No abstract available.

PURPOSE: Correlations between maximum flexion and functional outcomes in total knee arthroplasty (TKA) patients are reportedly weak. We investigated whether there are differences between passive maximum flexion in nonweight bearing and other types of maximum flexion and whether the type of maximum flexion correlates with functional outcomes. MATERIALS AND METHODS: A total of 210 patients (359 knees) underwent preoperative evaluation and postoperative follow-up evaluations (6, 12, and 24 months) for the assessment of clinical outcomes including maximum knee flexion. Maximum flexion was measured under five conditions: passive nonweight bearing, passive weight bearing, active nonweight bearing, and active weight bearing with or without arm support. Data were analyzed for relationships between passive maximum flexion in nonweight bearing by Pearson correlation analyses, and a variance comparison between measurement techniques via paired t test. RESULTS: We observed substantial differences between passive maximum flexion in nonweight bearing and the other four maximum flexion types. At all time points, passive maximum flexion in nonweight bearing correlated poorly with active maximum flexion in weight bearing with or without arm support. Active maximum flexion in weight bearing better correlated with functional outcomes than the other maximum flexion types. CONCLUSIONS: Our study suggests active maximum flexion in weight bearing should be reported together with passive maximum flexion in nonweight bearing in research on the knee motion arc after TKA.
Arm ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Humans ; Knee ; Weight-Bearing

No abstract available.
Carcinoma, Hepatocellular* ; Natural History* ; Survival Rate*

OBJECTIVE: The aim of the present study was to investigate the pain intensity, quality, and pattern in experimental muscle pain. METHOD: Eleven healthy adults and eleven myofascial pain syndrome (MPS) patients participated in this study. Hypertonic saline (5%) was injected into upper trapezius, infraspinatus and tibialis anterior muscles of 11 healthy adults. A continuous recording of ongoing pain intensities of the local pain and referred pain was measured. After pain had subsided, the subjects completed a Korean version of the McGill Pain Questionnaire (MPQ). This study included 11 patients who have trigger point on upper trapezius muscle. Pain pressure thresholds (PPTs) and pain intensity ratings of different pressure stimuli in upper trapezius muscles were compared with experimental group. RESULTS: In experimental group, local pain became maximal after one minute and referred pain after one and a half minutes. At that time, Visual analogue scale (VAS) score was 3.8 and 1.9 each other. The referred pain of upper trapezius muscle primarily radiated to the posterolateral side of neck. The one of infraspinatus muscle radiated to the shoulder joint and anterolateral side of upper arm area and the one of tibialis anterior muscle radiated to the shin and dorsum of ankle joint. The PPTs were found to be significantly lower in upper trapezius muscle of patients with myofascial pain syndrome (MPS) than in those of experimental group. The slope of VAS to different stimuli showed the linear relationship at both group, and in that of patient groups was found to be significantly steeper than in that of experimental group. The experimental muscle pain group had no difference in pain quality compared with MPS patients except affective subscale. CONCLUSION: The present results suggest that intramuscular injection of hypertonic saline can be used a experimental pain model of MPS, and PPTs and pain intensity ratings of different pressure stimulus are valuable tools for quantitative description of chronic and experimental muscle pain.
Adult ; Ankle Joint ; Arm ; Humans ; Injections, Intramuscular ; Muscles ; Myalgia* ; Myofascial Pain Syndromes ; Neck ; Pain Measurement ; Pain, Referred ; Shoulder Joint ; Superficial Back Muscles ; Trigger Points

Unilateral brachial plexus injury is a rare complication of thoracoscopic sympathectomy, which is generally considered to be a simple and safe procedure. We report on a 20-year-old female patient who developed persistent pain and weakness of the left arm after thoracoscopic sympathectomy for hyperhidrosis. An electromyographic study revealed evidence of denervation at the C5-C7 level, and a nerve conduction study on the left brachial plexus showed decreased amplitude of the compound muscle action potential of the left musculocutaneous and axillary nerves. The above findings are compatible with left brachial plexopathy, with predominant involvement of the lateral and posterior cord. We suggest that this complication was caused by stretch and/or compression of the left brachial plexus when the arm was hyperabuducted upwards during the operation. Careful attention to positioning by the surgeon and anesthesiologist is needed to prevent this debilitating injury.
Action Potentials ; Arm ; Brachial Plexus Neuropathies ; Brachial Plexus* ; Denervation ; Female ; Humans ; Hyperhidrosis ; Neural Conduction ; Sympathectomy* ; Young Adult

