Many injuries of the hand have been occurred in these days because of frequent industrial hazards and frequent handling of tools in modern civilizing life. A voluminous amount of literature has been recently concerned with many problems and questions posed by tendon surgery. Many investigations have been devoted to discussion of suture materials, tendon suturing, grafting, healing, rate of healing, nutrition and related clinical and laboratory endeavors. Whatever the material, the aim of tendon suture is not only restoration of a strong mechanical union but also sliding function of the tendon. Thus the question has always been after what delay active mobilization can be allowed or encouraged. If immobilization allows fibroblasts to invade the tendon extremities and form a scar mass, its prolong leads to adhesion and loss of normal sliding. On the other hand, one can admit that early passive or active mobilization, even if only over a short distance may distend the adherences and transform them into a kind of mesotenon assuring a better sliding function. Before permiting early motion, several factors must be considered such as tensile strength of the suture material, holding power of the suture for the tnedon, bulkiness of the repair and stress that must be withstood. Thus it is the purpose of this study to analysis and comparing of tensile strength and morphological changes in the healing process of tendon tissues by different suturing methods. For this study deep flexor tendon on third toe of adult chicken with an initial weight of about 2Kg was used. The animals were divided into 4 sutured groups which including different suturing methods. Suturing methods used were interrupted suture, Bunnels lace suture, Kessler suture and end-weave anastomosis, which have been applied frequently in tendon surgery. All suture material used were the same size 4-0 Ethilon which has least tissue reaction but high strength. In the animals, after the sharp dissection of the distal portion of the deep flexor tendon on third toe, the tendon stumps were approximated and sutured by 4 different methods. Then a long leg cast in the position of flexion of the foot and ankle joint was applied. On operation day and fifth, tenth, fourteenth and twenty-first postoperative day; the animals were sacrified and the specimens were gained. The measurement of the tensile strength of the sutured tendon was performed through the use of force transducer with the recording of polygraph for permitting continous monitoring of a progressively increasing load until the failure of tendon repair. Specimens stained with hematoxylin-eosin and Massontrichrome stain were observed during 42 days after operation. The findings are as follows. 1. The tensile strength of sutured tendon groups using interrupted suture, Kessler suture, and end-weave anastomosis were reduced maximally on fifth postoperative fay and the tensile strength of Bunnel's lace suture group was reduced maximally on tenth postoperative day. Thereafter the strength was increased progressively on entire experimental groups. 2. The tensile strength of end-weave anastomosis group was the strongest among all experimental groups during experimental period. 3. Just after the repairs of injured tendon, the order of strength was Bunnel. Kessler and inerrupted suture but the strength was nearly approximated on 21st day. 4. The morphological healing process of interrupted and Kessler suture were better than that of Nunnel and end-weave suture. From these morphological and physical results, it is suggested that Kessler suture is better suturing method in tendon repair.
Adult ; Animals ; Ankle Joint ; Chickens ; Cicatrix ; Extremities ; Fibroblasts ; Foot ; Hand ; Humans ; Immobilization ; Leg ; Methods ; Nylons ; Sutures ; Tendons ; Tensile Strength ; Toes ; Transducers ; Transplants

The term “ganglion” was given by Hippocrates to designate a knot of tissue filled with mucin. A ganglion may be defined as a cystic benign tumor filled with a mucoid material usually surrounded by a thin wall and occurring in the region of the capsule and connective tissue of joints and tendon sheaths. The regions of the wrist, ankle, and knee and the volar regions of the fingers and hand are most frequently affected. The authors experienced a case of ganglion which had occurred at anteromedial aspect of right hip joint and had been connected with hip joint by cord like band.
Ankle ; Connective Tissue ; Fingers ; Ganglion Cysts ; Hand ; Hip Joint ; Hip ; Joints ; Knee ; Mucins ; Tendons ; Wrist

