Cubital tunnel syndrome is the second most common compressive neuropathy. Its diagnosis is largely based on clinical findings. It has been well known that patients with mild to moderate grade of cubital tunnel syndrome have a high chance of spontaneous resolution, while those with severe degree do not. Thus, the former is treated with conservative methods initially, and the latter is indicated for surgical intervention. There are three types of surgical techniques for cubital tunnel syndrome. Of these, in-situ decompression technique has been gaining popularity as it is simpler and shows similar efficacy with less complications compared to other techniques. In this review, we deal with current concepts of the cubital tunnel syndrome pertaining to the primary clinical practice.
Cubital Tunnel Syndrome ; Decompression ; Diagnosis ; Humans ; Ulnar Nerve ; Ulnar Neuropathies*

The aim of our study is to achieve complete periodontal tissue regeneration by the application of BMP and resorbable membrane. Three beagle dogs aged over one and half years and weighed 14 to 16 kg were used in this study. Mandibular 1st, 2nd premolars were extracted bilaterally. Horizontal furcation defects were induced around 3rd, 4th premolars bilaterally. BMP-4 were applied in the right side with resorbable membranes and only resorbable membranes were applied in the left side respectively. Each animal was sacrificed at 2, 4, and 8weeks, after regenerative surgery. Specimens were prepared with Hematoxylin-Eosin stain and Goldner's modified Masson Trichrome stain for light microscopic evaluation. The results were as follows: 1. At 2 weeks after regenerative surgery, downgrowth of junctional epithelium was observed both in the membrane-applied site and BMP-4-and-membrane-applied site. 2. At 4 weeks after regenerative surgery, resorbable membranes were completely resolved, therefore would not prevent downgrowth of junctional epithelium. New bone formation, new cementum formation and Sharpey's fiber were observed in BMP-4-and-membrane-applied site. 3. At 8 weeks after regenerative surgery, downgrowth of junctional epithelium was observed in the membrane-applied site. But, new cementum formation was observed in the same site. The extensive regeneration of new bone, new cementum and remarkable formation of Shapey's fiber were showed in BMP-4-and-membrane-applied site. 4. Resorbable membranes were resolved via the cell-mediated processes. 5. Periodontal tissue regeneration were better achieved in the BMP-4-and-membrane-applied site than in the membrane-applied site. Within the above results, BMP-4 may have the strong capability to form the new bone and resorbable membrane may be able to prevent the bony ankylosis. However, resolution rate of resorbable membrane may not be enough to protect rapid epithelial downgrowth for ideal periodontal regeneration. In conclusion, I suggest BMP-4 may have the strong possibility to be utilized in the clinical periodontal treatments.
Animals ; Ankylosis ; Bicuspid ; Dental Cementum ; Dogs ; Epithelial Attachment ; Furcation Defects ; Membranes* ; Osteogenesis ; Regeneration*

Cortical blindness means visual loss caused by bilateral destruction of visual cortex. Cortical blindness can develop after cerebral angiography due to hypertonic contrast medium which open the blood-brain barrier and then alternate the function of visual cortex transiently. About 30 minutes after injection of contrast medium (Ultravist 370(R)) during cerebral angiography, the patient complained of decrease of visual acuity. And 3 hours later, evaluation revealed that she could not see even the light. But her vision began to improve after 19 hours and recovered completely after 7 days. MRI taken at 12 hours after cerebral angiography showed high signal intensities in the both occipital lobes. But in repeated MRI study, which was taken after 3 days, previously noted high densities were completely disappeared. So we diagnosed this case as cortical blindness caused by hypertonic contrast medium.
Blindness, Cortical* ; Blood-Brain Barrier ; Cerebral Angiography* ; Humans ; Magnetic Resonance Imaging ; Occipital Lobe ; Visual Acuity ; Visual Cortex

Cortical blindness means visual loss caused by bilateral destruction of visual cortex. Cortical blindness can develop after cerebral angiography due to hypertonic contrast medium which open the blood-brain barrier and then alternate the function of visual cortex transiently. About 30 minutes after injection of contrast medium (Ultravist 370(R)) during cerebral angiography, the patient complained of decrease of visual acuity. And 3 hours later, evaluation revealed that she could not see even the light. But her vision began to improve after 19 hours and recovered completely after 7 days. MRI taken at 12 hours after cerebral angiography showed high signal intensities in the both occipital lobes. But in repeated MRI study, which was taken after 3 days, previously noted high densities were completely disappeared. So we diagnosed this case as cortical blindness caused by hypertonic contrast medium.
Blindness, Cortical* ; Blood-Brain Barrier ; Cerebral Angiography* ; Humans ; Magnetic Resonance Imaging ; Occipital Lobe ; Visual Acuity ; Visual Cortex

External fixation with or without ancillary K-wire fixation, once being one of the most popular methods of surgery for unstable distal radius fractures, is now losing its position due to a recent surge in the use of volar locking plates. However, these changes are not firmly grounded on scientific evidence. Recent clinical trials showed that a similar wrist function was achieved when the use of external fixation was compared with that of volar locking plates at 1 year after surgery for the treatment of unstable distal radius fractures, even though the rate of functional recovery was slower in the former. In addition, it is still a question whether additional costs and time paid for volar locking plates can be justified by such a small gain in wrist function. We will review recent studies comparing external fixation with volar locking plates regarding wrist function and costs, and discuss current indication of external fixation for unstable distal radius fractures.
Radius Fractures* ; Wrist

