Animal shoulder models are important in the investigation of the natural history of various pathologic conditions and for evaluation of the effectiveness of different treatments and biomaterials. The characteristics of animal shoulder models that may be used for rotator cuff related experiments are different with regard to the anatomy, behavioral pattern, advantages and disadvantages in application to each other. The lower primates and all the non-primate species, except the tree kangaroo, were neither functional overhead nor had a true rotator cuff. Utilizing more advanced primates, or perhaps even the tree kangaroo would be ideal and the most relevant to man as they possess a true rotator cuff. However, ethical concerns, costs, and many limitations in obtaining primates generally preclude the use of these animals for such research. Finally we should consider the differences in comparative anatomy and behavioral pattern of each animal model during performance or interpretation of rotator cuff experiments.
Anatomy, Comparative ; Animals ; Biocompatible Materials ; Macropodidae ; Models, Animal ; Natural History ; Primates ; Rotator Cuff* ; Shoulder*

The contamination period of the sterilized pack is influenced by the storage environment such as air contamination, temperature, humidity and the quality of the wrapping material. This study was conducted to provide basic data, for the expiration date of the EO gas sterilized pack (which was wrapped with polypropylene / polyester one side and paper the other side) by investigating the storage environment and monthly contamination period. The duration of study was 12 months, from Dec. 1, 1997 to Nov. 30, 1998. A total of 144 EO gas sterilized packs were kept in six storage cabinets of storage area after selecting four Operating Room, the Central Supply Department and General Surgery Clinic of one University Hospital in Taegu city. The samples were cultured in fluid thioglycolate media 30m1 in 37degrees C incubator for 48 hours. Air microbial bioburden in the six storage area and storage cabinet was monitored by exposing blood agar plate for fit teen minutes and culture were observed at 37t incubator for 2 thours. Temperature and Humidity were investigated four times(8 am, 2, 5, & 10 pm) a day and the mean values calculated. The results of this study are as follows 1. There was no contaminations in EO gas sterilized packs for 12 months observation. 2. The mean air contamination rate of storage area and cabinet in Operating Room was 4.9 CFU and 2.4 CPU during observation period. The mean air contamination rate of storage area and cabinet was 4.2 CPU and 2.2 CPU each during observation period. The rate of air contamination in storage room was at least twice than that of storage in Operating Room. The period that showed highest air contamination was in Feb. 98 as 9.2 CPU and the lowest in Mar. 98 as 1.1 CPU. 3. The predominant microorganisms were gram post five staphylococci, gram negative staphylococci in all storage environment, gram positive bacilli, gram negative bacilli in C cabinet of Operating Room and storage area in General Surgery Clinic, Fungi in storage area of Operating Room. 4. The mean temperature was 24.9+/-0.6degrees C(mean standard deviation) in storage area and 24.8+/-0.5degrees C in storage cabinet of Operating Room. The temperature was not differentiated between storage area and cabinet of Operating Room. The mean humidity was 63.6 7.3% (mean standard deviation) in storage area, 663+/-7.9% in cabinet of Operating Room. The humidity was observed high rate in storage area than cabinet of the six area environment. There was no growth of microorganism in sterilized packs during the observation. So we concluded that the contamination period of EQ gas sterilized packs was over 12 months. The high rate of air contamination in storage area might increase the degree of contamination of sterilized packs and the infection rate of operative wound. So the methods which could reduce the air contamination should be developed.
Adolescent ; Agar ; Daegu ; Ethylene Oxide* ; Fungi ; Humans ; Humidity ; Incubators ; Operating Rooms* ; Polyesters ; Polypropylenes ; Wounds and Injuries

No abstract available.
Electric Stimulation* ; Evoked Potentials, Auditory, Brain Stem* ; Spiral Ganglion*

Many types of osteotomy have been proposed for the treatment of cubitus varus deformity of the elbow, and various methods for fixation of the osteotomy site have also been described. However, no method has been perfect. We treated two cases of cubitus varus elbow deformity with step-cut osteotomy using a new fixation method with two crossing screws and an anatomically designed locking plate. Active assisted elbow range of motion (ROM) exercise was permitted at postoperative 3 days, after removal of the drainage. Preoperative and postoperative humerus-elbow-wrist angles and ranges of motion of the two patients were compared. At 3 months follow-up, each patient had recovered the preoperative elbow ROM, and achieved the complete bony union of the osteotomy site and proper correction of the cubitus varus deformity. In addition, the appropriate remodeling of the lateral bony protrusion was observed. Therefore, we introduce a new fixation method for achievement of stable fixation allowing immediate postoperative elbow motion after corrective osteotomy for cubitus varus deformity in young adults.
Congenital Abnormalities* ; Drainage ; Elbow* ; Follow-Up Studies ; Humans ; Osteotomy ; Range of Motion, Articular ; Young Adult*

