In 1933 Shope described an infectious papilloma of wild cattontail rabbits. Shope rabbit papilloma is a virus-induced epidermal neopIasm indigenous to western cottontail rabbits and readily transmissible to domestic rabbits by inocuiation with an cell-free extract of wild cottontail papilloma. Shope papilloma induced in the domestic rabbits may spoataneously, remain benign, or progress to carcinoma. Kidd et al. (1936) noted that the regression is not correlated with the titer of virus neutralizing antibody. The possibility that papilloma regression is brought about by a mechanism anaIogous to that operating in allograft rejection was suggested by kidd et al. (1938) with the view of the histological resemblance between papilloma regression and rejection of allografted tissue. That regression is mediated by an immune mechanism is strongly indicated by the findings of Evans et al.(1962) that the proportion of rabbits showing regression is substantially increased by vaccination of rabbits with their own papilloma tissue or with papilloma tissue from another rabbits. McMichael (1967) demonstrated that suppression of regression was achieved by use of large doses of corticosteroid. The effect of 5-fluorouracil on human warts was mentioned as being effective by Goldman et al. (1963). In Korea resinous extract from Paulownia coreana has long been used empirically in the treatment of human warts. In this investigation effects of dexamethasone administration on the development and the spontaneous regression of Shope papillomas in domestic rabbits were studied. At the same time, observations were made to evaluate the comparative effectiveness of topical application of 5% 5-fluorouracil ointment and resinous extract from Paulownia coreana on Shope papilloma in the domestic rabbit. The results are summarized as follows: l. Administration of dexamethasone significantly reduced the spontaneous regression of Shope papillomas in domestic rabbits by 12 weeks after virus inoculation. 2. Topical application of 5% 5-fluorouracil ointment on Shope papillomas cured the tumors by 4 weeks of drug application. However, similar treament with resinous extract from Paulownia coreana was without any demonstrable effects. 3. Marked losses of body weights became manifest in dexamethasone treated rabbits. 4. Reinoculation of Shope papilloma virus into 2 rabbits whose papillomas had regressed 3 months ago failed to produce papillomas.
Allografts ; Antibodies, Neutralizing ; Body Weight ; Cottontail rabbit papillomavirus ; Dexamethasone* ; Fluorouracil ; Humans ; Korea ; Papilloma* ; Rabbits ; Tumor Virus Infections ; Vaccination ; Warts

No abstract available.
Spinal Stenosis*

In shape and dimensions, the tibial plateaus are asymmetric with the larger medial tibial plateau and both have a posterior inclination with respect to the shaft of the tibia. Maximizing tibial coverage is an impotant consideration in total knee arthroplasty to provide stahility and load transfer and to improve long-term survival rate of the implants. Most tihial tray designs are symmetric, but several asymmetric designs are available. We evaluated the proximal tibial resection surface during total knee aithroplasty to delineate the tibial plateaus in korean. After tihial bone cut during 100 TKA procedures, the outline of tibial resection suiface was traced and rotational axis of true tibial component was marked intraoperatively. A line was drawn at the maximal anteroposterior (AP) diameter of lateral tibial condyle with parallel to rotational axis of component, and then a transverse axis was drawn at the midpoint of maximal AP diameter of 1ateral tibial condyle. Anteroposterior 10, 20, 30., 40% and midpoint from the media1 and lateral peripheries were calculated manually. The average AP medial 10, 20, 30 and 40% dimensions were 34.7, 43.8, 48.0 and 43.2mm, respectively. The average AP lateral 10, 20, 30 and 40% dimensions were 30.2, 38.4, 42.0 and 40.9mm, respectively. The ratio of medial/lateral AP dimensions 10, 20, 30 and 40% from periphery were 116.9, 114.7, 114.5 and 106.4%, respectively. From these data, we know the asymmetry of the proxirnal tibia1 plateaus in korean. We hope that rnore data will be ohtained in multicenter studies and it will help us to select tibia1 tray and to design the tibial component in korean. But, more accurate standard measures will he need to minimize an error of measurements.
Arthroplasty* ; Axis, Cervical Vertebra ; Hope ; Knee* ; Survival Rate ; Tibia

No abstract available.

