The potential for nerve regeneration and recovery of its function exists in the presence of a suitable pathway for regenerating axon and endoneurial tube can serve as nerve conduit for regenerating axon in fresh nerve graft. But value of degenerated nerve as donor nerve has not been established till now. This experiment assessed the chronologic influence of fresh and degenerated nerve graft on axonal growth for 10mm gap of sciatic nerve in rabbit and how long degenerated nerve was ahle to serve as a nerve conduit microscopically. Electromicroscopically, the regenerating axons which were ohserved in the degenerated nerve graft had more abundant unmyelinated fibers and revealed abundant collagen fibers in the endoneurium. And these regenerating axons became gradually surrounded with newly developed basal lamina and decreased the collagen fibers at l2 week of degenerated nerve graft. Histologically, myelinated axons which were observed in central area of the degenerated nerve graft at 8 week of degenerated nerve graft were relatively thinner, but a definite structural difference of regenerating axons was not found except reduction of number compared with those of tresh nerve graft. The numher of myelinated axons was 6,072+/-l42 in normal sciatic nerve, 4,479+/- 157 in fresh nerve graft group, and 2,968+/-168 in the degenerated nerve graft group. Difference of the number of myelinated axons between fresh and degenerated nerve graft group was significant stati stically(P<0.05). These results showed that the ability of a degenerated nerve graft as a passage for the regenerating axons and it can be employed as one of the favorable nerve conduits.
Axons ; Basement Membrane ; Collagen ; Humans ; Myelin Sheath ; Nerve Regeneration ; Peripheral Nerves ; Sciatic Nerve* ; Tissue Donors ; Transplants*

Authors reviewed 28 cases of displaced acetabular fracture treated operatively from Februay 1991 to January 1996 and followed up more than 1 year. The clinical results were retrospectively analyzed with consideration of surgical problems and complications. The results were as follows; 1. According to Letournels classification, we had 16 elementary fractures(57%) and 12 associated fractures(43%). 2. Kocher-Langenbeck approach in 16 cases, ilioinguinal in 9 cases, extended iliofemoral 2 cases and combined approach in 1 case were used. 3. The devices for internal fixation were as follows: screw only in 12 cases(elementary fracture 9cases, associated fracture 3 cases), plate and screw in 16 cases(elementary fracture 7 cases, as-sociated fracture 9 cases). 4. There were complications such as 3 degenerative arthritis, 2 superficial wound infection, 1 iatrog-enic sciatic nerve palsy and 1 avascular necrosis of femoral head and no postoperative heterotro-phic ossification. 5. Satisfactory reduction by radiologic criteria was gained in 23 cases(82%). Satisfactory results by clinical criteria(by dAubigne & Postels) was gained in 21 cases(75%). Only 2 patient with a satisfactory radiologic reduction was clinically unsatisfactory. It seems that the satisfactory operative reduction of the fracture is the factor that correlates best with a satisfact-ory clinical result.
Acetabulum* ; Classification ; Head ; Humans ; Necrosis ; Osteoarthritis ; Retrospective Studies ; Sciatic Neuropathy ; Wound Infection

Background & Objective: Hiccups is a disabling condition of lateral medullary infarction (LMI). Unlike other symptoms of LMI, the anatomical lesions of hiccups are not well known. Few studies have evaluated the relationship between the lesional location of LMI and hiccups. We performed this study to correlate hiccups and magnetic resonance imaging (MRI)-based lesional location in pure LMI. Methods: Between January 1997 and February 2013, we identified 24 patients with pure LMI who presented with hiccups in addition to typical lateral medullary syndrome. Sixty six pure LMI patients without hiccups were included as a control group. Clinical and radiologic findings were compared between the two groups. MRI-identified lesions were classified rostrocaudally as rostral, middle and caudal, and horizontally as typical, ventral, large, lateral and dorsal. Results: The pure LMI patients with hiccups had significantly more frequent aspiration pneumonia (P = 0.001) and longer hospital stay (P = 0.03). The patients with hiccups significantly more often had dorsal rather than ventral lesion at horizontal levels (P = 0.012). But, there were no rostro-caudal differences at vertical levels (P = 0.162). Conclusions: We suggest that pure LMI associated with hiccups often locates in the dorsal medulla at horizontal correlation. This MRI-based comparative study has advanced the understanding of the neural substrate for hiccups in LMI, and indicates that hiccups become predictable when specific lesional locations in the lateral medulla are considered.

