A case of the bilateral idiopathic aseptic necrosis of the femoral head which was treated by a Colonnas arthroplasty and was followed by an Austin Moores prosthesis on the other hip joint satisfactorily is reported with review of literatures. A 44-year-old woman has a long history of steroid therapy for allevation of pain which started in hips for many months and also had an indigestion secondary to chronic hepatic disease. Diagnosis of the idiopathic necrosis of the femoral head was made by the typical roentgenologic findings and the clinical symptoms, and it was confirmed by the operative findings. The choice of treatment in bilateral idiopathic necrosis of the head of the femur is considered to be cup arthroplasty, but circumstances under which cup and instruments are not available certain another surgical procedures should be considered such as other metalic replacement or non-metalic arthroplasty. Here in this case Colonnas arthroplasty without metalic replacement in a hip and the prosthetic replacement in the other joint were thought to be the best procedure. Bilatal Colonnas arthroplasty is not chosen because they develop bilateral abduction deformity of the hips. She was discharged from the hospital with a pair of crutches in good function in her hips without any complication.
Adult ; Arthroplasty ; Congenital Abnormalities ; Crutches ; Diagnosis ; Dyspepsia ; Female ; Femur ; Head ; Hip ; Hip Joint ; Humans ; Joints ; Necrosis ; Prostheses and Implants

The spinal injuries were reported by relatively low incidence than other fracture and dislocation in the body. However, the rate of spine injury tend to increase year by year as the rate of traffic accident and industrial accident have been increased. Authors have experienced 403 cases of various type of injuries from Jan, 1966 to Aug. 1971. They were analysed as follows. 1. Out of 330 patient, males were 212 cases (64.2%) and female 118 (37.8%) Among them 74% of cases were between 20 to 40 years of age. About 51.9% of cases of the spinal injury were caused by traffic road accident. 2. The most most common fracture site in the spinal segments were between 12th thoracic spine and 2nd lumbar spine (69.0%) and most common types of spine injury was simple wedge fracture (70.7%) which is induced by flexion violence. 3. The stable injuries of the spine (69.4% 229 cases) were treated by functional methods such as bed rest, early ambulation. Injured spine were not immobilized in cast. They gave a more functional results than rigidly immobilized group. 4. 27 cases (8.2%) were complicated by paraplegia and mostly (59.3%) were caused by rotational fracture-dislocation. The common site of lesion were between D12-L2 (67.4%) 5. Among the 185 cases who were followed over 6 months, sponetaneous spinal fusion within 6 months after injury occured in 166 cases (89.7%) 76.8% of them were fused within 4 months. 6. Among the 27 paralysed cases, 3 were died within 2 weeks of admission, and 3 cases had complete recovery without residua.
Accidents, Occupational ; Accidents, Traffic ; Bed Rest ; Dislocations ; Early Ambulation ; Female ; Humans ; Incidence ; Male ; Paraplegia ; Spinal Fusion ; Spinal Injuries ; Spine ; Violence

Multiple myeloma is considered to be the most common primary malignant bone tumor which has the flat bone as a predilection site in old ages. We experienced a case of an unsual multiple myeloma which formed a huge tumor mass on medial end of left clavicle. The tumor mass together with medial half of the clavicle was excised completely. We have discussed the rationale for the excision of the clavicle.
Clavicle ; Multiple Myeloma

It is difficult to know whether the presence of infection in the plantar ulcer in patients with leprosy or not. Because routine bacteriology is often unhelpful, we need to investigate diagnostic method in this situation. C-reactive protein(CRF) levels have been known to be useful in detecting infection in some diseases. In this study, CRP levels were measured in 20 leprosy patients with plantar ulceration and 14 patients with leprosy alone. The results were as follows : 1. There was no elevation of CRP levels in patients with leprosy alone, and in the majority of patients with ulcers. 2. Of 20 patients with plantar ulcers, four had raised CRP levels one had clinically obvious infection, and three had erythematous skin of uncertain cause surrounding their ulcers. 3. Treatment with an appropriate antibiotics reduced CRP levels to normal, which was associated with clinical improvement. Therefore, it is suggested that increased CRP levels can be a useful probe for detecting significant bacterial infection in plantar ulcers of leprosy patients.
Anti-Bacterial Agents ; Bacterial Infections ; Bacteriology ; Foot Ulcer ; Humans ; Leprosy* ; Skin ; Ulcer*

No abstract available.

Clinical study on 62 patients (26 males and 36 females) with neurofibromatosis seen during past ten years at the Department of Dermatology, Pusan National Universitg Hospital, was made the variable clinical manifestations of the disease and Riccardis ciassification were emphasized. The results were as follows . 1) Family history was noted in 32 cases(51.6%) and exhibited autosomal dominant inheritance pattern. 2) Cutaneous neurofibromas were found in 52 cases(83.8%). 3) Cafe-au-lait spots, measuring greater than 1.5cm in its longest diameter, were found in 60 cases(96.8%) and 44 cases(71.0%) had more than 6 in number. 4) Among associated abnormalities were,' mental retardation(20,9%), skeletal abnormalities(11.2%), seizure, severe headache, etc. 5) According to Riccardis classification, 38 cases could be classified as type I, 28 cases(73.7%); type II, 0 case ; type III, 1 case(2.6%); type IV, 3 cases(7, 9%); type V, 1 case(2.6%); type VI, 4 cases(10.5%); type VII, l case(2.6%); and type VIII, 0 case.
Busan ; Cafe-au-Lait Spots ; Classification* ; Dermatology ; Headache ; Humans ; Inheritance Patterns ; Male ; Neurofibroma ; Neurofibromatoses* ; Seizures

