Attempt to treat degenerative arthritis of the knee by surgical means have been limited. Patellectomy or patelloplasty may be done in the presence of symptomatic patellofemoral arthritis; and joint debridement, including removal of loose bodies, large osteophytes, and damaged menisci, is occasionally used. Most patients with degenerative arthritis of the knee bear more of their weight on one tibial condyle than on the other. As the articular cartilage degenerates over the tibial condyle that bears the most weight, the natural varus or valgus deviation increases and a vicious cycle is set up in which increasing deformity creates increasing degenerative change. If weight-bearing and other stresses could be increased on this more normal area and decreased on the involved portion, it would been that pain might be relieved and the useful life-span of the knee joint considerably prolonged. The tibia in degenerative arthritis of the knee has become the preferred site for the osteotomy because of restriction of knee motion. The osteotomy is increasingly performed proximal, rather than distal, to the attachment of the patellar tendon at the tibial tuberosity because healing occurs faster in the cancellous bone of the metaphysis as compared with the cortical bone of the diaphysis, and particularly as the quadriceps extensor mechanism stabilizes the osteotomy. We have had 4 cases of modified high tibial osteotomy in the degenerative arthritis patients by division of proximal tibio-fibular ligament instead of removal of fibular head. And the follow-up resutts are “good” in all cases without any complication.
Arthritis ; Cartilage, Articular ; Child ; Clinical Study ; Congenital Abnormalities ; Debridement ; Diaphyses ; Femur Neck ; Follow-Up Studies ; Head ; Humans ; Joints ; Knee ; Knee Joint ; Ligaments ; Osteoarthritis ; Osteophyte ; Osteotomy ; Patellar Ligament ; Tibia ; Weight-Bearing

This is a long term follow-up study to clarify whether arthroscopic synovectomy would be able to prevent further destruction of the articular cartilage in rheumatoid joints. Three hundred and eighteen rheumatoid joints of 94 patients who had surgery in the multiple joints(average 3.4 joints per person) and was followed for an average 39.9 months (range, 24-126 months) were selected. Diagnosis of rheumatoid arthritis was made according to the 1987 revised criteria of the American College of Rheumatology. The preoperative roentgenographic narrowing of cartilage space (modified classification of ARA) and the arthroscopic findings (grading of Outerbridge) were recorded. The points of investigation were 1) further destruction of articular cartilage on X-ray, postoperatively, and 2) reaccumulation of effusion. The results were as follows; 1) Knee Joint: Among 103 knee joints there were 92 (89.3%) Stage I, G-0 knees, 8 Stage II (G-2: 1, G-3: 3, G-4: 4 joints), and 3 Stage IIIB, G-4, preoperatively. The 3 Stage IIIB, G-4 knees showed progression of narrowing of joint space and were replaced by artificial joints two years after the synovectomy. 2) Wrist joint: Fifteen joints (28.3%) out of 53 joints were Stage II, G-4, and 2 joints joints (3.8%) were Stage I, G-3, preoperatively. They were progressed to Stage IIIB at final follow-up. 3) Other Joints: There was no further narrowing of the joint space following surgery in 22 fingers, 2 toes, 34 elbows, 34 shoulders and 70 ankles. 4) Prognosis seemed to depend upon postoperative medication. From these results it would be suggested that the rate and severity of recurrence of synovitis and further destruction of articular cartilage can be decreased with early synovectomy so long as proper anti-rheumatic medication is followed, although the surgery can not halt the disease process.
Ankle ; Arthritis, Rheumatoid ; Cartilage ; Cartilage, Articular ; Classification ; Diagnosis ; Elbow ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Knee ; Knee Joint ; Prognosis ; Recurrence ; Rheumatology ; Shoulder ; Synovitis ; Toes ; Wrist Joint

Since last August, 29 cases of synovial punch biopsy have been carried out with Franklin-Silverman needle which was used in liver biopsy, instead of the specialized needle for the synovium. Authors report the applicable utility of Franklin-Silverman needle for the synovial biopsy, diagnostic value of this procedure and histopathologic findings of the results. The rate of the technical success to abtain synovial tissue was about 76%. Complications after procedure have been very rarely encountered, consisting of mild transient hemarthrosis. In 17 cases, the histopathologic changes was compatible with their clinical findings. In the remainders, we experienced the failures to get synovial tiasue at all in 7 cases and to give the significant synovial changes in 5 successful specimens. Fortunately, the important diagnostic aid was achieved in 3 cases which were conformed early diagnosis of tuberculous arthritis. This needle biopsy was also thought to contribute to rule out the gouty arthritis from other hyperuricemic conditions. But the histologic changes were non specific inflammatory findings in the synovial mambrane of rheumatoid arthritis, osteoarthritis, traumatic and infectious arthritis.
Arthritis ; Arthritis, Gouty ; Arthritis, Infectious ; Arthritis, Rheumatoid ; Biopsy ; Biopsy, Needle ; Early Diagnosis ; Hemarthrosis ; Liver ; Needles ; Osteoarthritis ; Synovial Membrane