Matrix metalloproteinases (MMPs) are zinc-dependent endopeptidases that degrade the extracellular matrix and other extracellular proteins. Upregulation of MMPs activity is known to be required for the inflammatory cell infiltration after spinal cord injury (SCI) and most likely contributes to early blood spinal barrier disruption and inflammation, thereby leading to the impairment of functional recovery. Here, we examined the effect of ethanol extract of Bupleurum falcatum (BF) on functional recovery by inhibiting MMP-2 and -9 activation and inflammation after SCI. Rats received a moderate, weight-drop contusion injury to spinal cord were administered orally with BF at a dose of 100 mg/kg for 14 d and functional recovery was measured by Basso-Beattie-Bresnahan locomotor open field behavioral rating test, inclined plane test and foot print analysis. To examine the neuroprotective effect of BF, TUNEL staining and counting were also performed. In addition, the expression and/or activation of MMP-2, MMP-9 and inflammatory mediators such as TNF-alpha, IL-1beta, COX-2, and iNOS were examined by RT-PCR and gelatin zymography using spinal cord tissue from 1 d after injury. Our data showed that BF significantly inhibited the expression and activation of both MMP-2 and MMP-9 after SCI. The mRNA expressions of TNF-alpha, IL-1beta, COX-2, and iNOS were also significantly attenuated by BF. Furthermore, BF reduced apoptotic cell death at 1 d after injury, thereby significantly reduced lesion volume and improved functional recovery. Taken together, these results suggest that BF can be used as a potential therapeutic agent for treating acute spinal injury.
Animals ; Blood-Brain Barrier ; Bupleurum ; Cell Death ; Contusions ; Endopeptidases ; Ethanol ; Extracellular Matrix ; Foot ; Gelatin ; In Situ Nick-End Labeling ; Inflammation ; Matrix Metalloproteinases ; Neuroprotective Agents ; Proteins ; Rats ; RNA, Messenger ; Spinal Cord ; Spinal Cord Injuries ; Spinal Injuries ; Tumor Necrosis Factor-alpha ; Up-Regulation

PURPOSE: The purpose of this study was to investigate the clinical efficacy of an optimized prolate ablation procedure for correcting residual refractive errors following laser surgery. METHODS: We analyzed 24 eyes of 15 patients who underwent an optimized prolate ablation procedure for the correction of residual refractive errors following laser in situ keratomileusis, laser-assisted subepithelial keratectomy, or photorefractive keratectomy surgeries. Preoperative ophthalmic examinations were performed, and uncorrected distance visual acuity, corrected distance visual acuity, manifest refraction values (sphere, cylinder, and spherical equivalent), point spread function, modulation transfer function, corneal asphericity (Q value), ocular aberrations, and corneal haze measurements were obtained postoperatively at 1, 3, and 6 months. RESULTS: Uncorrected distance visual acuity improved and refractive errors decreased significantly at 1, 3, and 6 months postoperatively. Total coma aberration increased at 3 and 6 months postoperatively, while changes in all other aberrations were not statistically significant. Similarly, no significant changes in point spread function were detected, but modulation transfer function increased significantly at the postoperative time points measured. CONCLUSIONS: The optimized prolate ablation procedure was effective in terms of improving visual acuity and objective visual performance for the correction of persistent refractive errors following laser surgery.
Coma ; Humans ; Keratectomy, Subepithelial, Laser-Assisted ; Keratomileusis, Laser In Situ ; Laser Therapy* ; Phosmet* ; Photorefractive Keratectomy ; Refractive Errors* ; Refractive Surgical Procedures ; Treatment Outcome ; Visual Acuity

