The growth plate is responsible for longitudinal bone growth and is involved in 6–15% of children's fracture. Of these injuries, 25–35% have been reported to result in some shortening or deformity, but in only 10% are the deformities sufficiently severe to lead to functional problems. The problem of repair of a demaged growth plate in children has never been adequately solved. The purpose of this study is to clarify that allograft of cultured chondrocytes can survive in the growth plate defect and can prevent the angular deformity by avoiding the formation of bone bridge. The chondrocytes were obtained from the rib cartilage of rabbit weighing 500g. The chondrocytes were cultured by socalled micromass culture method. The rabbits were divided two groups; the group I in which medial proximal tibial growth plate was destroyed, and the group II in which the cultured chondrocytes were transplanted into the right medial proximal tibial physeal defect. Each group has 10 rabbits. The tibial growth was observed grossly, radiologically and histologically until 16 weeks after graft. The angular deformity was observed from 3 weeks after operation and histologically the fusion of growth plate was observed in all of group I. In group II, there were no angular deformity and no fusion of growth plate in 7 out of 10 rabbits. Allografted cultured chondrocytes survived and produced matrix in the physeal defects. Through this study it was inferred that allograft transplantation of cultued chondrocytes in the iatrogenical physeal defect is a useful method to keep the physeal growth without cessation. However, further studies will be necessary to prove that the longitudinal growth potential resides in the transplanted chondrocytes as growth plate cartilage.
Allografts ; Bone Development ; Cartilage ; Child ; Chondrocytes ; Congenital Abnormalities ; Growth Plate ; Humans ; Methods ; Rabbits ; Ribs ; Transplants

No abstract available in English.
Animals ; Dogs ; Spine

Authors had reviewed the results of 20 anterior cervical fusions performed between 1975 and 1980 to determine which factors were important to a successful result. There had been 18 single level fusions and 2 fusions at two levels, the majority at C and C. The indications for fusion operation were: firstly in acutely traumatized patient was the spine representing radiologically the signs of segmental instability, secondly was the chronic segmental instability in old traumatized spine representing the nuchal rigidity and severe cervicobrachial pain which. was not ceased by conservative treatments. The index of successful fusion was complete relief of pain, loss of cervical rigidity and radiologlcal stability of fused segment indicated by no-movement in flexion-extension lateral radiograms, and the bony bridges between the fused segments. The postoperative stability of spine was assessed by measuring the changes of disc space and kyphotic angle. The result obtained were as follows: 1. Pre-and post-operative immobilization with cervical traction played an immportant role for successful results after fusion: 4–6 weeks of pre-operative traction in acutely injured spine provided the torn soft tissue structures with sufficient time needed for its healing, and 6 weeks of postoperative traction also provided the bone graft with sufficient time needed for its cooperation with graft bed. 2. ln all cases succeasful fusion was obtained. In a case a adjacent level was incorrectly fused, but it was fused soundly in time, while the unstable unfused segment was not fused spontaneously. 3. The fused segment or segments of spine stabilized clinically in 6-8 weeks after fusion operation which was proven by serial radiograms, and solid bony fusion was obtained radiologically averaging in 12 weeks after fusion operation. 4. The average increase of kyphosis after interbody fusion till solid fusion was negligible, averaging 3.0 degrees. 5. The solid fusion occurred in one to 2 weeks earlier in the spines with wedge and axial conpression fractures than the spines with flexion-rotation and shear types of fractures. 6. No further neurogical damage developed after successful fusion.
Dislocations ; Humans ; Immobilization ; Kyphosis ; Muscle Rigidity ; Spine ; Traction ; Transplants

