In Korea, owing to effective vaccination, occurences of poliomyelitis begen to decrease rapidly from 1964 and in recent years less than 10 cases of acute infection are being reported annually. However, patients crippled with poliomyeltis residua, mainly the legacy of the many epidemics of 1950s, and early 1960s, are many and pose a social and national problem as well as a personal and family ordeal. We reviewed 536 patients with residual poliomyelitis admitted and treated at Seoul National University Hospital during the past 18 years, from 1963 to 1980 They were divided into four chronological groups; the first, 1993 to 1968, the second 1968 to 1973, the third, 1974 to 1977, and the fourth, 1978 to 1980, In each group, based on in-patient records, and out-patient records, epidemology, deformities, and treatment were extensively reviewed. The followings are the outcome of this investigation 1. The male-to-female ratio was 53.7%: 46.3%, The male majority, distinct in the first group with 63. 7%, became less conspicuos in the fouth group with 50. 3%. 2. Average age oe admission, which was 10. 7 years in the first group, had increased decidedly to 17. 8 years in the fourth group. 3. The age of onset was most frequent between 1 to 2 years with 45.8% and next frequent between 7 to 12 months with 23. 5%. The ages below 5 years occupied 97. 6% of the cases. 4. The year of onset was most frequent from 1961 to 1963 with 28.7%. The incidence markedly and steadily decreased thereafter. 5. 94. 5% of the cases were unvaccinated. The remaining cases, except one, had had incomplete vaccination. 6. Fever, with 74. 0% was by far the most frequent initial symptom. Vomiting and diarrhea were the next frequent symptoms. 7. Of the 60% of the patients who had had any previous treatment, 25. 9% had operations and 20. 4% had braces and crutches. 8. Average number of admissions per patient were 1. 7 and average number of operations were l. 9. Average length of hospitalization was 39. 2 days. 9. 23. 6% of the patents had hip deformities, of which flexion defermity was most frequent with 4. 7%. Soutter fasciotomy or Campbell operation was employed in order to correct flexion deformity. In the earlier groups, Mustard operation, Sharrard operation, Ober-Barr operation, and pem-berton osteotmy were commonly practiced, whereas in the later groups, Thomas-Thompson-Straub operation, combined Thomas-Thompson-Straub and Ober-Barr operation, Salter osteotomy, Chiari osteotomy, Steel osteotomy were favored. 10. 45.2% of the patients had knee and leg deformities, of which flexion deformit; was most frequent with 14.5%. Flexion-valgus-external rotation deformity and flexion-valgus deformity with 4.6% and 4.5%, respectively, followed next. 11. 83. 9% of the patients had foot and toe deformities, of which equinovarus deformity occupied 6. 5% equinovalgus deformity 6.8%, and clawing of great toe 25. 2%. Triple arthodesis was done most frequently with 45. 9% of the cases, or 282 feet. Jone's operation or its modification, Tendo Achilles lengthening, plantar fasciotomy, and Peroneal tendon transfer were also frequntly performed. 12. There was leg length inequality in 90%. of the cases, Epiphysiodesis and femoral shortening were carried out, except for 4 cases of stapling in the earliest group, and femoral lengthening was done in 3 cases. 13. Spineal deformity was found in 19.7 % Of the cases, of which scoliosis was most freqent with 11. 5%. 7% of the cases had pelevic obliquity. Lumbodorsal fasciotomy, and postrior spinal fusion with Harrington instrument were carried out in order to ameliorate these deformities. 14. Deformities in the upper extremity were found in 3.6% of the patients. Procedures carried out inclulded shoulder fusion, Saha's operation, Steindler's flexorplasty, sternocleidomastold transfer, wrist fusion and opponensplasty, etc. 15. Generally, there was marked improvement of disability after treatment. The patients having moder.ate to severe limping decreased from 41.3%, preoperatively, to 25% after operation.
Age of Onset ; Animals ; Arterial Switch Operation ; Braces ; Clubfoot ; Congenital Abnormalities ; Crutches ; Diarrhea ; Fever ; Foot ; Hip ; Hoof and Claw ; Hospitalization ; Humans ; Incidence ; Knee ; Korea ; Leg ; Leg Length Inequality ; Male ; Osteotomy ; Outpatients ; Poliomyelitis ; Scoliosis ; Seoul ; Shoulder ; Spinal Fusion ; Steel ; Tendon Transfer ; Toes ; Upper Extremity ; Vaccination ; Vomiting ; Wrist

