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: The treatment of chronic pelvic pain syndrome (CPPS) is based on antibiotic therapy, but many patients experience a relapse after treatment. Cranberry juice is known for its roles in both the treatment and prevention of urinary tract infections. This study was performed to evaluate the effectiveness of cranberry juice in the prevention of a relapse after the treatment of CPPS. MATERIALS AND METHODS: Fifty patients, diagnosed as CPPS (National Institutes of Health; NIH-catagory IIIa), were included in this study. All the patients had initially been treated with levofloxacin and supportive treatment for 8-12 weeks. After completion of the initial treatment, 26 volunteer patients were recommended to drink 150ml of cranberry juice twice a day, 24 patients, as a control group, received no cranberry juice and all the patients re-evaluated after 3 months. RESULTS: On initial diagnosis, the white blood cell (WBC) count in the high power field (HFP) of expressed prostatic secretions (EPS) and the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) in cranberry group were 18.2 3.4 and 23.1 4.4 and those of the control group 16.4 4.8 and 22.4 3.7, respectively. When the medical treatment was ended, the WBC of the EPS and NIH-CPSI in the cranberry group were 2.5 2.1 and 14.1 4.1, and those of the control group were 2.7 1.9 and 13.7 2.1, respectively. After the three month follow-up, the cranberry group showed a WBC of 2.2 2.5 in the EPS and a NIH-CPSI of 12.7 3.9, a slight decrease or similar result compared to the treatment completion period. No patient showed aggravation of symptoms after drinking cranberry juice, whereas five from the control group did. CONCLUSIONS: Cranberry juice showed an effect in the prevention of a relapse in CPPS patients, with no adverse effects.
Academies and Institutes ; Diagnosis ; Drinking ; Follow-Up Studies ; Humans ; Leukocytes ; Levofloxacin ; Pelvic Pain* ; Prostatitis ; Recurrence* ; Urinary Tract Infections ; Vaccinium macrocarpon* ; Volunteers

PURPOSE: To assess changes in MR signal intensity in the pars interarticularis and adjacent structures in pa-tients with lumbar spondylolysis. MATERIALS AND METHODS: The MR images of 36 patients with lumbar spondylolysis, confirmed by plain radiographs, were retrospectively analyzed. Using a 1.0T unit, we evaluated the signal intensity of a total of 216 parts interarticulares and adjacent structures from L3 to L5, as seen on sagittal images, and differences between areas with and without spondylolysis. The signal intensity of T1-and T2-weighted images was graded 0 (more hypointense than spinal body), 1(as isointense as spinal body), 2(more hyperintense than spinal body and more hypointense than epidural fat), or 3(as isointense as epidural fat). Signal intensity change in end-plates and degree of spondylolisthesis were analyzed, and the relationship between these factors was deter-mined. RESULTS: Spondylolysis was noted at L5 in 61 cases, at L4 in 22, and of L3 in no case. In three cases spondylolysis was unilateral, and in the remainder it was bilateral. The degree of signal intensity was the same on T1- and T2-weighted images, and no case was grade 0. Eighty-six of 133 areas without spondylolysis were grade 1, 43 were grade 2, and four were grade 3. In 42 of 47 cases, signal intensity change was localized at pedicles. Among 83 areas with spondylolysis, on the other hand, nine were grade 1, 48 were grade 2, and 26 were grade 3. Signal intensity change was most commonly observed at the pars interarticularis, pedicle, and lamina (50/74) (p<0.001). Signal intensity change at the pars interarticularis and adjacent structures was accompanied in most cases by degenerative endplate change(10/11) and spondylolisthesis(11/13) (p<0.001). CONCLUSION: In patients with spondylolysis, signal intensity was frequently higher at the pars interarticularis and adjacent structures, and is thought to have a close relationship with degenerative endplate change and spondylolisthesis. Increases in signal intensity at the pars interarticularis and adjacent structures can help diagnose spondylolysis in patients without spondylolisthesis.
Hand ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies ; Spondylolisthesis ; Spondylolysis*

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