The injured tendon is thought to be healed by, extrinsic healing from tendon sheath and adjacent connective tissue, and intrinsic healing from epitenon and endotenon. About the factors influencing the healing of injured tendon, many authors reported the effects of mobilization, electricity, ultrasound and various druge. Especially, active or passive mobilization had been known to promote the healing process and to reduce adhesion. To investigate the influences of active limited mobilization, intrinsic and extrinsic healing process, right Achilles tendons of 30 New Zealand white rabbits were grouped according to the types of treatments (Group I; tenotomy of Achilles tendon only, Group II; Tenotomy and long leg cast, Group III; surgical repair after tenotomy and long leg cast). The tendon sheath was repaired in all the groups, and the left Achilles tendons were used as control. At six weeks after operation, the tendons were removed and analysed biomechanically using Instron 1000, and histologically. The following results were obtained: 1. There were significant decreased of break strength, in order of Group III, Group I and Group II(p < 0.05). But, no difference was found between control group and Group III. 2. Extension length to the rupture, was decreased significantly in the experimental groups than control group. But there was no difference among the experimental groups. 3. Histologically, dense proliferation of fibroblasts and hypertrophy of tendon was observed in Group I; and matured fibricytic tendon tissues in Group II and III. In Group II, the amount of matured tendon tissues and degree of maturity were less than in Group III. In summary, suture and active limited motion were considered as promoting factors on the tendon healing.
Achilles Tendon ; Connective Tissue ; Electricity ; Fibroblasts ; Hypertrophy ; Leg ; Rabbits ; Rupture ; Sutures ; Tendons ; Tenotomy ; Ultrasonography

No abstract available.

No abstract available.
Anesthesia, Epidural* ; Radiculopathy*

During the period from January 1980 to September 1988, 59 patients suffering from brachial plexus injury, have admitted to Seoul National University Hospital. Fifty-four patients were male and 5 patients were female, and age ranged from 6 to 58 years (mean:26.8 years). The most common cause of injury was traffic accident accounting for 66% (39patient), and among them 24 patients(62%) had the motor cycle accident. Birth injury, stab or gun shot wound, fall down and industrial hazard were following causes. Fracture and dislocation of involved limb accompanied in 19 patients(32%) and 2 patients of arterial injury were also found. EMG and cervicsl myelography with or without CT were performed in almost all the patients and MRI was performed in selected patients. Forty-five patients(76%) had supra-clavicular lesion and 14 patients (24%) had infra-clavicular lesion. In supra-clavicular lesion, upper roots or whole roots were involved in most of cases. Forty-nine cases were treated with conservative treatment for more than 8 months and operative procedures were performed in 36 cases. In operative cases, 30 patients were followed up for more than 1 year (average 24.3 months). Signs of root avulsion were found in 25 out of 31 cases of cervical myelography. MRI was performed in 7 cases, but it was inconclusive in diagnosis of root involvement. Infra-clavicular lesion showed better prognosis than supra-clavicular lesion. In supra-clavicular lesion, upper root involvement had the best prognosis. A pseudocyst detected by myelography usually precluded recovery in the root at the level of pseudocyst. Result of reparative treatment was better than that of conservative treatment. Overall satisfactory result in reparative treatment was 36%. However, if we include neurological improvement, positive result was 53%. Complete recovery was gained in half cases of neurolysis and other half showed no recovery, but all the cases of neurotization showed poor result. Reconstructive surgery including arthrodesis or muscle transfer can be effective treatment method, if it is performed properly on a selective patient.
Accidents, Traffic ; Arthrodesis ; Birth Injuries ; Brachial Plexus ; Diagnosis ; Dislocations ; Extremities ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Methods ; Myelography ; Nerve Transfer ; Prognosis ; Seoul ; Surgical Procedures, Operative ; Wounds and Injuries

We present here, a case of pemphigus erythematosus developed in a 31-year-old woman, who had been suffering from repeated episode, of remission and exacerbation with several erythematous, and somewhat oozing patche accompanying a mild pruritus or her face, upper part of the back and anterior chest. In serological studies, she had antinuclear antiboc@lies at. a titer of 1:160. Histopathological finding showed subcorneal bullae. Immunofluorescent study revealed IgG and C, deposition in the intercellular space of the epidermis and along the de rmoepidermal junction.
Adult ; Epidermis ; Extracellular Space ; Female ; Fluorescent Antibody Technique ; Humans ; Immunoglobulin G ; Pemphigus* ; Pruritus ; Thorax

