No abstract available.
17-alpha-Hydroxyprogesterone*

No abstract available.
Rheumatic Diseases*

No abstract available.
Rheumatic Diseases*

PURPOSE: To cmpare the clinical results of complex tibial plateau fractures treated by hybrid external fixation and dual plate fixation. MATERIALS AND METHODS: We studied forty patients with Schatzker type V and VI fractures respectively and selected twenty seven patients who were followed at least one year between January 2000 and December 2005. We evaluated the clinical results in which fourteen fractures with hybrid external fixation were compared with thirteen fractures with dual plate fixation. The clinical results were evaluated according to Knee Society Clinical Rating System and the statistical analysis was performed by Student t-test. RESULTS: There were no significant differences in terms of bone union time (average union time: dual plate fixation 13.8 weeks, hybrid external fixation 14.2 weeks). The quality of osseous reduction was superior in the fractures with dual plate fixation than those with hybrid external fixation. There were significant differences in functional score (average functional score: dual plate fixation 73, hybrid external fixation 62), but not in average knee score. CONCLUSION: The hybrid external fixation can be a useful modality for treatment of complex proximal tibial plateau fractures. But the good quality of the fracture reduction by dual plate fixation may be a indicator for favorable prognosis for satisfactory knee function.
Chimera ; External Fixators ; Humans ; Knee ; Prognosis

It is often difficult to achieve bony union and eradicate infection in treating infected non-unions of the fractured long bones. Authors carried out a clinical analysis of the 35 infected non-union cases, all aged 21 years or older, treated and followed for 6 months to 6 years from July 1979 to July 1988 in order to determine the possible factors which might influence the time required for attaining union. The results were as follows: l. In 22 of the 35 infected non-unions, the primary fracture site was open (62.9%). The remaining 13 cases (37.1% ) were the closed fractures associated with postoperative infection. 2. The sites of infected non-union were tibia in 19 (54.3%), femur in 13 (37.1%), and upper extremity in 3 (8.6%) cases. Tibia was more often involved in open fractures (63.6%). Femur, on the other hand, was more involved in closed fractures (61.5%). 3. After an average of 3.3 times of bony procedures, primary fixation was left in place in 15 (42.9%), external fixation was required in 11 (31.4%), and internal fixation was performed in 9 (25.7%). Bone graft was performed in 26 cases (74.3%). 4. Time required for achieving union was 7.1 month with stable primary fixation and 21.7 months with unstable primary fixation. Femur and tibia united at 10.5 (mean; ranged from 4 to 29) and 7.0 (mean; ranged from 3 to 19) months, respectively. 5. Bony union was delayed as the number of prior surgical procedures before successful treatment increased; the time for union was significantly shorter when either stable primary fixation or external fixation was combined with bone grafting. 6. Firmer bony union was achieved after performing Osteoperiosteal decortication with autogenous cancellous bone graft even in the presence of remaining infection at the non-union site.
Bone Transplantation ; Femur ; Fractures, Closed ; Fractures, Open ; Hand ; Tibia ; Transplants ; Upper Extremity

Panniculitis, Lupus Erythematosus*

No abstract available.

The authors reviewed 85 knees in 59 patients(9 males, 50 females) who had preoperative flexion contracture(FC) greater than 20° and taken total knee arthroplasty(TKA) at the Seoul National University Hospital from Jan.1987 to Dec.1992. We reviewed the surgical methods according to preoperative FC, changes of postoperative FC and range of motion, and clinical and radiologic findings. In our series, 48 knees were degenerative arthritis(average FC: 26°), 34 knees, rheumatoid arthritis(average FC: 40°)and 3 knees, others(average FC:28°). The average follow-up period was 2 years(range, 1 to 4(+8) years). Seventy three knees with FC less than 45 (Group I)had been treated with TKA accompanied with adequete soft tissue release, removal of osteophyte and appropriate bone resection. Eleven knees with FC greater than 50° (Group II) had been treated with skin traction followed by TKA. One knee with 65° of FC(Group III)was treated with posterolateral and posteromedial release including tendon lengthening at first, and then TKA in second stage. Preoperative FC was significantly greater in RA group than in DA group. Flexion contracture improved until postoperative 3 years in DA group and improved until postoperative 2 years and slightly deteriorated after then in RA group, but statistically insignificant(p>0.05). There was no difference of FC at postoperative 2 weeks and final follow-up between Group I and II. Range of motion improved until postoperative 2 years in DA group significantly(p < 0.05). In RA group, range of motion improved until postoperative 2 years(p>0.05) and deteriorated after then(p < 0.05). With TKA, range of motion increased significantly in both Group I and II and there was no difference of range of motion between Group I and II at final follow-up. Postoperative HSS score and pain score improved in DA and RA groups significantly, and final HSS score with greater in DA group than RA group(p < 0.05). Preoperative HSS score and pain score of Group I were significantly higher than those of Group II, but final follow-up, there was no difference between two groups. There was no correlation between final FC and HSS score. There was no difference in score of radiolucency between two groups in which final FC was greater and lesser than 10°. We thought that in knees with fixed flexion contracture, successful correction of moderate to severe flexion contracture and satisfactory result of total knee arthroplasty can be achieved by adequate soft tissue release, appropriate bone resection, and/or preoperative management.
Arthroplasty, Replacement, Knee ; Contracture ; Follow-Up Studies ; Humans ; Knee ; Male ; Osteophyte ; Range of Motion, Articular ; Seoul ; Skin ; Tenotomy ; Traction

