Since the first experimental nerve graft by Philipeaux and Vulpian in 1870, many successful graft have been reported by Bunnell, Boyes, Millesi, Sunderland and Seddon. Advances in microsurgery techniques prompted Millesi to introduce the concepts of interfascicular nerve grafting whereby groups of fascicles, and not whole nerve, are connected together. Hunt and Taylor described a free vasculized nerve graft with microvascular anastomoses and obtained rapid axonal advance and maturation of grafted nerve in a clinical case. It is true that a nerve graft should be inferior to an end-to-end nerve repair, because in the case of nerve grafting the axon have to cross two suture lines instead of one. On the other hand, nerve grafting is indicated whenever a significant gap is produced in a nerve as a result of injury. In a retrospective study of 46 patients, defect of the nerve with treated by nerve graft were analyzed from March, 1983 to January, 1993 and following results were obtained. 1. Nerve graft was useful method to repair nerve whenever a significant gap is produced in a nerve as a result of injury. 2. The sural nerve was used as a donor nerve and vasculized nerve graft can be useful. 3. Postoperative results of cases caused by electric burns were worse than others. 4. There were little significant value in the treatment results between epineural and perineural nerve graft. 5. Recovery of intrinsic function in median and ulnar nerve lesion above the elbow was poor and recovery of the intrinsic function in median nerve graft at the forearm level was better than level for lesion in the ulnar nerve at the same level.
Axons ; Burns, Electric ; Elbow ; Forearm ; Hand ; Humans ; Male ; Median Nerve ; Methods ; Microsurgery ; Retrospective Studies ; Sural Nerve ; Sutures ; Tissue Donors ; Transplants ; Ulnar Nerve

A 63 Year-old-lady has had substernal chest pain on exertion for 8 years. The chest pain has been increased over the last 3 years. A continuous murmur was heard at the left second to third inercostal spaces along the left sternal border. The electrocardiogram showed the inverted T-waves in the precordial leads. The right heart catheterization revealed 5% oxygen step up between RV and PA. The right sided pressures were normal. The coronary arteriography revealed markedly tortuous vessels starting shortly after the left main stem coronary artery was normally originated. One of the large vessel was shown to be drained into the pulmonary artery. In the operation room, without using heart-lung machine this abnormally drained vessel was simply ligated at it's draining site into pulmonary artery. After the operation the patient is feeling well with little symptoms and the continuous murmur is no longer heard.
Angiography ; Arteriovenous Fistula* ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Coronary Vessels* ; Electrocardiography ; Heart-Lung Machine ; Humans ; Middle Aged* ; Oxygen ; Pulmonary Artery*

Ganglia of the cruciate ligament are quite rare. About 60 cases were reported previously in the world and 6 cases were reported at two articles in korea. It's symptoms may be similar to those of internal derangement of knee, especially meniscal lesion. We report a case of isolated ganglion of posterior cruciate ligament with brief of literatures.
Ganglia ; Ganglion Cysts* ; Knee ; Korea ; Ligaments ; Posterior Cruciate Ligament*

Reliable and valid evaluation of hand strength is of paramount importance in determining the effectiveness of various normative data area needed to interpret evaluation data, to set realistic treatment goals and to assess a patient's ability to return to employment. The primary purpose of this study was to establish normal value of grip and pinch strength for men women in normal Korean adult. A Jamar dynamometer(Hydraulic Hand Dynamometer. PC 5030, USA) was used to measure grip strength and Jamar pinch gauge(Hydraulic Pinch Gauge, PC 5030HPG, USA)was used to measure tip, key and palmar pinch. Two hundreds forty eight male and two hundreds thiry one female adults, aged 20 to 74 years were tested for using standardized positioning with their shoulder adducted and neutrally rotated, elbow flexed at 90。 and the forearm and wrist in neutral position. Right and left hand data were stratified into age groups for both sexes. This stratification provides a means of comparing the scores of individuals to that of normal subjects of the same aged and sex. The following results were obtained; 1. The average grip strength of the dominant hand was highest(43.9±7.3kg)in 3rd decade male group. 2. The average tip pinch strength of the dominant hand was highest in 4th decade(7.3±3.5kg)and 5th decade (7.3±2.4kg) male group. 3. The average key pinch strength of the dominant hand was highest in 5th decade(8.3±2.3 kg)male group. 4. The average palmar pinch strength of the dominant hand was highest in 4th decade(9.6±3.3 kg)male group. 5. A high correlation was seen between grip strength and age, but a low correlation between pinch strength and age. 6. The average grip strength of dominant hand was 5.6% higher than that of nondominant hand in men, and 6.5% higher in women. 7. In pinch strength, palmer pinch strength was highest among the three groups of pinch strength, then key pinch and tip pinch strength in order. 8. The mean scores of the dominant hand were larger than that of the nondominant hand on all hand strength.
Adult ; Clinical Study ; Elbow ; Employment ; Female ; Forearm ; Hand ; Hand Strength ; Humans ; Male ; Pinch Strength ; Reference Values ; Shoulder ; Wrist

