Adhesion formed between tendon and its sheath after repair often impairs functional recovery. There have been many attempts to reduce adhesion around a repaired tendon, but most results have been unsatisfactory or impractical in clinical application. Moreover, most attempts were focused on extrinsic tendon healing. whereas studies on the intrinsic tendon healing are sacrce in the literature. We have previously reported that fibrotic tendon adhesion after repair was decreased by decorin, a natural inhibitor of TGF-beta. Accordingly, the serial tensile strength was measured after complete tensection and repair of the tendon severance in order to confirm the effect of decorin inhibition of intrinsic healing capability. Forty White Leghorn chickens were subject to complete transection and repair of the third toe flexor digitorum profundus tendon in Zone II. In the experimental group, 0.5ml of diluted decorin(50microgram/ml) was injected around the repaired site, and the same volume of saline solution in the control group. Tendons were harvested at 1, 3, 5 and 7 weeks. The disrupting force of the repair site was analyzed using tensiometry(LLOYD LR 30K, U.K). The tensile strength of repaired tendon was similar in both groups for all postoperative periods. This indicates that intrinsic healing proceeds normally within the decorin group in spite of the blockade of TGF-betaactivity. Decorin, a natural inhibitor of TGF-beta, showed a significant inhibitory effect on reducing post-repair tendon adhesions, without disruption of intrinsic healing in the chicken flexor tendon injury model. Therefore, decorin is expected to be a useful agent for preventnion on tendon adhesion after the repair in clinical usage.
Chickens ; Decorin* ; Postoperative Period ; Sodium Chloride ; Tendon Injuries ; Tendons* ; Tensile Strength* ; Toes ; Transforming Growth Factor beta

Osteopathia Striata is a rare developmental abnormality characterized by striation of the skeleton, especially the metaphyses of the long bones. It has been seen on only a few occasions since it was first described by Voorhoeve in 1924. This case, a nine year old boy, showed well marked striation throughout bones of right lower extremity and pelvis and so justifies the title of paper.
Humans ; Lower Extremity ; Male ; Pelvis ; Skeleton

Congenital clasped thumb is an unusal condition characterized by the thumb being held tightly beneath the flexed fingers in such a way that it cannot escape for normal prehension. New-born infants frequently hold their thumbs beneath their flexed fingers. If the flexed thumb persists and normal independent action of the thumb does not develop third or fourth month after birth, congenital clasped thumb is suggested. It is the result of failure of normal developmenl of the muscles and tendinous structures that provide extension for the thumb and fingers at the metacarpophalangeal joint. The deformity also includes volar soft tissue contractures of digits in varying degrees of severity. Since first description of Zadek in 1934 for bilateral thumb extensor agenesis. total 48 cases of congenital clasped thumb have been reparted throughout the world. A case of bilateral congenital clasped thumb with bilateral calcaneo-varus deformity in one month-old boy was diagnosed and treatment with prospect of complete funtional recovery.
Congenital Abnormalities ; Contracture ; Fingers ; Humans ; Infant ; Male ; Metacarpophalangeal Joint ; Muscles ; Parturition ; Thumb ; United Nations

In an effort to find more comprehensive and general diagnosis of erectile failure, we already have analysed 90 cases and reported the results. After that we added 199 more cases and performed a computer based analysis of total 289 cases in the dynamic changes of penile blood flow during natural physiologic erection after exposure to the audiovisual stimulation. The following results were obtained. 1. In normal volunteers, we were able to achieve uniform penogram findings in all cases with T.T.(Transit Time) ranging 1 to 3 minutes(mean 2.17 minutes), the EPT(Erection Persistent Time) over 30 minutes and no fluctuation phenomena after AVS. 2. Erectile failure group.(2.83 cases) (1) Group I.(108 cases; 38.2%). They demonstrated similar penogram features with the normal volunteers but EPT more than 5 minuets(mean 18.26 minutes) at least. most common causes were psychogenic origin(57 cases). (2) Group II.(175 cases ; 61.8%). Patients were showing abnormal penogram findings, and were divided into following 3 types. a) A type-Impossible type(10 cases ; 3.5%). They failed to show more than 2 fold increase in the maximal radioactivity after AVS when compared to the pre-stimuli level(mean 1.83 times). The underlying causes were identified to be arteriogenic and neurogenic. b) B type-Unstable type(124 cases ; 43.8%). They were unable to sustain erection due to fluctuation(mean 1.83 times). The underlying causes were psychogenic, vasculogenic and neurogenic origins. c) C type-Delayed type(41 cases ; 14.5%). They were showing T.T. more than 15 minutes(mean ; 23.71 minutes), and the underlying causes were arteriogenic, psychogenic and neurogenic origins. Based on these results, we have concluded that AVS-Penogram seems to the most appropriate diagnostic method for screening test and follow-up evaluation after vascular surgery. Through more clinical experience and investigation, and more comparison and analysis with other diagnostic methods, it will be a standard diagnostic approach in the future.
Diagnosis ; Follow-Up Studies ; Healthy Volunteers ; Humans ; Mass Screening ; Radioactivity

