Open fracture characteristically has higher chances of infection and sof tissue damage in comparison with closed fracture. In spite of the development of operation methods and antibiotics, complications such as infection, nonunion, delayed union, and joint stiffness are continuously confronted as problems in the field of orthopedics. Different methods of treatment have been advocated as regards the care of the open wound and the method of stabilization of the fracture fragments. Therefore a comparative analysis of the type of open fracture and the bone union time according to the initial treatment methods was made from 47 cases over the age of 20, who were followed up until bone union developed among the inpatients who were treated for open fracture of tibia in the period of 7 years from January, 1982 to December, 1988, and the results are as follows: 1. The highest incidence of fractures was encountered in 3rd decade(34%) and male to female ratio was 6:l. 2. The most common cause of fractures was traffic accident(76.6%). 3. The most common level of fracture was in mid one-third and the bone union time was longest in mid one-third. 4. The bone union time was longer, and the rate of complication was greater in order of type 1, 2 & 3 according to Gustilo's classification. 5. The good result was obtained in type 1 fractures, by using the closed reduction & cast immobilization and pin & plaster method; in type 2, the bone union time was shortest in the cases of pin & plater method; in type 3, the bone union time was shortest in the cases of closed reduction or open, reduction & external fixation. 6. Bone union was obtained in all cases of delayed union and nonunion and the bone union time was shortest in cases treated with plate & bone graft.
Anti-Bacterial Agents ; Classification ; Clinical Study ; Female ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Incidence ; Inpatients ; Joints ; Male ; Methods ; Orthopedics ; Tibia ; Transplants ; Wounds and Injuries

Background: The insulin-like growth factors, IGF-I and
Animals ; Calcimycin ; Calcium ; Egtazic Acid ; Extracellular Fluid ; Glucose ; Hepatocytes ; Insulin ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Liver ; Metabolism ; Parathyroid Hormone ; Perfusion ; Rats ; Somatomedins

This study was performed to observe the therapeutic effects of interferon-gamma(IFN-gamma) and gamma-globulin(gamma-globulin) in experimental Pneumocystis carinii pneumonia of immune suppressed mice. After 9 weeks, trimethoprim-sulfamethoxazole(TMP-SMZ; 10-50 mg/mouse/day), mouse IFN-gamma(5 x 10(4) units/mouse/day) and mouse gamma-globulin(20 mg/mouse/day) were administered to the mice for 3 weeks by the experimental group. The therapeutic efficacy was evaluated by body weights, histopathologic and electron microscopic findings of the lungs, and number of P. carinii cysts by Gomori's methenamine silver stain. Body weights of the mice were significantly increased in the group of combination therapy of TMP-SMZ with IFN-gamma or gamma-globulin, and in the group of TMP-SMZ treatment (p < 0.05), however, little effect was found in the group of gamma-globulin alone. Histopathologic findings of P. carinii pneumonia were much improved in the group of combination therapy of TMP-SMZ with IFN-gamma. Treatment with either TMP-SMZ or IFN-gamma significantly reduced the number of cysts in the P. carinii pneumonia, but gamma-globulin alone was ineffective. In electron microscopic findings of P. carinii pneumonia, the number of trophozoites and cysts were reduced by treatment with either TMP-SMZ or IFN-gamma, and most of the cysts were empty or containing one or two intracystic bodies. The present results suggested, that combination therapy of TMP-SMZ with IFN-gamma had synergistic effects in treatment of P. carinii pneumonia in experimental mice.
Drug-Synergism ; Drug-Therapy,-Combination ; English-Abstract ; Gamma-Globulins-administration-and-dosage ; Interferon-Type-II-administration-and-dosage ; Mice- ; Trimethoprim-Sulfamethoxazole-Combination-administration-and-dosage ; *Gamma-Globulins-therapeutic-use ; *Interferon-Type-II-therapeutic-use ; *Pneumonia,-Pneumocystis-carinii-therapy ; Gamma-Globulins ; Trimethoprim-Sulfamethoxazole-Combination ; Interferon-Type-II

