Successful repair of lacerated tendons must restore continuity of the tendon and should yield a strong tenorrhaphy. Mechanical strength of repair should be adequate to early postoperative motion and mobility, The optimal repair technique must be able to withstand the rigors of early motion and also must not interfere with tendon healing. The relative strength of three suture methods of lacerated tendon were measured by mechanical disruption in effort to determine the strength of suture technique. Fifty-four Calcaneal tendons of 27 the New Zealand white rabbit were transected at mid portion and repaired with the three suture technique: group 1, Kessler suture, group 2, Pennington’s modified-Kessler suture and group 3, augmented- Becker suture technique. Each group was composed of 18 calcaneal tendons. Nine rabbits were sacrified immediately after suture, nine in postoperative 2 weeks and nine in postoperative 4 weeks Six calcaneal tendons in each three experimental group were obtained immediately after suture, at postoperative 2 and 4 weeks respectively. Tensile strength, maximum strength and modulus of elasticity of all experimental specimens were measured with Instron-UTM-4-100(Toyo-Baldiwin, Japan). The results were evaluated statistically to compare the strength of the three suture technique at three different periods. The tensile strength was predominantly strongest in augmented-Becker method among three suture technique at immediate suture, postoperative 2 weeks and 4 weeks respectively. The augmented Becker repair was strongest in maximum stress among Kessler and modified Kessler repair at immediate operation, postoperative 2 weeks and 4 weeks respectively. The augmented Becker repair was highest in modulus of elasticity than Kessler method and modified-Kessler method at immediate operation, postoperative 2 weeks and postoperative 4 weeks respectively. Tensile strength, maximum stress and modulus of elasticity were gradually increased from immediate operation to postoperative 4 weeks, but there were not statistically significance between experimental three suture methods at postoperative 4 weeks.
Elastic Modulus ; Methods ; New Zealand ; Rabbits ; Suture Techniques ; Sutures ; Tendons ; Tensile Strength

PURPOSE: We evaluated the MR and CT findings of the masticator space lesions in order to identify the differences among the malignant and benign tumors and infectious conditions. MATERIALS AND METHODS: MR and CT findings in 46 cases with proven masticator space lesions were reviewed retrospectively. We analysed the involvement of masticator muscles, adjacent spaces, orbit and intracrahium, homogeneity, necrosis, cystic changes, growth patterns, calcifications, enhancement patterns, MR signal intensity, and CT attenuation. RESULTS: Among the 29 cases of malignant tumors, seven cases were mandibular tumors including four chondrosarcomas, and 22 cases were extramandibular tumors. Malignant tumors of mandibular origin showed large masses with severe bone destruction and epicenter of mandible. Extramandiblular malignant tumors showed the epicenter out of the mandible and less severe bone destruction than mandibular tumors: Among the nine benign tumors, four cases were ameloblastomas which showed the well-defined masses and the expansion of the mandible, and four cases were extramandibular tumors which showed well-marginated extramandibular masses with no bone destruction. Among the eight infectious conditions, five cases were mandibular osteomyelitis with or without abscess formations, and the other three cases were infections from adjacent soft tissue or limited to the soft tissue. CONCLUSION: By careful observations of growth patterns, involvement of the masticator and adjacent spaces, bone changes, and epicenter of the lesions, one can discriminate a mandibular lesion from an extramandibular lesion. With this approach, it is thought to be easier to suggest a dignosis among a wide spectrum of masticator lesions.
Abscess ; Ameloblastoma ; Chondrosarcoma ; Magnetic Resonance Imaging* ; Mandible ; Muscles ; Necrosis ; Orbit ; Osteomyelitis ; Retrospective Studies

