OBJECTIVE: To explore the healing effect of low intensity pulsed ultrasound with three different timing of intervention after tenotomy of Achilles tendon in rats. METHOD: One hundred and thirty-two male rats were divided into experimental and control groups. Both groups were classified according to treatment phase: treatment on inflammatory phase (group I), proliferative phase (group II), and maturation phase (group III). Each groups were divided into 2 subgroups according to tendon excision time: 1 day after 7 consecutive treatment on 3 different phases (I-A, II-A, and III-A) and 30 days after tenotomy (I-B, II-B, and III-B). Three MHz pulsed ultrasound was administered on right tendon for 4 mins at 0.5 W/cm2. The excised tendons of all groups were compared histologically and biochemically as control. RESULTS: The tendons of II-A experimental group revealed increased fibroblasts. The collagen fibers in the neo-tendon of II-B and III-B experimental groups had a tendency to be arrayed more regularly. On I-A group, the neo-tendon showed high immunoreactivity for type I and particularly type III collagen in cytoplasm of fibroblasts and collagen fibers. The imunoreactivity for type III collagen in the neo-tendon of II-A experimental group increased than control. The concentration of collagen of the neo-tendon was significantly increased on I-A and II-A experimental groups compared with control (p<0.05). Collagen concentration of the neo-tendon of II-B experimental group increased significantly compared with control and I-B and III-B experimental groups (p<0.05). CONCLUSION: These results suggest that low intensity pulsed ultrasound therapy on injured Achilles tendon may be of benefit such as increasing collagen synthesis in the early healing process, especially in proliferative phase.
Achilles Tendon* ; Animals ; Collagen ; Collagen Type III ; Cytoplasm ; Fibroblasts ; Humans ; Male ; Rats* ; Tendons ; Tenotomy ; Ultrasonography*

OBJECTIVE: To assess the correlation between the risk categories of diabetic foot screening test by 5.07 Semmes- Weinstein monofilament and the findings of standard nerve conduction studies of upper and lower extremities. METHOD: We studied 74 patients who were consulted to our department to rule out the diabetic neuropathy. We classified the patients to 4 risk groups by foot screening test using 5.07 Sememes-Weinstein monofilament, and performed the standard nerve conduction studies of upper and lower extremities. The risk categories of foot screening tests were compared to the findings of the nerve conduction studies. RESULTS: When the risk category becomes higher, there were more delay in latencies (motor and sensory potentials of median and ulnar nerve, sensory potentials of sural and superficial peroneal nerve, median and peroneal F-wave), slower conduction velocities (median, ulnar, peroneal, posterior tibial nerve) and lower amplitudes (motor and sensory potentials of media and ulnar nerve, peroneal and posterior tibial nerve, sural nerve) (p<0.05). Except for the amplitude of ulnar nerve and the latencies of peroneal and ulnar nerve, there were significant differences in the nerve conduction study data between the risk group 3 and the risk group 0 (p<0.05). CONCLUSION: We confirmed that the risk category of diabetic foot screening test by Semmes-Weinstein monofilament can meaningfully reflect the severity of diabetic neuropathy. We also suggest that it is necessary to pay attention to the nerve conduction study in the patients with history of foot ulcer.
Diabetic Foot* ; Diabetic Neuropathies ; Foot ; Foot Ulcer ; Humans ; Lower Extremity ; Mass Screening* ; Neural Conduction* ; Peroneal Nerve ; Tibial Nerve ; Ulnar Nerve

Bifidobacteria is one of the prototypes of probiotics bacteria, normally inhabitating the intestinal tract of humans. To search for a potent immunoregulatory Bifidobacteria strain, we screened the Bifidobacteria strains isolated from the feces of healthy Korean children. The mRNA or protein expression of an anti-inflammatory cytokine, IL-10, from mouse macrophages stimulated with live Bifidobacteria was examined. Of tested strains, Bifidobacteria A28 induced the highest IL-10 gene expression of murine macrophages. To probe immunoregulatory activity of the selected strain on the mice, we evaluated the proportional changes of CD4+CD25+ surface marker in the murine splenocytes. Flow cytometric analysis showed that the overall percentages of CD4+CD25+ cells in A28-treated splenocytes were higher than those of untreated splenocytes. In parallel, IL-10 release from A28-treated mouse peritoneal macrophages and splenocytes was significantly higher than that of untreated control cells. Collectively, the Bifidobacteria A28 strain isolated from the feces of healthy Korean children augments the mRNA or protein expression of IL-10 release from mouse peritoneal macrophages as well as the proportion of CD4+CD25+ cells of naive splenocytes. These provide in vitro scientific clues that Bifidobacteria A28 might be usable for anti-inflammatory disease such as inflammatory bowel disease (IBD).
Animals ; Bacteria ; Child ; Feces ; Gene Expression ; Humans ; Inflammatory Bowel Diseases ; Interleukin-10 ; Macrophages ; Macrophages, Peritoneal ; Mice ; Probiotics ; RNA, Messenger ; Sprains and Strains

