The vestibular system is a sensory motor system concerned with the sensation of linear or angular acceleration, eliciting several vestibular postural reflexes. This study was designed to figure out the functional relationship in vestibulocollic reflex. The electromyographic responses of the cervical muscles were observed during stimulation of the horizontal semicircular canal nerves. The sternomastoid muscle was inhibited by stimulation of the ipsilateral horizontal canal nerve and excited by stimulation of the contralateral horizontal canal nerve. The splenius capitis muscle was inhibited by stimulation of the ipsilateral horizontal canal nerve and excited by stimulation of the contralateral canal nerve. The semispinalis capitis revealed same pattern responses as splenius capitis or sternomastoid muscles to stimulation of the horizontal canal nerve. These experimental results indicate that the cervical extensor or flexor muscles respond in a uniform fashion to the stimulated horizontal canal nerve. And taken these results and other morphological study results together, the excitatory neural pathways from the vestibular nucleus in brain stem to cervical motoneurons are crossed to the opposite side but the inhibitory pathways from the nucleus to the cervical motoneurons are uncrossed.
Acceleration ; Animals ; Brain Stem ; Cats* ; Muscles ; Neck Muscles* ; Neck* ; Neural Pathways ; Paraspinal Muscles ; Reflex ; Semicircular Canals* ; Sensation

No abstract available.
Cervix Uteri* ; Classification* ; Female ; Humans*

To assess the efficacy of 2 different mitral balloon valvotomy (PMV) techniques, PMV was performed using Inoue balloon (I) in 35 pts and double balloon (D) in 33 pts with mitral stenosis (male 27, female 41, mean age 42+/-12 years). The success rate of PMV was 89%(31/35 pts) in I group and 97%(33/33 pts) in D group. Mitral valve area after dilation increased equally effectively in both groups (I and D) from 0.9+/-0.2 and 0.8+/-0.2 to 1.9+/-0.2 and 1.9+/-0.3cm2 respectively (p<0.0001). There were no differences in degree of improvement of cardiac output, mitral gradient, left atrial pressure, pulmonary artery pressure and various doppler echocardiographic findings in both groups, but EF slope was more improved from 13+/-7 to 48+/-16 mm/sec in D group than those (from 15+/-6 to 39+/-15mm/sec) of I group. Increments of long and short diameters of mitral valve orifice by 2D-echocardiogram were 1.1+/-0.6 and 0.3+/-0.3cm in D group and 0.9+/-0.5, 0.4+/-0.3cm in I group. The ratio of long and short diameter increase was significantly larger in D than that of I group (long/short 2.8+/-0.7 vs 2.4+/-0.7, p<0.05) and short diameter of orifice after dilation was more improved in I than that of D group (1.1+/-0.2 vs 1.0+/-0.2cm p<0.05). Complications included deflation failure of Inoue balloon in 2, and cerebral embolic episode in 1 (D). Incidence of increased mitral regurgitation was 50% in D and 45% in I, development of ASD (Qp/Qs>1.2) was 20% in D, 13% in I group respectively and mean amount of left to right shunt (Qp/Qs) was 1.7+/-0.3 in D and 1.5+/-0.1 in I group. Total procedure and fluoroscopic time were 84+/-24 and 25+/-11 min. in D and 56+/-20 and 16+/-6 min. In I, which had statistically significant differences (p<0.002). Thus we concluded PMV using Inoue or double balloons was equally effective in selected patients. Total procedure and fluoroscopic time of Inoue balloon technique were significantly shorter than those of double balloons. Double balloon technique had more tendency of longitudinal splitting of the commissures.
Atrial Pressure ; Balloon Valvuloplasty* ; Cardiac Output ; Echocardiography ; Female ; Follow-Up Studies* ; Humans ; Incidence ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Pulmonary Artery

