Dupuytren's contracture is characterized by a proliferative fibroplasia and contracture of the palmar fascia with resultant deformity of hand and finger. It is most common in those of Scandinavian and Celtic origin but it is very rare in the orientals. We experienced 30 hands of 21 patients from January 1985 to December 1995 in Soonchunhyang University Hospital. Among 21 patients, operative treatment was done in 28 hands of 19 patients. Partial fasciectomy was done in 24 hands and complete fasciectomy was done in 4 hands. The longitudinal straight skin incision was done in 14 cases and the transverse or Zig-Zag incision was done in 12 cases. Average follow-up period was 24 months. The results of the operative treatment were classified by Honner's classification. Excellent result was obtained in 16 cases (57%), good in 8 (29%), fair in 3 (11%), poor in 1 (3%). The complications were 5 cases as follows; recurrence 2, skin defect 1, hypoesthesia 2. In conclusion, partial fasciectomy utilizing longitudinal straight incisions overlying diseased area is suggested as one of the good method for the treatment of Dupuytren s contracture.
Classification ; Congenital Abnormalities ; Contracture ; Dupuytren Contracture* ; Fascia ; Fingers ; Follow-Up Studies ; Hand ; Humans ; Hypesthesia ; Recurrence ; Skin

Lipoma Arborescens is rarely encountered in hip joint. This term was first used by Mueller in 1838, to describe a fatty trmor of the knee which presented branched villous-like projection. The etiology is unknown, Suggests its probable reationship to tuberculosis, rheumatoid arthitis, trauma, chronic inflammation, diabetes mellitus and degenerative arthritis. It frequently involves knee joint, hand, wrist, foot, ankle, tendon sheath and hip joint. It usually presents bilaterally. Their nonspecific symptoms and signs are mild pain, joint swelling with minimum effusion, festriction of joint motion, redness, local heating and crepitus. We experienced a case of lipoma arborescens of hip joint, which was treated by synovectomy with excision of lesion.
Ankle ; Arthralgia ; Diabetes Mellitus ; Foot ; Hand ; Heating ; Hip Joint ; Hip ; Hot Temperature ; Inflammation ; Joints ; Knee ; Knee Joint ; Lipoma ; Osteoarthritis ; Tendons ; Tuberculosis ; Wrist

PURPOSE: Tongue cancer is the most common malignant tumor of the oral cavity and the ultimate goal in treatment of the cancer is not only complete excision and meticulous closure of the wound, but also, reconstruction of a demensional and functional tongue. Our study focuses on various factors, such as defect size, extent of tumor, age, application of mandibulectomy or radiotherapy, and their influences on postoperative speech and swallowing function. METHODS: Our study was based on 59 patients who underwent tongue cancer operation and reconstruction of the tongue. Speech and swallowing were evaluated according to categories documented by Sultan and Teichgraeber. Patients were classified into 3 groups as partial glossectomy, hemiglossectomy and total glossectomy groups for evaluation. The average age of the patients were 51, and the mean follow-up period was 4 years 2 months. RESULTS: The partial glossectomy group showed statistically relevant results for speech articulation and swallowing abilities compared to the total glossectomy group. In cases of defects involving the mouth floor, the group showed decreased results compared to the group without mouth floor involvement. Increased age showed decreased postoperative results with statistical significance, while mandibulectomy and radiotherapy revealed no statistically significant data. Analysis according to TNM staging resulted in decreased functional result with advanced staging without statistical significance. CONCLUSION: To summarize the factors influencing the functional outcome in tongue reconstruction, younger patients and early stage cancer with minimal surgical extent revealed more satisfying results while mandibulectomy and radiation did not have influence on our analysis. Addition of various influencing factors and studies with longer follow up periods on our patient groups may provide effective data for more satisfying functional outcomes in the future.
Deglutition ; Eugenol ; Follow-Up Studies ; Glossectomy ; Humans ; Mouth ; Mouth Floor ; Neoplasm Staging ; Tongue ; Tongue Neoplasms ; Zinc Oxide

BACKGROUND: Hydatidiform mole (H-mole) is characterized by the neoplastic proliferation of trophoblasts. Only 1~10% of patients with partial H-mole will develop a trophoblastic tumor, but 18~29% of those with complete H-mole will develop a persistent trophoblastic tumor. Therefore, the early diagnosis and monitoring after operation of an H-mole disease are very important. Recently, the pregnancy associated plasma protein-A (PAPP-A) was proved to have a similar role as that of IGF binding protein-4 (IGFBP-4) protease, which has shown an increasing function in fetal growth and development by degradation of IGFBP-4 and an increase in IGF in the serum during pregnancy. Our hypothesis is "the H-mole, which shows placental hyperplasia will also have an IGFBP-4 protease activity, which may be used as in the early diagnosis and monitoring of H-mole disease". METHODS: Serum samples from 6 non-pregnant, 18 pregnant (5 in the 1st trimester, 10 in the 2nd, and 3 in the 3rd), 12 postpartum women and 3 H-mole patients(2 with complete H-mole and 1with partial H-mole) were collected and measured for the -HCG, IGF and PAPP-A levels and IGFBP-4 protease activities by a IGF-II ligand blot analysis and electrophoresis method. The IGFBP-4 protease activity of the serum during normal pregnancy was compared with that of H-mole disease. RESULTS: The results from the in vitro protease assays using recombinant IGFBP-4 determined that IGFBP-4 proteolysis was significantly increased during the first (56%) and second trimesters (90%), but reached a plateau by the third trimester (94%). In H-mole disease diagnosed 11 weeks after conception, the IGFBP-4 proteolytic activity was 97%, which was nearly the same as at terminal pregnancy. This activity gradually decreased to 75% at 1 week, 58.7% at 2 and 33% at 3 weeks after the operation. The -HCG was also decreased from 490,400 to 123,822.7, 1,352.3, and 128.5 mIU/mL at 1, 2 and 3 weeks after the operation, respectively. The PAPP-A level also gradually decreased from 34.87 to 25.5, 12.0 and 2.7 g/mL 1, 2 and 3 weeks after the operation, respectively. However, the IGF decreased from 238.3 to 172.9 ng/mL 1 week after the operation, but increased to 251.4 and 295 ng/mL at 2 and 3 weeks after the operation, respectively. CONCLUSION: These results demonstrated that the IGFBP-4 protease activity was significantly increased during pregnancy, and was extremely elevated durimg the early stages of H-mole disease, but gradually decreased after removal of molar tissue. Therefore, measuring the IGFBP-4 protease activity may play an important role in the early diagnosis and monitoring of H-mole disease
Early Diagnosis ; Electrophoresis ; Female ; Fertilization ; Fetal Development ; Humans ; Hydatidiform Mole ; Hyperplasia ; Insulin-Like Growth Factor Binding Protein 4 ; Insulin-Like Growth Factor II ; Molar ; Plasma ; Postpartum Period ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnancy-Associated Plasma Protein-A ; Proteolysis ; Trophoblastic Neoplasms ; Trophoblasts

