Gold salts have been used in the treatment of the rheumatiod arthritis for nearly 40 years. While the effectiveness is not consistant, their clinical application has been well established and conflicting results concerning the effectiveness of gold salts on adjuvant arthitis in rat have been reported. In light of conflicting reports in the literature we made an experimental study to observe the influence of gold salts and estrogen on the histopathology of the synovium in normal and hemarthrosis joints with bone marrow findings in rabbits in our test conditions. Rabbits weighing about 2kg were devided into 6 major groups of control, estrogen, gold, high dosage gold, and high dosage gold and estrogen. Each group subdivided into male group and female group. Estrogen(estradiol benzoate) and gold(sodium aurothioumalate) were injected intramuscularly at weekly intervals for 10 weeks. Autologous blood 1cc was injected into left knee joint through infrapatellar tendon after 10 weeks of treatment and right knee reserved as a control. Animals in each group were sacrifieced at day 1, 3, 7 after hemarthrosis and serial section from the synovial membrane and bone marrow were made. The following conclusions were obtained from observation of the experiment; 1. The mean hemoglobin levels were decreased in all groups including control, however, the decrease was most significant in estrogen treated group. 2. The mean W.B.C. count level during experiment decreased significantly in the experimental groups treated with large amount of gold and large amount of gold and estrogen. 3. In W.B.C. differential count, decrease of segmented neutrophils with increased lymphocyte was noted in the group treated with large amount of gold. 4. The plasma globulin level was decreased in all groups except the control and estrogen only treated groups, while total protein level was not changed. 5. The marrow cellularity was significantly decreased in all of the gold treated groups with increased percentage of lymphocyte, plasma cell, histiocyte and tissue basophils indicating the bone marow depression. The decreased cellularity in estrogen combined groups is less significant than in gold only treated groups. 6. The synovial changes in normal knee joints (right) were not significant. 7. The synovium of hemoarthrosed knee with autologus whole blood showed variable histopathological changes; Inflammatory responses with the proliferation of synovial cells and villi were significantly depressed in gold and gold with estrogen treated groups at the day 3 of hemarthrosis. The proliferative responses and inflammatory cell infiltrations were almost completely recovered to the normal synovium by the 7th day of hemarthrosis in gold treated groups still showing proliferative and inflammatory responses.
Animals ; Arthritis ; Bone Marrow ; Depression ; Estrogens ; Female ; Hemarthrosis ; Histiocytes ; Humans ; Joints ; Knee ; Knee Joint ; Lymphocytes ; Male ; Mast Cells ; Neutrophils ; Plasma ; Plasma Cells ; Rabbits ; Rats ; Salts ; Synovial Membrane ; Tendons

A case of chondromyxoid fibroma, which was experienced at Seoul National University Hospital, is presented with a brief review of the literature, because of its relative rarity in incidence, its unusual location and its huze size in demension which seems to be largest in reported series in literatures.
Fibroma ; Incidence ; Seoul

This study is performed to investigate whether free transplanted iliac physis can grow in the resected epiphyseal plate and prevent growth arrest secondary to an injury of epiphyseal plate. Growth arrest, angulation and regeneration of epiphyseal plate after free physeal transplantation from iliac crest in the partial resection of epiphyseal plate on the lateral aspect of the distal femoral epiphysis were analysed in process of time and compared with those of the simple partial resection of epiphyseal plate of distal femur. Seventy-six skeletally immature, three month-old rabbits with an initial weight of about 1200 to 1400gm were used for this study. The following experimental groups were made after partial resection of epiphyseal plate on lateral aspect of distal femoral epiphysis(2×7×3mm). Group A: partial resection alone(19 rabbits); Group B: muscle piece interposition(19 rabbits); Group C: free autogenous iliac crest physeal transplantation (38 rabbits). The opposite side of the leg was used as a control. Animals were killed and examined at the following time-intervals(14, 21, 30, 60 and 90 days after operation). The following results were obtained. 1. In the group of partial resections alone, the bone-brige formation between the femoral epiphysis and metaphysis revealed as early as 14 days, and this bridging was found consistently in all anlmals, which led to the growth arrest and valgus deformity. 2. In the group of muscle piece interpositions, the interposition materials were found temporarily effective for the prevention of epiphysiometaphyseal bone-bridge formation, but the effect was not significant to regain bone growth. 3. Histological studies showed that the grafted physis united with the residual part of the original femoral physis at 14 days after transplantation, and regained its columnar arrangement. The physeal graft appeared to be viable and contribute endochondral bone formation in following section (60, 90 days). 4. In the grodp of free autogenous iliaccrest physeal transplantations, the transplanted physis prevented or minimized the formation of a bone brige, growth arrest, and valgus deformity in most animals. Although not all of the physeal transplants were successful, physeal grafts would be most suceessful method regaining bone growth after focal injury of epiphyseal plate.
Animals ; Bone Development ; Congenital Abnormalities ; Epiphyses ; Femur ; Growth Plate ; Leg ; Methods ; Osteogenesis ; Rabbits ; Regeneration ; Transplants

