This study was designed for the evaluation of the mean proportions and range of individual difference of muscle fiber types in human Gastrocneminus, Soleus, Peroneus longus and Tibialis anterior muscles, respectively. Flash-frozen muscle sections obtained from 15 cadavers were stained for H&E, trichrome, PAS, regular & reversed myosin ATPase, succinic dehydrogenase (SDH), acid phosphatase (Ac-Pase) and alkaline phosphatase (Alk-Pase). The results obtained were as follows. 1) Differentiation of muscle fiber types was not evident in H&E and trichrome stained specimen. Three types of muscle fibers were, however, evident in PAS-stained sections according to the degree of positivity in observed skeletal muscles. 2) Two fiber types (Types I and II) were only differentiated and the predominant muscle fiber type was type I by regular myosin ATPase reaction in Gastrocnemius, Soleus, Peroneus longus and Tibialis anterior muscles. 3) Three muscle fiber types (Type I, IIa and IIb) were, however, differentiated and the predominant muscle fiber type was type IIa, contrary to patterns of regular myosin ATPase in skeletal muscles except for Soleus muscle by reversed myosin ATPase stains. Only two muscle fiber types (Type I and II) and predominant type I fibers were shown in Soleus muscle. 4) SDH stains showed three types of muscle fiber except Soleus muscle. The mean proportions(%) of type 1 fibers were 48.0% in Gastrocnemius, 62.3% in Soleus, 40.8% in Peroneus longus, and 39.8% in Tibialis anterior muscles, respectively. 5) The mean proportions (%) of muscle fiber types in human skeletal muscles were markedly different, according to individuals and various enzyme histochemical stains. 6) The size of muscle fibers was relatevely small in type I fibers compared with type IIb. 7) Evaluation for the combination patterns of various enzyme histochemical activities showed that the common muscle fiber types (Type I, IIa and IIb) were markedly reduced in the mean proportions and unusual rare muscle fibers predominant. This predominance of unusual muscle fiber types and marked discrepancy in muscle fiber types between regular and reversed myosin ATPase seemed to be ascribed to decreased muscle enzyme activities following postmortem period.
Humans

Pyogenic vertebral osteomyelitis is rare. It most commonly occurs at the lumbar area and in the fifth to seventh decades of life. Most individuals present with back pain, abdominal pain, hip pain and meningeal syndrome. We experienced three cases of unusual patterns of pyogenic osteomyelitis. The first case developed after sepsis. The second case developed after open fracture and infection of other site. The third case was misdiagnosed as metastatic cancer. We present these cases with a brief review of literatures.
Abdominal Pain ; Back Pain ; Fractures, Open ; Hip ; Osteomyelitis ; Sepsis ; Spondylitis*

Fracture of the carpal scaphoid bone is the most common fracture of the carpus. Unfortunately, nonunion are common since the symptoms do not alert patents to seek early medical treatment and the diagnosis is easily missed. Fracture of the scaphoid is a common condition whose management remains controversial. The conservative treatment has many complications, these include inability to word while in plaster, stiffness of the wrist afterwards, muscle wasting, weakness and malunion. So various operative treatments of scaphoid fracture have been developed. Open reduction by use of screws suggested by Maclaughlin first in 1954. In 1984 a new and simple operative technique has been developed to provide rigid internal fixation for all types of fractures of the scaphoid by T.J. Herbert. This involves the use of a double-treaded bone screw which provides good fixation that, after operation, a plaster cast in rarely required and most patients are able to return to work within a few weeks. Authors have experienced 10 cases of scaphoid fracture and accomplished good result in all cases by internal fixation using Herbert screw. The results are as follows Of these 10 fractures, 2 were fresh fractures and 8 were nonunions of scaphoid fracture. In nonunion cases, the time interval between fracture and operation was from 5 months to 5 years. The postoperative immobilization period was average of 4 weeks. Short period of immobilization achieved early functional recovery of the wrist. The bony unions in roentgenogram were seen from 3 months to 9 months after operation. In 2 cases the fracture gap was seen after 9 months. But in these cases the symptoms such as pain and range of motion of wrist were improved.
Bone Screws ; Casts, Surgical ; Diagnosis ; Humans ; Immobilization ; Range of Motion, Articular ; Return to Work ; Scaphoid Bone ; Wrist

