1. Fifty one cases of fractures of the shaft of the femur in children, treated at Seoul National University Hospital during the seven years, from August 1962 to July 1969, were analyzed. 2. In thirty eight of the cases fracture involved the middle third of the shaft, in eleven the upper third, and in two the lower third. 3. Bryant traction was employed in fifteen of the cases ranging from four months to six years of age. One case, five years old, was complicated by Volkmanns ischemic contracture on both legs. 4. Russell traction was employed in eleven of the cases ranging from six to fourteen years of age. Angulation and distraction must be watched especially in the younger age group, although we encountered no serious complications which required subsequent treatment. 5. Hoke traction was employed in twelve of the cases ranging from six to eleven years of age. Although this form of treatment is not particularly popular, we are of the opinion that it is the treatment of choice over two years of age and,under six years of age and that between six and twelve years of age it may be optionally employed along with Russell traction. We found it. particularly useful and convenient in selected cases in which Russell traction could not be effectively employed. 6. In some of the complicated cases, open reduction and internal fixation, closed reduction with pin and plaster immobilization, or skeletal traction was employed.
Child ; Clinical Study ; Femur ; Humans ; Immobilization ; Ischemic Contracture ; Leg ; Pelvis ; Seoul ; Traction

One of the most important aspect of hemophilia is repeated bleeding into the joint. The frequency of such hemorrhages varies with the severity of the disease. In moderate or severe cases, repeated hemorrhages result in considerable impairment of joint structure and function: Contractures and gross deformity are frequent end result. This paper described a case of hemophilia A, 24-year-old male, who developed deformity of the shoulder, elbow, ankle and knee joint because of repeated hemoarthrosis. Author attempted to treat this patient by transfusion of fresh whole blood and traction, which resulted in some clinical improvement.
Ankle ; Congenital Abnormalities ; Contracture ; Elbow ; Hemophilia A ; Hemorrhage ; Humans ; Joints ; Knee Joint ; Male ; Shoulder ; Traction ; Young Adult

PURPOSE: To evaluate the anatomic and functional change in acutely obstructed kidneys, and the probability of functional recovery after resolving the obstruciton. MATERIALS AND METHODS: There were 5 animal groups(6 rabbits in each group)-normal control group, 4 acute ureteral obstruction group. Each of the latter group was imaged with Gd-DTPA enhanced dynamic MR 2, 6, 24, and 48 hours after ligation of the left proximal urter, respectively. We compared the findings of dynamic MR imaging and histopathological findings. RESULTS: We could observe centripetal movement of dark band pattern which could be defined as 3 phasesrenal cortex, outer medulla, and inner medulla in normal rabbits. The appearance of the dark band pattern was delayed or absent in ureteral obstruction group with a linear relationship to the duration of the obstruction. CONCLUSION: Gd-DTPA enhanced MR can be used to differentiate acute obstructive nephropathy from other causes of nephropathy and foretell the prognosis of the obstruction.
Animals ; Gadolinium DTPA* ; Kidney ; Ligation ; Magnetic Resonance Imaging* ; Prognosis ; Rabbits* ; Ureter* ; Ureteral Obstruction*

No abstract available.
Humans ; Pregnancy* ; Twins*

To investigate the correlation between EBV infection and p53 overexpression in laryngeal carcinomas (LC) and nasopharyngeal carcinomas (NPC) in Korea, we analyzed 37 laryngeal squamous cell carcinomas and 33 nasopharyngeal (11 squamous cell and 22 undifferentiated) carcinomas. We used the immunohistochemistry and polymerase chain reaction-single stranded conformational polymorphism (PCR-SSCP) for p53 overexpression and p53 gene mutation, respectively, and EBER-1 in situ hybridization and PCR using primer for EBNA-1 and EBNA-2 type 1 and 2 for prevalence and the subtype of EBV. The results were as follows; 1) The p53 expression was found in 43.2% of squamous cell LCs, in 54.6% of squamous cell NPCs and in 22.7% of undifferentiated NPCs. The p53 gene mutation was detected in 6 of 23 squamous cell LCs and 3 of 14 undifferentiated NPCs. 2) EBV was detected more frequently in undifferentiated NPCs (95.5%) than in squamous cell NPCs (63.6%) and squamous cell LCs (37.0%). Only type 1 was found in squamous cell LCs and NPCs, whereas both type 1 and type 2 were detected in undifferentiated NPCs. 3) There was no difference according to EBV infection (EBV+ ; 7 cases, EBV- ; 7 cases) in the cases with p53 protein overexpression but mutaion. From the above results, it can be concluded that squamous cell LCs and NPCs are associated with both p53 and EBV, whereas undifferentiated NPCs are more closely associated with EBV than p53. In Korea, both type 1 and 2 are detected in undifferentiated NPCs. Also, our result suggests that EBV infection does not seem to contribute to p53 overexpression. The interrelationship between EBV infection and p53 remains to be further defined.
Carcinoma, Squamous Cell ; Epstein-Barr Virus Infections ; Genes, p53 ; Herpesvirus 4, Human* ; Immunohistochemistry ; In Situ Hybridization ; Korea ; Polymerase Chain Reaction ; Prevalence