Common environmental allergens play an important role in the pathogenesis of atopic dermstitis and urticaria via type I hypersensitivity reaction. The present study was undertaken to observe the prick test reactivity to common environmental allergens and peripheral blood eosinophil and total serum IgE levels in 20 patients of atopic dermatitis, 26 patients of chronic urticaria and 27 patients of artificial urticaria The results were as follows : 1, The psitive reactivities of allergens in patients with atopic dermatitis, chronie urticaria and artificial urticaria were 75.0%, 84.6% and 66.7%, respectively. 2. The positive reactivities of the inhalant allergens were more common than those of the food allergens, but statistically significant difference was found only in patients with chronic urticaria. 3. The most frequent allergen in prick test reactivity was D. farinae. 4. In patients with atopir, dermatitis, chrcnic urticaria and artificial urticaria, peripheral blood eosinophilias were encountered in 31.3%, 30.4%, and 25.0%, respectively. And statisticnlly significant elevations of eosinqphils in the prick test positive groups were observed in patients with atopic dermatitis. 5. ln patients with atopic dermatitis, chronic urticaria and artificial urticaria, elevati
Allergens ; Dermatitis ; Dermatitis, Atopic* ; Eosinophilia ; Eosinophils* ; Humans ; Hypersensitivity, Immediate ; Immunoglobulin E* ; Urticaria*

We report herein a case of pityriasis rubra pilaris in a 39-year-old male, who had erythematous scaly patches on the face, trunk and extremities for one year. The skin lesion showed well defined plaques on the elbow and knee joint areas, and exfoliative hyperkeratotic sheets with fissures on the palms and soles. He had no family and past history of such skin lesion. He was treated with etretinate lmg/kg/day for 1 week initially, and then tapered off 0.5mg/kg/day for 5 weeks with marked improvement. There was no exacerbation and recurrence of the skin lesion for about 1 year.
Acitretin* ; Adult ; Elbow ; Etretinate* ; Extremities ; Humans ; Knee Joint ; Male ; Pityriasis Rubra Pilaris* ; Pityriasis* ; Recurrence ; Skin

We report a case of classic Kaposi's sarcoma (KS) in a 67-year-old man, who had multiple cutaneous lesions of the feet and left hand as well as an internal involvement of the stomach. The histopathologic findings showed typical features of KS as a mid-dermal tumor composed of vascular proliferations, vascular slits, spindle cells, extravasated erythrocytes and deposits of hemosiderin. Analysis of T-cell subpopulations showed decreased T4 lymphocytes and in-creased T8 lymphocytes; the ratio of T4M lymphocytes was decreased. Natural killer cell activity was also decreased. These findings suggest a possible relationship between immunological abnormalities and the pathogenesis of this disease. The patient's serum was negative for antibodies to the human immunodeficiency virus (HM). This report describes a case of classic KS with immunological abnormalities and internal involvement and possible pathogenetic mechanisms are discussed.
Aged ; Antibodies ; CD4-Positive T-Lymphocytes ; CD8-Positive T-Lymphocytes ; Erythrocytes ; Foot ; Hand ; Hemosiderin ; HIV ; Humans ; Killer Cells, Natural ; Lymphocytes ; Sarcoma, Kaposi* ; Stomach ; T-Lymphocytes

We report a case of tinea incognito occurring in a 47-year-old woman who deveoped erythematous papules and scaly patches on whole body after taking corticosteroid therapy intermittently over a period of 3 months. Direct smear and culture for fungus of the lesions demonstrated hyphae and C. albicans and T. mentagrophytes, which confirms the diagnosis. The lesions disappeared three months after systemic and topical antifungal therapy.
Diagnosis ; Female ; Fungi ; Humans ; Hyphae ; Middle Aged ; Tinea*

Segmental Spinal Instrumentation(S.S.I.) is more effective means of managing unstable thoraco-lumbar spine fractures than traditional Harrington Rod Instrumentation as an operative procedure which afforded rigid internal fixation with stability and needed minimal external immobilization. Early return to normal activity and successful rehabilitation are facilitated by efficient stabilization with S.S.I. Fifty-nine patients with fractures and fracture-dislocations of thoraco-lumbar spine were treated by Harrington Rod Instrumentation (29 patients) and S.S.I. (30 patients) at this hospital from June 1979 to July 1984. We have analysed the results of these treatment and obtained following conclusions: 1. S.S.I. is more rigid internal fixation than Harrington Rod Instrumentation. a) no or minimal external immobilization b) early ambulation and rehabilitation c) lowered complications 2. There was no significant difference in correction rate, loss of correction, and neurologic recovery between Harrington Rod Instrumentation and S.S.I.
Early Ambulation ; Humans ; Immobilization ; Rehabilitation ; Spine ; Surgical Procedures, Operative