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

No abstract available.
Lipoma*

Gastric bezoars are large masses or concretions, composed with plant fiber, hair and miscellaneous foreign bodies, found in the stomach and occur usually as sequele of gastric surgery. We experienced 2 cases of fat bezoars which developed after drinking of melted beef fst. They had postprandial epigastric fullness and pain, those were relieved on supine and left recumbent position. Upper gastrointestinal series showed a large movable mass in the stomach in hoth cases. On gastrofibercopic examination, a large egg sized white bezoar was cordirmed in both cases and a gastrie ulcer at antrum associated in one case. In attempt to removal of the bezoars, we tried to break them, but failed because of its character. The patients were treated with pancreatic lipase containg digestives, Pancreon-F and Azintal. From one day after this treatment, symptoms were completely relieved. Five days later, we confirmed disappearance of bezoars by gastrofiberscopy. and upper gastrointestinal barium
Barium ; Bezoars* ; Drinking ; Foreign Bodies ; Hair ; Humans ; Lipase* ; Ovum ; Plants ; Stomach ; Ulcer

Three cases of giant hydronephrosis containing 9,800 cc, 3,800cc, and 1,300cc, Developed in the Korean soldiers are presented. The important clinical, laboratory and x-ray features are discussed. Brief review of literature was also made.
Humans ; Hydronephrosis* ; Military Personnel

No abstract available.
Humans ; Male*

The mechanism of development of pulmonary edema associated with -sympathomimetic agent is still not fully understood. 2-sympathomimetic drugs such as ritodrine, terbutaline, and fenoterol are widely used for the treatment of premature uterine contraction. We describe a case of pulmonary edema that occurred suddenly during Cesarean section in a previously healthy parturient, associated with ritodrine pretreatment for 5 days in an attempt to arrest preterm labor. Pulmonary edema was completely treated with mechanical ventilation and diuretic therapy.
Cesarean Section* ; Female ; Fenoterol ; Humans ; Obstetric Labor, Premature ; Pregnancy ; Pulmonary Edema* ; Respiration, Artificial ; Ritodrine* ; Terbutaline ; Uterine Contraction

The purpose of this experiment was to determine the effect of dividing the periosteum circumferentially on the growth of long bones and the effect of partial division of the periosteum on the formation of angular deformity of growing bones and to investigate the tethering effect of the periosteum on the epiphyseal plate as its possible mechanism. One hundred twenty rabbits, one-month old with average weight of 570g, were divided into four groups. In the first group, the periosteum of the right distal femur was completely divided circumfer- entially; in the control group, the medial aspect of the right distal femur was surgically approached but the periosteum was not divided, in the third group, the medial half of the peristeum of the right distal femur was divided transversely; in the fourth group, the medial half of the periosteum was divided and resutured. Following the operation, X-rays were taken every two weeks until twelfth week and then at twentieth week and the length of the femur and the physis-shaft angle were measured. l. After complete circumferential division of the periosteum, the ratios of right over left femoral length before operation, and two, four, six, eight, ten, twelve, and twenty weeks postoperatively, were 100.0±0.0%, 102.1±0.1%, 102.±0.0%, 102.9±0.0%, 103.5±0.0%, 103.6±0.0%, 103.5±0.0%, and 103.5±0.0%, respectively. The overgrowth was most conspicuous during the first two weeks. On the other hand, in the control group there was slight overgrowth, but this was not statistically significant. 2. After partial division of the periosteum, the physisvhaft angles before operation, and two, four, six, eight, ten, twelve, and twenty weeks postoperatively, were 91.0±1.2, 87.8±2.5,84.4±2.4, 83.1±3.2, 84.2±3.5, 86.4±2.3, 86.2±2.3, and 86.8±1.9, respectively. The valgus deformity was induced most conspicuously during the first four weeks, whereas partial correction of the de- formity took place between the eighth and tenth week postoperatively. After repair of the partially divided periosteum, only 0.9 of angular deformity was observed at sixth week, but this became statistically insignificant at tenth week as were in the complete division and control groups. 3. Histologically, no difference was observed in the cartiage cells of the epiphyseal plate and the bony trabeculae of the metaphysis between the control group and other groups. The divided periosteum regenerated at the ninth week, this being same also in the repaired group. There was no statistical difference in the thickness of the epiphyseal plate between the operated femur and the opposite normal femur in the completely divided group, this being same in the control group. Threr was also no statistical difference in the thickness of the epiphyseal plate between the medical and lateral halves in the partially divided group, this being same in the repaired group. Based on these results, the investigator was able to draw following conclusions. 1. In the growing long bone, complete circumferential division of the periosteum near the epiphyseal plate results in stimulation of growth and lengthening of bone. 2. Partial transverse division of the periosteum results in asymmetrical overgrowth, inducing an angular deformity. 3. It is suggested that the mechanism of overgrowth following division of the periosteum lies in the removal of the tethering effect of the periosteum. These findings may bear clinical implications on leg length inequality and angular deformities following certain fractures and epiphyseal injuries during growth period.
Bone Lengthening ; Congenital Abnormalities ; Femur ; Growth Plate ; Hand ; Humans ; Leg Length Inequality ; Periosteum ; Rabbits ; Research Personnel

