Structural Changes of the Nucleus Pulposus Cells and Cartilage Cells of Age-Related Intervertebral Disc in Mongrel Dog / 대한해부학회지

The intervertebral discs of the dog from the newborn, the 1 year old, and the 5 years old were examined about the cell morphologies and their structural changes according to the advancement of age by histomorphometry and electron microscopy. The three regions of the disc - the nucleus pulposus, the inner and outer annulus fibrosus were considered. Each region was divided into the three zones - the peripheral, intermediate, and central zones. The cell morphology of the three regions were as follows : A. The nucleus pulposus 1. At the newborn, the cells of the nucleus pulposus had long cytoplasmic processes forming large extracellular vacuoles. In the peripheral and intermediate zones, the cells with euchromatic nucleus had fine cytoplasmic granule-like fibers and some of free ribosomes. In the central zone, the cells with heterochromatic nucleus had many cytoplasmic vacuoles filled with free ribosomes. 2. At the 1 years old, the cell-group composed of 4 to 8 cells contacted each other with their cytoplasmic processes. In the peripheral zone, the elliptical chondroblast-like cells with euchromatic nucleus had well-developed rough endoplasmic reticulum and mitochondria. In the intermediate zone, the foam-like large round cells with euchromaic nucleus had multiple cytoplasmic vacuoles filled with granular contents. In the central zone, the cells with heterochromatic nucleus had large cytoplasmic vacuoles, and seemed to be degenerated type of the outer zone-cells. 3. At the 5 years old, the cells in the periphery were rhomboid or polygonal with euchromatic nucleus, and had broad cytoplasmic contact surface with adjacent cells. They had small cytoplasmic vacuoles, well-developed Golgi apparatus and rough endoplasmic reticulum. The cells in the intermediate zone had heterochromatic nucleus and a lot of variable size of cytoplasmic vacuoles, and seemed to be degenerated form of the cells of the periphery. In the central zone, the star-like cells with heterochromatic nucleus had multiple sharp cytoplasmic processes and vacant cytoplasm because of large cytoplasmic vacuoles. B. The cartilaginous part and the inner annulus fibrosus 1. At the newborn, the outer zone of the cartilaginous part of the intervertebral disc showed the isogenous group with 2 to 3 chondrocytes within the cell nest. The cells were distributed mainly around the blood vessels, and had euchromatic nucleus. They had small cytoplasmic vacuoles, well-developed rough endoplasmic reticulum and abundant ribosomes. The cells of the inner zone showed heterochromatic nucleus, well-developed rough endoplasmic reticulum and expanding terminal cisternae. 2. At the 1 year old, the inner annulus fibrosus was divided into the fibrocartilaginous part and the hyaline cartilaginous part. The former, the outer zone showed the cell nest with 2 to 4 of elliptical chondrocytes which had euchromatic nucleus, small cytoplasmic vacuoles and scattered fine granules. The latter, the inner zone showed the chondrocytes within the dissociated cell nest with heterochromatic nucleus. They had disperse rough endoplasmic reticulum and microvilli-like cytoplasmic processes. 3. At the 5 years old, the annulus fibrosus was composed mainly of fibrocartilage. The chondrocyte showed heterochromatic nucleus, long cytoplasmic processes, large cytoplasmic vacuoles and densely packed abundant granules. C. The outer annulus fibrosus 1. At the 1 year old, the outer annulus fibrosus was composed of the palisading collagenous bundles. The chondrocytes with heterochromatic nucleus located in the cartilage cell nest. The cells had well-developed rough endoplasmic reticulum, mitochondria, and Golgi apparatus, and 4 to 5 processes of interterritorial matrix surrounded the collagenous bundles. 2. At the 5 years old, the collagenous bundles were invaded by the processes of interterritorial matrix, and made them incomplete ones. The cell had heterochromatic nucleus and scanty cytoplasm containing small mitochondria and poorly developed organelles. The Summary of The Above Mentioned Findings Are : 1. The cells of the nucleus pulposus were degenerated gradually from the periphery toward the center. 2. The cells of the nucleus pulposus were degenerated gradually according to the aging process. 3. With age, the cells of the annulus fibrosus were degenerated, the hyaline cartilage was replaced gradually by fibrocartilages, and fragmentation of the collagenous bundles appeared. 4. The older the age, the smaller the nucleus of the nucleus pulposus cells, and the larger the nucleus of the annulus fibrosus cells were encountered in the histomorphometric measurement.

Ganglion of the Posterior Cruciate Ligament: 1 case report / 대한정형외과학회잡지

Ganglia of the cruciate ligament are quite rare. About 60 cases were reported previously in the world and 6 cases were reported at two articles in korea. It's symptoms may be similar to those of internal derangement of knee, especially meniscal lesion. We report a case of isolated ganglion of posterior cruciate ligament with brief of literatures.

