During the period of 25 years from Apr. 1959 to Jan. 1984, 58 patients of non-tuberculous infec-tion of the spine (53 pyogenic osteomyelitis and 5 iatrogenic and primary discitis) were admitted and treated at our department. Clinical analysis was carried out following results were obtained. 1. The incidence was higher in the 3rd and 4th decade and the sex ratio between male and female was 2.1:1 2. The relative frequency of the commonly involved sity were lumbar(60), thoracic(17.), cervical(9%), lumbosacral(7%), thoracolumbar(3.5%), cervicothoracic(1.5%), in that orders. 3. The morbidity period less than 1 month was only in 22% and that less than 1 year was only 4. The frequent clinical symptoms and signs were back pain(91), tenderness(88%), muscle spasm (76%), and fever and chillness(41%). 5. The causative microorganism was identified in 43 cases among which 77% was coagulase positive staphylococcus. 6. Expected spontaneous bony fusion was not found in any case of 9 follow-up cases of conservatively treated group, while excellent bony union was noticed in all 16 follow-up cases of anterior fusion group except one. 7. Anterior spinal fusion seems be to indicated in those cases such as with failure of conservative treatment, paraplegia, concomitant mechanical instability, long duration of sinus tract and even with dubious bacteriological diagnosis. 8. Anterior spinal fusion for pyogenic osteomyelitis and discitis has the advantages, that is eradication of diseased foci with easier bacteriological diagnosis, cord decpmpression, increase of bony stability, and promotion of bony union. 9. Laminectomy was indicated in those cases with epidural abscess. 10. Bone scan and computed tomography were useful in the early diagnosis and evaluation of treatment results.
Coagulase ; Diagnosis ; Discitis ; Early Diagnosis ; Epidural Abscess ; Female ; Fever ; Follow-Up Studies ; Humans ; Incidence ; Laminectomy ; Male ; Osteomyelitis ; Paraplegia ; Sex Ratio ; Spasm ; Spinal Fusion ; Spine ; Staphylococcus

No abstract available.
Animals ; Autografts* ; Rats*

Clinical study of 40 cases who have used steroid preparations was done during past 6 months from March 72 to September 72. 1. The youngest patient was twenty, the oldest seventy-four and the average fifty-two. Eighty percent was included between from 41 to 70 year of age. 2. And the sex ratio was 1:4.7. 3. Diagnostic incidence was 47.5% in degenerative arthritis and 40% in rheumatoid arthritis. 4. The causes of administration were multiple joint pain (35%), lumbago (27.5%) and pain on knee joint (25%) in order. 5. Prednisolone (60%), dexacortisil (25%) and dexamethasone (12.5%) were used in 97.5%. 6. The source of steroid was drung store (95%) or doctor (5%). 7. The time from first dose to last dose was less than 1month (20%), 1–3 month(10%), 4–6 month (7.5%) and more than 1 year (52.5%). And 3 cases have used for more than 5 years, 8. Eighteen cases (45%) used steroid continuously and 22 cases (55%) irregularly. 9. Transient effectiveness was experienced in 92.5% with steroid administration, that was one of the causes of steroid usage without doctor's prescription. 10. The side effects were as follows; moon face (62.5%), ulcer (20%), fat deposition (15%), osteoporosis (15%), peripheral edema (10%), elevation of blood pressure (7.5%), malar flush(7.5%), vertebral compression fracture (7.5%), obesity (5%), psychotic change (5%), pyogenic arthritis (5%), diabetes (2.5%), sepsis (2.5%), adrenal insufficiency (2.5%), avascular necrosis (2.5%) and stress fracture of femur neck (2.5%).
Adrenal Insufficiency ; Arthralgia ; Arthritis ; Arthritis, Rheumatoid ; Blood Pressure ; Clinical Study ; Dexamethasone ; Edema ; Femur Neck ; Fractures, Compression ; Fractures, Stress ; Humans ; Incidence ; Knee Joint ; Low Back Pain ; Moon ; Necrosis ; Obesity ; Orthopedics ; Osteoarthritis ; Osteoporosis ; Prednisolone ; Prescriptions ; Sepsis ; Sex Ratio ; Ulcer

