Various types of arthroplasty has been performed to obtain mobile joint in the treatment of the hip disease. In the view of stabilization and painlessness of the hip joint arthrodesis has been the treatment of choice in many hip problems, especially in unilateral tuberculosis of the hip. There are many kinds of techniques to gain arthrodesed hip: intra-articular only, extra-articular and combined method. The author reviewed the 42 cases of the arthrodesis of the hip performed at Dept. of Orthopedic surgery, SNUH during the period of 1964 to 1972 with following results. 1. Among 42 patients, there were 29 males and 12 females. Age group of predominence was 2 nd and 3rd decade (66.7%). 2. Thberculosis was the most common causative disease (61.9%) and remainders were fracturedislocation and avscular necrosis of femoral head. Average duration of illness was 3.8 years 3. The operative techniques were 21 Ghomley method (50%) and 11 Davis (26.2%). Satisfactory fusion was gained in 25 cases(92.6%) among 27 cases which follow-up study were possibe for more than 6 months. 4. There was no definite difference in fusion rate between Ghomley and Davis techniques. 5. Satisfactory fusion was gained with Davis technique in avascular necrosis of femoral head. 6. The fusion rate was superior in less than 39 years age group (95%).
Arthrodesis ; Arthroplasty ; Female ; Follow-Up Studies ; Head ; Hip Joint ; Hip ; Humans ; Joints ; Male ; Methods ; Necrosis ; Orthopedics ; Tuberculosis

The authors attempted to examine the distribution of S-100 protein in the human fetal skin. Immunohistochemical staining(ABC rnethod) using anti-S-100 antibodies was carried out on skin specimens taken from 11 human fetuses ranging from 9 weeks to 27 weeks of estimated gestational age. At 9 weeks of estimated gestational age, the embryonic epidermis consisted of three cell layers,' the basal layer, intermediate layer and periderm, all of them being stained for S-100 protein. But after 18 weeks, the basal layer changed to be negative. Granular and cornified layer's, beginning their development at 22 weeks, were not stained for S-100 protein. Hair germ of 12 week-fetuses was recognized unstained as a bulge of basal cells. In fully differentiated structural components of the hair follicle after 18 weeks, the outer root sheath only was stained for S-100 protein whereas the inner root sheath, hair matrix cells and sebaceous glands were unstained. Eccrine gland germs developed at 12 weeks of embryonic life as undulation of the basal layer and were not, stained. And at 22 weeks, the secretory portion of the eccrine glands were formed in the dermis and stained for S-100 protein. Our present study suggests that the expression of S-100 protein can undergo considerable changes during ernbryonic differentiation in the epidermis and epidermal appendages.
Antibodies ; Dermis ; Eccrine Glands ; Epidermis ; Fetus ; Gestational Age ; Hair ; Hair Follicle ; Humans* ; S100 Proteins ; Sebaceous Glands ; Skin*

Hemangioma in peripheral nerves is a very rare condition. Two such conditions are experienced. One case aceompanied by nerve symptom was observed in ulnar nerve and was operated on by extirpation of the tumor including the nerve and was followed by nerve grafting. The other case involved the median nerve had no signs of nerve irritation and was also treated by tumor extirpation.
Hemangioma ; Median Nerve ; Peripheral Nerves ; Transplants ; Ulnar Nerve

Treatment of a paralysed or flail shoulder falls into two categories; arthrodesis and reconstructive surgery. Of these the latter is preferable in view of mobility. Most authors have tried to reconstruct the paralysed abductor by transferring the trapezius muscle only. The final result of these procedures were poor in severe paralysis of the deltoid muscle or combined paralysis of the deltoid and the rotator cuff muscles. Noting the importance of the action of the rotator cuff muscles in abduction of the shoulder, Saha, in 1967, recommended simultaneous reconstruction of tne paralysed deltoid and rotator cuff muscles. We treated a case of paralysed shoulder that followed poliomyelitis by the Saha meshod, i.e., transfer of the trapezius muscle for the paralysed deltoid, transfer of the levator scapulae muscle for the supraspinatus, transfer of the pectoralis minor muscle for the subscapularis, all in one stage. Duration of the follow up was 3 months and the initial result seemed to be good in view of stability, mobility, and abductor power.
Accidental Falls ; Arthrodesis ; Deltoid Muscle ; Follow-Up Studies ; Methods ; Muscles ; Paralysis ; Poliomyelitis ; Rotator Cuff ; Shoulder ; Superficial Back Muscles

Long term follow-up study was done on 38 cases of anterior fusion for spinal tuberculosis especially about effect of buttress graft. The average follow-up period was 16 months. 14 cases of effective buttress group were appeared' to achieve more rapid bony union and prevent further kyphosis or lateral wedging of the involved vertebral body than inadequate buttress group of 7 cases.
Follow-Up Studies ; Kyphosis ; Spine ; Transplants ; Tuberculosis ; Tuberculosis, Spinal

