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

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

No abstract available.
Leiomyoma*

No abstract available.
Arthroplasty, Replacement, Hip*

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

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: 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*

In performing general anesthesia, the endotracheal tubes are most commonly used and the space between trachea and tubes are sealed with inflatable cuffs to apply positive pressure ventilation. But in children, especially small children, a plain oral-tracheal tube is to be used. The subglottic region is very narrow and the tubes of the small diameter are used. The endotracheal tub. cuffs are not used and the largest correct sized tubes may cause air leak around them. The V-pack, designed by Vickery and Burton and manufactured at Dentmad Ltd, England was used to seal the laryngeal inlet to control air leak during intermittent positive ventilation. This attempt seems to be very successful to prevent air leaks around trachea in case of ruptured inflatable cuffs of the adult during surgery. The damage of tracheal wall by increasing pressure of endotracheal cuff with nitrous oxide-oxygen anesthesia will be prevented when using V-packs. The V-packs were inserted with plain endotracheal tubes to throat to evaluate the efficacy of sealing the air leak around trachea and the post-operative sore throat with 10 adults(age between 21 and 72) and 10 children (age between 2 and 6). In the all cases, 1) The sealing of air leakage around throat with V-pack use was satisfactory. 2) Three out of ten adult cases, slight sore throat were complained but there were none such cases in children. 3) The V-pack was shown to te especially effective and convenient to seal the air leak around trachea when plain-endotracheal tubes were intubated through nasotracheal route. 4) Additionally, in two adult cases with the punctured endotracheal cuffs during surgery, the V-pack was satisfactory to seal the air leak around trachea during positive pressure ventilation.
Adult ; Anesthesia ; Anesthesia, General ; Bays ; Child ; Clinical Study* ; England ; Humans ; Pharyngitis ; Pharynx* ; Positive-Pressure Respiration ; Trachea ; Ventilation