CT scan is widely used in the evaluation of hepatobiliary system and contrast study is generally performedwith non-biliary contrast media. Therefore the normal intrahepatic bile ducts are not readily visible and alsoextrahepatic bile ducts are occasinally not discriminated from adjacent structures, in spite of improvedresolution of the CT scanner. This study was performed to evaluate the usefulness of cholangiographic enhancementin biliary CT examination. In the control group (n=5), we measured the CT number of the peripheral hepatic duct,perioportal duct, common bile duct and gall bladder, respectively, at the interval of 30 minutes upto 2 hoursafter intervenous infusion of biliscopin(30ml) and observed time-denstiy relationship of infused biliscopin in thebiliary system. In the patient group (n=23), we observed visualization rate of the bilary system and serumbilirubin level at 30 minutes after infusion of biliscopin(30ml). The results were as follows: 1. The peak densityoccurred at 30 minutes after infusion of biliscopin. 2. Visualization rate was 100% in normal bilirubin groupwhereas it was 91.7% in abnormal bilirubin group. 3. The cholangiographic enhancement of biliary CT scan is usefulin the evaluation of intra-and extraheptaic biliary system.
Bile Ducts ; Bile Ducts, Intrahepatic ; Biliary Tract ; Bilirubin ; Common Bile Duct ; Contrast Media ; Humans ; Tomography, X-Ray Computed ; Urinary Bladder

Tuberculosis of the vertebral column is a slowly developing disease, characterized by pain, spinal deformity, and occasionally paralysis. The following varieties of vertebral tuberculosis are commonly recognized, such as a central variety, metaphysial tuberculosis (inter-vertebral articular type), an anterior or periosteal variety, appendiceal tuberculosis, and a true tuberculous arthritis. Among these appendiceal tuberculosis is rare. This form of Potts disease may be unilateral or bilateral and may be isolated or present at multiple levels. Disk space changes and deformity are minor features, but large paravertebral abscesses are invariable. Extradural extension may lead to the development of paraplegia. Two cases of destructive lesions at the neural arch of 10th. and 11th. thoracic vertebra were revealed to be appendiceal tuberculosis. All cases treated with antituberculous medication, radical curettage and body jaket casts and made recoveries. Patients had no complaints and no evidence of recurrence. A brief summary of the literature is submitted.
Abscess ; Arthritis ; Congenital Abnormalities ; Curettage ; Humans ; Paralysis ; Paraplegia ; Recurrence ; Spine ; Tuberculosis ; Tuberculosis, Spinal

BACKGROUND/AIMS: The caudal anesthsia is most commonly used for benign anorectal surgery, The combination of long-acting anesthetics and opiates has been used for longer duration and successful control of postoperative pain. But the side effects of peridural anesthesics and morphine have commonly occured in caudal anesthesia. This study was performed to assess the difference in clinical effects between peridural mepivacaine and bupivacaine with morphine. METHODS: We evaluated the clinical effects in 60 patients who had anal operation with Jack-Knife position under caudal anesthesia. We divided randomly these 60 patients into two groups, M and B groups (in each group, 30 patients included). Group M (n=30) was given 2% mepivacaine 20 ml with morphine 2 mg caudally, and Group B (n=30) was given 0.5% bupivacaine 20 ml with morphine 2 mg in the same manner. We measured the onset time, duration, postoperative analgesia, and side effects including urinary retention. RESULTS: The onset time for analgesia was significantly shorter in group M than in group B. The duration of postoperative pain complaints was significantly longer in group M than in group B. The postoperative analgesic effects and side effects were not significantly different between two groups. CONCLUSIONS: Caudal mepivacaine and morphine mixture is effective for control of postoperative pain without significant side effects.
Analgesia ; Anesthesia, Caudal* ; Anesthetics ; Bupivacaine* ; Humans ; Mepivacaine* ; Morphine* ; Pain, Postoperative ; Urinary Retention