Backgrouad & Aims: Cyclophosphamide, adriamycin and cisplatin(CAP) combination chemo- therapy improved the response rate in the treatment of advanced epithelial ovarian cancer, and it has been the gold standard. However, adriamycin is a rather toxic drug, and there is still confusion concerning the choice of adriamycin to be included in optimal regimen. The present study was designed to compare the activity and toxicity of combination regimens in advanced epithelial ovarian cancer between CAP and CTP which substitutes adriamycin with pirarubicin(THP- adriamycin). PATIENTS AND METHODS: From March 1995 to December 1997, 47 patients with FIGO stage III-IV epithelial ovarian cancer who were diagnosed after initial cytoreductive surgery were divided into two groups at random: (1) The case group were treated with CTP(500/40/50 mg/m2) as a first line chemotherapy. (2) The control group were treated with CAP(500/50/50 mg/m2) as that of case group. Clinical characteristics, response rates and toxicities according to Gynecologic Oncology Group criteria were compared between those treated with CAP and CTP respectively. RESULTS: Forty one patients out of 47 were evaluable and the number of patients in case and control group was 22 and 19 respectively. There was no significant differences in patient characteristics such as age, stage, histologic type between two groups. Clinical complete response rate was 50.0%(11/22) in patients treated with CTP regimen and 47.4%(9/19) with CAP regimen and there was no significant difference between two groups. Second look operation was undergone in 10 patients of CTP group and 7 patients of CAP group who showed clinical complete response and the pathologic complete response rate was 27.3%(6/22) with CTP and 21.1%(4/19) with CAP. The incidence of leukocytopenia of grade 3 or 4 was more frequently occurred in CAP group(52.6%, 10/19) than CTP group(22.7%, 5/22). There was no significant difference in the incidence of other toxicitied such as hepatic, renal and G-I toxicities. Suspicious cardiac toxicity according to the finding of EKG was seen in 15.8%(3/19) only with CAP regimen and all of them showed decreased cardiac function in gated blood pool scan. There were no significant differences in risponse rates between two groups, but the incidence of cardiac toxicity and leukocytopenia o f grade 3 or 4 was more frequently occurred in CAP group than CTP group. CONCLUSION : CTP regimen has comparable response rates to CAP regimen, with lower incidence of hematolohic and cardiac toxicity.
Cyclophosphamide* ; Cytidine Triphosphate ; Doxorubicin* ; Drug Therapy ; Drug Therapy, Combination* ; Electrocardiography ; Humans ; Incidence ; Leukopenia ; Ovarian Neoplasms*

Nine scaphoid non-unions, which were treated by through curettage of the scar tissue on pseudarthrosis, iliac bone grafts between the fragments and Herbert screws fixation, were analysed. The average follow up period from operation was 16.9 months. The interval between the fracture and the time of the operation ranged from 10 months to 48 months(average 21.6 months). Average union time was 14 weeks after operation. The initial radiologic cystic changes disappeared and overall clinical results were improved. Mean postoperative range of motion of the wrist was flexion 55 and extension 45°. Three of them had DISI deformity preoperatively which their scapholunate angles (mean 104°) has been corrected after reduction (mean 75°). In one case among three DISI deformities, partial radial styloidectomy and triscaphe fusion were added (to bone graft and Herbert screw fixation). A case of incorrect positioning of the screw and a case of neuroma were complicated. Treatment of scaphoid nonunion with curettage of the scar tissue and iliac bone graft and Herbert screw fixation seems to be encouraging to regain the normal anatomy of scaphoid and function of the wrist.
Cicatrix ; Congenital Abnormalities ; Curettage ; Follow-Up Studies ; Neuroma ; Pseudarthrosis ; Range of Motion, Articular ; Transplants ; Wrist