Hemorrhagic fever with renal syndrom is an acute febrile disease which is caused by Hantanvirus and several other viruses that belong to the genus Hantavirus. Gl and G2 glycoproteins of Hantanvirus have been thought to be involved in protective immunity against Hantanvirus infection. In this study, the antigenicity of G1 and G2 glycoproteins in cell mediated immune response was investigated. When peripheral blood mononuclear cell fraction from recovered hemorrhagic fever with renal syndrome patient was cultivated with a recombinant protein containing amino-terminal 78 amino acids of G2 glycoprotein, these cells were activated to proliferate and secreted significant amount of interleukin-2 and interferon-r. These results suggest that T cell epitope exists in the amino-terminal region of G2 glycoprotein.
Amino Acids ; Epitopes, T-Lymphocyte ; Fever ; Glycoproteins* ; Hantavirus ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Interleukin-2

Serum lipids and lipoproteins were determined in 70 patients with hypertension, 40 patients with cerebral infarctions, and 41 patients with cerebral hemorrhage. The results were compared with findings in 64 healthy controls. The results are as follows; 1) Total cholesterol, VLDL-cholesterol, LDL cholesterol and total cholesterol/HDL-cholesterol ratio were significantly higher in patients with hypertension or cerebral infarction than in control group, but HDL-cholesterol showed no significant difference. 2) In Patients with cerebral hemorrhage, total cholesterol, LDL-cholesterol and HDL-cholesterol were higher than in normal controls. Total cholesterol/HDL-cholesterol ratio was within the limits of normal. It is possible that the susceptibility to cerebral infarction is the result of high total cholesterol/HDL cholesterol ratio rather than low HDL cholesterol. But our study suggests that hyperlipoproteinemia plays a minor role in the development of cerebral hemorrhage.
Cerebral Hemorrhage ; Cerebral Infarction ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Humans ; Hyperlipoproteinemias ; Hypertension* ; Lipoproteins

A sepsis or multiple organ dysfunction occurs frequently in the intensive care unit and causes a significant number of mortality and morbidity. Somtimes polyneuropathy of varying severity occurs in association with a sepsis or critical illness. Since the clinical evaluation is often difficult, electrophysiologic studies are employed to reveal a definitive evidence for polyneuropathy. The purpose of this study was to investigate the frequency of polyneuropathy and to determine the electrophysiologic features of critically ill patients. The subjects were 23 patients between ages of 42 and 72 with a sepsis or systemic inflammatory response syndrome combinded with the multiple organ failure. The results revealed reductions in the amplitude of compound motor action potential and sensory nerve action potential, as the most marked abnormality. Needle EMG revealed the signs of denervation of limb muscles. Approximately 65.3% of adult patient with sepsis or multiple organ dysfunction has an axonal polyneuropathy. We suspect that the axonal polyneuropathy is related to the severity of multiple organ dysfunction.
Action Potentials ; Adult ; Axons ; Critical Illness* ; Denervation ; Extremities ; Humans ; Intensive Care Units ; Mortality ; Multiple Organ Failure ; Muscles ; Needles ; Polyneuropathies* ; Sepsis ; Systemic Inflammatory Response Syndrome

We retrospectively analysed plain radiographs and MR imaging of 16 conventional osteosarcoma cases(8 children, 8 adults) which underwent amputations or limb salvage operations. Pathologic correlation was performed with gross and microscopic sections to evaluate 1) whether the open epiphyseal plate can function as a barrier against transphyseal spread of osteosarcoma and 2) the diagnostic value of MR imaging for the detection of the detection of the epiphyseal involvement of osteosarcoma. In children with open epiphyseal plates, conventional radiographs suggested transphyseal tumor growth in one of eight cases(12.5% and MR imaging in seven cases(87.5%). Pathologic examination confirmed epiphyseal involvement in six of seven cases noted with MR imaging(75%). On the the other hand, in adult patients with closed epiphyseal plates, conventional radiographs showed transphyseal tumor growth in six of eight cases(75%), while MR imaging and pathologic exam demonstrated tumor invasion in all cases(100%). We conclude that open epiphyseal plate does not function as and effective barrier against tumor extension, and MR imaging is an excellent method in detecting the extent of transphyseal tumor growth.
Adult ; Amputation ; Child ; Growth Plate ; Hand ; Humans ; Limb Salvage ; Magnetic Resonance Imaging* ; Methods ; Osteosarcoma* ; Retrospective Studies