BACKGROUND: To investigate the effectiveness of reverse total shoulder arthroplasty (RTSA) in treating irreparable massive rotator cuff tears (RCTs). METHODS: Twenty-nine patients who underwent RTSA for the treatment of irreparable massive RCTs and completed follow-up for at least 1 year were selected. Their mean age was 69.7 years (range, 59-80 years). The mean follow-up was 17.7 months (range, 12-42 months). The shoulder range of motion was measured preoperatively and at final follow-up. The functional result was evaluated using visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeon (ASES) score, and Korean Shoulder Society (KSS) score. Additionally, the shoulders were categorized into two groups depending on prior history of surgery and the clinical outcomes were analyzed between two groups. RESULTS: Mean pain VAS improved, from 6.6+/-1.2 to 2.7+/-0.9 (p=0.001), and the mean functional VAS from 35.7+/-4.2 to 73.3+/-5.4 (p=0.006). The mean ASES score improved from 37.2+/-2.8 to 75.0+/-3.8 (p=0.012). The mean KSS improved from 36.5+/-7.2 to 75.6+/-5.4 (p=0.009), the mean forward elevation from 66.3+/-4.7 to 135.6+/-8.4 (p=0.0001), and the mean abduction from 45.2+/-4.2 to 119.0+/-6.5o (p=0.0001). Internal rotation differed significantly from the first sacral to the third lumbar vertebrae (p=0.036). External rotation did not change significantly (p=0.076). There was also no statistically significant difference between groups (no previous operation versus none). Four complications occurred: one superficial infection, one with anterior dislocation, one acromial fracture, and one clavicle fracture. CONCLUSIONS: RTSA provides reliable pain relief and recovery of shoulder function in patients with massive irreparable RCTs in short-term follow-up.
Arthroplasty* ; Clavicle ; Dislocations ; Elbow ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; Range of Motion, Articular ; Rotator Cuff* ; Shoulder* ; Visual Analog Scale

No abstract available.
Erythroblastosis, Fetal* ; Infant, Newborn

Vasectomy has become a popular method for male sterilization in Korea and this, in turn, has been followed by an increase in the number of patients requesting vasectomy reversal. Recently, many authors have reported a high success rate of vasovasostomy using microsurgical techniques. However, a significant discrepancy persist between the patency and pregnancy rate despite improvements in surgical techniques. A total of 200 patients undergoing vasovasostomy from May 1983 to April 1990 were reviewed. Of these 200 patients, only 130 patients (98 patients by two-layer, 32 patients by modified two-layer technique) could be followed up and analyzed as to pregnancy rate related to age, vasal obstructive interval, gross appearance and sperm quality of the vas fluid, operative method, and presence or absence of sperm granuloma. Success rates were 90.3% for patency and 65.4% for pregnancy. With regard to factors influencing to operation, it seemed that the results were better when there was a shorter vasal obstructive interval, watery vas fluid, presence of normal morphologic sperm quality, presence of sperm granuloma, and when the operation was done using the two-layer technique. However, no statistically significant difference was found, except between the bilateral presence and absence of sperm granuloma at the vasectomy site. Thus it is suggested that the most important single factor influencing the success rate of vasovasostomy is a meticulous and skillful operative technique itself, althought other factors may affect the outcome. More effort and research are needed to find the factors affecting the success rate of vasovasostomy.
Granuloma ; Humans ; Infertility* ; Korea ; Pregnancy Rate ; Pregnancy* ; Spermatozoa ; Sterilization, Reproductive ; Vasectomy ; Vasovasostomy*

In the present study, we examined to determine the development of various lymphoid tissue including mucosa-associated lymphoid tissue (MALT), thymus, lymph node and liver. In order to investigate the relationship between the morphological events and the expression pattern of MIC2 antigen (CD99) during the development of lymphoid system, we performed the immunohistochemical study using DN16, a monoclonal antibody against MIC2 (CD99), on formalin-fixed and paraffin-embedded lymphoid sections in 68 human embryos and fetuses, between 5 and 39 gestational week (GW). Four neonates, an infant, and 5 adults are also included. CD99 has been expressed along the membrane of hepatocytes and sinusoidal endothelial cells for 10-28 GW, in when the liver the major site of hematopoiesis. In the thymus, CD99 was firstly detected in the presumptive epitheial cells at 10 GW. When the thymus matured and corticomedullary differentiation appeared, CD99 was exclusively expressed in cortical thymocytes. The CD99 expression in epithelial cells of MALT has initiated at 6 GW and 10 GW earlier than that at the onset of MALT development and its expression has been persisted during MALT formation especially 16-25 GW. The finnding that CD99 antigen was expressed in epithelial cells during the development of MALT rnight provide a means to identify a novel epithelial differentiated substance. In addition, endothelial cells that are present in various organs such as liver and small intestine concurrently expressed CD99 antigen and its expression persisted to late fetal period. This point rnight suggest that CD99 antigen regulate the irnigration of lymphocytes from liver, major hematopoietic organ, to thymus or peripheral lyrnphoid organ via the interaction between endothelial cells and lymphocytes.
Adult ; Embryonic Structures* ; Endothelial Cells ; Epithelial Cells ; Fetus* ; Hematopoiesis ; Hepatocytes ; Humans* ; Infant ; Infant, Newborn ; Intestine, Small ; Liver ; Lymph Nodes ; Lymphocytes ; Lymphoid Tissue* ; Membranes ; Thymocytes ; Thymus Gland

