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

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*

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

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

OBJECTIVE: The purpose of this study was to evaluate the therapeutic efficacy and toxicity of high dose cisplatin-cyclophosphamide combination chemotherapy on patients with primary epithelial ovarian cancer. METHODS: A review of 63 patients previously diagnosed as primary epithelial ovarian cancer after initial operation and histology at Pusan National University Hospital from Jul. 1993 to Jun, 1997 was performed. Patients were received the combination chemotherapy including cisplatin 100mg/m2/day and cyclophosphamide 750mg/m2/day, repeated 6 cycles every 4 weeks. The mean age was 48 years old, and previous surgical procedures were total abdominal hysterectomy and bilateral salpingo-oophorectomy with omentectomy. The patients were classified into FIGO stage and pathologic results. RESULTS: The clinical response rate was 100% in the FIGO stage Ic patients with PC combination chemotherapy, 100% in stage II, 53.5% in stage III, and 25% in stage IV. The overall response rate was 69.8%. The 3-year survival rate according to the treatment groups was 93.3% in stage Ic group, 60% in stage II, 50% in stage III and 0% in stage IV. The mean survival duration was 34.6 months. Hematologic toxicities in cisplatin-cyclophosphamide chemotherapy were neutropenia and anemia. Nausea and vomiting were the most common side effects and occurred in 96.8%. Most of the toxicities were grade 1 and 2. CONCLUSION: The combination chemotherapy with cisplatin-cyclophosphamide is relatively safe and effective method in the treatment of primary epithelial ovarian cancer.
Anemia ; Busan ; Cisplatin* ; Cyclophosphamide* ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Hysterectomy ; Middle Aged ; Nausea ; Neutropenia ; Ovarian Neoplasms* ; Survival Rate ; Vomiting

This study is to compare the diagnostic usefulness and relationships between AVS penogram. Snap gauge test, and NPT monitoring in impotent patients confirmed using multidisciplinary diagnostic approach at the Department of Urology, Yonsei University College of Medicine from December 1986 to June 1987. Following results were obtained. 1. Among 24 cases of Group I(AVS penogram) 20 cases(83.3%) were psychogenic impotence, where 15 cases(75%) revealed sufficient penile rigidity on the Snap gauge test. 4 cases(16.7%) of group I were organic impotence, which revealed incomplete penile rigidity on the Snap gauge test. Among 45 cases of Group II-B(AVS Penogram) 34 cases(75.6%) were psychogenic impotence, where 28 cases(82.4%) showed sufficient penile rigidity on the Snap gauge test. 10 cases(24.4%) of Group II-B were organic impotence, which showed incomplete penile rigidity on the Snap gauge test. Among 17 cases of Group II-A and II-C 5 cases were psychogenic impotence, all of which revealed sufficient penile rigidity on the Snap gauge test. >From above results, the AVS Penogram is not a confirmative method, but using AVS Penogram and the Snap gauge test simultaneously will give useful information differentiating organic impotence and psychogenic impotence. 2. In comparison of AVS penogram and NPT monitoring, among 20 cases 7 cases of erectile curve showed similar shape, but the precise mechanism of each penile erection is not yet certain, more study is needed in the near future.
Erectile Dysfunction ; Humans ; Male ; Penile Erection ; Urology

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*