Double primary cancer is defined as the case of primary malignant tumors in one person, which must be arisen in different sites and have a different histologic appearances in each other. The number of reported cases of multiple primary malignant tumors has increased in recent years, because of more developed diagnostic procedure and long survival of cancer patients, We have experienced 4 cases of double primary malignant tumors which were stomach cancer with colon, bronchus and esophagus cancer, and report these cases with review of literatures.
Bronchi ; Colon ; Esophageal Neoplasms ; Humans ; Stomach Neoplasms

Double primary cancer is defined as the case of primary malignant tumors in one person, which must be arisen in different sites and have a different histologic appearances in each other. The number of reported cases of multiple primary malignant tumors has increased in recent years, because of more developed diagnostic procedure and long survival of cancer patients, We have experienced 4 cases of double primary malignant tumors which were stomach cancer with colon, bronchus and esophagus cancer, and report these cases with review of literatures.
Bronchi ; Colon ; Esophageal Neoplasms ; Humans ; Stomach Neoplasms

Sacro-iliac joint is, as other joints, the prediIection site of tuberculous or pyogenic arthritis as well as primary or metastatic tumor. The writers reviewed twenty cases of sacro-iliac lesion performed at the Department of Orthopedic Surgery, Seoul National University Hospital, for the period of five years from June 1972 till May 1977. 1. They are tuberculous arthritis eleven, pyogenic arthritis five, ankylosing spondylitis two(one associated with spinal stenosis, the other with hip invoIvement), osteosarcomatosis one, metastatic tumor from adenocnrcinoma of prostate one 2. Infection is the predominant Iesion in sacro-iliac joint, and tuberculous arthritis is twice than pyogenic arthritis. 2. Early diagnosis of sacro-iliac lesion is difficult, but S-I stress test is a valuable finding. 4. Two of eleven cases of tuberculous arthritis, two of five cases of pyogenic arthritis with mild involvement were treated conservatively without sequele, but in more advanced cases, surgical intervention was preformed.
Arthritis ; Early Diagnosis ; Exercise Test ; Hip ; Joints ; Orthopedics ; Prostate ; Seoul ; Spinal Stenosis ; Spondylitis, Ankylosing

We have experienced 11 cases of large bony defect that were treated using microsurgery since 1981. Free vascularized bone transplantation was performed in 8 of them, vascularized bone transposition in 2 cases, and free vascularized joint transplantation in the remaining 1 case. The causes of the large bony defect were primary bone tumor (4 cases), congenital pseudoarthrosis (3 cases), open comminuted fracture (2 cases), sequela of osteomyelitis (1 case), and post-traumatic ankylosis of PIP joint of second finger (1 case). As a donor, fibula was used in 8 cases, iliac crest in 1 case, rib in 1 case and in the remaining 1 case, the second M-P joint of foot was transplanted. In 9 of 11 cases, successful result was obtained and 2 cases were failed because of vascular damage following tibial lengthening in one case and infection on the grafted area in the other one. From the above data and review of articles, following conclusions were obtained. 1. Fibula is thought to be the most appropriate donor for the large bony defect in the extremity, especially in lower extremity, but the donor site must be determined according to the anatomical and physilogical condition of the patient. 2. After mechanical lengthening of the extremity, it is recommened to perform the microvascular surgery after sufficient time for the recovery of vascular damage. But further studies are required for the identification of the change in the vascular tissue following stretching and its recovery time. 3. Progression of the ossification in the epiphysis of transplanted iliac crest was observed and this finding proposed us the idea that the epiphyseal plate injury or leg length discrepancy will be able to be treated with free vascularized epiphyseal plate transplantation and the reconstruction of the destroyed joint of growing children will be possible using free vascularized joint transplantation. 4. As the technique become more popular, the free vascularized bone transplantation is being used for the reconstruction of the extremity more frequently, but it seems to be wise to restrict its indication to cases which are impossible to be treated with more simple methods such as vascularized bone transposition or pedicled bone graft.
Ankylosis ; Bone Transplantation ; Child ; Epiphyses ; Extremities ; Fibula ; Fingers ; Foot ; Fractures, Comminuted ; Growth Plate ; Humans ; Joints ; Leg ; Lower Extremity ; Microsurgery ; Osteomyelitis ; Pseudarthrosis ; Ribs ; Tissue Donors ; Transplants

