No abstract available.
Diagnosis* ; Hypertension*

In order to determine the beneficial or detrimental effects of motion on fracture healing, rabbits femora were fractured surgically and each fracture was immobilized with a apecially designed external skeletal flxation device, which permitted a controlled spontaneous angulatory motion. in the first control group no motion was permitted; in the second group 5 degrees, and in the third group 10 degrees of angulatory motion was permitted. At 7th post-operative week, the bony union rates were 79%, 93%, and 54% In the first, second and third groups, respectively. Radiographically, the fractures were united most sufficiently in the second group. The ultimate bending load was signlficantly greater In the second group than the control but no significant differences were observed between the other groups. The ultimate bending stress and the modulus of elasticity were significantly greater ln the second group than the control and the third group, but no signlficant dlfferences were observed between the control and the third group. Fracture healing was significantly enhanced in the second group as compared to the control and the third group. It is suggested that a certain amount of motion at the fracture site enhances fracture healing, while excessive motion hinders it. Such enhancement seems to be related with the motion itself, and not wlth the muscle or jolnt function, since the rabbits Included in this study permitted the spontaneous full weight bearing which also permitted near normal muscle and joint function.
Elastic Modulus ; Fracture Healing ; Joints ; Rabbits ; Weight-Bearing

Five cases of osteogenesis imperfecta are reported, and the available literatures concerning to its clinical pictures and treatments are reviewed.
Osteogenesis Imperfecta

Maffuccis syndrome was first reported by Maffucci, an Italian, in 1881. It is manifested by unilateral multiple hemangiomas and enchondromas. It is congenital but is not hereditary. We encountered a case of this rare syndrome, with which bleeding tendency was combined. All who have multiple hemangioma on his unilateral side of the body should be checked with bone X-rays to rule out this syndrome. This syndrome is noted for transformation to malignant tumors. When there is pain or enlargenent of the tumor without any significant trauma, biopsy is in order. There can develop bleeding tendency due to microangiopathic coagulopathy which is associated with throm-bocytopenia and hypofibrinogenemia.
Biopsy ; Chondroma ; Hemangioma ; Hemorrhage

The purpose of this study is to confirm the effectiveness of stay-suture which is commonly used in the procedure of end to end anastomosis, to find out general biomechanical properties of peripheral nerve with gradual stretching and to evaluate the histological difference after breakage of the nerve. The sciatic nerves of adult rabbits were excised and they were grouped by I and II. Group I was composed of 14 normal sciatic nerves and group II, 14 sciatic nerves sutured with 5-0 nylon after transection. They were stretched on the "Instron" universal testing machine at a constant rate of 200mm/min until breakage took place and the results were compared. The mean maximal tensile strength was 13.6N in group I and 2.1N in group II, representing about one seventh value. The mean ultimate tensile strength was 4.2MPa in group I and 0.9MPa in group II, representing about one fifth value. In load-elongation curve of group I, viscoelastic property was noted as all other biological tissues have. The mean modulus of elasticity was 19 in normal sciatic nerves, which is somewhat lower value than other tissues, indicating superior elastic property of peripheral nerves. Transverse histologic examination showed that epineurium lost its continuity earlier than perineurium, implying perineurium is a more resistant structure than epineurium. However, to confirm this, it is thought to be necessary to examine the nerves serially during distraction at each different status. In conclusion, stay-suture provided about one fifth of ultimate tensile stress, implying its usefullness of resisting excessive tension in end to end anastomosis of peripheral nerves. Normal sciatic nerves showed viscoelastic property with mean modulus of elasticity of 19.
Adult ; Elastic Modulus ; Humans ; Nylons ; Peripheral Nerves ; Rabbits ; Sciatic Nerve ; Tensile Strength