No abstract available.
Tendons*

There have been numerous hypotheses about the pathogenesis of idiopathic scoliosis, but it is still unclear. There are some reports that abnormalities of contractile proteins may play a role in the pathogenesis of idiopathic scoliosis. The purpose of this report is to study the quantitative abnormalities of contractile proteins in muscles and nonactivated and activated platelets, and to determine whether or not the abnormalities in contractile proteins may play a role in the pathogenesis of idiopathic scoliosis. The materials were 21 idiopathic scoliosis patients aged from 13 years to 28 years(average 19.2 years) and 20 persons aged from 17 years to 25 years(average 20.1 years) as a control group. The electrophoretic analysis(SDS-PAGE method) was done on platelets both unstimulated and stimulated with thrombin and also on proteins of paraspinal muscles and gluteus maximus of idiopathic scoliosis patient and paraspinal muscles of control group. The results are as follows. 1. The myosin/actin ratios of triton-insoluble fractions to paraspinal muscles in convex sides of main curvatures of scoliosis patients(1.69±0.81) were significantly decreased compared to those of concave sides(2.55±1.28), gluteus maximus muscles(2.56±1.70) and control group(2.61±1.01). 2. There were no significant differences between scoliosis group and control group in the actin/myosin ratios of triton-insoluble fractions of the platelets both nonactivated and activated by thrombin. In conclusion, abnormalities of contractile protein in paraspinal muscles of convex side may play a role in the pathogenesis of idiopathic scoliosis, rather than abnormalities of systemic contractile protein.
Actins ; Blood Platelets ; Contractile Proteins ; Humans ; Muscles ; Myosins ; Paraspinal Muscles ; Scoliosis ; Thrombin

This paper presents the result and statistical analysis of the experiment, in which selective anterior or posterior rhizotomy were carried out under microscopic surgery. The materials used for the experiment were 48 young rabbits, and they were divided into four groups. The group I, which was used as control, was subjected to lower dorsal bilateral laminectomies with dural incision, the group II to laminectomies with three right posterior rhizotomies, the group III to laminectomies with three right anterior rhizotomies, and the group IV to laminectomies with three right anterior and posterior rhizotomies. Scoliosis was induced in group Il, Ill and IV. There was no significant statistical difference in the degrees of curvatures among these three groups. The convexity of the curvature faced to the side of the divided roots. In group III and IV, scoliotic curvatures were obvious within two weeks, but there were no considerable changes thereafter. In group Il, the curves progressed slowly up to the 12th week. They were statistically significant at the 4th week and increased continuously thereafter. The histological findings in the group III and IV showed denervation atrophy of the paravertebral muscles at the apex of the curvature, but there was little or no muscle atrophy in the group I and II. We came to a conclusion from the experimental results that scoliosis may be induced not only by anterior root paralysis but also by selective posterior root paralysis.
Atrophy ; Denervation ; Laminectomy ; Muscles ; Muscular Atrophy ; Paralysis ; Rabbits ; Rhizotomy ; Scoliosis