Bipolar Endoprosthesis between Femoral Neck Fracture and Avascular Necrosis of Femoral Head: Comparison of the Acetabular Migration and Function / 대한정형외과학회잡지

In 1974, bipolar hip prosthesis was developed by Giliberty and Bateman to reduce the problems of unipolar prosthesis, including acetabular wear and acetabular protrusion, but the indications for it are still controversial. From July, 1988, to February, 1991, at Pusan maryknoll hospital, 37 hips in 33 patients of femoral neck fracture (25 hips) and avascular necrosis (12 hips) with relatively normal acetabular articular cartilage were treated with bipolar hip prosthetic replacement. The thirty-seven cases were reviewed for more than 3 years(range, 3 years to 4 years 8 months: average, 3 years 10 months), and assessed in terms of acetabular migration and function. The authors compared the datas of the femoral neck fracture with those of the avascular necrosis of femoral head. There was no statistical difference between two groups in function. But the acetabular migration of bipolar hip prosthesis used in femoral neck fracture was lesser than that of avascular necrosis of femoral head, and the serial acetabular migration disclosed gradual decrease. The authors concluded that the results of bipolar endoprosthesis used in femoral neck fracture was superior than those of avascular necrosis of femoral head with relatively normal acetabular articular cartilage.

The Use of Ender nails in Distal One-Third Fractures of Tibia / 대한정형외과학회잡지

The distal one-third fractures of tibia have much difficulty in treatment due to enumerous complications such as skin necrosis, angular deformity and delayed union. As for using Ender nails in distal tibial fractures, the stability of fixation can be strengthened with fanning of the nails in distal fragments and using more than 3 nails and 1cm longer nail. Twenty-two patients having distal tibial fractures, were carried out Ender nailing at Department of Orthopaedic Surgery, Maryknoll Hospital from May 1989 to September 1992. The results were as follows; 1. The distal end of fracture line was situated from 3cm to 9cm above plafond, and the mean duration of radiological bony union was 14.9 weeks except one case of nonunion. 2. Mild angulation developed in two cases and complications such as nonunion, superficial infection and backing out of nail were noted, but it did not affect the results.

Treatment of the tibial shaft fractures with ender nails / 대한정형외과학회잡지

No abstract available.

The treatment of the lateral malleolar fracture of the ankle with a gripper plate / 대한정형외과학회잡지

No abstract available.

The transscaphoid perilunar dislocation / 대한정형외과학회잡지

No abstract available.

A Treatment of Ipsilateral Shaft Fracture of the Femur and Tibia in Adult / 대한정형외과학회잡지

Twenty-eight cases of fracture of the femur and tibia on the same leg were treated in Pusan Maryknoll Hospital during the period from April 1981 to Jun 1988. We studied all of these patients, divided by five groups according to the method of treatment, with analysis of treatment and end results. The following results were obtained. 1. The incidence of trauma was high in the young man, and most frequent in the third decade (42.9%). 2. The main cause of injuries was traffic accident; 22 patients (78.6%). 3. The common fracture site was middle one-third in femur and tibia respectively. 4. The most common associsted injury was head trauma (9 case). 5. The average healing time of fracture was 20.7 weeks in femur and 22.7 weeks in tibia of group 3, 4, 5. 6. The best results were obtained in cases both fractures stabilized surgically.

The Clinical analysis of Acetabular Fracture / 대한정형외과학회잡지

If the treatment of acetabular fractures are not satisfactory, there will be serious complication such as traumatic arthritis or avascular necrosis of the femoral head. There is much continuing discussion as to where conservative or surgical treatment should be used. The authors experienced 41 cases of acetabular fractures, that wrere treated at the Department of Orthopaedic surgery, Maryknoll Hospital from January 1981 to September 1987. The results of 29 cases who were followed over a 1 year period are as follows:1. According to Letournel's classification, the most common type of elementray fracture was posterior wall(24.1%) and a T- shsped fracture was 10.3 % and both column fractures were 10.3%. 2. Complications were traumatic arthritis(14 cases), superficial infection(5 cases), ectopic ossification(5 cases), osteomyelitis(1 case), AVN of the femoral head(1 case), and iartrogenic femoral shaft fracture(1 case). 3. According to matta's assessment, satisfactory results of conservative treatment were 38% clinically and 38% radiologically, and by surgical treatment, 73% clinically and 64% radiologically. 4. Surgical treatment in acetabular fractures, such as an anatomical reduction and rigid fixation fixation followed by early joint motion were improved the result and decresed the rate of traumatic arthritis.

