When the effusion and pain of the joint caused by rheumatoid arthritis, osteoarthritis, and non-specific synovitis is persistent in spite of various conservative measures, the intra-articular injection of radioactive colloidal gold is recommended. Although the cause of rheumatoid arthritis and similiar types of inflammatory arthritis is not well known, the basic pathology appears to be in the synovium Colloidal particles of radioactive coiloidal gold injected into an inflamed joint are phagocytosed and dispersed uniformly on the superficial layers of the synovium Radioactive colloidal gold was first introduced in the malignant peritoneal effusions by Muller in 1950, and it was later used by Andrew and Mackay in malignant pleural effusion in 1953 and 1957. The malignant ascite, pleural effusion, and synovial effusion are collections of fluid in closed cavities lined by a thin sensitive endothelial layers; and apart from repeated aspirations, accepted forms of treatment frequently fail to cure or even control the effusions. Because of this resemblance it was decided in 1957 to attempt to treat persistent synovial effusions by intra-articular injection of radioactive colloidal gold. 198Au has a half-life of 2.7 days and emits both beta and gamma rays, Beta rays, which produce 90% of the therapeutic effect, penetrate tissue to an average depth of 1 to 2 mm. The particle of colloidal suspension of 198Au is 20 to 50 mu. The colloidal state of the preparation aids in limiting radiation to the synovial surface, and it has been shown that large colloidal particles are not absorbed into the blood or lymphatic systems after intra-articular injection and penetrate no deeper than the synovial tissues as a result of phagocytic activity. Good results have been reported since the radioactive colloidal gold was introduced in the treatment of persistent effusion of the human knee by Makin in 1963. The knee is chosen as the most suitable joint for this trial because of the ease of performing accurately intra-articular injections and the ease with which knee effusions can be recognized and measured. Furthermore, the knee joint is superficial and distant from vital structures which may be radio-sensitive. In this study, thirty-nine knee and three ankle effusions and pains unresponsive to the usual methods of therapy were treated by intra-articular injection of radioactive colloidal gold from November 1964 to January 1979 with follow up. Thirteen cases had classical rheumatoid arthritis; ten osteoarthritis; fifteen non-specific synovitis; two pigmented villonodular synovitis; one post-synovectomy, and one tuberculous arthritis. The results were as follows; 1. In eleven cases(84.6%) of rheumatoid arthritis, fourteen cases (93.3%) of nonspecific synovitis, and five cases(50.0%) of osteoarthritis, the effusion disappeared. 2. In twelve cases(92.3%) of rheumatoid arthritis thirteen cases(86.7%) of non-specific synovitis, and only two cases(20.0%) of osteoarthritis, the pain disappeared. 3. As a whole, in thirty-three cases(78.6%), the effusion disappeared and in twenty-eight cases (66.7%), the pain disappeared.
Ankle ; Arthritis ; Arthritis, Rheumatoid ; Ascitic Fluid ; Aspirations (Psychology) ; Beta Particles ; Colloids ; Follow-Up Studies ; Gamma Rays ; Gold Colloid ; Half-Life ; Humans ; Injections, Intra-Articular ; Joints ; Knee ; Knee Joint ; Lymphatic System ; Osteoarthritis ; Pathology ; Pleural Effusion ; Pleural Effusion, Malignant ; Synovial Membrane ; Synovitis ; Synovitis, Pigmented Villonodular

No abstract available.

No abstract available.

