Adhesion formed between tendon and its sheath after repair often impairs functional recovery. There have been many attempts to reduce adhesion around a repaired tendon, but most results have been unsatisfactory or impractical in clinical application. Moreover, most attempts were focused on extrinsic tendon healing. whereas studies on the intrinsic tendon healing are sacrce in the literature. We have previously reported that fibrotic tendon adhesion after repair was decreased by decorin, a natural inhibitor of TGF-beta. Accordingly, the serial tensile strength was measured after complete tensection and repair of the tendon severance in order to confirm the effect of decorin inhibition of intrinsic healing capability. Forty White Leghorn chickens were subject to complete transection and repair of the third toe flexor digitorum profundus tendon in Zone II. In the experimental group, 0.5ml of diluted decorin(50microgram/ml) was injected around the repaired site, and the same volume of saline solution in the control group. Tendons were harvested at 1, 3, 5 and 7 weeks. The disrupting force of the repair site was analyzed using tensiometry(LLOYD LR 30K, U.K). The tensile strength of repaired tendon was similar in both groups for all postoperative periods. This indicates that intrinsic healing proceeds normally within the decorin group in spite of the blockade of TGF-betaactivity. Decorin, a natural inhibitor of TGF-beta, showed a significant inhibitory effect on reducing post-repair tendon adhesions, without disruption of intrinsic healing in the chicken flexor tendon injury model. Therefore, decorin is expected to be a useful agent for preventnion on tendon adhesion after the repair in clinical usage.
Chickens ; Decorin* ; Postoperative Period ; Sodium Chloride ; Tendon Injuries ; Tendons* ; Tensile Strength* ; Toes ; Transforming Growth Factor beta

No abstract available.
Facial Asymmetry

BACKGROUND AND OBJECTIVE: The clinical manifestation of Henoch-Schonlein purpura and existance of renal involvement may influence on its course and prognosis. To verify prevention with early administration of steroid, we studied the efficacy of corticosteroid treatment. MATERIAL AND METHOD: We analysed 65 children under 15 years of age with Henoch-Scho nlein purpura according to their age, sex, and seasonal incidence. Forty children showed typical skin lesions, arthralgia and abdominal pain. We have divided them two groups. Group A consisted of 20 children who received 1 mg/kg of prednisolone/perday for 2 weeks and group B did not. We carried out their physical examination and urinalysis monthly for a year. RESULT: The main clinical manifestations were skin rash(100% ), abdominal symptoms(41.5 %), joint symptoms (49.2%), and renal involvement(34%). As for gastrointestinal symptoms, abdominal pain(66.7% ) was most commonly observed one and others were nausea or vomiting (44.7%) and melena(25.9%). The joint involvement was observed mostly in knee(56.3%) and ankle joint(31.3% ), Hematuria was observed in all cases with renal involvement and proteinuria, in 28% of them. The improvement of renal manifestations were noted in 84.2% of them within 4 months. Mild elevation of IgA was more frequently observed in renal involvement group than non-involved group (p< 0.01). There were no significant differences in immonologic parameters such as IgG, IgM, IgE, duration of the acute phase and severity of cutaneous symptoms between two growps. None of steroid treated growp showed progression of nephropathy. Of the 20 non-steroid treated growp, 2(10%) developed nephropathy. Conclusion We may suggest that existance of renal involvement in Henoch-Schonlein purpura influences its course and prognosis.
Abdominal Pain ; Ankle ; Arthralgia ; Child ; Hematuria ; Humans ; Immunoglobulin A ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Joints ; Nausea ; Physical Examination ; Prognosis ; Proteinuria ; Purpura* ; Purpura, Schoenlein-Henoch ; Seasons ; Skin ; Urinalysis ; Vomiting