Free vascularized tissue transfer to preserve upper extremity amputation level is uncommon but very useful procedure. To cover the below-elbow amputee stump and restore the function of the elbow, we have used a free flap as a spare part concept from the contralateral hand which was so severely damaged that amputation was inevitable.
Amputation ; Amputees* ; Elbow* ; Forearm* ; Free Tissue Flaps ; Hand ; Humans ; Upper Extremity

PURPOSE: to find out the change and limit of the changes of tibiofemoral joint line, patellar position and other related variables for improved postoperative knee function after PCL retaining TKRA. MATERIALS AND METHODS: The variables mentioned above were measured from the plain radiographs of 101 knees with PCL retaining TKRAs, correlated with clinical outcomes such as HSS score, range of motion and anterior knee pain. Then they were analyzed statistically. RESULTS: Tibiofemoral joint line, patellar height and femoral condylar size affected clinical outcomes. Excellent postoperative knee function resulted when the shift of tibiofemoral joint line position was between 5mm inferiorly to 5mm superiorly, postoperative patellar height between 15mm to 30mm, and the change of the femoral condylar size between 10mm decrease and 5mm increase. CONCLUSION: Excellent clinical results would be expected if the changes of the joint line position are kept within the range suggested in this paper.
Joints ; Knee ; Knee Joint ; Patellofemoral Joint* ; Range of Motion, Articular

We present a case of medial plantar nerve injury by screw tip after open reduction and internal fixation of intraarticular calcaneus fracture. We reviewed the risk and prevention technique of medial plantar nerve injury in fixing the calcaneus fracture.
Calcaneus* ; Tibial Nerve*

This study was performed to evaluate the effect of mixed culture of rat's calvaria cells and periodontal ligament cells on calcification. These cells have been known to do important role on the periodontal tissue regeneration, especially alveolar bone and cementum. Experimental groups were made which based on the different rate of rat's calvaria cells and periodontal ligament cells, and then these cells were cultured with Dulbecco's Modified Eagle's Medium contained with 10% fetal bovine serum, 50microgram/ml ascorbic acid, and 10mM/ ml Na-beta-glycerophosphate. Each group was characterized by examining the cell proliferation rate, amount of total protein synthesis, alkaline phosphatase activity, and the number of calcified nodules in vitro. In cell proliferation rate , the cells of control groups were cultured Dulbecco's Modified Eagle's Medium contained with 10 % fetal bovine serum. The results were as follows ; 1. The cell proliferation rate in control groups decreased stastically significantly along with the decrease of the rate of bone cells at 7 day and 20 day(P < 0.01). 2. The cell proliferation rate in experimental groups decreased stastically significantly along with decrease of the rate of bone cells at 3 day and 14 day(P < 0.01). 3. The amount of total protein synthesis was significantly decreased along with decrease of the rate of bone cells at 3 day and 6 day(P < 0.01). 4. Alkaline phosphatase activity showed reverse time dependent pattern and was significantly decreased along with decrease of the rate of bone cells during the experimental periods (P < 0.01). 5. Calcified nodules were observed in group 1 (Rat calvaria cells alone) for the first time, and the number of calcified nodule decreased stastically significantly along with the decrease of the rate of bone cells at 12 day(P < 0.01). From the above results, When bone cells and periodontal ligament cells were mixed cultured, the cell proliferation rate was mostly dependent on the actual rate of bone cells and same pattern was showed in amount of total protein synthesis, alkalinephosphatase activity, and the number of calcified nodules. And the calcified nodule forming capacity of bone cells was inhibited by periodontal ligament cells
Alkaline Phosphatase ; Animals ; Ascorbic Acid ; Cell Proliferation ; Dental Cementum ; Periodontal Ligament* ; Rats* ; Regeneration ; Skull*

The purpose of this study is to introduce a new method to reduce the donor morbidity of radial forearm free flap using ulnar forearm flap, and to evaluate its usefulness and results. 6 patients underwent radial forearm free flap designed by authors and we repaired radial forearm flap donor defect using ulnar forearm flap following ablative surgery for oropharyngeal cancers from June 1995 to February 1997. Radial forearm flap was designed just proximal to wrist crease, and its vascular pedicle was placed in the center of flap. Donor defect was repaired with V-Y fashion closure using ulnar artery axial pattern fasciocutaneous flap. Mean closing time of donor site was 30 minutes. and mean healing period of donor site was 10 days. There was no difficulty in closure. All donor sites healed completely without complication. Limitation of motion was not noticed in the wrist and forearm. We conclude that repair of radial forearm flap donor defect using ulnar forearm flap is new excellent method to prevent the prominent scar of forearm in cases of conventional skin graft for donor defect, and provide rapid healing of wound with low risk of complication
Cicatrix ; Forearm* ; Free Tissue Flaps* ; Humans ; Oropharyngeal Neoplasms ; Skin ; Tissue Donors* ; Transplants ; Ulnar Artery ; Wounds and Injuries ; Wrist