To 48 adult patients general and spinal anethesia was administered for elective orthopedic (intra-thoracic and extremity) and abdominal(general and gynecological) operations. Radial artery was cannulated and postoperative change of PaO2 was observed for 7days. The results are as follows: 1) General anesthesia administered for operations on the legs results in a reduction of PaO₂ which is maximal immediately after discontinuation of anesthesia, gradually returns toward normal in a 3-hour period, and becomes normal on the first postoperative day. 2) General anesthesia administered for thoracomy and laparotomy is followed by the same early changes, which do not return toward normal in the first 3 hours. Reduciton of PaO₂ persists, and PaO₂ continue to deteriorate for several days, not completely returning to normal even 7days post-operatively. 3) When spinal anesthesia is administered for laparotomy, PaO₂ does not begin to fall untill several hours after the end of operation. The subsequent course follows as that in 2, above. 4) When spinal anesthesia is administered for operation on the legs, PaO₂ does not change significantly throughout the postoperative period. 5) Thus, it is concluded that late forms of postoperative hypoxemia is influenced primarily not by the method of anesthesia, but by site of operation.
Adult ; Anesthesia ; Anesthesia, General ; Anesthesia, Spinal ; Anoxia ; Humans ; Laparotomy ; Leg ; Methods ; Orthopedics ; Oxygen ; Postoperative Period ; Radial Artery

Early diagnosis and treatment of congenital dislocation of the hip is the only means of obtaining good results with consistent regularity. But a large number of congenital dislocation of the hip remain undiagnosed before the child begins to walk. One hundred and nine cases of congenital dislocation of the hip had been clinically diagnosed and 48 cases of them were treated conservatively or operatively at Department of Orthopedic Surgery, College of Medicine, Seoul National University from January, 1965 through September, 1975 with following results. 1. Among 109 cases of congenital dislocation of the hip, 48 cases were admitted and treated. In recent 10 years the number of the out-patient was increasing. 2. The preponderance of female to male (4:1) was found. 3. The age ranged between 3 months and 24 years, and 46 cases (42%) between 12 and 24 months. 4. In most cases the chief complaint was limping. 5. The associated congenital anomalies were observed in 3 cases of the series, comprising two cases of arthrogryposis multiplex congenita and one case of hydrocephalus. 6. The scetabular index was increased in affected hip. 7. The ratio of unilateral cases to bilateral ones was 100: 9, and right to left was 47: 53. 8. Closed reduction was satisfactory in 25 cases under 2 years of age. 9. Open reduction was necessary in 18 cases of failed closed reduction and 5 cases of redislocation. 10. Eleven cases of Salter's operation, 4 cases of Pembertons operation, 2 cases of Colonnas operation, and 8 cases of derotational osteotomy were performed to increase the stability of the hip joint.
Arthrogryposis ; Child ; Dislocations ; Early Diagnosis ; Female ; Hip Joint ; Hip ; Humans ; Hydrocephalus ; Male ; Orthopedics ; Osteotomy ; Outpatients ; Seoul

The deformed and rigid spine presenting moderate to severe kyphosis and scoliosis results in a restriction of function of the lung best characterized spirographically by a reduction in vital capacity. When the lesion involves the thoracic spine, restriction of function is more marked. Spinal deformities such as kyphosis and scoliosis develop from various causes. Tuberculous spondylitis, a main cause of kyphosis and scoliosis, is increasingly found in Korea. Cardiorespiratory dysfunction caused by spinal deformity poses another problem besides the spinal deformity perse. To perform therapeutic measures such as Harrington instrumentation, with or without preoperative localizer cast and halofemoral traction, as well as anterior interbody fusion, evaluation of pulmonary function and arterial gas analysis preoperatively is helpful to prevent and reduce postoperative cardiorespiratory failure or complications. The authors have reviewed the results of arterial gas analyses and pulmonary function tests on 35 cases of scoliosis and 60 cases of kyphosis done at the Department of Orthopedic Surgery, Seoul National University Hospital, from January 1975 to February 1978. The results were as follows: 1. Average degree of scoliosis in 35 cases was 89; vital capacity 60% of normal, and maximum breathing capacity 72%. Average degree of dorsal spine kyphosis in 38 cases was 93.5; vital capacity 38%, and maximum breathing capacity 73% Average degree of lumbar spine kyphosis of 22 cases was 79; vital capacity 77%, and maximum breathing capacity 84%. 2. Static values for pulmonary function such as vital capacity and dynamic values such as maximum breathing capacity hed a significant negative correlation with the severity of scoliosis and kyphosis. 3. Decrease in vital capacity due to scoliosis and kyphosis correlated positively with decrease in maximum breathing capacity. 4. Arterial oxygen saturation had a significant negative correlation with the severity of scoliosis and kyphosis.
Congenital Abnormalities ; Korea ; Kyphosis ; Lung ; Orthopedics ; Oxygen ; Respiration ; Respiratory Function Tests ; Scoliosis ; Seoul ; Spine ; Spondylitis ; Traction ; Vital Capacity