OBJECTIVES: Developing mental health services and systems to identify children with Attention Deficit/Hyperactivity Disorder (ADHD) and providing early therapeutic interventions for them are important to prevent further impairments or disturbances associated with the disorder. The purpose of this study is to examine the clinical validities and efficiencies of Korean Child Behavior Checklist (K-CBCL) and Korean ADHD Rating Scale (K-ARS) for screening and identifying children with ADHD in community. METHODS: Randomly selected 1st to 3rd graders of the two elementary schools (n=1668) in the City of Gunsan participated in the study. K-CBCL and K-ARS were used as screening instruments. Diagnoses were determined by clinical psychiatric interviews and confirmed by Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version (K-SADS-PL-K) using DSM-IV criteria. RESULTS: The rate of inclusion above the T score of 60 with regard to the attention problems profile of K-CBCL was 4.5%. There was a significant correlation (p<.01) between parent and teacher reports of K-ARS, and the rate of inclusion was 2.5% when 90th percentile cut-off points were applied for both of the reports. Of the 46 subjects who underwent clinical psychiatric interviews, 33 (71.7%) were diagnosed as ADHD. The T score of 60 with regard to the attention problems profile of K-CBCL resulted in a reasonable level of sensitivity or positive predictive value in the diagnosis of ADHD. 90th percentile cut-off scores in both parent and teacher reports of K-ARS resulted in a high level of predictive value. The highest level of specificity and positive predictive value were computed when K-CBCL (T> or =60 in attention problems) and K-ARS (parent/teacher total> or =90th percentile) reports were combined. CONCLUSION: These findings suggest that the K-CBCL and K-ARS together could serve as a rapid and useful screening instrument to identify children with ADHD in epidemiologic case definitions.
Checklist ; Child Behavior ; Child* ; Community Mental Health Services* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Jeollabuk-do ; Mass Screening* ; Mental Health ; Mental Health Services ; Mood Disorders ; Parents ; Sensitivity and Specificity

This study is based on 155 patients of congenital me colon. For the diagnosis, 93 cases were histologically proven and the remaining 63 cases were diagnosed on clinical basis including barium enema or surgical gross findings. On histologic examination, 80 cases(86%) showed typical features of absence of ganglion cell in the myenteric plexus and the 13 cases(14%) had atypical features which were segmental absence Of ganglion cell in one case. There we 127 males(82%) and 28 females(18%). The age at diagnosis was younger than 30 days in 87 cases(56%), I month to 1 year in 39 cases(25%) and older than I year in 29 cases(18%). The levels of aganglionosis were variable: short segment (rectosigmoid) in 134 cases(86%), intermediate segment (more proximal colon) in 14 cases(100%). and 6 cases(4%) had total aganglionosis. Common clinical presentations were abdominal distention, delayed meconium passage or bilious vomiting in neonate, and chronic constipation in infancy or childhood. Following initial colostomy or ileostomy, a definitive procedure was performed in 151 cases(Duhamel type in 150 cases; Soave type in 2 cases; Swenson type in 3 cases). Frequently associated problems after definitive procedure were persistent constipation(ll%) due to septum formation, fecaloma, remnant aganglionic segment and rectal stenosis. Overall mortality rate was 4%, and increased mortality was associated with enterocolitis(14%) which was the most frequent cause of death. The follow-up study longer than 3 months was available in 138 patients who underwent a definitive procedure(mean 2 year 11 months). Seventy-three cases(53%) had normal bowel function, 38cases(27.5%) had occasionally used enema or stool softners, and 27 cases(19.5%) had severe constipation or soiling. The bowel habit improved with time, and were considered normal in 60% of patients after follow-up more than 3 years. The results of definitive procedures for congenital megacolon including Duhamel operation was satisfactory, and long-term follow-up appeared an important and critical component of patients'care.
Child ; Male ; Female ; Infant, Newborn ; Humans ; Mortality ; Follow-Up Studies

PURPOSE: The aim of this retrospective study is to analyze the relationship between local factors and survival rate of dental implant which had been installed and restored in Seoul Veterans Hospital dental center for past 10 years. And when the relationship is found out, it could be helpful to predict the prognosis of dental implants. MATERIALS AND METHODS: A retrospective study of patients receiving root-shaped screw-type dental implants placed from January 2000 to December 2009 was conducted. 6385 implants were placed in 3755 patients. The following data were collected from the dental records and radiographs: patient's age, gender, implant type and surface, length, diameter, location of implant placement, bone quality, prosthesis type. The correlations between these data and survival rate were analyzed. Statistical analysis was performed with the use of Kaplan-Meier analysis, Chi-square test and odds ratio. RESULTS: In all, 6385 implants were placed in 3755 patients (3120 male, 635 female; mean age 65 +/- 10.58 years). 108 implants failed and the cumulative survival rate was 96.33%. There were significant differences in age, implant type and surface, length, location and prosthesis type (P<.05). No significant differences were found in relation to the following factors: gender, diameter and bone quality (P>.05). CONCLUSION: Related factors such as age, implant type, length, location and prosthesis type had a significant effect on the implant survival.
Dental Implants ; Dental Records ; Hospitals, Veterans ; Humans ; Kaplan-Meier Estimate ; Male ; Prognosis ; Prostheses and Implants ; Retrospective Studies ; Survival Rate

