No abstract available in English.
Blood Pressure ; Immobilization ; Orthopedics

Leprosy is an infectious dis as in which the immune machanism, in addition to the bacillus, plays an important role in Pathogenesis. As leprosy has two polar types, one of which is characterized by well preserved cellular immunity with a good prognosis and the other which shows no cellular immunity and a poor prognosis, it has been considercd the best human model for immunologic research. By studying the differences between these two typs, insights into immune deficiecies might well lead to the improved treatment of leproatous leproy(i.e.no cellular immunity) patients. Therefore, some immuno-theraputic trials for leprosy patients have already been reported by somc authors. In an attempt to survey spcific as well as nonspecific cellular immunity in leprosy, the authors prformed the lepromin and tuberculin skin tests with DNCB active cutanous sensitization on 203 leprosy patients in residence at the national leprosarium of Korea. All groups of Ieprosy patients showed decreased skin reactivity to the three tests, compared with normal, healthy control groups(p<0.01). This phenomenon is probably due to disorganization of lymphnode architecture and antigenic competition. Although a, statiscally significant difference could not be found in the tubercuIin and DNCB sensitization test results among all groups, the tuberculoid leprosy group and the arrested leprosy group showed stronger reactivity than the non-tuberculoid leprosy group. Patients positive for DNCB sensitization showed more positivity to the tuberculin test (66%)than to the lepromin test (30%) (p<0.01), thus suggesting that nonsp cific CMI and specific CMI exerted diffenent effects. Patients positive for DNCB sensitization also showed a greater probability (77%) to be responsive to either of the other two delayed cutanous hyperssensitivity tests than not. Leprosy patients in the third or fourth decade of life showed 63-66% positivity to DNCB active sensitization, while those in the six or seventh decad showed a positivity of 18-28%. These points toward significant correlation batween age and immun status. (p<0.01). The spontansous flare up during DNCB sensitization most frequently occurred on the 10th to 12th day of senitization: positive reaction after chalenge was most frequent in 72 hrs. after the test but some ractions were seen as late as five days after th. test. Two patiants of whole blood and its equivalent of leukocyte-rich plasme were irfused into 10 patients who had shown negative reaction to al! three tests. Conversion of delayed cutaneous hyprs:nsitivity among then was as follows; Four in tuberculin test (3 cases of which were strengthenings of preexisting ractivity). 2 in lepromin test, and 4 m DNCB sensitization. Of th 6 patients who showed a conversion in any one of the delayed cutaneous hypcrsensitivity evaluation tests, 4 showed conversion in more than two tests Of the 10 patients, who receivcd the transfusions (whole blood or lecocyte-rich plasma), 5 cases showed a high fever for 2 days afterrvards. The authors regard histocytotoxicity, incompatible histocompatibility, or perhaps simply a transfusion reaction as the underlying cause of this febrile reaction. One patient developed probably a phobia type psychosis following the blood transfusion and was subseuetly dropped from this study. Two months of observation following the transfusion revealed no definite clinical improvement.
Bacillus ; Blood Group Incompatibility ; Blood Transfusion ; Dinitrochlorobenzene ; Fever ; Histocompatibility ; Humans ; Immunity, Cellular* ; Korea ; Lepromin ; Leprosy* ; Leprosy, Tuberculoid ; Phobic Disorders ; Prognosis ; Psychotic Disorders ; Skin ; Skin Tests ; Tuberculin ; Tuberculin Test

Slipped femoral capital epiphysis is a rare entity in Korea and only three cases have been reported so far1,2,3). One of our cases was a unilateral mild chronic slip in a 14 year old boy with Frohlich body type. It was treated by gentle closed reduction followed by knowles' pin fixation. The other case, a 20 year old female, presented chondrolysis of the left hip. Scrutinization of roentgenograms revealed typical features of an unrecognized slipped femoral capital epiphysis. It was treated by Wagner resurfacing replacement arthroplasty.
Arthroplasty, Replacement ; Epiphyses ; Female ; Hip ; Humans ; Korea ; Male ; Somatotypes