Supracondylar fracture of the humerus in children is the most common fracture of the elbow in contrast with infant or adult, and there are also many problem in treatment and accompanying complication. These injuries are difficult to manage in case of a delayed initial treatment or repeated close manipulation. We analysed 32 cases which failed and delayed initial management, at department of orthopedic surgery, Chung Nam University Hospital from Jan. 1977 to Dec. 1981. The results obtained were as follows: 1. The cases admitted after unsatisfactory treatment at other hospital among all cases are most common (59.4%). 2. The average duration after trauma are 5.3 days. The average duration until successful reduction after initial trauma are 7.3 days, 3. In types of fracture, there are all displaced supracondylar fracture (Type II, III, IV). 4. In treatments, initial sucessful close reduction are 5 cases (15.6%). The others require other managements, ie, final successful tractions are 5 cases, final sucessful percutaneous pinnings are 5 cases and final open reductions are 16 cases. 5. Cubitus varus deformity was more common in manual reduction and traction groups than in open reduction and percutaneous pinning groups, but limitation of elbow motion was more common in open reduction and percutaneous pinning groups. 6. In complications, there were 5 nerve palsies (4 radial nerves, 1 median nerve), 3 pin tract infections, 1 myositis ossificans, 9 severe cubitus varus and 5 severe limitation of motion.
Adult ; Child ; Clinical Study ; Congenital Abnormalities ; Elbow ; Humans ; Humerus ; Infant ; Myositis Ossificans ; Orthopedics ; Paralysis ; Radial Nerve ; Traction

Total Hip Replacement is well documented and widely used procedure for painful arthritic hip in past two decades and each year still seems to be increased in numher of total hip replacement. And recently, there is a few reports of follow-up study on total hip arthroplasty in our country. The aim of this study was to present the clinical material which was performed on 27 hips of 21 patients who were treated at Dept. of Orthopedic Surgery. College of Medicine, Chungnam university from jan, 1979 to Jan. 1982. The longest follow up was 4 years, shortest was 8 months, average time was 2 years and 8months The results were obtained as follow; 1. The age incidence ranged from 26 to 69 years old, and average were 47 years old. 2. There were 17 males (81%) and 4 females (19%). 3, The causes of hip disease were mostly avascular necrosis of the femoral head (67%). 4, The most commonly used prosthesis were Muller type with trochanteric ostcotomy approaches. 5. Several complications were found: perforation of acetabulum with bone cenent in pelvis, postperative pneumonia wire breakage and painful bursitis around the trochanteric area which was on osteotomy sites. 6. Postoperative functional evaluation was evaluated by method of d'Aubigne and Postel, and improved from 10.0 scores to 15.8 scores. Relief of the pain is the most effect of the total hip replacement in this study, But case are not enough to more detail evaluation, especially, the problem of loosening of stem, acetabular cup wearing and heterotopic bone formation after total hip replacement.
Acetabulum ; Arthroplasty, Replacement, Hip ; Bursitis ; Chungcheongnam-do ; Female ; Femur ; Follow-Up Studies ; Head ; Hip ; Humans ; Incidence ; Male ; Methods ; Necrosis ; Orthopedics ; Osteogenesis ; Osteotomy ; Pelvis ; Pneumonia ; Prostheses and Implants

In 1868 Charcot described the joint in tabes dorsalis, which since then has been designated as Charcot neuroarthrophathy. It is characterized by painless swelling and abnormal mobility of the affected joint. Arthrophthy of the type described by Charcot has been associated with various other conditions, such as diabetes mellitus, syringomyelia, injury to nerve root, congenital indifference of pain, leprosy, and intra articular use of steroid, etc. Authors present a case of Charcot spine due to tabes dorsalis.
Diabetes Mellitus ; Joints ; Leprosy ; Spine ; Syringomyelia ; Tabes Dorsalis

The characteristic multiple cystlike bone lesions of tuberculosis in children is termed multiple pseudocystic tuberculosis of bone, A Korean girl aged 4 4/12 years was diagnosed as multiple pseudocystic tuberculosis of bone, This case which revealed typical findings is presented with a brief review of a literature.
Child ; Female ; Humans ; Tuberculosis

PURPOSE: The trinucleotide repeat expansion in the 3' untanslated resion of the gene is known to be the cause of myotonic dystrophy which is one of most common neurodegenerative disorder manifested by myotonia, cataract, mental retardation and even respiratory distress in neonates. The hereditary pattern of myotonic dystrophy shows more severe symptoms and shows earlier onset with successive generations and congenital cases, the most severe form of myotonic dystrophy,. Occurs by maternal transmission. This genetic transmission mode does not follow Mendelian genetic trait. To find the molecular genetic abnormalities of Korean myotonic dystrophy patients, we investigated the general distribution of myotonic dystrophy alleles and compared the results with referred patients. METHODS: During an 8 month study, from June 1995 to February 1996, 5 patients were referred with presumed diagnosis of myotonicdystrophy. Among these patients, four cases were confirmed to have the disease by clinical and electrophysiological findings. We included family members of the studied probands and 50 normal blood donor DNAs were included as controls. The DNAs of the enrolled cases were evaluated by Southern blot. Subsequently, copy numbers of the repeats were determined using PCR amplification. RESULTS: (1) Two peaks were found in the distribution of trinucleotide repeats in the normal Korean population. One peak had 5 copies and the other had 11 to 13 copies. The highest number of copies was 27. (2) Of the referred cases, 4 pedigrees showed typical expanded repeats. (3) The minimum expanded copy number was 55 and we were able to detect the expanded band only by PCR in 2 cases. In other cases, expaded bands were visible by Southern blotting. (4) There were trend of earlier onset of the disease, progressive worsening symptoms and larger expanded bands with successive generations. CONCLUSION: We established the methodology for myotonic dystrophy DNA diagnosis using Southern blot and PCR amplification based on the normal Korean allele distribution. These methods might be useful in genetic counselling and detection of minimally affected myotonic dystrophy patients.
Alleles ; Blood Donors ; Blotting, Southern ; Cataract ; Diagnosis ; DNA ; Family Characteristics ; Humans ; Infant, Newborn ; Intellectual Disability ; Molecular Biology ; Myotonia ; Myotonic Dystrophy* ; Neurodegenerative Diseases ; Polymerase Chain Reaction ; Trinucleotide Repeat Expansion* ; Trinucleotide Repeats*