This study was undertaken to obtain baseline data on electrolyte composition of bone marrow blood and compare it with those of simultaneously obtained peripheral blood in order to assess the clinical usefulness of bone marrow blood as an indicator of the early changes of bone mineral metabolism. The mineral salts deposited in the skeleton are not in chemical equilibrium with the circulating blood (Ramp and Neuman), and while the local concentration in bone lesions might thus be high, after dilution into the entire circulating volume, the total amount of enzyme might be too small to cause changes in the peripheral blood readings. And even when no tissue is obtained, the bone blood from the lesion may provide useful information(Woodard and Marcove). In the animal experimental group, electrolyte composition of femoral bone marrow blood was compared with a simultaneously obtained peripheral blood from the abdominal aorta of six week old Long Evans male rats with normal and calcium deficient diets. In the human group, 10 ml of bone marrow blood was obtained from the iliac donor site at the time of bone grafting for spondylolysis, spondylolisthesis and lumbar disc herniation and 10 ml of peripheral blood. was obtained from the cephalic vein immediately before the bone grafting. Electrolyte and enzyme composition of bone marrow blood from bone tumor sites was compared with peripheral blood and also with that obtained from the bone grafting(control) group. The results obtained are as follows.; 1. The concentration of total and ionized calcium in the bone marrow blood was significantly lower and inorganic phosphorus was significantly higher than values obtained from the peripheral blood of rats fed with normal and calcium deficient diets. 2. Similar differences were demonstrated in the human bone marrow blood and peripheral blood obtained from the bone grafting group. A modertae excess of alkaline phosphatase was found in the bone marrow blood. 3. A large excess of alkaline phosphatase was found in the bone marrow blood obtained from bone tumor.
Alkaline Phosphatase ; Animal Experimentation ; Animals ; Aorta, Abdominal ; Bone Marrow ; Bone Transplantation ; Calcium ; Chemistry ; Diet ; Humans ; Male ; Metabolism ; Miners ; Phosphorus ; Rats ; Reading ; Salts ; Skeleton ; Spondylolisthesis ; Spondylolysis ; Tissue Donors ; Veins

The mineral salts deposited in the skeleton are not in chemical equilibrium with the circulating blood (Ramp and Neuman), and while the local concentration in bone lesions might thus be high, after dilution into the entire circulating volume, the total amount of enzyme might be too small to cause changes in the peripheral blood readings. And even when no tissue is obtained, the bone blood from the lesion may p ovide useful information (Woodard and Marcove); This study was undertaken to assess the clinical usefulness of bone marrow blood as an indicator of the early findings of bone tumor. Ten ml. of bone marrow blood was obtained from the iliac donor site at the time of bone grafting for spondylolysis, spondylolisthesis and lumbar disc herniation and 10 ml. of peripheral blood was obtained from the cephalic vein immediately before the bone grafting. And electrolyte composition of bone marrow blood was compared with peripheral blood. Electrolyte and enzyme composition of bone marrow blood from bone tumor sites was compared with peripheral blood and also with that obtained from the bone grafting (control) group. The results obtained are as follows.; 1. The concentration of total calcium in the bone marrow blood was significantly lower and inorganic phosphorus was significantly higher than values obtained from the peripheral blood of obtained from the bone grafting group. A moderate excess of alkaline phosphatase was found in the bone marrow blood. 2 A large excess of alkaline phosphatase was found in the bone marrow blood obtained from bone tumor.
Alkaline Phosphatase ; Bone Marrow ; Bone Transplantation ; Calcium ; Chemistry ; Humans ; Miners ; Phosphorus ; Reading ; Salts ; Skeleton ; Spondylolisthesis ; Spondylolysis ; Tissue Donors ; Veins

The fractures which develop from a already structually damaged or weakened bones are called pathologic fracture and it can be caused by many different diseases. The way of treatment and prognosis of these pathologic fractures differ in many ways according to causative factors. So, regarding frature that developes without definite history of trauma, one shoud approach them with concepts of pathologic fracture. In the cases of pathologic fracture caused by metastatic bone tumors, physicians are employing more aggressive methods of treatment these days. Authors have analysed 87 cases of pathologic fracture who were admitted to department of orthopedic surgery, Severance Hospital during the period of 10 years(from Jan. 1976 to Dec. 1985). Those cases of osteoporosis were all excluded from the study. The conclusion were as follows : 1. There were no discrepancies regarding sexes but 69% of patients were over forty years of age. 2. Fifty percent of pathologic fracture were fractures of femur. 3. Most common causes were metastatic bone tumors(55%), and 36% of these were with unknown primary lesions. 4. In the cases that were caused by metastatic bone tumor, sugical treatment was performed on 46% of these cases. And most cases of patients who were treated with surgical methods improved in pain and ambulation state, especially in patients with use of bone cement.
Femur ; Fractures, Spontaneous ; Humans ; Orthopedics ; Osteoporosis ; Prognosis ; Walking

