No abstract available.
Skull Base* ; Skull*

Tumors involving the proximal humerus confront the surgeon with the problem of both eradicating the osseous lesions and restoring shoulder joint function. This problem is magnified because of the biomechanical complexity of the shoulder, its anatomic configuration, and its inherent lack of stabillity. With the increased interest in limb-sparing resection for lesions in the area, efforts are being made to improve the reconstructive techniques. These include leaving a flail shoulder, an being made to improve the reconstructive techniques. These include leaving a flail shoulder, an arthrodesis using intercalery graft between the scapula and the remaining humerus, or if the glenoid is preserved, an arthroplasy. From January 1984 to December 1993, 23 patients with a malignant or locally aggressive bone tumor in the proximal humerus were treated by limb-sparing surgery in Seoul National University Hospital. Histologic diagnosis included osteosarcoma(6), chondrosarcoma(2), Ewing's sarcoma(1), metastatic bone tumor(11), and recurred giant cell tumor(3). Options for reconstruction following limb-sparing resection in our cases were 10 prosthetic arthroplasties, 3 arthrodeses with an living fibula graft, and 10 arthroplasties with intramedullary nailing and cementization. We performed a retrospective analysis in view of tumor eradication and performance status with modified functional evaluation system of Musculoskeletal tumor Society. In 7 cases(74%), good or fair performance status was acquired with average 3.6 years follow-up(6 months-11 years). Each option for reconstruction resulted in relatively good outcome but rather better result was acquired in giant cell tumor and chondrosarcoma. Estimated survival rates by Kaplan-Meier's method, 5 year survival rate was 81% in primary malignant bone tumors(12), 76% in stage Ⅱ B malignancies(5) with 4 years and 4 months follow-up. There was no regional recurrence in primary malignant bone tumors but there were three cases in which distant pulmonary metastases were found in follow-up. Complicationss were one soft tissue infection, two nonunions in arthrodesis with a living fibula graft and one dislodgement of prosthesis in prosthetic arthroplasty. In summary, each option for limb-sparing surgery in malignant bone tumor of proximal humerus might result in rather satisfactory outcome in performance and survival rate when effective preoperative and postoperative chemotherapy were performed in adequately selected cases.
Arthrodesis ; Arthroplasty ; Chondrosarcoma ; Diagnosis ; Drug Therapy ; Extremities ; Fibula ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Giant Cell Tumors ; Giant Cells ; Humans ; Humerus ; Methods ; Neoplasm Metastasis ; Prostheses and Implants ; Recurrence ; Retrospective Studies ; Scapula ; Seoul ; Shoulder ; Shoulder Joint ; Soft Tissue Infections ; Survival Rate ; Transplants

Acute osteomyelitis is usually shown as a localized area of increased activity (hot uptake) in the infectious focus on bone scintigraphy. In our patient, absence of radioactivity (cold lesion) was noted in the distal metaphyseal and diaphyseal regions of his right femur. Initial x-ray was interpreted as normal except for mild soft tissue swelling in the right thigh. The lesion was confirmed as an acute osteomyelitis with subperiosteal abscess on surgery. Staphylococcus aureus was the etiologic organism. We describe a case of acute osteomyelitis in a one-year-old boy shown as a cold lesion on bone scan.
Abscess ; Femur ; Humans ; Male ; Osteomyelitis* ; Radioactivity ; Radionuclide Imaging ; Staphylococcus aureus ; Technetium Tc 99m Medronate ; Thigh

There have been several reports that total knee arthroplasty(TKA) was most likely to survive successfully if the coronal tibiofemoral angle was close to 7 degree of valgus, the accepted normal. In order to know whether the postoperative coronal tibiofemoral angle influences the result of total knee arthroplasty, we examined the 152 TKA cases in 106 patients which had been performed at Department of Orthopaedic Surgery, Seoul National University Hospital from Jan. 1987 to Dec. 1991. In our series the average follow-up period was 31 months(range, 13 months to 75 months). Coronal tibiofemoral angles of all cases were checked on weight bearing anteroposterior plain X-rays and were divided into three groups(less than valgus 2° ; valgus 3° to 7° ; greater than valgus 8°). All cases were analyzed on the knee score of Hospital for Special Surgery and the American Knee Society total knee arthroplasty roentgenographic evaluation and scoring system and the cases with radiolucent lines wider than 2mm were checked. Three groups were analyzed comparatively with statistical means(Wilcoxon signed rank test, X² test). There were no significant differences in the clinical results of total knee arthroplasty according to the postoperative coronal tibiofemoral angle. Lateral subluxation of the patella occurred more frequently when the postoperative coronal tibiofemoral angle was above valgus 8°. In the tibial components of group lesser than valgus 2°, the frequency of radiolucent lines wider than 2mm was higher than those of other groups, but its significance should be examined through long term follow-up.
Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Humans ; Knee ; Patella ; Seoul ; Weight-Bearing

