A new open reduction treatment for congenital hip dislocation: long-term follow-up of the extensive anterolateral approach.

Congenital hip dislocation, which is conservatively unmanageable, has usually been treated using open reduction. However, a long-term follow-up study of the results suggests that this procedure is unsatisfactory. Since 1973, Tanabe has used a new open reduction procedure that circumferentially dissects the joint capsule and produces sufficient concentric reduction of the femoral head in the acetabulum immediately after the surgery. Fifty-six children (65 hips) from the age of 1 to 3 years were treated by this procedure, and fifty-one of them were clinically and roentgenographically followed up from 6.3 to 12.4 years after the surgery. At the final follow-up session, all children had grown to be over 9 years of age, and no patient had clinically significant symptoms. According to Severin's classification, 33 hips were rated in Group I, and 14 hips in Group II. Another 10 hips were in Group III, and one hip was in Group IV. The incidence of avascular necrosis was 5.2 per cent. These data suggest that our procedure is more useful than the previous ones

Unique features of monoclonal IgG2b in the cleavage reaction with pepsin.

Preparations of IgG2b purified from several mouse hybridoma clones were highly susceptible, compared to other subclasses, to peptic digestion under conditions usually used to prepare F (ab')2 fragments. Analyses of the digestion products revealed that no F (ab')2 was produced and that the main product was a Fab-like fragment. Demonstration of the hinge disulfides in the Fc portion clearly indicated that in IgG2b the primary peptic cleavage occurs on the NH2-terminal side of the inter-heavy chain disulfide bridge. The resulting Fab failed to bind with antigen, suggesting the importance of the CH1-hinge region in maintaining the native conformation of the antigen-binding site.</p

On the Treatment of Congenital Disocation of Hip Joint

Of 451 cases treated by the non-bleeding technique at Department of Orthopedic Surgery, Okayama University Medical School for the period from June 1954 to December 1955, the author pursued the 47 cases on which the follow-up study was possible for the periods of 3 years and one month to 4 years and seven months after the treatment, and obtained the following results. 1. For the treatment of infants with congenital dislocation of hip joints we took a special care so as to keep the tissue damage as little as possible by the atraumatic technique. As a consequence with one exception that developed cerebral paralysis in all other 46 cases we were able to obtain excellent clinical results. 2. However, by the X-ray examination the majority of them revealed the roof of acetabulum to be still steep and also the head of femur to have moved slightly exteriorly upward. Moreover, at this instance various measurement of α angle, h/1 and H/1 were significant, but CE angle and Schenton line was not. Furtnermore, although the atrophy and sclerosis of bone can not be represented numesically, it is believed that these will have a significant bearing on the treatment and prognosis of congenital dislocation of hip joints. 3. From the examinations of the tissues obtained from the edge of the acetabular roof of foetus and of the biopsy specimen from infants both with dislocation of the hip joint, it is assumed that the congenital defect of mesenchym coupled with the kinetic relationship between the roof of acetabulum and the head of femur presents pathological findings. 4. For those showing a poor growth of the acetabular roof in congenital dislocation of hip joint during the treatment by non-bleeding technique and still revealing a steep acetabular roof we replaced the cartilagenous tissues of that part by trephin, expecting to promote the growth in that part. The results were at variance, and in the final analysis, it seems that a more important problem in such cases is the method how the head of femur may be kept centripetally

Operative treatment of congenital muscular torticollis: long term results of myotomy

Myotomy was performed in 40 patients under 10 years of age with typical congenital muscular torticollis. Follow-up studies were carried out on 29 out of 40 cases. The patients without muscle relief of the affected sternomastoid muscle after myotomy had good range of motion of the neck. On the other hand, the patients who had undergone muscle release had, to grater or lesser extent, disturbances of the range of movement. For complete release of contracture, total excision may be the only operation in younger cases

Analysis of cellular oncogenes in human bone and soft tissue tumors

The amplification and rearrangement of five cellular oncogenes (c-myc, c-K-ras, c-fos, c-raf-1, and N-myc) were studied by Southern hybridization in fourteen human bone and soft tissue tumors obtained at surgery. Amplification of c-myc was detected in the two of four osteosarcomas and one of two malignant fibrous histiocytomas. The c-myc genes in these tissues were amplified 4- to 8-fold in comparision with the placenta DNA. One of these osteosarcomas had 16- to 32-fold amplification of c-raf-1 gene without rearrangement. The clinical course of osteosarcoma and malignant fibrous histiocytoma with the amplified c-myc or c-raf-1 gene showed a rapid malignant progress with lung or bone metastasis. There appears to be a correlation between clinical prognosis and oncogene amplification