In order to assess the difference of healing of the medial collateral ligament (MCL) of the knee according to the treatment methods, in vivo animal experiment using a rabbit model was perfoimed. Thirty six MCLs in eighteen rabbits were surgically transected at the mid-portion and treatm nt was done with two different methods, e.g. immobilization wiih plaster cast in right knees (Group I ), and non-immohilization in left knees (Group 2 ). Five rabhits were used as normal controis. To evaluate the biomechanical property of the femur-MCL-tibia complex (FMTC) in time progression, tensile stress tests using material testing machine (Model 8511, Instron company, 1993) were done at 6, 10, l2 weeks postoperatively and the results were as follows. 1. The ultimate load and stiffness (structural property) of the FMTC increased with time in both groups, but group ][ showed significantly higher values than group I . 2. The material property of the MCL checked by stress-strain curve showed higher Young s modulus in group ][ than in group ] . As a results, joint motion seems to improve the biomechanical propeity of the healed MCL.
Animal Experimentation ; Casts, Surgical ; Collateral Ligaments* ; Exercise Test ; Immobilization* ; Joints ; Knee ; Ligaments* ; Rabbits*

Cutaneous horn is a clinical diagnosis based upon the presence of a large protuberant mass of keratin. We report a case of cutaneous horn arising from dermatofibroma in a 31-year old woman. A silver whitish colored comical hyperkeratotic protruding lesion (1.0  0.7 cm size) from the red brown colored nodule was observed. Histopathologic findings showed characteristic findings of dermatofibroma and cutaneous horn. The lesion was removed by surgical excision.
Animals ; Diagnosis ; Female ; Histiocytoma, Benign Fibrous* ; Horns* ; Humans ; Silver

The alcoholic neuropathies developed in approximately 34% of chronic alcoholics and the sexual dysfunction had been experienced in 8-54% of male alcoholics(Schiavi 1990). The aims of this study were to identify the prevalence of subclinical polyneuropathies and sexual disorders in alcohol dependence, and to evaluate the association between them. The nerve conduction velocity(NCY), electromyography(EMG), and pudendal somatosensory evoked potentials(SEPs were tested for the male alcoholics(N=34) and controls(N=17 for NCV & EMG, N=25 for pudendal SEPs). The pudendal SEPs were measured by the following procedures, in which we simulated the dorsal nerve of penis attached by the ring electrode(stimulus intensity, three times of threshold ; stimulus rate, 1-4.7Hz: stimulus duration, 0.1 or 0.2msec), and recorded at the scalp(active electrode, 2cm behind Cz ; reference electrode, Fz. The NCV and EMG detected signs of peripheral neuropathies in 79.4% of alcoholics. Among the alcoholics, 64.7% were abnormal on the pudendal SEPs. Among the alcoholics who revealed abnormality on EMG and NCV, 81.4% were abnormal on the pudendal SEPs, in which 51.9% were not responded. The P1 latencies between peripheral neuropathies and sexual disorders in the alcoholic. The prevalence of subclinical neuropathies and sexual disorders seemed to be much higher in alcohol dependence that expectation, and these two problems were relatively correlated, and our results suggested that the peripheral polyneuropathies were one of the prerequisites of sexual disorders.
Alcoholic Neuropathy ; Alcoholics ; Alcoholism* ; Electrodes ; Humans ; Male ; Neural Conduction ; Peripheral Nervous System Diseases* ; Polyneuropathies ; Prevalence ; Pudendal Nerve

Locking of the metacarpophalangeal(MP) joint of thumb in mild hyperextension is relatively uncommon problem. The most frequently recognized cause appears that proximal palmar ligament or volar plate were ruptured tranversely with its distal part riding over the volar prominence of the radial condyle of the first metacarpal head. We experienced two cases of locking of the MP joint of the thumb due to volar plate injury. Closed reduction was failed in both cases and open reduction was done by cutting the constricted ligament hundle over the radial condyle of the first metacarpal head. Our description of this mechanism is supported by expeimental evidence that we obtained from the cadeveric specimens. The height of radial side condyle of first metacarpal head is higher than ulna side of that by 1.76mm in both hands of 16 cadeveric specimen. So we are going to report these cases with a review of the literature, and suggest that the preferable location of surgical incision in open reduction is radial side of metacarpal head.
Hand ; Head* ; Joints ; Ligaments ; Metacarpal Bones* ; Metacarpophalangeal Joint* ; Thumb* ; Ulna ; Palmar Plate

