Since surgical bone banks were set up at several university hospitals in early 1970s, the number of allograft is getting increased in Korean society. Most orthopedic surgeons have used allografts supplied by their own surgical bone banks for tumor reconstruction, arthroplasty, and ligament reconstruction. In 2000, a nation-wide survey for surgical bone banks was performed by Korean orthopedic Association. The questionnaires were prepared by the Committee on Tissue Bank in the Association, and sent to 110 university and training hospitals. Fifty-six surgical bone banks were encountered. However, facilities of the banks were not updated. Most of them were using one or two deep freezers only. Most of them do not have a full-time technician. While most bone banks were using surgically excised femoral heads and amputated limbs, some banks retrieved the tissues from cadaver or organ donors. Since the law for organ transplantation from brain death was established in February 2000, the number of allograft transplantation is growing tremendously. In order to secure the safety of allograft transplantation, the enactment of "the Law for Tissue Transplantation" is mandatory. Unlike organs, the tissues can be procured and stored in advance and can be used whenever they are needed by establishing and operating a form of tissue bank. Therefore, since it is difficult to regulate or supervise tissue banking by "the Law on the Organs and Transplantation", the enactment of a separate law is highly recommended. The government should set the certification standards for the bone and tissue banks suitable for the domestic circumstances. The request of certification of bone and tissue banks should be obtained by the banks that are currently in operation. Also, actual inspection team should be organized involving the professionals and public officers. This team will be responsible for audit of the banks. The certified bone and tissue banks should renew by paper review or actual inspection every 2~3 years. For safe and smooth operation of the banks, the licence system for certified tissue bank specialist(CTBS) should be adopted. Requirements such as academic requirement or professional experience in bone and tissue banks for a certain period of time will be needed.
Allografts ; Arthroplasty ; Bone Banks* ; Brain Death ; Cadaver ; Certification ; Extremities ; Head ; Hospitals, University ; Humans ; Jurisprudence ; Korea* ; Ligaments ; Organ Transplantation ; Orthopedics ; Quality Improvement* ; Surgeons ; Tissue Banks ; Tissue Donors ; Transplants

No abstract available.
Candidiasis* ; Drug Therapy* ; Lymphoma, Non-Hodgkin*

No abstract available.
Candidiasis* ; Drug Therapy* ; Lymphoma, Non-Hodgkin*

Allografts or autografts of bone-tendon unit have been used for ligament injuries or deficiencies after limb salvage operation for malignant bone tumors around joints. While the remodeling process of the ligament or tendon of the allograftor autograft and the microscopic and biomechanical changes of tendon-bone graft interface have been widely investigated, little is known about the ultrastructural and biochemical changes of the transitionall zone in tendon-bone junction. This study was performed to analyzed the ultrastructural and biochemical changes of the transitional zone after tendon-bone auto-and allo-grafting. A total of twenty four rabbits were divided into two group. In 12 animals(allograft group), two Achilles ten-don-bone unit per each animal were taken and transplanted to another rabbit after preservation below -70degrees C for 2 weeks. In the other 12 animals(autograft group), the Achilles tendon-bone unit was harvested from one side and transplanted to the other side of the rabbit. After operation, their legs were immobilized with short leg cast for 4 weeks, and then mobilized freely. Four animals in each group were sacrificed at four, eight and sixteen-weeks after the transplantation, and their grafted Achilles tendon-bone interfaces were used for analysis of the ultrasturctural and biochemical changes. The following results were obtained. 1. Histologically new cartilage cells were observed at postoperative 16 weeks with local presence of faint tidemark in the autograft group but not in the allograft group. Complete remodeling of the transitional zone had not observed histologically in both groups. 2. Ultrasturctural analysis revealed no definite differences between both groups. However, the slightly rapid appearance of parallelism and cross-striation of microfibrils in the autograft group and time-related restoration of fibers and fibroblasts were observed. 3. From biochemical analysis, type I collagen concentratin was increased, and an early rapid increase of type III collagen and glycosaminoglycan were also observed. In conclusion, these data suggested that type III collagen and glycosaminoglycan are important in stabilization of grafted tendon-bone unit, especially in the transitional zone. The histological and biochemical changes in allograft group were relatively similar to that of autograft group although the allograft group showed the delayed pattern of remodeling. Therefore, the tendon- allograft could be used as a good substitute for the autograft for tendon or ligament reconstruction when no suitable autograft is available.
Allografts ; Animals ; Autografts ; Cartilage ; Collagen Type I ; Collagen Type III ; Fibroblasts ; Joints ; Leg ; Ligaments ; Limb Salvage ; Microfibrils ; Rabbits* ; Tendons ; Transplants*