The contour of mandibular angle is important for facial esthetics in the oriental population, because the wide and square face is thought to have had an unhappy life. A prominent mandibular angle produces a characteristics quardrangle, coase, and muscular appearance. So, uni- or bi-lateral mandibular angle reduction is usually performed. However, there is little guideline for bi-lateral angle reduction. So, this study was to investigate the pattern of Korean mandibular angle for bi-lateral mandibular angle reduction as guideline. This study was included 66 adult men and women over 19 years old who are having the normal mandibular angle. We measured the posterior border, angle, and inferior border of mandible using cephalometric view. The results of study was as followed : 1. The ratio of posterior mandible was 96.6, 97.3% in male, and 103.0, 106.0% in female. 2. The ratio of mandibular angle(R1-Go/R1-R2) was 120.2% in male, and 117.3% in female. 3. The ratio of inferior mandible(D5, 6, 7, E, F, G/D4) was 97. 3, 90.9, 79.5, 65.2, 57.8, 46.9% in male, and 98.5, 91.2, 80.5, 67.6, 59.1, 50.2 % in female. The results of this study should be useful to decide accurate amount of reduction.
Adult ; Esthetics ; Female ; Humans ; Male ; Mandible ; Young Adult

PURPOSE: To compare the effect of nerve regeneration with infiltration of normal saline and nerve growth factor after vein graft to the resected sciatic nerve of rat. MATERIALS AND METHODS: Eighty Sprague-Dawley rats were divided into five experimental groups: orthotopic nerve graft as control group, inside-in vein graft with normal saline infiltration, inside-out vein graft with normal saline infiltration, inside-in vein graft with nerve growth factor infiltration and inside-out vein graft with nerve growth factor infiltration group. Animals of each group were sacrificed after electromyography at 2, 4, 8 and 12 weeks after operation. Also the light microscopy and transmission electron microscopy were performed to observe histologic change of grafted sites. RESULTS: This study demonstrates that autogenous vein graft serves as a conduit for nerve regeneration, and inside-out vein graft technique and nerve growth factor induce faster and more numerous axonal regeneration and earlier recovery of muscle power. CONCLUSION: Inside-out vein graft with nerve growth factor infiltration is supposed to be a promising technique to take the place of autogenous nerve graft.
Animals ; Axons ; Electromyography ; Microscopy ; Microscopy, Electron, Transmission ; Nerve Growth Factor* ; Nerve Regeneration* ; Rats ; Rats, Sprague-Dawley ; Regeneration ; Sciatic Nerve* ; Transplants* ; Veins*

PURPOSE: To compare the effect of nerve regeneration with infiltration of normal saline and nerve growth factor after vein graft to the resected sciatic nerve of rat. MATERIALS AND METHODS: Eighty Sprague-Dawley rats were divided into five experimental groups: orthotopic nerve graft as control group, inside-in vein graft with normal saline infiltration, inside-out vein graft with normal saline infiltration, inside-in vein graft with nerve growth factor infiltration and inside-out vein graft with nerve growth factor infiltration group. Animals of each group were sacrificed after electromyography at 2, 4, 8 and 12 weeks after operation. Also the light microscopy and transmission electron microscopy were performed to observe histologic change of grafted sites. RESULTS: This study demonstrates that autogenous vein graft serves as a conduit for nerve regeneration, and inside-out vein graft technique and nerve growth factor induce faster and more numerous axonal regeneration and earlier recovery of muscle power. CONCLUSION: Inside-out vein graft with nerve growth factor infiltration is supposed to be a promising technique to take the place of autogenous nerve graft.
Animals ; Axons ; Electromyography ; Microscopy ; Microscopy, Electron, Transmission ; Nerve Growth Factor* ; Nerve Regeneration* ; Rats ; Rats, Sprague-Dawley ; Regeneration ; Sciatic Nerve* ; Transplants* ; Veins*