PURPOSE: We tried to determine whether six-hour fasting before abdominal computed tomography (CT) scan is necessary to prevent aspiration of gastric contents in patients with acute abdominal pain. METHODS: Adult patients with acute abdominal pain who were checked abdominal CT were enrolled. Exclusion criteria were age <15 years, pregnancy, traumatic cause of symptoms, chronic pain(>7 days), renal impairment and hypersensitivity to contrast media. We compared Group-I (<6-hour fasting) with Group-II(> or =6-hour fasting). We collected the demographic and clinical data on the causes of abdominal pain, pain duration, presence of nausea and vomiting, and use of medications before and after abdominal CT. In order to estimate the volume of gastric contents, we measured the area on the CT image which showed the largest volume of gastric contents. RESULTS: Among the 122 patients, Group-I consisted of 38 patients(31.1%) and Group-II included 84(68.9%). The demographic makeups of the two groups were similar, except for gender proportion (more males in Group-I). Group-I showed significantly greater gastric contents compared than Group-II(46.8+/-32.1 vs. 33.7+/-28.3, p=0.024). A slightly negative correlation (r=-0.2313; 95% CI=-0.3929 to -0.0559) was observed between the fasting time and the volume of gastric contents. However, the frequencies of the nausea [13/38 (34.2%) vs. 26/84 (31%), p=0.721] and vomiting [6/38 (15.8%) vs. 18/84 (21.4%), p=0.468] showed no difference between two groups. There were no aspiration events in either groups. CONCLUSION: Six hours of fasting before abdominal CT may not be required to prevent aspiration of gastric contents in patients with acute abdominal pain.
Abdomen, Acute ; Abdominal Pain ; Adult ; Contrast Media ; Fasting ; Humans ; Hypersensitivity ; Male ; Nausea ; Pregnancy ; Tomography, Spiral Computed ; Vomiting

No abstract available.
Humans ; Stenotrophomonas maltophilia*

PURPOSE: The purpose of this study was to develop in vivo dosimetries using both chromosomal aberrations and micronuclei in mice to assess biological effects of radiations. MATERIALS AND METHODS: Five each mice were irradiated with 0, 1, 2, 3, 4, 5, 10 Gy of Cs-137 gamma-rays. We scored numbers of chromosomal aberrations in metaphase spreads and numbers of micronuclei in bone marrow smears under light microscope, and obtained the dose-response relationships. We also examined the relationship between the two dose-response curves. RESULTS: The frequency of both chromosomal aberrations and micronuclei increased with dose, in a linear-quadratic manner. The delta, beta, and alpha coefficients were 0.0176, 0.0324, and 0.0567 for metaphase analysis (r=1.0, p<0.001) and 0.0019, 0.0073, and 0.0506 for micronuclei assay (r=1.0, p<0.001). The frequency of chromosomal aberrations and micronuclei in diffirent radiation doses was significantly correlated (r=0.99, p<0.01). CONCLUSION: In vivo dosimetry using either metaphase analysis or micronucleus assay was feasible in mice. These methods could be useful to evaluate biological effects of radiation.
Animals ; Bone Marrow Cells* ; Bone Marrow* ; Chromosome Aberrations ; Metaphase* ; Mice* ; Micronucleus Tests

