This is a retrospective review of 11patients of type II SLAP lesion which were found during arthroscopic treatment of 26 patients diagnosed SLAP lesion, clinically and radiologically, hetween March l989 and June 1996. Follow-up time was averaged 26 months (range, l2 months to 72 months) and average age was 30 years old. All patients were treated arthroscopically for SLAP lesion. In type II 2 cases were repaired hy biodegradable tacks (Suretac(R)), 9 cases were repaired by transglenoid and transscapular tcchnique that included dehridement of the frayed lahrum and ahrasion of the superior glenoid neck, followed hy the placement of multiple suture on the torn capsular-labrum complex and lahrum-biccps tendon complex using suture hook, heath pin and # 0 PDS (Rhee's method). Among 9 cases with transglenoid and transscapular suture technique in type II SLAP lesion, the result were quantitated with Rowe ratin scale, 4 cases were exellent, 3 cases were good and 2 cases were fair. Our modification technique, using transglenoidal two bone hole technique and tying on scapular spine can ohtain as compatible fixation as other techniques which include metal staple, bioderadahle tacks (Suretac(R)) and anterior anchoring system such as mini-Revo. Our technique also has reasonable recurrence rate with few complication. The advantage of our modified technique is able to do superior capsular advancement, capsular plication and capsular shift which procedures are very difficult in other techniques. We propose arthroscopic transglenoid and transscapular suture technique (Rhee's method) for type II SLAP lesion as one of new method of suture for type II SLAP lesion.
Adult ; Follow-Up Studies ; Humans ; Neck ; Recurrence ; Retrospective Studies ; Spine ; Suture Techniques ; Sutures ; Tendons

This is retrospective study of the 18 patients of SLAP lesion which were found during arthroscopic treatment of 92 patients. The patients were diagnosed as recurrent shoulder dislocation (50 patients), shoulder impingement syndrome (36 patients) and SLAP lesion (four patients), clinically and radiologically, between March 1989 and June 1995. SLAP lesion were found in eleven patients with recurrent shoulder dislocation, three patients with impingement syndromes. Solitary SLAP lesions were found in four patients. Mean follow-up time was 36 months (range, 12 to 72 months) and average age of patients were 26 years old. Type I SLAP lesion by Snyder's classification were eight cases, type II were seven cases, type III were two cases and type IV was one case. Arthroscopic debridement of frayed or degenerated labrum and biceps tendon anchor were per formed in ten cases of type I and III. In type II and IV, six cases were repaired by arthroscopic placement of multiple suture, two cases were repaired by biodegradable tack (Suretac). The result were quantitated with Rowe rating scale. Eleven cases were exellent, four cases were good, and three cases were fair with Rowe rating scale. Our study revealed that these lesions were not uncommon in instability or impingement of shoulder. Type II SLAP lesion was frequently associated with anterior shoulder instability.
Adult ; Classification ; Debridement ; Follow-Up Studies ; Humans ; Retrospective Studies ; Shoulder ; Shoulder Dislocation ; Shoulder Impingement Syndrome ; Sutures ; Tendons