PURPOSE: The purpose of the present study was to determine the risk factors for predicting the recurrence in first-time urinary stone formers. MATERIALS AND METHODS: A total of 121 patients, who presented at our hospital with first-time urinary stone episodes, between 1996 and 2005, and followed up for at least 3 years, were retrospectively evaluated. Of these, 65 patients (41 males, 24 females) recurred (R group) and 56 (38 males, 18 females) not (NR group) during the follow-up period. The blood chemistry and urinary analytes values, as well as the clinical characteristics between the NR and R groups were compared by gender. p-values less than 0.05 were used to indicate statistical significance. RESULTS: There were no differences in the clinical characteristics between the NR and R groups. A comparison of the blood chemistry showed differences in the phosphate and calcium in men and women (p=0.047 and 0.034), respectively. Greater urinary excretion of phosphates were found in the R group than in the NR group (p=0.018), but was more prominent in men (p=0.006). No significant differences were found between the two groups with regard to metabolic abnormalities. A multivariate analysis revealed that urinary phosphates excretion was the sole predictor for stone recurrence (Exp beta=8.347, p=0.033). CONCLISIONS: Our results suggested that the increased excretion of urinary phosphates was a significant risk factor for stone recurrence, which might be useful as a prognostic marker.
Calcium ; Chemistry ; Female ; Follow-Up Studies ; Humans ; Male ; Multivariate Analysis ; Phosphates ; Recurrence* ; Retrospective Studies ; Risk Factors ; Urinary Calculi

PURPOSE: We investigated the causative organism and its antibiotic susceptibility of community acquired urinary tract infection (UTI) in children at a secondary hospital to test the adequacy of the current guidelines. METHODS: Children diagnosed with UTI at the Department of Pediatrics, Kwandong University Myongji Hospital by pyuria and bacterial growth of greater than 1.0x10(5) CFU/mL on clean catch midstream urine from January 2005 to December 2008 were studied retrospectively. The epidemiologic data, causative organism, and the antibiotic susceptibility were analyzed. RESULTS: Sixty two children were diagnosed with sixty four cases of UTI's. Two bacteria were isolated in one case and thus data on 65 urine cultures were analyzed. The male:female ratio was 1.6:1 and 78.1% were less than 12 months of age. Escherichia coli was the predominant cause consisting of 53 cases (82.8%) of the cases. K. pneumoniae (5), Enterobacter (4), Enterococcus (1), beta-streptococcus (1), Diphtheroides (1) were isolated. The antibiotic resistance of E. coli were as follows; ampicillin 69.8%, cefotaxime 1.9%, gentamicin 15.1%, amikacin 0.0%, levofloxacin 1.9%, and trimethoprim/sulfamethoxazole 26.4%. Only one case of the E. coli was extended spectrum beta-lactamase (ESBL) positive. CONCLUSION: Compared to prior reports from other tertiary hospitals in Korea, E. coli was the predominant cause in childhood UTI and the rate of ESBL positivity was low. The antibiotic resistance was also different compared to prior reports. We conclude that a difference in the cause and antibiotic resistance of childhood UTI exists between centers and this should be taken into consideration when prescribing antibiotics for childhood UTIs.
Amikacin ; Ampicillin ; Anti-Bacterial Agents ; Bacteria ; beta-Lactamases ; Cefotaxime ; Child ; Drug Resistance, Microbial ; Enterobacter ; Enterococcus ; Escherichia coli ; Gentamicins ; Humans ; Korea ; Ofloxacin ; Pediatrics ; Pneumonia ; Pyuria ; Retrospective Studies ; Tertiary Care Centers ; Urinary Tract ; Urinary Tract Infections

PURPOSE: The resective treatment in mandibular Degree III furcation areas includes root resection and tunnel preparation. The purpose of this retrospective study is to evaluate which treatment procedure(root resection vs tunnel preparation) has more favorable prognosis in mandibular Degree III furcation involvement. MATERIALS AND METHODS: The subjects of this study were patients who were treated their mandibular posteriors with either root resection(22 teeth on 22 patients) or tunnel preparation(24 teeth on 22 patients) and have participated in periodic recall check program for at least 2 years. Failure rate, plaque index, bleeding on probing and probing pocket depth were measured and the results were compared and statistically analysed. RESULTS: Failure rates of root resection and tunnel praparation were 13.6% and 16.7%, respectively, and showed no significant difference between two procedures. No significant differences were observed between two procedures with respect to plaque index, bleeding on probing and probing pocket depth. CONCLUSION: root resection and tunnel preparation are both effective procedures to treat mandibular posterior furcation involvement, if adequate treatment of choice is made and patient's cooperation is accompanied. However, tunnel preparation is more preservative procedure in mandibular posterior furcation involvement since root canal treatment and prosthetic restoration are needed additionally, in case of root resection.
Dental Pulp Cavity ; Hemorrhage ; Humans ; Molar ; Prognosis ; Retrospective Studies ; Tooth

