No abstract available.

The skin defect with sensory impairment of volar aspect of fingers should be reconstructed for the better function of hand. The Neurovascular island graft has been used to provide sensation to volar surface the thumb and to replace pulp tissues avulsed from thumb or index finger. Authors performed neurovascular island graft for defective sensibility of finger tip loss in 14 cases since Jun. 1979 to Mar. 1985. The donor flaps were obtained from the ring finger in 9 cases and middle finger in 5 cases. Among 14 cases, the donor flaps were taken from the ulnar side of 3rd and 4th finger in 11 cases. We followed up the the patients from 7 months to 4 years and 6months and in last follow-up, recovery of protective sensation such as sharp/blunt discrimination, temperature discrimination, and touch/stroke discrimination, was good but two point discrimination and reorientation of sensa-tion were poor. Cold intolerance was developed in 11 cases, and longitudial linear scar band of donor digit was demonstrated in 12 cases.
Cicatrix ; Discrimination (Psychology) ; Fingers ; Follow-Up Studies ; Hand ; Humans ; Sensation ; Skin ; Thumb ; Tissue Donors ; Transplants

BACKGROUND AND OBJECTIVES: Turner and colleagues introduced a new method that can detect tinnitus in animals. The stimulus is composed of a small background noise that is identical to the pitch of the tinnitus and a large pulse noise that can evoke a startle response. In normal rats, the gap decreases the startle reflex. However, in tinnitus rats, the gap does not decrease the startle reflex. The goal of this study was to optimize the stimulation paradigm so that the prepulse inhibition of N1-P2 amplitude would be maximized in the normal human subjects. SUBJECTS AND METHODS: Seven normal control subjects without tinnitus were recruited. The stimulus was composed of two different sounds: the softer background noise and the louder pulse noise. A 50 msec silent gap was inserted before the pulse noise as the gap condition (G condition) but not in the no-gap condition (N condition). The averaged amplitude of the N1-P2 cortical response was recorded for the G and N conditions. RESULTS: The G/N ratio was the smallest when the gap was 20 msec prior to the pulse noise. The G/N ratio was 84.8+/-16.8% with the Hanning window and 78.5+/-5.9% without the window. The G/N ratio was 91.1+/-24.9%, 78.0+/-5.4%, and 79.0+/-18.1% when the intensity of the background noise was 10, 20, and 32 dB SL, respectively. When the intensity of the background noise was 20 and 32 dB SL, the N1-P2 amplitude of the G condition was significantly smaller than that of the N condition. CONCLUSIONS: The optimal stimulus should be composed of the 1 kHz pulse noise without Hanning window. The intensity of the background noise should be 20 dB HL and the location of the gap should be 20 msec prior to the pulse noise. It seems that with these optimized parameters we could expect a 78.0% inhibition of N1-P2 amplitude in normal subjects without tinnitus.
Animals ; Humans* ; Methods ; Noise ; Rats ; Reflex ; Tinnitus

PURPOSE: Contrast-enhanced 3-D ultrafast MR angiography is a widely accepted MR imaging technique for theevaluation of the carotid artery, aorta, renal artery, mesenteric artery and portal venous system. To esti-mateitsclinical usefulness, single -and double- dose contrast-enhanced 3-D ultrafast pulmonary MR angiography wasassessed after a timing examination was performed. MATERIALS AND METHODS: Twenty volunteers underwentgadolinium-enhanced ultrafast pulmonary MR angiog-raphy( 3-D FISP, TR[msec]/TE[msec]=5.0/2.0, with 25 degrees flipangle). In ten volunteers(single-dose injection group) pulmonary MR angiography was performed after theadminstration of 0.1 mmol/kg(single dose injec-tion group), while the other ten(double-dose injection group) eachreceived, prior to angiography, 0.2 m m o l / kg. In all cases, a timing examination was performed during axialturbo-FLASH imaging(TR/TE/TI=8.5/4.0/100, 1 0 degree flip angle) after injection of the same dose as that used forsubsequent contrast-enhanced pulmonary MR angiography. In both groups, overall image quality, pulmonary arteryvisibility and contrast-to-noise ratio of the pulmonary artery were assessed on the basis of images obtained.RESULTS: With regard to overall image quality, there was no significant statistical difference between the twogroups (P>0.05), and in both, depiction of the central and lobar pulmonary artery was excellent. As regardsdepiction of the segmental artery, the average grading of the single dose injection group was 2.83 +/- 0.32, that ofthe double dose injection group was 2.85 +/-0.3, with no statistical significance(P>0.05). With respect tocon-trast-to-noise ratio of the central, lobar, and segmental arteries, the best results were obtained by thedouble dose injection group(P<0.05). CONCLUSION: Although the contrast-to-noise ratio in the double-dose injectiongroup was better than that in the single-dose group, differences in overall image quality and pulmoanry arterydepiction were not statistically significant. Thus, single-dose, contrast-enhanced 3-D ultrafast pulmonary MRangiography can provide useful images in clinical trials.
Angiography* ; Aorta ; Arteries ; Carotid Arteries ; Magnetic Resonance Imaging ; Mesenteric Arteries ; Pulmonary Artery ; Renal Artery ; Volunteers