No abstract available.
Fracture Fixation, Intramedullary*

Forty-five modified arthroscopic transglenoid suture capsulorrhaphy were performed between January 1989 and May 1995 with minimum follow-up of one year among sixty-four recurrent anterior shoulder instability in Chungnam National University Hostital. The average age at operation were 25 year and average time interval from injury to surgery were 12 month. we classify the Bankart lesion into 4 type according to the extent of capsulolabral complex detatchment, associated glenoid rim fracture, type II SLAP lesion and absence of glenoid labrum. Type Ia have a separation of labrum and inferior glenohumeral ligament from the glenoid rim and scapular neck (classic Bankart lesion) and type IIa have a capsular separation and glenoid rim fracture. Type IIIa have above mentioned type Ia or type IIa with type II SLAP lesion and type IVa have capsular separation without identifiable labral structure. We also subdivided the each type into subgroup b according to coexistence of capsular laxity. We modify the capsular suture technique according to classification. Type Ia, and type IIa were treated with in situ Bankart repair. Type Ib and type IIb were treated with capsular advancement. Type IIIa and 1IIb were treated with Bankart repair and additional fixation of SLAP lesion. Type IVa and IVb were treated with purse string type suture (capsular shift superiorly) with multiple stitches. All patients had various shape of Bankart lesion, so author s proposed classification of the Bankart lesion can be applied to each type. Arthroscopic finding were as follows. Twelve shoulders (27%) have type Ia Bankart lesion and six patient (13%) have type lIa lesion. Type lIIa were observed in eight shoulders (18%) and four patient (9%) were type IVa. The capsular laxity (subgroup b) were found in 15 patient (33%). None of the 45 patients experienced intraoperative complications or infec tion. All patients had full, painless range of motion and had no recurrence except four patient. One is type IIIa Bankart lesion in which associated type II SLAP was not repaired and the other two patients had sport injury and one patient had severe retrauma on 2 years after operation. We conclude that Bankart lesion is the essential lesion of recurrent anterior shoulder instability and were founded in all cases of recurrent anterior shoulder instability, and modified athroscopic transglenoid suture capsulorrhaphy according to arthroscopic classification is safe and effective method with acceptable recurrence rate.
Chungcheongnam-do ; Classification* ; Follow-Up Studies ; Humans ; Intraoperative Complications ; Ligaments ; Neck ; Range of Motion, Articular ; Recurrence ; Shoulder ; Sports ; Suture Techniques ; Sutures*

No abstract available.
Extremities* ; Osteogenesis* ; Ultrasonography*

BACKGROUND: There are many reports about the correlation between cardiovascular disorders and estrogen deficiency in postmenopausal women. The purpose of current study is to know that postmenopausal estrogen therapy may affect the lipid metabolism and endogenous fibrinolytic system and exercise tolerance. METHOD: We investigated the relation of estrogen treatment (srogen 0.625 mg/day) to serum lipid levels, angiotensin converting enzyme activity, plasminogen activator inhibitor-1 and parameters of treadmill test in 22 postmenopausal women of normal coronary artery with abnormal exercise test complained with chest pain accompanied by postmenopausal symptoms. RESULTS: Estrogen treatment significantly elevated the serum HDL-cholesterol level (42.8 to 50.1 mg/dl, p<0.05) and reduced the PAI-1 level (16.2 to 10.4 ng/dl, p<0.01) without considerable side effects. During the exercise test, the positivity appearance time and total exercise duration is significantly increased after estrogen treatment. CONCLUSION: The postmenopausal use of estrogen favorably changed the lipid level, fibrinolytic system and might improve the microcirculation which may protect against the ischemic heart disease risk without significant side effects.
Chest Pain ; Coronary Vessels ; Estrogens* ; Exercise Test ; Exercise Tolerance ; Female ; Humans ; Lipid Metabolism ; Microcirculation ; Myocardial Ischemia ; Peptidyl-Dipeptidase A ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Postmenopause

The ethyl acetate fractions prepared from the leaves of Thuja orientalis significantly inhibited nitric oxide (NO) production in lipopolysaccharide-stimulated BV2 microglial cells. According to bioassay-coupled LC-QTOF MS/MS, the components near 22 and 25 mins in the mass chromatogram highly inhibited NO production and were expected to be labdane diterpenes, and the active components were characterized via further isolation. The results of the NO production inhibitory assay of the isolated compounds correlated well with the results of bioassay-coupled LC-QTOF MS/MS. Among the identified constituents, NO production inhibitory activities of 16-hydroxy-labda-8(17),13-diene-15,19-dioic acid butenolide (2) and 15-hydroxypinusolidic acid (3) were newly reported. Taken together, these results demonstrated that LC-QTOF MS/MS coupled with NO production inhibition assay was a powerful tool for accurately predicting new anti-inflammatory constituents in the extracts from natural products. Moreover, it provided a potential basis for broadening the application of bioassay-coupled LC-QTOF MS/MS in natural product research.

