200 cases of bone and joint tuberculosis complicated with mixed infection treated at the Department of Orthopedic Surgery, National Medical Center through the year of 1958 to 1971 were analyzed and reported in this paper. 1. All the mixed infections complicated in bone and joint tuberculosis occurred secondarily as a complication of the formation of fistula in this series. 2. The incidence of the fistula formation as a complication of bone and joint tuberculosis was considerably higher as 117 out of 200 cases in the age group of 10–30 years compared with other age groups. Accordingly the incidence of mixed infection was higher in this age group than other groups in same proportion in this seiies. 3. Mixed infection occurred relatively earlier after the fistuIar was formed. 46 out of 200cases (23%) had mixed infection one month after the fistula was formed. 4. Majority of the fistula developed spontaneously as 129 out of 200 cases (64.5%) 5. 135 cases of fistula developed during the treatment with PAS. and INH, and 11 cases developed fistula during triple antituberculosis therapy with PAS. INH. and Streptomycin. 6. Majority of the causative microorganism was Staphylococcus aureus as 210 out 360 cultures. (58.3%). 7. The result of the treatment was evaluated, and the result of radical operation gave remarkably higher incidence of healing, 110 out of 130 cases, than that of medical treatment, 33 healing out of 64 cases.
Coinfection ; Fistula ; Humans ; Incidence ; Joints ; Orthopedics ; Staphylococcus aureus ; Streptomycin ; Tuberculosis, Osteoarticular

This study has been examined different morphologic measurements in the evaluation of patients with lumbar spinal stenosis. Preoperative CT-Myelography from 30 patients who underwent surgery for central lumbar stenosis were analyzed. Based on this, we concluded as follows : 1) Bony measurement alone did not reliably identify patients with spinal stenosis. 2) Measurement of the transverse area of the dural sac on CT-Myelography was the most accurate method for identifying stenosis. 3) Lumbar myelography was still considered to have an important role in the valuation of a patient with stenosis because of correlation between the cross-sectional area of the dural sac and the anteroposterior diameter of the dural sac was excellent. 4) We identified soft-tissue problems as the main cause of stenosis. 5) The most common level of maximum stenosis was L4-5.
Constriction, Pathologic ; Humans ; Myelography* ; Spinal Stenosis*

The development of the arthroscopic surgery technique presented a great method in the reconstruction of anterior cruciate ligament. There were many debates about the timing of reconstruction in the acute anterior cruciate ligament injury. However, it was regarded true that primary reconstruction in the acute phase have higher complication rate of arthrofibrosis than in the chronic phase. Many authors recommended delay of reconstruction at least 3 weeks in acute tear of anterior cruciate ligament. In contrast, some surgeons have tried to suture the ruptured anterior cruciate ligament accompanied by 'over-the-top' augmentation with the hamstring tendon or the artificial ligament arthroscopically. Since Jan. 1992, the authors have implanted the synthetic polyester ligament(ABC ligament; Surgicraft, U.K.) into the substance of ruptured ligament proper and fixed at the 'over-the-top' position without any procedure for repair of the ruptured anterior cruciate ligament. Our indication for this surgery is only acute rupture of anterior cruciate ligament with good stump condition. We report the clinical results of 22 cases at 20.3 months follow-up(mean) preliminarily. l. On measurement of pre-operative and post-operative differences between the normal and the affected side by Telos stress X-ray study and KT-2000 arthrometer. Differences were markedly improved from 5.6mm(mean: pre-op) to 1.9mm(mean: post-op) on Telos stress X-ray study(on 15 Kp stress) and both knee showed minimal differences on KT-2000 study(2.2mm on 9Kp, 2.5mm on maximum stress) at the time of follow-up. 2. The average Lysholm score was 82. By Clancy criteria, the 20 cases(91%) showed good and excellent results. 3. Second look arthroscopy was available in three cases. In two cases, there were marked fibrous proliferation around the ligament. The stability felt good on probing. We could observe healing-like appearance of ruptured ACL with minimal fibrous tissue proliferation in one another case.
Anterior Cruciate Ligament ; Arthroscopy ; Follow-Up Studies ; Knee ; Ligaments ; Methods ; Polyesters ; Rupture ; Surgeons ; Sutures ; Tears ; Tendons