Photoplethysmography(PPG) employs an infrared light-emitting diode to transmit light into the skin noninvasively. Light reflected from blood cells is received by a photocell or phototrotransistor which permits recording of the pulsatile cutaneous microcirculation. The use of PPG for vascular measurements in extremities is not new. Since Hertzmann, in 1938, first described the technique to measure skin blood flow, a few investigators have used PPG for clinical application. However, experimental reports on the photoplethysmographic assessment of blood flow after arterial reanastomosis are rare. We assessed the changes of blood flow after reanastomosis of the femoral artery in rabbits using photoplethysmography. We divided 20 rabbits into 3 experimental groups. In Group I, the femoral artery was surgically exposed and clamped for 60 minutes. In Group II, the femoral artery was surgically exposed and clamped, as in Group I, and then severed and anastomosed crudely in order to creat thrombus formation. In Group IU, the femoral artery was prepared as Group II and then anastomosed carefully to ensure patency. Blood flow was measured by photoplethysmography on the anteromedial aspect of the right hind leg, every 15 minutes for the fisrt 2 hours, at the 3rd day, I week, and II weeks post-operatively. The following results were obtained l. After the removal of vascular clamp, the mean time for the pulse wave to return to normal form was 63±24.0 minutes in Group I and 63±18.7 minutes in Group III. There was no statistically significant difference beween the two groups. When the wave form was normalized, it remained so continuously. 2. After the removal of vascular clamp, the mean time for the wave amplitude to return to normal was 108±11.2 minutes in Group I and 102±16.4 minutes in Group III. There was no statistically significant difference between the two groups. 3. The thrombosis which obstructed blood flow was formed within the first 60 minutes(mean time: 49±12.4 minutes) in all the animals in Group II. When the thrombosis was formed, it was readily detected by the change of wave form and by decrease in amplitude. 4. It is concluded from this experiments the changes of blood flow after reanastomosis of the femoral artery in rabbits were accurately assessed by PPG. It is suggested that PPG can be used clinically in monitoring blood flow after arterial reanastomosis.
Animals ; Blood Cells ; Extremities ; Femoral Artery ; Humans ; Leg ; Microcirculation ; Photoplethysmography ; Rabbits ; Research Personnel ; Skin ; Thrombosis

Collagen is the major structural protein in the human body, especially in connective tissues. There are more than 13 types of collagen. Among them, type II collagen is a main component of articular cartilage structure. Altered immunological conditions against type II collagen may be closely related to the pathologic conditions of joint, especially arthritis. Since 1977, animal model for collageninduced arthritis(CIA) has been developed and used in the investigation of arthritis. In those animals, high titers of anti-type II collagen antibody were noticed. Pathologic findings were similar to rheumatoid arthritis of human, which suggested that rheumatoid arthritis might be one of the autoimmune diseases. There had been many reports about elevation of serum and synovial level of anti-type II collagen antibody in rheumatoid arthritis patients. But majority of them did not discriminate the antibody titers according to the type of immunoglobulin(i.e. IgG, IgM). And the question whether the elevated antibody titers are cause or effect of the arthritis is still in controversy. In this study, the serum levels of anti-type II collagen antibody were determined in 82 persons(35 degenerative arthritis patients, 24 rheumatoid arthritis patients and 22 normal controls without any joint problem) via ELISA method. In each person the serum IgG, IgM and IgG+M+A antibody levels against bovine type IIcollagen and chicken typeII collagen were determined individually. Statistical evaluation of these data among degenerative arthritis group, rheumatoid arthritis group and normal control group was performed. The results were as follows; 1. Degenerative arthritis group revealed significant elevation of anti-type II collagen antibody(IgG, IgG+M+A) compared to normal control(p < 0.05). 2. Rheumatoid arthritis group showed significant elvation of IgM and IgG+M+A compared to normal control. 3. Between degenerative arthritis and rheumatoid arthritis group, no sigificant difference was noticed. 4. Rheumatoid arthritis group showed significant increase of IgM antibody level compared to normal control. 5. Female rheumatoid arthritis group showed significant increase of IgM level compared to female degenerative arthritis group. These findings suggested that the elevation of anti-type II collagen antibody titer is not specific for rheumatoid arthritis and related with general pathologies destroying articular cartilage. And it is suggested that anti-type II collagen antibody associated with rheumatoid arthritis is mainly IgM proportion, especially in female patients. So further investigation of anti-type II collagen antibody associated with rheumatoid arthritis is needed to target IgM antibody.
Animals ; Arthritis ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Cartilage, Articular ; Chickens ; Collagen ; Collagen Type II ; Connective Tissue ; Enzyme-Linked Immunosorbent Assay ; Female ; Human Body ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Joints ; Methods ; Models, Animal ; Osteoarthritis ; Pathology

