The therapeutic results of anti-rheumatic agents in the treatment of rheumatoid arthritis were as follows: These agents had good effects in acute signs and symptomes, but when the agents were discontinued, signs and symptomes reappeared, the ill-effects in the cases of cortisone and ACTH were absent, and in T. T. G and Salcylamid were slight. In Irgapyrin, edema was observed, but agranulocytosis was absent.
Synovectomy was performed on 8 cases which proved the effusion within the joint caused by nonspecific proliferative synovitis. There were 6 cases of the knee joint, 2 cases of the elbow joint and 2 cases of these knee joints were bilateraly. In most cases, symptomatic relief and improved function was obtained after operation but one case which proved the destruction of the articular cartilage in the elbow joint give the poor result. Synovectomy in properly selected cases give rise to striking results.
The patient, a girl of 8 years age, was clinically made a diagnosis of acute lymphatic leukemia, but histologically of acute myeloid leukemia. She had a obvious waist-ache and her tadiograms of the vertebrae showed a pecular abnormal changes. That is to say, at the beginning of changes, there were some erosive images like a tumor of bone in her second and third lumbar, but later on, I saw conspicuous kompressed images on her vertebrae, which were below seventh thoracic vertebra, and her sacrum-image was obscure like a claud. In the white-cell count, lymphocytes amounted to 97 per cent and her peroxydase-reaktion was negative.
Author examined the human foot pressure in normal gait by oscillographic method, and found that variations between individuals were very large. The foot pressure was dominant on lateral aspects of male sole and on medial aspects of female sole. Normal foot pressure on flat surface was generally higher than on oblique surface. In comparison of this method with oppress spur by dental modelling, they were not always confortable.
Author investigated roentgenologically the growth of tarsus of young dogs after panastragalar and triple arthrodrsis. Results obtained were as follows; 1) In both groups, no remarkable retardation or promotion of longitudinal growth of the calcaneus and cuboid were observed. 2) In the transverse growth of the calcaneus, considerably remarkable retardations were observed in early stages after the operation, but in late stages, especially in the second group, remarkable retardations were not observed.
Tomography can play an important role in the investigation of the bone and joint tuberculosis. It shows the more clear appearance of the affected bone and joint than that in routine radiograph. In some cases, it can shown up the bone destruction, which is normally difficnlt to be demonstrated by routine radiography.
I operated 41 old tuberculous joints in past 3 years, Though I cannot draw a conclusion from my experiences in only three years, I think that next methods are proper plans of operation by their experiences. 1. The clearing of focus under giving the specifics of tuberculosis has good results by using with bone graft. Thereby, if the extra-articular arthrodesis is tried, I advance the clearing of focus at the same time as the extra-articular arthrodesis. 2. In patients over ten years of age, I advance to try the arthrodesis at the same time as the clearing of focus in the tuberculosis of hip joint. 3. In children under five-six years of age, we can expect rarely a certain movement of the joints after healing of tuberculosis by the clearing of focus.
According to prolonged observation of the patients of paraplegia complicating tuberculosis of the spine, we studied the indication for treatment. (1) By exclusion of the backabscess communicating to paravertebral abscess, the condition of paralysis became rapidly betteer. (2) It is important to prevent patients with paraplegia, having a large paravertebral abscess, especially in childhood, from increasing the kyphosis and expending the tuberculous impingement. (3) Patients with Pott's paraplegia should not be allowed to remain in resting treatment indefinitely. It is difficult to obtain the standard for deciding the indication.
64 Cases of extremity amputation were hospitalized in a year since May 1951, 32 cases of them were lower extremity amputation, 10 cases of which were schort amputated within 6cm from knee joint. They were given prostetic and trained. The forward kick ability of lower extremity were from 4kg to 10kg, the supporting ability of amputation face were from 30kg to 85kg. In 2 cases of 10 short amputated were fibula exstirpated, but they had the same ability as the another non exstirpated. We could, by using double socket, apparently increase the walking and suppo rting ability of short lower extremity amputation.
