Adult wounds heal with scar-tissue formation, whereas fetal wounds heal without scarring and with a lesser inflammatory and cytokine response. The unique fetal wound repair process is not dependent on the sterile, aqueous intrauterine environment. The differences between fetal and adult wound healing appear to reflect processes intrinsic to fetal tissue, such as the unique fetal fibroblast, a more rapid and ordered deposition and turnover of tissue components, and, particularly, a markedly reduced inflammatory infiltrate and cytokine profile. Among these cytokines, the transforming growth factor-beta(TGF-beta) is a growth factor which plays an important role in the regulation of cell growth and differentiation. The fibrosis characteristic of adult wound repair may be associated with TGF-betaexcess. Recent experimental studies have focused on the specific anti-TGF-beta strategies for scarless wound healing. Decorin, a proteoglycan, is known to regulate TGF-beta. This factor antagonizes the action of TGF-betain tissues. However, little is known about the functions of this factor in vivo. The objects of the present study were to analyze the effects of TGF-beta, an important regulatory molecule in adult healing events, and the effects of decorin, known inhibitor against TGF-beta, on the fetal tissue response following wounding. Fetal cellular and extracellular matrix response to injury were evaluated by treating the wound with TGF-beta and decorin in fetal rat at 14 days gestation (term = 21 days). Histologic response and histomorphometric analysis two to eight weeks later were compared between TGF-betaonly treated wound and TGF-betawith decorin treated wound.The histologic finding of the TGF-beta treated wound was characterized by an early acute inflammatory response : by week 6 fibroblasts and collagen were predominant. In contrast, TGF-beta with decorin treated wound had no remarkable histologic evidence of acute inflammation or fibroblast penetration and few collagen was deposited. These observations demonstrate that the fetal response becomes adultlike with fibroblast proliferation and collagen accumulation when TGF-betais added, thus documenting the responsiveness of the fetal system to adult repair signals. Such responsiveness thus suggests a critical difference in the fetal wound environment. Fetal repair may proceed in the absence of trophic factors like TGF-beta, thus accounting for optimal "healing" in the absence of excessive fibrosis. And these observations also confirmed the inhibitory action of decorin against TGF-beta in rat fetus model. We can suggest that the decorin minimize the inflammatory response and subsequent cellular proliferation in wound healing process, thus eventually prevent collagen deposition and scar tissue formation.
Adult ; Animals ; Cell Proliferation ; Cicatrix ; Collagen ; Cytokines ; Decorin ; Extracellular Matrix ; Fetus ; Fibroblasts ; Fibrosis ; Humans ; Inflammation ; Pregnancy ; Proteoglycans ; Rats* ; Transforming Growth Factor beta ; Wound Healing* ; Wounds and Injuries*

The traditional aesthetic blepharoplasty has limitations in correcting the heaviness and bulkiness of the lateral orbital region. These limitation is due to presence of sub-orbicularis oculus fat(SOOF) which is defined as that layer of fibrofatty soft tissue deep to the orbicularis oculus muscle, superficial to orbital septum and orbital rim, and extending medially from supraorbital nerve and laterally to varying distance over the lateral upper orbit. Therefore authors performed resections of the SOOF in conjunction with aesthetic blepharoplasty in 15 patients, who visited the clinic with complaints of thickness and heaviness over their lateral eyebrow, often accompanied by tired or sad-looking appearance. We believe that in these patients the heaviness. bulkiness and fullness in the lateral upper orbital region were corrected effectively and smoothly in aesthetical aspect. No patients developed postoperative hematoma, dry eye syndrome, lacrimal gland injury and significant paralysis of the orbicularis oculus of corrugator muscle. Our department performed the SOOF resection to those who had bulkiness and heaviness in lateral upper orbital region. From this experience, the SOOF resection would appear to be a useful adjunct to standard blepharoplasty technique in selected patients. Since we achieved a satisfactory result aesthetically through this method on patients who showed proper indications, we are recording the indications, operative techniques and complications in addition to review of reference.
Blepharoplasty* ; Dry Eye Syndromes ; Eyebrows ; Hematoma ; Humans ; Lacrimal Apparatus ; Orbit ; Paralysis

In this article neuroanatomical and verbal developmental process were introduced, followed that disorders and assessment of language function were reviewed. Finally, the causes and assessment of developmental dyslexia as a childhood disorder related to verbal function were reviewed.
Dyslexia ; Neuropsychology