Among the complications of cataract surgery, the reported frequency of posterior capsular opacification was 20~50 percent. We experienced a case of new type of posterior capsular opacification in the seventy-one year old woman patient, who undertook the cataract operation with phacoemulsification six years ago and visited our hospital with the decreased vision. With biomicroscopic examination, posterior capsular opacification, creating a closed chamber between the lens and the posterior capsule in which a liquefied, milky white substance accumulates was detected. The patient was treated with Nd: YAG laser capsulotomy. To our knowledge, there has been no reported case of liquefied posterior capsular opacification in Korea. Therefore we report this case with literature review.
Cataract ; Female ; Humans ; Korea ; Lasers, Solid-State ; Phacoemulsification

PURPOSE: The purpose of this study was to evaluate the effects of revision endoscopic endonasal dacryocystorhinostomy (EDCR) and the causes of postoperative failure after primary endoscopic DCR in patients with nasolacrimal duct obstruction. METHODS: This prospective study enrolled 32 patients (32 eyes) who had undergone revision of endoscopic DCR with the diagnosis of obstruction of nasolacrimal system after primary EDCR between October 1997 and February 2003. RESULTS: The most common cause of revision operation after primary EDCR was granuloma, followed by membranous obstruction and common canalicular obstruction. The success rate of the cases with granuloma was 69.2%, and that with membranous obstruction was 100%. CONCLUSIONS: Revision EDCR success rate can be improved by reducing the frequency of granuloma as this was the most common factor for revision EDCR. The effect of antimetabolites in revision EDCR success rate is to be further evaluated.
Antimetabolites ; Dacryocystorhinostomy ; Diagnosis ; Granuloma ; Humans ; Nasolacrimal Duct ; Prospective Studies

No abstract available.
Ciprofloxacin* ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus*

BACKGROUNDS: Since the advent of MRI, cavernous angioma has been recognized as an important cause of chronic epilepsy. However, the natural course or optimal treatment strategies of chronic epilepsy with cavernous angioma have not been established yet. METHODS: We conducted a retrospective review of the Yonsei Epilepsy Data Bank and found 13 patients with characteristic MR findings of cavernous angioma who have been followed at the Yonsei Epilepsy Clinics for longer than one year. The clinical variables and outcome of the patients were analyzed. RESULTS: The subjects consisted of 7 men and 6 women. The age of seizure-onset was approximately 21 years old and the duration of seizure were 9 years. All patients in this study had small(< 2cm) and single cavernous angioma and the majority of lesions(9/13) were located in the temporal lobe. One patient also had hippocampal atrophy and another two had combined venous malformations. After adequate trials of antiepileptic drug therapy, 5 patients became seizure free, 2 patients showed worthwhile improvement and the remaining 6 patients did not have any improvement. The withdrawal of antiepileptic drugs was tried in two patients after seizure free period of 3 years but seizure recurred in all patients. Epilepsy surgery had been performed in two patients. One patient who had the left hippocampal atrophy has been remain seizure free after a standard anterior temporal lobectomy but the other patient who had performed a lesionectomy alone did not improve after surgery. During the period of follow up for about 36 months, no symptomatic bleeding had been occurred in any patiet included to the study. CONCLUSION: The incidence of hemorrhagic events in chronic epilepsy patients with cavernous angioma is extremely low. About half of the patients can be adequately managed by antiepileptic drugs therapy but the chance of successful withdrawal of AEDs seems slim.
Anterior Temporal Lobectomy ; Anticonvulsants ; Atrophy ; Drug Therapy ; Epilepsy* ; Female ; Follow-Up Studies ; Hemangioma, Cavernous* ; Hemorrhage ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Prognosis* ; Retrospective Studies ; Seizures ; Temporal Lobe ; Young Adult

