treatment.These results indicate that this E. coli derived methionyl recombinant growth hormone is effective in improving the index of linear growth in the children with growth hormone deficiency without significant side effect.
Body Height ; Chemistry ; Child ; DNA, Recombinant ; Growth Hormone ; Human Growth Hormone ; Humans ; Insulin-Like Growth Factor I ; Korea ; Plasma ; Thyroid Gland ; Treatment Outcome ; Urinalysis