No abstract available.
Pancreatic Pseudocyst*

PURPOSE: Recently, indirect lymphangiography has been developed as a relatively good and noninvasive imaging modality of the lymphatic system at extremities. But the disadvantage of the indirect lymphangiography is a low contrast ratio between the surrounding tissues and the contrast media in lymphatic vessels, because dimeric nonionic contrast media is water soluble and diluted in the proximal leg lymphatic vessels. We could have relatively better image than previously published images for the leg lymphatic system, when we injected contrast media with adequate high pressure in intradermal space of the interdigital areas at the foot dotsum. So, we would like to report the results. MATERIALS AND METHODS: We could study all 9 lymphedemas(primary :6, secondary: 3) from April 1990 to May 1993 on outpatient base. They were diagnosed as lymphedema clinically and radiologically. Ten ml of dimeric nonionic aget, iotrolan(Isovist 300 ) was injected into intradermal space with five 30-gauge needles The injection speed was more than 0.2mi/min. We have done one side pedal lymphangiogram in 30 minutes. The evaluation of the anterior superficial lymphatics was accordig to the criteria of the Weissleder(2). RESULTS: The results were as follows:1. All lymphatic vessels from foot to inguinal area could be visualized. 2. Two or three inferior inguinal lymph nodes could be visualized about 42%. 3. The most common abnormal finding of the lymphedma was the neovascularization of the lymphatics on indirect pedal lymphangiogram. CONCLUSION: If we use adequate technique relatively high pressure injection, correct intradermal needle insertion, adequate soft tissue exposure technique indirect lymphangiography is considered to be a safe and noninvasive imaging modality for the evaluation of the lymphedema of lower extremity lymphatics including inferior inguinal lymph nodes.
Contrast Media ; Extremities ; Foot ; Humans ; Leg ; Lower Extremity ; Lymph Nodes ; Lymphatic System ; Lymphatic Vessels ; Lymphedema ; Lymphography* ; Needles ; Outpatients

Oral mucositis continues to be a major complaint of patients who have chemotherapy for the acute leukemia. An innovative and inexpensive remedy which produces favorable results for those afficted is not yet introduced. So we tried to develop two oral care protocols for reducing the level of oral mucositis during cytotoxic therapy through literature review and our clinical experience. The one is sodium bicarbonate-normal saline gargling, and the other consists of chlorhexidine gargling. This quasi-experimental study was performed to compare the efficacy of these two different oral care protocols. Twenty subjects were assigned to one of the two specific diagnosis of leukemia, aim of the chemotherapy. The Oral Assessment Guide(OAG), the Beck's perception of oral comfort, WHO Grading system fot mucositis and the discomfort of oral gargling solution were used to assess oral status and subject's oral discomfort during chemotherapy. Each subjects were observed daily from the start of the chemotherapy until Absolute Neutrophil Count(ANC) reached 1,000. It continued about 2-4 weeks. The data analyzed by Mann-Whittney U test and ANCOVA. The result was follows as: The patient who used sodium bicarbonate-normal saline gargling showed significantly higher mean score of the discomfort of oral gargling solution than chlorhexidine gargling. The other scores were not significantly different between two groups. However the subjects using the sodium bicarbonate-normal saline gargling showed a lower level of oral mucositis. We concluded that oral using sodium bicarbonate-normal saline gargling was between to reduce the level of oral mucositis during chemotherapy and nursing assessments of the oral cavity seemed to promote patient's compliance with the oral care regimen.
Chlorhexidine* ; Compliance ; Diagnosis ; Drug Therapy ; Humans ; Leukemia* ; Mouth ; Mucositis ; Neutrophils ; Nursing Assessment ; Sodium* ; Stomatitis*

The pinching motion is thought to be one of fundamental hand functions, the power of which has been quantified by measuring it isometrically with variously devised pinch-meters. The present authors describe the investigations on the pinching power of 350 healthy persons, 200 male and 150 female Koreans, by the use of Preston Pinch Gauge. Six kinds of pinch were chosen: (1) thumb index finger tip pinch (1-2TP), (2) thumb-middle finger tip pinch (1-3TP), (3) thumb-index finger pulp pinch (1-2PP), (4) thumb-middle finger pulp pinch (1-3PP), (5) thumb-index-middle finger pulp pinch (3PP), (6) key pinch (KP), which were classified again into 19 kinds according to the shape of thumb, index, middle, or other fingers during each pinch. We describe those as principal type, hyperextension-flexion type, hyperextension type and other type into four. It should be justified to calculate the mean normal value of principal type pinching power in Korean. Principal type of pinch involves 1-2TP, 1-3TP, 1-2PP, 1-3PP, 3PP and KP, as to Hyperextension type of 1-2PP, 1-3PP, 3PP and KP. Other type of pinch involving 1-2TP, 1-3TP, 1-2PP, 1-3PP, 3PP and KP is different from Principal type simply because of the shape of nonjoining fingers during pinch. Generally, the pinching power of Principal type was clearly highest among the four types except for pulp pinches.
Asian Continental Ancestry Group ; Female ; Fingers ; Hand ; Humans ; Male ; Reference Values ; Thumb

