Rheumatoid arthritis (RA) is a systemic disease with medication as the treatment of choice. However, surgical treatment is recommended when no improvement is noted despite aggressive conservative treatment. Synovectomy provides desirable outcomes for RA patients in the early stage with a glenohumeral joint of Larsen grade II or less; conversely, arthroplasty is recommended for patients with a glenohumeral joint of grade III or higher. RA patients often have attenuation and dysfunction of the rotator cuff, and reverse shoulder arthroplasty has been proven to provide favorable outcomes in some patients. RA is often complicated with osteoporosis and bony deformity; therefore, close attention is necessary to prevent fractures during shoulder arthroplasty.
Arthritis, Rheumatoid ; Arthroplasty ; Congenital Abnormalities ; Humans ; Osteoporosis ; Rotator Cuff ; Shoulder Joint* ; Shoulder*

The authors performed experimental study to produce proliferative vitreoretinopathy by intravitreal injection of homologous fibroblasts in pigmented rabbits. Twenty four eyes of 12 rabbits were divided into control and experimental groups. In experimental group, the eyes were pretreated with expanding gas, perfluoropropane for the vitrectomy. In control group, no such procedure was preceded. In both groups, 5.0×10⁴, 1.0×10⁵ and 1.5×10⁵ cells of homologous fibroblasts were injected into the vitreous cavity. All the eyes were observed regularly with indirect ophthalmoscope followed by fundus photography. Those eyes were enucleated in 1, 2, 4 weeks for the light and electron microscopic studies. The development and severity of the proliferative vitreoretinopathy were correlated with the numbers of the injected fibroblast. This was more pronounced in the experimental group.
Fibroblasts ; Intravitreal Injections ; Ophthalmoscopes ; Photography ; Rabbits ; Vitrectomy ; Vitreoretinopathy, Proliferative*

The present study has been performed to investigate the neural axis of rat digastric muscle using viral tracer, pseudorabies virus. The upper nuclei to innervate digastric muscle were in accumbens nucleus, agran-ular insular cortex, central nucleus of amygaloid, lateral septal nucleus, frontal cortex, and subfornical organ etc, in telencephalon ; arcuate hypothalamic nucleus, lateral hypot-halamic area, medial preoptic nucleus, bed nucleus of stria terminalis, dorsomedial hypot-halamic nucleus, suprachiasmatic nucleus, paraventricular nucleus, and retrochiasmatic area etc, in diencephalon ; nucleus Darkschewitsch, interstitial nucleus of the medial logitudinal fasciculus, parabrachial nucleus, locus ceruleus, Kolliker-Fuse nucleus, trigeminal mesencephalic nucleus, red nucleus, substantia nigra, nucleus of posterior commissure, Edinger-Westphal nucleus, and dorsal raphe nucleus etc, in mesencephalon ; giganto-cellular reticular nucleus, raphe magnus nucleus, raphe pallidus nucleus, raphe obscuous nucleus, nucleus of solitary tracts, lateral reticular nucleus, parvocellular reticular nucleus, area postrema, facial nucleus, pontine reticular nucleus, pontine nucleus of trigeminal nerve and spinal nucleus of trigeminal nerve etc, in rhombencephalon. There are significant difference of numbers of PRV-Ba immunoreactive cells between right and left sides of brain in almost nuclei[P< 0.05]. But PRV-Ba immunoreactive cells were observed only ipsilaterally in accessory trigeminal motor nucleus, accessory facial nucleus and agranular insular cortex. Frontal cortex was the only area which were shown contralateral immunoreactivity. The results of this study provide anatomical support that both the cranial and caudal bellies are innervated by the same upper nuclei. The results also support the suggestion that the lower nuclei of digastric muscle, accessory trigeminal motor nucleus and accessory facial nucleus consist of somatotopic motor complex.
Animals ; Area Postrema ; Axis, Cervical Vertebra* ; Brain ; Diencephalon ; Herpesvirus 1, Suid ; Hypothalamic Area, Lateral ; Immunohistochemistry ; Locus Coeruleus ; Mesencephalon ; Paraventricular Hypothalamic Nucleus ; Raphe Nuclei ; Rats* ; Red Nucleus ; Rhombencephalon ; Septal Nuclei ; Subfornical Organ ; Substantia Nigra ; Suprachiasmatic Nucleus ; Telencephalon ; Trigeminal Nerve ; Trigeminal Nuclei

A number of methods have been introduced for support the orbital floor following a maxillectomy without orbital exenteration or severe facial trauma. These methods including skin graft and muscular sling provided the unsatisfactory results, like as diplopia, orbital ptosis, enophthalmos and severe facial deformity. Therefore the bone and soft tissue reconstructions using microvascular free flaps were performed recently by many surgeons, but long time operation, donor site morbidity, postoperative large scar, and ptosis of the flap were pointed out as disadvantages of free flap reconstruction. Vascularized calvarial bone flap, a modified method of free calvarial bone graft, was adequate for reconstruction of the orbital floor and the infraorbital rim as a horizontal buttress, especially in case of poor vascular bed and postradiated state. The authors introduced the vascularized calvarial bone flap for the orbital floor and the infraorbital rim reconstruction in 3 cases of maxillectomy, and could be obtained satisfactory results aesthetically and functionally.
Cicatrix ; Congenital Abnormalities ; Diplopia ; Enophthalmos ; Free Tissue Flaps ; Humans ; Orbit* ; Skin ; Tissue Donors ; Transplants

