No abstract available.
Catheters* ; Renal Dialysis*

No abstract available.
Elbow*

Adhesion around tendons of the hand and wrist and subsequent limitation of motion, is one of the major complications after tendon surgery. In addition to the tendon surgery such as tendon repair or graft, infection, open reduction of fracutres, and burn scar contracture could be the casuses of tendon adhesion. Tenolysis and adequate postoperative rehabilitation program, has been proved to be effective in preventing of adhesion, whatever the cause may be, if its continuity is maintained. In order to evaluate the efficiency and problems of tenolysis, we reviewed 37 fingers of 31 patients who had been treated by tenolysis at Seoul National University Hospital from 1981 to 1991. There were 20 men and 11 women, and the average age was 28.2 years(9-45 years). The causes of adhesion were various; 24 fingers(64%) after tendon repair or tendon graft, 3 fingers(8%) after infection, 4 fingers(10%) after treatment of fracture, 4 fingers(10%) after burn scar contracture, and the other 2 fingers(5%) after curettage of enchondroma. Involved tendon were flexor tendon in 28 fingers and extensor in 9. The average duration of follow-up was 17 months(13 months to 4 years). Active motion of involved finger was started within 2 days after operation. The Total Active Motion(TAM) after operation was average 213°(100°-260°), compared to 123°(40°-180°) before operation. According to Strickland formula which was modified by us, the postoperative results were excellent in 17 fingers, good in 9 fingers, fair in 6 fingers and poor in 5 fingers. In 24 cases who had tenolysis after repair or graft, 19 case(79%) were rated as excellent or good. But in 7 cases whose causes of adhesion were infection or burn scar contracture, only 3 cases(42%) were rated as excellent or good. Compairing the results between younger(less than 30 years of age) and older(more than 30 years of age) group, the younger group showed excellent and good in 8496 and the older group in 41%, The complications were tendon rupture in 3 fingers and minor infection in 2 fingers, respectively. In summary, tenolysis was considered as a useful procedure to improve function of tendon bound down in scar tissue. And the results were better in younger age group(p < 0.05) and in previous tendon repair or graft(p < 0.05) group.
Burns ; Chondroma ; Cicatrix ; Contracture ; Curettage ; Female ; Fingers ; Follow-Up Studies ; Hand ; Humans ; Male ; Rehabilitation ; Rupture ; Seoul ; Tendons ; Transplants ; Wrist

Congenital radial clubhand is a rare deformity, which is characterized by total or partial absence of the radial ray of forearm and hand. We experienced 9 radial clubhands in 7 patients during the last 12 years. Excluding 3 clubhands in 2 patients which were very mild in their deformity, 6 clubhands in 5 patients were operated. Radialization was done in 5 clubhands, and centralization in one. Concomitant corrective osteotomy of ulna was combined in all. The results of the surgical treatment were evaluated by ; radiological findings including Hand-forearm angle(HFA), Hand-forearm position(HFP) and Ulnar bowing(UB) range of motion of the wrist ; and parents' satisfaction. Patients were followed up for average 2 years and 6 months, ranging from 1 to 6 years. All the radiological findings were improved. Although their range of wrist motion was not increased, this was changed into more functional position, that is the radial deviation decreased but ulnar deviation increased. Most parents were satisfied with the surgical results.
Congenital Abnormalities ; Forearm ; Hand ; Humans ; Osteotomy ; Parents ; Range of Motion, Articular ; Ulna ; Wrist