The status of health administration and medicare insurance program of 58 universities and colleges of 4-year course was studied in 1971 and the following results were obtained; 1. The average number of students of 20 universities was 4,800+/-2,600 and that of 36 colleges was 780+/-620. 2. The types of health service facilities for the students varied widely according to the institutions, from an elaborate one, university health center, to a poor one first aid room. 3. Thirty-six out of 58 institutions had some sort of health service facilities, either health center or health service room. And 14 out of 36 institutions had elaborate health service facilities such as university health center or student health center. 4. The number of full time staff of the health center and that of the health service room were 2 to more than 10 and 0 to 3 respectively. 5. The range of student health service fee varied widely according to the institutions from won50 to won550 per student, per semester. The average cost of student health service fee at the institutions with health centers was won300+/-150 and that with health service rooms was won200+/-150 per student, per semester. 6. Utility rate of the student health service facilities at the institutions with health centers and with health service rooms were 1,200 to 1,400 and 3,900 to 4,100 per 1,000 students per year. 7. There was an obvious increasing tendency of tuberculosis prevalence rate in the students. 8. The institutions which had appointed hospitals for student medicare were 24 ; where the reduction rate of medical expenses for students varied from 10 to 50 percent. 9. Students medicare insurance program was adopted by six universities which accommodated more than 2,000 students. 10. The range of student medicare insurance fee varied widely according to the institutions from won140 to won800 per student per year. Each of the six universities which had adopted the insurance program had each own's special regulations to apply for pay claims.
Fees and Charges ; First Aid ; Health Services ; Humans ; Insurance* ; Korea* ; Medicare* ; Prevalence ; Social Control, Formal ; Student Health Services ; Tuberculosis

The status of health administration and medicare insurance program of 58 universities and colleges of 4-year course was studied in 1971 and the following results were obtained; 1. The average number of students of 20 universities was 4,800+/-2,600 and that of 36 colleges was 780+/-620. 2. The types of health service facilities for the students varied widely according to the institutions, from an elaborate one, university health center, to a poor one first aid room. 3. Thirty-six out of 58 institutions had some sort of health service facilities, either health center or health service room. And 14 out of 36 institutions had elaborate health service facilities such as university health center or student health center. 4. The number of full time staff of the health center and that of the health service room were 2 to more than 10 and 0 to 3 respectively. 5. The range of student health service fee varied widely according to the institutions from won50 to won550 per student, per semester. The average cost of student health service fee at the institutions with health centers was won300+/-150 and that with health service rooms was won200+/-150 per student, per semester. 6. Utility rate of the student health service facilities at the institutions with health centers and with health service rooms were 1,200 to 1,400 and 3,900 to 4,100 per 1,000 students per year. 7. There was an obvious increasing tendency of tuberculosis prevalence rate in the students. 8. The institutions which had appointed hospitals for student medicare were 24 ; where the reduction rate of medical expenses for students varied from 10 to 50 percent. 9. Students medicare insurance program was adopted by six universities which accommodated more than 2,000 students. 10. The range of student medicare insurance fee varied widely according to the institutions from won140 to won800 per student per year. Each of the six universities which had adopted the insurance program had each own's special regulations to apply for pay claims.
Fees and Charges ; First Aid ; Health Services ; Humans ; Insurance* ; Korea* ; Medicare* ; Prevalence ; Social Control, Formal ; Student Health Services ; Tuberculosis