Natural look of breast after augmentation mammoplasty is a common end of both plastic surgeons and patients. Palpability and visible rippling after augmentation mammaplasty is not a simple complication to correct in relatively thin patients especially when there is not much soft tissues remain to cover the implant for smooth contour. And asymmetry of the breast in accordance with the skeletal deformity, such as pectus excavatum, can not be easily reformed with insertion of silicone implant alone. In the present study, volume enhancement was accomplished by silicone implant augmentation and contour management was improved with the help of fat graft technique. We named the technique "Hybrid Augmentation Mammoplasty". From May 2011 to Feb. 2012, the hybrid augmentation mammoplasty procedure were performed on 9 patients who expected to have palpable implants, visible rippling or asymmetry due to their soft tissue and skeletal condition. Breast augmentation with silicone implant was done in regular pattern followed by grafting fat tissues utilizing Harvest-jet device into the pre-pectoral, sub-glandular and subcutaneous layer. During the follow-up period, any patient complained palpability of the implant and all of them were satisfied with the contour of their breast. Hereby we suggest that the hybrid augmentation mammoplasty can be an ideal, effective and useful option in management of thin skinned patients or patients with chest wall deformities.
Breast ; Breast Implants ; Chimera ; Congenital Abnormalities ; Female ; Follow-Up Studies ; Funnel Chest ; Humans ; Mammaplasty ; Silicones ; Skin ; Thoracic Wall ; Transplants

We report a patient with an unusual manifestation of Trichophyton violaceum infection, who lives in Seoul. An 8-year-old male presented an erythematous nodule on the lower eyelid of the left eye which had persisted for 10 weeks. On physical examination, there was no abnormality except a skin lesion on the eyelid. The skin biopsy of the nodule showed epidermal hyperplasia and granulomatous change in the upper dermis. The biopsy specimen yielded Trichophyton uiolaceum on culture. The skin lesion disappeared 2 months after administration of ketoconazole.
Biopsy ; Child ; Dermis ; Eyelids ; Granuloma* ; Humans ; Hyperplasia ; Ketoconazole ; Male ; Physical Examination ; Seoul ; Skin ; Trichophyton*

No abstract available.
Molecular Biology

The biomechanical responses, such as nucleus pulposus pressure, facet contact force, stress distribution among ligaments in the cervical spine under static loading like flexion and extension, were examined with 3-D nonlinear finite element model. Finite element model consisted of whole cervical spines with intact discs and ligaments was developed from 1mm thick CT-cross sections of a 25-year-old healthy young man. Geometrical nonlinearity was considered for the large deformation and ABAQUS package was used for calculation. Results were verified comparing with those of existing in vivo and in vitro experiments. Results indicated that, developed cervical spine FEM was well consistent with other experiments. Nucleus pulposus pressure increased in flexion and extension more in lower cervical region. Facet contact force increased more in lower cervical spine in extension. In addition, capsular ligament was the most important one among 7 cervical ligaments surrounding cervical spine both in flexion and extension. We could better understand the biomechanics of whole cervical spine with developed finite element model and it might be applied to dynamic or postoperative study.
Adult ; Humans ; Ligaments ; Spine*

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

BACKGROUND: Korea is, known to be an endemic area of viral hepatitis B, and 5-6% of population are carriers. Immunization can reduce the spread of hepatitis B infection. Hower, not all people respond to hepatitis B immunsation. 5-15% of primary vaccinees fail to be immunized. After revaccination, only 37.5 44% of the primary failures elicit antibody response. Recent studies have reported that it is effective to inject a double dose vaccination in immunocompromsed patients. In some country, they recommend that neonate whode mother is HBV carrier shoud receive double dose vaccination. This study documented the results of double dose vaccintion only once to nonrsponders toward the HBV immunzation. METHODS: Healthy nonresponders to Hepatitis B immunization were recuited from Sep. 1995 to Aug. 1996. Subjects with their AST/ALT level over 40, or over 65 years old were excluded. They were received 2ml of plasma-derived vaccine(Hepavax-B) intramuscularly in the deltoid muscle. Anti-HBs antibody testing were performed at 1 to 3 months after vaccintion. RESULTS: 17 healthy nanreponders to Hepatitis B immunization(male 10, female 7) were included. Their mean ages were 47(32 to64), AST/ALT level 20/19(16 to 28/11 to 35), smoking 4.3pys(1 to 7). Seroconversion occured in 13 of them(76.5%). CONCLUSIONS: Nonresponders to Hepatitis B vaccintion respond well to double dose vaccination once.
Aged ; Antibody Formation ; Deltoid Muscle ; Female ; Hepatitis B* ; Hepatitis* ; Humans ; Immunization ; Immunization, Secondary ; Infant, Newborn ; Korea ; Mothers ; Smoke ; Smoking ; Vaccination*