Intrinsic plus deformity, which results in severe functional impairment of the hand, is caused by contracture of intrinsic muscles. This deformity can be resulted from many causes such as ischemic damage, spasm of intrinsic muscles, thermal injury, and so on. The surgical release of tightened intrinsic muscles, may be the only solution to make usable hand, especially for severe cases. Sixty five digits in 22 patients who were operated on from 1982 to 1992, were evaluated retrospectively, to analyse the effects of surgery for intrinsic plus hand. Among 65 digits, 13 were thumbs and 52 fingers. The mean age of the patients was 26 years and 8 months and 17 cases were males and 6 females. The causes were ischemic damage by laceration or crushing injuries in 11 patients, compartment syndrome in 5, cerebral palsy in 5, and burn in one. Involved digits were thumb only in 4 patients, thumb and fingers in 9, and fingers in nine. All the digits were classified preoperatively by Zancolli's classification. In 13 thumbs retropulsion contracture was 4 and adduction-antepulsion contracture was nine. All of the thumbs were treated by intrinsic release and Z plasty(or rotational flap). Other procedures including arthrolysis, arthrodesis and tendon reconstruction were combined in 9 thumbs. In 52 fingers, in addition to distal release, arthrolysis was combined in 12 fingers, and arthrolysis plus volar plate release were combined in 4 fingers. For the assessment, our criteria, based on subjective satisfaction of the patient and range of motion, was used. The duration of follow up was from one year to 9 years with the average of 26 months. In 14 thumbs the results were excellent in 2, 6 good, 4 fair, and one poor. In 52 fingers excellent was 12, 24 good, 13 fair, and 3 poor. In summary we could improve the function of intrinsic plus deformity by appropriate sugery, and their results were good.
Arthrodesis ; Burns ; Cerebral Palsy ; Classification ; Compartment Syndromes ; Congenital Abnormalities ; Contracture ; Female ; Fingers ; Follow-Up Studies ; Hand ; Humans ; Lacerations ; Male ; Muscles ; Range of Motion, Articular ; Retrospective Studies ; Spasm ; Tendons ; Thumb

Polydactyly is one of the most common congenital anomalies of the limb, however its surgical treatment varies from simple excision to reconstruction. The purpose of this study is to present out classification of polydactyly in which the type of surgery was concerned primarily. Two hundred and thirty five digits(134 fingers and 101 toes) in 188 patients were operated from 1980 to 1992. We divided the polydactyly into two types-the simple type, in which the extradigit arises from only one digit, and the complex type in which the extradigit connects more than two adjacent main digits. The simple type was subdivided into joint type(type I), in that the extradigit has its own joint in its origine; epiphyseal type(type II), the extradigit share common epiphysis with main digit; and hypoplastic type(type III), the extradigit is connected only by soft tissue to the main digit. The epiphyseal type(type II) was further divided into subtype A(type IIA), in that the origin seems to be directly derived from the epiphysis; and subtype B(type IIB), which resemble an osteochondroma. Type III and type IIB can be treated by simple excision, however the type I and type IIB can be treated by arthroplasty with or without osteotomy as well as excision of extradigit. Result of surgical treatment in 1 digit of the simple form, which siginifies the extradigit arising from only one digit, are good in 193 digits(91%), fair 14(6.6%), and poor 5(2.4%) after an average follow-up period of 20 months. Our principles in the surgical treatment of polydactyly was treatment according to the type, and early treatment.
Arthroplasty ; Classification ; Epiphyses ; Extremities ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Osteochondroma ; Osteotomy ; Polydactyly

Being a rare disease entity, there have been few references about the cleft hand in Korea. We evaluated the postoperative cosmetic results of 17 cleft hands in 14 patients, who were treated surgically at the Department of Orthopedic Surgery of Seoul National University Hospital, from 1982 to 1993. Among 14 patients, 8 were males. Bilateral cleft hands were in five patients and unilateral in 9. Three of five patients who had bilateral cleft hands, were treated surgically on both hands. Remaining two patients had an operation on one hand which affected more severely. Average age at the time of operation was 2 years and 5 months(5 months-10years). Average duration of follow-up was 34 months(1 year 1 month-7years 5 months). By Lange's classification, typical patterns were 16 hands and atypical pattern one. By Flatt's classification, there were 8 hands of I b, 7 I c, 1 I a, 1 II. One patient had family history whose father had both cleft hands and feet. Congenital anomalies other than cleft hand were associated in 10 of 14 patients. Two patients had 3 associated anomalies, 4 patients 2, and 4 patients one. Syndactyly was the most common associated anomaly of affected cleft hand. Central cleft was closed by Snow-Littler technique in 4 hands(24%), Barsky method in 12(71%) and others in 1(6%). Metacarpal bone was treated by intermetacarpal ligament reconstruction in 1 hand(6%), excision only 7(41%), transfer of 2(rd) metacarpal to 3(rd) metacarpal base after excision 5(29%), and 2(rd) metacarpal corrective osteotomy 3(18%). Complications were in 2 hands; one wound dehiesence of cleft, and one partial necrosis of skin. The cosmetic results of surgical treatment were graded into good, fair or poor by the parents-Good ; when parents were satisfied with the result, Fair; improved cosmesis but not satisfied, and Poor; no improvement after surgery. Good was in 16 hands and fair in one.
Classification ; Fathers ; Follow-Up Studies ; Foot ; Hand ; Humans ; Korea ; Ligaments ; Male ; Methods ; Necrosis ; Orthopedics ; Osteotomy ; Parents ; Rare Diseases ; Seoul ; Skin ; Syndactyly ; Wounds and Injuries

