Nitric oxide ( NO ) is now recognized as a mediator of several biological and immunological functions, but unlike classical neurotransmitters, NO simply diffuse of the postsynaptic cell and around affecting cells. Human chorionic gonadotropin ( hCG ), produced by placental trophoblasts may act as stimulator on NO synthesis in oocytes of mouse's ovary. How-ever, in the various organs or cells, the action of hCG on NO synthesis is unknown. We have examined that the effect of hCG on NO synthesis in microglial cells of murine's brain, using the Griess method. And this study was evident that hCG did not induce NO produc-tion without recombinant interferon gamma ( rIFN-gamma), whereas hCG ( 10~500 IU/ml ) with rIFN-gamma effectively produced NO in microglial cells of brain. As result, NO production in microglial cells increased most significantly in dose of 100 IU/ml of the hCG and the pro-duction of NO was dependent on the dose of hCG ( Table 1 and Fig. 1 ). And N(G)-monomethyl-L-arginine ( N(G)MMA ), competitive inhibitor of NO synthase, reduced the NO production by hCG stimulation with rIFN-gamma in microglial cells of murine. Conclusively, this study sugge-sted that hCG stimulate NO production at microglial cells in brain, which may be an important factor for mediating immune and neuroendocrinologic regulation in nervous system.
Brain ; Chorionic Gonadotropin* ; Female ; Humans* ; Interferons ; Negotiating ; Nervous System ; Neurotransmitter Agents ; Nitric Oxide Synthase ; Nitric Oxide* ; Oocytes ; Ovary ; Trophoblasts

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Drug Eruptions*

The concept of surface replacement arthroplasty of the hip is to replace the diseased joint surface with artificial plastic and metal cup in the acetabular and femoral head respectively, and to restore the normal anatomy and gain biomechanical function. Ten cases of Wagner type's surface replacement arthroplasty performed in Department of Orthopedic Surgery, Seoul National University Hospital since July 1979 are reviewed, and their minimum follow up is two months. In terms of the Pain control and improvement of range of motion in the hip, surface replacement arthroplasty showed about the same result compared with conventional total hip. In our cases there was no one complicatian, even though it is too short to evaluate the result of this operation. Wagner recommends surface replacement arthroplasty to perform through anterior approach, but 2 cases of our ten patients that have relatively good range of motion of the hip could be operated on this surgery by anterolateral approach (oblique skin incision) without trochanteric osteotomy, because of high incedence of myositis ossification with anterior approach. It is our conclusion that surface replacement arthroplasty of the hip may be used as an interim procedure to gain time in young patient who needs conventional total hip replacement which reveals increasing complication with the lapse of time.
Acetabulum ; Arthroplasty, Replacement ; Arthroplasty, Replacement, Hip ; Femur ; Follow-Up Studies ; Head ; Hip ; Humans ; Joints ; Myositis ; Orthopedics ; Osteotomy ; Plastics ; Range of Motion, Articular ; Seoul ; Skin

Twelve neglected congenital dislocations of the hip in ten patients over the age of eight years were treated by open reduction and chiari osteotomy. Reduction was aided by preoperative traction only in two hips, by femoral shortening with preoperative traction in three and by femoral shortening only in seven. The average follow up period in our series is 3 years, ranging from 1 year and 2 moths to 4 years and 5 months. The overall results were good but one case of avascular necrcsis and one case of redislocation were seen. By our experience it is thought that all old and congenitally dislocated hip in the growing age can be reduced by femoral shortening with soft tissue release, and preoperative traction for its reduction is not undispensable. The most problem in the treatment of the old congenital dislocation of the hip is the postoperative partial ankylosis in the affected hip and this problem would be overcome by delicate operative technique and meticulous hemostasis.
Ankylosis ; Dislocations ; Follow-Up Studies ; Hemostasis ; Hip ; Humans ; Moths ; Osteotomy ; Traction