Collagen is the major structural protein in the human body, especially in connective tissues. There are more than 13 types of collagen. Among them, type II collagen is a main component of articular cartilage structure. Altered immunological conditions against type II collagen may be closely related to the pathologic conditions of joint, especially arthritis. Since 1977, animal model for collageninduced arthritis(CIA) has been developed and used in the investigation of arthritis. In those animals, high titers of anti-type II collagen antibody were noticed. Pathologic findings were similar to rheumatoid arthritis of human, which suggested that rheumatoid arthritis might be one of the autoimmune diseases. There had been many reports about elevation of serum and synovial level of anti-type II collagen antibody in rheumatoid arthritis patients. But majority of them did not discriminate the antibody titers according to the type of immunoglobulin(i.e. IgG, IgM). And the question whether the elevated antibody titers are cause or effect of the arthritis is still in controversy. In this study, the serum levels of anti-type II collagen antibody were determined in 82 persons(35 degenerative arthritis patients, 24 rheumatoid arthritis patients and 22 normal controls without any joint problem) via ELISA method. In each person the serum IgG, IgM and IgG+M+A antibody levels against bovine type IIcollagen and chicken typeII collagen were determined individually. Statistical evaluation of these data among degenerative arthritis group, rheumatoid arthritis group and normal control group was performed. The results were as follows; 1. Degenerative arthritis group revealed significant elevation of anti-type II collagen antibody(IgG, IgG+M+A) compared to normal control(p < 0.05). 2. Rheumatoid arthritis group showed significant elvation of IgM and IgG+M+A compared to normal control. 3. Between degenerative arthritis and rheumatoid arthritis group, no sigificant difference was noticed. 4. Rheumatoid arthritis group showed significant increase of IgM antibody level compared to normal control. 5. Female rheumatoid arthritis group showed significant increase of IgM level compared to female degenerative arthritis group. These findings suggested that the elevation of anti-type II collagen antibody titer is not specific for rheumatoid arthritis and related with general pathologies destroying articular cartilage. And it is suggested that anti-type II collagen antibody associated with rheumatoid arthritis is mainly IgM proportion, especially in female patients. So further investigation of anti-type II collagen antibody associated with rheumatoid arthritis is needed to target IgM antibody.
Animals ; Arthritis ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Cartilage, Articular ; Chickens ; Collagen ; Collagen Type II ; Connective Tissue ; Enzyme-Linked Immunosorbent Assay ; Female ; Human Body ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Joints ; Methods ; Models, Animal ; Osteoarthritis ; Pathology

Even though various kinds of diagnostic and therapeutic measures have been used for the detection and cure of the acute osteomyelitis, this disease is difficult to be eradicated in many clinical cases. However it is rather easy to treat once this disease can be detected in early stage. So far radiological examination and many kinds of maneuvers including blood culture, clinical laboratory, xeroradiography, computed tomography have been performed for the early detection of this disease but invalid in the most cases. Recently some authors reported that the bone scanning was useful for the early detection of acute osteomyelitis, but this method also had difficulty in differential diagnosis and uncertaninty of its activity. This study aims to try to find methods of early detection of acute osteomyelitis. Experimental osteomyelitis was developed by the inoculation of Staphylococcus aureus to proximal tibias of 39 young rabbits already sclerosed by solution of sodium morrhuate. By comparing the clinical, radiological, bacteriological and laboratory findings in sequence from 2 days to 7 weeks after inoculation, the following results were obtained. 1. The incidence of experimental osteomyelitis after inoculation of staphylococcus aureus SNUH-S-188 in suspension of 1×10(7) colony forming units was 84%, 74%, and 79% in radiological, blood culture and pathologic examination respectively. 2. The leucocytosis was noticed only in early stage and slight degree of anemia was found during the 1st and 2nd weeks after inoculation. The sedimentation rate was increased only in early acute stage and same was eosinophil count. The leucocyte alkaline phosphatase(LAP) and platelet count. showed no significant abnormal changes. 3. Lymphocyte and eosinophil turned over from normal and eosinophil was predominant in experimental osteomyelitis. 4. Serum calcium, phosphorus, total protein and albumin showed significant decrease in all stages and was conversely paralle1 to changes in groin temperature. The level of BUN was normal indicating normal kidney function in experimental osteomyelitis. 5. Even though the enzymes of which showed no significant changes enrolled alkaline phosphatase and serumgluiamicoxalic-transaminase(S-GOT), but some increa.e was attained to 27% and 44% respectively. 6. It is important and significant to find continuous increase of lactic dehydrogenase (LDH) and creatine phosphokinase (CPK) since 48 hours after inoculation and author, think these will be the reliable and sensitive indices in early detection of the development of osteomyelitis and efficacy of therapeutic measures.
Alkaline Phosphatase ; Anemia ; Calcium ; Creatine Kinase ; Diagnosis, Differential ; Eosinophils ; Groin ; Incidence ; Kidney ; Lymphocytes ; Methods ; Osteomyelitis ; Oxidoreductases ; Phosphorus ; Platelet Count ; Rabbits ; Sodium Morrhuate ; Staphylococcus aureus ; Staphylococcus ; Stem Cells ; Tibia ; Xeroradiography