The morbidity of spondylolisthesis tends to increase in accordance with the popularization of sports and increase of mean life span by the development of medicine. We had applied surgical treatment for 39 cases of spondylolisthesis during the period of 8 yrs. from Jan. 1976 to Dec. 1983 at Department of Orthopaedic Surgery, National Police Hospital, among them 35 cases were followed up for mean 27 months. Twenty eight cases with posterolateral spinal fusion were isthmic spondylolisthesis and seven cases with posterior spinal fusion and facetectomy were degenerative type. We analysed them with clinical aspects and surgical treatment for 35 cases. The results were as follows: 1. The most common clinical symptoms were low back pain (96.7%) and tenderness (93.5%). 2. The degree of slipping was Grade I by Meyerding's classification in all cases and mean 12.5% by Taillard method. 3. In the 7 cases of isthmic spondylolisthesis, the degree of slipping increased on standing lateral view. And in these cases the clinical symptoms were aggrevated at welking. 4. In the degenerative spondylolisthesis with posterior spinal fusion and facetectomy, we found mean 70% spontaneous correction of slipping commpared with preoperative. 5. In postoperative evaluation we gained 94.3% above good according to Gill's criteria and no pseudarthrosis.
Classification ; Humans ; Low Back Pain ; Methods ; Police ; Pseudarthrosis ; Spinal Fusion ; Spondylolisthesis ; Sports

Fracture of the scaphoid constitute 60% to 70% of all diagnosed carpal injury. The acute fracture will heal approximately 90% of the time if recognized early and properly immobilized. But nonunion are common since the symtoms do not alert patients to seek early medical treatment and the diagnosis is easily missed. Authors have experienced 19 cases of scaphoid nonunion and accomplished good result in all case by Russe procedure. The results were summerized as follow: 1 The cause of fratures was mainly due to fall down dinjury (36.8%). 2. The most common mechanism of the fracture was fall on the outstretched hand (52.7%). 3. Fractures were shown on the anterior-posterior, lateral and billiards view in all cases. 4. In ten cases, the fractures were found on the waist of scaphoid. 5. The cases of nonunion were probably inadequate intial treatment and delayed diagnosis. 6. The good results were obtained by bone graft according to Russe procedure.
Delayed Diagnosis ; Diagnosis ; Hand ; Humans ; Transplants

No abstract available.
Aneurysm, False* ; Blood Pressure Monitors* ; Blood Pressure* ; Compression Bandages* ; Humans ; Radial Artery*

To clarify the mechanism of the protective effect of hemodialysis on lipid peroxidation in RBC membrane structures, the level of malondialdehyde (MDA) which is the lipid peroxidation product, and the activities of antioxidant enzymes such as superoxide dismutase (SOD), catalase, and glutathione peroxidase (GSH-Px) were determined before and after hemodialysis in the RBCs from 20 patients with end stage renal disease (ESRD), and from 14 healthy subjects. Before dialysis, MDA levels in the RBCs from the patients with ESRD were higher than those from healthy controls. SOD and catalase activities in the RBCs were lower. After hemodialysis, MDA, SOD, and catalase in the RBCs from the patients with ESRD were normalized. These results indicate that hemodialysis treatment is helpful to protect the peroxidative darnage through normalizing the activities of antioxidant enzymes.
Catalase ; Dialysis ; Erythrocytes* ; Glutathione Peroxidase ; Humans ; Kidney Failure, Chronic* ; Lipid Peroxidation ; Malondialdehyde* ; Membranes ; Renal Dialysis* ; Superoxide Dismutase

The elbow injury is frequent among the children. The cubitus varus and cubitus valgus deformities are the common late complications of the elbow fracture. Although, these deformities rarely limit elbow function, the correction is frequently requested due to cosmetic problem and/or tardy ulnar nerve palsy. We performed 33 supracondylar closed wedge osteotomies from Jan. 1976 to Jan. 1986, of which 27 cases were cubitus varus, and 6 cases were cubitus valgus at Yonsei University College of Medicine. The results were as follows; 1. Cubitus varus deformity was more common than cubitus valgus; the ratio was 4.5 : 1. 2. The most common initial injury resulted in such angular deformity of elbow was supracondylar fracture of humerus. 3. The duration of plaster-cast immobilization after operation was much longer in cases who operated over 15 years old than under 15 years old. 4. There is no relationship between the duration after initial injury and the result of operation. 5. The result of supracondylar osteotomy was excellent in 11 cases(33.3%), good in 17 cases(51.5 %), and poor in 5 cases(15.2%). 6. Three fourths of cases resulted in excellent and good result were under 15 years old. 7. It is recommeneed that the angular deformity of elbow is corrected early rather than at the conclusion of growth.
Child ; Congenital Abnormalities ; Elbow ; Humans ; Humerus ; Immobilization ; Osteotomy ; Ulnar Neuropathies