Benign tumors and tumor like lesions in the foot are uncommon and those that are malignant are rare. Metastatic cancer of bone distal to the knee and elbow is unusual. By contrast, non-tumorous lisions that cause swelling, pretuberance, or deformity are common. Fifty two cases of tumors on foot were treated at our department from Jan. 1970 to Dec. 1991, we have treated fifty two cases of foot tumor and analysed their clinical characteristics. Bone tumors were more frequent than soft tissue tumors (2:1). Among soft tissue tumors benign tumors were frequent than malignant(1.4:1), and fibroma was the most frequent tumor(30%). Benign soft tissue tumors occured frequently at Edward and Michael's Zone 3(57%). Benign bone tumors has higher incidence than malignant(20:1). Osteochondroma was the most frequent tumor (48%). Predilection sites for osteochondroma and enchondroma of foot was distal phalanges and mitatarsal bone, respectively.
Bone Neoplasms ; Chondroma ; Congenital Abnormalities ; Elbow ; Fibroma ; Foot ; Incidence ; Knee ; Osteochondroma

The object of treatment of Legg-Calve-Perthes disease (L.C.P.D.) is to shorten the clinical course and minimize, or prevent residual deformity, This is accomplished by placing the femoral head deeply within the acetabulum, so that its articular surface is completely contained and maintaining a full range of motion, thereby preventing lateral extrusion of head, concentrated vertical loads and collapse. The purpose of this study was to determine the predicting value of prognosis and correlation of three different evaluating methods, when examining an identical series of radiographs to assess the effect of treatments, and to determine whether the result obtained by femoral osteotomy gave better result than those by non-surgical means. During the past ten years prior to writing, 89 patients with L.C.P.D. were treated by authors. Seventy eight (87.6%) patients were boys and 11 (12.4%) girls. Their ages at the time of initial visit ranged from 2 to 13 years. Twelve (13.5%) patients had bilateral and 77 had unilateral involvement for a total of 101 hips. They were analysed according to Catteralls classification, and also comparative study was done for 32 patients who were followed up over 15 months. The longest follow-up was 5 years and 2 months. They were divided into 2 groups: clildren in group A were treated by rest and abduction brace,. followed over 3 years and 3 months in average, and children in group B were treated, by intertro-chanteric osteotomy, followed over 2 years and 6 months in average. End results for 32 cases were evaluated at each follow-up time by Length/Width Index (L/W.I.) of femoral neck (Robichon, 1974), Migration Index (M.I.) and Spherical quotient (S.Q.) of capital femoral epiphysis (Edsberg et al, 1979). L/W.I.,M.I, S.Q. were used not only as the method of evaluation, but also were used as a predicting the prospective clinical course during the treatment by regular measurement whether it takes the good course or not. Results obtained were as follows: 1. 21(20.8%) were classified as group I, 30(29.7%) as group Il. 31(30.7%) as group III and 19 (18.8%) as group IV. 43 children (42.6%) on their initial visit were found to have this diasbling hip condition at stage II (necrosis and early fragmentation stage). 2. Regardless of the type of treatment, good results were obtained in younger children under age of 7 years, and in mild form as in group I, and lI. Also good, results were obtained in the cases who had treatment at early stage of the disease. No difference was found in the end results between girls and boys when they had same degree of head involvement. 3. In 14 surgically-treated patients, the good results were obtained in 9(64.3%) when assessed by L/W I. 10(75.4%) by M.I., and 7(50%) by S.Q., while in 18 conservatively treated patients good results were obtained in 8(44.4%) when assessed by L/W I. in 6(33.3%) by M.I., and 7(38.7%) by S.Q.. This fact means that S.Q. under-estimates the results of well-treated cases, while M.I. seemingly over-estimates them. 4. when X-rays of the hips were taken in different position's, different L/W Indices were unexpectedly obtained; these deviations in assessment may be listed as a drawback. Migration Index can prognosticate the healing process of the disease during treatment, if the index together with medial joint space is measured repeatedly with certain intervals. Also it is difficult to obtain accurately the S. Q. by measurements because of difficulty locating the center of fragmentary head, but it is considered the best method assessing the end-result at the healed stage. S.Q. expresses the head spherocity, while the M. I. expresses the degree of head coverage and the neck L/W.I. expresses the indirectly amount of neck deformity. 5. When the clinical course is assessed by three evaluating methods, occasionally these three results contradict to each other and do not show similar prognostic tendency or trend. The reason is that neck L/W Index and Spherical quotient indicate directly the progress of the disease while Migration Inex receases only the state of femoral head containment and there by indirectly indicates ensuing prospective course when containment is good, and do not indicate the state of severity of the involved head. 6. In this study, the result of surgically treated patients were superior to those of conservatively treated patients.
Acetabulum ; Braces ; Child ; Classification ; Congenital Abnormalities ; Containment of Biohazards ; Epiphyses ; Female ; Femur Neck ; Follow-Up Studies ; Head ; Hip ; Humans ; Joints ; Legg-Calve-Perthes Disease ; Methods ; Neck ; Osteotomy ; Prognosis ; Prospective Studies ; Range of Motion, Articular ; Writing