PURPOSE: To compare the effect of nerve regeneration with infiltration of normal saline and nerve growth factor after vein graft to the resected sciatic nerve of rat. MATERIALS AND METHODS: Eighty Sprague-Dawley rats were divided into five experimental groups: orthotopic nerve graft as control group, inside-in vein graft with normal saline infiltration, inside-out vein graft with normal saline infiltration, inside-in vein graft with nerve growth factor infiltration and inside-out vein graft with nerve growth factor infiltration group. Animals of each group were sacrificed after electromyography at 2, 4, 8 and 12 weeks after operation. Also the light microscopy and transmission electron microscopy were performed to observe histologic change of grafted sites. RESULTS: This study demonstrates that autogenous vein graft serves as a conduit for nerve regeneration, and inside-out vein graft technique and nerve growth factor induce faster and more numerous axonal regeneration and earlier recovery of muscle power. CONCLUSION: Inside-out vein graft with nerve growth factor infiltration is supposed to be a promising technique to take the place of autogenous nerve graft.
Animals ; Axons ; Electromyography ; Microscopy ; Microscopy, Electron, Transmission ; Nerve Growth Factor* ; Nerve Regeneration* ; Rats ; Rats, Sprague-Dawley ; Regeneration ; Sciatic Nerve* ; Transplants* ; Veins*

Although it is evident that even a very short below knee stump is superior to the lengest above knee stump, short below knee stumps present difficult pmblems in fitting prostheses. To solve these problems, twenty-nine short below knee amputees, those could not be fitted prostheses because of stump complications, had been treated by fibulectomy and resection of the peroneal nerve from March 1978 to March 1983. All the cases were followed up average 2 years and 3 months and the following results were obtained: 1. The complications of short below knee stumps decreased significantly after fibulectomy and res ection of the peroneal nerve. 2. After fibulectomy, weight bearing areas under the lateral tibial condyle increased considerably. 3. In group of below knee stumps between 5cm and 7.4cm long, P.T.B. prostheses with metal joints and thigh corsets should be fitted without difficulties. 4. In group of short below knee stumps between 7.5cm and 9.9cm long, P.T.B. prostheses with steel joints and thigh corsets, P.T.B. prostheses with knee cuff only, or supracondylar P.T.B. prostheses (K. B. M.) could be fitted selectively without any difficulty. 5. In group of short below knee stumps between 10cm and 12cm long, P. T.B. prostheses with knee cuff only or supracondylar P. T.B. prostheses could be fitted selectively without any difficulty. 6. After fibulectomy and resection of the peroneal nerve, all the short below knee amputees except for one case of very short stump (4.5cm long) could walk with their prostheses satisfactorily.
Amputees ; Humans ; Joints ; Knee ; Peroneal Nerve ; Prostheses and Implants ; Steel ; Thigh ; Weight-Bearing

OBJECTIVE: This study was performed to determine the anatomical landmarks and optimal dissection points of the facial nerve (FN) and the hypoglossal nerve (HGN) in the submandibular region to provide guidance for hypoglossal-facial nerve anastomosis (HFNA). METHODS: Twenty-nine specimens were obtained from 15 formalin-fixed adult cadavers. Distances were measured based on the mastoid process tip (MPT), common carotid artery bifurcation (CCAB), and the digastric muscle posterior belly (DMPB). RESULTS: The shortest distance from the MPT to the stylomastoid foramen was 14.1+/-2.9 mm. The distance from the MPT to the FN origin was 8.6+/-2.8 mm anteriorly and 5.9+/-2.8 mm superiorly. The distance from the CCAB to the crossing point of the HGN and the internal carotid artery was 18.5+/-6.7 mm, and that to the crossing point of the HGN and the external carotid artery was 15.1+/-5.7 mm. The distance from the CCAB to the HGN bifurcation was 26.6+/-7.5 mm. The distance from the digastric groove to the HGN, which was found under the DMPB, was about 35.8+/-5.7 mm. The distance from the digastric groove to the HGN, which was found under the DMPB, corresponded to about 65.5% of the whole length of the DMPB. CONCLUSION: This study provides useful information regarding the morphometric anatomy of the submandibular region, and the presented morphological data on the nerves and surrounding structures will aid in understanding the anatomical structures more accurately to prevent complications of HFNA.
Adult ; Cadaver ; Carotid Artery, Common ; Carotid Artery, External ; Carotid Artery, Internal ; Facial Nerve ; Humans ; Hypoglossal Nerve ; Mastoid ; Muscles