Recently, morbidity and mortality are reduced in elderly trochanteric fracture patients, which is best accomplished with multiple flexible intramedullary nail fixation under image intensifier control. Condylocephalic nailing of the trochanteric fractures offers four advantages; Minimally traumatic, short operation time, little blood loss, and very early weight bearing on the injured limb after surgery. The authors treated 15 cases of intertrochanteric fractures from June 1981 to March 1983 with multiple flexible intramedullary nails (Ender or P.G.P.). The results obtained were as follows; l. Among 15 cases, two patients were ages between 41 and 50, there between 51 and 60, one between 61 and 70, seven between 71 and 80, and two patients above 81 years, Nine were men and six women. 2. The average operation time was 60 minutes (range, 30 to 150 minutes) and average blood loss was 140ml (range, 50 to 400ml). After operation, Bucks extension traction was applied for 3 weeks in three cases. 3. Partial weight bearing ambulation was recommended one day after operation in eleven cases, and at 21th days in the other three cases. Full weight bearing ambulation, using appropriate assistive devices, was recommended as early as possible. 4. The clinical union was obtained as early as 5 weeks after operation in 7 cases, 9 weeks in two cases and 12 weeks in one case. 5. Among the complications, downward migration of the nail occured in two patients. With early weight-bearing, varus deformity due to collapse of the reduced fracture resulting secondary leg shortening (less than 3 cm) occured in 8 cases and mild external rotation deformity of lower leg in 3 cases (less than 15), but did not present any clinical problem in elderly patients, Irritation by the nail tip caused pain around the knee and also developed the partial stiffness of the joints temporarily after surgery. No nails migrated into the oits. It was felt that most difficult thing to manage was the maintenance of reduced fracture till clinical union to prevent varus deformity and distal nail migration, and the method was technically simple and could be employed succesfully.
Aged ; Congenital Abnormalities ; Extremities ; Female ; Femur ; Hip Fractures ; Humans ; Joints ; Knee ; Leg ; Male ; Methods ; Mortality ; Self-Help Devices ; Traction ; Walking ; Weight-Bearing

The femoral fracture, occurred associated with the cemented hip arthroplasty, is well-known cornplication but the proximal femoral fractures of the noncemented hip arthroplasty, were occurred more than those. Among the 290 patients, who were treated by the noncemented hip arthroplasty from Dec. 1987 to April 1992, the 24 cases of the femoral fracture were experienced and the results were as follows: 1) of the 24 cases, the male was nine and the female was fifteen. The age distribution was mostly occurred between 41 and 60 years old and most fracture were developed in 1 1mm stem size. In revision cases, 225mm stem length (Wagner) was common. The locations of fracture were proximal 1/3 (type I: 19 cases), tip (type II; 1 case), distal 1/3 (type III; 1 case) and comminuted (type IV; 3 cases) by Johansson; siclassification. 2) The femoral fracture was mostly developed during the stem insertion and the fracture site in anatomical stem was only proximal femur. 3) 1n cases of revision, most of the fractures were occured on the anterior or lateral side of the femur. It was difficult to manage the fracture because of the severe osteoporosis and comminution. 4) As the problem of the operative technique, the fracture incidence can be decreased by accurate preoperative measurement and it must be cautious in the stem more than 225 mm length, which were used in revision case. 5) The circumferential wiring for proximal and plate & screws in middle and distal were done as the treatment of fracture and the results were all good, but stem tip fracture in osteoporotic patients was troublesome. We think that long plate(>8 holes) & both cortex purchase and bone graft are best methods so far.
Age Distribution ; Arthroplasty ; Female ; Femoral Fractures ; Femur ; Hip ; Humans ; Incidence ; Male ; Osteoporosis ; Transplants