sodium hyaluronate in beagle dogs. METHODS:In group 1, hGH(Eutropin, r-hGH) 0.29mg/kg was injected subcutaneously to 6 beagle dogs everyday for 7 days. In group 2, 1mg/kg in sustained- release formulation using sodium hyaluronate(SR-hGH), was injected subcutaneously to 6 beagle dogs. In group 3, 2mg/kg of the same formulation(SR-hGH) was injected subcutaneously to 6 beagle dogs. Blood samplings were done for the measurement of GH and IGF-1 concentrations with ELISA kit(Diagnostic Systems laboratories, Inc., USA) RESULTS:GH concentration in group 1 was below 0.5ng/ml before injection and elevated to 98.1+/-15.7 at 1 hr, 124.2+/-15 at 2 hr, 57.8+/-18.1 at 4 hr, 23.8+/-4.8 at 6hr, 10.8+/-3.7 at 8 hr, 2.8+/-1.6 at 10 hr, 1.0+/-0.7 at 12 hr, and 0.5+/-0.1ng/ml at 24hr after injection. Peak GH concentration was observed in 2 hr and thereafter decreased progressively and returned to basal level at 10 hr after injection. From the 2nd day GH concentration was measured only at 6 hr after daily GH injection, indicating the values of 20.9+/-8.7, 16.2+/-14.9, 23.1+/-8.5, 34.3+/-9.9, 16.1+/-7.0, and 21.8+/-13.0ng/ml at 2nd, 3rd, 4th, 5th 6th, and 7th day, respectively. GH concentrations in group 2(SR- hGH 1mg/kg) were 136.7+/-22.8 at 1hr, 149.3+/-29.9 at 2hr, 110.6+/-17.8 at 4hr, 103.7+/-18.2 at 6hr, 108.3+/-21.0 at 8hr, 91.4+/-21.4 at 10hr, 79.6+/-15.9 at 12hr, 23.7+/-8.3 at 24hr, 5.5+/-1.5 at 30hr, 0.7+/-0.2 at 48hr, 1.4+/-1.4 at 54hr, and 0.5+/-0.1ng/ml at 72hr after injection. GH concentration was elevated above the basal level for 72hr with the peak at 2hr after injection of SR-hGH of 1mg/kg. GH concentrations in group 3(SR-hGH 2.0mg/kg) were 196.7+/-45.2 at 1hr, 219.4+/-39.8 at 2hr, 198.1+/-38.0 at 4hr, 196.0+/-31.4 at 6hr, 179.2+/-28.3 at 8hr, 151.8+/-19.5 at 10hr, 141.3+/-23.1 at 12hr, 72.9+/-14.7 at 24hr, 43.7+/-14.2 at 30hr, 3.8+/-1.6 at 48hr, 1.6+/-0.5 at 54hr, 0.8+/-0.5 at 72hr, 0.5+/-0.1 at 78hr, and 0.5+/-0.2ng/ml at 120hr. Peak GH concentration occurred at 2hr after injection and remained high concentration till 72hr and returned to basal level thereafter. IGF-1 concentrations in group 1 changed from 190.5+/-68.1ng/ml before injection, to 326.4+/-96.2, 346.4+/-79, 391.4+/-86.9, 417.0+/-96.1, 422.1+/-92.0, 429.9+/-86.4, and 478.0+/-90.2ng/ml at 12hr, 30hr, 54hr, 78hr, 102hr, 126hr, and 150hr, respectively. IGF-1 concentrations in group 2 were 128.5+/-37.0 ng/ml before and 268.0+/-64.2, 307.6+/-63.1, 374.8+/-55.3, 335.5+/-39.4, 301.9+/-44.8, 288.5+/-42.5, 272.8+/-51.8, 273.9+/-46.0, 251.1+/-40.9, and 239.2+/-45.0ng/ml at 24hr, 30hr, 48hr, 54hr, 72hr, 78hr, 96hr, 102hr, 126hr, and 150hr, respectively after injection. Peak IGF-1 concentration was measured at 48hr and remained in high concentration till 150hr after injection. IGF-1 concentrations in group 3 were 116.0+/-68.9ng/ml before and 365.5+/-118.6, 400.0+/-135.1, 463.6+/-138, 450.2+/-140.0, 337.2+/-122.4, 301.4+/-113.4, 236.3+/-89.1, 226.3+/-75.5, 148.9+/-55.2, and 129.8 48.4ng/ml at 24hr, 30hr, 48hr, 54hr, 72hr, 78hr, 96hr, 102hr, 126hr, and 150hr, respectively after injection. Peak IGF-1 concentration was at 48hr and remained in high concentration till 150 hr after injection. There was no significant difference in IGF-I conc between group I and group 3. CONCLUSION: Sustained-release form(1mg or 2mg/kg) of hGH with sodium hyaluronate released GH for 72 hours with the peak level at 2 hours and higher concentration of IGF-I above baseline maintained for 150 hour after injection with peak level at 48 hour. There was no difference in IGF-1 concentration between SR-hGH 1mg/kg and 2mg/kg injection. So sustained release form 1mg/kg will be more effective for GH therapy as weekly injection mode. More extensive study is needed to permit for new therapeutic application.
Animals ; Dogs* ; Drug Delivery Systems ; Enzyme-Linked Immunosorbent Assay ; Growth Hormone* ; Hyaluronic Acid ; Insulin-Like Growth Factor I ; Sodium