No abstract available.
Absorptiometry, Photon* ; Bone Density* ; Femur* ; Osteoporotic Fractures*

No abstract available.
Absorptiometry, Photon* ; Bone Density* ; Osteoporotic Fractures* ; Spine*

PURPOSE: We intended to check the growth rates and phenotypic markers of chondrocytes in the dedifferentiated cells cultivated in various conditions in order to establish the ideal culture system for implantation. MATERIALS AND METHODS: Culturing rabbit chondrocytes from proximal tibia, we checked the phenotypes at first, second, and third week. Then we cultured the chondrocytes in different circumstances such as monolayer or three dimensional gel in the presence or abscence of TGF-B1, and checked the growth rates and phenotypic markers. RESULTS: There was no difference in growth rates and mRNA level of type I, type II collagen and aggrecan between the cells cultured in monolayer and three dimensional gel of collagen. However, the responses of the cells to TGF-B1, were quite different between these two groups. In monolayer culture, the expression of type I collagen was depressed by TGF-B1 while the growth rate was markedly increased. Oppositely in three dimensional culture, the mRNA level of type I collagen was markedly increased and the growth rate was completely suppressed by TGF-B1. The expression of type II collagen could be detected only in TGF-B1-treated cells cultured in three dimensional gel for 4 or more days. The mRNA level of aggrecan was also increased by TGF-B1, in the cells cultured in three dimensional gel. CONCLUSIONS: These results suggest that the number of chondrocytes can be efficiently expanded by culturing the cells in monolayer and the phenotypes of chondrocyte can be restored by culturing the cells in three dimensional gel containing TGF-B1. The application of semi-solid gel containing differentiated chondrocytes in physeal implantation should be further evaluated
Aggrecans ; Chondrocytes* ; Collagen ; Collagen Type I ; Collagen Type II ; Phenotype ; RNA, Messenger ; Tibia ; Transforming Growth Factor beta1*

This study was aimed (1) to evaluate osteoporotic vertehral fracture using normal morphometric dimensions in the Korean women (2) to test the relative importance of vertebral morphometry and fracture characteristics in predicting lumbar spine hone mineral density (3) to study clinical significance of the patients of 2 standard deviation to 3 standard deviation morphometric value. Normal morphometric data was ohtained from 60 heolthy women and 100 women with osteoporotic vertebral fracture defined by normal morphometry were evaluated. Fracture identification by 3SD cut off value was almost similar with that of qualitative method. Fracture identification by 2SD cut off value showed an increased number of fractures on the mid thoracic and thoracolumbar junction. Distrihution of the osteoporotic vertehral fracture showed double peaks on mid thoracic and thoracolumbar junction. Bone mineral density of third lumhar spine (LSBMD) in the multiple fracture group was significantly decreased from that of the single tracture group(p<0.05). LSBMD in the disperse fracture group was not different from that of the cluster fracture group(P>0.05). Comparing LSBMD of 3SD, 2SD-3SD fracture group and controls, the 3SD fracture group showed lowest value (P<0.01). But LSBMD of 2SD-3SD fracture group showed no difference with that of controls. Fracture threshold was 0.847gm/cm2 in 90th percentile. The correlation of LSBMD with the sum of normalized height of vertebral bodies, the sum of the deformity ratio of the vertebral body and spinal deformity index were all statistically insignificant.
Bone Density* ; Congenital Abnormalities ; Female ; Humans ; Osteoporosis ; Spine

