No abstract available.
Cerebral Palsy* ; Contracture* ; Hip* ; Muscle Spasticity*

Osteitis condensans ilii is one of the rare disease which represents an alteration in the normal bony architecture of that portion of the ilium alongside the sacro-iliac joint: namely condensation without involvement of joint space or adjacent sacrum. We analyzed clinically 9 cases of osteitis condensans ilii who were treated at the Department of Orthopedic Surgery, Medial college of Yonsei University. The results were as follows :l. All patients were women and oldest patient was 47, the youngest 23 years of age. 2. The pain occured following delivery in 3 cases and in one case ofter trauma. There was urinary tract infection in one case. 3. All patients complained low back pain and the pain extended to buttock in 2 cases whereas the radiating pain to lower extremity in 4 cases. 4. In 4 cases was a positive straight leg raising test elicited. 5. In 3 cases the blood sedimentation rate was increased above normal. 6. All patient succeed in relieving pain with conssrvative treatment. In 2 instances steroid was used. 7. There were combined diseases in 4 cases : herniated nucleus pulposus in 2 cases, rheumatoid arthritis in 1 case, osteoarthritis in 1 case.
Arthritis, Rheumatoid ; Blood Sedimentation ; Buttocks ; Clinical Study ; Female ; Humans ; Ilium ; Joints ; Leg ; Low Back Pain ; Lower Extremity ; Orthopedics ; Osteitis ; Osteoarthritis ; Rare Diseases ; Sacrum ; Sclerosis ; Urinary Tract Infections

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

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

No abstract available.
Spine*

Bone formation by osteoblast may be closely related to the increase in intracellular Ca2+ activity of osteoblast. In order to study the effects of changes in Ca2+ activity of osteoblast-like cell on fracture healing, we changed intracellular Ca2+ activity of osteoblast-like cells by vanadate and verapamil. And the process of fracture healing was observed after injection of the treatment osteoblast-like cells into the fracture site by hematoxylin-eosin (H-E) stain and bromodeoxyuridine (BrdU) stain. The results were as follow: 1) The most effective range of concentration which could facilitate bone formation was 10-6 to 10-5 M. 2) H-E stain showed more abundant osteoblast and osteoid tissues, more active mitotic division of osteoblast, and earlier appearance of chondroblast and chondroid tissue, making the maturation of woven bone faster in the vanadate-treated group than in the control group. The opposite was true in the verapamil-treated group compared with the control group. 3) BrdU labeling index showed more active osteoblastic proliferation in the vanadate-treated than in the control group. The opposite was observed in the verapamil-treated group compared with the control group. From these results, the fracture healing appears to be facilitated and decelerated by vanadate which apparently increase intracellular Ca2+ activity of osteoblast and verapamil which decreases it, repectively. Therefore the change of intracellular Ca2+ activity of osteoblast can be considered to be one of fracture healing mechanisms and expected to be applied for clinical purpose.
Bromodeoxyuridine ; Chondrocytes ; Fracture Healing ; Osteoblasts ; Osteogenesis ; Vanadates ; Verapamil

