Adhesion around tendons of the hand and wrist and subsequent limitation of motion, is one of the major complications after tendon surgery. In addition to the tendon surgery such as tendon repair or graft, infection, open reduction of fracutres, and burn scar contracture could be the casuses of tendon adhesion. Tenolysis and adequate postoperative rehabilitation program, has been proved to be effective in preventing of adhesion, whatever the cause may be, if its continuity is maintained. In order to evaluate the efficiency and problems of tenolysis, we reviewed 37 fingers of 31 patients who had been treated by tenolysis at Seoul National University Hospital from 1981 to 1991. There were 20 men and 11 women, and the average age was 28.2 years(9-45 years). The causes of adhesion were various; 24 fingers(64%) after tendon repair or tendon graft, 3 fingers(8%) after infection, 4 fingers(10%) after treatment of fracture, 4 fingers(10%) after burn scar contracture, and the other 2 fingers(5%) after curettage of enchondroma. Involved tendon were flexor tendon in 28 fingers and extensor in 9. The average duration of follow-up was 17 months(13 months to 4 years). Active motion of involved finger was started within 2 days after operation. The Total Active Motion(TAM) after operation was average 213°(100°-260°), compared to 123°(40°-180°) before operation. According to Strickland formula which was modified by us, the postoperative results were excellent in 17 fingers, good in 9 fingers, fair in 6 fingers and poor in 5 fingers. In 24 cases who had tenolysis after repair or graft, 19 case(79%) were rated as excellent or good. But in 7 cases whose causes of adhesion were infection or burn scar contracture, only 3 cases(42%) were rated as excellent or good. Compairing the results between younger(less than 30 years of age) and older(more than 30 years of age) group, the younger group showed excellent and good in 8496 and the older group in 41%, The complications were tendon rupture in 3 fingers and minor infection in 2 fingers, respectively. In summary, tenolysis was considered as a useful procedure to improve function of tendon bound down in scar tissue. And the results were better in younger age group(p < 0.05) and in previous tendon repair or graft(p < 0.05) group.
Burns ; Chondroma ; Cicatrix ; Contracture ; Curettage ; Female ; Fingers ; Follow-Up Studies ; Hand ; Humans ; Male ; Rehabilitation ; Rupture ; Seoul ; Tendons ; Transplants ; Wrist

The gastrointestinal polyp is a premalignant lesion in varying degree. According to the size, the pathology and the location of polyps, it should be removed. Polyps in the gastrointestinal tract can be removed by surgical excision, electrosurgery, cryotherapy, regional radiotherapy and laser therapy with some limitations. Considerable advance in therapeutic endoscopy as well as in diagnostic endoscopy along with newly developed instruments has now made it possible to excise gastrointestinal polyps by means of high frequency generator. We have underwent endoscopic polypectomy, strip biopsy and "O" ring ligation on gastric polyps in 112 patients who visited in this hospital from July l988 to January 1994, and the clinical characteristics including histopathology has been evaluated. Removed polyps were variable in size from less than 0.5 cm up to 4cm. Finally, we concluded that endoscopic polypectomy is a safe and relativly simple procedure and postpolypectomy complication can be considerably reduced by conservative antiulcer therapy.
Biopsy ; Cryotherapy ; Electrosurgery ; Endoscopy ; Gastrointestinal Tract ; Humans ; Laser Therapy ; Ligation ; Pathology ; Polyps* ; Radiotherapy

Previous reports have documented the occurrence of sterile peripheral corneal ulcer and perforation after cataract surgery in patients with systemic autoimmune vasculitic disease or Sjogren's syndrome. But the corneal complication after cataract surgery in patients with Terrien's marginal degeneration, characterized by bilateral slowly progressive thinning of peripheral cornea with opacity and superficial vascularization, have not been reported. We report a case of sterile peripheral corneal perforation following recent cataract surgery in a 77 year old woman with Terrien's marginal degeneration, treated with partial penetrating keratoplasty.
Aged ; Cataract* ; Cornea ; Corneal Perforation ; Corneal Ulcer ; Female ; Humans ; Keratoplasty, Penetrating ; Sjogren's Syndrome