Interferon(IFN) has been noted to augment the cytotoxicity of cisplatin analogues and S-FU, and varying degrees of success were reported when combined with chemotherapy in a number of squamous cell carcinomas. The aims of this study were to assess its therapeutic efficacy and to establish the feasibility and toxicity of biochemical modulation of the interferon-a-2a when combined with 5-FU and carboplatin(CBDCA) in locally advanced(> or =FIGO clinical stage IJb) and/or bulky(largest diameter > or = 3cm) cervical cancer. From January 1995 to December 1996, 20 patients with bulky and/or locally advanced cervical cancer were enrolled in this study and received FAC(5-FU/Interferon-a/CBDCA) combination chemotherapy as a neoadjuvant setting. The FAC regimen was composed of IFN- a -2a 3x10(6) IU/day from day l to day 6, 5-FU 750mg/m2/day from day 2 to day 6, and carboplatin at a dose calculated by Calvert formula with AUC(area under the curve) 6.0 on day 2. Three cycles of neoadjuvant chemotherapy was performed with 3 weeks interval if toxicity permitted it. Patients were examined after every treatment cycle and evaluated for toxicities and responses using standard GOG criteria. Two patients(10.0%) showed complete clinical response and 15 patients(75,0%) had partial response. The other patients had stable(10.0%) or progressive disease(5.0%). Among fifteen patients who have undergone radical hysterectomy, pathological complete response was not noted. Surgery was possible in 15 patients(75.0%) and 10 patients received adjuvant radiotherapy. Lymph node metastases were found in 5 patients(33.3%) and the number of positive nodes was ranged from 1 to 5. The most frequent grade 3 or 4 toxicity was neutropenia(60.0%) followed by alopecia(40.0%), nausea/vomiting(35.0%), thrombocytopenia(15.0%), diarrhea(5.0%), and anemia(5.0%). (continue)
Carboplatin ; Carcinoma, Squamous Cell ; Cisplatin ; Drug Therapy* ; Drug Therapy, Combination ; Fluorouracil ; Humans ; Hysterectomy ; Lymph Nodes ; Neoplasm Metastasis ; Radiotherapy, Adjuvant ; Uterine Cervical Neoplasms

BACKGROUND & OBJECTIVES: Glutamate is a major neurotrammitter in corticostriatal, subthalamopallidal, and subthalamonigral pathways and interacts with other neurotrammitters. The study was done to investigate the effects of NMDA blockade on dopaminergic responses. METHODS: We made a unilateral Parkinson model in rats by injecting 6-hydroxydopamine into the substantia nigra. Rotational behavior was observed using apomorphine (mixed Dl/D2 agonist, 0. 5 mg/kg), SKF 38393 (Dl agonist, 1. 5 mg/kg), LY-171555 (D2 agonist, 0. I mg/kg), MK-801 (uncompetitive NMDA blocker, 0. 067 mg/kg), and memantine (non competitive NMDA blocker, 10 mg/kg). RESULTS: Contralateral rotation was induced by apomorphine (total turns for 2 hours, 1160+/-154), SKF 38393 (total turns for 3 hours, 1374+/-400), and LY 171555 (total turns for 3 hours 2316+/-395). NMDA antagonists per se induced mild ipsilateral rotation (MK 801; 587+/-131, memantine; 166+36). Apomorphine induced rotation was potentiated by MK 801 (1683+/-186, p<0.05) and memantine (170+/-264, p<0.05). SKF 38393 induced rotation tended to be potetiated by MK-801 (2451+/-741, p=0.08) and memantine (1794+/-450, p=0.21), though not statistically significant. However, LY 171555 induced rotation was reduced by MK-801 (1153+/-284, p<0.05) ad memantine (22.1+/-42.5, p<0.05). CONCLUSION: NMDA blockers act synergistically with Dl- and antagonistically with D2-mediated behavioural responses, suggesting that glutamate has different interactions with Dl- and D2 pathway.
2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-benzazepine ; Animals ; Apomorphine ; Dizocilpine Maleate ; Glutamic Acid ; Hydroxydopamines* ; Memantine ; N-Methylaspartate* ; Oxidopamine ; Rats* ; Substantia Nigra

This study analyzed the factors causing the angular deformity as the tibia fracture below isthmus were treated with interlocking nails. For this purpose, we observed 70 cases of tibia fractures in the Gil General Hospital as subjects. Of the 70 cases under the treatment, 32(45.7%) showed the angulation of over one degree, and 11(15.7%) showed that of 5-10 degrees in any plane. According to the outcomes of this studies, the degree of angulation seemed to have close relation to the length of fracture line. Also, if the fracture line reached to the isthmus, angulation was apt to be caused. Even though most angulated cases had concomitant fibular fracture, fibular fracture, itself, seemed to have no direct relation to angulation. In consequence, the intramedullary interlocking nailing needs special carefulness in the case of breakage of cortical buttress such as long fracture line, butterfly fragment and fracture including isthmus.
Butterflies ; Congenital Abnormalities* ; Hospitals, General ; Tibia*

