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.
Humans ; Osteosarcoma*

This study was designed to assess the antihypertensive efficacy and overall tolerance of doxazosin in patients with mild-to-moderate essential hypertension. Doxazosin was administered in once-daily dose from 1 to 3mg to 97 patients both in a general hospital and a local clinic in rural area. These patients are composed of three groups. One group has 49 Patients treated with doxazosin monotherapy, another group with 31 patients treated with doxazosin as well as other antihypertensive drugs combined and a third group is composed of 17 patients with renal insufficiency n addition to hypertension. The patients in the third group with renal insufficiency had 2.5mg/dl-5.0mg/dl in serum creatinine. Results are as follows : 1) The study sample is composed of 37 males (38.1%) and 60 females (61.9%) with mean age 51.4 years. Among three subasmples no statistically significant difference is observed in age, sex, mean body weight and heigh at 0.05 error level. 2) A total of 47 patients (48.5%) of the 97 patients have completed twelve-week doxazosin antihypertensive treatment. At a mean dose of 4.4+/-0.4mg at twelfth week, 37 patients (78.7%) responded to doxazosin therapy. Twenty-nine(61.7% patients achieved "excellent" blood pressure control(mean sitting DBP of < or =90mmHg), and 8 patients (17.0%) showed "good respone" (10mmHg or more DBP reduction from baseline). Whereas remaining 10 patients (21.3%) showed only "fair response" (5-9mmHg DBP reduction) or "failed"(0-4mmHg DBP reduction). In doxazosin monotherapy group thirteen(68.4%) of nineteen patients showed "excellent" or "good response" at a mean dose of 4.8mg/day. Combination therapy group with eighteen patients showed 100% therapeutic success. This group had fourteen(77.8%) "excellent" and four(22.2%) "good respinse" at a mean daily dose of doxazosin 3.9mg. Renal insufficiency group with ten patients showed six(60.0%) "excellent" and four (40.0%) "failure"cases at a mean daily dose of 4.6mg. 3) The mean baseline sitting blood pressures of doxazosin monotherapy group were 175/109 whose blood pressure at twelfth week were 150/94 at a mean daily dose of 4.8mg. The baseline blood pressure of combined therapy group 180/111 were reduced to 145/91 at twelfth week at a mean daily dose of 3.9mg. Those of renal insufficiency group were 177/112 and 156/98 respectively at a mean doxazosin daily dose of 4.6mg. 4) Of the 97 study cases, adverse effect were reported in 19.6%. The most prevalent adverse effects were dizziness(11.3%), blurred vision(9.3%), headache(5.2%), most of which were mild or moderate and disappeared with or were tolerated on continued therapy. But three cases(3.1%) had to refrain from doxazosin administration due to blurred vision, dizzines, and headache. 5) The change of lipid analysis between before and after treatment in the monotherapy group with doxazosin showed 3.8% decrease of total cholesterol and 4.6% increase of HDL cholesterol and 11% increase of triglycerides, which were not statistically significant. In the combination therapy group 0.4% decrease of total cholesterol, 24.1% decrease of HDL cholesterol and 44.3% increase of triglycerides were observed. In the renal insufficiency group 4.9% decrease of total cholesterol, 22.1% decrease of HDL cholesterol, 0.1% decrease of triglycerides were observed. But all these findings have limitation in generalization due to small number of sample and a short period of observation. 6) Laboratory chemistry test results revealed no apparent treatment-related abnormalities.
Antihypertensive Agents ; Blood Pressure* ; Body Weight ; Chemistry ; Cholesterol ; Cholesterol, HDL ; Creatinine ; Doxazosin* ; Female ; Generalization (Psychology) ; Headache ; Hospitals, General ; Humans ; Hypertension ; Male ; Renal Insufficiency ; Triglycerides

