When chemical agents penetrate the placenta, it is potentially hazardous to the embryo because the embryonic stage is known to be extremely sensitive to various toxic agents. It has been reported that exposure to some chemical agents during pregnancy resulted in the induction of malformation or cancer in the offspring of experimental animals (Larsen, 1947; Klein, 1952; DiPaolo, 1964; Druckrey et al. 1966; Mohr et al, 1966; DiPaolo and Elis, 1967; Spatz and Laqueus, 1967; Alexandrov, 1968; Fujii and Nishimura, 1969; Rice, 1969; Bulay and Wattenberg, 1970; Currie, 1970; Vesselinovitch et al, 1971; Swenberg et al, 1972; Nomura et al, 1973). Fraser and Fainstat (1954) and Kalter (1954) found that administration of cortisone to pregnant female mice induced the appearance of cleft palates in the offspring. The frequency with which this deformity appears was observed to depend on: I) the genotype of the treated animal (strain differences), 2) the dose of the chemical administered, 3) the time during the gestation period when the animal was treated. A single intraperitoneal injection of 5-fluorouracil at 10, 11, 12 or 13 days after copulation in mice also produced abnormalities to the feet, deft palate and deformities of the tail in a large proportion of fetuses (Dagg, 1960). Urethan has been considered to be a highly teratogenic and carcinogenic agent in experimental animals (Nishimura and Kuginuki, 1958: Nomura and Okamoto, 1972). However, they stated that accurate timing of urethan toxicity and accurate calculation of urethan dosage actually reaching the embryo make it possible to analyze the sensitivity of the developing mouse embryo to mortality, growth inhibition, malformation and neoplasm. Nomura and Okamoto (1972) reported that when pregnant mice were exposed to urethan on various days of gestation (day 5 to 19) by a single injection malformations and neoplasms were induced in their offspring. It is frequently implied that an abnormal phenotype is due to the aberration in the genotype, but it is not possible to prove the specitic causal relation. Though, the frequent association between a variety of chromosomal abnormalities solves the problem of how the genotypic and phenotypic are interreiated (Schultz, 1965). 5-bromodeoxyuridine (BUdR) and dimethylnitrosamine (DMN) induce chromosome aberrations in Chinese hamster cells cultured human lymphocytes and mouse cells in vivo (Somers and Hus, 1962; Kato, 1968; Matsuoka et al, 1979; Hahn and Kim, 1979). BUdR is a thymidine analog incorporated into only the DNA of proliferating cells and its mutagenic action is well understood (Freese, 1963). DMN is a potent carcinogen which induces tumors of the liver, lung, and kidney in rats (Magee and Bames, 1959). This agent has no teratogenic effect in rats when given in doses of different concentrations for different periods of time and by several routes of administeration during all stages of embryogeny (Alexandrov, 1967). The experiments reported in this study were undertaken to investigate the possibility that treatment of ICR inbred pregnant mice with BUdR and DMN might shows deformities or abnormalities in their offspring and also to determine whether chemical exposure during fetus will effect at 32 weeks after birth with second exposure to DMN by cytogenetical means. In this study, estrus ICR females were mated and 32 mice which had been diagnosed as pregnant were used. BUdR at the rate of 70, 100 and 150mg/kg of body weight was injected intraperitoneally at 6, 7, 8 days and 9, 11, 13 days of gestation, and DMN at the rate of 10, 20 and 30 mg/kg of body weight was injected at 8, 10, 12 days and 14, 15, 16 days of gestation, The offspring were examined macroscopicaily at time of birth for malformations. All animals were killed at 32 weeks of age and examined for liver abnormalities. The liver were cultured and treated with 1, 5 and 10 ug/ml of DMN for 18 hours. The frequencies of chromosome aberrations and sister chromatid exchanges (SCE) were analyzed. The results are summarized as follows: 1. The litter size was reduced on treated animals. 2. Among the 279 progeny from 36 BUdR treated mothers, malformations were seen in a total of 10 progeny and the group treated at the 9 to 13 gestation days stage had the most. 3. Of the 155 progeny from 24 mothers injected with DMN, none had any visible deformity. However. 37.5% of the group were found to have liver nodules after 32 weeks treated at the 8 to 12 gestation day stage. 4. Repetitive treatment with DMN of the liver culture of the previously BUdR and DMN treated progeny, showed increased chromosome aberrations and SCE frequencies. In conclusion since the exposure of the mother of BUdR and DMN during pregnancy leads to increased chromosomal abnormalities of the cultured liver cells of progeny when treated with DMN a second time, it is necessary to keep in mind that genetic damage may be occure to the progeny by exposing the mother during pregnancy.
Animals ; Body Weight ; Bromodeoxyuridine ; Chromosome Aberrations ; Cleft Palate ; Congenital Abnormalities ; Copulation ; Cortisone ; Cricetinae ; Cricetulus ; Cytogenetics ; Dimethylnitrosamine ; DNA ; Embryonic Structures ; Estrus ; Female ; Fetus ; Fluorouracil ; Foot ; Genotype ; Humans ; Injections, Intraperitoneal ; Kidney ; Litter Size ; Liver ; Lung ; Lymphocytes ; Mice ; Mortality ; Mothers ; Mutagens ; Palate ; Parturition ; Phenotype ; Placenta ; Pregnancy ; Rats ; Sister Chromatid Exchange ; Tail ; Thymidine ; Urethane

