BACKGROUND: Many mammals normally have a population of dermal melanocytes but these are not found in man, In humans, persistent dermal melanocytes can occur in the Mongolian spot, the nevus of Ota, and the blue nevus. Mongolian spot develops in the fetal or neonatal time and disapperars almost invariably during childhood. In contrast, nevus of Ota and blue nevus are not usually present at birth and persists in adult life. Recently, it was established that apoptosis can be involved in the development of melanocytes. The integrins mediate cell-cell and cell-matrix interactions, and apoptosis can be induced by disruption of cell-matrix interactions. OBJECTIVE: The purpose of this study was to investigate the expression of integrins (a2, a3, ar) and in situ detection of fragmented DNA in Mongolian spot, nevus of Ota, and blue nevus. METHODS: Formalin-fixed and paraffin-embedded tissues from 8 cases of Monglian spot, 5 cases of nevus of Ota, and 4 cases of blue nevus were immunolabelled with monoclonal antibodies TM directed against az, ay, and av integrin, and stained with ApopTag in situ using an Apoptosis Detection kit. The cases of Mongolian spot were divided into two groups in which group A represented the the cases of more than 45 melanocytes and group B represented the cases of less than 10 melanocytes in a tissue section of 4-mm taken from punch biopsy specimens. RESULTS: Blue nevi showed az and e integrin expressions in dermal melanocytes and weak to negative staining of g v integrin in comparison with all positive expressions of a z, a s, and g y integrin in A group-Mongolian spots and nevi of Ota. The B group-Mongo]ian spots showed the continuous expressions of a z and a y integrin with negative expressions of a v integrin. The ApopTag kit staining was all negative in the Mongolian spots, nevi of Ota, and blue nevi. CONCLUSION: Our results support the view that dermal melanocytic tumors, such as the Mongolian spot, the nevus of Ota, and the blue nevus, might be induced by the disturbance or inhibition of the apoptotic process of the melanocytes, and that the spontaneous disappearance of the Mongolian spot may not be related to the apoptosis.
Adult ; Antibodies, Monoclonal ; Apoptosis ; Biopsy ; DNA ; Humans ; Integrins ; Mammals ; Melanocytes ; Mongolian Spot ; Negative Staining ; Nevus ; Nevus of Ota ; Nevus, Blue ; Parturition

PURPOSE: The aim of this study is to investigate the biomechanical and histological changes in the muscles after tendon injury that have been little studied previously. MATERIALS AND METHODS: Triceps insertion was tenotomized on the left hidlimbs of 60 rabbits. Mechanical extension testing with Instron (rate: 10 mm/min) was performed 1, 2, 4, 8, 12 and 16 weeks after tenotomy in vivo. A load deformation curve was obtained, and this was analyzed in terms of strength and deformation at the elastic limit and at the point of maximal load. Histologic changes were observed after H < E staining and Matson s trichrome staining to measure the percentage area of collagen fibers. RESULTS: Between weeks 1 and 4, the excursion range fell gradually, and after that period, this value showed little changes. After its initial period of disequilibrium, the muscle regained its elastic nature within its newly formed excursion range. The average amount of collagen fibers increased gradually after tenotomy until 8th week. CONCLUSIONS: unless tendon ruptures are repaired early, the accompanying muscle would be irreversibly damaged, both bimechanically and histologically.
Collagen ; Muscles ; Rabbits ; Rupture ; Tendon Injuries ; Tendons ; Tenotomy*