Hemorrhagic shock is one of the most common causes of death in patients with multiple trauma and therefore rapid control of bleeding is the main strategy to save these patients. Resuscitative balloon occlusion of the aorta (REBOA) has been applied in several trauma cases and because of the effectiveness of this procedure it has been adopted in the trauma field. Herein, we report the first successful case of REBOA in Korea performed on a 46-year-old man with hemorrhagic shock after a fall from a height of 14-stories. The patient visited our hospital emergency room with hypovolemic shock, we performed Resuscitative Endovascular Balloon Occlusion of the Aorta under bed side blind technique. His vital sign was stabilized after procedure, then we could performed endovascular bleeding control. The patient was discharged on his 33rd in-hospital day without invasive procedure and major scar.
Aorta* ; Balloon Occlusion* ; Cause of Death ; Cicatrix ; Emergency Service, Hospital ; Hemorrhage ; Humans ; Korea ; Middle Aged ; Multiple Trauma ; Shock* ; Shock, Hemorrhagic ; Vital Signs

BACKGROUND: Single or multiple episodes of brief period of ischemia and reperfusion(ischemic preconditioning, IP) have been shown to limit infarct size after a subsequent longer period of ischemia. A considerable number of possible mechanisms has been proposed, however, controversies still remain. Accordingly, we evaluated the effect of four cycles of 5 minutes ischemia and 5 minutes reperfusion(IP) followed by subsequent 30 minutes ischemia(ISCH) and 60 minutes reperfusion using isolated Langendorff-Perfused rabbit hearts. Methods and RESULTS: After a 50-minute recovery phase, parameters of the left ventricular function(LVF) including left ventricular developed pressure(LVDP), contractility and the heart rate were recorded, and ultrastructure was examined. Myosin ATPase activity was determined by measurement of inorganic phosphorus and isozymes of the myosin heavy chain were examined by polyacrylamide gel electrophoresis containing pyrophosphate buffer. The ISCH hearts showed severe to irreversible change of the cardiac myocytes homogenously in contrast to the IP hearts in which changes were not homogenous and irreversible injury was only focal. However, parameters of the LVF were not significantly different between the IP and the ISHC hearts during reperfusion. Myosin ATPase activities were also not significantly different(0.67+/-0.123 micromol/mg protein/h in the IP hearts, 0.56+/-0.172 micromol/mg protein/h in the ISCH hearts, and 0.76+/-0.239 micromol/mg protein/h in the control hearts). Band patterns of the myofibrillar proteins, separated by sodium ddodecyl sulfate-polyacrylamide gel electrophoresis, revealed no differences between the IP, ISCH and the control hearts. Myosin heavy chains in the IP and the ISCH hearts were separated into 3 isozymes, V1,V2and V3in pyrophosphate gel electrophoresis in contrast that the control hearts revealed two isozymes, V1and V2. However, there were no differences in the protein composition and electrophoretic motility between the IP and the ISCH hearts. CONCLUSION: These results indicate that IP could not attenuate the changes in LVF, myosin ATPase activity and myosin isozymes on reperfusion, however, it could attenuate the ultrastructural changes of the cardiac myocytes.
Adenosine Triphosphatases* ; Electrophoresis ; Electrophoresis, Polyacrylamide Gel ; Heart Rate ; Heart* ; Ischemia ; Ischemic Preconditioning* ; Isoenzymes ; Myocytes, Cardiac ; Myosin Heavy Chains ; Myosins* ; Phosphorus ; Reperfusion ; Sodium ; Ventricular Function, Left*

Anaphylactic deaths are frequently observed at autopsies. Since death associated with medical practice has become social concern, the identification of anaphylactic shock is an important part of forensic medicine. However, autopsy findings of anaphylactic shock are usually non-specific; therefore, the diagnosis of anaphylactic shock must be inferred from collecting data on the past history of the deceased, circumstances of death, and negative autopsy findings. The analysis of serum mast cell tryptase level is a well-known, useful ancillary test for the diagnosis of anaphylactic shock, but is not widely used in daily practice in Korea. We recently encountered 2 autopsy cases of anaphylactic shock and confirmed that analysis of serum mast cell tryptase level was useful for the diagnosis of anaphylactic shock. In this report, we present these 2 autopsy cases of anaphylactic shock, with literature review of the usefulness and limitations of serum mast cell tryptase analysis.
Anaphylaxis ; Autopsy ; Forensic Medicine ; Korea ; Mast Cells ; Tryptases