There are many procedures for stabilizing the foot but all frail feet, all complete drop feet, and all calcaneocavus deformities due to paralysis are best treated by pantalar fusion. Hunt and Thompson advised one stage pantalar arthrodesis by astragalectomy and replacement of the denuded bone in paraiytic feet resulting from poliomyelitis. At the Presbyterian Medical Center, Jeonju, Korea, 12 one stage pantalar arthrodesis were performed between 1973 and 1978 and following observations were made. 1. Seven of the patient had pantalar fusions because of poliomyelitis. 2. Five feet were equinovarus and 4 had frail feet with varying amounts of varus or valgus of the forepart of the foot and of the heel. 3. Nine patients were considered to have a good result, two had a fair and one was failure 4. Length of immobilization was from 13 weeks to 37 weeks and the average length of immobilization was 17 weeks. 5. In one stage pantalar arthrodesis, there was no complication except one non-union and the period of hospitalization was decreased.
Arthrodesis ; Clubfoot ; Congenital Abnormalities ; Foot ; Heel ; Hospitalization ; Humans ; Immobilization ; Jeollabuk-do ; Korea ; Paralysis ; Poliomyelitis ; Protestantism

No abstract available.
Craniocerebral Trauma* ; Head*

OBJECTIVE: Estrogen is a major regulator/modulator of bone metabolism, and bone loss in estrogen deficiency is associated with increased bone turnover, But the mechanism for estrogen action on bone metabolism is still unknown. Recent studies have suggested that the increase in bone loss induced by estrogen deficiency is mediated by increased paracrine production of bone resorbing cytokines. Among cytokines, 1nterleukin-6(IL-6) is released from osteoblasts in estrogen deficiency and increases bone resorption by stimulation of osteoclastic activities and recruitment. Thus we performed this study to evaluate the effect of ovariectomies on bone mineral density and IL-6 in cultured monocytes of peripheral blood and bone marrow. METHODS: The experimental animals were 13 female Sprague-Dawley rats that were 8 weeks of age and weighed an average of 188.5 gram at the beginning of the study. Bilateral ovariectomies were performed in all rats from a ventral approach. Bone mineral density(BMD) of the total body, spine and level of IL-6 of cultured monocytes of peripheral blood and bone marrow were measured before and 8 weeks after ovariectomy. RESULTS: 1) BMD of total body and spine were lower after ovariectomy(0.257+/-0.069g/cm2, 0,208+/-0.005g/cm2) than before ovariectomy (0.276+/-0.005g/cm2, 0.229+/-0.011g/cm2), respectively (P<0.01). 2) Although IL-6 level of cultured monocytes in peripheral blood tended to be higher after ovariectomy than before ovariectomy, this difference was not statistically significant (P>0.05). 3) IL-6 level of cultured monocytes in bone marrow was higher after ovariectomy(82.78+/-4.99pg/ml) than before ovariectomy(48.85+/-2.42pg/ml)(P<0.05). CONCLUSION: It is possible that increased production of IL-6 in estrogen deficiency induced by ovariectomy occurs in the local environment of bone or bone marrow rather than in the pheripheral blood and stimulates bone resorption.
Animals ; Bone Density* ; Bone Marrow ; Bone Resorption ; Cytokines ; Estrogens ; Female ; Humans ; Interleukin-6* ; Metabolism ; Monocytes ; Osteoblasts ; Osteoclasts ; Ovariectomy* ; Rats* ; Rats, Sprague-Dawley ; Spine

Vimentin is an intermediate filament protein normally expressed in mesenchymal cells, but the evidence of the aberrant expression of vimentin in epithelial cancer cells suggests that the vimentin expression might be related to local invasiveness and metastatic potential. There have been a few previous studies on the vimentin expression in human cervical carcinogenesis using in vivo and in vitro models. We examined the immunohistochemical vimentin expression in various squamous epithelial neoplasms of the uterine cervix, including the cervical intraepithelial neoplasia group (n=25), the microinvasive squamous cell carcinoma group (n=15), the invasive squamous cell carcinoma group (n=15) and the metastatic squamous cell carcinoma group (n=8). Vimentin positivity was significantly higher in the invasive than in the intraepithelial group, and in the cases with lymph node metastasis than in those without metastasis, suggesting a relationship between the vimentin expression and progression of the uterine cervical epithelial tumors.
Carcinogenesis ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; Cervix Uteri* ; Female ; Humans ; Intermediate Filaments ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasms, Glandular and Epithelial* ; Vimentin*