According to literatures, the different types of fractures can occur as a result of arm wrestling ; Spiral fracture of the humeral shaft associating often with a bntterfly fragment, fracture of medial epicondyle of the humerus, and the marginal radial head fracture with anterior dislocation. The last type is very rarely reported. In addition to the fracture occurrence, other injuries such as muscular strain of the arm, and sprain or luxation of the shoulder, elbow and wrist joints can be taken place. However, it is thought that the most of those injuries by arm wrestling have been treated simply by general practioners unreported. The arouse the attention of the jury of the game, wrestlers and the surgenons, the cases of bony injuries sustained during the arm-wrestling are reported. Thirteen patients were treated by us since 1977. Among them, five cases had fractures of the humeral shaft, and eight cases had fractures of medial epicondyle of the humerus. Among the five shaft fractures, three were treated by conservatively, and two by operatively. Among 8 avulsion fractures of the medial epicondyle only two were treated conservatively, and 6 operatively. One patient sustained the medial epicondylar avulsion fracture twice for which K-wire fixation treatment was done. The results of treatment were all satisfactory. However, because of the possibility of wrestlers sustaining such injuries. Arm wrestling should not be considered a totally benign sport.
Arm ; Dislocations ; Elbow ; Head ; Humans ; Humerus ; Shoulder ; Sports ; Sprains and Strains ; Wrestling ; Wrist Joint

OBJECTIVES: Methylenetetrahydrofolate reductase (MTHFR) mutation are commonly associated with hyperhomocysteinemia, and through their defects in homocysteine metabolism, they have been implicated as a risk factor for recurrent spontaneous abortion. Recent report describe that 28-bp tandem repeat polymorphism in thymidylate synthase enhancer region (TSER) that influence enzyme activity would affect plasma homocysteine level. We have investigated the relationship between TSER genotype and plasma homocysteine level in 54 patients with recurrent spontaneous abortion. METHODS: Plasma homocysteine level was measured by fluorescent polarizing immunoassay. MTHFR mutation (C677T and A1298C) was identified by PCR-restriction fragment length polymorphism assay and TSER mutation was analyzed by PCR method. The data were analyzed using the program SAS 8.2 for Windows. RESULTS: Total homocysteine level was significantly higher in MTHFR 677TT genotype (9.80+/-3.87 mumol/L) than MTHFR 677CC genotype (8.14+/-1.74 mumol/L) in Korean patients with unexplained recurrent spontaneous abortion (p=0.0143). However, the plasma homocysteine level was not significantly different in the MTHFR 1298AA (8.42+/-2.65 mumol/L) and 1298CC (6.09+/-0.32 mumol/L; p=0.2058) and, TSER 2R2R (8.61+/-1.68 mumol/L) and 3R3R (8.05+/-2.81 mumol/L; p=0.9319) mutant genotypes, respectively. In this study, we found the combination effects of TSER and MTHFR C677T genotypes. Plasma homocysteine levels were the highest (11.47+/-4.66 mumol/L) in individuals with TSER 3R3R (8.05+/-2.81 mumol/L) and MTHFR 677TT (9.80+/-3.87 mumol/L) genotypes. Individuals with a combination of both TSER 2R2R/2R3R and MTHFR 677CC/CT genotypes (7.69+/-1.77 mumol/L) had lower plasma homocysteine levels than TSER 2R2R (8.61+/-1.68 mumol/L) and MTHR 677CC (8.14+/-1.74 mumol/L) genotypes, respectively. The effect of MTHFR polymorphism in the homocysteine metabolism appears to be stronger than that of TSER polymorphism. CONCLUSION: Although statistically not significant, we found the elevated level of plasma homocysteine in combined genotypes with TSER and MTHFR (C677T and A1298C) in Korean patients with unexplained habitual abortion. In this study, we reported the possibility that TSER polymorphism is a genetic determinant of plasma homocysteine levels in the Korean patients as well as MTHFR C677T polymorphism. A large prospective study is needed to verify our findings.
Abortion, Habitual ; Abortion, Spontaneous* ; Female ; Genotype ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Immunoassay ; Metabolism ; Methylenetetrahydrofolate Reductase (NADPH2) ; Plasma* ; Polymerase Chain Reaction ; Pregnancy ; Risk Factors ; Tandem Repeat Sequences ; Thymidylate Synthase*