Congenital pseudarthroses and non-unions have been recognized as some of the most challenging problems in orthopaedic surgery. with a standard surgical procedure, such as bone grafting, nailing, plating or a combination of these, it was frequently failed to unit. After repeated surgical failures, amputation has been the main course. With the advent of an electrical control of osteogenesis, however, this dismal outlook is brightening. The earliest report of the use of electrical energy to directly stimulate bone healing seems to be in 19th century, but it was not reliable. In this century, the electrical properties of bone were first described by Yasuda et al in 1953. After then, several investigators have shown that the application of small amounts of the electrical current to bone stimulates osteogenesis at the site of the cathode. Clinical trials using various froms in the treatment of delayed union, non-union, and congenital-pseudarthrosis began early in the 1970's. Constant direct current, pulsed current, and electromagnetically induced current have all been used clinically to heal bone defects with varying degrees of success. But, to-this date it is unknown what is the mechanism of stimulating bone healiag with electricity, and which from of electricity is most efficient in stimulating osteogenesis. We have experienced direct current stimulation to promote osteogenesis in 9 cases of non-union and 4 cases of congenital pseudarthses of the tibia from august, 1978 to december, 1980. Of 9 non-unions, 7 (77.8%) achieved solid bony union. We had obtained bony union in 4cases of non-union only with the electrical stimulation. In 4 cases of congenital pseudarthses of the tibia, all cases achieved solid bony union with the electrical stimulation and bone graft, but in 3 cases, refractures were occurred. At this moment, our conclusions from this study are as followa. I. Direct current stimulation is one of the reliable methods inducing ostengenesis. 2. Regular follows-up and determination of the stimulator integrity are essential steps in the electrical stimulation. 3. Combined treatment with the electrical stimulation and bone graft have markedly improved the success rate. 4. In direct current stimulation of congenital pseudarthsis, the mechanically sound bony alignment, massive bone graft and protection using long leg brace seem to be mandatory procedures.
Amputation ; Bone Transplantation ; Braces ; Electric Stimulation ; Electricity ; Electrodes ; Humans ; Leg ; Magnets ; Osteogenesis ; Pseudarthrosis ; Research Personnel ; Tibia ; Transplants

Experiences of 26 cases of electrical bone stimulation on normal adult rabbits was documented in this paper. The cathodic electrode was introduced longitudinally into the medullary cavity of the proximal tibia and the anodic electrode was introduced transversely in the distal femur of the same side. The contralateral tibia was used as the control, of which the Teflon coated Kirschner wire was introduced longitudinally into the medullary cavity. 10uA of direct current was passed continuously through the fixed wires between the proximal tibia and distal femur. At the second, fourth and sixth week, random bone scan with 99m-Tc was performed and the animals were sacrificed. The specimen X-rays of the tibia and femur were taken and the specimens were prepared for the microscopic study. The followings are obtained from this experimental study. 1. The rate of new bone formation is 69.2% in the stimulated group and 7.7% in the control group. There were also fibrosis and cartilage formation as well as the new bone formation. The fibrosis and cartrilage formation are observed only in the electrically stimulated side and their occurances are 69.2% and 11.1% respectively. So The new bone formation and fibrosis are definitely increased in the bones of the cathodic electrical stimulation than those of the control side. 2. The intramembraneous ossification is the predominent feature of this electrically stimulated new bone formation. 3. Bone and soft tissue necrosis was the main microscopic feature in the anode side. 4. Since new bone, fibrous tissue and sometimes new cartilage were observed in this study, it seems that the cathodic electrical stimulation is not specific for the new bone formation, but induce crude tissues such as bone, cartilage, fibrous tissue or vessels. Furthermore, it can be postulated that the 10uA electrical stimulation is only one of the best electrical environment for the formation of the crude tissues, especially for bone and fibrous tissue.
Adult ; Animals ; Cartilage ; Electric Stimulation ; Electrodes ; Femur ; Fibrosis ; Humans ; Necrosis ; Osteogenesis ; Polytetrafluoroethylene ; Rabbits ; Tibia

Based on the theory that benign prostatic hypertrophy may be induced by androgenic effect of testosterone derivatives, especially 5-alpha - dihydrotestosterone, on prostatic tissue, Chlormadinone acetate(CMA), potent oral synthetic antiandrogen was investigated in the treatment of benign prostatic hypertrophy. Twenty-two patients of prostatic hypertrophy were studied over six months period with a special reference to uroflowmetry and following results were obtained : 1) Chlormadinone acetate induced improvement of obstructive urinary symptoms in terms of uroflowmetric measurement. 2) It is very worthwhile to initiate medical treatment before undergoing any surgical intervention or when surgery is contraindicated.
Chlormadinone Acetate* ; Dihydrotestosterone ; Humans ; Prostatic Hyperplasia* ; Testosterone