Lymphoepithelioma-like carcinoma (LELC) that histologically resembles nasopharyngeal lymphoepithelioma has been reported in various sites including the stomach, salivary gland, lung, skin, thymus, tonsil and uterine cervix. LELC of the stomach was rarely reported after the first report by Burke et al. in 1990. More than 60% of them were associated with Epstein-Barr virus (EBV). Most commonly affecting elderly Asians with slight male predominance (M/F ; 1.2/1), it usually is located in the proximal portion of the stomach and distinguished from lymphoid-rich adenocarcinoma by the absence of definitive glandular differentiation in the LELC. We recently experienced 4 cases of LELC of the stomach associated with EBV. Patients consisted of two Korean females and two Korean males with one in 3rd decade, one in 5th decade and two in 6th decade. The tumors of all cases were located in the proximal portion of the stomach. Gross types were 1 Borrman type I, 2 Borrman type II and 1 early gastric carcinoma type IIc. The size of the tumors varied from 0.8 cm to 7 cm. Microscopic findings were similar in all 4 tumors.; The tumors were composed of syncytial nests of undifferentiated cells having vesicular nuclei with prominent nucleoli, admixed with abundant lymphoplasma cell infiltration in the stroma. Immunohistochemical staining revealed that the tumor cells were reactive for cytokeratin and the stromal lymphocytes were mostly T cells. There were dark hybridization signals in the nuclei of most of the tumor cells but no signals in the stromal lymphocytes in three cases on in situ PCR hybridization and on all cases PCR amplification for EBNA-1. It is concluded that LELCs of the stomach have distinctive histologic characteristics and the usual association with EBV. Further accumulation of these cases will define the prognosis.
Adenocarcinoma ; Aged ; Asian Continental Ancestry Group ; Cervix Uteri ; Female ; Herpesvirus 4, Human* ; Humans ; Keratins ; Lung ; Lymphocytes ; Male ; Palatine Tonsil ; Polymerase Chain Reaction ; Prognosis ; Salivary Glands ; Skin ; Stomach* ; T-Lymphocytes ; Thymus Gland

p27kip1, a cyclin dependent kinase inhibitor, has been recognized as a negative regulator of cell cycle. To investigate the role of p27kip1 on progression of cancer and apoptotic pathway, we analyzed p27kip1 expression using immunohistochemical stain in 40 cases of prostatic adenocarcinoma and apoptotic index by TUNEL method in 30 cases of prostatic adenocarinoma. Both were correlated with Gleason grade and Gleason score. Loss of p27kip1 expression was more frequent in prostatic adenocarcinomas of higher score (Gleason score 7 to 10) (60.7%) than in those of lower score (Gleason score 4 to 6) (33.3%) (p<0.05). The value of mean apoptotic index of carcinoma was 1.13+/-0.26, 1.80+/-0.91, 2.06+/-0.79, and 2.12+/-0.82 in grade 2, 3, 4, and 5, respectively, and was positively correlated with grade of carcinoma (p<0.05). Mean apoptotic index of higher Gleason score (score 7 to 10; 2.05+/-0.63) was also significantly increased than in lower Gleason score (score 4 to 6; 1.34+/-0.39) (p<0.05). Mean apoptotic index in cases with and without p27kip1 expression was 1.92+/-0.86 and 1.89+/-0.81, respectively (p>0.05). These results suggest that loss of p27kip1 expression and increased apoptotic index may be the morphologic markers to predict the behavior of prostatic adenocaricnoma. The role of p27kip1 on apoptotic pathway seems to be meager in this study and needs further study.
Adenocarcinoma* ; Cell Cycle ; Cyclins ; In Situ Nick-End Labeling ; Neoplasm Grading ; Phosphotransferases