Although long-term studies of total knee arthroplasty(TKA) have confirmed reliable relief of pain and maintenance of function, survivorship at nine to ten years has been inconsistent with late component loosening being the most frequent mode of failure. Tibial component failure has been more frequent than failure of the femoral or patellar component in most TKA series. Encouraged by the early results of porous-ingrowh femoral and patellar components, and aware of retrieval studies showing poor bone ingrowth into tibial components, the “hybrid” method of fixation with an uncemented femoral component and a cemented tibial component, has been introduced and incorporated the potential advantages of both traditional fixation techniques. Between January 1987 and December 1991, forty-five “hybrid” TKAs(group I) were performed in degenerative arthritis and evaluated retrospectively in comparison with the results of nineteen noncemented porous-coated TKAs(group II) in degenerative arthritis. The average follow-up period was 31 months(range, 14 to 60 months) in group I and 26 months(range, 13 to 63 months) in group II. Using the knee rating scale of the Hospital for Special Surgery and the American Knee Society Roentgenographic Evaluation and Scoring System, clinical and radiological comparative study between two groups was performed. Pain scores, range of motion and HSS knee scores improved in both groups, but there was no significant difference between group I and group II(p>0.05). In both groups, the scores of radiolucent lines were significantly higher in zone 1 and 4 of A-P roentgenograph of the tibial component than in other zones(p < 0.05). The tibiofemoral angle was corrected from varus 2.7° to valgus 5.8° in group I and from varus 3.4° to valgus 4.6° in group II. There was no significant differences in component position and scores of radiolucnet lines between group I and group II. In conclusion, there were no significant differences in clinical and radiological results between the “hybrid” and the cementless groups. Results of this study suggest that both the hybrid fixation and the comentless techniques can reliably provide satisfactory clinical and radiological results in properly selected degenerative arthritis patients. But the final outcomes of this study need further evaluation through long term follow-up.
Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Humans ; Knee ; Methods ; Osteoarthritis ; Range of Motion, Articular ; Retrospective Studies ; Survival Rate

Interleukin-6 (IL-6) is introduced as a marker of disease. At present, a variety of method may be used to quantify expression of this protein. Antigen capture-ELISA is a sensitive and accurate quantification method previously used with ovine, rat, and human IL-6 proteins. However, it has never been reported to quantify porcine IL-6 protein using capture ELISA. In this study, we generated and characterized a set of IgY and mono-specific polyclonal antibodies to recombinant porcine IL-6 (rpIL-6), and combining these with a sensitive and specific capture-ELISA for a diagnostic purpose. cDNA encoding the mature protein coding region of porcine IL-6 was cloned and expressed with pQE-30UA expression vector. rpIL-6 was then expressed and purified by using Ni-NTA resin. Protein mass of 24 kDa was found with SDS-PAGE and the identity of the protein was confirmed by Western-blot. Production of polyclonal antibodies against rpIL-6 was performed using the purified rpIL-6 in mice and hens. An antigen capture-ELISA was developed with the antibodies after their extraction. To compare the IL-6 level in the different sanitary state of farms, pig sera were randomly collected and concentration of IL-6 in the sera was measured with the antigen capture-ELISA. The capture-ELISA with the optimal concentration of antibodies, in this study, was able to detect about 10 ng/ml of rpIL-6. IL-6 levels determined with the capture-ELISA in pig sera showed positive correlation with the sanitary states of the farms. These results suggested that the developed antigen capture-ELISA could be a good tool for the screening of microbial infection in pig farms.
Animals ; Biological Markers/blood ; Blotting, Western/veterinary ; Chickens ; Cloning, Molecular ; DNA, Complementary/genetics/isolation&purification ; Electrophoresis, Polyacrylamide Gel/veterinary ; Enzyme-Linked Immunosorbent Assay/methods/*veterinary ; Female ; Immunoglobulins/*blood ; Interleukin-6/*immunology ; Mice ; Mice, Inbred ICR ; Recombinant Proteins/immunology ; Swine/*immunology

Squamous cell carcinoma of the skin arises mostly in the head and neck regions, less frequently in the rest of the body, and rarely in the palms and soles. We report a case of a 6S-year-old man who had had time-sequential development of multiple squamous cell carcinomas on his palms and soles for the past 12 years. These lesions were, in order of time, ulcerative nodules, ulcerative hyperkeratotic papules, hyperkeratotic plaques, maceratied plaques, dark discolored patchs, and hyperkeratotic papules. They were treated by total excision and cryotherpy apart from the last squatnous cell carcinoma in 1994.
Carcinoma, Squamous Cell* ; Head ; Neck ; Skin ; Ulcer

BACKGROUND: Psoriasis is a disabling and intractable disease influencing the psychosocial life of the patients. Patients who are frustrated with orthodox medicine may explore alternative therapies. OBJECTIVE: This study was done to research on the actual condition of the use of alternative medicine in the patients with psoriasis. METHODS: A self-administered questionnaire was constructed, and was given to the patients to answer our questions. RESULTS: Among 128 patients with psoriasis, 61 (47.7%) reported previous use of one or more forms of alternative medicine. The absence of satisfactory long-term effects of physician-provided therapy was the main reason for patients trying alternative medicine. Persons without skin s disease and the mass media were the main sources of information on alternative medicine. CONCLUSION: Alternative therapies were widely utilized by subjects participating in this study, and dermatologists need to be aware of alternative treatments employed by their patients.
Complementary Therapies* ; Humans ; Mass Media ; Psoriasis* ; Skin

No abstract available.
Mesenteric Artery, Superior*

Trichoadenoma is a rare tumor with differentiation towards the infundibular portion of the pilosebaceous canal. Clinically, it is a nodular growth, usually on the face and buttock. Histologically, it is characterized by numerous horn cysts lined with squamous epithelium in the dermis. In this report, we describe a 44-year-old man who developed trichoadenoma on his right shin. Anti-CD34 antibody stained spindle-shaped cells in the stroma just adjacent to the peripheral layers of keratinous cysts and solid masses of squamous epithelial cells. To our knowledge, this is the first description of an occurrence of trichoadenoma in the lower leg and the first to use immunohistochemical staining to know the CD34 staining pattern.
Adult ; Animals ; Buttocks ; Dermis ; Epithelial Cells ; Epithelium ; Horns ; Humans ; Leg