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

OBJECTIVE: The goal of this study is to determine the efficacy of rapid karyotyping from fetal ascitic fluid. METHODS: In three cases of isolated fetal ascites diagnosed by prenatal ultrasonography, ultrasound guided fetal paracentesis and amniocentesis were performed and successfully obtained. Fetal karyotyping in each case at 29, 30 and 32 weeks gestation using modified lymphocyte culture method was conducted. RESULTS: The chromosomal analysis was successful within 72 hours and abnormalities were detected in two cases and revealed trisomy 21 in each case. Our study demonstrated that the majority distribution of white blood cells was lymphocytes which ranged from 2.1 * 10(6) cells/ml to 3.7 * 10(6) cells/ml and the cell density for culture was at least than 0.35 * 10(6) cells/ml. CONCLUSION: The use of ascitic fluid as a cell source to achieve rapid fetal karyotyping can be valuable when cordocenteis or amniocentesis would be technically more difficult, or when rapid result is required for planning of perinatal management at late second or third trimester gestational age.
Amniocentesis ; Ascites ; Ascitic Fluid* ; Cell Count ; Cytogenetics* ; Diagnosis* ; Down Syndrome ; Female ; Gestational Age ; Humans ; Karyotyping ; Leukocytes ; Lymphocytes ; Paracentesis ; Pregnancy ; Pregnancy Trimester, Third ; Ultrasonography ; Ultrasonography, Prenatal

No abstract available.
Leiomyoma*

Cardiac lymphangioma is one of the rarest, primary, benign tumor of the heart. We report a case of cardiac lymphangioma, which was diagnosed with CT and MRI in a 50 years old female. Plain chest film showed minimal enlargement and globular shape of the heart. On CT scan, abnormal fluid density mass lesion was noted within pericardial sac. The signal intensity was lower on T1-weighted image and hgher on T2-weighted image than that of the myocardium and located along the left atrioventricuar groove. Several small low signal spots representing hemorrhage were seen within this lesion.
Female ; Heart ; Hemorrhage ; Humans ; Lymphangioma* ; Magnetic Resonance Imaging ; Myocardium ; Thorax ; Tomography, X-Ray Computed

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

No abstract available.
Arthroplasty, Replacement, Hip*

Injury of the ankle ligaments is one of the most common sports-related injuries. Although there are some debates as to the best initial treatment for an acute tear of a lateral ligament, persistent functional instability of the ankle develops in approximately 20% of patients regardless of the type of initial treatment. In these patients, late reconstruction of the lateral ankle ligaments may become necessary. Among 13 cases which have been operated with Larsen procedure using peroneus brevis tendon from March 1991 to February 1993, the 11 cases followed up over 1 year were examined clinically and radiologically. We introduced the clinical analysis and results with the brief review of the literatures. 1. The indication of surgical treatment was the ankle instability which had differences over 10° in talar tilting angle or over 3mm in anterior displacement compared wit the uninjured site. 2. The postoperative results were 5 cases in excellent and 4 in good. 3. The Larsen procedure was considered a good method to anatomically and simply stabilize both the ankle and subtalar joint and to fix tendon depending on the type of instability.
Ankle ; Collateral Ligaments ; Humans ; Ligaments ; Methods ; Subtalar Joint ; Tears ; Tendons

PURPOSE: The nephrotic syndrome is characterized by proteinuria, hypoproteinemia, edema and hyperlipidemia. These can change body homeostasis and cause hypertension. This study was designed to determine the relationship between the forearm vasodilating capacity and serum cholesterol level of nephrotic syndrome patients. METHODS: 15 Nephrotic syndrome patients and 17 normal control children who visited Chung-ang University Youngsan Hospital from Sep. 1995 to Sep 1996, were investigated. Each subject underwent forearm plethysmography for mearsurement of blood flow and vascular resistance. RESULTS: 1) Resting blood pressure, heart rate, forearm blood flow, vascular resistance was not significantly different in nephrotic syndrome group and control group. 2) After peak hyperemic periods, blood pressure, heart rate was not significantly different in nephrotic syndrome group and control group. 3) After hyperemic periods, peak forearm vascular blood flow was lower in nephrotic syndrom group (52.0+/-10.6mL/min/100ml) than control group (59.5+/-4.5mL/min/100mL), and minimal forearm vascular resistance was significantly higher in nephrotic syndrome group (1.8+/-0.5mmHg/mL/min/100mL) than control group (1.5+/-0.4mmHg/mL/min/100mL) (p<0.05). 4) vascular dilatation capacity (resting-hyperemic forearm vascular resistance difference) was also significantly lower in nephrotic syndrome group (6.3+/-1.6mmHg/mL/min/100) than control group. 5) Serum cholesterol level is significantly higher in nephrotic syndrome group (253.1+/-133.4mg/dL) than control group (183.5+/-41.0mg/dL). High cholesterol level related with nephrotic duration. 6) resting-hyperemic forearm vascular resistance difference is associated with relapsing frequence, but not associated with cholesterol level and nephrotic syndrome duration. CONCLUSIONS: These data suggest that reactive vascular changes in the forearm of nephrotic syndrome demonstrate early abnormalities of subclinical vascular changes, and these vascular change may contribute to cardiovacular disease and artherosclerosis.
Blood Pressure ; Child* ; Cholesterol ; Dilatation ; Edema ; Forearm ; Heart Rate ; Homeostasis ; Humans ; Hyperlipidemias ; Hypertension ; Hypoproteinemia ; Nephrotic Syndrome* ; Plethysmography* ; Proteinuria ; Vascular Resistance

