Diagnostic Signification of Antiperinuclear Factor(APF) in Rheumatoid Arthritis / 대한정형외과학회잡지

In systemic rheumatic disease, marker antibodies such as anti-Sm, anti Scl-70 and anti Jo-1 are helpful in the diagnosis of disease, but in rheumatoid arthritis, the diagnosis is difficult due to the low sensitivity and specificity of the rheumatoid factor(RF). So, a new maker antibody with high sensitivity and specificity was needed. Recently, the antiperi- nuclear factor(APF) has gained particular attention. The results of the APF and RF test in 165 patients with rheumatoid arthritis, 77 patients with osteoarthritis, and 109 normal healthy persons, which were taken between January, 1994 through December 1994 were as follows; 1. The sensitivity, specificity, and predictive value of positivity of the RF test in patients with rheumatoid arthritis were 58.2%, 93.5%, and 95.0%, and that of the APF test were 72.1%, 94.6% and 92.2%, respectively. 2. The sensitivity, specificity and predictive value of positivity when combining the APF with the RF were 83.0%, 85.7%, and 92.6%, respectively. 3. The disease status of the patients correlated with intensity of the APF test, that is, the more severe the disease status, the higher intensity. In conclusion, the APF was useful in the diagnosis of rheumatoid arthritis, and may be used as an indicator of disease status. When combining test the APF with RF, the incidence of sero-negative rheumatoid arthritis decreased.

The Operative Treatment of the Resistant clubfoot: Comparative study between modified Turco's Operation and combining calcaneocuboid release / 대한정형외과학회잡지

The 17 patients with 22 resistant clubfeet were treated with modified Turco's operation with or without combining release of calcaneocuboid joint at Department of Orthopaedic Surgery, Hanyang University School of Medicine between 1896 and 1991. They were analysed preoperatively and postoperatively with chinical and radiological methods. In patients who were treated with combined procedures, the latetal talocalcaneal angle and anteroposterior talo-first metatarsal angle in radiological findings were showed better improvement(p < 0.05), and anteroposterior talocalcaneal angle was also showed better improvement but not significant statistically, than those who were treated with modified Turco's operation alone. The final results of combined procedures were better than that of modified Turco's operation. And the most common characteristic physical findings in resistant clubfoot were small heel, deep longitudinal crease on the medial aspect of midfoot area and a single transverse crease on the posterior heel just proximal to the insertion of the tendocalcaneus. So we suggest these physical findings may be expectance for the resistance of the congenital clubfoot to conservative treatment, but it need further comparative study.