The tibial plateau fracture is a common fracture in the knee joint. Tibial plateau fracture involves most always the articulating cartilage and produce the disability of the knee joint oftenly. The 25 cases of tibial fractures have been classified by Hohls method and analysed their clinical courses more than three month period. The 13 cases out of 25 had treated in conservative method such as plaster of Paris with or without closed reduction. Remaining 12 cases were treated operatively due to the failure of closed reduction or associated injury of major ligaments. More than 8 mm of depression or 5 mm split of the plateau fragment is classified as failure of closed reduction. Excellent end result is obtained in 21 cases with free of pain on walking and full range of joint motion without instability and muscle weakness, Three cases were classified as Good result with occasional pain on walking, range of joint motion is available more than 0~90 degree and good grade of muscle power without instability. One case was poor in result with instability of joint and pain on walking. The radiological end result of accurate reduction of fragment is not closely correlated with functional result in the treatment of tibial plateau fracture. The most important factor in the treatment of tibial plateau fracture is the exercises of the joint as early as possible.
Calcium Sulfate ; Cartilage ; Depression ; Exercise ; Joints ; Knee Joint ; Ligaments ; Methods ; Muscle Weakness ; Tibial Fractures ; Walking

No abstract available.
Animals ; Colon* ; Colonic Neoplasms* ; Oncogenes* ; Point Mutation* ; Rats*

No abstract available.
Carcinoma, Squamous Cell* ; Teratoma*

OBJECTIVES: The purpose of this study is to evaluate effects of patients' age, amenorrhea duration, motivation, purpose, regimen, side effects on compliance to hormone replacement therapy(HRT) Methods: Compliance to HRT was assessed in 258 postmenopausal women who began HRT in the Menopause Clinic of Hangang Sacred Heart Hospital, Hallym university. One hundred sixty nine women who had intact uterus received continuous combined therapy with 0.625 mg of conjugated equine estrogen (CEE) and 100 mg of micronized progesterone. Eighty nine women who were hysterectomized received only 0.625 mg of CEE. RESULTS: A total of 103 women (39.9%) reported that they continued HRT at least for one year. Continuation of HRT was significantly more common among women who started HRT becuase of recommendation by gynecologist after hysterectomy in our department (p< 0.05). A greater percentage of women who received only CEE without uterus continued HRT than women who received continuous combined therapy (p< 0.05). Duration of amenorrhea, reasons for taking HRT and side effects such as irregular bleeding or breast tenderness were not related to the continuation of HRT. CONCLUSION: Education of menopausal women about the benefit/risk and side effects of HRT may be critical in improving compliance.
Amenorrhea ; Breast ; Compliance* ; Education ; Estrogens ; Female ; Heart ; Hemorrhage ; Hormone Replacement Therapy ; Humans ; Hysterectomy ; Menopause ; Motivation ; Progesterone ; Uterus

No abstract available.

Percutaneous removal of residual biliary stone was performed through T-tube tract in 10 patients at theDepartement of Radiology, College of Medicine, Seoul National University from November, 1982 to May, 1983. Forpercutaneous biliary stone removal is easy to perform, high in success rate, applicable in outpatient andnegligible in complication, active clinical application of the percutaneous removal is recommended as the primarymethod for residual stone instread of surgical re-operation.
Humans ; Outpatients ; Seoul

Fracture of the femoral neck occurred after internal fixation of intertrochanteric fracture of the femur is very rare and have been described previously in terms of stress fracture, stress-riser fracture, Youngs modulus fracture or iatrogenic fracture in the literature. This fracture documented about 20 cases in the English literature and usually occurred in elderly patients with osteoporosis and it always occur in the subcapital region. We report a case of subcapital stress fracture of the femur occurred after internal fixation with compression hip screw of intertrochanteric femur fracture.
Aged ; Elastic Modulus ; Femur Neck ; Femur* ; Fractures, Stress* ; Hip ; Humans ; Osteoporosis