The leprous involvement of the ankle joint and the upper surface of the talus is said to be a rare entity and this is in sharp contract to the Charcot joint of other causes in which the ankle involvement is relatively common. This can partly be explained by the concept that the articular branch of tibial nerve to the ankle joint is usually spare din leprosy, although the fibular nerve is affected around the knee level. During the survey of nearly 3000 leprous patients in the National Leprosy Center we selected 26 cases with obvious bone change of the ankle joint and the clinical study on these 26 cases was made with the following results. 1. The 26 cases consisted of 15 males and 11 females 2. Average age of the patients was 56 years and those over 50 years numbered 20(77%)and undre 39 years of age there was only one involvement. 3. Ankle destruction can be classified according to the causative factors attributable to its occurrence as follows: destruction of ankle joint following fracture of which four were Potts type and eight hyperdorsif-lexion injury: those following idiopathic arthritis in four, and those following subtalar incongruity due to calcaneal flattening in ten. 4. The results of this study which clarify the pathogenesis of ankle involvement in leprous patients may offer reliable preventive measures for each case of ankle destruction.
Ankle Joint ; Ankle ; Arthritis ; Arthropathy, Neurogenic ; Clinical Study ; Female ; Humans ; Knee ; Leprosy ; Male ; Peroneal Nerve ; Talus ; Tibial Nerve

The authors report a clinical experience of 95 patients (98 hips) with congenital dislocation of hip under the age of 2 years who were followed up at least 1 year at Chonnam University Hospital between 1979 and 1988. The result of clinical analysis are as follows; 1. The most patients were girls, comprising 87 girls (89 hips) and 8 boys (9 hips). 2. The age at treatment were under the age of 6 months in 49 hips, 7 to 12 months in 5, 13 to 18 months in 30 and 19 to 24 months in 14. 3. The initial treatment of the 98 hips were Pavlik harness in 49 hips, closed reduction in 18, and open reduction in 31. 4. Pavlik harness was applied to the patients under the age of 7 months and the results were acceptable in 37 hips (76%), uncertain in 4 (8%) and unacceptable in 8 (16%). The 8 unacceptable hips were retreated by closed reduction in 6 hips and open reduction in 2. 5. Closed reduction was applied to the patients ranging from the age of 4 months to 21 months and the results were acceptable in 14 hips(78%), unacceptable in 4 (22%). The 4 unacceptable hips were retreated by open reduction in 3 hips and Salter innominate osteotomy in l. 6. Open reduction was applied to the patients ranging from the age of 7 months to 20 months, and the results were acceptable in 26 hips (84%), uncertain in 3 (10%) and unacceptable in 2 (6%). The one of 2 unacceptable hips was retreated by Salter innominate osteotomy. 7. The overall results of 98 hips following initial treatment were acceptable in 77 hips (79%), uncertain in 7 (7%), and unacceptable in 14 (14%). The final results after secondary treatment were acceptable in 89 hips (91%), uncertain in 7 (7%), and unacceptable in 2 (2%).
Child ; Dislocations ; Female ; Hip ; Humans ; Jeollanam-do ; Osteotomy