We have experienced 11 cases of large bony defect that were treated using microsurgery since 1981. Free vascularized bone transplantation was performed in 8 of them, vascularized bone transposition in 2 cases, and free vascularized joint transplantation in the remaining 1 case. The causes of the large bony defect were primary bone tumor (4 cases), congenital pseudoarthrosis (3 cases), open comminuted fracture (2 cases), sequela of osteomyelitis (1 case), and post-traumatic ankylosis of PIP joint of second finger (1 case). As a donor, fibula was used in 8 cases, iliac crest in 1 case, rib in 1 case and in the remaining 1 case, the second M-P joint of foot was transplanted. In 9 of 11 cases, successful result was obtained and 2 cases were failed because of vascular damage following tibial lengthening in one case and infection on the grafted area in the other one. From the above data and review of articles, following conclusions were obtained. 1. Fibula is thought to be the most appropriate donor for the large bony defect in the extremity, especially in lower extremity, but the donor site must be determined according to the anatomical and physilogical condition of the patient. 2. After mechanical lengthening of the extremity, it is recommened to perform the microvascular surgery after sufficient time for the recovery of vascular damage. But further studies are required for the identification of the change in the vascular tissue following stretching and its recovery time. 3. Progression of the ossification in the epiphysis of transplanted iliac crest was observed and this finding proposed us the idea that the epiphyseal plate injury or leg length discrepancy will be able to be treated with free vascularized epiphyseal plate transplantation and the reconstruction of the destroyed joint of growing children will be possible using free vascularized joint transplantation. 4. As the technique become more popular, the free vascularized bone transplantation is being used for the reconstruction of the extremity more frequently, but it seems to be wise to restrict its indication to cases which are impossible to be treated with more simple methods such as vascularized bone transposition or pedicled bone graft.
Ankylosis ; Bone Transplantation ; Child ; Epiphyses ; Extremities ; Fibula ; Fingers ; Foot ; Fractures, Comminuted ; Growth Plate ; Humans ; Joints ; Leg ; Lower Extremity ; Microsurgery ; Osteomyelitis ; Pseudarthrosis ; Ribs ; Tissue Donors ; Transplants

Functional-Below-Knee Total Contact Cast characterized by early weight bearing and free motion of affected knee joint during the cast immobilizaton has brought to significant result on trearment of tibial fractures, and is considered to take early bony union by establishment of almost physiological environment on fracture site during immobilization. For recent 2 years, writers have experienced many tibial fractures to treat with Functional Below-Knee Total Contact Cast. In them, clinical data and results of 17 cases which were studied well are reviewed, and method of cast application is illustrated.
Clinical Study ; Immobilization ; Knee Joint ; Methods ; Tibial Fractures ; Weight-Bearing

