The deformed and rigid spine presenting moderate to severe kyphosis and scoliosis results in a restriction of function of the lung best characterized spirographically by a reduction in vital capacity. When the lesion involves the thoracic spine, restriction of function is more marked. Spinal deformities such as kyphosis and scoliosis develop from various causes. Tuberculous spondylitis, a main cause of kyphosis and scoliosis, is increasingly found in Korea. Cardiorespiratory dysfunction caused by spinal deformity poses another problem besides the spinal deformity perse. To perform therapeutic measures such as Harrington instrumentation, with or without preoperative localizer cast and halofemoral traction, as well as anterior interbody fusion, evaluation of pulmonary function and arterial gas analysis preoperatively is helpful to prevent and reduce postoperative cardiorespiratory failure or complications. The authors have reviewed the results of arterial gas analyses and pulmonary function tests on 35 cases of scoliosis and 60 cases of kyphosis done at the Department of Orthopedic Surgery, Seoul National University Hospital, from January 1975 to February 1978. The results were as follows: 1. Average degree of scoliosis in 35 cases was 89; vital capacity 60% of normal, and maximum breathing capacity 72%. Average degree of dorsal spine kyphosis in 38 cases was 93.5; vital capacity 38%, and maximum breathing capacity 73% Average degree of lumbar spine kyphosis of 22 cases was 79; vital capacity 77%, and maximum breathing capacity 84%. 2. Static values for pulmonary function such as vital capacity and dynamic values such as maximum breathing capacity hed a significant negative correlation with the severity of scoliosis and kyphosis. 3. Decrease in vital capacity due to scoliosis and kyphosis correlated positively with decrease in maximum breathing capacity. 4. Arterial oxygen saturation had a significant negative correlation with the severity of scoliosis and kyphosis.
Congenital Abnormalities ; Korea ; Kyphosis ; Lung ; Orthopedics ; Oxygen ; Respiration ; Respiratory Function Tests ; Scoliosis ; Seoul ; Spine ; Spondylitis ; Traction ; Vital Capacity

OBJECTIVE: The objective of this study is to evaluate the expressions, microvessel counts and angiogenic pathway of VEGF and PD-ECGF and proliferative activity of Ki-67 according to clinicopathologic feature of cervical tumor. METHODS: Two hundred three cervical specimens were evaluated; among these 20 were designated normal epithelium, 36 mild dysplasia, 28 moderate dysplasia, 36 severe dysplasia, 28 carcinoma in situ, 17 microinvasive carcinoma and 38 invasive cervical carcinoma (21 squamous cell carcinoma and 17 adenocarcinoma). Microvessel count was determined by immunohistochemical staining using anti-factor VIII-related monoclonal antibody. The expression of VEGF (vascular endothelial growth factor) and PD-ECGF (platelet-derived endothelial cell growth factor) were evaluated by immunohistochemical staining with anti-human VEGF monoclonal antibody and anti-dThdPase monoclonal antibody. The proliferative activity was examined using a Ki-67 equivalent monoclonal antibody (MIBl). RESULT: There was no statistical significance on microvessel count except invasive cancer comparing with mild dysplasia including normal tissue, but there was a little increase in microvessel counts according to severity of tumor. The intensity of VEGF and PD-ECGF expression was significantly correlated with severity of cervical tumor. And the microvessel density was significantly higher in the positive expression of VEGF and PD-ECGF than in the negative expression. The intensity of PD-ECGF expression in invasive adenocarcinoma was significantly lower in comparison with VEGF expression. The intensity of Ki-67 expression had no correlation with severity of cervical tumor and was significantly higher in moderate and severe dysplasia than in microinvasive and invasive carcinoma. Ki-67 expression had no statistical correlation with VEGF and PD-ECGF. CONCLUSION: The VEGF and PD-ECGF are important angiogenic factors and associated with progression of cervical tumor. The VEGF may be involved in the progressions of squamous cell carcinoma and adenocarcinoma, but the PD-ECGF may not be involved or be minimally involved in the progression of adenocareinoma. There seems to be a different angiogenic pathway pertaining to the histologic difference of cervical cancer. There was no difference of Ki-67 expression according to severity of cervical tumor.
Adenocarcinoma ; Angiogenesis Inducing Agents ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Endothelial Cells ; Epithelium ; Microvessels ; Thymidine Phosphorylase* ; Uterine Cervical Neoplasms ; Vascular Endothelial Growth Factor A*