Total hip replacement arthroplasty is the most commonly used method in the surgical treatment of degenrative arthritis of the hip nowadays. If degenrative arthritic changes of the hip is caused mainly by abnormal femoral head, and the acetabular chnages are secondary to it, replacement of the femoral head without acetabular implanting can be expected to elicit regenerative acetabular changes secondary to the newly implanted femoral head component with spherical contour. 8 cases of degenerative arthritis of the hip were treated with bipolar endoprosthesis at the Seoul National University Hospital from January, 1987 to November, 1988 Acetabular reaming to the subchondral bone was performed in all the cases. In 2 cases, bone graft was added for augmentation of the thin medial wall. The mean follow-up was 15.5 months ranging from 12 to 26 months. The results were compared with 18 cases treated with total hip replacement arthroplasty during the same period. Both two groups showed no significant difference in the postoperative improvement of the range of motion and Harris score. In 2 cases treated with bipolar endoprosthesis, follow-up radiographs demonstrated some improvement of the degenerative changes such as subchondral sclerosis or cyst, which suggests the occurrence of the regenerative reaction in the scetabular side. 7 cases among 8 cases were pain-free, and 1 case had mild pain. In conclusion, bipolar endoprosthesis can be considered as another useful, less invasive method with shorter operation time in the surgical treatment of degenerative arthritis of the hip although more expericnces and longer follow-up are needed.
Acetabulum ; Arthritis ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Head ; Hip ; Methods ; Osteoarthritis ; Range of Motion, Articular ; Sclerosis ; Seoul ; Transplants

Cervical spine injury, because of its increasing frequency and catastrophic neurological complication, has attracted many attention of every orthopedic surgeons. Moreover, the indications of surgical treatment and the indications of anterior or posterior fusion have been argued till now. Forty-one patients with cervical spine injury had been treated operatively at Department of Orthopedic Surgery, Seoul National University Hospital from January, 1980 to April, 1987. The surgically treated patients were followed up from 1 year to 7 years with average duration of 2.5years. We performed this study to define the advantages of the surgical treatment, the indications of the anterior and posterior fusion, the postoperative neurological changes, the importance of early reduction, and the result of surgical treatment in late instability cases and obtained the following results. 1. Flexion-rotation injury, in twenty three patients(56.0%), was the most frequent mechanism of injury. 2. Anterior decompression and fusion was performed in 8 patients(19.5%) when there were neural compression by fractured bone fragment or ruptured intervertebral disc material and rupture of anterior longitudinal ligament with hyperextension injury, without poterior ligament complex injury, and posterior fusion and wiring in 33 patients(80.5%) when there were upper cervical spine(C1, C2) injuries and posterior ligament complex injury. 3. Neurological involvements were observed in 35 patients(85.4%) on arrival, and partial and complete neurological recoveries were obtained in 20 patients(57.1%) out of 35 patients postoperatively. 4. Neurological recovery was obtained in 80% when the closed reduction was performed within 12 hours after the injury and only 40% after 12 hours. 5. Neck pain and/or neurology was improved in all 9 patients with late instability postoperatively. 6. Postoperative complication rate was totally 43.9%, but direct surgical complications were 2 cases(4.9%) out of 18 cases.
Decompression ; Humans ; Intervertebral Disc ; Ligaments ; Longitudinal Ligaments ; Neck Pain ; Neurology ; Orthopedics ; Postoperative Complications ; Rupture ; Seoul ; Spine ; Surgeons

PURPOSE: The replacement of functional genes into cells that lack genes or mutant genes is the basis of gene therapy. In cancer, where cells often have multiple genetic defects, the replacement of critical genes may suffice to suppress cell growth or induce cell death. In malignant brain tumors, p53 mutation are among the most frequently observed genetic findings and inactivation p53 suggests that p53 plays a critical role in carcinogenesis and tumor progression. Therefore, we study the successful transfer of the wild-type p53 gene using a replicative deficient adenovirus vector into human glioma and medulloblastoma c~ell lines. Meterials and Methods: The human glioma cell line T-98G, U-87MG, U-373MG were used. To determine the efficiency of the adenovirus vector, cell lines were transfected with the Ad-p gal and analysed with X-Gal staining. Cell viability was determined by trypan blue exclusion every day after infection and Westem blot analysis was used to conform the expression of the exogenous p53 protein. RESULTS: Cell growth of the Ad-CMV-p53 infected U-373MG, and U-87MG was significantly suppressed. It appeared that exogenous p53 protein expression had an earlier ad more profound suppressive effect on U-373MG having a mutated p53 gene than on U-87MG having a wild-type p53. The expression of the exogenous p53 was more than 10 times higher than the expression of the endogenous p53. To examine the decreased viability, U-373MG was stained with Hochest 33258 and detected nuclear condensation and apoptic body. Staining results suggest that cells undergo apoptosis. CONCLUSION: The replicative deficient adenoviral vector can transfer and express p53 in human glioma cell lines in vitro, restoring wild-type p53 tumor suppressor functions. The restoration of normal p53-encoded protein in the mutant ceil lines induced cell death. The high expression of the newly transduced protein had different effects on the growth rate of the infected cell lines depending on the p53 status of the cells.
Adenoviridae* ; Apoptosis ; Brain Neoplasms ; Carcinogenesis ; Cell Death ; Cell Line* ; Cell Survival ; Genes, p53 ; Genetic Therapy ; Glioma* ; Humans ; Medulloblastoma ; Trypan Blue