No abstract available.
Paralysis* ; Radial Nerve*

No abstract available.
Sotos Syndrome*

No abstract available.
Patella*

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

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

PURPOSE: Nonsteroidal anti-inflammatory drugs inhibit the synthesis of prostaglandin(PG) through inhibition of the enzyme, cyclooxygenase. Some of the arachidonic acid metabolites may influence the spread of electrocortical activity, and delay the pentylenetetrazol(PTZ)-induced seizures. The purpose of the present study was to evaluate systematically the effect of pretreatment with PG synthetase inhibitors on PTZ-induced seizures. METHODS: To evaluate the effects of pretreatment with PG synthetase inhibitors on seizures produced by 30mg/kg, 60mg/kg PTZ, free-moving Sprague-Dawley rats weighing 250-300gm with chronically-implanted supracortical electrodes were used. Electrocorticogram was recorded for 1hr prior to pretreatment administration of either saline (control) or PG synthetase inhibitor and 1hr after administration of PTZ. RESULTS: 1) A 30mg/kg dose of PTZ produced bursts of high voltage activity after a latency of 616+/-72sec. Although the animals showed spontaneous movements throughout the test period, they were motionless or myoclonus. The number of high voltage bursts during the first hr of the test period was 368+/-31.2) A 30mg/kg of PTZ produced high voltage bursts after a latency of 1118+/-35sec which was significantly greater for the ibuprofen-pretreated groups receiving 90mg/kg when compared to the saline-pretreated group. In addition, the number of high voltage bursts(173+/-17) which occurred during the first hr of the test period was significantly smaller than that recorded from the saline-pretreated group. 3) After pretreatment with a 450mg/kg dose of paracetamol, a 30mg/kg of PTZ produced bursts of electrocortical activity with onset latencies of 665+/-112sec which were not significantly different than those recorded from the saline-pretreated group. The number of high voltage bursts during the first hr of the test period was 141+/-30 which was significantly smaller than that recorded from the saline-pretreated group. 4) A 50mg/kg dose of mefenamic acid pretreatment caused 30mg/kg PTZ-induced high voltage bursts after latency of 227+/-47sec which was significantly shorter than that recorded from the saline-pretreated group. The number of high voltage bursts during the first hr of the test period was 522+/-42 which was significantly greater than that recorded from the saline-pretreated group.5) A 60mg/kg dose of PTZ produced bursts of high voltage activity after a latency of 79+/-14sec. An electrocortical seizure with concurrent convulsions appeared subsequently by 129+/-30sec. 6) A 60mg/kg of PTZ produced high voltage bursts after a latency of 217+/-38sec which was significantly greater for the ibuprofen-pretreated groups receiving 90mg/kg when compared to the saline-pretreated group. An electrocortical seizure with concurrent convulsions appeared subsequently by 287+/-30sec.7) After pretreatment with paracetamol(450mg/kg), a 60mg/kg of PTZ produced bursts of electrocortical activity with onset latencies of 143+/-36sec which were significantly different than those recorded from the saline-pretreated group. There was no convulsive or no electrocortical seizure.8) A 50mg/kg mefenamic acid pretreatment caused 60mg/kg PTZ-induced high voltage bursts after latency of 35+/-5sec which was significantly shorter than that recorded from the saline-pretreated group. An electrocortical seizure appeared subsequently by 58+/-10sec which was significantly different than that recorded from the saline-pretreated group. CONCLUSION: It is possible that the delay and/or block of convulsions induced by the higher doses of PTZ was the result of PG synthesis inhibition. However, the PG synthetase inhibitors had a more differential effect on general PTZ-induced excitation of the CNS evidenced by changes in electrocortical activity. The mechanism underlying this action could be either through inhibition of the activity of cyclooxygenase in tissues which play a role in the manifestation of seizure activity or through an action not related to their common action on cyclooxygenase.
Acetaminophen ; Animals ; Arachidonic Acid ; Electrodes ; Ibuprofen ; Ligases ; Mefenamic Acid ; Myoclonus ; Pentylenetetrazole ; Prostaglandin-Endoperoxide Synthases* ; Rats, Sprague-Dawley ; Seizures*

No abstract available.
Glycogen Storage Disease Type II* ; Wolff-Parkinson-White Syndrome*