We analysed 26 cases of pyogenic osteomyelitis of the spine who were treaed at Younsei University Hospital during 25 years from January 1952 to August 1977 by operative or conaervative treatment. The diagnosis of pyogenic osteomyelitis of the spine is not easy and very confused. The cause and entry of the offending organism is mainly by venous drainage from the genitourinary and lower extremity circulation and the next is direct spreading from the adjacent focus. The typical clinical symptom is severe pain and tenderness over the lesion accompanied by febril history and the clinical course is relatively rapid than tuberculosis of the spine. In blood examination leukocytosis is uncommon but it showed relative increase of neutrophils in 62%, and erythrocyte sedimentation rate in 89%. Radiological findings are narrowing of joint space, erosion and/or destuctive change of vertebral body, vertebral marginal sclerotic change, and new bone formation and less frequently abscess shadow. The results obtained from this study were as follows, 1) The incidence of pyogenic osteomyelitis of the spine among total cases of the pyogenic osteomyelitis was 2.5% and the ratio of the pyogenic osteomyelitis of the spine to the spine tuberculosis was 2.8%. 2) The sexual incidence was in 11 and 15 each male and female. and the avrage, prevalent age was 34 years of age. 3) The pathogenic organism was isolated in 20 cases from the diseased focus during surgical procedure; stapyhloccus in 16 cases, pseudomonas in two and in a case of E.coli and proteus each. 4) The lumber vertebrae was mostly involved, i.e.lumbar in 11 cases, cervical in four, thoracic in nine, lumbosacral and sacrum in one each. 5) The operative treatment was performed in 23 cases and conservative in 3 cases with the satisfatory result in all cases. 6) We conclude that the focal curettage with anterior interbody fusion through anterior approach was better than the conservative treatment.
Abscess ; Blood Sedimentation ; Curettage ; Diagnosis ; Drainage ; Female ; Humans ; Incidence ; Joints ; Leukocytosis ; Lower Extremity ; Male ; Neutrophils ; Osteogenesis ; Osteomyelitis ; Proteus ; Pseudomonas ; Sacrum ; Spine ; Tuberculosis

Syndactyly is one of most common congenital anomalies of the limb. We reviewed 89 webs of 40 patient with syndactyly which had been treated at Seoul National University Hospital from 1979 to November 1984. It is the purpose of this article to compare the operative methods used in the treatment of syndactyly. In our hands, using the volar interdigital flap in the treatment of syndactyly gives the most excellent postoperative result in both function and cosmesis.
Extremities ; Hand ; Humans ; Seoul ; Syndactyly

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

No abstract available.
Mandibular Reconstruction*

Fity-four patients with head and neck cancers were prospectively examined with the CT to determine its valuein staging cervical lymph nodes metastases and to compare with the clinical staging. The CT staging agreed withthe clinical staging in 61%(33/54), upgraded the clinical staging in 22%(12/54) and downgraded in 17%(9/54). Thepost-surgical confirmation was made in only 11 patients, The possible causes of disagreement between the CT andthe clinical staging, and the diagnostic value of the CT in the evaluation of the cervical nodes metastases werediscussed.
Head and Neck Neoplasms ; Head ; Humans ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Prospective Studies