The patellar tendon is known as the strongest material for the substitution of anterior cruciate ligament. There are many technical difficulties in reconstruction of the ligament with this tendon since patellar aponeurosis is weak, and the length of the tendon is restricted, and the adquate insertion in proper place is difficult. Authors harvested the middle 1/3 of patellar tendon c bone block of tibial tubercle and patella with the superficial layer of the quadriceps tendon left attached. The large triangular tibial tubercle piece was impacted into the femoral tunnel from distally to proximally, of which the orifice is the very place of the middle of the original anterior cruciate ligament. Two bundles of 0-dexon sutures made at the tibial tubercle portion, were pulled through to different outlet of femoral condyle during this procedure and were tied over the cortical bone of lateral supracondylar region. The tendon twisted 180°(clockwise for the right knee and counter-clockwise for the left knee) to adapt to screwhome movement. The patellar piece was fixed at the isometric point in full flexion and extension, which is usually the middle point of original tibial insertion c one or two barbed staples made at the original position of tibial insertion of the ligament. We tried this methods in 26 knees (12 vascularized grafts and 14 free grafts) and was followed for more than one year and the results was compared with those of 12 knees of original McIntosh operation (follow up period: 16-72 months, average 34.3 months). The instability were evaluated c Lachman test and OSI sagittal knee tester. The knee of negative Lachman test & pivot shift test was defined as "normal" The results were as follows;l. In modified McIntosh operation group negative Lachman test was noted only in 6 knees (50.0 % ) and there were 2 knees (16.7% ) of GI, II & III, respectively. 2. In vascularized bone block patellar tendon graft group II out of 12 knees (91.7%) showed negative Lachman test and only one knee (8.3%) revealed G II. 3. In free bone block patellar tendon graft 13 out of 14 knees (92.9%) showed negative Lachman test and the other one knee (7.1%) revealed GI. 4, The overall success rate (normal) of bone block patellar tendon graft was 92.3%. The success rate of patellar tendon bone block operation was significantly higher than that of modified McIntosh operation (χ²=6.48, df=1, P=0.0109) and there was no statististical difference between vascularized and free graft group (χ²=0.39, df=l, P=0.5322).
Anterior Cruciate Ligament ; Knee ; Ligaments ; Patella ; Patellar Ligament ; Sutures ; Tendons ; Transplants

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

Subluxation of hip is a disease commonly experienced in orthopaedic field, which is classified into primary subluxation and secondary subluxation. Generally, secondary subluxation of the hip in children who once suffered from infected hips, Legg-Calve-Perths disease and also as sequellae of incompletely treated congenital dislocation of the hip can be often seen in Korea. Especially in Korea, subluxation of the hip with some destruction of the affected femoral head frequently arose from late complication of the tuberculous or septic hip in children. But, no definite treatment for the condition was established and no satisfactory results were obtained with various operative methods. Authors experienced satisfactory result by combining the intertrochanteric varus osteotomy and administration of crystalline glucosamine sulphate (Viatril, Rotta pharmaceuticals, Italy) in subluxated burnt-out tuberculous hip of 6 years old male.
Child ; Crystallins ; Dislocations ; Glucosamine ; Head ; Hip ; Humans ; Korea ; Male ; Osteotomy ; Tuberculosis