Tureta and his colleagues have stressed the important role that vessels play in osteogenesis. Numerous arthors attempted to provide new bone formation by placing vascular pedicles into the bone. Some reports are convining, but experimental model and histological investigation leave something yet to learn. We conducted an experiment to demonstrate the feasibility of using a vascular bundle to create new bone formation in medullary canal. Vasculsr bundle of the femoral artery and vein was transplanted in same side of the femoral canal of rabbits. The transplanted vascular bundle was studied histologically for eight weeks. At 3 weeks transplanted artery started proliferation of intima and media, and its lumen was obliterated completely at 6 weeks. Transplanted vein collapsed from begining, and didn't involve in revascularization and new bone formation. At 2 weeks the proliferation of capillaries promoting revascularization originated from the adventitia of the transplanted artery, and peaked at 6 weeks. New osteoid appeared around the transplanted vessel at 2 weeks, and surrounded the entire vessel in 5 weeks, and had no more progression in amount at 6 weeks. Cortical hypertrophies showed in the vascular bundle transplanted group from 3 weeks. Examination of control group revealed no sign of new osteoid formation around the hole during the whole study period.
Adventitia ; Arteries ; Capillaries ; Femoral Artery ; Hypertrophy ; Models, Theoretical ; Osteogenesis ; Rabbits ; Veins

A study of concentration smear, culture for AFB and sensitivity test for antituberculous drugs was carried out in 810 patients who had been admitted in SNUH in the period of 12 months from January 1976 to December 1976. Acid-fast bacilli was confirmed in 110 cases (13.6%) by concentrated direct smear and in 88 cases(10.9%) by culture, and concomitantly sensitivity test was performed in 26 isolated cases. Streptomycin, INH, PAS, Kanamycin and Ethionamide were rather less sensitive to the strains of Mycobacterium tuberculosis, but all strains obtained during the period of this study were highly sensitive to Rifampicin.
Ethionamide ; Humans ; Kanamycin ; Mycobacterium tuberculosis ; Mycobacterium ; Rifampin ; Streptomycin

No abstract available.
Diabetic Foot*

In the treatment of dislocations and subluxations of the hip in the older children, whether congenital or paralytic, orthopedic surgeons are blessed with a wide variety of commonly used surgical procedures; namely, Salters innominate osteotomy, acetabtloplasties, Pembertons pericapsular osteotomy, shelf operations, Chiaris pelvic displacement osteotomy. and Colonnas capsular arthroplasty. However, with increasing age and soft tissue contractures,these procedures become ineffective, leaving a wide range of age between older children and young adults subject to uncertain or unfavarable prognosis. Steels triple osteotomy (1973) is aimed at coverig this age group, when displacement or in nominate osteotomy is either technically infeasible or likely to fail. It consists of an open reduction with or without soft tissue release and skeletal traction, redirection of the acetabulum to cover the femoral head by osteotonmies of the pelvis that has lost its young cartilagenous resiliency, and preservation and physiological remodelling of the articular cartilage of the acetabulum. We performed Steels osteotomy on a 21-years-old female with a severe paralytic subluxation of the hip associated with pelvic obliquity and paralytized both lower extremities. One and a half year follow-up result was satisfactory with a stable and congruous joint despite paralysis and with the patient walking for the first time in her life.
Acetabulum ; Adult ; Arthroplasty ; Cartilage, Articular ; Child ; Dislocations ; Female ; Follow-Up Studies ; Head ; Hip ; Humans ; Joints ; Lower Extremity ; Orthopedics ; Osteotomy ; Paralysis ; Pelvic Bones ; Pelvis ; Prognosis ; Steel ; Surgeons ; Traction ; Walking ; Young Adult