BACKGROUND: Previous studies examining the pharmacodynamic effects of succinylcholine(SCC) on subsequent doses of nondepolarizing muscle relaxants showed potentiation with resultant prolonged respiratory depression or no interaction at all. The interaction between SCC and mivacurium especially has not been investigated in animal and other clinical studies. METHODS: The pharmacodynamic effects of SCC on mivacurium-induced neuromuscular blockade and its reversal were investigated in 10 cats of either sex using the anterior tibialis muscle-sciatic nerve preparation. RESULTS: There was no significant difference at the onset of mivacurium neummuscular blockade between the control group(1.81+/-0.48 min) and SCC-pretreated group(1.86+/-1.04 min). However the duration of action of mivacurium neuromuscular blockade was significantly longer in the SCC-pretreated group(33.08+/-19.13 min) than that of the control group(10.65+/-2.45 min). In the control group recovery indices(RI) were 2.35+/-1.01 min and 0.68+/-0.30 min at spontaneous recovery and antagonism with neostigmine, respectively and in the SCC-pretreated group they were 6.88+/-2.42 min and 1.90+/-0.64 min. RI were significantly shortened by antagonism with neostigmine whether or not SCC was pretreated. In the SCC-pretreated group, RI were significantly longer than in the control group at spontaneous recovery and antagonism with neostigmine. But the maximal recovery and antagonism effect were 100% in all cases. There was no sigriificant difference in the train-of-four ratios measured after antagonism with neostigmine between the control group(0.91+/-0.01) and the SCC-pretreated group(0.93+/-0.06). CONCLUSIONS: The prior administration of SCC prolonged the duration of mivacurium-induced neuromuscular blockade and delayed recovery but had no influence in antagonism with neostigmine in cats.
Animals ; Cats* ; Drug Interactions ; Neostigmine ; Neuromuscular Blockade* ; Respiratory Insufficiency ; Succinylcholine*

We studied clinicopathologic features of 44 cases of PM (proper muscle) gastric cancer, correlated the lymph node metastasis and found the result of immunohistochemical staining for tumor angiogenesis using antibodies to Factor VIII-related antigen and nm23-H1, known as meatastasis inhibitory substance. The results were as follows: 1) The average age of these 44 cases of PM gastric cancer was 55.1 years old (range 35-81). The ratio of male to female was 2.2 : 1. The tumor was located at the antrum of stomach in 72.7% of the cases. The average size of the tumor was 4.1 cm (range 0.6-9). The gross features were comprised of Borrmann type I (6.8%), II (29.6%), III (56.8%), IV (6.8%), respectively. The microscopic type was a diffuse type in 70.5% and an intestinal type in 29.5%. There were lymph node metastasis in 25 of the 44 cases (56.8%). 2) The microvessel count was higher in the lymph node positive group (average 69.3) than in the lymph node negative group (average 45.6) (P=0.004). There was a higher microvessel density in diffuse type, over 4 cm of tumor size, proximally located tumor, older than 50 years, Borrmann type II and IV, but there was no statistically significant correlation. 3) The more decreased expression of nm23-H1 was found in the lymph node positive group (56.0%) than in the lymph node negative group (31.6%), but showed no statistical significance (P=0.0142). There was no significant correlation between the expression of nm23-H1 and the other clinicopathologic factors. We suggest that the microvessel count of the tumor angiogenesis may be a prognostic factor for predicting lymph node metastasis and also help to determine the therapeutic modalities of PM gastric cancer.
Antibodies ; Female ; Humans ; Lymph Nodes* ; Male ; Microvessels ; Neoplasm Metastasis* ; Stomach ; Stomach Neoplasms* ; von Willebrand Factor

Severely comminuted tibial condylar fracture is a major threat to the structures and function of the knee joint. Recently, anterior approach with Z-tenotomy of the patellar tendon was introduced for these complicated fractures. It provides wide exposure of the tibial articular surface for maximum joint reconstruction. The purpose of this study was to describe the operative technique and to evaluate the clinical results of this method. We had performed operative treatment in 13 cases (12 patients) of severely comminuted Schatzkers type II, V, and VI tibial condylar fractures through anterior approach from December 1993 to April 1996. Twelve cases out of 13 (92%) showed acceptable results according to Blokkers criteria. There was no superficial or deep infection. On the basis of these results, we suggest that the anterior approach is a valuable aid in the operative treatment of severely comminuted tibial condylar fractures.
Joints ; Knee Joint ; Patella* ; Patellar Ligament* ; Tenotomy* ; Tibia