No abstract available.
Femur* ; Hip Fractures* ; Osteoporosis*

No abstract available.
Muscular Diseases*

Subacute osteomylitis is far less common than acute osteomyelitis, characterized by insidious onset of the symptoms of mild local pain or discomfort without any acute systemic illness. Radiographic findings are not infrequently confused with benign or malignant bone tumors. From Jan, 1983 to Dec. 1991, we experienced twelve patients with subacute osteomylitis of long bones. Our clinical observations were as follows. 1. There were 11 boys and one girl with an average age of 9.7 years(range, 30months-16years). 2. The involved sites were proximal in 1, distal radius in 3, midshaft of femur in 3, distal femur in 2, proximal tibia in 1, and distal tibia in 2 cases. 3. All patients had insidious onset of mild to moderate pain. ESR was increased in 9 cases(75%) with a mean value of 44 mm/hr, but leukocytosis was not found. 4. According to the Green and Edwards' classification, there were type 1 in 1, type 2 in 3, type 3 in 3, and type 6 in 5 cases. 5. Eleven patients had operative treatment. The remaining one patient was treated by antibiotic treatment. 6. Primary treatment was successful in 11 patients who were followed for and average 9.5 months. One patients was lost to follow-up.
Child ; Classification ; Clinical Study ; Female ; Femur ; Humans ; Leukocytosis ; Lost to Follow-Up ; Osteomyelitis ; Radius ; Tibia

Experiments were performed in mice (Balb/C) to support the basic efficacy of the human immunoglobulin (IgG) preparation. The antibacterial activity of IgG purified from human sera was examined with or without the quinolone agent, ciprofloxacin (CPFX), against Pseudomonas aeruginosa isolated from clinical specimens. Results were as follows: Antibacterial activities in terms of percentage of survivors, after administration of Ps. aeruginosa into mouse intraperitoneal cavity were in the following order, single IgG group, CPFX administration after IgG pretreatment group, IgG and CPFX combined administration group and CPFX alone group. The number of living bacteria was monitored in blood and liver tissue of mice infected with Ps. aeruginosa and treated by IgG administration. The increase of living bacteria in liver was more drastic than that in blood. Leukocytosis was observed in mice injected with IgG, excluding those only with ciprofloxacin, after 8 hours of administration to see a decrease to normal number of bacteria after 18 hours. No significant difference was noticed between pretreatment group and post treatment group. In vitro susceptibility test of IgG against Ps. aeruginosa, minimal inhibitory concentration (MIC) was 250 µg/ml, resistant to IgG, regardless of a combined administration with CPFX. In vitro test revealed that the IgG itself did not have anti-Ps. aeruginosa activity.
Animals ; Bacteria ; Ciprofloxacin* ; Humans ; Immunoglobulin G ; Immunoglobulins* ; In Vitro Techniques ; Leukocytosis ; Liver ; Mice ; Pseudomonas aeruginosa* ; Pseudomonas* ; Survivors

In pediatric ages, the supracondylar fractures of the humerus are common and often associated with complications. In these days, the serious complications were reduced with a lot of apprehension for the treatment. While the fracture itself was healed properly, the remained deformity was frequent and it was known that this deformity was derived not from growth disturbance after fracture but from inaccurate reduction at the time of initial reduction. We have performed an anatomical study. Identical skeletal models were osteotomized at the supracondyle of the humerus and every combination of 0°,10°, 20°, 30° of each of varus, valgus tilt, internal rotation and flexion were tried at osteotomized site and were taken radiography and photographed. We measured T-C angle, carrying angle and displacement of distal radial styloid process on X-ray. We got the results as follow. 1. Simple rotational deformity of 50° have resulted in only 20% decrease of width of distal osteotomized surface in AP films in pure rotational deformity. 2. Flexion at the osteotomized site have no specific effect on the change of varus and valgus deformity. There were remarkable increase from 0° to 20° after then the changes were decreased in varus tendency according to internal rotation. 3. Among the changes of varus and valgus angle, the varus deformity was largest at the change of angle from 0° to 10° and other change of angle of varus and valgus deformity were incrersed at similar degree. 4. At the osteotomy site, without changes of varus and valgus angle, it showed that internal rotation resulted in varus defromity.
Congenital Abnormalities ; Humerus ; Osteotomy ; Radiography

No abstract available.
Patella*

Acquired perforating disease(APD) is characterized by hyperkeratotic papules with transepidermal elimination of degenerated material and is associated with renal disease and/or diabetes. Particular attention has been directed to transepidermal elimination because the articles on perforating diseases among patients with chronic renal failure and/or diabetes have been increasingly reported. We describe four patients with chronic renal failure and/or diabetes whose skin biopsy specimens showed transepidermal elimination.
Biopsy ; Humans ; Kidney Failure, Chronic* ; Skin