Eosinophilic granuloma of bone is the most common variant of histiocytosis X. Most of the lesions occur in the skull, ribs, spine or long bone and may be single or multiple. The occurrence in a growing epiphysis is extremely rare and only seven cases have been reported in the literature. A 13 year old boy with eosinophilic granuloma occurring in proximal humeral epiphysis was seen at Seoul National University Hospital in Nov. 1984 and was treated with curettage and autogenous bone graft followed by radiotherapy. The patient was followed for 13 months and complete healing was obtained.
Curettage ; Eosinophilic Granuloma ; Eosinophils ; Epiphyses ; Histiocytosis, Langerhans-Cell ; Humans ; Male ; Radiotherapy ; Ribs ; Seoul ; Skull ; Spine ; Transplants

Benign odontogenic neoplasms are rare, but malignant odontogenic neoplasms are extremely rare. The majority of malignant epithelial neoplasms occurring in the jaws are the result of metastasis from distant primary neoplasms of direct invasion from contiguous carcinoma of the oral mucosa, sinus mucosa, salivary gland or skin. A few remaining primary intraosseous carcinoma of the jaw are presumed to be of mostly odontogenic origin since epithelial remnants of odontogenesis are numerous in the maxilla arts mandible. Although calcifying odontogenic cyst(COC) is a well-established pathologic entity, it has been recognized that there is an odontogenic neoplasm with histologic features similar to the COC(malignant epithelial odontogenic host cell tumor; EOGCT) that has been diagnosed as COC. Some authors have reported previously in the literature describing malignant EOGCT. We experienced one case of malignant EOGCT with aggressive growth pattern and histologic features strongly implying its malignant potential. The lesion was excised by anterior mandibular resection, total 1 resection of the tongue and bilateral functional neck dissection. The tongue was reconstructed by using the infrahyoid muscle neurovascular island flap and neurovascular radial forearm free flap. The mandible was reconstructed by using the osteocutaneous fibular free flap.
Carcinoma ; Forearm ; Free Tissue Flaps ; Jaw ; Mandible* ; Maxilla ; Mouth Mucosa ; Mucous Membrane ; Neck Dissection ; Neoplasm Metastasis ; Odontogenesis ; Salivary Glands ; Skin ; Tongue*

Forty-five patients with primary neoplasm of the spine, disgnosed and operated at Dept. of Orthopedic Surgery, Seoul National University Hospital, from 1970 to 1988, were reviewed in an attempt to analyze the incidence of the primary spine tumors and effectiveness of surgical treatment. Mean follow-up was 2.5 years. Among 29 benign tumors, 7 cases of osteoid osteoma, 6 cases of giant cell tumor, 4 cases of osteoblastoma and aneurysmal bone cyst, and 2 cases of fibrous dysplasia and osteochondroma, and others were identified. Of 16 malignant tumors, 6 cases of eosinophilic granuloms, 4 cases of chordoma, 3 cases of solitary plasmacytoms, and others were noted. 17 cases occurred in the anterior compartment, 18 cases in the posterior compartment, and 10 cases involved both compartments. Surgical treatment consisted of complete or near complete excision, decompression, and additional stabilization procedure when the stability of the vertebral column was compromised. Stablization was achieved either by fusion, strut bone graft, or by additional Zielke, Cotrel-Dubousset, or Luque-Harringtion instrumentation. The results were astisfactory in most of the cases with benign tumors except cases of giant cell tumor. The results in malignant tumor were satisfactory especially in eosinophilic granuloma and solitary plasmacytoma with respects to symptoms and survival, and this fact was attaibuted to good response to adjuvant chemotherapy and radiation therapy. Recent application of Cotrol-Dubousset or Zielke instrumentation after agressive resection made early ambulation a clinical reality.
Aneurysm ; Bone Cysts ; Chemotherapy, Adjuvant ; Chordoma ; Decompression ; Early Ambulation ; Eosinophilic Granuloma ; Eosinophils ; Follow-Up Studies ; Giant Cell Tumors ; Humans ; Incidence ; Orthopedics ; Osteoblastoma ; Osteochondroma ; Osteoma, Osteoid ; Plasmacytoma ; Seoul ; Spine ; Transplants

22 cases of giant cell tumor of bone treated between 1973 and 1979 have been reviewed after a miaimum follow-up of two years and following results were obtaind. 1. Fourteen cases (63%) were in the third and fourth decade. 2. Fourteen cases (63%) were located around the knee joint. 3. Five (42%) of the twelve tumors treated by curettage and bone graft recurred. Five tumors treated by En bloc resection and two tumors treated by amputation had no recurrences. 4. Five of six recurrences occured within two years after mitial treatment.
Amputation ; Curettage ; Follow-Up Studies ; Giant Cell Tumor of Bone ; Giant Cell Tumors ; Giant Cells ; Knee Joint ; Recurrence ; Transplants