No abstract available.
Evoked Potentials* ; Spinal Cord* ; Spine*

Mammary carcinoma was induced in rats by itravenous injection of N-methy-N-Nitrosourea. Microangiography was perfromed to evaluate the microvascular alterations in mammary carcinoma after irradiation. The tumors were givena single dose of 1.400 rads using Co-60 telethrapy unit with field size of 4 x 4 cm at 40 cm SSD. The dose ratewas 147.5 rads per minute. Microangiography was performed prior to irradiation and at one, two, and four weeksfollowing irradiation. The results are as follows: 1. Before irradiation, mammary carcinoma in rats tended to formlobules and the basic vasculature consisted of peripheral vascular pattern with central penetrating vessels. Theperipheral vascular pattern was always richer than that of the center. Irregular and tortuous vessles stretchedfrom the periphery into the center of lobule. 2. One week following irradiation, an increase in the number ofsmaller, tortuous vessels and decreased intervasular distance were obseved in the central portion of each lobule.This finding seems to be due to an improved filling of some previously existing but unfilled vessels. This maylead to improved metabolic changes and reoxygenation. 3. Later's changes of microvasculature after irradiation aretortuosity, irregularity, narrowing, abrupt tapering, fragmentation, and extravasation. These findings progressedafter a lapse of time. 4. The results can be considered as the microangiographic demonstration of the fact that reoxygenation after irradiation is mainly due to dilatation of the collapsed tumor vessels.
Animals ; Dilatation ; Microvessels ; Radiation Effects ; Rats ; Silver Sulfadiazine

Calcaneus is very important in weight bearing and maintaining the normal contour of the foot. Many diseases can cause the cyst-like destructive changes of the calcaneus. In most cases, histological confirmation and bacteriological examination are necessary for the final diagnosis. In recent years, four cases of the cyst-like destructive lesions of the calcaneus were treated and had satisfactory results. They were confirmed with biopsy and bacterial culture as followings; acute osteomyelitis, chronic osteomyelitis, tuberculous osteomyelitis and simple bone cyst. Operations on the osteomyelitis were curettage with or without sequestrectomy and the simple bone cyst the curettage and bone graft. After operations, proper antibiotics and plaster immobilization followed routinely.
Anti-Bacterial Agents ; Biopsy ; Bone Cysts ; Calcaneus ; Curettage ; Diagnosis ; Foot ; Immobilization ; Osteomyelitis ; Transplants ; Weight-Bearing

Remarkable improvement in control of malignant tumor was achieved by combined surgery and postoperative radiation therapy. In Past, radiation therapy had been recommended after 4-6 weeks from operation because of worry about increased complication rate of surgical wound by post-operative irradiation. Nowadays, early surgical extirpation and early post-operative irradiation is recommended for better therapeutic effect. To evaluate the relationship between surgery-radiation interval and healing of surgical wound, an experimental study was undertaken using a total of 132 mice. A single dose of 2000 rads irradiation was delivered immediate after and on 1,3,5,10,14days after incision and suture on the skin of hind limbs of mice. Tensile strengths of the wounds were measured after removal of stitches on 1st, 3rd, 5th, 7th, 10th, 14th and 21st post-operative days. The results are summarized as follows; 1. Wound healing was delayed by irradiation delivered within 3 days from operation. 2. No significant delay of wound healing was observed by irradiation on 5 or more days after operation. 3. Normal wound strength was attained at 21st post-operative day in any surgery-radiation interval. 4. More severe delay of wound healing by irradiation at 24 hrs after operation than by immediate post-operative irradiation although statistical significance is not confirmed. In conclusion, early post-operative irradiation delays healing of the surgical wound though ultimately tensile strength reaches the value of non-irradiated wound.
Animals ; Extremities ; Mice ; Radiation Effects ; Skin ; Sutures ; Tensile Strength ; Wound Healing ; Wounds and Injuries

The closed reduction has made an important contribution to the treatment of children under the age of 24 months. The authors report a clinical experience of 20 patients(21 hips) with congenital dislocation of hip who were treated by closed reduction at the department of Orthopaedic Surgery of Chonnam University Hospital. There were total 230 patients(237 hips) disgnosed as having congenital dislocated hip for 10 years from 1978 to 1987 and 20 patients of them were included in this study. The follow-up period ranged from 1 year to 10 years with an average 3 years. The results are as follows: l. All but one were girls, comprising 19 (20 hips) of 20 patients. 2. The age at closed reduction were under 6 months in 2, 7 to 12 months in 4, 13 to 18 months in 10 and 19 to 24 months in 4. 3. Of the 21 hips treated by closed reduction, 17 hips achieved a satisfactory result(81%). The other four hips had redislocation(2 hips) and subluxation(2 hips). 4. Four additional treatments were open reduction in 3 and Salter innominate osteotomy in l. 5. The acetabular and center-edge angle improved from the averge 36.1 and
Acetabulum ; Child ; Dislocations ; Female ; Follow-Up Studies ; Hip ; Humans ; Jeollanam-do ; Joints ; Methods ; Necrosis ; Osteotomy

