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

Natural cytotoxicity mediated by natural killer (NK) cells is believed to play an important role in host anticancer defense mechanisms. The aim of this study is to compare the number of NK cells in patients with colorectal cancer and hemorrhoids, and before and after surgery in patients with colorectal cancer. Twenty colorectal cancer patients and twenty hemorrhoid ones were studied. Venous blood samples were obtained preoperatively, and on the 7th, and 14th postoperative days. Mononuclear cells were isolated over Ficoll-Hypaque gradients, and T cells, B cells, and NK cells were measured with CD3 FITC (T cell), CD 19 PE (B cell), and CD56 FITC (NK cell) antibody, The number of T cell (/mm3) was 1224, 1280, and 1125 at preoperative, 7th, and 14th postoperative day in hemorrhoid patients and 1195, 901, and 1060 in colorectal cancer patients respectively. The number of B cell (/mm3) was 243, 160, and 250 in hemorrhoid patients and 147, 78, and 113 in colorectal cancer patients. The number NK cell (/mm3) was 148, 156, and 143 in hemorrhoid patients and 129, 85, and 128 in colorectal cancer patients. There was no difference among Dukes stages in the number of NK cells. In conclusion, the number of NK cells was not changed in colorectal cancer patients compared with hemorrhoid ones. Major operation changed the number of NK cells in colorectal cancer patients.
B-Lymphocytes ; Colorectal Neoplasms* ; Defense Mechanisms ; Fluorescein-5-isothiocyanate ; Hemorrhoids ; Humans ; Killer Cells, Natural* ; T-Lymphocytes

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

Abdominal pregnancy that is a life threatening variant of ectopic pregnancy, has been a rare event with high maternal mortality. It is very difficult to diagnose a abdominal pregnancy clinically. We have experienced a case of early abdominal pregnancy diagnosed at emergency laparotomy and this case was presented with a brief review of the literatures.
Emergencies ; Female ; Laparotomy ; Maternal Mortality ; Pregnancy ; Pregnancy, Abdominal* ; Pregnancy, Ectopic

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*

Pick's disease is a rare neurodegenerative disorder presenting cortical type of dementia. Pick's disease shows unique clinical and pathological features, that are due to a degeneration of fronto-temporal lobes of the cerebrum. The authors experienced a case of Pick's disease in a 58-year-old male patient who had dementia symptoms for five years. The patient showed compulsive behavior since five years ago. Memory decline started from four years ago and progressed. Brain CT disclosed lobar atrophy of the cerebral gyri in frontal and temporal lobes. He died of septicemia associated with aspiration pneumonia. At autopsy, both cerebral hemispheres showed marked encephalomalacia. The gyral atrophy was moderately severe in prefrontal and anterior temporal lobes. Coronal section disclosed moderate dilatation of the lateral ventricles. Microscopically, there were marked neuronal loss in prefrontal and anterior temporal cortices. Also noted were Pick's cells and Pick's body in occasional pyramidal cells preserved.
Atrophy ; Autopsy* ; Brain ; Cerebrum ; Compulsive Behavior ; Dementia ; Dilatation ; Encephalomalacia ; Humans ; Lateral Ventricles ; Male ; Memory ; Middle Aged ; Neurodegenerative Diseases ; Neurons ; Pick Disease of the Brain* ; Pneumonia, Aspiration ; Pyramidal Cells ; Sepsis ; Temporal Lobe

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*

Myofascial pain syndrome (MPS) can be characterized by pain caused by trigger points (TrPs) and fascial constrictions. Patients with MPS of the gluteus minimus muscles often complain of symptoms such as hip pain, especially when standing up after sitting or lying on the affected side, limping, and pain radiating down to the lower extremities. A 24-year-old female patient presenting with motor and sensory impairments of both lower extremities was referred to our pain clinic after initially being diagnosed with lumbar radiculitis. Under the impression of MPS of the gluteus minimus muscles following through evaluation and physical examination of the patient, we performed trigger point injections under ultrasonography guidance on the myofascial TrPs. Dramatic improvement of the patient's symptoms was observed following this treatment, and she was discharged without any further remaining symptoms.
Constriction ; Deception ; Female ; Hip ; Humans ; Lower Extremity ; Muscles ; Myofascial Pain Syndromes* ; Pain Clinics ; Physical Examination ; Radiculopathy* ; Trigger Points ; Ultrasonography ; Young Adult

Malignant hyperthermia is a subclinical myopathy, usually triggered by anesthetics and associated with a mortality rate of up to 70%, when left untreated. But with early diagnosis using capnography and with the advent of dantrolene, the mortality rate could be reduced to less than 5%, which implies the significance of early diagnosis and proper treatment. Owing to the reduced mortality rate, anesthesiologists get more chances to encounter patients with a previous history of malignant hyperthermia and knowledge to provide proper anesthetic management become essential. We present a case in which malignant hyperthermia was detected in a 67 year old female patient with gastric cancer and a thyroid mass during the first operation and successfully treated with promptly initiated supportive measures based on capnography finding without dantrolene which was not available at the time and the same patient rescheduled for subsequent gastrectomy in which we chose non-triggering agents in adjunct to epidural anesthesia without provoking malignant hyperthermia.
Aged ; Anesthesia, Epidural ; Anesthesia, General* ; Anesthetics ; Capnography ; Dantrolene ; Early Diagnosis ; Female ; Gastrectomy ; Humans ; Malignant Hyperthermia* ; Mortality ; Muscular Diseases ; Stomach Neoplasms ; Thyroid Gland