There have been numerous hypotheses about the pathogenesis of idiopathic scoliosis, but it is still unclear. There are some reports that abnormalities of contractile proteins may play a role in the pathogenesis of idiopathic scoliosis. The purpose of this report is to study the quantitative abnormalities of contractile proteins in muscles and nonactivated and activated platelets, and to determine whether or not the abnormalities in contractile proteins may play a role in the pathogenesis of idiopathic scoliosis. The materials were 21 idiopathic scoliosis patients aged from 13 years to 28 years(average 19.2 years) and 20 persons aged from 17 years to 25 years(average 20.1 years) as a control group. The electrophoretic analysis(SDS-PAGE method) was done on platelets both unstimulated and stimulated with thrombin and also on proteins of paraspinal muscles and gluteus maximus of idiopathic scoliosis patient and paraspinal muscles of control group. The results are as follows. 1. The myosin/actin ratios of triton-insoluble fractions to paraspinal muscles in convex sides of main curvatures of scoliosis patients(1.69±0.81) were significantly decreased compared to those of concave sides(2.55±1.28), gluteus maximus muscles(2.56±1.70) and control group(2.61±1.01). 2. There were no significant differences between scoliosis group and control group in the actin/myosin ratios of triton-insoluble fractions of the platelets both nonactivated and activated by thrombin. In conclusion, abnormalities of contractile protein in paraspinal muscles of convex side may play a role in the pathogenesis of idiopathic scoliosis, rather than abnormalities of systemic contractile protein.
Actins ; Blood Platelets ; Contractile Proteins ; Humans ; Muscles ; Myosins ; Paraspinal Muscles ; Scoliosis ; Thrombin

This is to present 44 cases of hip fractures, of these 28 being fractures of femoral neck and the remainder, intertrochanteric, which were treated at the Department of Orthopedic Surgery, Seoul National University Hospital for four years and 8 months from Jan. 1965 to Aug. 1969. 1. There were 33 males. and 11 females in the series. 26 cases(59.1) were over 51 years of age. 2. The femoral neck fractures were treated by means of Smith Petersen nailing in 16 cases, modified Girdlestone hip arthroplasty in 3 cases, Austin-Moore hip prosthesis in 6 cases and other methods in 3 cases. 3. Modified Girdlestone hip arthroplasty could be a treatment of choice for femoral neck fracture requiring hip arthroplasty for those unsuitable for extensive surgery. 4. The intertrochanteric fractures of femur except for 3 unstable fractures were treated successfully with the Smith-Petersen nail and plate, following anatomical reduction of fracture. In 3 unstable fractures, satisfactory stabilization and internal fixation was obtained by the method of medial displacement of proximal part of distal fragment of fracture.
Arthroplasty ; Clinical Study ; Female ; Femoral Neck Fractures ; Femur ; Femur Neck ; Hip Fractures ; Hip Prosthesis ; Hip ; Humans ; Male ; Methods ; Orthopedics ; Seoul

One case of osteoid osteoma in the lamina of the fifth lumbar spine with hamstring muscle tightness was experienced and successfully treated by surgery at the department of orthopedic surgery in Seoul National University Hospital. Literature on the subject was reviewed in detail.
Muscle Tonus ; Orthopedics ; Osteoma, Osteoid ; Seoul ; Spine

The use of antituberculous drug made it possible to develop the radical operative procedure in the treatment of the spine tuberculosis. The anterior fusion is the most frequently used surgical measure in the treatment of the spine tuberculosis but several problems were observed not infrequently. One hundred and twenty-nine cases of childhood spine tuberculosis were treated by the anterior spinal fusion for the period of ten years from 1968 to 1977 at Seoul National University Hospital, and following results were obtained. Problems of the anterior spinal fusion could be divided into two categories; one is the complications and the others are difficulties in the surgical procedure. Complications of the anterior spinal fusion were divided into early and late. Early complications include graft failure, pulmonary problems, cord compression and spinal fluid leakage. Late complications include increasing kyphosis, draining sinus and graft failure. Degrees of increasing kyphosis were the greatest in the age group between the and five years, and greater degrees of increasing kyphosis were observed in more joint involvement. Increasing kyphosis were observed more frequently in longer follow up. The causes of increasing kyphosis could be considered as the relative discrepancies between the growth of the anterior and posterior comparment, and graft failure.
Child ; Follow-Up Studies ; Humans ; Joints ; Kyphosis ; Seoul ; Spinal Fusion ; Spine ; Surgical Procedures, Operative ; Transplants ; Tuberculosis ; Tuberculosis, Spinal

Metaphyseal Chondrodysplasia is a disease characterized by metaphyseal ossification leading to shortening of stature. The extremities, especially lower, and mainly affected, resulting in a disproportionate drarfing which spares the trunk. The first case was reported in a patient with irregular metaphysis of lower extremities and hands, and severe shorteness of stature by Murk Jansen in 1934. A milder form of Metaphyseal Chondrodysplasia was noted in 1949 by Schmid, which is more common and transmitted in autosomal dominant. Mckusick recently reported another form of Metaphseal Chondrodysplasia, and other types were reported, but they are extremly rare, and of little clinical significance. In the Schmid type, patient is normal at birth, but characteristically shortness of stature, bowed leg, and waddling gait developed at biginning of walking. Ali labratory findings including serum calcium level, phosphorous, alkaline phosphatase, renal function test is normal in Metaphyseal Chondrodysplasia. The most difficult differential diagnosis is Vitamin D-resistant rickets in clinical and x-ray findings. The only treatment is careful observation and properly timed corrective surgery. Authors experienced on case of Schmid type of Metaphyseal Chondrodysplasia which had been treated with Vitamin D under impression of rickets for 1 year before the case was consulted to Orthopedic Department. Proximal tibial osteotomy and subtrochanteric valgus osteotomy were performed for the correction of genu varum and coxa vara deformity with satisfactory results for one year follow up.
Alkaline Phosphatase ; Calcium ; Congenital Abnormalities ; Coxa Vara ; Diagnosis, Differential ; Extremities ; Follow-Up Studies ; Gait ; Genu Varum ; Hand ; Humans ; Leg ; Lower Extremity ; Orthopedics ; Osteotomy ; Parturition ; Rickets ; Rickets, Hypophosphatemic ; Vitamin D ; Walking

No abstract available in English.
Congenital Abnormalities ; Paraplegia