In the treatment of proximal tibial condyle fracture, it should be considered that it can often accompany injuries of the collateral ligament, both cruciate ligament, and the menisci of the knee. Moreover it is necessary to restore anatomical congruity of the articular surface accurately. We performed reduction of the depressed articular fragment under monitoring of arthroscopy and fixed with cannulated cancellous screws and accompanied by bone graft under the control of image intensifier in 2 cases of Type I(Pure cleavage) and 3 cases of type II(cleavage with depression) fractures. The results were very satisfactory. Arthroscopy assisted reduction and fixation are very useful method in the treatment of proximal tibial condyle fracture because of (1) the minimized operative morbidity, (2) the ability to evaluate and manage associated intraarticular pathology simultaneously, (3) the rapid rehabilitation, (4) the achievement of good reduction comparable to open reduction.
Arthroscopy ; Collateral Ligaments ; Knee ; Ligaments ; Methods ; Pathology ; Rehabilitation ; Transplants

A 68-year-old woman who suffered from polycythemia vera presented at our clinic with the chief complaints of pain, swelling, and a warm sensation in her left thigh. She had undergone a left bipolar hemiarthroplasty following a hip fracture 24 days prior to this presentation. Her erythrocyte sedimentation rate and C-reactive protein (CRP) levels were elevated. In addition, a postoperative infection was suspected in the 3-phase bone scan; therefore, she received intravenous antibiotic therapy. This approach proved to be ineffective and she was subsequently diagnosed with a deep vein thrombosis via color Doppler ultrasonography. It is interesting to note that a deep vein thrombosis can present with symptoms similar to those of a postoperative infection. Furthermore, an elevated CRP level is frequently observed in patients suffering from polycythemia vera. Therefore, the two conditions, which require completely different treatments, can be confused. We report on this case with a review of the relevant literature.
Aged ; Blood Sedimentation ; C-Reactive Protein ; Female ; Hemiarthroplasty ; Hip* ; Humans ; Polycythemia Vera* ; Sensation ; Thigh ; Ultrasonography, Doppler, Color ; Venous Thrombosis*

OBJECTIVES: Causes of diverse clinical sourses of patients with chronic hepatitis B virus(HBV) infection are not fully-known. The host immune response to HBV antigen and the appearance of mutant viruses are believed to be important factors. To determine whether appearance of precore and core mutant viruses are related to the clinical course of the patients, we analysed the entire core region of viral DNA in 7 HBV chronic carriers. METHODS: Serum was obtained from 7 patients(3 chronic active hepatitis, 4 CAH with cirrhosis) and pre-C and core region of HBV were amplified by polymerase chain reaction, then directly sequenced. RESULT: In all 7 HBV DNA there was a point mutation from T to C at nucleotide 2104 of core region, and each DNA also contained 6 to 17 variable point mutations at different nucleotides yielding various amino acid substitution. One of DNA had a point mutation from A to G at nucleotide 1898, converting tryptophan(TGG) to a stop codon(TAG). Two cases of deletion mutations covered C-region segment ranging from nucleotide 2142 to 2306 and one case of deletion covered pre-C region ranging from nucleotide 1815 to 1843. CONCLUSION: Three out of seven DNA contained mutational sites coincided with known immunodominant T cell epitopes and rest of the mutational sites could also affect the antigenecity of the HBV. Therefore, mutant HBV could after the host immune response, and may modulate the clinical course of infection.
Amino Acid Substitution ; DNA ; DNA, Viral ; Epitopes, T-Lymphocyte ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Nucleotides ; Point Mutation ; Polymerase Chain Reaction ; Sequence Deletion

We experienced two cases of de novo fetal chromosomal abnormalities after assisted reproductive technology (ART): One case was reciprocal translocation 46,XX,t(6;14)(p21.3;q12) after intracytoplasmic sperm injection and embryo transfer (ICSI-ET) and the other case was 46,X,iso(Xq) after in vitro fertilizaton and embryo transfer (IVF-ET), both were diagnosed prenatally by amniocentesis and postnatally cord blood culture. We report these cases with a brief review of literatures.
Amniocentesis ; Chromosome Aberrations* ; Embryo Transfer ; Fetal Blood ; Reproductive Techniques, Assisted* ; Sperm Injections, Intracytoplasmic