PURPOSE: Immunosuppression is important for early success of renal transplantation. Mycofenolate mofetil (MMF) has been substituted for Azathioprine (AZA) and has been shown to have greater effect on T cell and also on B cell function than AZA. Although many side effects like infections have been investigated in patients who received AZA based therapy, they have not extensively been studied in MMF based protocol. The aim of this study is to evaluate the differences in incidence and frequency of infections during the first 6 months in the patients who received AZA or MMF based therapy. METHODS: Renal transplant recipients who received either AZA or MMF based therapy were reviewed. From January 1994 to December 2003, 112 patients were enrolled and analyzed the types and frequency of infection. RESULTS: 78 patients received AZA based therapy, and 34 patients received MMF based therapy. Infection developed in 37 (47.4%) and 12 (35.3%) patients respectively. AZA group showed higher incidence of infection than MMF group (P<0.05). In AZA group, UTI developed in 15 patients (19.2%), URI in 7 patients(9%), CMV infection in 7 patients (9%), tuberculosis in 2 patients (2.6%), and wound infection in 6 patients (7.7%). In MMF group, UTI developed in 6 patients (17.6%), URI in 2 patients (5.9%), CMV infection in 2 patients (5.9%), tuberculosis in 1 patient (2.9%), wound infection in 1 patient (2.9%). There were no significant differences in the type of various infectious episodes between two groups. CONCLUSION: AZA group showed higher incidence in total infection, but there were no differences in the type of various infectious episodes between two groups. MMF has more powerful immunosuppressive effect (18) but has similar infectious adverse effects compared with AZA.
Azathioprine ; Humans ; Immunosuppression* ; Incidence ; Kidney Transplantation ; Transplantation* ; Tuberculosis ; Wound Infection

No abstract available.
Chemokine CCL2* ; Humans* ; Monocytes* ; Muscle, Smooth, Vascular*

PURPOSE: Voiding function of the neonate is considered to be different from that of adult. Although immaturity in the central nervous system that governs urinary bladder is thought to be the cause, few well-designed physiological studies on the properties of bladder itself have been reported. MATERIALS AND METHODS: Urinary bladders were removed from male Sprague-Dawley rats, 1 to 3-day old neonate and 12 week-old adult. Anterior longitudinal muscle strips without mucosa were obtained and isometric contractions were recorded. Contractile responses induced by carbachol (CCh 0.05-10.0 microM) were obtained. To investigate length-tension relationship between adult and neonate bladder, each strip was stepwise stretched up to 300% L (taking L, 100% length in a resting state) by micropositioner. In each step it was fully permitted to reach steady state in which electrical field stimulations (0.8ms, 50Hz, 2.5s duration) were applied to assess optimal length for contraction. RESULTS: CCh produced a large phasic contraction followed by a sustained tonic contraction superimposed by rapid phasic activities (RPAs) in both group but the patterns were quite different. Neonatal bladder was characterized by its tonic contractions; lesser tone increase with dose increment and taller RPAs of shorter duration. Amplitude of CCh-induced contraction were corrected by tissue weight, neonatal bladder generated greater force than that of adult. Length-tension analysis revealed that the range of active contraction in neonatal bladder according to the stretch were similar, while passive properties were quite different from that of adult bladder. Stress in the muscle strips was derived from tension divided by cross-sectional area of the strip (g/cm2). Steep increase in total tension per area as stepwise stretch was observed in neonatal bladder, which was mainly ascribed to passive properties of the bladder. Optimal length of maximal active force generation was noted in 220% of resting length in both neonatal and adult bladder. CONCLUSIONS: Our results demonstrated that CCh-induced contractile pattern and length-tension relationship in neonatal bladder are quite different from those of adult bladder in the rats, which suggests, aside from the neural immaturity, functional difference exists in the bladder itself. During development, neonatal urinary bladder seems to undergo remarkable changes in both active and passive properties.
Adult* ; Animals ; Carbachol ; Central Nervous System ; Humans ; Infant, Newborn ; Isometric Contraction ; Male ; Mucous Membrane ; Rats* ; Rats, Sprague-Dawley ; Urinary Bladder*