PURPOSE: To determine the value of CT(Computerized Tomography) in the diagnosis of laryngeal tuberculosis and to assess to what extent its characteristic findings different from those of aryngeal carcinoma. Materials and Methods : CT scans of twelve patients with laryngeal tuberculosis were reviewed and compared with those of fifteen patients with laryngeal cancer, retrospectively. Clinical symptoms, laryngoscopic examinations and the presence of pulmonary tuberculosis on chest radiographs were also reviewed. RESULTS: In laryngeal tuberculosis, bilater alsymmetric or asymmetric involvement was noted in nine(75%) patients, while unilateral involvement was seen in three(25%). This was significantly different from laryngeal cancer in which unilateral involvement was noted in twelve patients(80%). Diffuse thickening of the free margin of the epiglottis was a characteristic and frquent finding in tuberculosis(n=6, 50%). No deep submucosal infiltration of preepiglottic and paralaryngeal fat spacesis seen in tuberculosis in spite of large areas of involvement of laryngeal mucosa, while twelve patients(80%) with laryngeal cancer showed thickened deep infiltration which resulted in a submucosal mass. CONCLUSION: CT was useful in the diagnosis of laryngeal tuberculosis and its CT findings wee characterized by bilateral involvement, thickening of the free margin of the epiglottis and good preservation of preepiglottic and paralaryngeal fatspaces in spite of large areas of involvement.
Diagnosis ; Epiglottis ; Humans ; Laryngeal Mucosa ; Laryngeal Neoplasms ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Laryngeal*

OBJECTIVE: The purpose of this study is to assess morphologically the changes of macrophages during various developmental periods of the corpus luteum in the rat ovary. METHODS: The female rats (Sprague-Dawley strain) at age 8 weeks, ovulatory period; 6 days of gestation, early pregnancy period; 19 days of gestation, late pregnancy period; and postpartum 5 days, postpartum period were used. Removed ovaries were dissected and used for TdT-mediated dUTP biotin nick end labelling (TUNEL), macrophages immunohistochemistry, and Transmission Electron Microscopy (TEM). RESULTS: Macrophages were observed in all the developmental periods. The number of apoptotic bodies and macrophages was highest at the ovulatory period, and decreased at postpartum period, early pregnancy period and late pregnancy period in order. The immunoreactivity of macrophages was high at ovulatory period, moderate at late pregnacy and postpartum period, and low at early pregnancy period. In TEM observations, two types of macrophages were observed. One was non-phagocytic macrophage which has slender cell body and long cytoplasmic processes and contained no apoptotic bodies, and the other was phagocytic macrophage which contained apoptotic bodies, phagocytic vacuoles and many lipid droplets and located near the capillaries. CONCLUSION: In the rat corpus luteum, the number and the degree of immunoreactivity of macrophages changed according to the functional developmental periods of the corpus luteum. The functions of the macrophages were suggested as the elimination of apoptotic bodies at the ovulatory and postpartum periods, and luteotropic action at the early and late pregnancy periods. Ultrastructurally, two types of macrophages, phagocytic and non-phagocytic, were confirmed.
Animals ; Apoptosis ; Biotin ; Capillaries ; Corpus Luteum* ; Cytoplasm ; Female ; Humans ; Immunohistochemistry ; Macrophages* ; Microscopy, Electron, Transmission* ; Ovary ; Postpartum Period ; Pregnancy ; Rats* ; Vacuoles

Peutz-Jeghers syndrome is a rare autosomal dominant disorder defined by hamartomatous polyps of gastrointestinal tracts and the occurrence of melanin spots on the mucocutaneous surface. This syndrome has important complications such as malignant transformation, gastrointestinal bleeding, and intussusception. About 50% of patients with Peutz-Jeghers syndrome involved Intussusception. A case of Peutz-Jeghers syndrome with intussusception was recently experienced and herein reported.
Gastrointestinal Tract ; Hemorrhage ; Humans ; Intussusception* ; Melanins ; Peutz-Jeghers Syndrome* ; Polyps