Authors clinically analysed the end results of the 56 elderly patients having fresh femoral neck fracture who were treated with osteosynthesis procedures and 23 endoprosthesis replacement surgery. All these 79 patients were treated between 1970 and 1979 at the St. Marys Hospital, Seoul. The indications of primary endoprosthesis replacement surgery in femoral neck fractured patients were in elderly patients over 65 years, displaced, comminuted sub capital or transcervical fractures, irreducible fractures, pathological fractures and patients having generalized diseases or senile psychosis. The results for the operated hip joints were assessed by duration of hospitalization, early and late post-operative complication. and the Jessels hip grading method at least post-operative one and half year later. The results obtained were as follows: 1. The average age of the patients were 65 years in 56 cases with initial osteosynthetic group, and 73 years in 23 cases of initial endoprosthesis group. 2. The slip down was the most common cause of injuries. The transcervical type of fracture was 54% of all cases. 3. The eligibility of ambulation was average 34 days after surgery in cases having initial osteosynthesis and 18 days in cases having endoprosthesis. 4. Early post-operative complications such as pneumonia and urethritis etc. were more common in cases of endoprosthesis than in osteosynthesis. But we think these complications were not related with surgery itself and transient. 5. Late post-operative complications in cases of osteosynthesis were avascular necrosis of head (16%), nonunion (9%), osteoarthritis (4%), and deep wound infection (2%), but in cases with endoprosthesis, leg length discrepancy (12%), acetabular erosion (4%) and loosening (4%) in order. 6. We performed the second operation in 12 cases among the 56 patients of osteosynthesis because of post-operative complications. 7. Good end results were obtained 90% in 56 osteosynthesis and 91% in 23 endoprosthesis. Conclusively, author's observation time was relatively short (11/2–3 years) and it is impressed that long term study for the prosthetic group is necessary for the more accurate evaluation of their hip function.
Acetabulum ; Aged ; Femoral Neck Fractures ; Femur Neck ; Fractures, Spontaneous ; Head ; Hip ; Hip Joint ; Hospitalization ; Humans ; Leg ; Methods ; Necrosis ; Osteoarthritis ; Pneumonia ; Psychotic Disorders ; Seoul ; Urethritis ; Walking ; Wound Infection

The results in thrity-six adolescent idiopathic scoliosis patients(thirty-nine curves) who have been treated with the Boston brace are reported. The average follow-up was two years and three months(range, one year to four years ten months). Before treatment, all the patients had a curve that measured 20 to 35 degrees; 26 patients were in Risser sign of zero or 1, 10 patients in Risser sign 2 to 4. Although the magnitude of the curve was generally reduced about 40 percent by the initial application of the brace, a gradual loss of this initial correction was observed both during active treatment and after the wearing of the brace. Although eleven(28.2 percent) of the curves had progressed more than 5 degrees at follow up. Sixty-seven percent of the thoracic curve, 33.3 percent of the thoracolumbar, 27.8 percent of the lumbar curve had progression of more than 5 degrees. Twelve patients wore the brace for sixteen hours a day, 19 patients wore for 16 to 20 hours a day and 5 patients wore more than 20 hours a day. 41.7 percent of sixteen hours bracing, 15,8 percent of 16 to 20 hours bracing and 60 percent of 20 hours bracing had progression of more than 5 degrees. Our finding indicates that the Boston brace prevents deterioration in certain cases but does not convert major deformity into minor ones, and part time bracing can prevent progression of the curve and can even afford some correction.
Adolescent ; Braces ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Scoliosis

In general, soft tissue and bone tumors are diagnosed clinically by physical findings, laboratory data, and X-ray findings with only limited reliability, and a definite diagnosis must be supported by histopathological evidence. For this purpose, open biopsy routinely has been carried out, but there have been many disadvantages and sometimes followed by surgical complications. The present study was undertaken to compare the cytologic findings of soft tissue and bone lesions with the histological findings. The specimen were obtained by fine needle aspiration and Franklin-Silverman needle. For cytodiagnosis Stormby's cell block of aspirates were utilized. For histological diagnosis small tissue fragments obtained by the Franklin-Silvermans cutting needle were used. Then, the diagnostic accuracy of 3 different methods were compared, and the clinical applicability of those methods as adjunctive diagnostic procedures in the diagnosis of the soft tissue and bone tumors were assessed. The results obtained were as follows: l. In 15 out of the 20 cases (75%) in which clinically and roentgenologically the soft tissue and bone tumors were suspected, sufficient material was aspirated to enable detailed cytological diagnosis possible by fine needle aspiration. ln 13 out of the 15 cases, diagnosis could be made by cytologic findings, which was similar to histologic findings of tissue obtained by Franklin-Silverman needle. 2. In 6 out of the 20 cases, sufficient tissue fluid for cell block preparation were obtained from the tumor tissues. In 5 cases, cytologic findings of cell blocks were consistent with that ot the tissue obtained by Silverman needle. But in one case malignancy was susupected by cytodiagnostic method, and definite diagnosis could not be made. Finally the lesion was found to be malignant schwannoma through the histological study of tissue specimen obtained by Franklin-Silverman needle biopsy. 3. In 19 out of the 20 cases, diagnosis could be made by Franklin-Silverman needle biopsy. 4. Diagnostic accuracy of the lesions by clinical and roentgenological method was 75%, which overall diagnostic accuracy of 3 methods were 86.7% in aspiration cytology, 83.3% in cytodiagosis of cell block and 95% of histodiagnosis of tissue specimen obtained by Franklin-Silverman needle. Through this study it is found that cytodiagnostic method of aspirates and histodiagnosis of the small tissue specimen by Franklin-Silverman needle are very useful adjunctive methods in enhancing the diagnostic accuracy of the soft tissue and bone lesion prior to open biopsy trial.
Biopsy ; Biopsy, Fine-Needle ; Biopsy, Needle ; Cytodiagnosis ; Diagnosis ; Methods ; Needles ; Neurilemmoma