The most commonly used graft source for anterior cruciate ligament reconstruction is the autogenous bone- patellar tendon-bone graft unit. Despite a good success record, intraoperative technical errors and postoperative complications have been known. Author analyzed intraoperative technical errors and postoperative complications, in 44 patients who were treated at the department of orthopaedic surgery, chosun university hospital from Jan. 1994 to Jun. 1996. The most common intraoperative technical errors was screw graft divergency in 5 cases. Other intraoperative technical errors were too anteriorly location of femoral tunnel in 1 case, too anteriorly location of tibial k femora) tunne.l both in 1 case, graft tunnel mismatching in 1 case, graft pullout in 1 case and partial destruction of posterior cortex of femoral tunnel in 1 case, fracture of the bone plug in 1 case. The most common postoperative complication was patellar tendinitis in 20 cases (45.5%). Other postoperative complications were anterior knee pain in 14 case. (31.8%), patellar crepitation in 12 cases (27.3%), quadriceps atrophy in 9 cases (20.5%), arthrofibrosis in 3 cases and graft failure in 2 cases. Author concluded the causes of intraoperative complications were technical errors, and anteriorly location of graft tunnel is most influenced factor to final fuctional results. To eliminate the postoperative complications, intraoperative technical errors should be avoided and also accelerated rehabilitation should be done.
Anterior Cruciate Ligament Reconstruction ; Atrophy ; Humans ; Intraoperative Complications ; Knee ; Patellar Ligament* ; Postoperative Complications* ; Rehabilitation ; Tendinopathy ; Transplants

No abstract available.
Hernia*

No abstract available.
Diabetes Mellitus* ; Syringoma*

BACKGROUND: We assessed the effectiveness of arthroscopic capsular release for the treatment of adhesive capsulitis. Further, we tried to ascertain the clinical benefits, if any, of pancapsular release over selective capsular release, where the two differ by performing or not performing a posterior capsular release, respectively. METHODS: Thirty-five consecutive patients with either primary or secondary adhesive capsulitis who failed conservative treatment for more than 6 months were enrolled in the study. A total of 16 patients allocated in group 1 received a pancapsular release that comprises the release of the rotator interval, anteroinferior capsular, and the posterior capsular release, whereas 19 patients in group 2 received a selective capsular release that comprises only the release of the rotator interval release and anteroinferior capsular release. The clinical outcomes, visual analogue scale (VAS) score, Constant score, and range of motion, were assessed preoperative and postoperatively. RESULTS: In both groups, the preoperative VAS score, Constant score, and ROM showed a significant improvement by the 6-month follow-up. We found that the immediate postoperative internal rotation was significantly higher in group 1 than group 2. Despite significant differences seen between the two groups at the initial postoperative period, there were no significant differences in Constant score, VAS score, and the ROM at all the subsequent follow-ups between the two groups. CONCLUSIONS: Arthroscopic capsular release for the treatment of adhesive capsulitis is very effective. However, pancapsular release did not show any advantage over selective capsular release in terms of overall clinical outcome.
Bursitis* ; Follow-Up Studies ; Humans ; Joint Capsule Release* ; Postoperative Period ; Range of Motion, Articular

No abstract available.
Paraganglioma*

No abstract available.
Hernia, Diaphragmatic*

Although intramedullary nailing is mostly used in the management of fractures in the long bone shaft, plate fixation is still alternative option in periprosthetic or metaphyseal fractures. For the rigid fixation during plating, sometimes we need wiring. Many surgeons experience slippage of wire resulting in loss of rigid fixation because plate and wire is so slippery and the diameter of bone is changing by level especially in the metaphyseal area. Wiring plate(CHO plate) was designed to prevent slippage. This plate has transverse holes for wires between screw holes on traditionally used dynamic compression plate. Sixteen fractures of long bone shaft were fixed with wiring plate and 11 cases which were followed up for more than one year were evaluated. There were periprosthetic fractures(4 cases), spiral or butterfly fractures(4 cases) and fractures of poor bone quality(two cases of malignancy and one case of osteoporosis). Nine cases were successfully reduced and the healed without loss of fixation. In two cases, delayed union and nonunion were observed due to wire breakage with plate loosening. Preliminarily, wiring plate fixation can be used for the periprosthetic fracture and one of alternative option in butterfly or spiral fracture and fracture in osteoporotic bone or pathologic fracture.
Butterflies ; Fracture Fixation, Intramedullary ; Fractures, Spontaneous ; Periprosthetic Fractures