Central hyperthermia is a very rare disease; however, once it happens, it is associated with a poor prognosis and high mortality for patients with severe brainstem strokes. Following a pontine hemorrhage, a 46-years-old female developed prolonged hyperthermia. Work-ups to the fever gave no significant clues for the origin of fever, and hyperthermia did not respond to any empirical antibiotics or antipyretic agents. The patient's body temperature still fluctuated in a range of 37.5degrees C to 39.2degrees C. Considering the lesion of hemorrhage, we suspected central hyperthermia rather than infectious diseases. We started with baclofen administration at a dose of 30 mg/day. The body temperature changed to a range of 36.6degrees C to 38.2degrees C. We raised the dose of baclofen to 60 mg/day. The patient's body temperature finally dropped to a normal range. Central hyperthermia, caused by failures of thermoregulatory pathways in brainstem, following the pontine hemorrhage rarely occurs. Baclofen can be used to treat suspected central hyperthermia in a patient with pontine hemorrhage.
Anti-Bacterial Agents ; Antipyretics ; Baclofen* ; Body Temperature ; Brain Stem ; Communicable Diseases ; Female ; Fever* ; Hemorrhage* ; Humans ; Mortality ; Pons ; Prognosis ; Rare Diseases ; Reference Values ; Stroke

Central hyperthermia is a very rare disease; however, once it happens, it is associated with a poor prognosis and high mortality for patients with severe brainstem strokes. Following a pontine hemorrhage, a 46-years-old female developed prolonged hyperthermia. Work-ups to the fever gave no significant clues for the origin of fever, and hyperthermia did not respond to any empirical antibiotics or antipyretic agents. The patient's body temperature still fluctuated in a range of 37.5degrees C to 39.2degrees C. Considering the lesion of hemorrhage, we suspected central hyperthermia rather than infectious diseases. We started with baclofen administration at a dose of 30 mg/day. The body temperature changed to a range of 36.6degrees C to 38.2degrees C. We raised the dose of baclofen to 60 mg/day. The patient's body temperature finally dropped to a normal range. Central hyperthermia, caused by failures of thermoregulatory pathways in brainstem, following the pontine hemorrhage rarely occurs. Baclofen can be used to treat suspected central hyperthermia in a patient with pontine hemorrhage.
Anti-Bacterial Agents ; Antipyretics ; Baclofen* ; Body Temperature ; Brain Stem ; Communicable Diseases ; Female ; Fever* ; Hemorrhage* ; Humans ; Mortality ; Pons ; Prognosis ; Rare Diseases ; Reference Values ; Stroke

PURPOSE: Recent studies have shown the important roles of cyclooxygenase-2 (COX-2) in a variety of cancers derived from epithelial cells, such as human colorectal adenocarcinoma and other tumors, including those of the breast, cervix, and stomach. In this study, we purposed to evaluate the clinical significance of COX-2 expression in prostate cancer. MATERIALS AND METHODS: Tumor specimens from 25 patients, who underwent a transurethral resection (TUR) or radical prostatectomy, were obtained between March 1995 and August 2004 from the Department of Urology, Chungbuk National University Hospital. Benign prostatic hyperplasia (BPH) tissues were also acquired from 27 age-matched control patients. Immunohistochemical staining for COX-2 was performed on paraffin embedded specimens, using the anti-human COX-2 monoclonal antibody. The immunoreactivity of COX-2 was scored from 0 to 3 , according to the intensity of the staining. RESULTS: COX-2 expression was detected in 24 of the 25 tumor samples (96%), but in none of the 27 BPH tissues (p<0.001). There was no significant correlation between the COX-2 expression and Gleason score. CONCLUSIONS: This study shows that COX-2 is expressed in human prostate cancer, as in other cancers, which supports the possibility that COX-2 might play an important role in the development of human prostate cancer. Further studies will be required to clarify the role of COX-2 in the development and progression of prostate cancer.
Adenocarcinoma ; Breast ; Cervix Uteri ; Chungcheongbuk-do ; Cyclooxygenase 2* ; Epithelial Cells ; Female ; Humans* ; Immunohistochemistry ; Neoplasm Grading ; Paraffin ; Prostate* ; Prostatectomy ; Prostatic Hyperplasia ; Prostatic Neoplasms* ; Stomach ; Urology