Clinical observation of thirty-eight cases of pyogenic osteomyelitis of the spine for the period of eleven years, from 1965, at Seoul National University Hospital was carried out with the following results. 1. The incidence of pyogenic osteomyelitis of the spine among total cases of the pyogenic osteomyelitis was 6.9% and the ratio between the spine tuberculosis and the pyogenic osteomyelitis of the spine was 1:0.067. 2. The sex ratio between male and female wss 3.8: 1 The incidence was higher ia the second and third decade and the average prevalent age was 30.8 years of age. 3. The site of infection was in the lumbar vertebrae in 25 cases(66%), thoracic in seven(19%), lumbosacral in three, sacral in two and cervical in one. In the region of a vertebra, the vertebral body was affected in 33 cases (87%) and the neural arch and processes in other 5 cases (13%) 4. The causative micro-organism was isolated in 27 cases from the diseased focus; coagulase positive staphylococcus in 18 cases (67%), streptococcus in one, salmonella in one and the mixed infection in two. 5. Frequent clinical symptoms and signs were back pain, tenderness, muscle spasm, fever and chillness, and limited motion of the spine. 6. The roetgenographic findings were in order of disc space narrowing, destruction of the vertebral body, kyphosis or loss of lordosis, erosion, bony bridging or spur formation, sclerosis and paravertebral abscess. 7. The conservative treatment was performed in 14 cases. Among 7 cases in which the follow-up was possible, only 3 cases obtained the satisfactory result, four cases were readmitted for the recurrence and two cases among them needed the operative treatment later. The operative treatment was peformed in 26 cases; The focal curettage with anterior interbody fusion through anterior approach was carried out in 13 cases with the satisfactory result in almost all cases. 8. The advantages of the operative treatment were that the isolation of the offending organism was efficient and the definite diagnosis was feasible, and especially in cases of anterior spinal fusion the healing and union of the infected spine was better clinically and roetgenographically in comparision with those of conservative treatment, in which the expected spontaneous fusion was not found in any case and the recurrence was also frequent.
Abscess ; Animals ; Back Pain ; Coagulase ; Coinfection ; Curettage ; Diagnosis ; Female ; Fever ; Follow-Up Studies ; Humans ; Incidence ; Kyphosis ; Lordosis ; Lumbar Vertebrae ; Male ; Myalgia ; Osteomyelitis ; Recurrence ; Salmonella ; Sclerosis ; Seoul ; Sex Ratio ; Spasm ; Spinal Fusion ; Spine ; Staphylococcus ; Streptococcus ; Tuberculosis

Rickets is a syndrome, characterised pathophysiologically by a failure of normal mineralization of bone and epiphyseal cartilage and clinically by skeletal deformity in growing children. The four principal causes of rickets are; vitamin D deficency, renal tubular insufficiency, chronic renal insufficiency, and hypophosphatasia. Of these, vitamin D resistant rickets may result from primary defect in function of the renal tubular reabsorption for phosphorus, later accompsnied with secondary hyperparathyroidism. We experiened a rare case of hypophosphstemic vitamin D resistant rickets accompanied with secondary hyperparathyroidism in adolescence.
Adolescent ; Child ; Congenital Abnormalities ; Familial Hypophosphatemic Rickets ; Growth Plate ; Humans ; Hyperparathyroidism, Secondary ; Hypophosphatasia ; Miners ; Phosphorus ; Renal Insufficiency, Chronic ; Rickets ; Vitamin D ; Vitamins

The “delta phalanx”, first named by BlundeII Jones in 1964, is a triangular(“delta-shaped”) or trapezoidal phalanx with C-shaped epiphyseal plate causing progressive angular deformity of the digit with growth. Neither splinting nor physical therapy is effective in improving the condition. Surgical correction is indicated and several methods of correction have been reported. Authors have experienced a rare case of “delta phalanx” occuring in the proximal phalanx of the syndactylous digit.
Congenital Abnormalities ; Growth Plate ; Splints ; Syndactyly

