Reconstruction of cruciate ligament has been controversial. Autogenous grafts has been used with inconsistent success rates due to their variable strength and limited length. If any autograft could cover such drawbacks it could surpass the advantage of artificial ligaments also. Recently, we used partial Achilles tendon autograft in reconstructive operation of anterior cruciate ligament with promising result. The main advantages of this Achilles tendon autograft are its sufficient length and strength. Preliminary study was done in 11 patients who received reconstruction of the anterior cruciate ligament using partial Achilles tendon autograft. The results were as followings :l. Anterior cruciate ligament reconstructions were done in 11 patients, with follow-ups ranging from 5 to 12 months, average being 8 months. 2. Average preoperative knee score was 49.1, and it was improved up to 87.4 after operation. 3. Among the 11 patients, 6 belonged to the Excellent, 4 to good, and 1 to fair. 4. Achilles tendon autograft turned out to be a good autograft substitute for the anterior crucate deficient knee. The results were promising. Long-term follow-up is needed to confirm the final status of the operated knee.
Achilles Tendon ; Anterior Cruciate Ligament ; Autografts ; Follow-Up Studies ; Humans ; Knee ; Ligaments ; Transplants

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second*

No abstract available.
Homocystine ; Homocystinuria*

To compare the efficacy of Stamey with that of Raz procedure in the correction of stress urinary incontinence, we studied retrospectively 43 patients who underwent either procedure at our institution between January, 1989 and June, 1994. Of 43 Patients were 23 underwent Stamey and 20 underwent Raz procedures. Patient's characteristics of the 2 groups were similar, but mean operative time was 107 minutes in Stamey and 76 minutes in Raz procedure(P<0.05), a care rate was obtained postoperatively in 65y. of the patient in Stamey and in 85% in Raz procedure(P<0.05). Postoperative complications were similar in 13.5% of the patients in Stamey and in 12.5% in Raz procedure. Although most predictive factors were not associated with cure or failure in our series, the postoperative cure rate was significantly higher in the group with urinary retention of more than a week. It is thought that Raz procedure is more safe and accurate than Stamey procedure by its shorter operation time and higher success rate(P<0.05). although patient's satisfaction with postoperative morbidity is similar between Stamey and Raz procedure.
Humans ; Operative Time ; Postoperative Complications ; Retrospective Studies ; Urinary Incontinence* ; Urinary Retention

The posterior cruciate ligament, because of its location and axial role in knee function, was assumed to be a fundamental stabilizer for the knee joint. Reconstruction of the posterior cruciate ligament has been a demanding operation due to difficulties of appropriate graft material. Posterior cruciate substituing material should be biocompatible, durable, stress-strain capable and ease to be used. Achilles tendon autografts were thought to meet these criteria. Recently, we have advocated partial Achilles tendon autograft in reconstructive operation of posterior cruciate ligament with promising result. Posterior cruciate ligament reconstructions were done in 8 knees, with follow-ups ranging from 7 to 23 months, averaging 13 months. The results were as followings: l. Average preoperstive knee score was 46 and it was improved up to 88 after operation. 2. Among the 8 knees, 3 belonged to the excellent, 4 to good, and 1 to fair groups respectvely. 3. Achilles tendon autograft turned out to be a good substitute for the posterior cruciate deficient knee. The results were promising. Achilles tendon autograft regarded to be suitable for the posterior cruciate liagament reconstruction and desirable features of this autogenous graft included distinguished biocompatability, mechanical stability in fixation strength as well as stress-strain capability, and consistency in reproducible operative technique.
Achilles Tendon ; Autografts ; Follow-Up Studies ; Knee ; Knee Joint ; Posterior Cruciate Ligament ; Transplants

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

From 1986 to 1993, we analyzed experiences in clean intermittent catheterization(CIC) of 62 patients with neurogenic bladder who were closely follow up for averaging 25months. Initial urodynamic study revealed hyperreflexic bladder in 21patients: 11 with detrusor sphincter dyssynergia. Areflexic bladder was found in 41patients: l5 with low compliance. Although positive urine culture were relatively frequent(61%), febrile urinary tract infections were rare(3%) and upper urinary tract function was stable. Other complications of CIC(29%) were burning sensation, resist on urethral catheter, epididymitis, scrotal abscess, bladder stone, etc. Although minor complications are not rare, we can conclude that preservation of renal function and improvement of urinary incontinence can achieved with intermittent catheterization and that patient must be well motivated and cooperative and be able to use their hands for continuation of CIC.
Abscess ; Ataxia ; Burns ; Catheterization ; Catheters ; Compliance ; Epididymitis ; Follow-Up Studies* ; Hand ; Humans ; Intermittent Urethral Catheterization* ; Male ; Sensation ; Urinary Bladder ; Urinary Bladder Calculi ; Urinary Bladder, Neurogenic* ; Urinary Catheters ; Urinary Incontinence ; Urinary Tract ; Urinary Tract Infections ; Urodynamics