No abstract available.
Edema* ; Hydrops Fetalis*

Two cases showed intermittent myoclonic movements in the lower extremities after receiving combined spinal-epidural anesthesia (CSE). Case 1: A 73-year-old female patient, underwent CSE, for a total knee replacement of right leg. Anesthesia was performed at L3/4 interspace with 2.0 ml of 0.5% tetracaine, mixed with normal saline and patient's own cerebrospinal fluid and epinephrine 1 : 200,000. Epidural catheter was inserted 3 cm-cephalad. Patient-controlled analgesia regimen was made with sufentanil 100 ug, 0.75% ropivacaine 30 ml, and naloxone 0.55 mg, with normal saline. The infusion regimen began at the end of the surgery, finished uneventfully after one and half hours. After 3 hours, the patient developed symmetric hip adductions of large amplitude and extensions of both legs for 2 to 3 seconds. Until valproate 800 mg was given, the movements repeated at 1 to 2 minute intervals for 3 hours. Case 2: The anesthesia and analgesia for 74-year-old female patient was done in similar fashion. Three hours after the end of operation, the patient showed myoclonic movements on right leg for about 30 seconds. The movements occurred at 2-3 minute intervals for the subsequent 2 hours and resolved spontaneously.
Aged ; Analgesia, Patient-Controlled ; Anesthesia and Analgesia ; Anesthesia* ; Arthroplasty, Replacement, Knee ; Catheters ; Cerebrospinal Fluid ; Epinephrine ; Female ; Hip ; Humans ; Leg ; Lower Extremity ; Naloxone ; Sufentanil ; Tetracaine ; Valproic Acid

PURPOSE: This study investigated the present conditions of clinical clerkship management in Korea to make recommendations for it. METHODS: The data were collected between April 15 and May 30 in 2009 using questionnaires that were sent to the clerkship directors of 41 colleges of medicine and medical graduate schools. RESULTS: The elective course system was established in 78% of the institutions; the 6 core specialties were found in all medical schools. The duration of clerkship was longest in internal medicine, followed by surgery, pediatrics, obstetrics and gynecology, psychiatry, and emergency medicine. There were differences between the planning and monitoring agencies. Preclinical courses existed in 92.7% of the institutions. However, much more remains to be done ie, with regard to the issues of student assessment in clinical clerkship, faculty development programs for the faculty and residents, incentive systems for educational involvement, provisions for yearly systematic clerkships, integration of basic-clinical science-medical humanities, and community-based education. CONCLUSION: Because clinical clerkship education is very important as a core curriculum, curriculum planning and its management must be given adequate attention. The following measures are suggested: elective systems that allow students to choose by career planning; concerns over faculty development programs for residents as a teacher; consensus on the concept, objectives, duration, content, evaluation tools of pre-clinical clerkship and clinical clerkship, and student well-being; and emphasis on community-based education.
Clinical Clerkship ; Clinical Competence ; Consensus ; Curriculum ; Education, Medical ; Emergency Medicine ; Gynecology ; Humanities ; Humans ; Internal Medicine ; Korea ; Motivation ; Obstetrics ; Pediatrics ; Schools, Medical ; Surveys and Questionnaires

No abstract available.
Bone Density* ; Hyperparathyroidism, Primary*

PURPOSE: The medial meniscus is injured much more than the lateral meniscus. Because the medial meniscus is much larger in diameter, is thinner in its periphery and narrower in body than the lateral meniscus, and does not attach to either cruciate ligament. We evaluated correlations with sites of tear and history of trauma. METHODS AND MATERIALS: We reviewed retrospectively in 43 patients with meniscal tears on MRI(51 cases) and correlated them with history of trauma. RESULTS: The most common site of injury was the posterior horn of the medial meniscus(32/51), but high incidence of lateral meniscal tear compared with previous reports was seen. In the cases which had history of trauma, the posterior horn of medial meniscus was most commonly injured(26/34) and 5 meniscal tears were combined with meniscal tear in the other site. The tear in the anterior horn of the medial meniscus was seen only in a patient which had history of trauma and combined with meniscal tear in the other site. But in the meniscal tears without definite history of trauma, the incidence of meniscal tear was different from the meniscal tear with history of trauma. The incidence of lateral meniscal tear(11/17) was highter than medial meniscal tear and the posterior horn of lateral meniscus was commonly injured. CONCLUSION: We concluded that the medial meniscus was commonly injured, especially posterior horn, but in the cases which had no definite history of trauma, the lateral meniscus was commonly ipjured. An awareness of prevalent site of meniscal injuries may be helpful in the diagnostic interpretation of MR imaging of knee.
Animals ; Horns ; Humans ; Incidence ; Knee ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Retrospective Studies

To evaluate MR findings of soft tissue masses in extremities and to find the helpful findings of distinguish benignity from malignancy, 28 soft tissue masses (22 benign and 6 malignant) in extremities were reviewed. T1-weighted, proton density, T2-weighted and Gd-DTPA enhanced images were obtained. MR images allowed a specific diagnosis in a large number of benign masses, such as hemangioma(8/9), lipoma(2/2), angiolipoma(1/1), epidermoid cyst(2/2), myositis ossificans(1/1), synovial chondromatosis(1/1) and pigmented villonodular synovitis (1/2). Specific diagnosis was difficult in the rest of the masses including malignancy. However, inhomogenous signal intensities with necrosis and inhomogenous enhancement may suggest malignant masses.
Diagnosis ; Extremities ; Gadolinium DTPA ; Myositis ; Necrosis ; Protons ; Synovitis, Pigmented Villonodular