Fixed pelvic obliquity refers to a composite deformity induced by contractures both above and below the pelvis and the elements of this deformity are frequently interrelated during the period of growth. From the functional standpoint, leg length discrepancy is caused by deformities of the pelvis and lower extremities, such as pelvic obliquity and acetabular dysplasia, as well as by inequality of true limb bone length, and these deformities either aggravate or compensate functional discrepancy. During fhe fourteen years period, from August 1968 to August 1982, at the Department of Orthopaedic Surgery, Seoul National University Hospital, we treated 35 cases of fixed pelvic obliquity and acetabular dysplasia associated with true or functional limb length discrepancy by means of lumbodorsal fasciotomy or pelvic osteotomies such as Salters innominate osteotomy or Steels triple osteotomy, combined, if necessary, with contralateral abductor fasciotomy to gain functional limb length as well as to improve posture and balance. In many cases of residual poliomyelitis, epiphysiodesis was also performed when indicated. These cases were reviewed and following observations were made: 1. Of the 35 cases, residual poliomyelitis with 29 cases (83%) was by far the main cause of leg length discrepancy. Cerebral palsy (2cases), Legg-Perthes disease (2 cases), and fibrous ankylosis secondary to septic hip (2 cases) comprised the remainder. 2. The male-to-female ratio was about equal, being 17 to 18. 3. The average age at the time of operation was 17.9 years, the youngest being 7 years and the oldest being 30 years. The average age at the time of current follow-up was 18.8 years. 67% of those followed was skeletally mature. 4. An average of 1.35cm of bone length was gained radiographically by pelvic osteotomies. Steels triple osteotomy was more effective in gain than Salters innominate osteotomy. 5. An average of 2.43cm of functional length when standing was gained radiographically by lumbodorsal fasciotomy alone. 6. An average of 2.61cm of functional length when standing was gained radiographically by lumbodorsal fasciotomy and combined contralateral Soutters or Campbells fasciotomy. 7. An average of 3.57cm of functional length when standing was gained radiographically by lumbodorsal fasciotomy and combined ipsilateral Steel's triple osteotomy. 8. An average of 1.73cm of functional lengthening when standing was corrected radiographically by ipsilateral Soutter's fasciotomy. 9. When lumbodorsal fasciotomy and Steel's triple osteotomy were combined with contralateral Soutter's or Campbell's fasciotomy, the average radiographic gain in standing length was 3.77cm. 10. Leg length discrepancy in terms of true bone length is conventionally corrected either by epiphysiodesis or bone shortening on the longer limb, or by bone lengthening on the shorter limb. We believe that when leg length discrepancy is associated with fixed pelvic obliquity, frequently aggravating the disability functionally, lumbodorsal fasciotomy and/or pelvic osteotomies on the shorter side and, combined if necessary, Soutters or Campbells fasciotomy on the longer side, can, in many instances, successfully correct or reduce functional limb discrepancy and improve balance, posture and function. Any residual discrepancy, true or functional, may then be corrected by conventional methods.
Acetabulum ; Ankylosis ; Bone Lengthening ; Cerebral Palsy ; Congenital Abnormalities ; Contracture ; Extremities ; Follow-Up Studies ; Hip ; Leg ; Legg-Calve-Perthes Disease ; Lower Extremity ; Osteotomy ; Pelvis ; Poliomyelitis ; Posture ; Seoul ; Socioeconomic Factors ; Steel

In 5 cases of congenital coxa vara, 7 cases of acquired coxa vara and 4 hips in 3 cases of acquired coxa valga, we performed subtrochanteric osteotomies at Department of Orthopedic Surgery, SeoulNational University Hospital, from December 1980 to February 1984. At a relatively short interim follow-up, following observations were made on the correction of the femoral neck-shaft angle deformities. l. In the congenital coxa vara group, at an average follow-up of 1 year and 3 months, 97.9% of the correction obtained by osteotomy was maintained, based on the roentgenographic measurements of femoral neck-shaft angle. In the acquired coxa vara group, at an average follow-up of 1 year and 2 months, 93.3 % of the correction obtained by osteotomy was maintained. In the acquired coxa valga group, at an average follow-up of 1 year and 5 months, 92.9% of the correction obtained by osteotomy was maintained. 2. At final follow-up, leg length gain averaged 1.26cm in the congenital coxa vara group and 2.23cm in the acquired coxa vara group. An average 0.70cm decrease in leg length was noted in the acquired coxa valga group. 3. Trendelenburg sign, which was positive in all the cases of the congenital and acquired coxa vara group, reverted to negative in all. 4. Slight overcorrection in cases of the acquired coxa vara and undercorrection in cases of the acquired coxa valga, is recommended for later loss of surgically corrected femoral neck-shaft angle. In the congenital coxa vara, it appeared that loss of correction was relatively minor.
Congenital Abnormalities ; Coxa Valga ; Coxa Vara ; Follow-Up Studies ; Hip ; Leg ; Orthopedics ; Osteotomy

Three cases of giant pituitray adenoma are reported. Two cases were operated by transsphenoidal approach and a case by transcranial approach. Transsphenoidal approach showed satisfactory results despite of marked suprasellar extension of tumors. We report rare giant pituitary adenomas with review of relevant literatures.
Adenoma ; Pituitary Neoplasms*

No abstract available.
Animals ; Cell Line* ; Guinea Pigs* ; Guinea* ; Hantaan virus* ; Humans*

No abstract available.
External Fixators*

In the treatment of an infected ununited fractures of a long bone, it often is difficult to achieve union and eradicate the infection. Over the past two decades, the electrical behaviour of bone has been studied with increasing interest and several reports reveal that electricity can stimulate osteogenesis. We have experienced 11 cases of infected non-union who were treated by immobilization plus direct current stimulation from January, 1980 to July, 1982. In all cases satisfactorv union occurred within averaging 8.1 months. The results obtained are as follows: 1. The direct current stimulation has revealed to be effective with antibiotics and some kinds of immobilization in treatment of infected non union. 2. If bone graft is combined with electrical stimulation, time from beginning of electrical treatment to union is shortened, as compared with cases of electrical stimulation alone. 3. The electrical stimulation is preferable to other surgeries in treatment of infected non-union due to its effectiveness and simplicity. 4. It is considered treatment of chronic osteomyelitis with silver anode is not due to electrically generated silver ion but its electricity per se. 5. To prevent refracture and assure complete healing, continued immobilization such as cast brace, walking cast, or conventional brace is necessary after electrical stimulation for the time being.
Anti-Bacterial Agents ; Braces ; Electric Stimulation ; Electricity ; Electrodes ; Fractures, Ununited ; Immobilization ; Osteogenesis ; Osteomyelitis ; Silver ; Transplants ; Walking

No abstract available in English.
Bone Transplantation ; Electric Stimulation ; Pseudarthrosis ; Tibia