PURPOSE: Bacillus Calmette-Guerin (BCG) is the most effective intravesical agent for patients with superficial bladder cancer, but the long-term efficacy of BCG has not been established. We report our long-term experience of intravesical BCG therapy in the recurrence and progression for superficial bladder cancer. PATIENTS AND METHODS: Between 1985 and 1993. high risk patients with superficial bladder cancer were received complete TURB plus intravesical BCG (n=77). 120mg Tice-Chicago strain BCG was administered weekly for 6 weeks and then monthly for 3 months. Patients were considered treatment failure if either urinary cytology or biopsy results were positive for tumor on every 3 to 6 months followup examination. All patients reported have had a minimum 2-year followup, with the mean of 63 months. RESULTS: The 1st course of BCG was successful in 47 (6696) of 71 patients treated for prophylaxis and 3 (50%) of 6 treated for carcinoma in situ. Subsequent progression of disease occurred in 6 patients (8%) and cystectomy was performed in 2 patients (3%). The response rate for the total patients population treated with the 1st course was 65% (50 of 77). Of 27 patients who failed the 1st treatment course 21 patients were given the 2nd BCG treatment course. Of the 2nd BCG course, subsequent progression of disease occurred in 3 patients (14%), and cystectomy was performed in 2 patients (9%). Thirteen (68%) had complete response and 5 (26%) had new tumors, who had rendered free of disease after TURB plus intravesical therapy (mitomycin and/ or BCG). Although serious BCG complications (hepatitis, miliary Tbc, sepsis) were observed in 2 patients, side-effects were self-limiting and well controlled in the majority of patients (fever, bladder irritability, and hematuria). CONCLUSIONS: Intravesical BCG therapy seems to be effective to prevent recurrence and progression of superficial bladder cancer with long-term follow-up. However, we must note the possibility of fatal generalized complications in patients with grossly trauma of lower urinary tract.
Bacillus* ; Biopsy ; Carcinoma in Situ ; Cystectomy ; Follow-Up Studies* ; Humans ; Mycobacterium bovis ; Recurrence ; Treatment Failure ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Tract

PURPOSE: Transglutaminase 4 (TGase 4) belongs to a family of enzymes that catalyzes the post-translational modification of proteins. In an attempt to establish its physiological function(s), the distribution of TGase 4 expression in the human eye was determined. METHODS: Ocular tissues obtained from five human whole eyeball postmortem (40(+1) weeks at gestation age, 2 months, 48, 66, 76 years) were stained with monoclonal antibodies against human TGase 4 using indirect immunohistochemical method. RESULTS: TGase 4 was found in the lacrimal glands, corneal epithelium and endothelium, conjunctival epithelium, lens epithelium, retina (inner segment of photoreceptor, external limiting membrane, outer plexiform layer, inner plexiform layer, retinal nerve fiber layer and internal limiting membrane), iris, ciliary muscle, ciliary nonpigmented epithelium and trabecular meshwork. Endothelium of blood vessels in all ocular tissues was also stained. Conjunctival stroma, choroid, anterior tenon's capsule were faintly stained. No evidence of immunostaining for TGase 4 was found in the corneal stroma, iris stroma, lens nucleus, ciliary process, sclera, extraocular muscle and optic nerve. CONCLUSIONS: The expression pattern of TGase 4 was different from those of other TGase isoforms in the human eye. This result may be helpful in further investigation of the role of TGase 4 in the ocular tissue.
Antibodies, Monoclonal ; Blood Vessels ; Choroid ; Corneal Stroma ; Endothelium ; Epithelium ; Epithelium, Corneal ; Humans* ; Iris ; Lacrimal Apparatus ; Membranes ; Nerve Fibers ; Optic Nerve ; Pregnancy ; Protein Isoforms ; Protein Processing, Post-Translational ; Retina ; Retinaldehyde ; Sclera ; Tenon Capsule ; Trabecular Meshwork

Background: This study examined the distribution of stress-cortisol responses and risk factors affecting perceived stress and cortisol responses among 187 university students in South Korea. Methods: Perceived stress, depressive symptoms, and health-promoting lifestyle were assessed using structured questionnaires. Blood analyses and anthropometrics were used to determine cortisol and cardiometabolic risks. Multinomial logistic regression analysis was used to examine the factors affecting stress-cortisol responses. Results: Four groups of stress-cortisol responses were found, including normal (39.0%), high stress (34.8%), high stress-cortisol (13.9%), and high cortisol group (12.3%). Age, systolic blood pressure, high-density lipoprotein cholesterol, depressive symptoms, and physical activity were associated with stress-cortisol responses. Conclusions Multidimensional interventions are needed to reduce stress levels and promote normal stress-cortisol responses.