A Malignant Schwannoma is a relatively rare primary nerve sheath tumor arises from Sehwann cells of the peripheral nerves. This tumor is frequently associated with von Recklinghausens disease. A high percentage of patients experience local recurrence even after radical surgical excision, and eventual pulmonary metastases via the intraneural and hematogenous routes. The treatment of choice is radical excision or amputation. Results of treatment with radiation and chemotherapy have been disappointing. The authors have experienced two cases of Malignant Schwannoma, one of which was located in the median nerve of the palm, the other in the ulnar nerve of the arm, but neither were associated with von Recklinghausens disease.
Amputation ; Arm ; Drug Therapy ; Humans ; Median Nerve ; Neoplasm Metastasis ; Neurilemmoma ; Neurofibromatosis 1 ; Peripheral Nerves ; Recurrence ; Ulnar Nerve

Lowe et al. have described a disease characterized by organic aciduria, decreased renal ammonia production, hydrophthalmos, and mental retardation, this disease is now called as Lowe's syndrome or oculo-cerebro-renal syndrome which manifests growth plates, metabolic acidosis, and characteristic eye changes, including bilateral cataract, glaucoma and nystagmus. It is a congenital hereditary affectation. Most of the patients with this syndrome are male sex. We report a new case of Lowe's syndrome in a 5-year old girl.
Acidosis ; Ammonia ; Cataract ; Child ; Female ; Glaucoma ; Growth Plate ; Humans ; Hydrophthalmos ; Intellectual Disability ; Male

The epidural injection of corticosteroid reduces the inflammatory process of the neural structure and its neighbor structures. Morphine, also injected epidurally, has been reported to alleviate severe pain with the short-acting property. In attempt to prolong the effectiveness of pain relief, we have studied the effect of the epidural injection of the morphine and steroid frorg May 1987 to Oct. 1987, and compared with the effect of the epidural injection of the steroid and local anesthetics from Jan. 1986 to Oct. 1987. In this study, we obtained following results; 1. The major causative diseases were herniated necleus pulposus in 34 cases(48.5%), spinal stenosis in 16 cases(22.9%) and spondylolisthesis in 9 cases(12.9%). 2. In morphine-injected group, 100% of acute group and 92.3% of chronic group was improved. In non-morphine injected group, there was no significant difference between the acute and chroinc groups. 3. The effect of epidural morphine and steroid was as follows; Complete relief 14 cases (63.6%), marked improvement 5 cases(22.7%), moderate improvement 2 cases(9.2%) and no relief 1 case(4.6%). The overall improvement was resulted in 21 cases(95.4%). 4. The effect of epidural steroid and local anesthetics was as follows; Complete relief 10 cases(20.8%), marked improvement 14 cases(29.2%), moderate improvement 12 cases(25%~ and no relief 12 cases(25%). The overall improvement was resulted in 36 cases(75%). 5. The average duration of pain relief was 2.5 months in morphine injected group and 1.3 months in non-morphine injected group. 6. The side effects associated with opiate, such as generalized pruritus, nausea, vomiting and urinary retention were reported in 16 cases(72.7%), but responded readily to Naloxone injection and subsided within 24 hours. It is considered that epidural injection of morphine and steroid prolong the effect and duration of pain relief for low back pain and sciatica when compared with the epidural injection of steroid and local anesthetics.
Anesthetics, Local ; Injections, Epidural ; Low Back Pain ; Morphine ; Naloxone ; Nausea ; Pruritus ; Sciatica ; Spinal Stenosis ; Spondylolisthesis ; Urinary Retention ; Vomiting