Bone grafts are used in the repair of segmental bone loss caused by severe trauma, bone tumors and infection, and to enhance bone healing in ununited fractures. Autograft is the most frequently used and the most effective method, but because of inadquate supply and additional operative morbidity, allograft or heterograft could be used. Heterograft has been shown to be poorly tolerated by the host and ineffective in providing an osteogenic system. The objective of this study is to observe healing process of a segmental defect of long bone following to heterograft, and to compare the difference of histologic process between autograft and hetero graft. Twenty-four white rabbits weighing 1,000 to 2,000 grams were used for the experiment. A segment measuring three times the diameter of the ulna shaft (1.5 to 2cm) of rabbit was resected with its periosteum. Twenty-four white rabbit were divided into three groups (control, autograft, heterograft group) according to graft methods, each group comprising of eight rabbits. The animals were sacrificed at 2, 4, 8 and 12 weeks after the experimental procedures and were periodically evaluated by radiographs and histology. The obtained results were as follows: 1. The results of the radiological evaluation showed that no ungrafted ulnar defects (control group) healed. In the heterograft group, partial union was observed from 8 weeks and complete union was obtained on 12 weeks. In the autograft group, partial union was observed on 2 weeks and complete union was obtained on 4 weeks. 2. The results from histological examination showed that the ungrafted ulnae did not heal across the defect but some immature trabeculae were founded on the edges of the defect. In the heterograft group, immature trabeculae were appeared from 4 weeks and defects were substituted with mature trabeculae on 12 weeks. In autograft group, defects were substituted with immature trabeculae on 2 weeks and with mature trabeculae on 4 weeks. As seen in the results of the experiment, union could be obtained with the heterograft, but needed more long time than autograft. Though the autograft is the most effective graft method in bone defect or non-union, above results suggest the heterograft as the alternative method in the treatment of large bone defect, in a multioperated patient, or in the children or the elderly, combined with autograft or alone.
Aged ; Allografts ; Animals ; Autografts ; Child ; Fractures, Ununited ; Heterografts* ; Humans ; Periosteum ; Rabbits* ; Transplants ; Ulna

No abstract available.
Knee* ; Rabbits* ; Tendons*

No abstract available.
Ankylosis* ; Radiotherapy* ; Temporomandibular Joint*

PURPOSE: To determine the plain film findings of acute neuropathic joint in diabetic foot. MATERIALS AND METHODS: Acute neuropathic joint in diabetic foot was considered when fragmentation of the articular ends of bone and subluxation of the affected joint developed within eight weeks after clinical onset of diabetic gangrene. Eight toes of six diabetics were satisfactory to our criteria. We analyzed plain radiographic findings of the affected joint and soft tissue, interval changes in follow-up radiographs, and deformities after healing. RESULTS: The time interval between clinical onset of gangrene and bone destruction ranged from 2 weeks to 4 weeks(mean 2.6 weeks). Plain radiographs showed fragmentation of the articular ends, subluxation, and soft tissue swelling of the metatarsophalangeal joint or interphalangeal joint. The significant feature of these patients was rapid progression of the lesions. Clinically, all patients had diabetic gangrene in affected toes, however, there was no evidence of osteomyelitis in our series. Amputation was done in 2 cases, and lesions in 3 of the remaining 4 cases were repaired spontaneously with regression of gangrene, leaving radiological residua such as pointed-end, tapered-end, and ball and socket deformity. CONCLUSION: Rapid disorganization of the joint with associated evidence of soft tissue gangrene in plain radiograph is believed to be valuable for the diagnosis of diabetic osteoarthropathy.
Amputation ; Congenital Abnormalities ; Diabetic Foot* ; Diagnosis ; Follow-Up Studies ; Gangrene ; Humans ; Joints* ; Metatarsophalangeal Joint ; Osteomyelitis ; Toes