BACKGROUND: Pachydermoperiostosis(PDP) is a rare genetic disease characterized by pachydermia, periostosis, arthralgia and finger clubbing. The pathogenesis of this disease is still unknown, but the concept that platelets and endothelial cells may play a major role in the developement of pachydermia is widely accepted nowadays, It is also suspected that several serum growth factors stimulate proliferation of soft tissue. OBJECTIVE: The purpose of this study was to investigate the pathogenesis of pachydermia in patients with pachydermoperiostosis through evaluating whether the fibroblasts from these patients have a higher proliferation rate than those from controls or whether the proliferation rate of those cells are affected by certain serum growth factors. METHOD: At first, we evaluated the proliferation rate of fibroblasts from patients and corntrols by the MTT colorimetric assay, and then the proliferation rate of fibroblasts from the prepuce of newborn infants under several conditions of media containing uncentrifuged patients serum, centrifuged patients serum, uncentrifuged control serum, or centrifuged control serum. RESULTS: The proliferation of fibroblasts from patients skin was slower than the control fibroblasts and fibroblasts derived from uninvolved skin of patients. The statistically significant highest proliferation rate was observed when fibroblasts were cultured in the uncentrifuged patients serum contained media and the order of proliferation was as follows: centrifuged patients serum, uncentrifuged control serum and centrifuged control serum condition at 20%, 10%, and 1% respectively. CONCLUSION: These results suggest that patients fibroblasts do not proliferate in vitro at a higher rate than control firoblasts. Fibroblasts in PDP may only play a role as target cells and certain serum factors are responsible for the pathogenesis of PDP.
Arthralgia ; Endothelial Cells ; Fibroblasts* ; Fingers ; Humans ; Infant, Newborn ; Intercellular Signaling Peptides and Proteins ; Osteoarthropathy, Primary Hypertrophic* ; Skin

BACKGROUND: Vasoconstrictors have been used as an adjunct to local anesthetics to prolong the duration of spinal anesthesia. Recently, clonidine, an 2-receptor agonist has been shown to prolong the duration of spinal anesthesia following intrathecal administration. Bupivacaine has been used for spinal anesthesia and compared with tetracaine in recent studies. We have undertaken this study to further evaluate the effect of clonidine in hyperbaric 0.5% bupivacaine spinal anesthesia. METHODS: Thirty patients who were scheduled for lower limb or urologic operation were divided into 2 groups: Group A (hyperbaric bupivacaine 13 mg, 2.6 ml + N/S 1 ml), Group B (hyperbaric bupivacaine 13 mg, 2.6 ml + clonidine 150 g, 1 ml). We used standardized techniques and injected above drugs to group A and B intrathecally for spinal anesthesia. We investigated the onset and the duration of spinal anesthesia along with hemodynamic changes (blood pressure and heart rate) in patients. RESULTS: There were no significant differences in the onset of spinal anesthesia and hemodynamic changes between two groups. The time taken to recover from the nerve block was more prolonged in the group B (touch 225, pain 262, foot dorsiflexion 271, knee flexion 290 minutes) than group A (touch 154, pain 188, foot dorsiflexion 198, knee flexion 216 minutes). There were no significant differences in sedation, and in experiencing dry mouth and other side effects between two groups. CONCLUSION: Intrathecal clonidine 150 g has been proved to prolong the duration of hyperbaric 0.5% bupivacaine spinal anesthesia without neurotoxicity or dangerous hemodynamic depression. Therefore, clonidine can be used as an effective adjunct in hyperbaric bupivacaine spinal anesthesia.
Anesthesia, Spinal* ; Anesthetics, Local ; Bupivacaine* ; Clonidine* ; Depression ; Foot ; Heart ; Hemodynamics ; Humans ; Knee ; Lower Extremity ; Mouth ; Nerve Block ; Tetracaine ; Vasoconstrictor Agents

The 38 kDa protein of Mycobacterium tuberculosis, which was known previously as antigen 5, has been extensively used in the serodiagnosis of tuberculosis. In an attempt to develop and evaluate a serodiagnostic test using the antigen, we expressed the 38 kDa protein in BCG and its seroreactivity was compared to that expressed in Escherichia coli. The coding region of the 38 kDa protein was amplified by PCR, and the gene was cloned into a Mycobacterium-E. coli shuttle expression vector pYMC-his and pQE30 expression vector and expressed in BCG and E. coli, respectively. Both recombinant 38 kDa proteins showed strong seroreactivity against pooled serum from tuberculosis patients. There was no significant difference in seroreactivity between the two recombinant antigens in sera from the far advanced tuberculosis patients. However, of 25 tuberculosis patients graded as ""minimal"" by chest X-ray, 5 (20.0%) were seropositive by r38 kDa expressed in E. coli, while 8 (32.0%) by that expressed in BCG. Likewise, higher seroreactivity by r38 kDa expressed in BCG was found in sera from the moderately advanced tuberculosis. This study thus indicates that the recombinant 38 kDa expressed in BCG is more effective than that expressed in E. coli in detecting antibodies to the native 38 kDa protein of M. tuberculosis in sera from minimally affected tuberculosis patients.
Antibodies ; Clinical Coding ; Clone Cells ; Escherichia coli ; Humans ; Mycobacterium bovis* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction ; Serologic Tests* ; Thorax ; Tuberculosis*