OBJECTIVE: To establish the reference values of the sensory conduction for all the digits in the hand, conduction studies were performed using the standard technique. METHOD: One hundred hands of fifty neurologically healthy adults with mean age of 45 years (range, 23~69) were tested. Depending on ages, the 50 adults were devided into three groups: group 1, 20~45 years old; group 2, 46~60 years old; group 3, 61~ years old. Antidromic sensory nerve conduction techniques using a fixed distance were performed. The onset latency and baseline to peak amplitude of the sensory nerve action potentials (SNAPs) were measured. During the test, the skin temperature of the hand was maintained at 34 degrees C or above. These variables from SNAPs were compared according to age, gender, side, and recording digits. RESULTS: Comparison of the median and ulnar SNAPs between age groups revealed longer onset latency and smaller amplitude in the elderly group. The amplitude of SNAPs was larger in females than in males and the left side than the right side. Comparison of the latencies and amplitudes between the second and third digits showed no significant difference statistically. Also, the latencies and amplitudes of the median and ulnar nerves recorded from the fourth digits showed no significant difference statistically. CONCLUSION: Based on these results, the reference values for sensory conductions from all the digits were obtained. These values would be helpful in evaluation of CTS or unspecified finger pain or upper extremity neuropathy.
Action Potentials ; Adult ; Aged ; Female ; Fingers ; Hand ; Humans ; Male ; Median Nerve ; Neural Conduction* ; Reference Values ; Skin Temperature ; Ulnar Nerve ; Upper Extremity

A 12-year-old, castrated male Yorkshire terrier dog presented with frequent regurgitations that had begun 45 days earlier and become more progressive. Radiographs revealed an air-trap region behind the cranial esophageal sphincter muscle in the esophagus and esophagographies with barium contrast showed mild esophageal dilation with decreased motility. Esophageal motility increased within 5 min of neostigmine methylsulfate administration and acetylcholine receptor antibodies titer increased to beyond the normal range. Based on these findings, acquired myasthenia gravis with focal form was diagnosed, making this the first such case diagnosed by an acetylcholine receptor antibody test in Korea.
Acetylcholine ; Animals ; Antibodies ; Barium ; Child ; Dogs* ; Esophageal Achalasia* ; Esophagus ; Humans ; Korea ; Male ; Myasthenia Gravis* ; Neostigmine ; Reference Values

Objective and METHOD: In order to identify the aggravating agents for intrinsic asthma, we performed ASA- and food additive-challenge tests on 182 subjects diagnosed as having intrinsic asthma. The following tests were performed: Lysine-aspirin bronchoprovocation test to confirm aspirin-sensitivity, sodium bi-sulfite (40-200mg) oral provocation test for sulfite sensitivity, tartrazine oral provocation test (50mg) for tartrazine sensitivity, and sodium benzoate (400mg) oral provocation test for sodium benzoate sensitivity. Positive reaction was defined as decrease in FEV, by more than 20% from the baseline value after the provocation. RESULT: Seventy-five (41.2%) of 182 subjects showed positive responses to more than one agent among the aspirin and three food additives challenged. The prevalence of aspirin-sensitivity was the highest (22.5%), followed by sulfite-sensitivity (8.8%), and then concurrent sensitivity to both aspirin and sulfite (6.0% ), to both aspirin and tartrazine (1.6% ), to aspirin, sulfite and tartrazine (1.1%) and to aspirin, sulfite and sodium benzoate (0.5%). Rhino-sinusitis was noted in 62.5% of aspirin-sensitive asthmatic subjects, 60% of sulfite-sensitive ones, and 80% of tartrazine-sensitive ones. Urticaria was noted in 21.4% of aspirin-sensitive asthmatic subjects, 16.6% of sulfite-sensitive ones and 6.3% of tartrazine-sensitive ones. Thirty-seven to 83% of positive responders had no adverse reaction history. CONCLUSION: These findings suggest that ASA and food additive challenge tests should be considered as a screening test to evaluate any aggravating factors in subjects with intrinsic asthma, even though they may not have experienced any adverse reactions.
Aspirin* ; Asthma* ; Food Additives* ; Mass Screening ; Prevalence ; Sodium ; Sodium Benzoate ; Tartrazine ; Urticaria