Experiments were performed to investigate the effects of pinealectomy on the renin-angiotensin system in Sprague-Dawley rats. The results obtained were as follows. 1) There was no differences of systolic blood pressure, heart rate, water intake, and plasma electrolytes between pinealectomized and sham-operated rats. 2) Renin activity in plasma and pituitary gland did not differ in two experimental groups. 3) The pituitary gland contained the renin activity of about 50pg AI/hr/mg of wet weight. The results suggest that the pineal gland has no correlation with cardiovascular and renin-angiotensin system.
Angiotensins ; Animals ; Blood Pressure ; Cardiovascular System ; Drinking ; Electrolytes ; Heart Rate ; Pineal Gland ; Pituitary Gland ; Plasma ; Rats ; Rats, Sprague-Dawley* ; Renin ; Renin-Angiotensin System*

In order to research the clinical utility of Pilogel(R), we administered Pilogel(R) to 13 POAG(primary open angle glaucoma) patients once daily for four weeks and measured the degree of intraocular pressure reduction and accompanying side effects three days after; one week after; two weeks after; three weeks after and four weeks administration. 1. Administration of Pilogel(R) single dose at bed time produced the same effect of intraocular pressure reduction as that of 4% Pilocarpine eye drop four times a day. 2. Up to four weeks of daily administration of Pilogel(R) did not produced tachyphylaxis. 3. Degree of intraocular pressure reduction after administration of Pilogel(R) was maintained at the almost same level from days 3 up to 4 weeks. 4. The intraocular pressure reduction effect with pilogel(R) was maintained at the constant level for 18 hours following administration of it. 5. Once a day regimen of Pilogel(R) was proven to be more comfortable than the 4 times a day regimen of pilocarpine eye drop. And the side effect of Pilogel(R) was no greater than that of pilocarpine eye drop.
Glaucoma* ; Humans ; Intraocular Pressure ; Pilocarpine* ; Tachyphylaxis

Human cytomegalovirus encodes an unusual protein kinase UL97 which can phosphorylate exogenous substrates, including histone H2B and nucleoside analogs such as ganciclovir. The previous result interestingly showed that the peptides phosphorylated by UL97 have K/R at the 5 positions (P+5) downstream from the pSer. To confirm the importance of the basic residue in the position, we used two peptide libraries, 4S4K (MAXXXXSXXXXKXANNN) and 4S6N (MAXXXXSXXXXXXNNN). The activity of phosphorylation by UL97 was higher in the peptide library 4S4K than 4S6N, suggesting the importance of basic residue at P+5 position. The screening with a peptide library 4S4K showed slight tendencies for N in the P+1 and P+2, M in the P+2, K in the P+4 and P+6 positions and several amino acids in the other positions. This result will give information to develop an optimal peptide for screening a novel UL97 inhibitor.
Amino Acids ; Cytomegalovirus* ; Ganciclovir ; Histones ; Humans* ; Mass Screening* ; Peptide Library* ; Peptides ; Phosphorylation ; Protein Kinases* ; Substrate Specificity*