PURPOSE: This study was designed to compare fracture healing in normal and ovariectomized rat, and to evaluate the effect of intermittent administration of parathyroid hormone on fracture healing in osteopenic animal model, MATERIALS AND METHODS: Four-months-old mature female Sprague-Dawley rats were randomly elivided into 5 groups. Group I underwent a sham operation, and others (Group II-V) were ovariectomized. At three months after ovariectomy or sham operation, standardized bilateral transverse tibial fractures were created and intramedullary nailings with Kirschner wire were performed. The rats were then treated with daily subcutaneous injection of placebo in Groups I and II, 17beta-estradiol in Group III, low doses of recombinant human PTH (1-84) in Group IV, and high doses of recombinant human PTH (1-84) in Group V for 4 weeks. At day 30 of post-fracture the animals were sacrificed and fracture healing was assessed with histologic/histomorphometric analysis and three-point bending mechanical testing. RESULTS: On histologic/histomorphometric evaluation of sham operation group, the fracture callus mainly consisted of dense trabecular bone. On the other hand, Groups II and III seemed to have much looser cancellous network, abundant in fibrous marrow. In parathyroid hormone-treated g roups, external callus consisted of more dense trabecular, woven bone than that of Groups II or III, and especially the high doses of parathyroid hormone-treated group was comparable to the sham operation group in terms of per cent trabecular bone volume (Group I>V>IV>III=II, P<0.05). Mechanical testing indicated that ultimate load was reduced in Group II and III compared to sham operated or parathyroid hormone-treated groups (Group I=V>IV>III=II, P<0.05). Other significant differences were the increase in absorbed energy at ultimate load of Groups I and V (Group I=V>IV=III=II, P<0.05), and increase in ultimate stress of Groups I and V (Group I=V>IV=II=III, P<0.05). CONCLUSIONS: On the basis of this study, it may be concluded that fracture healing is delayed in the ovariectomy-induced osteopenic rat model. Our experiment also showed dose-related stimulation of parathyroid hormone in the strength of fracture, and that antiresorptive agents such as estrogen had no effect. Further study is needed in large animal model, and attention should be focused on systemic/long-term effect of parathyroid hormone and its relationship with local growth factors in fracture healing.
Animals ; Bone Density Conservation Agents ; Bone Marrow ; Bony Callus ; Estrogens ; Female ; Fracture Fixation, Intramedullary ; Fracture Healing* ; Hand ; Humans ; Injections, Subcutaneous ; Intercellular Signaling Peptides and Proteins ; Models, Animal ; Ovariectomy ; Parathyroid Hormone* ; Rats* ; Rats, Sprague-Dawley ; Tibial Fractures

Juvenile rheumatoid arthritis is basically the same disease as rheumatoid arthritis in the adult. However juvenile rheumatoid arthritis has many features that differ from rheumatoid arthritis in adult, and since the onset of the disease occurs before the age of puberty variable alteration in growth may occur. Still, in his classic description of 22 cases of rheumatoid arthritis in children, emphasized the florid form of the disease with fever, lymphadenopathy, and splenomegaly. Since the time of Still many more children with chronic arthriits, which is called Stills disease in England and juvenile rheumatoid arthritis in the United States, have been described, and it has become apparent that the disease has extremely variable manifestations. Forty cases of juvenile rheumatoid arthritis treated at the Severance Hospital from June 1970 to June 1976 were analysed clinically and the following results were obtained. 1. On type classification, the polyarticular type (45%) was most frequent followed by the pauciarticular type (35%) and systemic type (20%) in order. 2. The most frequent joint affected was the knee (77.5%) followed by the ankle (55%), wrist (20%),. elbow (17.5%), etc. 3. The extra-articular manifectations on admission were high fever (42%), rash (20%), carditis (17%) hepatosplenomegaly (12%), etc. 4. Laboratory findings on admission showed increased ESR (85%), positive rheumatoid factor (14.3%),. positive ANA (2.5%), etc. 5. Treatment and drugs were aspirin (57.5%), salicylate and steroid (37.5%), physical therapy (25%), synovectomy (2.5%).
Adolescent ; Adult ; Ankle ; Arthritis, Juvenile ; Arthritis, Rheumatoid ; Aspirin ; Child ; Classification ; Elbow ; England ; Exanthema ; Fever ; Humans ; Joints ; Knee ; Lymphatic Diseases ; Myocarditis ; Puberty ; Rheumatoid Factor ; Splenomegaly ; United States ; Wrist

This is a report of three cases of congenital dislocation of the knee with the chief complaint of extension contracture knee, seen at the Severance Hospital Department of Orthopedic Surgery from January 1975 to the present time(April, 1978). In the first case, the dislocated knee was associated with congenital dislocation of the hip and congenital club foot. Family history revealed that the elder brother of the patient had died of complications of premature birth. The second case appeared to be an isolated congenital dislocation of the knee, without associated anomalies or relevent history in the family. In the third case, the dislocated knee was associated with adducted thumbs and genu valgum, as well as congenital dislocation of the hip and congenital club foot, although family history was irrelevant. In all the cases roentgenographic examinations revealed in the lateral view that the tibia was displaced anteriorly in relationship to the femur. Two cases were treated by four or five successive corrective castings, each lasting one week to ten days. It is contemplated that the third case will also be treated by a simillar corrective cast immobilization. Following this course of treatment, each of the two dislocated knees was completely reduced and the original limitation of flexion improved. Experience with these two cases suggests that good results may be obtained with conservative treatment in congenital dislocation of the knee. A brief review of the literature is submitted.
Contracture ; Dislocations ; Femur ; Foot ; Genu Valgum ; Hip ; Hospital Departments ; Humans ; Immobilization ; Knee ; Orthopedics ; Premature Birth ; Siblings ; Thumb ; Tibia