In order to develop an experimental DNA vaccine for the prevention and treatment of hepatitis B virus infection, hepatitis B virus surface antigen (HBsAg) DNA was subcloned into an E. coli-eukaryotic cell shuttle vector and was expressed in the Baculovirus expression system. Intramuscular, intradermal, and intraperitoneal injections of 30 microg of the plasmid DNA expressing HBsAg induced humoral and cellular immune responses in ICR mice. The first IgG antibodies were detected after ten days and specific IgG antibody titers peaked after two months of a single intramuscular DNA injection. Anti-HBs antibody titers gradually increased and peaked at four months following intradermal DNA injection, and in case of intraperitoneal injection they peaked at seven months. Generation of HBs-specific helper T lymphocytes was also investigated through the production of interleukin-2 by T helper cells. Boosting effects of HBs DNA were investigated without much results. In general, DNA-mediated HBs immunization induced humoral and cellular immune responses in mice that appears to simulate immune responses in human during the course of HBV vaccination.
Animal ; Cloning, Molecular ; DNA, Viral/immunology* ; Hepatitis B/prevention & control* ; Hepatitis B Antibodies/immunology ; Hepatitis B Surface Antigens/genetics* ; Hepatitis B Vaccines/immunology* ; Human ; Interleukin-2/biosynthesis ; Male ; Mice ; Mice, Inbred ICR ; Plasmids/immunology* ; Spleen/immunology ; Spleen/cytology ; Vaccination ; Vaccines, DNA/immunology*

PURPOSE: This study was conducted for comparison of clinical and second look arthroscopic results between early and delayed reconstruction of acute anterior cruciate ligament (ACL) injuries. MATERIALS AND METHODS: Thirty-six patients who underwent ACL reconstruction between March 2008 and October 2011 were enrolled in this study. We divided the patients into two groups, those in the early reconstruction group underwent surgery before one week, and those in the delayed reconstruction group underwent surgery after three weeks, before six weeks. We checked clinical results and second look arthroscopic results and analyzed correlation of clinical and second look arthroscopic results. RESULTS: At the final follow up, the Lysholm, International Knee Documentation Committee, and Tegner score were not statistically different between the two groups (p=0.173, p=0.154, p=0.109). No difference for the range of motion (p=0.808, p=0.680), Lachman test (p=0.377), and pivot shift test (p=0.894) was observed between the groups. In the results of second look arthroscopy, there was no difference in graft continuity (p=0.936), tension (p=0.944) and synovial coverage (p=0.789). No statistical clinical correlation was observed between clinical and second look arthroscopic results (p>0.05). CONCLUSION: We obtained satisfactory clinical and second look arthroscopic results in both the early and delayed ACL reconstruction groups. Therefore, early reconstruction of ACL performed before one week could be a treatment options for acute ACL injury.
Anterior Cruciate Ligament* ; Arthroscopy ; Follow-Up Studies ; Humans ; Knee ; Range of Motion, Articular ; Transplants

In order to study the functions of migration inhibitory factor (MIF) as macrophage activating cytokine and to investigate the possibility of MIF cDNA as gene therapeutic agent or adjuvant, we produced recombinant MIF (rMIF), anti-MIF antibody and pcDNA I plasmid containing mMIF cDNA (mMIF plasmid). We have investigated the effects of recombinant mMIF or mMIF plasmid on the expression of immune response-related gene in the mouse peritoneal macrophage or splenocyte. Recombinant mMIF produced by Baculovirus expression system was biologically active; it increased mRNA expression of tumor necrosis factor (TNF)-a, Interleukin (IL)-1, IL-6, granulocyte monocyte-colony stimulating factor (GM-CSF), nitric oxide synthase (NOS), Fas and Bcl-x when applied to the cultures of mouse peritoneal macrophage. Anti-mMIF antibody blocked these effects of mMIF on macrophage. Plasmid DNA carrying MIF cDNA inoculated into mouse peritoneal cavity also increased mRNA transcriptions from TNF, IL-1, IL-6, IL-12, GM-CSF, NOS genes of peritoneal macrophage. It enhanced proliferation of splenocyte stimulated with phorbol myristate acetate and IL-2 mRNA expression of splenocytes. Frorn these results, we conclude that rMIF is a strong macrophage activating factor and especially MIF plasmid can be used as an immune potentiating DNA drug in gene therapy for cancer or DNA adjuvant in vaccination in future.
Animals ; Baculoviridae ; DNA ; DNA, Complementary* ; Genetic Therapy ; Granulocyte-Macrophage Colony-Stimulating Factor ; Granulocytes ; Interleukin-1 ; Interleukin-12 ; Interleukin-2 ; Interleukin-6 ; Interleukins ; Macrophages* ; Macrophages, Peritoneal ; Mice ; Nitric Oxide Synthase ; Peritoneal Cavity ; Plasmids ; RNA, Messenger* ; Tetradecanoylphorbol Acetate ; Tumor Necrosis Factor-alpha ; Vaccination