Reconstructive surgery has reached a point where now massive bones with or without articular cartilage can be replaced in such cases as resections for tumors, chronic infections, hydatid cysts, traumatic arthritis and intractable juxta-articular non-union. The histological fate of autogenous and allogenous bone grafts has been described in numerous papers since 1901. However, few workers have reported on transplantation of bone as an organ, the bone being composed of articular cartilage, cancellous bone, cortical bone, marrow, and fat. It is well known that tissue-incompatible allogenous marrow has strong antigenicity that renders transplantation immunity to the host. In order to observe histological and rentgenographic changes of autogenous and allogenous bone transplantation, the distal portions of the left femurs of one hundred rabbits were resected at a point one centimeter above the epiphyseal plate. In fifty of these rabbits, the resected femur was freed of any soft tissue attachment and was replaced in situ as a fresh orthotopical autogenous transplantation. In the other fifty, the femurs of pairs of rabbits were exchanged as fresh orthotopical allogenous transplantations. In a control group of twenty rabbits, the left distal femur was fractured surgically without disturbing its blood supply and soft tissue attachment. All the rabhits were then sacrificed from three days up to twelve weeks postoperatively. 1. In the autogenous group, new bone regeneration was observed as early as the third day. Lamellar structure was evident from the second week. Bony union between the host and grafted bone took place from the sixth week with remodelling of new trabeculae and was almost completed by the twelfth week. with creeping substitution of the grafted bone still under way. 2. In the allogenous group, new bone formation was seen on the cortical surface from the third day, but gradually decreased from the third week. Immature fibrous callus was transformed into bony callus by metaplasia of surrounding young fibrous tissue, which was rich on the host side and progressed distally. Osteogensis within the grafted bone was scanty and bony incorporation was incomplete at the twelfth week even though creeping substitution was still in progress. 3. Infiltration of inflammatory cells was much more conspicuous in the allogenous group than in the autogenous group. Revascularization, absorption of organized hematoma, bony substitution, and remodelling of newly formed bone were all delayed in the allogenous group. Marrow regeneration, seen from the eighth week in the autogenous group, was delayed in the allogenous transplantation, being increasingly so in the more distal part of the grafted bone. There is evidence that new bone formation, creeping substitution and revascularization are all delayed in allogeneous bone transplantation. As suggested by many, transplantation immunity following tissue incompatibility and vascular interruption by surgery may be responsible for the delay. It is believed that rigid fixation of the host and grafted bone and a sufficient period of immobilization are mandatory in order to ensure bony incorporation in allogenous transplantation.
Absorption ; Arthritis ; Bone Marrow ; Bone Regeneration ; Bone Transplantation ; Bony Callus ; Cartilage, Articular ; Echinococcosis ; Femur ; Growth Plate ; Hematoma ; Immobilization ; Metaplasia ; Osteogenesis ; Rabbits ; Regeneration ; Transplants

1. Fifty one cases of fractures of the shaft of the femur in children, treated at Seoul National University Hospital during the seven years, from August 1962 to July 1969, were analyzed. 2. In thirty eight of the cases fracture involved the middle third of the shaft, in eleven the upper third, and in two the lower third. 3. Bryant traction was employed in fifteen of the cases ranging from four months to six years of age. One case, five years old, was complicated by Volkmanns ischemic contracture on both legs. 4. Russell traction was employed in eleven of the cases ranging from six to fourteen years of age. Angulation and distraction must be watched especially in the younger age group, although we encountered no serious complications which required subsequent treatment. 5. Hoke traction was employed in twelve of the cases ranging from six to eleven years of age. Although this form of treatment is not particularly popular, we are of the opinion that it is the treatment of choice over two years of age and,under six years of age and that between six and twelve years of age it may be optionally employed along with Russell traction. We found it. particularly useful and convenient in selected cases in which Russell traction could not be effectively employed. 6. In some of the complicated cases, open reduction and internal fixation, closed reduction with pin and plaster immobilization, or skeletal traction was employed.
Child ; Femur ; Humans ; Immobilization ; Ischemic Contracture ; Leg ; Seoul ; Traction