No abstract available.
Carcinoma, Squamous Cell ; Humans ; Osteosarcoma

Cervical spine injuries are increasing recently due to increasing traffic accidents. Many patients have been treated with cervical laminectomy but stabilization of the cervical spine has been neglected as a part of the treatment. 30 patients with cervical spine injuries who were admitted to our hospital from January 1, 1973 to December 31, 1978 were evaluated. The following observations were made: 1. The ratio between male and female was 2:1 and the majority(43%) were found in the 4th decades. 2. The common causes of cervical spine injuries were traffic accident(40%) and falls(33.3%). The most common site of the lesion was the 5th and 6th cervical spine level (33.3%). 3. Among 30 cases, 10 cases(33.3%) had complete paralysis, 12 cases(40%) incomplete paralysis, 6 cases (20%) had nerve root injury and no neurological change is 2 cases. 4. The mechanisms of cervical injuries were classified morphologically and flexion-rotation injuries (55.5%) were the most common. 5. We evaluated the results of treatment neurological & radiographically. In complete paralysis, there was no neurological improvement and cervical kyphosis increased after laminectomy. In incomplete paralysis and nerve root injury, anterior fusion showed slight neurological recovery but mild cevical kyphosis and displacement of the graft were observed. In posterior fusion or cast immobilization, we had a satisfactory result with a high fusion rate and normal cervical curvature. 6. lt is impossible to compare anterior interbody fusion with posterior fusion for neurological recovery. For early mobilization and rehabilitation, we emphasize early stabilization by anterior or posterior fusion according to the mechanism of injury.
Accidents, Traffic ; Clinical Study ; Early Ambulation ; Female ; Humans ; Immobilization ; Kyphosis ; Laminectomy ; Male ; Paralysis ; Rehabilitation ; Spine ; Transplants

The function of the knee joint is determined by the anatomical integrity of ligamentous structures, however the ligaments and soft tissues which support by the knee joint are too weak to tolerate forceful stresses. The knee joint is one of the most susceptible joints to ligamentous injury. Recently, the incidence of ligamentous injuries of the knee increased because of rise in traffic accidents and participation in sports. For good results, it is very important to make an early diagnosis and to give prompt management. The authors reviewed 67 cases of ligamentous injuries in patients who were admitted and managed at the Department of Orthopaedic Surgery of Presbyterian Medical Center from March of 1976 to December of 1982. The results of the clinical study are as follows: 1. The prevalent age group is the 3rd through 5th decades, and more frequent in males (8. 6 times). 2. The traffic accident is the most common cause of injury (80. 6%) and many ligamentous injuries were associated with fracture (53. 2%). 3. The most common ruptured individual ligament was the medial collateral ligament. The isolated ligamentous rupture of anterior and posterior cruciate ligament was 3 cases each, but most of the cruciate ligaments were combined with other ligament injury. 4. The rupture sites of the individual ligaments were found to be the following: (a) The medial collateral ligament was ruptured most frequently in the mid-substance (45. 2%), with the deep layer ruptured at the femoral attachment and the superficial layer in the mid-substance; (b) The lateral collateral ligament torn at the fibular attachment (62. 5%); (c) The anterior cruciate ligament torn at the femoral and tibial (47. 6%, respectively); (d) The posterior cruciate ligament torn at the femoral attachment (40. 0%). 5. It is significant if the difference between the normal knee and the injured knee on the stress film is more than 10 or 10mm. 6. Excellent and good results were obtained in 95.2% by non-surgical management and in 93.0% by surgical management. 7. Early surgical repairs, made within 2 weeks after injury, gave much better results than late repairs.
Accidents, Traffic ; Anterior Cruciate Ligament ; Clinical Study ; Collateral Ligaments ; Early Diagnosis ; Humans ; Incidence ; Joints ; Knee Joint ; Knee ; Lateral Ligament, Ankle ; Ligaments ; Male ; Posterior Cruciate Ligament ; Protestantism ; Rupture ; Sports