No abstract available
Constriction, Pathologic* ; Stents*

Fat embolism is one of a rare catastrophic complication after multiple fraetures and extensive soft tissue injury. Many hypothesis on its pathogenesis has been postulated by many writers, still its exact pathogenesis, definite diagnostic criteria and treatment is not established. Nowadays fat embolism is considered as a respiratory insufficiency syndrome, even disseminated intravascular coagulation rather than isolated phenomena after extensive trauma of musculoakeletal system. Respiratory failure associated with fat embolism is a major cause of death, but is usually seIf-limited and is responsive to intensive treatment. Monitoring of blood gas is required for early diagnosis and respiratory supportive treatment with continued monitoring is necessary until resolution. The writers experienced six cases of fat embolism, at the Department of Orthopedic Surgery, Seoul National University Hospital for the period of three years from June 1974 till May 1977. Respiratory support, parenteral steroid and low molecular weight dextran with other supportive measure was a mainstay of treatment. Of six cases, five was recovered without sequalae and one was expired four days after trauma.
Cause of Death ; Dextrans ; Disseminated Intravascular Coagulation ; Early Diagnosis ; Embolism, Fat ; Molecular Weight ; Orthopedics ; Respiratory Insufficiency ; Seoul ; Soft Tissue Injuries

Despite the technical improvements in Internal flxation of neck fracture were made in recent years, complications, such as non-union of the fracture and avascular necrosis of the femoral head, are not infrequent. Various operative techniques have been proposed to secure the reduced fracture fragment till union, and to restore or improve the circulation in the femoral head. One of them is muscle-pedicle bone graft to the fracture site of neck. It is very important if one can predict the vascularity of the femoral head prior to treatment and also the healing process of the neck fracture during treatment. In the past, there have been considerable investigations to achieve these goal, but no method universally has been accepted as reliable and practical. Among them, Intra-osseous venography (I.O.V.) and sclntimetry utilizing the isotope trace techniques were widely used in recent. Authors adopted a cephalic and trochanteric I.O.V. to observe the fracture healing and to predict viabillty of the femoral head, and also tried a new technique (Indirect cepallc I.O.V.) to perform both techniques of I.O.V. at the same time. With the ald of image Intensifler, a bone marrow needle Is inserted 1 inch below the greater trochanter of femur, and when the tip of the needle is reached 0.5 to 1.0 cm near to fracture line in the marrow cavity, about 25 cc of 75% Urograffin is Injected by speed of 1 cc per second with sereial X-rays taken at 1,3,5 and 15 minutes (trochanteric I.O.V.). Then already inserted puncture needle for trochanteric I.O.V. are more advanced through the fracture line of the neck into the femoral head. About 10 cc of 75% Urograffin Is Injected by speed of 1 cc per second with serial X-rays taken (Indirect cephallc I.O.V.). The merits of this indirect cophalic l.O.V. via trochanteric route is that it is also simple and Practical and there is no significant complication: such as septic arthritis of hlp & thrombophlebitis. Difficulties of inserting the needle through the trochanter and the neck into the head and occasional unwanted hip-arthrogram are listed as the main demerits of this technique. But these demerits can be minimized by the accurate image intensifier control. A positive trochanteric venography is one in which venous drainage is established across the fracture site with opaque contrast medium being spread out diffusely into the head, and eventually draining out into the surrounding soft tissue via draining velns. While positive cephalic venography via trochanteric route is one in which contrast medium is spread out diffusely in the head and trochanteric region via crossing veins. Hereby, we performed internal fixation and an autogenous muscle-bone pedicle graft composed of the quadratus femoris muscle in 4 cases of femoral neck fracture which are confirmed that there are head viability by using of the cephalic I.O.V.. Since then, we checked the both I.O.V. every 6 wks post-operatively. The results seemed to be good in regard to bony union in all 4 cases, and we have also found that cephalic and trochanteric I.O.V. are a useful diagnostic tool in hip fracture.
Arthritis, Infectious ; Bone Marrow ; Drainage ; Femoral Neck Fractures ; Femur Neck ; Femur ; Fracture Healing ; Head ; Hip ; Methods ; Neck ; Necrosis ; Needles ; Phlebography ; Punctures ; Thrombophlebitis ; Transplants ; Veins