No abstract available.
Cartilage* ; Rabbits* ; Ribs*

No abstract available.
Coxa Vara* ; Follow-Up Studies*

The syndrome of lower-back pain associated with sciatic pain has probably been a problem since man first assumed the upright position. In 1937 Barr delineated herniation of the nucleu pulposus as a pathologic entity. Since that time, the standard surgical treatment has become laminectomy or laminectomy combined with fusion, with the emphasis on the disc between L4−5 and L5−Sl. Another mode of treatment was suggested when Smith and Brown” reported their clinical experience using intradiskal injection of chymopapain as the definite treatment of lumbar disk disease in 1967. In recent many years investigators in separate clinical studies showed that a benificial result can be achieved in a high percentage of patients treated by chymopapain injection. Our 29 patients who can be observed for more than 6 months after chemonucleolysis were clinically analysed. The results were as follows: 1. Of the 29 patients studied, 15 were males and 14 were females. 11 patients (37.9%) were in age between 41 and 50 years. 2. On clinical symptoms, 24 patients (82.8%) had radicular pain in the lower extremity. All patients had the limitation of the straight leg raising. 3. The most common level of herniated area was L4−5 disk as 22(75.9%) cases. In four cases (13.8 %) two levels of disks (L4−5 and L5−Sl) were involved. 4. On myelography the hour glass appearance was shown in 14 patients (49.3%).Complete block was found in 4 (13.8%) cases. 5. The increase of the straight leg raising was found within 3 weeks after chemonucleolysis in all cases. Motor power were recovered in 20 out of 22 cases and abnormal sensation were recovered in 17 out of 19 cases within 3 months after chemonucleolysis. 6. There were no correlation between persisting low back pain and narrowing of the disk space after chemonucleolysis, statistically. 7. In 23 out of 29 cases discometry test was positive. Among 23 cases, 21 cases recovered from their symptoms successfully after chemonucleolysis. 8. In chymo. R.A.S.T., 9 out of 15 cases were positive in 3 weeks after chemonucleolysis, and 12 out of 15 cases were positive in 3 months after chemonucleolysis.
Chymopapain ; Female ; Glass ; Humans ; Intervertebral Disc ; Intervertebral Disc Chemolysis ; Laminectomy ; Leg ; Low Back Pain ; Lower Extremity ; Male ; Myelography ; Research Personnel ; Sensation

Supracondylar fracture of the humerus is the most common fracture of the elbow in children. Early accurate reduction is very important to obtain good results. Authors tried to reduce the fracture accurately under the concept of intact hinge mechanism. Forty-five displaced supracondylar fractures which were not able to be reduced by closed method were admitted for open reduction at our department from April 1981 to October 1985. They were analysed clinically. The result are as follows: 1. The patient age ranged from 3 to 14 years; 16.2% were between 7 and 8 years. 70.3% were boys Left humerus was affected in 70.3% of all cases. 2. The most common cause of fracture was falling down from height. 94.6% of fractures were extension type. The severity of displacement in 34 patients(90.2%) were grade III or 1V of Holmberg classification. 3. Only in 2 patients cubitus varus deformity was observed as residua and among the patients who were followed more than one year, only 2 had about 10 degrees of limitation of elbow motion. 4. In Holmberg's grade II, III, IV group, 22 cases(100.0%) of the both side pinned and 12 cases (80.0%) of one side pinned showed excellent or good results. Therefore, both side pinning could have contributed in obtaining more accurate reduction. 5. According to Mitchell and Adams' Criteria, 34 cases(91.9%) had satisfactory results.
Accidental Falls ; Child ; Classification ; Clinical Study ; Congenital Abnormalities ; Elbow ; Humans ; Humerus ; Methods