The purpose of this study is to observe histopathologic changes in the bilateral craniomandibular joints after allowing 6 weeks of consolidation by varying the amount of distraction in rabbit mandible. Eight rabbits weighing about 2 to 3kg were used. After corticotomy was performed on the left mandibular body between the first premolar and the second premolar region, a unilateral fixation device was placed. Then, a 7-day period was allowed without distraction of the device. The mandible was lengthened 0.5mm/day. Corticotomy and lengthening of mandible were not performed in control group. After the completion of the lengthening process, a 6-week-consolidation period was allowed. Then, the rabbits were sacrificed, and histologic examination of the craniomandibular joints was performed. Proliferative changes were observed in the craniomandibular joints in all groups. With the increasing amount of distraction, hypertrophy of the cartilage layer became more severe, bone formed was dense and enchondral ossification was clearly shown in subchondral bone. Hypertrophy of the cartilage layer was also seen in the non-distracted side as the distracted side in the experimental group. These results indicate that when physical force is applied constantly to joints, the proliferation of articular cartilage and bone formation are present. When more than 6 weeks of consolidation period is allowed at the time of performing distraction for more than 5mm, articular changes, especially, in the contralateral side should also be noted.
Bicuspid ; Cartilage ; Cartilage, Articular ; Hypertrophy ; Joints* ; Mandible ; Osteogenesis ; Osteogenesis, Distraction* ; Rabbits*

Eight patients with diffuse panbronchiolitis were evaluated with chest radiograph and high-resolution computed tomography(HRCT). Paients consisted of 5 med and 3 women, aged 27-75 years(average, 54 years). Chest radiographic findings were diffuse small nodular densities, linear shadows, and thickened bronchial wall predominantly in both lower lung fields. All 8 patients had pansinusitis. On HRCT, small nodules and branching linear structures, 1-3mm internal to the pleural surface, representing centrilobular bronchiolar lesion, were found along with thickening of medium and small sized bronchial wall. These nodules did not show coalescence. In conclusion, chest radiographs were usually suggestive and high-resolution CT was diagnostic of diffuse panbronchiolitis.
Female ; Humans ; Lung ; Radiography, Thoracic* ; Thorax*

PURPOSE: To evaluate the usefulness of Gd-DTPA enhanced MR imaging in determining the metastatic lymph nodes in uterine cervical carcinoma. MATERIALS AND METHODS: Sixty nine patients with histologically proven cervical carcinoma underwent Gd-DTPA enhanced MR imaging. One hundred and thirty-eight pelvic regions(69 right,69 left) in 69 patients were analyzed for lymph node metastases. Pelvic lymph nodes were considered to be abnormal if they were greater than lcm in diameter and were enhanced on postcontrast T1 weighted images. RESULTS: Metastatic lymph nodes were found in 22 pelvic regions by surgicopathologic examinations. On MR imaging there were 14 true positives, 106 true negatives, 10 false positives and 8 false negatives. Gd-DTPA enhanced MR image had an accuracy of 86.9%, a sensitivity of 58.3%, a specificity of 91.4%, a positive predictive value of 58.3% and negative predictive value of 92.9% in evaluation of pelvic lymph node metastases. CONCLUSION: MR imaging with contrast enhancement may be useful in the evaluation of pelvic lymph node metastases in patients with uterine cervical carcinoma.
Gadolinium DTPA ; Humans ; Lymph Nodes* ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Pelvis ; Sensitivity and Specificity