The present study is concerned with angiographic findings of bone tumors in patients who have been admitted to Severance Hospital from April 1968 to March 1971. Angiography of peripheral tumors is a valuabIe procedure in that it provides important information concerning the presence or absence of a tumor, defines its size and extent, and gives indication of malignancy. Angiography as an additional aid in the diagnosis of malignant bone lesions was first presented by dos Santos, Lamas and Caldos (1931). Begg (1955) stated that a normal angiogram of a limb shows that the branches of the main artery follow a slightly curved and undulating course, and that their calibre slowly and progressively decreases. None of these vessels are seen to reach the periosteum, nor is the nutrient artery ever visible. dos Santos (1931) proposed certain angiographic criteria of malignancy, notably the presence of numerous irregular vessels at the transit of the contrast medium from the arteries to the veins. Margulis(1964)stated a large number of malignant neoplasms are highly vascular and present chaotic patterns. Their vessels have irregular lumina and arteriovenous communications are present within them. Areas of intense contrast staining occupy parts of or the entire tumor. This appearance, frequently described, has been assumed to be characteristic of and uniformly encountered in malignant tumors. Angiographies in the present study include 6 cases of Osteogenic sarcoma, 4 cases of Chondrosarcoma, 2 cases of Giant cell tumor, 1 case of Liposarcoma, 1 case of Kaposis sarcoma, 1 case of Hemangioma, 1 case of Metastatic bone tumor, 1 case of Fibrous dysplasia and 1 case of Neurofibromatosis. Angiography was performed 13 times under local and 5 times under the general anesthesis. 20 to 30cc of 50 per cent Hypaque was utilized for examination. Angiographic findings are as follows: 1. HypervascuIarity is seen in osteogenic sarcoma, giant cell tumor, hemangioma and metastatic bone tumor. But neurofibromatosis and fibrous dysplasia are avascular. 2. Irregularity of the vascular net work seems characteristic in osteogenic sarcoma, hemangioma, and metastatic bone tumor. 3. Blood pools are seen prominently in osteogenic sarcoma, giant cell tumor, hemangioma and metastatic bone tumor. but no blood pools in neurofibromatosis and fibrous dysplasia. 4. Arteriovenous shunt is seen in osteogenic sarcoma, chondrosarcoma, hemangioma and metastatic bone tumor. But there is no A-V shunt in giant cell tumor, liposarcoma, Kaposis sarcoma, neurofibromatosis and fibrous dysplasia. 5. Retention of contrast medium is seen prominently in osteogenic sarcoma and hemangioma. But no retention of contrast medium is noted in liposarcoma, neurofibromatosis and fibrous dysplasia. While I do not regard arteriography as a necessary procedure for the differantial diagnosis of all presumptive bone neoplasms, it is indeed valuable in selected cases, in differential diagnosis of bone tumors and in the demonstration of the vascularity and extent of extraosseous soft tissue masses and it can be helpful in selecting an appropriate biopsy site. By indicating the size ar,d vascularity of a lesion and its major blood supply, it may influence the surgical approach.
Angiography ; Arteries ; Biopsy ; Bone Neoplasms ; Chondrosarcoma ; Diagnosis ; Diagnosis, Differential ; Diatrizoate ; Extremities ; Giant Cell Tumors ; Hemangioma ; Humans ; Liposarcoma ; Neurofibromatoses ; Osteosarcoma ; Periosteum ; Sarcoma, Kaposi ; Veins

Although the incidence of tuberculous arthritis of the hip is being decreased with improvement of hygiene and preventive measures and chemotheraphy, it remains as important disease in orthopedic surgery. In order to evaluate which treatment is best in the view of eradication of the tuberculosis and preservation of the function, seventy two patients of tuberculous arthritis of the hip who were treated at the Department of Orthopedic Surgery, Seoul University Hospital for periods of 14 years between January 1970 and August 1983 were analysed clinically. The results are as follows: 1. Age distribution showed that patients below 15 years were thirty (41.7%) and those above 16 years were forty two (58.3%). 2. Onset of the symptoms above 1 year occupied forty two patients (58.3%). 3. Duration of follow up is between 1 year and 14 years with average duration of 3.5 years. 4. Recurrence rate according to the modality of treatment was 12.9% as 4 cases among 31 cases of hip fusion group, 15,2% as 5 cases among 33 cases of synovectomy group, and 28.6% as 2 cases among 7 cases of conservative group. 5. Follow up of the functional evaluation of the hip was 92.9% of “above Fair” as 26 cases among 28 cases of synovectomy group, 60% of “above Fair” as 3 cases among 5 cases of conservetive treatment group, and 25.7% of “above Fair” as 9 cases among 35 cases of hip fusion group. 6. Although the recurrence rate of synovectomy group is a little higher than that of hip fusion group, synovectomy is a better treatment in the view of the preservation of the function of the hip considering Korean life style.
Age Distribution ; Arthritis ; Follow-Up Studies ; Hip ; Humans ; Hygiene ; Incidence ; Life Style ; Orthopedics ; Recurrence ; Seoul ; Tuberculosis