Various types of arthroplasty has been performed to obtain mobile joint in the treatment of the hip disease. In the view of stabilization and painlessness of the hip joint arthrodesis has been the treatment of choice in many hip problems, especially in unilateral tuberculosis of the hip. There are many kinds of techniques to gain arthrodesed hip: intra-articular only, extra-articular and combined method. The author reviewed the 42 cases of the arthrodesis of the hip performed at Dept. of Orthopedic surgery, SNUH during the period of 1964 to 1972 with following results. 1. Among 42 patients, there were 29 males and 12 females. Age group of predominence was 2 nd and 3rd decade (66.7%). 2. Thberculosis was the most common causative disease (61.9%) and remainders were fracturedislocation and avscular necrosis of femoral head. Average duration of illness was 3.8 years 3. The operative techniques were 21 Ghomley method (50%) and 11 Davis (26.2%). Satisfactory fusion was gained in 25 cases(92.6%) among 27 cases which follow-up study were possibe for more than 6 months. 4. There was no definite difference in fusion rate between Ghomley and Davis techniques. 5. Satisfactory fusion was gained with Davis technique in avascular necrosis of femoral head. 6. The fusion rate was superior in less than 39 years age group (95%).
Arthrodesis ; Arthroplasty ; Female ; Follow-Up Studies ; Head ; Hip Joint ; Hip ; Humans ; Joints ; Male ; Methods ; Necrosis ; Orthopedics ; Tuberculosis

No abstract available in English.
Classification ; Clinical Study

Even though various kinds of diagnostic and therapeutic measures have been used for the detection and cure of the acute osteomyelitis, this disease is difficult to be eradicated in many clinical cases. However it is rather easy to treat once this disease can be detected in early stage. So far radiological examination and many kinds of maneuvers including blood culture, clinical laboratory, xeroradiography, computed tomography have been performed for the early detection of this disease but invalid in the most cases. Recently some authors reported that the bone scanning was useful for the early detection of acute osteomyelitis, but this method also had difficulty in differential diagnosis and uncertaninty of its activity. This study aims to try to find methods of early detection of acute osteomyelitis. Experimental osteomyelitis was developed by the inoculation of Staphylococcus aureus to proximal tibias of 39 young rabbits already sclerosed by solution of sodium morrhuate. By comparing the clinical, radiological, bacteriological and laboratory findings in sequence from 2 days to 7 weeks after inoculation, the following results were obtained. 1. The incidence of experimental osteomyelitis after inoculation of staphylococcus aureus SNUH-S-188 in suspension of 1×10(7) colony forming units was 84%, 74%, and 79% in radiological, blood culture and pathologic examination respectively. 2. The leucocytosis was noticed only in early stage and slight degree of anemia was found during the 1st and 2nd weeks after inoculation. The sedimentation rate was increased only in early acute stage and same was eosinophil count. The leucocyte alkaline phosphatase(LAP) and platelet count. showed no significant abnormal changes. 3. Lymphocyte and eosinophil turned over from normal and eosinophil was predominant in experimental osteomyelitis. 4. Serum calcium, phosphorus, total protein and albumin showed significant decrease in all stages and was conversely paralle1 to changes in groin temperature. The level of BUN was normal indicating normal kidney function in experimental osteomyelitis. 5. Even though the enzymes of which showed no significant changes enrolled alkaline phosphatase and serumgluiamicoxalic-transaminase(S-GOT), but some increa.e was attained to 27% and 44% respectively. 6. It is important and significant to find continuous increase of lactic dehydrogenase (LDH) and creatine phosphokinase (CPK) since 48 hours after inoculation and author, think these will be the reliable and sensitive indices in early detection of the development of osteomyelitis and efficacy of therapeutic measures.
Alkaline Phosphatase ; Anemia ; Calcium ; Creatine Kinase ; Diagnosis, Differential ; Eosinophils ; Groin ; Incidence ; Kidney ; Lymphocytes ; Methods ; Osteomyelitis ; Oxidoreductases ; Phosphorus ; Platelet Count ; Rabbits ; Sodium Morrhuate ; Staphylococcus aureus ; Staphylococcus ; Stem Cells ; Tibia ; Xeroradiography

No abstract available.
Autografts*

No abstract available.
Abortion, Spontaneous* ; Cytogenetics* ; Female ; Humans ; Pregnancy