PURPOSE: The function of urinary bladder in neonate and adult are regarded as different but little is investigated on the physiological function of the neonatal urinary bladder. In this study, we compared the contractile responses of bladder muscle strips between neonate and adult rats to repeated electrical field stimulations(EFSs). MATERIALS AND METHODS: Postnatal 1 to 3-day-old Sprague-Dawley(SD) rats (7.3+/-1.5gm, mean+/-SE, n=15) and 12-week-old adult SD rat(386+/-21gm, n=15) were sacrificed and longitudinal strips of the anterior wall of the bladder were prepared. Each preparation was mounted in a vertical chamber and connected to a force transducer (FT03, Grass, U.S.A.). Isometric contractions were induced by three different methods; 1) intrinsic nerve activation by applying EFSs(5, 20, or 60Hz frequency, square pulse of 0.8ms width, 70V/cm, 2,5s duration) every 50 seconds, 2) the activation of muscarinic receptors on smooth muscle cell membrane with 5.0microM carbachol(CCh), 3) direct smooth muscle stimulation by applying EFSs(60Hz frequency, 50ms width, 70V/cm, 2.5s duration) in the presence of tetrodotoxin every 50 seconds. RESULTS: Contractile responses to intrinsic nerve stimulations reached maximal amplitude at 60Hz stimulation in both adult and neonate rat bladder. Recovery from the fatigue in neonate and adult bladder muscle was evaluated by the amplitude changes in contractions evoked by EFS with 3 min. or 1 min. rest periods. Poor recovery was induced in neonates even by 3 min. rest period. In neonate group, the amplitude of contractions declined gradually (fatigue response) with 20 and 60Hz stimulations, while the fatigue responses were negligible in adult group. The responses to the exogenous CCh before and immediately after the repeated stimulations were not significantly different in both groups. Repeated direct muscle stimulations did not induce significant decreases of contractile responses in both groups. CONCLUSIONS: These results demonstrate that neonatal bladder becomes fatigued faster than adult bladder and the fatigue seems to occur at pre-receptor level of the smooth muscle cells rather than at the muscle itself.
Adult* ; Animals ; Carbachol ; Fatigue* ; Humans ; Infant, Newborn ; Isometric Contraction ; Membranes ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Poaceae ; Rats* ; Receptors, Muscarinic ; Tetrodotoxin ; Transducers ; Urinary Bladder*

BACKGROUND AND OBJECTIVES: We evaluated the clinical characteristics and vestibular function of patients with direction changing vibration induced nystagmus (DC VIN) and unilateral vestibular hypofunction and suggest clinical implication and a proposed mechanism of DC VIN. SUBJECTS AND METHOD: The records of 315 patients who underwent the VIN test were reviewed retrospectively. Among these, 18 patients (5.7%) showed DC VIN, and out of whom, 15 patients (4.8%) were diagnosed as unilateral vestibular hypofunction by caloric, rotation chair (RCT), and video head impulse test (vHIT). We analyzed the relationship between DC VIN and the dizziness characteristics, duration of disease, and the outcome of the vestibular function test. RESULTS: The mean age of 15 patients was 67.4±10.7 years and the mean duration of dizziness was 13.6±29.7 months. The caloric test revealed 25% of the patients to have significant canal paresis [Caloric vestibular neuritis (VN)], while 75% showed normal caloric response. However, unilateral vestibular hypofunction was observed by abnormal results in RCT or vHIT (Non-caloric VN). Seven patients showed ipsilateral DC VIN (nystagmus to vibrated side) and eight patients contralateral DC VIN (nystagmus to opposite side of vibration). Patients with ipsilateral DC VIN were shown to have a significant longer duration of dizziness than those with contralateral DC VIN. CONCLUSION: Although rare, DC VIN can also be found in patients with unilateral vestibular hypofunction. Patients with DC VIN had a mild vestibular asymmetry with Non-caloric VN or Caloric VN in the process of compensation. The mechanism of ipsilateral DC VIN seems to be due to the small amount of vestibular asymmetry, which is smaller than the interaural attenuation of vibration.
Caloric Tests ; Compensation and Redress ; Dizziness ; Head Impulse Test ; Humans ; Methods ; Paresis ; Retrospective Studies ; Vestibular Function Tests ; Vestibular Neuronitis ; Vibration*

It is well known that cochlear implant device repositioned in the posterosuperior direction will cause intracochlear electrode extrusion. We have recently repositioned a cochlear implant device due to infection and device exposure. The device repositioning was performed under C-arm assisted fluoroscopic monitoring. The exposed device was covered with a local scalp flap. During and immediately after the repositioning operation, electrodes seemed to be well positioned in place. Mapping and neural response imaging were performed 4 days after the operation, and the results were quite similar to the preoperative results. But when the same tests were performed one month after repositioning operation, we found that the number 15 and 16 electrodes were not responsive. The transorbital view also revealed a slight extrusion of the intracochlear electrode. In the present article, we discuss the possible cause of delayed electrode extrusion and its clinical implication.
Cochlear Implants ; Electrodes ; Hypogonadism ; Mitochondrial Diseases ; Ophthalmoplegia ; Reoperation ; Scalp