Internuclear ophthalmoplegia is a conjugated gaze disorder characterized by impaired adduction on the side of a lesion involving the medial longitudinal fasciculus with dissociated nystagmus of the other abducting eye. Six patients with INO (who had clinical cerebrovascular diseases) underwent MR imaging and the results were as follows: 1. The MLF lesions were identified by MR imaging in 5 cases 2. The ratio of unilateral INO to bilateral INO was 5:1 3. The nature of lesions was infarction in 4 cases and hemorrhage in 1 case 4. The sites of MLE lesion were in the midbrain in 4 cases and in the pons in 1 case 5. All 5 cases of INO identified by MR imaging had other lesion sites in addition to MLE lesion.
Cerebrovascular Disorders* ; Hemorrhage ; Humans ; Infarction ; Magnetic Resonance Imaging* ; Mesencephalon ; Nystagmus, Pathologic ; Ocular Motility Disorders* ; Pons

Arthroscopic treatment of shoulder instability involves two techniques mainly, transglenoid suture technique and anterior anchoring system. However, anterior anchoring system has some disadvantages such as limited indication, high cost, technical difficulty and incapability to suture or reconstruct for all types of Bankart lesion. Disadvantages of transglenoid suture techniques are indirect suture tie, bump effect and possibility of the suprascapular nerve injury. The authors use modified transglenoid suture technique (Rhees method) for shoulder instability involving Bankart lesion, type II SLAP lesion and capsular laxity. The purpose of this study is to accurately describe the relationship between the major neurovascular structures and the pinning sites used in transglenoid suture technique (Rhees method). Placement of two or three arthroscopic Beath pinning sites was simulated in four fresh cadaveric shoulder specimens by placing Steinman pins into the glenoid rim under open field. The specimens were then dissected and the relationship of the pinning sites to the suprascapular nerve and suprascapular artery were recorded. In Bankart lesion repair, safe zone of pinning sites were 2 and 5 oclock in two portals in right shoulder, safe zone of pinning sites were 7 and 10 oclock in two portals in left shoulder. Safe direction of pinning was as possible as inferomedial side in scapula. In type II SLAP repair, safe zone of pinning sites were 2 oclock and just above 2 oclock of glenoid in right shoulder and 10 oclock and just above 10 oclock of glenoid in left shoulder. Safe direction of pinning was pararell to glenoid cavity and slightly superior in horizontal plane. From this study, these sites and directions appeared to be safe. Proper pinning depends on careful attention to the topographical anatomy about the shoulder.
Arteries ; Cadaver* ; Glenoid Cavity ; Scapula ; Shoulder ; Suture Techniques* ; Sutures*

PURPOSE: To assess the MR findings of chondromalacia patella and correlate the grade and associated lesionswith the arthroscopic findings. MATERIALS AND METHODS: Twenty-five patients with pain in the anterior part of theknee underwent fat-suppressed axial and coronal T2-weighted, dual echo sagittal proton density-weighted andT2-weighted, and in some cases, T1-weighted and T2*-weighted imaging, using a 10-cm field of view, and a 5-inchgeneral purpose coil. We retrospectively assessed these find dings, and the locations, grades and associatedlesions, and correlated these with the arthroscopic findings. RESULTS: Fourteen cases(56%) of chondromalaciapatellae were arthroscopic grade I / II, nine(36%) were grade III, and two(8%) were grade IV; associated lesionswere medial synovial plicae (16 cases, 64%), meniscus tear (10 ; 40%), cruciate ligament injury (two ; 8%),complete or incomplete discoid meniscus (four ; 16%), bipartite patella (one ; 4%) and Osgood-Schlatter disease(one ; 4%). In 24 cases, MR imaging indicated chondromalacia patella ; 17 cases were grade I / II, five were gradeIII, and two were grade IV. the location of chondromalacia patella was the medial facet (five cases ; 20%), lateralfacet (three ; 12%), junction of the medial and odd facet (13 ; 52%), and diffuse involvement (four ; 16%). Thesensivity and specificity of MR imaging were 72% and 96% respectively. CONCLUSION: We evaluated the exact locationand grade of chondromalacia patella and associated lesions, as seen on MR images. These and the arthroscopicfindings showed close correlation, and in cases involving this condition, MRI is thus a useful indicator of anappropriate surgical method and plan.
Cartilage Diseases* ; Humans ; Ligaments ; Magnetic Resonance Imaging ; Patella* ; Protons ; Retrospective Studies ; Sensitivity and Specificity