We report a case of kerion celsi caused by Trichophyton verrucosum in a 4-year-old male. He presented painful, tender, indurated, boggy masses discharing pus on the vertex and occiput. Kerion celsi caued by T. verrucosum was diagnosed by the characteristic gross and microscopic findings of the colony on the Sabourauds glucose. agar. The possible source of infection was searched and wq found that he raised the cattles in his house. They had multiple, scaly, whitish plaques on the skin and T. verrucosum was identified from the hairs of the lesions. He had been treated with griseofulvin and prednisolone, and all lesions were cleared leaving partial alopecia in 2 months.
Agar ; Alopecia ; Child, Preschool ; Glucose ; Griseofulvin ; Hair ; Humans ; Male ; Prednisolone ; Skin ; Suppuration ; Tinea Capitis* ; Trichophyton*

Microsurgery offers a more effective approach to the brachial plexus lesions than any treatments previously available. The authors have performed operation to the injured plexus by microsurgical techniques since 1980. We selected 15 patients whom we could follow more than one year and had results as follow. 1. The causes of injuries were traffic accident(7 cases), gun-shot injury(4 cases), stab wound(3cases), and belt injury (1 case). 2. Two patients had preganglionic lesion and 13 patients had postganglionic lesions, among which seven cases were supraclavicular and six cases were infraclavicular. Most frequently injured site was in upper two roots and upper trunk (7 cases). 3. All of them were treated by surgical intervention, 12 cases by interfascicular nerve graft using autogenous sural nerve, one case by intercostal neurotization, one case by neurolysis, and one case by exploration only. 4. Elbow flexor and deltoideus were involved easily by injury than other muscles, but they had best prognosis to the microsurgical treatment. 5. The recovery of wrist and finger function was poor but they were frequently preserved from injury.
Brachial Plexus ; Elbow ; Fingers ; Humans ; Microsurgery ; Muscles ; Nerve Transfer ; Prognosis ; Sural Nerve ; Transplants ; Wrist

SS-cream is a topical agent for treating premature ejaculation (PE) which is made with extracts from 9 natural products. We evaluated the efficacy of SS-cream in the treatment of PE. An open pilot study was performed in 186 patients with PE. The mean ejaculatory latency from intromission to ejaculation was 1.5 minutes. Sixty-four of the 186 patients (34.4%) were combined with mild erectile dysfunction in whom penile rigidity was not sufficient to be satisfied in sexual activity. Patients were instructed to apply 0.1 gm. of SS-cream on the glans penis 1 hour before sexual contact and to wash out the cream before sexual intromission. Patients were asked to complete a report form including ejaculatory latency, the degree of satisfaction in the sexual lives of both themselves and their partners, and any adverse effects after each application. One hundred and sixty-six out of 186 patients (89.2%) reported they were satisfied with the application of the SS-cream and the mean ejaculatory latency was significantly prolonged to 10.89 +/- 5.60 minutes. The mean ejaculatory latency was 9.85 +/- 3.58 minutes in 52 out of 64 patients (81.2%) with mild erectile dysfunction. There was no significant difference in the changes of ejaculatory latencies between patients with pure PE and patients with mild erectile dysfunction. Twenty patients (10.8%) claimed to have no changes of ejaculatory latencies after the application of SS-cream. Adverse effects were noted in 11 patients (5.9%), which were mild local irritation symptoms in 7 patients, and delayed ejaculation of more than 30 minutes in 4 patients, the symptoms subsided spontaneously within 4 hours. These results indicate SS-cream is effective in the treatment of PE and also PE combined with mild erectile dysfunction with a few side effects. Further studies on the action mechanisms of SS-cream and a double blind placebo-controlled trial are needed.
Administration, Topical ; Adult ; Drugs, Chinese Herbal/administration & dosage* ; Ejaculation/drug effects* ; Human ; Male ; Middle Age ; Penile Erection/drug effects

