The significance of the angle of anteversion of the femur is widely recognised, especially incongenital dislocation of the hip, cerebral palsy, Legg-Calve-Perthes' disease, and in-toeing gait, And many methods of measuring the anteversion have been described since the early work by Drehmann (1909) who determined anteversion by fluoroscopy. But there has been no reliable method of measuring the angle until recently. The authors studied the comparative accuracy and reproducibility by the use of experimental model of femur on computerized tomography, axial technique(Dunn), biplanar method (Ryder-Crane) and fluoroscopic method(Rogers) and reported the results with consideration in clinical utility. 1. The most accurate and reproducible method is computerized tomography, but it has much clinical disadvantages such as uneconomic, limited supply, more time requiring in measuring, and also limited information until the ossification of the femoral head was not occur (below the 18 months of age). 2. The next accurate and reproducible method is fluoroscopic method and it is widely useful except the case of limited motion of hip joint. 3. The Ryder-Crane's biplanar method is very difficult in clincal use because of its poor accuracy and reproducibility, difficult mtasuring technique, limited in the situation of contracture, deformity around the hip. 4. The axial technique of Dunn are also useful in any state of hip joint and simplicity in its technique. 5. The more acceptable clinical slection of measuring the femoral anteversion are the combination of the above two or three methods and comparing it with the opposite hip.
Cerebral Palsy ; Congenital Abnormalities ; Contracture ; Dislocations ; Femur ; Femur Neck ; Fluoroscopy ; Gait ; Head ; Hip ; Hip Joint ; Methods ; Models, Theoretical ; Neck

This study is performed to investigate whether free transplanted iliac physis can grow in the resected epiphyseal plate and prevent growth arrest secondary to an injury of epiphyseal plate. Growth arrest, angulation and regeneration of epiphyseal plate after free physeal transplantation from iliac crest in the partial resection of epiphyseal plate on the lateral aspect of the distal femoral epiphysis were analysed in process of time and compared with those of the simple partial resection of epiphyseal plate of distal femur. Seventy-six skeletally immature, three month-old rabbits with an initial weight of about 1200 to 1400gm were used for this study. The following experimental groups were made after partial resection of epiphyseal plate on lateral aspect of distal femoral epiphysis(2×7×3mm). Group A: partial resection alone(19 rabbits); Group B: muscle piece interposition(19 rabbits); Group C: free autogenous iliac crest physeal transplantation (38 rabbits). The opposite side of the leg was used as a control. Animals were killed and examined at the following time-intervals(14, 21, 30, 60 and 90 days after operation). The following results were obtained. 1. In the group of partial resections alone, the bone-brige formation between the femoral epiphysis and metaphysis revealed as early as 14 days, and this bridging was found consistently in all anlmals, which led to the growth arrest and valgus deformity. 2. In the group of muscle piece interpositions, the interposition materials were found temporarily effective for the prevention of epiphysiometaphyseal bone-bridge formation, but the effect was not significant to regain bone growth. 3. Histological studies showed that the grafted physis united with the residual part of the original femoral physis at 14 days after transplantation, and regained its columnar arrangement. The physeal graft appeared to be viable and contribute endochondral bone formation in following section (60, 90 days). 4. In the grodp of free autogenous iliaccrest physeal transplantations, the transplanted physis prevented or minimized the formation of a bone brige, growth arrest, and valgus deformity in most animals. Although not all of the physeal transplants were successful, physeal grafts would be most suceessful method regaining bone growth after focal injury of epiphyseal plate.
Animals ; Bone Development ; Congenital Abnormalities ; Epiphyses ; Femur ; Growth Plate ; Leg ; Methods ; Osteogenesis ; Rabbits ; Regeneration ; Transplants

We have reviewed our experiences of computerized tomography(CT) in the fracture of the spine. Between December 1983 and June 1985, we treated 33 fractures of the spine in 32 patients. We have used CT for the diagnosis of fractures of the spine in 29 cases (28 patients). Also we have used Louis scoring system to evaluate the stability of the fractured spine. The results are as follows. 1. CT has many advantages that were not given from simple radiograp hies or laminagrams. It reveals the vertebral body, vertebral column, posterior compartments and surrounding soft tissues excellently, and it is easy to interpretate. Also it can be done comfortably and rapidly without the need of manipulations. 2. We could acquire many informations from post-operative or long term following up of CT examinations. 3. If the Louis score is higher than 3, we should think it is unstable, and should take internal fixation of the vertebral column. 4. There is a correlation between Louis score and neurologic signs (p < 0.01). If there was a neurologic sign with low Louis score, less than 1, the recovery was soon, less than 24 hours. 5. According to CT findings for fragmentation or location of fragment, we can alternate an anterior decompression or a posterior decompression. 6. It is necessary to use CT as a initial diagnostic procedure with the simple radiographic examination in spine fracture.
Clinical Study ; Decompression ; Diagnosis ; Humans ; Neurologic Manifestations ; Spine

Osteopoikilosis is an asymptomatic osteosclerotic dysplasia, initially described by Albers-Schönberg and Ledoux-Lebard and associates. This disorder is described as extremely rare. Inherited and sporadic cases of osteopopikilosis have been reported. A Case of familial osteopoikilosis is presented with a brief review of literatures.
Osteopoikilosis

No abstract available.
Latency Period (Psychology)* ; Osteogenesis, Distraction* ; Rabbits*

Relapsing polychondritis is a rare disease characterized by widespread destructive inflammatory lesions, involving cartilaginous tissue throughout the body. Commonly involved organs include the external ear, nose, joints, eyes, tracheobronchial tree, cardiovascular system and cutaneous tissues. Erythema nodosum or mesenteric panniculitis have sometimes been described in association with relapsing polychondritis, but cutaneous panniculitis is rarely reported in relapsing polychondritis. We report here a relapsing polychondritis patient who developed cutaneous panniculitis, which was resolved by corticosteroid therapy.
Cardiovascular System ; Ear, External ; Erythema Nodosum ; Humans ; Joints ; Nose ; Panniculitis* ; Panniculitis, Peritoneal ; Polychondritis, Relapsing* ; Rare Diseases

No abstract available.