This study was carried out to assess medical care expenditure of residents in urban poor area. The study population included 377 family members of 85 households in the poor area of Daemyung 8-Dong, Nam-Gu, Taegu and 442 family members of 96 households in a control area. The data was collected through self-administered q'iestionnaires completed by housewives. The survey was conducted. from , March 1 to May 31; 1992. The mean age was 31. 1 years in the poor area and 37. 1 years in the control area. The average number of households per house was 4.5 in the poor area and 4.5 in the control area. The frequency of medical care utilization per household in a one month period was 4.6 in the poor area and 4.3 in the control area. The average number of days of utilization was 12.9 in the poor area and 12.5 in the control area. The averge monthly income of a househlod in the poor area was 848,600 Won compared to the control area's 1,752,300 Won. The average monthly consumption expenditure of a household in the poor area was 568,800 Won and that in the control area 1,238,400 Won. The average medical care monthly expenditure per household was 34,500 Won in the poor area and 58,400 Won in the control area. The proportion of the medical care expenditure to monthly income and to monthly consumption expenditure was 4.1% and 6.1% respectively in the poor area, and 3.3% and 4.7%, respectively in the control area. The premium of medical insurance was 1.5% in both areas. The proportion of cost for drug was 57.4%, for medical appliance was 1.2%, and for medical treatment was 41.1% in the poor area and in the control area 52.4%, 1.9%, 45.7%, respectively. The highest proportion of medical care expenditures in the poor area was herb clinic utilization (36.9%). while hospital and clinic (37.8%) was the highest proportion in the control area. Mean medical care expenditure per visit was 7,400 Won in the poor area and 12,600 Won in the control area. Mean medical care expinditure per day was 2,800 Won in the poor area and 6.300 Won in the control area.
Daegu ; Family Characteristics ; Health Expenditures* ; Humans ; Insurance

A subperiosteal ganglion has been very rarely reported, since Ollier reported first one in 1864. A subperiosteal ganglion is produced by mucoid degeneration and cyst formation within the periosteum, which results in cortical erosion. The characteristic plain radiolographic appearance of irregular cortical erosion and scalloping, with reactive periosteal bone spicules, has been considered pathognomonic of subperiosteal ganglion. Magnetic resonance imaging is performed to further characterize the soft tissue component of the mass. As in our patient, the characteristic signal intensities of magnetic resonance imaging are especially useful in identifying the lesion as a ganglion and in defining the lobular nature and the anatomical extent. We report here the case of a 35-year-old female who had a sudperiosteal ganglion of the distal radius.
Adult ; Female ; Ganglion Cysts* ; Humans ; Magnetic Resonance Imaging ; Pectinidae ; Periosteum ; Radius*

The anterior fusion became the popular measure in the treatment of the tuberculosis of the spine. We analysed the 208 cases of the tuberculosis of the spine (174 anterior fusion) who were treated at our department during the period of 1966 to 1973 and compared these results with that obtained during the period of 1957 to 1966. Following has been observed from this comparison. 1. Spine was the most common site in bone and joint tuberculosis (51.7%) but with decreasing tendency. And it was followed by hip, knee, ankle and sacroiliac joints of order. 2. Common age incidence was below 30 years (72.7%) and most common in below 5 years (20.7%). 3. Average duration of disease was 2 years and 2 months. This value was 6 months lower than in previous study. 4. The most common site was changed from lumbar to thoracic vertebrae. 5. The incidence of sinus, cold abscess formation decreased but paraplegia increased in incedence due to high prevalence in thoracic vertebrae. 6. Anterior fusion was performed in 86.1% of the cases. 7. Postoperative complications was found in 17.2%. Adequate rnanagement of chest tube in thoracic areas and blood vessels in lumbosacral areas may be necessary.
Abscess ; Ankle ; Blood Vessels ; Chest Tubes ; Hip ; Incidence ; Knee ; Paraplegia ; Postoperative Complications ; Prevalence ; Sacroiliac Joint ; Spine ; Thoracic Vertebrae ; Tuberculosis ; Tuberculosis, Osteoarticular