No abstract available.
Plasma ; Protein C Deficiency* ; Protein C* ; Purpura Fulminans* ; Purpura* ; Warfarin

OBJECTIVE: The author investigated the association between the genotype distribution of 5-HTTLPR and the effects of atypical antipsychotics on serum glucose and lipids in schizophrenic patients. METHODS: Study subjects were 66 schizophrenic patients taking atypical antipsychotics (risperidone, olanzapine, clozapine, quetiapine, zotepine). The control group consisted of 82 schizophrenic patients taking typical antipsychotics (haloperidol). All subjects were medicated for at least 12 weeks. The author examined serum fasting blood sugar (FBS), HbA1c, total cholesterol, triglyceride, and the genotype distribution of 5-HTTLPR in all subjects. The presence of the 5-HTTLPR gene was determined by using polymerase chain reaction of genomic DNA with primers flanking the promoter regions of the 5-HTT gene. Between group comparisons of the genotype distribution and the effects of antipsychotics on the serum glucose and lipid levels were performed by using score test for t-test, one way ANOVA, and chi-square test. RESULTS: There was a significant increase in FBS level in all patients taking atypical antipsychotics except for those treated with risperidone. However, there was no statistically significant correlation between 5-HTTLPR genotype distribution and the effect of atypical antipsychotics on FBS, HbA1c, total cholesterol, and triglyceride serum levels in schizophrenic patients. CONCLUSION: These results suggest that 5-HTTLPR polymorphism has no significant association with the effect of atypical antipsychotics on serum glucose and lipids in Korean schizophrenic patients.
Antipsychotic Agents* ; Blood Glucose* ; Cholesterol ; Clozapine ; DNA ; Fasting ; Genotype ; Humans ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; Risperidone ; Schizophrenia ; Serotonin Plasma Membrane Transport Proteins* ; Serotonin* ; Triglycerides

Severe injury to the knee and the surrounding area is frequently associated with injury to ligaments of the knee joint and structures in the popliteal fossa. This case involved a popliteal artery occlusion, severe bone loss of distal femur, loss of collateral ligaments, and extensor mechanism destruction of the knee. Initially, prompt recognition and correction of associated popliteal artery injury are important for good results after treatment. After successful revascularization, treatment for severe bone loss of distal femur and injury of the knee joint must be followed. We treated this case by delayed reconstruction using modular segmental endoprosthesis after revascularization of the popliteal artery. This allowed early ambulation. At 36 months after surgery, the patient had good circulation of the lower limb and was ambulating independently.
*Arthroplasty, Replacement, Knee ; Femur/*injuries/radiography/*surgery ; Humans ; Internal Fixators ; Knee Injuries/*surgery ; Knee Joint/surgery ; Male ; Middle Aged ; Popliteal Artery/*injuries/radiography/*surgery

Hydrosalpinx is an entity commonly encountered in gynecologic practice. However, giant hydrosalpinx is rare. Although the exact pathophysiology is unknown, most feel that hydrosalpinx is the result of chronic pathological condition of the fallopian tube when the fimbrial end of the tube is occluded and distal part distended with fluid. The occlusion usually occurs secondary to pelvic inflammatory disease or endometriosis or adjacent appendicular inflammation. Hydrosalpinx is associated with infertility, torsion and hemorrhagic infarction. We present an unusual case of giant hydrosalpinx, which was misdiagnosed as ovarian cyst with a review of brief literature.
Endometriosis ; Fallopian Tubes ; Female ; Infarction ; Infertility ; Inflammation ; Ovarian Cysts ; Pelvic Inflammatory Disease

BACKGROUND AND OBJECTIVES: We carried out an acoustic analysis to investigate the phonatory characteristics of patients undergoing short-term endotracheal intubation with or without thyroidectomy, and who had no nerve injury. MATERIALS AND METHODS: The patients were divided into two groups, one undergoing thyroidectomy (39 cases) and the other not undergoing thyroidectomy (25 cases). All patients of the thyroidectomy group had undergone thyroidectomy using general anesthesia with endotracheal intubation. All patients of the other group had undergone chronic ear surgery with the same anesthetic method and duration. For the evaluation of voice, preoperative and postoperative acoustic analyses were done. RESULTS: On the acoustic analysis of thyroidectomy group, jitter, shimmer and the vocal range were significantly increased at one day after thyroidectomy. But one month after thyroidectomy, these changes return to statistically insignificant increments, except for shimmer and the vocal range. These acoustical changes were not related to the extent of surgery between total thyroidectomy and hemithyroidectomy. In comparison with acoustical changes after short-term endotracheal intubation, the change of jitter and shimmer of thyroidectomy group did differ significantly. CONCLUSION: Voice alteration after thyroidectomy without nerve injury may be associated with the disturbance of the prelaryngeal musculature. This voice changes emphasize the importance of the extralaryngeal skeleton for pitch control and early intensive speech therapy, especially in patients who need their voice professionally.
Acoustics* ; Anesthesia, General ; Ear ; Humans ; Intubation, Intratracheal* ; Skeleton ; Speech Therapy ; Thyroidectomy* ; Voice