Subperiosteal Cortical Defect is a symptomless rarefaction of cortical bone which begins most often on the external surface of the medial and posterior cortical walls of the lower end of the femur in children between the ages of 3 and 6 years. The name of Subperiosteal Cortical Defect was first used by Aegerter who differentiated it from non-osteogenic fibroma. The authors found out 5 positive cases of incidental findings among 62 cases of both knee joint X-ray of which 3 was male and 2 was female. Also we experienced 3 cases which necessiat d a correct diagnosis and differential diagnosis. Because this is a common lesion, it frequently accompanies more serious bone conditions, and because this is self-limited disease, treatment is not necessary. It was emphasized that its nature should be understood by all those dealing with bone disease lest it be overdiagnosed and overtreated.
Bone Diseases ; Child ; Diagnosis ; Diagnosis, Differential ; Female ; Femur ; Fibroma ; Humans ; Incidental Findings ; Knee Joint ; Male

Rhabdomyosarcoma which was first described by Weber has generally been considered an uncommon tumor. Recently it was classified as four types such as pleomorphic, embryonal, botryoid and alveolar type by Stout, Stobbe et al, Horn et al. and Riopelle et al. Five cases of rhabdomyosarcoma treated recently in Seoul National University Hospital were repored in this paper. 1. There were three pleomorphic types, one alveolar type and one undifferentiated malignant mesenchymal tumor. 2. Four cases were between 18-23 years old and one was 37 years old. 3. Three were male and two were female. 4. Time to be consulted to us was average 8 months. 5. Three were in lower extremity (two in thigh, one in calf) and two were in upper extremity (one in elbow, the other in forearm). 6. Follow-up study was done for three cases. One was exoired at,three months after hindquarter amputation, the other was expired at two years after supracondylar amputation and no recurrence and metastases were developed one year after local resection in another one case.
Amputation ; Animals ; Elbow ; Female ; Follow-Up Studies ; Horns ; Humans ; Lower Extremity ; Male ; Neoplasm Metastasis ; Recurrence ; Rhabdomyosarcoma ; Seoul ; Thigh ; Upper Extremity

Five cases of the spinal tuberculosis with severe kyphosis and paraplegia were treated with radical surgery at the Department of Orthopedic Surgery, Seoul National University Hospital. All the cases were involved at the thoracic spine and kyphosis were ranged 100 through 150 degrees. Severe fixed chest deformity and impaired pulmonary function were observed. By thoracotomy, aorta was seen to be adherent to the surrounding tissue and this was separated from the verterbral lesion with meticulous procedure. The focus was curetted radically exposing spinal cord which was decompressed with anterior transposition. Then the spine was stabilized with anterior interbody fusion. Postoperative intensive pulmonary care and antituberculous therapy are imperative for the good result. Spinal tuberculosi with severe kyphosis and paraplegia could be benefited with the radical surgery by the experienced surgeon.
Aorta ; Congenital Abnormalities ; Kyphosis ; Orthopedics ; Paraplegia ; Seoul ; Spinal Cord ; Spine ; Thoracotomy ; Thorax ; Tuberculosis, Spinal

Polymorphism in the angiotensin-converting enzyme(ACE) gene may confer an increased risk of vascular disease. DD type of ACE polymorphism predispose a person to myocardial infarction and IgA nephropathy. The roles of the ACE insertion/deletion polymorphism are unknown in the patients with hypertensive intracerebral hemorrhage (HICH). Our objective is to test and to identify whether genotype distribution of the insertion/deletion polymorphism in ACE gene is different in HICH patients from control subjects. Fifty six HICH patients and sixty one control subjects were studied. Genotypes were determined by the polymerase chain reaction(PCR) with specific oligonucleotide primers flanking the polymorphic region in intron 16 of ACE gene to amplify genomic DNA isolated from patients blood PCR products were separated in 2% agarose gels and bands were visualized by ethidium bromide staining. The PCR reaction amplified a 490bp DNA fragment(II type) from genomic DNA if the subjects had an intact intron 16, and amplified a both 490bp and 190bp DNA fragments(ID type) if subjects had heterozygous polymorphism. While the distribution of ACE polymorphism in control subjects was 26.2%:57.4%:6.4%(II:ID:DD), and the distribution of it in patients with HICH was 37.5%:35.7%:26.8%. Thus, the pattern of distribution was no significant different between control subjects and patients with HICH. The factors of age and sex did not influence on the ratio of distribution in both control and HICH subjects. From these results, we conclude that there is no significant association between I/D polymorphism and HICH.
Angiotensins* ; DNA ; DNA Primers ; Ethidium ; Gels ; Genotype ; Glomerulonephritis, IGA ; Humans ; Intracranial Hemorrhage, Hypertensive* ; Introns ; Myocardial Infarction ; Peptidyl-Dipeptidase A* ; Polymerase Chain Reaction ; Sepharose ; Vascular Diseases