Rectovagianl fistula(RVF) is a congenital or acquired communication between the two epithelial-lined surface of the rectum and the vagina. We present our experience with 62 patients with RVF. There were various etiologies and repair methods of rectovaginal fistula. The purpose of this study was to retospectively review the clinical course of the patients we treated and to evaluate the efficacy of various treatment options. The mean age was 40.5 yr, The type of RVF was classified to one of two(simple and complex), according to their location, size and etiology. RVF was developed most commonly after radiotherapy due to cervical cancer(n=17), then after pelvic surgery due to malignancy(n=16), obstetric trauma after episiotomy at delivery(n=7), congenital malformation(n=4), inflammatory bowel disease(n=1), Bechet's disease(n=1), infections such as perianal fistula or abscess(n=2), direct invasion of carcinoma(n=3), after chemotherapy(n=1), and idiopathic(n=6). Three cases of them associated with rectovesicovaginal fistula. Surgical therapeutic option was divided to local repair, abdominal approach and tissue transposition by the type of RVF. Most simple RVFs were repaired with local approach through the vagina or rectum. Most complex RVFs were repaired through abdominal approach or tissue transposition. With an average follow up of 20 months, the treatment results were as follows: completely healed(n=36, 58.1%), persistent symptom(n=6, 9.7%), recurrence after repair(n=5, 8.1%), loss of search or death(n=15, 24.1%). Therefore we assist that the management of RVF depends on size, location, and cause. anal sphincter function and overall health status of the patient. Careful preoperative assessment of the fistula, surrounding tissues, and anal sphincter and exclusion of associated disease are essential. With through evaluation, thoughtful consideration of treatment options, and meticulous operative technique, patient can be assured of an optimal outcome.
Anal Canal ; Episiotomy ; Female ; Fistula ; Follow-Up Studies ; Humans ; Radiotherapy ; Rectovaginal Fistula* ; Rectum ; Recurrence ; Vagina

Infantile fibrosarcoma is a rare malignant soft tissue tumor occurring especially in newborn and young children under 2 years. We experienced three cases of infantile fibrosarcoma presenting in the neonatal period. Case 1 presented with a multiseptated cystic mass on his left thigh at birth that was diagnosed as lymphangioma. After picibanil injection, we noted the size of the mass doubled and a solid lesion was prominent in the magnetic resonance image. Case 2 was found to have a reddish mass on his lower back mimicking hemangioma. Over 2 weeks, the mass grew rapidly with internal hemorrhaging. Case 3 was noted to have an encircling mass around the splenic flexure, which developed into congenital bowel obstruction. All of the tumors were resected completely, but microscopic resection margin was not clear in two patients. The two patients received adjuvant chemotherapy and all patients are well without evidence of recurrence.
Chemotherapy, Adjuvant ; Child ; Colon, Transverse ; Fibrosarcoma ; Hemangioma ; Humans ; Infant, Newborn ; Lymphangioma ; Magnetic Resonance Spectroscopy ; Parturition ; Picibanil ; Recurrence ; Thigh

No abstract available.
Carcinoma, Renal Cell* ; Carcinoma, Squamous Cell* ; Cervix Uteri* ; Female ; Kidney*

BACKGROUND: To describe the fast experience of case-leased advanced cardiac life support(ACLC) course in Korea. METHODS: We have given case-based ACLC course to 13 nurses(6 emergency nurses, 4 coronary care unit muses, 3 professors) and 17 physicians(4 emergency physicians, 12 emergency residents, 1 intem). We performed the case-based ACLS course according to 1992 American Heart Association guidelines and recommendations for advanced cardiac life support by american ACLS instructors(1 pulmonologist, 4 critical care nurses). We performed final theoretical written test and 2 times written survey (immediate and 100th day after the course) about the course. RESULTS: On final written test, all practitioners answered at leasts 70% of the questions correctly. There was no significant difference between nurses and physicians(86.2+/-3.6 of physicians and 82.5+/-6.8 of nurses, p=0.06). 90%of participants considered that case-based advanced cardiac life support was acceptable. 100th day after the course, 93%of participants answered that ACLS course have been helpful on his/her job and also want retraining of ACLS course. 70%of participants considered that ideal ACLS training committee in Korea is the Korean Society of Emergency Medicine. CONCLUSION: Case-based ACLS course is a useful educational method far physicians and nurses in Korea. In the future, we should organize Korean resuscitation committee and then make guidelines for ACLS, and then continuously educate physicians and nurses.
Adult* ; Advanced Cardiac Life Support ; Alprostadil ; American Heart Association ; Coronary Care Units ; Critical Care ; Emergencies ; Emergency Medicine ; Humans ; Korea* ; Resuscitation