Primary non-Hodgkin's lymphoma of the brain is a rare malignancy and there are known to occur almost exclusively in brain parenchyme. Recent immunological advances and immunohistochemical techniques have provided new insights into the pathogenesis and diagnosis of the malignant lymphoma even in the small biopsied tissue and the majority of these CNS tumors is thought to be derived from B lymphocytes. A 22-year old man was admitted due to headack, dizziness and walking difficulty for 2 months. On the initial CT scan, there were two enhancing lesion in the suprasellar area and pineal gland which were completely disappeared with steroid therapy and three new lesions appeared on the follow-up CT and MRI studies in corpus callosum, third ventricle and left cerebral peduncle. The serial cytologic smears of cerebrospinal fluid and a stereotaxic biopsy tissue from the corpus callosum mass showed diffusely homogenous infiltration of neoplastic large noncleaved lymphocytes with focal perivascular arrangement. On the immunocytochemical stains, the reaction was negative for GFAP, positive for LCA and MB2, and negative for MT1. After radiation therapy, the masses completely disappeared on the follow-up CT scan and the patient was discharged free of all the clinical symptoms.
Male ; Humans ; Biopsy

PURPOSE: Chronic pelvic pain syndrome (CPPS) is the most common urogenital disease in middle aged men, and it shows various symptoms and a high recurrent rate. Uro-Vaxom(R) is effective for the treatment of urinary tract infection via the activation of the urothelial immune system. The main objectives of this study were to investigate the recurrence of CPPS and to find out if Uro-Vaxom(R) is helpful to suppress the recurrence of this condition. MATERIALS AND METHODS: After completing treatment for CPPS (NIH-IIIa 45, NIH-IIIb 85), 130 patients were given a 12 week course of Uro-Vaxom(R) 60mg once a day before breakfast. Sixty patients were also included in the study as a control group after they completed the treatment for CPPS (NIH-IIIa 22, NIH-IIIb 38). All of patients were reevaluated 12 weeks and 24 weeks later with the NIH-CPSI criteria and the EPS findings. RESULTS: The overall recurrent rate for NIH-IIIa disease was 22.7%, and it was 26.3% for the patients with NIH-IIIb disease in the control group, and it was 6.7% for the patients with NIH-IIIa disease and 7.1% for the patients with NIH-IIIb disease in the Uro-Vaxom(R) group (p<0.05). The classification of the recurrent CPPS was 46.7% NIH-IIIa and 53.3% NIH- IIIb in the control group, and 11.1% NIH-IIIa and 88.9% NIH-IIIb in the Uro-Vaxom(R) group. The possible predisposing factors related to the recurrence of CPPS were excessive alcoholic drinking (29.2%), overwork (25.0%) and stress (16.7%). In the non-recurrent patients, there was no change of the NIH-Chronic Prostatitis Symptom Index and the EPS findings for all patients during the follow-up period. CONCLUSIONS: There was about a 30% recurrence rate of CPPS within 6 months after treatment, and Uro-Vaxom(R) may play a significant role to suppress the recurrence of CPPS.
Alcoholics ; Breakfast ; Causality ; Classification ; Drinking ; Follow-Up Studies ; Humans ; Immune System ; Male ; Middle Aged ; Pelvic Pain* ; Prostatitis ; Recurrence* ; Urinary Tract Infections