OBJECTIVES: To investigate the outcome of preterm infants and the prevalence of cerebral palsy and to examine the relevance between clinical risk factors, ultrasonographic abnormalities and the development of cerebral palsy. METHODS: From January, 1993, to December, 1994, we selected and followed up 437 cases of survived preterm infants born in Seoul National University Hospital. Clinical risk factors such as gestational age, birth weight, maternal complications, birth asphyxia, and neonatal sepsis were evaluated. Sequential ultrasonographic observations were done at the interval of 7 or 10 days. Ultrasonographic abnormalities could be classified into periventricular echodensity, periventricular leukomalacia (PVL) including cystic PVL, intraventricular hemorrhage, ventriculomegaly and brain atrophy. Diagnosis of the cerebral palsy was confirmed after the follow up more than 2 years after birth, and the correlations of ultrasongraphic abnormalities with clinical types and severities of cerebral palsy were analyzed. RESULTS: Twenty one cases (4.8%) among survived infants were diagnosed as a cerebral palsy. The prevalence of cerebral palsy was 20% in infants with less than 32 weeks of gestation, and 1.4% after 34 weeks. The prevalence of cerebral palsy was 12% in infants with less than 2000 g of birth weight, while, 0.4% in more than 2000 g of birth weight. Mother's age, primiparaty, and history of abortion did not influence the prevalence of cerebral palsy, but preterm labor, preterm rupture of membrane, severe birth asphyxia, neonatal sepsis, and respiratory distress syndrome were significantly relevant to the increased prevalence of cerebral palsy. Fifty six percents (18/32) of PVL (100% of cystic PVL) and 53% (7/13) of third grade IVH progressed to a cerebral palsy. Without PVL, third grade IVH had no explicit correlation with a cerebral palsy. Multiple logistic regression analysis of clinical risk factors and ultrasonographic abnormalities revealed that PVL is a determinant and independent risk to the cerebral palsy. Most cases turned out a spastic diplegia. The cases with cystic lesions especially showed the worse clinical outcomes. CONCLUSION: Four point eight percents of survived preterm infants developed a cerebral palsy. The existence of PVL was the most important risk factor among the perinatal problems and ultrasonographic abnormalities.
Asphyxia ; Atrophy ; Birth Weight ; Brain ; Cerebral Palsy* ; Diagnosis ; Female ; Follow-Up Studies ; Gestational Age ; Hemorrhage ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Leukomalacia, Periventricular ; Logistic Models ; Membranes ; Obstetric Labor, Premature ; Parturition ; Pregnancy ; Prevalence ; Risk Factors* ; Rupture ; Seoul ; Sepsis ; Ultrasonography

As the survival rate of preterm infants increasing, much perinatologic concern has been paid to the possibility of their getting into cerebral palsy. The purpose of this study is to determine the relationship between the early periventricular abnormalities and the incidence of cerebral palsy among preterm infants, and then to estimate the value of periventricular leukomalacia(PVL) as the prognostic factor by verifying the clinicopathological correlation of it with cerebral palsy. We have selected 174 cases with periventricular abnormality in early ultrasonographic findings among the survival preterm infants. 163 of them were followed up successfully to verify the incidence of cerebral palsy. Sequential ultrasonographic observations had been made at the interval of 7 or 10 days. Periventricular abnormalities could be classified into three types, which consist of the PVL(including cystic PVL), suspicious PVL, and periventricular echodensity without tissue loss. Associated lesions such as intraventricular hemorrhage, ventriculomegaly, brain atrophy were evaluated. Diagnosis of cerebral palsy was confirmed after following up more than 2 years of age, and the correlations of periventricular abnormalities with the clinical type and severity of cerebral palsy were analyzed. The 24.5% (40/163) of our samples revealed periventricular leukomalacia and the 17.8% (29/163) of them were diagnosed as cerebral palsy. The 65% (26/40) of preterm infants with definite PVL were cerebral palsy and their relative risk ratio for cerebral palsy is 26.7. Without PVL, there were no explicit correlations between cerebral palsy and associated abnormalities. Most cases with cerebral palsy turned out to be the spastic diplegia. In the cases with cystic lesions especially, the clinical outcome appear to be more severe. We've reached the point that the presence of PVL in preterm infants had a strong correlation with the development of cerebral palsy. Moreover, the association with cystic lesions is not only a strong correlation with cerebral palsy, but also a poor prognostic value for functional outcome.
Atrophy ; Brain ; Cerebral Palsy* ; Diagnosis ; Hemorrhage ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature* ; Leukomalacia, Periventricular* ; Odds Ratio ; Survival Rate ; Ultrasonography