The congenital dislocation of the hip is one of the most common congenital disease in the field of the orthopedic surgery. For the normal development of the acetabulum and femoral head, the displaced femoral head shouid be replaced in the acetabular socket as early as possible. In most cases treated in proper time, closed reduction is successful. If not, operative correction will almost always be necessary due to abnormal changes of the acetabulum and femoral head. We experienced 33 cases in 32 patients of the congenital dislocation of the hip at the Department of Orthopedic Surgery of Hanyang University Hospital from May, 1972 to December, 1980. The results obtained were as follows: 1. The most common aged group at the first visit was ranged from 12 months to 24 months and the preponderance of girl to boy was 3.6:1. 2. The ratio of left to right side was 1.6:1. 3. In delivery history, there were 3 cases of breech presentation, 1 case of Cesarean section and 1 case of prematurity. The associated congenital anomaly was observed in a case of which combined internal tibial torsion and talipes metatarsus varus deformity. 4. In 33 cases in 32 patients, 22 cases were treated conservatively and 11 cases were treated surgically. The results of treatment were excellent in 21 cases, good in 11 cases and fair in 11 case. We experienced 4 cases of neglected congenital dislocation of the hip in the period of late childhood, 3 cases were treated with Chiari osteotomy and the other 1 case was treated with Colonna capsular arthroplasty. The overall results were excellent.
Acetabulum ; Arthroplasty ; Breech Presentation ; Cesarean Section ; Clinical Study ; Clubfoot ; Congenital Abnormalities ; Dislocations ; Female ; Head ; Hip ; Humans ; Male ; Metatarsus ; Orthopedics ; Osteotomy ; Pregnancy

Although the goal of fracture treatment is alive bony union with anatomical reduction, prosthetic replacement is indicated for some complicated femoral neck fracture. However it is not defined until now which one is selected between hemiarthroplasty and total hip replacement for the delayed or complicated femoral neck fracture. In order to get the criteria which one is better for this patient when indicated, we reviewed the result of 39 endoprosthetic and 16 total hip replacement patients at Seoul National University Hospital between June of 1975 to June of 1980. Both methods of endoprosthesis and total hip replacement showed satisfactory results of 72% and 90% respectively. Considering two points of the pain-relief and walking ability, total hip replacement is believed to be far better than endoprosthesis, especially for those patients who are over 50 years of age and have had more active living conditions before fracture.
Arthroplasty, Replacement, Hip ; Femoral Neck Fractures ; Femur Neck ; Femur ; Hemiarthroplasty ; Humans ; Joints ; Seoul ; Social Conditions ; Walking

In performance of total hip replacement in the cases of acetabular deficiency, a few authors suggest cement inforcement with screws fixation or bone graft with resected femoral head for repair of it. In our cases another problem was loss of femoral head with acetabular deficiency, therefore resected femoral head could not be used. Our solution to this problem is to use the ilium, as a bone graft and to attach it to the acetabular wall to provide bone stock for the reconstruction. In six hips followed for over one year, all grafts appeared to be united and none showed evidence of resorption. All hips are functionally good and no case shows loosening.
Acetabulum ; Arthroplasty, Replacement, Hip ; Head ; Hip ; Ilium ; Transplants

The dynamic blood flow is regulated by the numerous complex mechanisms. Since blood flow varies directly with the radius of the vessel, blood flow is markedly affected by small changes in the caliber of the vessels. Using the hotoplethysmography, we assessed the relative changes of blood flow after topical application of the vasoactive drugs to the femoral arteries of the rabbits. It is the purpose of this study to evaluate the immediate and delayed effects of the vasoactive drugs such as epinephrine, methylergonovine, chymopapain, and lidocaine in course of time when the drugs applied topically to the vessel. 60 rabbits were divided into 6 experimental groups. In group I, the femoral artery was surgically exposed only. In Group g-A, epinephrine was applied to the femoral artery after surgical exposure. In Group Il-B, after spplication of epinephrine, the effect of epiniphrine was reversed with lidocaine. Another drugs were applied as follows methylergonovine in Group Hl-A, methylergonovine and lidocaine in Group Ill-B as in group Il-B, Chymopapain in Group lV. The relstive changes of blood flow were measured by the photoplethymograph for 3 weeks. The results are as follows ; 1. The amplitude of the photoplethysmographic wave decreased immediately after the topical application of epinephrine, methylergonovine and chymopapain. Such an effect could be observed until the 3rd week after the topical application of the drugs, 2. The delayed dffect of reducing the amplitude could be seen during the 1st week in the epinephrine and methylergonovine treated groups. However, it was seen after 1st week in the chymopapain treated group. 3. The delayed effect of epinephrine and methylergonovine could be reversed with lidocaine. 4. It seems that lidocaine can be used clinically to preyent the delayed effect of epinephrine and methylergonovine.
Blood Vessels ; Chymopapain ; Epinephrine ; Femoral Artery ; Lidocaine ; Methylergonovine ; Photoplethysmography ; Rabbits ; Radius