Paralytic hand is the ultimate result of permsnent damage of the central nervous system, failure of the functional repair of peripheral nerve injuries and extensive muscular or tendinous defect resulting in the impairment of hand function. There are a lot of controversies in the side of treatment methods in the paralytic hand, and it is very difficult to formulate the most adequate surgical reconstruction for a given pstient. At Depsrtment of Orthopedic Surgery, Seoul National University Hospital, 66 cases oi paralytic hands in 62 patients have been treated surgically with tendon transfers for 7 years from Jan, 1980 to Dec, 1986. 49 case in 46 patients were followed up for more than one year, and surgical method and its results were anslysed. They consist of CNS lesion (17), peripheral nerve lesion(23) and musulotenidinous defect(9). The methods of surgical reconstruction were opponenesplasty(12), standard set extensor reconstruction(9), Green and Bsnks FCU transfer(11), intrinsic reconstruction(7), pronator rerouting(7), adductorplasty (5) and so on. The mean follow-up was 2.2 years, and in 38 cases good or excellent results were obtained.
Central Nervous System ; Follow-Up Studies ; Hand ; Humans ; Methods ; Orthopedics ; Peripheral Nerve Injuries ; Peripheral Nerves ; Seoul ; Tendon Transfer

Posteroanterior radiographs of normal wrist were taken in seventeen volunteers, and analysed to determine the dynamic relationships between the radiocarpal and midcarpal joint during radioulnar deviation. The total arc of radioulnar deviation was 59 degrees, and the motion was 44% radiocarpal and 56% midcarpal. During radioulnar deviation, the motion at the midcarpal joint was more than that at the radiocarpal joint. It is suggested thst dorsoradial and palmar-ulnar flexion as it occurs at the midcarpal joint can be correlated in radio-ulnar deviation of the wrist more than the coronal sliding motions as it occurs mainly at the radiocarpal joint.
Joints ; Volunteers ; Wrist

We have experienced 29 cases of microvascular surgery during a year since Apr. 1981. We performed 18 cases of composite tissue transfer in 17 patients. 3 cases of axillary flap, 5 cases of dorsalis pedis flap, 4 cases of living fibula transplantation, 2 cases of groin flap using deep circumflex iliac vessels, a case of osseocutaneous flap using the 11th rib, living M-P joint from the 2nd toe to finger, neurovascular island flap from the lateral side of the 3rd finger, and a case of musculocutaneous flap using the gracilis muscle were done. The causes of the soft tissues and/or bone loss were open fracture, which is the most common cause, osteomyelitis, congenital pseudarthrosis of the tibia, bone tumor, and scar contractures, etc. The success rate of the composite tissue transfer was 89%. The 2 cases of failure were observed. The one is due to the vascular damage after the leg lengthening in congenital pseudarthrosis of the tibia and the other due to the infection on the grafted area. The follow up period was from 4 to 18 months. The patients except failed 2 cases were pleased the result of the surgery. The composite tissue transfer using microvascular surgery has many advantages in that the tissue defect can be filled by one stage operation, the patient would be less dependent wish shorter hospital stay, the patient would be less morbid with better function than the patient with multi-staged complex operations. The composite bone and soft tissue transfer used for the infected bony defect made the infection heal more rapidly than the other conventional methods. The deep circumflex iliac artery played a good role in making the osseocutaneous flap, which has many advantages such that Taylor had described. But it is not the truth for the skin only problem. So we darely suggest the third category of the arterial supply to the skin as osseocutaneous artery to supply the overlying skin through the bone, which is exampled with the deep circumflex iliac artery. The vessels in the area of a limb lengthening would be stretched and severely damaged. And the overstretched vessels in limb lengthening should not be used in the microvascular surgery, if the time interval from the traction is not plentifully elapsed and the vessel status is not converted to normal.
Arteries ; Cicatrix ; Contracture ; Extremities ; Fibula ; Fingers ; Follow-Up Studies ; Fractures, Open ; Groin ; Humans ; Iliac Artery ; Joints ; Leg ; Length of Stay ; Myocutaneous Flap ; Osteomyelitis ; Pseudarthrosis ; Ribs ; Skin ; Tibia ; Toes ; Traction ; Transplants