OBJECTIVES: Gallium 67(Ga-67) scintigraphy has been used to diagnose inflammatory and neoplastic diseases. We undertook a study to determine the clinical value of Ga- 67 renal scan in patients with various glomerular diseases. METHODS: Ga-67 scintigraphy was performed in 48 patients with various biopsy proven forms of renal diseases. Renal uptake in 48 patients images was graded as follow: Grade 0 = not visualization at 48 hours: 1 = faintly visualize: 2 = equal to uptake in spine: 3 = greater than over the spine: 4 = greater than activity over the liver. RESULTS: 1) Of the 48 patients, 31 were male, and mean age was 32 years. 11 patients had hypertension and 29 patients had hematuria. 2) Positive scintigram were seen in 40 of 48(83%) cases. In results of renal biopsy, IgA nephropathy(IgAN) was 15 patients, minimal change disease(MCD) was 14, focal segmental glomerulosclerosis (FSGS) was 8, membranoproliferative glomerulonephritis (MPGN) was 3, lupus nephritis(LN) was 3, poststreptococcal glomerulonephritis(PSGN) was 3 and membranous glomerulonephritis(MGN) was 2. 3) In 26 patients (54%) with nephrotic-range proteinuria, Grade 2 or higher renal uptake was observed in 9 (75%) of MCD, 5(100%) of FSGS, 2(100%) of LN and 3(75%) of IgAN. 4) In comparision nephrotics with non-nephrotics at biopsy, renal Ga-67 uptake in who patients had nephrotic-range proteinuria was correlated with clinical severity determined by serum albumin, serum total cholesterol and 24 hours urine protein excretion. CONCLUSIONS: Renal Ga-67 scintigraphy may be able to be a predictor in the assessment for severity of nephrotic syndrome.
Biopsy ; Cholesterol ; Gallium ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative ; Glomerulosclerosis, Focal Segmental ; Hematuria ; Humans ; Hypertension ; Immunoglobulin A ; Liver ; Male ; Nephrotic Syndrome ; Proteinuria ; Radionuclide Imaging* ; Serum Albumin ; Spine

Low dose methotrexate (MTX) is widely used for treatment of rheumatoid arthritis (RA) due to prompt clinical response, relatively lack of serious side effects, tolerability and simplicity of medication. However, several serious adverse effects have been reported with the use of MTX. The prevalence of hematologic toxicity, including leukopenia, thrombocytopenia, megaloblastic anemia, and pancytopenia, is estimated to be 3% in MTX-treated RA patients. Pancytopenia, which occurs unpredictably, is one of the most serious adverse effects and the prevalence is estimated to be 1.4% and fatal pancytopenia reported to occur in 17% of these patients. Old age, impaired renal function, concurrent infection, hypoalbuminemia, increased mean corpuscular volume of red blood cell, concomitant medication such as trimethoprim-sulfamethoxazole and nonsteroidal antiinflammatory drug, are the risk factors of MTX induced pancytopenia. We experienced a case of fatal MTX induced early aplastic anemia in RA patients who medicated 3 times MTX (7.5mg/weekly, 22.5mg of cumulative dose) refractory to treatment with steroid pulse, recombinant human granulocyte macrophage colony stimulating factor (rhGM-CSF) and immunoglobulin.
Anemia, Aplastic* ; Anemia, Megaloblastic ; Arthritis, Rheumatoid* ; Erythrocyte Indices ; Erythrocytes ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Hypoalbuminemia ; Immunoglobulins ; Leukopenia ; Methotrexate* ; Pancytopenia ; Prevalence ; Risk Factors ; Thrombocytopenia ; Trimethoprim, Sulfamethoxazole Drug Combination

Membranoproliferative glomerulonephritis(MPGN) is a morphologic entity and characterized by several pathologic feature. MPGN is classified into a primary (or idiopathic) and secondary forms. We report a case of type I MPGN associated with cellulitis on pathologic feature. MPGN is classified into a primary (or idiopathic) and secondary forms. We report a case of type I MPGN associated with cellulitis on lower leg. He was admitted due to ingrowing nail complicated by surrounding cellulitis and edema. Chraracteristically, hematuria and proteinuria(3.2gm/ day) were noted. We couldn't find any secondary causes', ANA, cryoglobulin, HBs Ag and RA factor were negative. Renal pathologic findings showed double-contoured basement membrane, electron-dense material infiltration and mesangial proliferation. This findings were concordant with type I MPGN and we treated with antibiotics and supportive care. During follow-up, skin lesion, proteinuria and hematuria were resolved and he readmitted in purpose of control renal biopsy, We observed resolution of previous abnormal findings other than mesangial proliferation. This case was considered as type I MPGN associated with cellulitis on lower leg.
Anti-Bacterial Agents ; Basement Membrane ; Biopsy ; Cellulitis* ; Edema ; Follow-Up Studies ; Glomerulonephritis, Membranoproliferative* ; Hematuria ; Leg* ; Proteinuria ; Skin