We studied 30 patients who participated in accelerated rehabilitation program after ACL reconstruction to evaluate the effects on knee joint function prospectively. This program emphasizes early full hyperextension, early weight bearing as tolerated, and closed-chain quadriceps functional activities with rapid return to sports. Timing of the return to occupation, activity level, manual knee test, range of motion, thigh circumference, Lysholm knee score and KT-2000 arthrometer measurement were checked at the latest follow-up which is at least more than 1 year. The result were as follows: 1. The mean time for patients to return to occupation was 7.5 weeks (2 weeks-6 months). 2. Range of motion of the knee were not limited in 25 cases (83%) at 1 year after reconstruction. 3. The mean Lysholm score was 92.7. 4. The mean manual maximum KT-2000 arthrometer score was 2.0mm. The results of this study show that patients who had an ACL reconstruction with an autogenous central 1/3 patellar tendon graft and followed an accelerated rehabilitation program obtained longterm stability, achieved full range of motion, had a low complication rate, and were able to return to full sporting activities predictably.
Follow-Up Studies ; Humans ; Knee Joint* ; Knee* ; Occupations ; Patellar Ligament ; Prospective Studies ; Range of Motion, Articular ; Rehabilitation* ; Sports ; Thigh ; Transplants ; Weight-Bearing

Vaginal foreign bodies in children are often associated with intermittent vaginal disch-arge, vaginal bleeding and create a clinical scenario similar to that of certain cases of sex-ual abuse and isolated premature menarche. Intravaginal foreign body of especially long duration can pose a diagnostic dilemma, since a number of diagnostic modalities may fail to detect its existence. A 4-year-old girl who suffered from a bloody, malodorous vaginal discharge visited SNUH. She had had such problems for over a year and had been evaluat-ed by several gynecologists. Preoperative evaluations including ultrasound was performed and pelvis MRI strengthened the suspicion that some foreign bodies could be an etiologic factor. A vaginal inspection performed under general anesthesia with 0degrees endoscope and nasal speculum size no. 43 revealed "pen top of ink pen" lodged in her vaginal mucosa of posterior fornix area. We were allowed to remove a foreign body without trauma of genital tract by nasal forceps. We report a case of intravaginal foreign body in a 4-year-old girl with a brief review.
Anesthesia, General ; Child ; Child, Preschool* ; Endoscopes ; Female* ; Foreign Bodies* ; Humans ; Ink ; Magnetic Resonance Imaging ; Menarche ; Mucous Membrane ; Pelvis ; Surgical Instruments ; Ultrasonography ; Uterine Hemorrhage ; Vagina ; Vaginal Discharge

Since coronary arteriovenous fistula(CAVF) was first reported by Krause in 1865, more than 400 cases have been reported. It is relatively rare disease and originates more commonly in the right than in the left coronary artery. We report a case of CAVF between right coronary artery and right ventricular inflow tract with significant left to right shunt in a 34-year old female who was admitted for the cardiomegaly on routine chest X-Ray. It was detected by transthoracic and transesophageal echocardiography, and confirmed by cardiac catheterization and coronary angiography. The opening of the fistula draining into the right ventricle was obliterated with sutures. There was no significant shunt in postoperative cardiac catheterization and coronary angiography.
Adult ; Arteriovenous Fistula* ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomegaly ; Coronary Angiography ; Coronary Vessels ; Echocardiography ; Echocardiography, Transesophageal* ; Female ; Fistula ; Heart Ventricles ; Humans ; Rare Diseases ; Sutures ; Thorax

The most frequent ectopic locations of endometriosis include, in descending order of frequency, the ovaries, uterine ligaments, the rectovaginal septum, and peritoneum covering the pelvic organs, that is, uterus, fallopian tubes, rectum, sigmoid colon, and bladder. Endometriosis at the site of episiotomy scar and abdominal scar following cesarean section are very rare conditions among the extrapelvic endometriosis. We have experienced two cases of endometriosis. One occurred from episiotomy scar and the other occurred from abdominal scar following cesarean section. The diagnosis of scar endometriosis is suggested if the symptoms are cyclic or in association with the patient's menstrual cycle. We can use ultrasonography, computerized tomography, magnetic resonance imaging to differentiate from other tumors. Surgical excision is the method of choice for diagnosis and treatment. We report the two cases with review of rare extrapelvic endometriosis.
Cesarean Section* ; Cicatrix* ; Colon, Sigmoid ; Diagnosis ; Endometriosis* ; Episiotomy* ; Fallopian Tubes ; Female ; Ligaments ; Magnetic Resonance Imaging ; Menstrual Cycle ; Ovary ; Peritoneum ; Pregnancy ; Rectum ; Ultrasonography ; Urinary Bladder ; Uterus