The Fractured Carpal Scaphoid / 대한정형외과학회잡지

The carpal scaphoid is the commonest of the carpal bones to be fractured, and this injury is the commonest to befall the wrist of working man. There is still some disaggrement as to the optimum treatment and as to how long immobilization should be maintained. The twenty seven cases of the carpal scaphoid were treated at department of orthopaedic surgery, Maryknoll Hospital. They were analyzed in regared to the clinical and radiological aspects. The results were summarized as follows. l. Of 27 cases 24 cases were in the age group 20 to 39, and all cases were male patients. 2. In 17 cases, the fracture was found in right side. 3. In 19 cases (70.4%), the fracture was found on the middle 1/3 of the carpal scaphoid and in 18 cases(66.8%), the fracture line was transverse. 4. The union rate of fracture was 100% in the distal 1/3 fracture, 89.5% in the middle 1/3 fracture and 66.3% in the proximal fracture. The average period of immobilization were 10.3, 14.9 and 15.3 weeks respectively. 5. By Maudsley's assessment, the end result was good in all cases of the distal 1/3 fracture, 84.2% in the middle 1/3 fracture and 66.7% in the proximal 1/3 fracture. 6. Traumatic arthritis developed in 3 cases, avascular ncerosis in 7 cases, nonunion in 4 cases.

A Clinical Study of the Ankle Fracture / 대한정형외과학회잡지

81 cases, 79 patients of ankle fracure treated at pusan Maryknoll hospital from May, 1980 to January, 1986 were analized in clinical and radiological aspect. The results obtained from this study were as following. l. Of the 79 patients, male was 61 patients and female was 18 patients. The average age of the patients was 36 years. 2. Main cause of the injury was traffic accident (35 cases, 43.3%) and the other causes were industrial accident, fall down, slip down, and sports accident in orders. 3. By the classification of Lauge-Hansen, the most common type was pronation external rotation(29 cases, 35.8%). 4. Open reduction was performed in 55 cases(67.9%), and closed reduction in 25 cases(30.1%) 5. The average duration of the cast immobilization was 8 weeks in closed reduction and 7 weeks in open reduction. 6. The result of the treatment was better in those cases of the open reduction than that of the closed reduction. 7. The most poor result was noticed in pronation dorsiflexion type. 8. We agree that Lauge-Hansen classification is useful in diagnosis and treatment of the ankle fracture.

Resection of Lateral Prominence in Malunited Calcaneus: Report of 7 Cases / 대한정형외과학회잡지

Pain snd disability often fractures of the cslcaneus even though the original injury was skillfully treated. The causes are traumstic arthritis of the subtalar joint, abnormalities of the peroneal tendons or weakness of Gastrocnemius, etc. We have experienced the resection of lateral prominence of calcaneus in 7 patients who complained of pain by entrapment of peroneal tendons between lateral malleolus and lateral prominence of malunited calcaneus. The follow up time after operation was 3 years and 4 months to 12 months. In all patients the pain was markedly improved between postoperative 5 weeks and 10 weeks. When the last follow up, 6 patients among 7 patients except one case of subtalar arthritis were astisfaetory.

Resurfacing Prosthesis in Comminuted Fracture of the Patella: Report of 7 Cases / 대한정형외과학회잡지

We have experienced 7 cases of resurfacing prosthesis in comminuted patellar fracture in 5 patients, The follow up time was from 1 year and 6 months to 3 years and 6 months. The dome-shaped plastic patellar prosthesis was used after fracture healing. Each case was evaluated by Levitt's method of evaluation and we compared with patellectomy in “End results of patellectomy” reported by West, F. E. in 1962 in quadriceps power, range of motion, appearance and pain on the knee. The results were as follows: 1. By Levitt's method of evaluation, 6 cases were satisfactory, but 1 case was unsatisfactory. 2. The resurfacing prosthesis was better than patellectomy in quadriceps power, range of motion and appearance, but it was a little more painful.

The Effect of Sliding Inlay Bone Graft with Cancellous Chip Bone Graft in Non-Union or Delayed Union of the Tibia / 대한정형외과학회잡지

In the treament of the non-union or delayed union of the long bone, it is very difficult to achieve union. We have experienced 15 cases of non-union or delayed union of the tibia who were treated by sliding inlay bone graft with cancellous chip bone graft from June, 1979 to April, 1984. The results were as follows: l. In all cases cancellous iliac bone graft were performed, and additionally internal fixation or simple cast immobilization were done for stabilization of the fracture site. 2. The average bone union time was 2.8 months in delayed union and 4.4 months in non-union. 3. 1n 5 failed cases there were reactivation of previous infections. 4. In 5 cases of postoperative infection, sliding grafts were sequestrated in all. 5. The advantage of this procedure in the cases without infection were: 1) In the anteromedial cortex of tibia, such a surgical intervention permits easy skin closure and prevents skin necrosis. 2) Such a procedure can recanalize the obliterated medullary cavity without disturbance of the fracture ends during operation. 6. This procedure was proved to be one of valuable adjuvant method in the treatment of uninfected non or delayed union of the tibiae.