The biomechanical responses, such as nucleus pulposus pressure, facet contact force, stress distribution among ligaments in the cervical spine under static loading like flexion and extension, were examined with 3-D nonlinear finite element model. Finite element model consisted of whole cervical spines with intact discs and ligaments was developed from 1mm thick CT-cross sections of a 25-year-old healthy young man. Geometrical nonlinearity was considered for the large deformation and ABAQUS package was used for calculation. Results were verified comparing with those of existing in vivo and in vitro experiments. Results indicated that, developed cervical spine FEM was well consistent with other experiments. Nucleus pulposus pressure increased in flexion and extension more in lower cervical region. Facet contact force increased more in lower cervical spine in extension. In addition, capsular ligament was the most important one among 7 cervical ligaments surrounding cervical spine both in flexion and extension. We could better understand the biomechanics of whole cervical spine with developed finite element model and it might be applied to dynamic or postoperative study.
Adult ; Humans ; Ligaments ; Spine*

Exploratory analysis was conducted in a health screening data which had been collected in residents of Taegu city in 1986 to seek out items of serum chemistry associated with hypertension. Six-hundred residents mere than 20 years of age were sampled by the multistage cluster sampling method. Because blood sampling and blood pressure measurements were possible in 384 residents of 600, the rest of 216(36%) were replaced with the healthy visitors to the Department of Health checkup, matched with age and sex. Fivehundred eighty subjects were used in the defined above systolic blood pressure 141mmHg and/or diastolic pressure 91mmHg. The most common age group was under 29 years of age in both sexes, with 103(38.3%) in males and 125(40.2%) in females. Mean body weight of males was Hypertensives were 24(8. in males and 21(6.8%) in females. The items of serum chemistry which showed p values less than 0.25 were glucose, albumin, total cholesterol, ALP and AST in males and glucose, creatinine, albumin, total cholesterol, AST and ALT in females. After controlling age and body weight, glucose and AST showed slightly decreased regression coefficients(beta=0.030, S.E.=0.018, beta= 0.021, S.E.=0.012, respectively) and p values 0.09, 0.08 respectively while albumin, total cholesterol and ALP showed substantially larger p values than unadjusted ones in males. After controlling age and body weight, total cholesterol only remained statistically significant (beta=0.015, S. E. =0. 007, p=0.04). These results suggested that certain items of serum chemistry might be associated with hypertension.
Blood Pressure ; Body Weight ; Chemistry* ; Cholesterol ; Creatinine ; Daegu ; Female ; Glucose ; Humans ; Hypertension* ; Male ; Mass Screening

Descending necrotizing mediastinitis (DNM) is one of the most lethal form of mediastinitis originating from an oropharyngeal infection. It requires an early and aggressive sugical treatment, but the operative approach and optimal form of mediastinal drainage remains controversial. We report a case of DNM in a 45-year-old male who underwent right cervicomediastinotomy to drain the deep neck space, upper mediastinum and anterior mediastinal drainage was accomplished through a subxiphoid approach. After this procedure, he steadily improved and was dischrged on hospital day 36. We report this case with a brief review of the literature.
Drainage ; Humans ; Male ; Mediastinitis* ; Mediastinum ; Middle Aged ; Neck