Treatments of tibia shaft fracture are closed reduction followed by cast immobilization, external fixation, intramedullary nailing and internal fixation with plate and screws. Among these, intramedullary nailing is commonly used method today. The tibia nailing has high rate of union, but malunion, infection, the joint stiffness and anterior knee pain develops frequently. We reviewed the clinical and radiological result of anterior knee pain retrospectively after tibia nailing. The result were as follows: l. Age distribution of tibia shaft fracture was 17 to 76, and mean age was 40 male patients were 35 and female 13. 2. The open fractures were 17 and the closed fractures were 34. 3. The causes of' tibia shaft fracture were traffic accidents(30cases), fall down injuries(6 cases), slip down injuries(1 1 cases) and other injuries(4 cases) Among the these, 19 cases were cornbined with other fractures or neuri.isurgical injuries. 4. The incision methods were recorded as follows: parapatella tendon incision were 9 cases, patella splitting incision were 25 cases and unrecorded were 17cases. 5. According to the radiological analysis, the average nail plateau distance was 10.3mm and the extent of nail protrusion beyond the anterior cortex was -1.73mm. Among these, protrusion of proximal targeting screws were 8 cases. 6. Insertion of nail through the patella tendon was associated with a hipher incidence of knee pain compared to paratendon site of insertion. The extent of nail protrusion were related to anterior knee pain after tibia intramedullary nailing.
Age Distribution ; Female ; Fracture Fixation, Intramedullary* ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Incidence ; Joints ; Knee* ; Male ; Patella ; Patellar Ligament ; Retrospective Studies ; Tendons ; Tibia*

Unicameral bone cyst is an uncommon tumor-like lesion of the bone, containing distended channels or cavities filled with serous fluid. Four cases of cystic lesion at the upper end of the humerus were revealed to be unicameral bone cyst roentgenographically and microscopically. Two cases were treated with radical curettage followed by homogenous and autogenous bone graft, and one case was treated with radical curettage followed by homogenous bone graft. The other was treated with radical curettage followed by autogenous fibula graft. All cases made uneventful recoveries, and they had no complaints and no evidence of recurrence, A brief summary of literatures is submitted.
Bone Cysts ; Curettage ; Fibula ; Humerus ; Recurrence ; Transplants

There are many procedures for stabilizing the foot but all frail feet, all complete drop feet, and all calcaneocavus deformities due to paralysis are best treated by pantalar fusion. Hunt and Thompson advised one stage pantalar arthrodesis by astragalectomy and replacement of the denuded bone in paraiytic feet resulting from poliomyelitis. At the Presbyterian Medical Center, Jeonju, Korea, 12 one stage pantalar arthrodesis were performed between 1973 and 1978 and following observations were made. 1. Seven of the patient had pantalar fusions because of poliomyelitis. 2. Five feet were equinovarus and 4 had frail feet with varying amounts of varus or valgus of the forepart of the foot and of the heel. 3. Nine patients were considered to have a good result, two had a fair and one was failure 4. Length of immobilization was from 13 weeks to 37 weeks and the average length of immobilization was 17 weeks. 5. In one stage pantalar arthrodesis, there was no complication except one non-union and the period of hospitalization was decreased.
Arthrodesis ; Clubfoot ; Congenital Abnormalities ; Foot ; Heel ; Hospitalization ; Humans ; Immobilization ; Jeollabuk-do ; Korea ; Paralysis ; Poliomyelitis ; Protestantism