Failure of total joint replacement is often due to infection. Many efforts have been made to reduce the rate of infection. The use of antibiotic-acrylic bone cement composites for the preventlon and treatment of infection after joint replacement surgery has been advocated. Early reports of clinical success using bone cement containing antibiotics are encouraging, but different results of antibacterial effect of antibiotic-acrylic bone cement were reported in vitro and in vivo studies. The purpose of this experiment is to determine the effectiveness of bone cement itself on bacterial growth, stability of antibiotics in cured bone cement, and whether antibiotic acrylic bone cement composites produce an effective antimicrobial concentration in tissue fluid of hip joint and if so, the duration of it. 30 rabbits were used as test animal: 3 each for hemiarthroplasty and for hemiarthroplasty with the insertion of bone cement as control; 6 each for dicloxacillin, cephacetrile, gentamycin and amlkacin impregnated bone cements. Antibiotic activities were measured by disk diffusion method and tube dilution method using tissue fluid collected through tube inserted in the hip joint of the animals. The results were as follows: 1. Bone cement itself does not have antibacterial effec: on the growth of Staphyiococcus aureus and Escherichia coli. Antibiotic impregnated acrylic bone cements showed antibacterial effects which were stable for 3 weeks in vitro test. 2. After the insertion of antibiotic-acrylic bone cement composites, maximal concentrations of antibiotics in tissue fluid were measured at 1 hour. The concentration of antibiotics remained in tissue fluid at relatively high level for 2 days, and decreased abruptly there after. Inhibition zones in disk diffusion method could be measured until 3rd day in dicloxacillin group and 4th day in cephacetrile, gentamycin and amikacin group. No antibacterial effect could be measured in control groups. 3. On first postoperative day the concentrations of antibiotics in tissue fluid were measured as 64 mcg/ml in dicloxacillin group and 128 mcg/ml in cephacetrille, gentamycin and amikacin group. The antiblotic activities in tissue fluid could be measured for 6 days in dicloxacillin group and 7 days in cephacetrile, gentamycin and amikacin group using tube dilution method. No antibiotic activities were measured in tissue fluid of control groups. As a result of this study, it is proved that the concentration of antibiotics in tissue fluid of hip joint can be maintained above the level of minimal inhibitory concentration for about a week when antibiotic-acrylic bone cement composite is used in joint replacement arthroplasty. The impregnation of antibiotics in crylic bone cement is proved to be effective in the prevention of exogenous infection, especially in the protection of damaged tissue prone to infection postoperatively.
Amikacin ; Animals ; Anti-Bacterial Agents ; Arthroplasty, Replacement ; Bone Cements ; Cephacetrile ; Dicloxacillin ; Diffusion ; Escherichia coli ; Gentamicins ; Hemiarthroplasty ; Hip Joint ; In Vitro Techniques ; Joints ; Methods ; Polymethyl Methacrylate ; Rabbits

A case of chondromyxoid fibroma, which was experienced at Seoul National University Hospital, is presented with a brief review of the literature, because of its relative rarity in incidence, its unusual location and its huze size in demension which seems to be largest in reported series in literatures.
Fibroma ; Incidence ; Seoul

Clinical experience with 99mTc-methylenediphosphonate was presented in 115 patients with trauma, who were treated at Seoul University Hospital from Jan. 1980 to Dec. 1983. The results were summarized as followings: 1. Bone scan exhibited increased uptake in all cases examined within 1 year of trauma and the frequency of scan positivity was diminished as the interval between trauma and the scan increased. 2. The possible factors associated with positive scans in cases more than 2 years after trauma were malunion and post-traumatic arthritis, but the age, general condition of the patient were not appeared to be significantly related to persistent positive scan. 3. Bone scan was thought to be sensitive enough to detect early stress fracture ot accompanied by radiographic abnormali ty. 4. It seemed to be reasonable to judge that the fracture was old when the bone scan of vertebral compression fracture in the young age group was negative except very early stage of trauina. 5. Bone scan was very sensitive to find early post-traumatic avascuhr necrosis in femoral neck fracture when the roentgenographic finding was equivocal.
Arthritis ; Femoral Neck Fractures ; Fractures, Compression ; Fractures, Stress ; Humans ; Necrosis ; Seoul

No abstract available.
Polymethyl Methacrylate*