PURPOSE: To review MR findings of the posterior fossa hemangioblastomas and to evaluate diagnostic value of MRI correlated with CT and anglographic findings. MATERIALS AND METHODS: The MR findings in twelve patients with surgically proven posterior fossa hemangioblastomas including one case of von Hippel- Lindau disease were retrospectively analyzed and correlated with CT (7 patients) and anglographic findings (9 patients). RESULTS: On MRI, five hemangioblastomas were located in the cerebellar hemisphere and seven in the vermis. The masses appeared to be solid in 3 cases(25%), solid tumors with central cyst in 2 cases(17%), and cyst with mural nodules in 7 cases(58%). Abnormal tumor vessels represented by characteristic signal voids on MRI were observed in 9 cases(75%) and were not seen in 3 cases(25%) with mural nodule below 1.5cm in diameter. On pre-contrast CT, hemangioblastomas appeared poorly marginated slightly hyperdense masses in solid tumors, and hypodense cystic masses in cysts. After contrast enhancement, solid tumors were markedly enhanced, but it was difficult to differentiate hemangioblastomas from other tumors. In nine patients, anglograms demonstrated hypervascular blush corresponding to the solid component of the tumors. CONCLUSION: MRI was superior to CT in evaluating the characteristic of abnormal tumor vessels and mural nodules, delineation of tumor margin and tumor extent. Angiography was useful in the diagnosis of cystic hemangioblastomas which contain small mural nodule (less than 1.5cm in diameter) without definite vascular signal voids on MRI. MRI demonstrated solid or cystic tumor with small mural nodule and abnormal vascular signal voids in the posterior fossa should suggest hemangioblastoma.
Angiography ; Diagnosis ; Hemangioblastoma* ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; von Hippel-Lindau Disease

No abstract available.
Adult* ; Humans ; Intussusception* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence*

OBJECTIVE: To investigate the anatomy of the ulnar nerve according to the degree of elbow flexion and to obtain optimal elbow position for ulnar nerve conduction study. METHODS: Eleven elbows in nine cadavers were dissected. We estimated the 10 cm elbow segment to be the distance between 2 points, 4 cm distal and 6 cm proximal to the center of the cubital tunnel, which was determined to be the halfway point between the medial epicondyle and olecranon with elbow position in extension and 45o, 90o, 135o flexion. Anatomical measurements of the actual length of ulnar nerve, distance between medial epicondyle and ulnar nerve, and distance between medial epicondyle and olecranon were obtained in each position. The actual length of the ulnar nerve was measured between two points of the ulnar nerve closest to the landmarks of the estimated 10 cm with flexible ligature. RESULTS: The actual lengths of ulnar nerve were 10.23 cm, 10.00 cm, 9.44 cm, and 9.08 cm in elbow extension, and 45o, 90o, 135o flexion, respectively. The difference between actual length and estimated lengths were least in 45o elbow flexion (p=0.0001). The distance between medial epicondyle and olecranon increased with increasing elbow flexion (p=0.0001). However, there was no difference in the distance between medial epicondyle and ulnar regardless of the elbow position. As a result, the ulnar nerve seemed to have migrated anteriorly in the cubital tunnel with increasing elbow flexion. CONCLUSION: This study suggest that the optimal angle in ulnar nerve conduction study would be 45o flexion, under the condition that the distance measurement is through the halfway point between the medial epicondyle and olecranon.
Cadaver ; Elbow* ; Ligation ; Olecranon Process ; Ulnar Nerve*

OBJECTIVE: The purposes of this study were to examine overall quality of life (QOL) in long term stroke survivals and to identify variables that predict QOL after stroke. METHOD: Subjects were 51 stroke patients (male; 28, female; 23) with stroke onset at least 6 months previously. Interview, measurement of depression and QOL were performed at outpatient clinic after discharge. Review of medical records included characteristics of stroke and communication disorders. Interview questionnare included caregiver, religion, education level, occupation and income. Depression and functional status was measured by the Beck depression inventory (BDI) and modified Barthel index (MBI), respectively. QOL was measured with the use of 5-item (activity, daily living, health, support, outlook) version of the Quality of Life Index (QLI) and its range of scores is 0~10. We compared QLI scores according to various factors obtained from medical records and questionnaire. RESULTS: Mean duration after onset of stroke was 33.6 months (range, 6~216 months). The mean score of QLI were 7.0+/-2.1. Low MBI score, communication disorder and depression had a negative effect on QOL (p<0.05). Sex, age, occupation, caregivers, religion, education level, income, duration after stroke onset and side of hemiplegia had no effect on QOL (p>0.05). CONCLUSION: Low MBI score, depression and communication disorders would be negative predictors of QOL and identification of these factor may assist stroke patients in coping their personal and social life.
Ambulatory Care Facilities ; Caregivers ; Communication Disorders ; Depression ; Education ; Female ; Hemiplegia ; Humans ; Medical Records ; Occupations ; Quality of Life* ; Surveys and Questionnaires ; Stroke*