30 cases of distal femur fracture were treated with cast-brace for 2 years and 6 months from Feb., 1977 till July, 1979 at the department of Orthopaedic Surgery, Presbyterian Medical Center, in Jeon Ju. The results were obtained as follows: 1. In 9 cases, cast-brace were applied initially and other 21 cases were treated with cast-brace secondarily after operation. 2. 20 cases were male and 10 cases were female. 3. 12 cases were on mid 1/3 fracture and 18 cases were distal 1/3 fracture involving 2 condylar fractures. 4. The average duration of fracture healing was 14.7 weeks in the cases with cast-brace which is compared with 20.7 weeks of hip-spica cast control group. 5. A.G.F. of knee joint was 80–115 degree at removal of cast-brace, otherwise merely 50–65 degree at dlscarding of hip-spica cast. 6. There were no complication such as nonunion or delayed union in the cases with cast-brace.
Braces ; Female ; Femur ; Fracture Healing ; Humans ; Jeollabuk-do ; Knee Joint ; Male ; Protestantism

Harrington Instrumentation is very effective method for treating the unstable thoraco-lumbar spine fracture and fracture-dislocations. Authors performed Harrington Instrumentations in 8 cases of unstable thoraco-lumbar spine fracture and fracture-dlslocations. The results obtained were as follows; 1. Spinal fracture and fracture-dislocations are most common in thoraco-lumbar junction. 2. Laminectomy increases the instability of the spine. 3. Pain was more common in the patient who has severe deformity of the spine. 4. Neurological recovery; a) In case of complete paralysis... returns of useless motor power in 2 of 6 cases. b) In case of incomplete paralysis... complete returns in all 2 patients. 5. Harrington Instrumentation is very effective for restoring the spine stability in unstable fracture and fracture-dislocations. 6. Early mobilization was possible and hospitalization period was shortened by Harrington Instrumentation.
Congenital Abnormalities ; Early Ambulation ; Hospitalization ; Humans ; Laminectomy ; Methods ; Paralysis ; Spinal Fractures ; Spine

Cervical spine injuries are increasing recently due to increasing traffic accidents. Many patients have been treated with cervical laminectomy but stabilization of the cervical spine has been neglected as a part of the treatment. 30 patients with cervical spine injuries who were admitted to our hospital from January 1, 1973 to December 31, 1978 were evaluated. The following observations were made: 1. The ratio between male and female was 2:1 and the majority(43%) were found in the 4th decades. 2. The common causes of cervical spine injuries were traffic accident(40%) and falls(33.3%). The most common site of the lesion was the 5th and 6th cervical spine level (33.3%). 3. Among 30 cases, 10 cases(33.3%) had complete paralysis, 12 cases(40%) incomplete paralysis, 6 cases (20%) had nerve root injury and no neurological change is 2 cases. 4. The mechanisms of cervical injuries were classified morphologically and flexion-rotation injuries (55.5%) were the most common. 5. We evaluated the results of treatment neurological & radiographically. In complete paralysis, there was no neurological improvement and cervical kyphosis increased after laminectomy. In incomplete paralysis and nerve root injury, anterior fusion showed slight neurological recovery but mild cevical kyphosis and displacement of the graft were observed. In posterior fusion or cast immobilization, we had a satisfactory result with a high fusion rate and normal cervical curvature. 6. lt is impossible to compare anterior interbody fusion with posterior fusion for neurological recovery. For early mobilization and rehabilitation, we emphasize early stabilization by anterior or posterior fusion according to the mechanism of injury.
Accidents, Traffic ; Clinical Study ; Early Ambulation ; Female ; Humans ; Immobilization ; Kyphosis ; Laminectomy ; Male ; Paralysis ; Rehabilitation ; Spine ; Transplants