No abstract available in English.
Child ; Hip ; Humans

It is well known that early diagnosis and early treatment is very important for the patient with congenital dislocation of the hip joint to provide a favorable function in the whole life. The goal of treatment, which is either conservative or operative, is to replace the dislocated hip into the socketand restore its anatomical position. If the head is reduced lately, it may subluxate or redislocate. As a result, secondary osteoarthritis will be complicated in such hips at a laterdate The most cases of congenital dislocation of hip have a increased anteversion and vaglus deformity. It is known that these deformity are cause of redislocation or subluxation, and should be corrected by varus or derotational varus osteotomy to restore for normal cephalocotyloid relationship. We analized 18 residual subluxation of hips which had been treated by derotational varus osteotomy. The results obtained are as follows. 1. Regardless of the age at the time of osteotomy and the amount of varization, the neck-shaft angle corrected to nearly normal in all cases within 3 years after the osteotomy. 2. Acetabular development, indicated by acetabular index, was satisfactory when the osteotomy was done before 4 years, but unsatisfactory in the cases after 4 years of age. 3. Coxa valga epiphysialis of the subluxated head corrected spontaenously after osteotomy in all cases. 4. Subluxated head, indicated by C-E angle and migration percentage, reduced in the cases who had by the derotational varus osteotomy in patients below age of 4 years, but it persisted without further luxation in the cases over 4 years of age.
Acetabulum ; Congenital Abnormalities ; Coxa Valga ; Dislocations ; Early Diagnosis ; Head ; Hip Joint ; Hip ; Humans ; Osteoarthritis ; Osteotomy

No abstract available in English.
Orthopedics ; Suction ; Wounds and Injuries

Four cases of subungal exostosis are presented. All of them were young male and big toe was involved in 2 cases. Histological features of subungal exostosis was characteristic; the cancellous bony stalk was capped mainly fibrocartilage, although scattered areas of hyaline cartilage were also found where enchondal ossification occured. Superficial to this cartilaginous cap, there was fibrous tisse covering. When terminal phalax of a toe shows deformity of nail and skin changes due to hard mass, radiological examination is required for the proper diagnosis and treatment. Complete local excision is required but damage to the nail bed during excision should be avoided.
Congenital Abnormalities ; Diagnosis ; Exostoses ; Fibrocartilage ; Hallux ; Humans ; Hyaline Cartilage ; Male ; Skin ; Toes

We performed ERCP manometry of Sphincter of Oddi(SO) before and after endoscopic sphincterotomy(EST) for evaluation of the effect af EST on the SO. The subjects were postcholecystectomized common bile duct stone patients(n=l2) and EST was performed by major incision. The pressure gradient between common bile duct and duodenum before EST (8.6 + 3.9 mmHg) decreased significantly after EST(2.4 +1.7 mmHg). The length of SO before EST(8.8 + 0.8mmHg) decreased significantly after EST(2.5 + 0.8mm). But in each patient, the pressure gradient between common bile duct and duodenum remained in spite of the major incision. In conclusion, EST alters the function of the sphincter of the Oddi, but does not destroy its all protective function. The positive pressure in the bile duct is preserved in contrast to the absolute loss of pressure following surgical transduodenal sphincteroplasty.
Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Duodenum ; Humans ; Manometry* ; Sphincter of Oddi* ; Sphincterotomy, Endoscopic* ; Sphincterotomy, Transhepatic