PURPOSE: To evaluate whether the degree of melanin pigmentation of fundus or intraocular pressure would have influence on the determination of laser power for effective transpupillary thermotherapy(TTT). METHODS: TTT was performed on 6 eyes of each of the brown, yellow and white rabbits. Immediately after diode laser irradiation to posterior pole, retinal periphery, and iris with various power(2 mm, 60 or 120 sec), macular threshold power(MTP), peripheral threshold power(PTP), and iris threshold power(ITP) were defined as a maximum power not causing any ophthalmoscopic change on the respective laser site. To assess the influence of intraocular pressure, TTT was performed with the eyeballs compressed as much as retinal arterial pulsation disppeared. Three weeks after laser irradiation, funduscopic and fluorescein angiographic appearance were correlated with histopathologic findings. RESULTS: We found no difference of MTP between brown and yellow rabbit but their MTP were smaller than that of white one(P<0.05). There was positive correlation between MTP, PTP and ITP in all experimental species. ITP/MTP and PTP/MTP were 3.45+/-0.68, 1.09+/-0.10 in brown rabbit, 3.84+/-0.79, 1.12+/-0.13 in yellow rabbit and 4.13+/-0.43, 1.16+/-0.14 in white rabbit respectively. When TTT was performed with the eyeball compressed, the laser spot looks whiter in all cases than without. Microscopic examination revealed occlusion of choriocapillaris and photoreceptor degeneration in the laser spots formed by MTP. CONCLUSION: When performing TTT, one should reduce the laser power according to the amount of melanin pigmentation of fundus and intraocular pressure. Empirical laser burn to the retinal periphery will be a helpful mean to determine optimal laser power for TTT.
Burns ; Choroidal Neovascularization ; Fluorescein ; Hyperthermia, Induced* ; Intraocular Pressure ; Iris ; Lasers, Semiconductor ; Melanins ; Pigmentation ; Rabbits ; Retinaldehyde

T cell activation is a critical event for initiation and regulation of immune responses and inhibitors of such signaling pathways are clinically useful for the treatment of patients received allogratt and autoimmune disease. In the course of screening soil microorganisms from the forest of Cheju island in Korea for new immunosuppressive agent, one of Streptomyces species (CK-95441) was found to produce a new immunosuppressant, tautomycetin which also had antifungal activity. Tautomycetin showed the inhibition of T cell proliferation in murine mixed lymphocyte reaction (MLR) and T cell activation induced by concanavalin A. Tautomycetin also blocked the induction of IL-2 gene expression which was examined in Jurkat TAg cell line in which multiple NFAT-binding sites and minimal IL-2 promoter drive the production of B-galactosidase. Also, the level of inhibition in activation-induced IL-2 receptor expression by tautomycetin was greater than those by cyclosporin A measured by flow cytometry. But, Fas ligand-induced apoptosis in Jurkat cells was unaffected by tautomycetin which was measured by DNA fragmentation assay. These results suggested that tautomycetin will be able to be used as a potent immunosuppressive drug following organ transplantation.

The injured tendon is thought to be healed by, extrinsic healing from tendon sheath and adjacent connective tissue, and intrinsic healing from epitenon and endotenon. About the factors influencing the healing of injured tendon, many authors reported the effects of mobilization, electricity, ultrasound and various druge. Especially, active or passive mobilization had been known to promote the healing process and to reduce adhesion. To investigate the influences of active limited mobilization, intrinsic and extrinsic healing process, right Achilles tendons of 30 New Zealand white rabbits were grouped according to the types of treatments (Group I; tenotomy of Achilles tendon only, Group II; Tenotomy and long leg cast, Group III; surgical repair after tenotomy and long leg cast). The tendon sheath was repaired in all the groups, and the left Achilles tendons were used as control. At six weeks after operation, the tendons were removed and analysed biomechanically using Instron 1000, and histologically. The following results were obtained: 1. There were significant decreased of break strength, in order of Group III, Group I and Group II(p < 0.05). But, no difference was found between control group and Group III. 2. Extension length to the rupture, was decreased significantly in the experimental groups than control group. But there was no difference among the experimental groups. 3. Histologically, dense proliferation of fibroblasts and hypertrophy of tendon was observed in Group I; and matured fibricytic tendon tissues in Group II and III. In Group II, the amount of matured tendon tissues and degree of maturity were less than in Group III. In summary, suture and active limited motion were considered as promoting factors on the tendon healing.
Achilles Tendon ; Connective Tissue ; Electricity ; Fibroblasts ; Hypertrophy ; Leg ; Rabbits ; Rupture ; Sutures ; Tendons ; Tenotomy ; Ultrasonography

Heat-treated autogenous bone graft has been utilized in the cases with large hone defects associated with tumors, chronic osteomyelitis, and trauma. Conventional autoclaved autogenous bone grafting, however, has inherent disadvantages that included decreased biomechanical strength, and loss of osteogenesity. In contrast, despite devitalizing the tumor cells, low heat-treatment can render autogenous hone grafts to retain better biomechanical strength as well as to preserve osteogenesity by avoiding destruction of hone morphogenetic protein. To investigate biomechanical strength and osteogenesity of heat-treated autogenous bone grafts, rahbits were classified into three groups: groupl, in-situ implantation of autogenous graft in the diaphyseal defect of the tibia without any heat treatment; group 2, reimplantation of graft after low heattreatment; group 3, reimplantation of graft after autoclaving. Radiological, histological, and scintigraphic examination were performed postoperativeIy at 2nd, 4th, 6th, 9th, 12th weeks. And biomechanical test was performed postoperatively at 6th, 9th, 12th weeks. Biomechanical test revealed that there were no statistical differences among three groups at 6th week and 9th week. However, at 12th week postoperatively, there were significant differences between group 2 and group 3, and between group 1 and group 3. Radiological and histological examinations showed that new bone formation started earlier in groups l and 2, compared to group 3. Also bone remodeling was advanced in group I and 2, com- pored to group 3. Scintigraphically, the increase of 99mTc-MDP uptake was delayed in group3, compared to group l and 2. Based upon above findings, it was concluded that low heat-treated autogenous bone grafting was hetter than autoclaved autogenous bone grafting in promoting bone healing with retained biomechanical strength.
Bone Remodeling ; Bone Transplantation* ; Hot Temperature* ; Osteogenesis ; Osteomyelitis ; Replantation ; Technetium Tc 99m Medronate ; Tibia ; Transplants

