No abstract available.
Fingers*

Carpal tunnel syndrome is the most common peripheral nerve entrapment syndrome. The elevated pressure in the carpal tunnel causes compression of median nerve. Although the diagnostic criteria for carpal tunnel syndrome are not clear, the diagnosis is based on the patient history and physical examination and may be confirmed by electrodiagnosis with nerve conduction test or ultrasonography. Nonsurgical treatments are generally recommended for early carpal tunnel syndrome and surgical treatments are preferred for failed nonsurgical treatment, however there is controversy regarding the optimal time when the surgery should be performed. Results of surgical treatment are usually satisfactory, however there are also complications after surgical treatment. In order to achieve good results without complications, normal anatomy around the median nerve and its anatomical variations should be thoroughly understood before the operation and careful surgical technique is absolutely required.
Carpal Tunnel Syndrome* ; Diagnosis ; Electrodiagnosis ; Humans ; Median Nerve ; Neural Conduction ; Peripheral Nerves ; Physical Examination ; Ultrasonography

No abstract available.
Free Tissue Flaps* ; Lower Extremity* ; Soft Tissue Injuries*

A 51 year-old male was admitted to our hospital complaining of right lower abdominal mass. Physical examination revealed nonpalpable right testicle in the scrotum. Echogram and CT scan of abdomen revealed a well defined round mass in the right lower abdomen. Exploration was performed under the suspicion of abdominal cryptorchid testicular tumor, and the mass was resected completely. The mass was 9X7X4cm in size and l90gm in weight, and cut surface of it showed yellowish-white spherical tumor nodules. Histological examination revealed seminoma. Postoperative right pelvic and retroperitoneal irradiation was performed under the diagnosis of seminoma of stage I. Here we report a case of seminoma developed in abdominal cryptorchid testis.
Abdomen ; Cryptorchidism ; Diagnosis ; Humans ; Male ; Middle Aged ; Physical Examination ; Scrotum ; Seminoma* ; Testis* ; Tomography, X-Ray Computed

PURPOSE: To describe the clinical presentation and course of necrotizing fasciitis of low extremity and to analyze the factors affecting the clinical result of necrotizing fasciitis. MATERIALS AND METHODS: The medical records and MRI of 26 patient who had suffered from necrotizing fasciitis were reviewed retrospectively. RESULTS: There were 18 men and 8 women with a mean age of 43.8 years. Twenty two of 26 patients had a medical disease and the most common comorbidity was diabetes mellitus. Exquisite pain, erythema, warm skin were the most consistent clinical feature at the time of admission. Only six patients had a diagnosis of necrotizing fasciitis initially. The interval between onset of symptom and operative treatment was average 5.4 days in 20 patients who didn't have a diagnosis of necrotizing fasciitis initially, and among them, 2 patients died. There were limited range motion of knee joint in 3 cases, sacral osteomyelitis in 1 case, and sciatic nerve palsy in 1 case as a complication. CONCLUSION: We think that the diagnosis of necrotizing fasciitis should be considered with a high index of suspicion in patients who present with unexplained limb pain, and delay in operative treatment and wide involvement of the necrosis is associated with poor results of necrotizing fasciits.
Comorbidity ; Diabetes Mellitus ; Diagnosis ; Erythema ; Extremities* ; Fasciitis, Necrotizing* ; Female ; Humans ; Knee Joint ; Magnetic Resonance Imaging ; Male ; Medical Records ; Necrosis ; Osteomyelitis ; Retrospective Studies ; Sciatic Neuropathy ; Skin

PURPOSE: The purpose of this study is to evaluate the effects of recombinant human bone morphogenetic protein-2 (rhBMP-2) after microfracture on the remodeling of subchondral bone and cartilage healing in a model of full-thickness articular cartilage injury in a rabbit. MATERIALS AND METHODS: A full thickness articular cartilage defect of 6x3-mm-size was created in the trochlear groove of the right femur in 24 rabbits. The defect was left empty in six rabbits, and microfracture was done in 18 rabbits. After microfracture, no treatment was done in six rabbits, defect was filled with fibrin glue in six rabbits, and with fibrin glue and rhBMP-2 in six rabbits. The effect of rhBMP-2 after microfracture was evaluated based on histological analysis and real-time polymerase chain reaction (PCR) for analysis of collagen type at 8 weeks after surgery. RESULTS: The score of histological grade scale of six rabbits in which the defect was filled with fibrin glue and rhBMP-2 was better than that of others and real-time PCR also showed a higher amount of collage type 1 and collage type 2 in these six rabbits. CONCLUSION: We consider that fibrin glue and rhBMP-2 after microfracture may accelerate cartilage healing in an articular cartilage defect and maybe helpful in healing the articular cartilage defect into more closely native hyaline cartilage.
Cartilage* ; Cartilage, Articular* ; Collagen ; Femur ; Fibrin Tissue Adhesive ; Humans ; Hyaline Cartilage ; Rabbits ; Real-Time Polymerase Chain Reaction