BACKGROUND: Staphylococcal scalded skin syndrome (SSSS) is defined as a spectrum of superficial blistering skin disease caused by the exfoliative toxins of Staphylococcus (S.) aureus. The spectrum of the disease includes generalized, localized (bullous impetigo), abortive and intermediate forms. OBJECTIVE: The purpose of this study is to reclassify clinical types of SSSS by reviewing the clinical and microbiologic features of SSSS and to redefine the clinical types exactly. METHODS: We retrospectively reviewed medical records, clinical photographs and the microbiologic results of 25 patients with SSSS and studied them according to the new classification. We defined the 3 clinical types as follows: i) The Generalized type is defined as a case where tender erythroderma and large thin bullae occur on the whole body excluding the mucous membrane, palms and soles. The nikolsky sign is positive. ii) The intermediate type is defined as a case where tender erythroderma and vesicles or pustules occur in the regionally limited area. The Nikolsky sign is positive. iii) The abortive type is defined as a case where tender erythema occurs only on the whole body or in regionally limited areas. The nikolsky sign is negative. All patients of SSSS have periorificial, radial crusting and fissuring. RESULTS: We could reclassify the clinical types of SSSS into 3 types (generalized, intermediate, abortive) according to this retrospective clinical study. Of the 25 patients, 3 patients were of the generalized type, 13 patients were of the intermediate type and 9 patients were of the abortive type. All the types have the acute eczematous lesion on the periorbital and perioral areas. The male to female sex ratio was 1: 1.3. The mean age of onset was 2.9 years. Cultures from the suspected site of the primary infection were positive in 14 out of 21 patients, and colonized sites were the throat (29%), conjunctiva (21%), nasal cavity (21%), ear (21%) and skin (8%) in 14 patients. Methicillin-sensitive S. aureus and methicillin-resistant S. aureus were 8 cases and 6 cases, respectively. In all clinical types, the most common complication was conjunctivitis (54.5%). Four cases were accompanied by atopic dermatitis. All the patients were cured with first generation cephalosporin without significant sequelae. CONCLUSION: We reclassified SSSS into generalized, intermediate and abortive types with reference to our 25 cases and previously existing papers, and offered a correct definition for the 3 types.
Age of Onset ; Blister ; Classification ; Colon ; Conjunctiva ; Conjunctivitis ; Dermatitis, Atopic ; Dermatitis, Exfoliative ; Ear ; Erythema ; Exfoliatins ; Female ; Humans ; Male ; Medical Records ; Methicillin Resistance ; Mucous Membrane ; Nasal Cavity ; Pharynx ; Retrospective Studies ; Sex Ratio ; Skin ; Skin Diseases ; Staphylococcal Scalded Skin Syndrome* ; Staphylococcus

No abstract available.
Cervix Uteri* ; Female ; Hysterectomy*

PURPOSE: MAGE (melanoma antigen gene) is a tumor associated antigen, presented by HLA class I molecules, which is recognized by cytotoxic T lymphocytes. The expression of MAGE proteins are confined to malignant tumor tissues, except for the normal testis and placental tissues. Therefore, MAGE may be a potential target for immunotherapy of malignant tumors. However, biological aspects associated with the cell cycle are not yet described. MATERIALS AND METHODS: The material used for this study was a novel human squamous cell carcinoma cell line (PNUH-12) from the hypopharynx, which had one point mutation of 78th base, C to G, in exon 7 of p53 gene. To understand the role of MAGE in relation to cell cycle and its relationship with p53 as the Gl checkpoint regulator, the expressions of MAGE-3 protein and mvtant p53 (Mtp53) were accessed by flow cytometry and immunohistochemistry. Double stains for MAGE-3/Mtp53 was analyzed with bivariate flow cytometry. DNA histograms using MAGE-3/PI (DNA) and Mtp53/PI (DNA) were also analyzed. RESULTS: The expression rate of MAGE-3 and Mtp53 were 83% and 85%, respectively. MAGE-3 was expressed in cytoplasm, while M:p53 were expressed in the nuclei of the tumor cells on the immunohistochemical sections. With bivariate analyses, coexpression rate of MAGE-3/Mtp53 was 0.96, and MAGE-3 and Mtp53 constantly showed high levels throughout the cell cycle except Go. CONCLUSIONS: These results mean that (I) MAGE-3 might have yet unknown relationship with mutant p53, (2) expressions of MAGE-3 and Mtp53 are not dependent on the cell cycle in PNUH-12 hypopharyngeal squamous carcinoma cell line, and suggest that MAGE-3 might have a role as important as p53 during the development of malignant tumors.
Carcinoma, Squamous Cell ; Cell Cycle* ; Cell Line ; Coloring Agents ; Cytoplasm ; DNA ; Exons ; Flow Cytometry* ; Genes, p53 ; Humans ; Hypopharynx ; Immunohistochemistry ; Immunotherapy ; Point Mutation ; T-Lymphocytes, Cytotoxic ; Testis