STUDY DESIGN: A retrospective study. OBJECTIVES: To compare the outcome of percutaneous vertebroplasty (VP), with kyphoplasty, in the treatment of osteoporotic painful vertebral compression fractures (VCF). SUMMARY OF LITERATURE REVIEW: There is much controversy relating to the treatment of painful osteoporotic VCF. Recent analytical data exists on VP and kyphoplasty. MATERIALS AND METHODS: A consecutive group of patients, undergoing VP and kyphoplasty at our institution, between July 2000 and November 2002, were retrospectively reviewed. A total of 23 patients underwent 25 VP procedures under local anesthesia, and 8 underwent 8 kyphoplasty procedures, 3 under general and 5 under local anesthesia. A radiological assessment was achieved by the percentage of height restored, using both the preoperative and postoperative radiographs. The Visual analog scale (VAS) scores, obtained pre and postoperatively were used for the clinical assessment. The activity levels were assessed preoperatively, after discharge and at the last follow up period, by the ambulatory stati. RESULTS: The VP restored 27.62% (anterior*) and 30.26% (middle**) of the lost height. The kyphoplasty restored 35.52% (anterior*) and 53.43% (middle**) of the lost height (P=0.3334*, P=0.0264**). The postoperative pain was improved in all patients after both procedures. The postoperative VAS score was 3.826 after the VP and 2.875 after the kyphoplasty (P=0.5647). The activity levels were improved in all patients after both procedures. CONCLUSIONS: The kyphoplasty was more efficient in restoring the middle vertebral body height than the VP in the treatment of osteoporotic painful VCF. However, both procedures showed similar clinical improvements in the pain and restoration of the anterior vertebral body height in the treatment of painful osteoporotic VCF. Both kyphoplasty and VP safely increased the vertebral body height, decreased the acute back pain and quickly returned geriatric patients to higher activity levels, resulting in an increased independence and quality of life.
Anesthesia, Local ; Back Pain ; Body Height ; Follow-Up Studies ; Fractures, Compression* ; Humans ; Kyphoplasty* ; Osteoporosis ; Pain, Postoperative ; Quality of Life ; Retrospective Studies ; Vertebroplasty* ; Visual Analog Scale

PURPOSE: We evaluated clinical aspects of the glaucoma patients who had undergone trabeculectomy. METHODS: We analyzed 211 patients' medical records who had undergone trabeculectomy in Chungbuk National University Hospital from August 1991 to December 1999 retrospectively. RESULTS: The mean age of the patients was 57.1+/-16.3 years and the 119 eyes (56.4%) had bilateral glaucoma. Among them, 57 eyes (47.9%) had primary open-angle glaucoma. Cataract was the most common cause of decreased vision in the fellow eye during the mean follow-up period of 25.4+/-22.3 months. The number of patients whose visual acuity in the fellow eyes less or equal to hand movement before surgery were 25 eyes (11.8%) and they resulted from glaucoma (18 eyes) and trauma (4 eyes). CONCLUSIONS: The fellow eyes of the glaucoma patients who had undergone trabeculectomy were easily subject to high prevalence of glaucoma that may lead to blindness. Therefore, more thorough and periodic ocular examination and appropriate treatments are mandatory to prevent further progress in these eyes with more advanced glaucoma.
Blindness ; Cataract ; Chungcheongbuk-do ; Filtering Surgery* ; Filtration* ; Follow-Up Studies ; Glaucoma* ; Glaucoma, Open-Angle ; Hand ; Humans ; Medical Records ; Prevalence ; Retrospective Studies ; Trabeculectomy ; Visual Acuity

PURPOSE: These case reports show the orthodontic treatment of lower anterior incisors with gingival recession. MATERIALS AND METHODS: Three cases were treated by an orthodontist and a periodontist. Each case had lingually tilted lower anterior incisors, anterior crossbite and skeletal Cl III pattern. RESULTS: A variety of etiological factors were thought to cause gingival recession: aging, oral hygiene, tooth malpositioning, occlusal trauma. CONCLUSION: Due to the interaction among many possible contributing factors, it is difficult to predict whether further gingival recession may occur at a given site. The position and the movement of the lower anterior incisors with gingival recession are important factors in diagnosis and orthodontic treatment planning.
Aging ; Gingival Recession ; Incisor ; Malocclusion ; Oral Hygiene ; Tooth