BACKGROUND: Hydatidiform mole (H-mole) is characterized by the neoplastic proliferation of trophoblasts. Only 1~10% of patients with partial H-mole will develop a trophoblastic tumor, but 18~29% of those with complete H-mole will develop a persistent trophoblastic tumor. Therefore, the early diagnosis and monitoring after operation of an H-mole disease are very important. Recently, the pregnancy associated plasma protein-A (PAPP-A) was proved to have a similar role as that of IGF binding protein-4 (IGFBP-4) protease, which has shown an increasing function in fetal growth and development by degradation of IGFBP-4 and an increase in IGF in the serum during pregnancy. Our hypothesis is "the H-mole, which shows placental hyperplasia will also have an IGFBP-4 protease activity, which may be used as in the early diagnosis and monitoring of H-mole disease". METHODS: Serum samples from 6 non-pregnant, 18 pregnant (5 in the 1st trimester, 10 in the 2nd, and 3 in the 3rd), 12 postpartum women and 3 H-mole patients(2 with complete H-mole and 1with partial H-mole) were collected and measured for the -HCG, IGF and PAPP-A levels and IGFBP-4 protease activities by a IGF-II ligand blot analysis and electrophoresis method. The IGFBP-4 protease activity of the serum during normal pregnancy was compared with that of H-mole disease. RESULTS: The results from the in vitro protease assays using recombinant IGFBP-4 determined that IGFBP-4 proteolysis was significantly increased during the first (56%) and second trimesters (90%), but reached a plateau by the third trimester (94%). In H-mole disease diagnosed 11 weeks after conception, the IGFBP-4 proteolytic activity was 97%, which was nearly the same as at terminal pregnancy. This activity gradually decreased to 75% at 1 week, 58.7% at 2 and 33% at 3 weeks after the operation. The -HCG was also decreased from 490,400 to 123,822.7, 1,352.3, and 128.5 mIU/mL at 1, 2 and 3 weeks after the operation, respectively. The PAPP-A level also gradually decreased from 34.87 to 25.5, 12.0 and 2.7 g/mL 1, 2 and 3 weeks after the operation, respectively. However, the IGF decreased from 238.3 to 172.9 ng/mL 1 week after the operation, but increased to 251.4 and 295 ng/mL at 2 and 3 weeks after the operation, respectively. CONCLUSION: These results demonstrated that the IGFBP-4 protease activity was significantly increased during pregnancy, and was extremely elevated durimg the early stages of H-mole disease, but gradually decreased after removal of molar tissue. Therefore, measuring the IGFBP-4 protease activity may play an important role in the early diagnosis and monitoring of H-mole disease
Early Diagnosis ; Electrophoresis ; Female ; Fertilization ; Fetal Development ; Humans ; Hydatidiform Mole ; Hyperplasia ; Insulin-Like Growth Factor Binding Protein 4 ; Insulin-Like Growth Factor II ; Molar ; Plasma ; Postpartum Period ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnancy-Associated Plasma Protein-A ; Proteolysis ; Trophoblastic Neoplasms ; Trophoblasts

PURPOSE: The effects of local injection of TGF-beta1 on the normal patellar tendon and the characteristics of remaining tendon after the partial resection of hypertrophic one were investigated. MATERIALS AND METHODS: TGF-beta1 was injected into the right patellar tendon of mature rats weekly for 3 weeks. Histological study, biomechanical analysis and the transmission electron microscopic evaluation were done. Half of hypertrophic tendon was resected at 4 weeks after the last injection and the same analyses were RESULTS: TGF-beta1 treated tendon increased in cross sectional area but decreased significantly in maximum tensile stress. The hypertrophic tissue was mainly composed of small collagen fibrils. After the partial resection of hypertrophic tendon, there was no significant difference in maximum tensile stress between remaining and control tendons. There were relatively larger collagen fibrils in the remaining tendon tissue than in non-resected hypertrophic one. CONCLUSION: Local injection of TGF-beta1 induced the hypertrophy of normal tendon. After the partial resection of hypertrophic tendon, the remaining one showed the more similar biomechanical properties to normal one.
Animals ; Collagen ; Hypertrophy* ; Patellar Ligament* ; Rats* ; Tendons ; Transforming Growth Factor beta1*