Fourty one cases of open fractures of tibial shaft complicated with varying degrees of soft tissue injuries were trested by one-plane unilateral external fixation with AO fixator. In seventeen csses among them, interfragmental lag screw fixation was applied in addition, for more rigidity and stability of the fixation. All of thern were followed up at least for one year and we obtained the following results. 1. Rigid stable external fixation provided by additional minimum internal fixation may not increase the rate of infection but rather enhance prompt primary bone healing. 2. One-plane unilatersl external fixation may facilitate good access to the wound for subsepuent reconstructive procedures, and enhance pain-free early full range of joint motion, thus promote early bone union. 3. Comparing with bilsteral fixation, there wss almost no difference in the union time of the fracture even with one-plsne unilatersl fixation.
Clinical Study ; External Fixators ; Fractures, Open ; Joints ; Soft Tissue Injuries ; Tibia ; Wounds and Injuries

The traditional treatment for the femoral shaft fractures in children is closed reduction by continuous traction, usually for 2–3 weeks, until the fracture has achieved partial stability, followed by spica cast immobilization. Fifty three cases, from 3 to 10 years of age, has been treated with closed reduction and immediate application of hip spica csst; all of them were closed fractures of femoral shaft and were not associated with head, abdominal, or vascular injuries. Any angulations in excess of acceptable ranges were corrected with wedging the cast; any overridings in excess of acceptable ranges were corrected by skeletal traction for 1 week, followed by incorporation of the pin to the cast. The resultant overriding and angulation of fragments were within acceptable ranges, and complications were not significant.This method of treatment not only is likely easy in nursing care and comfortsble to the patients but also has some advantages of short stay in the hospital, better utilization of hospital beds, and costsaving. This immediate hip spica cast immobilization seems to be a good method of treatment for the femoral shaft fracture in children.
Child ; Clinical Study ; Fractures, Closed ; Head ; Hip ; Humans ; Immobilization ; Methods ; Nursing Care ; Traction ; Vascular System Injuries

The goals of orthopaedic management of pelvic ring injuries are to achieve anatomical reduction and secure fixation of fragment and mobilize the patient as early as possible. Previously, pelvic ring injuries have been treated by a wide variety of conservative methods. Their application, however, necessitated a prolonged period of recumbency with associated likelyhood for many complications and did not facilitate accurate reduction and stabilization of most types, resulting in pelvic deformity, non-union and late sacroiliac joint instability. During the past decade, experience with techniques of external and internal fixation of the pelvis has grown and the goals of the methods include provision for sufficient pelvic stability in satisfactory position so that immediate postoperative bed-to-chair transfers can be undertaken and complications due to prolonged recumbency and pelvic deformity can be markedly reduced. We reviewed 47 cases of unstable pelvic ring injuries treated at the depatment of orthopaedic surgery, Dongkang Hospital from January 1984 to December 1987, and the results were as follows ;1. The highest incidence was in the 4th decade and sex ratio between male and female was 1.6:1 2. The most common cause of injury was traffic accident (68.2%) followed by falling down accident (19%) 3. Associated injuries occurred in 28 cases (60%): injuries of the extremities were most common (30%) followed by head injury (13%) and genitourinary tract injury (11%). 4. According to classification of Pennal et al, lateral compression injury was most common (51.1%). Bucholz Group II injury was 57% of all and Group III, 43%. 5. Operative methods, with which 21 cases were treated, were anterior external fixation with AO apparatus or symphyseal plating in Bucholz Group II injuries ; and external fixation, internal fixation (anterior and/or posterior) or both, in Group III injuries. 6. Advantages of operative treatment of unstable pelvic ring disruptions were, by giving stability, early mobilization; easy care of associated injuries, open wounds and nursing; prevention of possible complications of prolonged recumbent position; rapid reduction of pain; and prevention of late complications such as lumbosacral or pelvic pain and gait disturbance.
Accidental Falls ; Accidents, Traffic ; Classification ; Congenital Abnormalities ; Craniocerebral Trauma ; Early Ambulation ; Extremities ; Female ; Gait ; Humans ; Incidence ; Male ; Nursing ; Pelvic Pain ; Pelvis ; Sacroiliac Joint ; Sex Ratio ; Wounds and Injuries