Acetabrum sustained a blow was attacked by osteomyelitis and mechanism of accident, term to falling ill and its progress was satisfied with standard of judgement of traumatic osteomyelitis on Liniger and Rosenberg. So author judged that was occured for accident during business.
We reported a case of dermatitis factitia that had begun on the traum by public business, in addition to diagnosis of simulation—mainly dermatitis factitia. The patient, 32 years old, fell dawn from a telegraph pole, and was bruised on the right vorarm. Since then, swelling and ulceration appeared on his limbs one after another during a period of 2 years and 3 months. Abnormality was not discovered on various tests. And so, he was fixed his both hands by plaster, then this swelling and ulceration healed up. Through the examination, it was detected that he had injured himself by sulphuric acid. We believe that his disease is not neurosis but simulation by which he watched economic and other interests.
Aus der Ergebniss der in Serien beobachteten histologischen Untersuchung, die an die 2 Lunatumnekrose von jungem Stadium mitsamt dorso-ventraler Weichteilgewebe und Teile der benachbarten Carpalknochen, ausgeführt war, fasste Verfasser das Wesen des Leidens als eine infektiöse, aber nicht entzündlich-eitrige, doch alle Gewebe zur Nekrobiose oder Nekrose führende, chronische deformierende Arthritis, welche die Hand- und Carpalgelenke, wie bei der Gelenktuberkulose, angegriffen hat. Verfasser negiert traumatische ebenso sogenannte dauertraumatische Entstehung des Leidens, und behauptet dass, die Verschlimmerung dieser Krankheit durch irgendeinen Betriebsunfall oder eine aussergewöhnliche Anstrengung bei der Arbeit, regelmässig entschädigt werden muss.
We investigated the end-results of 28 patients (30 limbs), and performed arthorography at 14 patients (15 limbs) of them. The end-results of definite lesions of the menisci was very good (91.7%), but that of the loose menisci was no better than the former. Therfore it is necessary to determine the exact diagnosis before the operation. The arthrosis derormans was not ensued from neniscotomy, but at only one limb remarkably grew the spicule-making of the bone edge, however it was independent of the functional end-results. The regeneration of menisci after operation was recognized to have some differences among the types of damage of menisci and the individuals. The regeneration of the menisci on the cases of damage at the attaching point of the joint capsule was rare, but this was also independent of the functional end-results.
The old dislocations of 24 shoulders and 42 hips were treated by open reduction in our clinic. The dislocations of shoulders could be reduced in every cases. But in the elder cases, in which the hips have been dislocated for long time, the reduction were difficult and some of the head or hals of the femur were resekted and reduced. In the most instances the free movement obtained is in proportion to the duration of the dislocation.
I have applied dorsal suspension method by the Hoffa's spine correction instrument to the spine fracture, and obtained satisfactory results in reduction and fixation. Nine cases treated by this method were reported in detail.
Recently the Küntscher's nail is used a good deal, as it has the strong stiffness and fixes both bones enough. The ventical direction of the nail is 30% stronger than the horizontal and in fracture the stiffness of the bone to be fixed by the nail is equivalent the nail itself regardless of the depth of the head of it, so it is unnecessary to strike the head in one bone too deeply. The three-wings nail is 20% lighter, 30% weaker than the Küntscher's nail of the same grade.
At present, Küntscher's medullary nailung is the best treatment for closed and open fractures of the shaft of the femur. One should take especial precautions against the child and the aged, about the growth and fragility of bones When fractures are near the proximal end, the fixation of the fragments by this method, is not so firm that the patients can walk within few weeks.
Author examined 60 cases of old fractures of the shaft of the femur in our hospital examination were performed about region of the fracture, years of age and occupation of the patients, cause of the trauma, method of treatment in our hospital and other ones, state of the union and the reposition, length and muscular atrophy of the legs and movement of the knee joint.
In recent half an year, five cases of humeral neck fractures were treated operatively in our clinic. The cases and the methods used were as following table; According to the types of fractures, the methods of fixation should be changed, however, the blade plate fixation was the best method of choice in the treatment of fracture of surgical neck.