Beurgers disease is a specific, recurrent, segmental, inflammatory, obliterative vascular disease involving principally the medium sized arteries and veins of the extremities. The disease was originally described by Leo Beurger in 1908. The results in treatment were not satisfactory in spite of many interaction and experiencies in treatment. So the present study is clinical analysis of 136 cases of Beurgers disease, who were treated at the Department of Orthopaedic Surgery and General Surgery, Presbyterian Medical Center, for the past 12 years, from 1971 to 1982. The results obtained are as follows: Sex distribution was predominent in male(97.1%) and peak incidence in the fourth decade. One hundred twenty eight cases had smoked over 10 years and sixty percent had more than one operation previously because of the same disease. The most common symptom was pain in the extrimities, necrosis, skin color change and coldness were in that order of frequency. The lower extremities were more commonly involved. The most common site of obstruction at the arteriogram was the popliteal artery. Among the surgery cases, 20 of the sympathetomized patients had followed-up, and the long term result showed improvement in 17 cases and all the results of the vascular surgery were poor.
Arteries ; Clinical Study ; Extremities ; Humans ; Incidence ; Lower Extremity ; Necrosis ; Popliteal Artery ; Protestantism ; Sex Distribution ; Skin Pigmentation ; Smoke ; Thromboangiitis Obliterans ; Vascular Diseases ; Veins

Hypernephroma comprises about 85-90% of renal malignancy in adults. The natural course of hypernephroma isvery diverse and unpredictable from abrupt explosive growth with wide spread metastasis to asymptomatic slowgrowth for several years. Reports from aliens indicated that hypernephroma with histopathological papillary growthpattern has better prognosis and more frequently hypovascular on renal angiography and less echogenic onultrasonography than non-papillary hypernephroma. Reviewed here retrospectively all the patients who were admittedand diagnosed as hypernephroma histopathologically at the Severance Hospital from March, 1973 through September,1984, in respective of angiographic vascularity, ultrasonographic echogenicity, histopathologic cell type andgrowth pattern, and following results were obtained. 1. The incidence of calcification in hypernephroma was 7cases out of 53 cases(13%). The incidence of hypernephroma according to cell type was clear cell type 20 cases(56%), mixed cell type 11 cases (31%), granular cell type 4 cases (11%), sarcomatous cell type 1 case(2%). Theincidence of hypernephroma according to growth pattern was papillary growth pattern 14 cases(45%) andnon-papillary growth pattern 17 cases(55%). 2. Renal angiographically, hypervascular hypernephroma was 19cases(73%), hypovascular hypernephromas was 6 cases(23%), all of which showed abnormal marginal vessels. 3.Angiographically hypervascular hypernephroma had high incidence of predominantly high echogenicity andangiographically hypervascular hypernephroma had high incidence of predominantly low echogenicity. 4. Clear celltype hypernephroma had high incidence of predominantly low echogenicity on ultrasonography. 5. Predominantly lowechogneic hypernephroma had high incidence of papillary growth pattern and predominantly high echogenichypernephroma had high incidence of non-papillary growth pattern. In summary, clear cell type hypernephroma hadhigh incidence of hypovascularity angiographically and hypovascularity on angiography was correlated withpredominantly low echogenicity on ultrasonography, and predominantly low echognicity had high incidence ofpapillary hypernephroma which was reported to have more good prognosis than non-papillary hypernephroma. So, itcan be suggested that if a hypernephroma show hypovascularity on angiography or predominantly low echogenicity onultrasonography, it has a good prognosis than hypervascular or predominantly high echogenic hypernephroma.
Adult ; Angiography ; Carcinoma, Renal Cell ; Emigrants and Immigrants ; Humans ; Incidence ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Ultrasonography

Unicameral bone cyst is an uncommon tumor-like lesion of the bone, containing distended channels or cavities filled with serous fluid. Four cases of cystic lesion at the upper end of the humerus were revealed to be unicameral bone cyst roentgenographically and microscopically. Two cases were treated with radical curettage followed by homogenous and autogenous bone graft, and one case was treated with radical curettage followed by homogenous bone graft. The other was treated with radical curettage followed by autogenous fibula graft. All cases made uneventful recoveries, and they had no complaints and no evidence of recurrence, A brief summary of literatures is submitted.
Bone Cysts ; Curettage ; Fibula ; Humerus ; Recurrence ; Transplants