Isolated avulsion fracture of the tibial attachment of the posterior cruciate ligament has been thought very rare. We also had experienced only nine cases of above injury in our center during 5.5 years from January, 1976 to June, 1981. Eight cases of them were followed for an average of the thirteen months, but one of them was eliminated from the study because follow-up study was impossible for the case. The purposes of this paper are to present eight cases of isolated avulsion fracture of the tibial attachment of the posterior cruciate ligament and to discuss the causes and mechanisms of the injury and the method of screw fixation for the avulsed fracture fragment. Seven were injured by traffic accident and one by fall on the knee. All cases seemed to be injured by the force directed against the flexed knee which violently stroke the anterior surface of the proximal end of the tibia or inferior portion of the knee and drove it backwards. We found the tear of posterior capsule only in one patient who was seeming injured by extensive force. All cases were treated operatively by means of screw fixation, and excellent results were obtained in five cases, good in two, and fair in one case.
Accidents, Traffic ; Follow-Up Studies ; Humans ; Knee ; Methods ; Posterior Cruciate Ligament ; Stroke ; Tears ; Tibia

It is well known that early diagnosis and early treatment is very important for the patient with congenital dislocation of the hip joint to provide a favorable function in the whole life. The goal of treatment, which is either conservative or operative, is to replace the dislocated hip into the socketand restore its anatomical position. If the head is reduced lately, it may subluxate or redislocate. As a result, secondary osteoarthritis will be complicated in such hips at a laterdate The most cases of congenital dislocation of hip have a increased anteversion and vaglus deformity. It is known that these deformity are cause of redislocation or subluxation, and should be corrected by varus or derotational varus osteotomy to restore for normal cephalocotyloid relationship. We analized 18 residual subluxation of hips which had been treated by derotational varus osteotomy. The results obtained are as follows. 1. Regardless of the age at the time of osteotomy and the amount of varization, the neck-shaft angle corrected to nearly normal in all cases within 3 years after the osteotomy. 2. Acetabular development, indicated by acetabular index, was satisfactory when the osteotomy was done before 4 years, but unsatisfactory in the cases after 4 years of age. 3. Coxa valga epiphysialis of the subluxated head corrected spontaenously after osteotomy in all cases. 4. Subluxated head, indicated by C-E angle and migration percentage, reduced in the cases who had by the derotational varus osteotomy in patients below age of 4 years, but it persisted without further luxation in the cases over 4 years of age.
Acetabulum ; Congenital Abnormalities ; Coxa Valga ; Dislocations ; Early Diagnosis ; Head ; Hip Joint ; Hip ; Humans ; Osteoarthritis ; Osteotomy