Involucrin is a recently recognized structural component of mature squamous epithelial cells and is considered as a marker of normal eratinocyte differentiation and ma.turation. In this study peroxidase-antiperoxidase techniques were used to assess involucrin expression in histologic sections of normal skin and a variety of epidennal tumors including squamous cell carcinomas(25 cases), keratoacanthomas(11 cases), basal cell carcinomas(20 cases), trichoepitheliomas(5 cases), Howens diseases(12 cases), arsenic keratoses(10 cases), actinic keratoses(10 cases) and Pagets diseases(2 cases). The results were as follows : l. In normal skin, the upper third of the viable epidermis showed diffuse cytoplasmic staining for involucrin. In hair follicles, the lower area of inner root sheath and inner area of the outer root sheath stained positively. The sebareous glands did not stain, but the ducts of sebaceous glands were positive. 2. Keratoacanthomas showed a relatively homogeneous staining pattern for inirolucrin ', all cells except basal cells stained with mild to moderate intensity. In contrast, squamous cell carcinomas disclosed a highly irregular involucrin staining pattern with marked variation in staining intensity from cell to cell. 3. Basal cell carcinomas were negative for involucrin except squamous horn cysts, and the epidermis overlying basal cell carcinomas showed the field effect, that is, the epidermis overlying the tumors exhibited diffuse, homogeneous positive staining of cells in all layers of the epidermis. 4. ln trichoepitheliomas, the involucrin reactivity was negative as in basal cell carcinoma.s, but the field effect was not observed. 5. In Elowens disease, actinic keratosis, arsenic keratosis and Pagets disease, the positivit.y for involucrin staining extended deeper into the stratum malpighii than was observed wit,h normal epidermis. And areas showing irregular patchy pattern of involucrin staining were considered to have the potentiality of malignant invasive change much more than the negative or homogeneous areas. Paget's cells were negative for involucrin as the adjoining keratinocytes in the lower portion af epidermis.
Actins ; Animals ; Arsenic ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cytoplasm ; Epidermis ; Epithelial Cells ; Hair Follicle ; Horns ; Keratinocytes ; Keratoacanthoma ; Keratosis ; Keratosis, Actinic ; Sebaceous Glands ; Secobarbital ; Skin

Since Maisonneuve mentioned osteomyelitis complicated by typhoid fever for the first time in 1835, numerous investigators had reported salmonella osteomyelitis. The authors recently experienced six cases of salmonella osteomylitis: four cases in lumbar spine and the remainders in bones adjacent to elbow. Four cases were in adult male ranging from 18 to 35 years old and the others were in a male, age of thirteen and female, age of seven in elbow respectively. The two among four spondylitic cases and two cases of long bone ostemyelitis were surgically treated, and the other two spondylitic cases were conservatively treated. Salmonella osteomylitis was confirmed in surgically treated group by culture of pus obtained from pathologic lesion, and conservatively treated group was diagnosed by history, clinical manifestation, laboratory data and especially characteristic progress of roentgenographic change. The causative organisms were paratyphoid group D in all cases. Review of literature was done with report of six cases of salmonella osteomyelitis.
Adult ; Elbow ; Female ; Humans ; Male ; Osteomyelitis ; Research Personnel ; Salmonella ; Spine ; Suppuration ; Typhoid Fever

Fractures of the hip are usually classified first according to their anatomic location. Isolated fractures of the lesser or greater trochanter are not common and rarely requir surgery, Femoral neck fractures, intertrochanteric fractures, and subtrochanteric fractures are common categories that usually require open reduction and internal fixation. These fractures most often occur in elderly patients. The prognosis of these three major categories of hip fractures seems to be entirely different because of their anatomic characteristics. Seventy three cases of hip fractures were experienced at the Department of Orthopedic Surgery, Eul-Ji General Hospital over the period from Jan. 1975 to Aug. 1980 and the following results were obtained. 1. Of the 73 hip fractures, femoral neck fractures were 28 cases (38.5%), intertrochanteric fractures were 23 cases (31.5%), subtrochanteric fractures 11 cases (15%), and acetabular, fractures 11 cases (15%). 2. Traffic accident was the major cause of hip fractures in our series. 42 cases (57.2%) were caused by traffic accident, whereas 27 cases (37.0%) by a fall from the height. 3. Hip fractures occured most frequently in the age group from 31 to 50 years (53.5%). Male to female ratio was 2:1. 4. Cases caused by traffic accident visited hospital earlier than the others. 5. The most common type was Garden's type IV (53.6%) in the femoral neck fractures, Boyd-Griffins type Il (47.8%) in the intertrochanteric fractures, and Fielding's type II (54.5%) in the subtrochanteric fractures. 6. Metal devices used to fix hip fractures were Knowles pin, Jewett nail plate, compression hip screw, plate and screws, and Kuntscher nail. Internal fixation was done anatomical reduction has been achieved in stable fractures, and Dimon-Hughston reduction in unstable fractures. 7. Postoperative cast immobillzation was performed in 13 cases of 21 femoral neck fractures, 15 cases of 22 intertrochanteric fractures and 6 cases of 11 subtrochanteric fractures. The average duration of immobilization was 10 to 12 weeks. 8. Incidence of avascular necrosis in femoral neck fractures was 16.7%, nonunion in intertrochanteric fractures was 11.8%, and nonunion is subtrochanteric fractures was 12.5%.
Accidents, Traffic ; Acetabulum ; Aged ; Clinical Study ; Female ; Femoral Neck Fractures ; Femur ; Hip Fractures ; Hip ; Hospitals, General ; Humans ; Immobilization ; Incidence ; Male ; Necrosis ; Orthopedics ; Prognosis

No abstract available in English.