The purpose of this study is to compare the biologic properties of tendon to hone healing and hone to hone healing in knee ligament reconstruction. The lateral 4mm of patellar tendon which was detached from its tihial insertion site either subperiostcally(group I) or with a bone block(group II) was implanted and fixed using pullout method to the proximal tihia. Ten rabbits were killed at each of four time periods (two, four, eight and twelve weeks after the implantation), and the histological and biomechanical characteristics of thc graft healing sites were evaluated. Serial histological analysis of tendon to hone healing group revealed organization of the healing site similar to normal tendon to hone attachment by twelve weeks, while hone to bone healing group demonstrated direct hony union by eight weeks. The tension failure test for the patellapatellar tendon graft - tihia complex revealed that group II had significantly higher values than group I at four and eight weeks. The findings ot this study demonstrated that bone to hone healing has more rapid process than tendon to hone healing, although no significant difference was noted once the healing has matured. We can suggest lhat the duration and extent of postoperative protection of the knee for pntients who had a reconstruction of a ligament using hone - lendon autograft should be longer and higher than lor patients who had a reconstruction using hone - tendon hone autogralf.
Autografts* ; Dronabinol ; Humans ; Knee ; Ligaments ; Patellar Ligament* ; Rabbits* ; Tendons* ; Transplants

No abstract available.
Compensation and Redress*

Arthroscopic surgery of the knee is now a widely performed orthopedic technique. Of this, arthrosoopic surgery of discoid meniscus is one of the most technically demanding procedures of this field. In our experience, discoid meniscus was appeared to be frequently accompanied with villous hypertrophied synovium, which obstructed the arthroscopic view. The purpose of this study is to prove the presence of synovial hypertrophy in discoid meniscus and to develop an adequate portal of entry for successful arthroscopic surgery of discoid meniscus. 155 cases of arthroscopy of the knee were performed at the Department of Orthopedic Surgery, College of Medicine, Seoul National University between January 1987 and March 1988. Of these, 25 cases were discoid menisci and they were all lateral. Operative findings were observed through arthroscopy and they were also reviewed by recorded video tapes in 25 cases of arthroscopic surgery of discoid meniscus and 57 cases of non-discoid meniscal lesions for the presence of synovial hypertrophy. Synovial biopsy was performed in selected cases with synovial hypertrophy for observation of histological findings. Hypertrophied synovium in discoid meniscus was mainly localized in anterior compartment and intercondylar area of tibia. Therefore, when conventional anterolateral or anteromedial portals were used, much difficulty was confronted because hypertrophied synovium obstructed the visual field and crowding with surgical instruments was occurred in restricted space of discoid meniscus. Much more clear visual field was obtained when the medial midpatellar portal was used instead of conventional portals. The conclusions of this study are as follows : 1. The incidence of discoid meniscus was 16.1%. 2. Synovial hypertrophy was present in all 25 cases of discoid meniscus and 21 cases among 57 non-discoid meniscal lesions(35%) on operative findings 3. Synovial biopsy of hypertrophied synovium showed irritative nonspecific inflammatory lesions but there was no histologicsl differences between discoid and non-discoid meniscus. 4. Medial midpatellar portal is considered to be better approach than conventional portals for clear visual field and less crowding with instruments in arthroscopic surgery of lateral discoid meniscus.
Arthroscopy ; Biopsy ; Crowding ; Hypertrophy ; Incidence ; Knee ; Orthopedics ; Seoul ; Surgical Instruments ; Synovial Membrane ; Tibia ; Visual Fields