PURPOSE: We investigated whether the expression levels of Transforming growth factor beta1 (TGF-beta1) and its receptors were related to the development, recurrence, progression and disease-free survival in the patients with bladder cancer. MATERIALS AND METHODS: The mRNA levels of TGF-beta1 and its receptors were examined in 102 tumor specimens from patients with primary bladder cancer, 29 corresponding normal bladder mucosae specimens surrounding these tumors and 15 normal bladder mucosae specimens by performing quantitative competitive PCR (QC-PCR). The protein levels of TGF-beta1 and its receptors were investigated by performing immunohistochemical staining on sections cut from 86 archival bladder tissue paraffin blocks. RESULTS: QC-PCR analysis showed that expressions of TGF-beta1, TGF-beta receptor I (TGF-betaRI) and receptor II (TGF-betaRII) in the superficial and low-grade bladder cancers were significantly higher than those in both the corresponding normal bladder mucosae surrounding the cancer (p= 0.0069, 0.0022 and 0.0046, respectively) and the control's normal bladder mucosae (p=0.0014, 0.0125 and 0.0089, respectively). Expressions of TGF-beta1 and its receptors were enhanced in the non-recurred and non-progressed patients compared to the recurred cases (p=0.0022, 0.0003 and 0.0001, respectively) and the progressed cases (p=0.0002, <0.0001 and <0.0001, respectively). Patients with high expression of TGF-beta and its receptors had a significantly higher disease-free survival rate than those patients with low expressions (p=0.0129, 0.0121 and 0.0132, respectively). CONCLUSIONS: The enhanced expression of TGF-beta1 and its receptors was correlated not only with superficial and low-grade bladder cancer, but also with enhanced patient survival. In conclusion, our findings suggest that the expressions of TGF-beta1 and its receptors are useful prognostic markers for a patient's resistance to disease recurrence and/or progression.
Disease-Free Survival ; Humans* ; Mucous Membrane ; Paraffin ; Polymerase Chain Reaction ; Receptors, Transforming Growth Factor beta ; Recurrence* ; RNA, Messenger ; Transforming Growth Factor beta ; Transforming Growth Factor beta1 ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: To evaluate the efficacy and the prognostic factors in arthroscopic treatment of degenerative arthritis of the knees MATERIALS AND METHODS: The results of 115 knees in 110 patients had been treated arthroscopically from Jan. 1990 to June 1999 were analysed. Mean age was 56 years old and mean follow-up period was 1 years 9 months(range: 1 year-7 year). Pain, Range of motion, Lysholm score, and changes of subjective symptoms were assessed for clinical evaluation, Preoperative and postoperative X-rays of the knees and arthroscopic findings were also reviewed and statistical analysis was performed. We tried to find out the clinical results and prognostic factars in arthroscopic treatment of the degenerative arthritis. RESULTS: The best clinical improvement was observed in postoperative 1-2 year period and the clinical improvement was continued by 3 years after surgery. Sixty two percents of patients had significant improvement of subjective symptoms for 1-2 year postoperatively, and 52% for at least 3 years after surgery. The patients of younger age, normal weight, normal alignment of lower leg(1 degrees - 7 degrees degree of tibio-femoral angle) and shorter duration of preoperative symptoms showed better clinical results. Eighty percents of improvement of subjective symptoms has been obseved in the group of patient who had the mechanical symptoms preoperatively. In the knee with mild cartilage degeneration(according to Jack-sons classification, stage I or II) and with torn meniscus showed better clinical improvement after surgery compared with those of severe cartilage degeneration or intact menisci. CONCLUSION: Arthroscopic treatment can be considered as a succesful treatment method for temperary relief of symptoms in the degenerative arthritis of knees. However, careful selection of patients looks mandatory for favorable results. The favorable prognostic factors in the study were younger age, no obesity, shorter duration of symptoms, nearly normal alignment of knees, less cartilage degeneration, mechanical symptoms, and torn meniscus.
Cartilage ; Classification ; Follow-Up Studies ; Humans ; Knee* ; Middle Aged ; Obesity ; Osteoarthritis* ; Range of Motion, Articular