Cavernous angiomas are considered to be congenital in origin. Patients under age of 14 years usually does not require imaging because they are likely to have a benign abducens nerve palsy, unless they develop additional signs or symptoms of neurologic disease during observation. Here we report a case of an isolated abducens nerve palsy caused by overt hemorrhage from de novo formation of cavernous angioma in the pons. Cavernous angiomas of the brain stem should be considered as a possible cause of isolated abducens nerve palsy in young adult and MRI, including gradient-echo sequences should be performed.
Abducens Nerve Diseases* ; Abducens Nerve* ; Brain Stem ; Hemangioma, Cavernous* ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Pons ; Young Adult

Cavernous angiomas are considered to be congenital in origin. Patients under age of 14 years usually does not require imaging because they are likely to have a benign abducens nerve palsy, unless they develop additional signs or symptoms of neurologic disease during observation. Here we report a case of an isolated abducens nerve palsy caused by overt hemorrhage from de novo formation of cavernous angioma in the pons. Cavernous angiomas of the brain stem should be considered as a possible cause of isolated abducens nerve palsy in young adult and MRI, including gradient-echo sequences should be performed.
Abducens Nerve Diseases* ; Abducens Nerve* ; Brain Stem ; Hemangioma, Cavernous* ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Pons ; Young Adult

We have retrospectively studied 118 eyes of 91 diabetic patients which underwent cataract surgery and followed up at least 3 months and the postoperative corrected visual acuity compared according to the degree of retinopathy, duration of diabetics and age of the patients The results were as follows: 1. Age distribution of the diabetic patients were 17-85 years old and 6th decade was most frequent group and the percentage of male patients were 64.8% and 82.4% of total patients were over 50 years of age. 2. The postoperative corrected visual acuity above 20/40 according to patient age was 100% in the 3rd decade and 1st decade, 87.5% in the 4th decade, 73.5% in the 5th decade, 80.9% in the 6th decade and 42.8% in the 2nd decade. The postoperative visual acuity was generally better in younger patients. 3. The postoperative corrected visual acutiy above 20/40 according to degree of diabetics was 94.2% in Non Diabetic Retinopathy, 78.5% in Background Diabetic Retinopathy, 11.1% in Proliferative Diabetic Retinophthy. The postoperative corrected visual acuity was worse in severe retinopthy group. 4. The postoperative corrected visual acuity above 20/40 according to duration of diabetics was 94.2% in under 5 years, 83.9% in 10 < -15 years, 56.1% in above 15 years and the result was better in short diabetic duraction group.
Age Distribution ; Cataract* ; Diabetic Retinopathy ; Humans ; Male ; Retrospective Studies ; Visual Acuity

We have retrospectively studied 118 eyes of 91 diabetic patients which underwent cataract surgery and followed up at least 3 months and the postoperative corrected visual acuity compared according to the degree of retinopathy, duration of diabetics and age of the patients The results were as follows: 1. Age distribution of the diabetic patients were 17-85 years old and 6th decade was most frequent group and the percentage of male patients were 64.8% and 82.4% of total patients were over 50 years of age. 2. The postoperative corrected visual acuity above 20/40 according to patient age was 100% in the 3rd decade and 1st decade, 87.5% in the 4th decade, 73.5% in the 5th decade, 80.9% in the 6th decade and 42.8% in the 2nd decade. The postoperative visual acuity was generally better in younger patients. 3. The postoperative corrected visual acutiy above 20/40 according to degree of diabetics was 94.2% in Non Diabetic Retinopathy, 78.5% in Background Diabetic Retinopathy, 11.1% in Proliferative Diabetic Retinophthy. The postoperative corrected visual acuity was worse in severe retinopthy group. 4. The postoperative corrected visual acuity above 20/40 according to duration of diabetics was 94.2% in under 5 years, 83.9% in 10 < -15 years, 56.1% in above 15 years and the result was better in short diabetic duraction group.
Age Distribution ; Cataract* ; Diabetic Retinopathy ; Humans ; Male ; Retrospective Studies ; Visual Acuity