PURPOSE: To analyze the clinical results of debridement arthroplasty through a medial approach for primary osteoarthritis of the elbow. MATERIALS AND METHODS: Ten patients with primary osteoarthritis treated with debridement arthroplasty trough a medial approach were investigated. The ulnar nerve was transposed anteriorly in all patients. The mean duration of follow-up was 20.8 months. The clinical results were evaluated by measuring the preoperative and postoperative range of motion (ROM) of the elbow and using Mayo Elbow Performance Score (MEPS). RESULTS: The mean flexion contracture of the elbow joint was reduced from 23 degrees preoperatively to 10 degrees, postoperatively and the mean further flexion was improved from 93 degrees preoperatively to 131 degrees postoperatively. The mean MEPS improved from 55.3 points preoperatively to 86.9 points postoperatively. CONCLUSION: Debridement arthroplasty through a medial approach is considered as an useful method for primary osteoarthritis of the elbow.
Arthroplasty ; Contracture ; Debridement ; Elbow ; Elbow Joint ; Follow-Up Studies ; Humans ; Osteoarthritis ; Range of Motion, Articular ; Ulnar Nerve

PURPOSE: The purpose is to evaluate and report the results that treated with open reduction and internal fixation in delayed diagnosed fracture and dislocation of the hamatometacarpal joint. MATERIALS AND METHODS: We evaluated 12 cases that had been treated with open reduction and internal fixation in delayed diagnosed fracture and dislocation of the hamatometacarpal joint. The mean interval between injury and operation was 34 days (21~60 days), the mean age of 12 cases was 28.1 years old, and mean follow-up period was 18 months. The computer tomography was done in all cases and the fracture and dislocation types were classified by Cain's classification. For the evaluation of results, pain scale, grasping power, range of motion of wrist and metacarpophalangeal joint were analyzed preoperatively and at final follow up, and the arthritic change of the hamatometacarpal joint was also checked. RESULTS: According to Cain's classification, type Ia was one case, type Ib was two, type II was six, and type III was three. The pain scale was improved from 7.75 preoperatively to 0.92 at last follow up. The mean grasping power was improved up to 97.5% of normal. The preoperative range of motion of the wrist joint measured to be 60 degrees in extension and 70 degrees in flexion; the final range of motion indicated to be 75 degrees in extension and 80 degrees in flexion. The preoperative range of motion of the metacarpophalangeal joint measured to be 0 degrees in extension and 70 degrees in flexion; the final range of motion indicated to be 0 degrees in extension and 85 degrees in flexion. Carpometacarpal arthritis was developed in two cases. CONCLUSION: The open reduction and internal fixation is considered as one of good treatment option in the delayed diagnosed hamatometacarpal fracture and dislocation.
Arthritis ; Dislocations ; Follow-Up Studies ; Hand Strength ; Joints ; Metacarpophalangeal Joint ; Range of Motion, Articular ; Wrist ; Wrist Joint

PURPOSE: We observed many cases which showed hypofluorescent spots in indocyanine green angiography (ICGA) at the late phase as well as white dot syndrome, so we analyzed for types and causes of these. METHODS: we analyzed the color photographs, fluorescein angiographs (FAG) and ICGA of the 21 patients (39 eyes) who have noted hypofluorescent spots at the late phase retrospectively. RESULTS: The hypofluorescent spots in ICGA could be classified into two types. The first is that which seen hypofluorescence from the early phase and clearly to the late phase and the second, relatively lighter dark spots which appeared after midphase and is seen in the late phase. But when we analyze these together with ophthalmologic findings and FAG, we found out that the lesion could not be found in the retina and FAG or that it is noted as hyperfluorescence or hypofluorescence in the early and late phase of FAG. So the causes were thought to be variable. CONCLUSIONS: We could find hypofluorescent spots in the late phase of ICGA in the lesions which were classified as white dot syndrome in the past as well as presented normal finding in the retina and FAG and they had variable morphologies and causes.
Angiography* ; Fluorescein ; Humans ; Indocyanine Green* ; Retina ; Retrospective Studies

The fruit of Chaenomeles sinensis (Thouin) Koehne (Chaenomelis Fructus) known as “Mo-Gua” in Korea has been commonly used in traditional medicine to treat inflammatory diseases, such as sore throat. However, its effect on bone metabolism has not been elucidated yet. Here, we examined the effect of Chaenomelis Fructus ethanol extract (CFE) on receptor activator of nuclear factor (NF)-κB ligand (RANKL)-mediated osteoclast differentiation and formation. CF-E considerably inhibited osteoclast differentiation and tartrate-resistant acid phosphatase-positive multinuclear cell formation from bone marrow-derived macrophages and osteoclast precursor cells in a dose-dependent manner. In addition, the formation of actin rings and resorption pits were significantly suppressed in CF-E-treated osteoclasts as compared with the findings in non-treated control cells. Consistent with these phenotypic inhibitory results, the expressions of osteoclast differentiation marker genes (Acp5, Atp6v0d2 , Oscar, CtsK, and Tm7sf4) and Nfatc1 , a pivotal transcription factor for osteoclastogenesis, were markedly decreased by CF-E treatment. The inhibitory effect of CF-E on RANKL-induced osteoclastogenesis was associated with the suppression of Nfatc1 expression, not by regulation of mitogen-activated protein kinases and NF-κB activation but by the inactivation of phospholipase C gamma 1 and 2. These results indicate that CF-E has an inhibitory effect on osteoclast differentiation and formation, and they suggest the possibility of CF-E as a traditional therapeutic agent against bone-resorptive diseases, such as osteoporosis, rheumatoid arthritis, and periodontitis.