Recently, the authors had an opportunity to treat a 73-year-old male patient who was transferred to our institution with problematic multiple strictures of the anterior urethra subsequent to a suprapubic cystostomy. A proximal urethra was reconstructed with scrotal skin, but due to the shortage of distal skin, as a last resort we reconstructed a distal urethra using a polytetrafluoroethylene graft in place of 10 cm long urethral strictures. About 5 months after surgery, we had to reexplore the polytetrafluoroethylene graft area because of pain and found, much to our surprise, that the urethra had been completely regenerated around the length of polytetrafluoroethylene graft which now remained freely detached in the urethral canal. Following removal of the polytetrafluoroethylene graft, the patient could urinate normally and was subsequently discharged without further problems. We concluded that this case was incidentally successful with good regeneration of urethral mucosa of the anterior urethra by grafting a polytetrafluoroethylene tube.
Aged ; Case Report ; Human ; Male ; Polytetrafluoroethylene ; *Prostheses and Implants ; Regeneration ; Urethra/physiopathology ; Urethral Stricture/physiopathology/*surgery

In a 73 year old male patient with multiple urethral strictures, we performed urethral replacement with Gore-Tex(Polytetrafluoroethylene) graft about l0cm long. On a follow up, 5 months later, operative field was reexplored due to pains and we found that urethral regeneration was complete around the Gore-Tex graft while the graft itself was remaining inside the urethral lumen in a freely detached state. After the removal of Core- Tex graft, patient could void in a normal fashion quite satisfactory. We think that urethral replacement graft with Gore-Tex should be given a consideration as a last resort.
Aged ; Follow-Up Studies ; Health Resorts ; Humans ; Male ; Polytetrafluoroethylene ; Regeneration ; Transplants* ; Urethral Stricture*

Due to the increased awareness of impotence, including primary impotence, in single males, we studied its characteristics and a comparative study was performed with other impotence groups. From March 1986 to February 1989, 53 impotent single males without previous trauma history (Group A) were evaluated and diagnosed by implementing diagnostic procedures when available. During the same period. Rigi Scans were performed in 66 patients with erectile failure (excluding impotent single males, Group B) and AVS penograms were also done in 647 patients belonging to the same group. Of the 53 evaluated patients, twenty were found to have primary impotence which was composed of 9 with organic and 11 with psychogenic impotence. The comparison of 9 Patients with primary organic impotence and 11 patients with primary psychogenic impotence showed significant differences in the results of diagnostic studies, but the data size was insufficient to obtain significance. Comparison of the ratio of organic and psychogenic impotence in primary impotence patients and nonprimary impotence patients among 53 single males revealed these to be almost the same, as 0.82 (45%/55%,9/20 / 11/20) and 0.83 (45.5 %/54.6 %, 15/33 / 18/33) respectively. According to these results, single males with erectile failure including primary impotence can be classified as one of the disease entities. The Rigi Scan classification used in this study was revealed to be significant in comparison of Groups A and B (p=0.02). The type distribution of the AVS penogram was statistically significant in comparing Group A to B (p=0. 004). The difference in Rigi Scan and AVS penogram results between Group A and B signifies psychologic and organic dissimilarity between these groups. The unstable erection seen in Rigi Scan was considered to be due to some organic, especially some form of hemodynamic problem that needs further investigation.
Classification ; Erectile Dysfunction* ; Hemodynamics ; Humans ; Male ; Male*