Uterine prolapse with pregnancy is rare condition. The overall incidence is 1/10000- 15000 deliveries. The complications from uterine prolapse range from minor cervical ulceration and infection to fetal death or uterine rupture. The fetal mortality was as high as 22% mainly due to prematurity, respiratory infection. The management of this condition is focused on preventing late occurrence of prolapse during pregnancy and continued reduction. We present a case of uterine prolapse in pregnancy with a brief review of the literature.
Fetal Death ; Fetal Mortality ; Incidence ; Pregnancy* ; Prolapse ; Ulcer ; Uterine Prolapse* ; Uterine Rupture

Intramedullary nailing has become the most popular fixation method in the treatment of the shaft fractures of long bones especially of tibia and femur because it affords most rigid fixation of fracture via closed method which makes early rehabilitation possible. Nowadays intramedullary nailing of the humeral shaft is being performed by many surgeons with good results. Newer implants and better surgical techniques are being developed, which suggests application of this method can be widened. Purpose of this study was aimed to define whether intramedullary nailing could be an effective method or not in the treatment of humeral shaft fractures by documenting the practical points in the application of intramedullary nailing of humerus, effectiveness in fracture healing, any complications or obstacles. We managed thirteen humeral shaft fractures with closed locked intramedullary nailing with distal fanning devices(Seidel nail) from March 1993 to April 1994. Average follow-up period was 14 months(12 months-18 months). The results were as follows; 1, Union of the fracture was obtained at average 12.9 weeks(9 weeks-20 weeks) postoperatively except one case of nonunion, in which case, union was obtained at postoperative 10 months finally. 2. Among the 13 cases, painful limitation of shoulder motion remained in 6 cases. This complication was more common in the cases with protruded proximal end of the nail. Above results suggest that locked intramedullary nailing seemed to be one of the useful method in the treatment of the humeral shaft fractures. However, destruction and irritation of shoulder by the nail was found to be a grave problem, and we found that further investigations should solve this problem.
Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fracture Healing ; Humerus ; Methods ; Rehabilitation ; Shoulder ; Surgeons ; Tibia

The 8 kDa antigenic protein of Clonorchis sinensis was partially purified by ammonium sulfate precipitation and subsequently by a column chromatographic steps. The purified protein was separated into 7 and 8 kDa protein bands through SDS-tricine gel electrophoresis, while the protein was found to migrate to a 8 kDa band in 7.5-15% SDS-PAGE. The molecular weight of the antigen was estimated to be 110 kDa by Superose 6 HR 10/30 gel filtration. The purified antigen strongly reacted with the human sera of clonorchiasis. The hyperimmune sera of BALB/c mice immunized against the 8 kDa protein were reacted with both the crude extract and the excretory-secretory product of adult worms, but not with the metacercarial extract. Immunohistochemical staining demonstrated that the protein was distributed to the tegument and subtegumental cells and also to the seminal receptacle. The present findings suggest that the 8 kDa protein is a partition of the multicomplex protein originating from various organs of adult C. sinensis, and that it is composed of several 7 and 8 kDa proteins.
Animals ; Antigens, Helminth/immunology/*isolation & purification/metabolism ; Clonorchiasis/immunology ; Clonorchis sinensis/anatomy & histology/*immunology/metabolism ; Helminth Proteins/immunology/*isolation & purification/metabolism ; Human ; Mice ; Mice, Inbred BALB C ; Molecular Weight ; Support, Non-U.S. Gov't