Adhesion formed between tendon and its sheath after repair often impairs functional recovery. There have been many attempts to reduce adhesion around a repaired tendon, but most results have been unsatisfactory or impractical in clinical application. Moreover, most attempts were focused on extrinsic tendon healing. whereas studies on the intrinsic tendon healing are sacrce in the literature. We have previously reported that fibrotic tendon adhesion after repair was decreased by decorin, a natural inhibitor of TGF-beta. Accordingly, the serial tensile strength was measured after complete tensection and repair of the tendon severance in order to confirm the effect of decorin inhibition of intrinsic healing capability. Forty White Leghorn chickens were subject to complete transection and repair of the third toe flexor digitorum profundus tendon in Zone II. In the experimental group, 0.5ml of diluted decorin(50microgram/ml) was injected around the repaired site, and the same volume of saline solution in the control group. Tendons were harvested at 1, 3, 5 and 7 weeks. The disrupting force of the repair site was analyzed using tensiometry(LLOYD LR 30K, U.K). The tensile strength of repaired tendon was similar in both groups for all postoperative periods. This indicates that intrinsic healing proceeds normally within the decorin group in spite of the blockade of TGF-betaactivity. Decorin, a natural inhibitor of TGF-beta, showed a significant inhibitory effect on reducing post-repair tendon adhesions, without disruption of intrinsic healing in the chicken flexor tendon injury model. Therefore, decorin is expected to be a useful agent for preventnion on tendon adhesion after the repair in clinical usage.
Chickens ; Decorin* ; Postoperative Period ; Sodium Chloride ; Tendon Injuries ; Tendons* ; Tensile Strength* ; Toes ; Transforming Growth Factor beta

No abstract available.
Coronary Vessels* ; Mammary Arteries* ; Transplants*

Background: Cerebral palsy is due to static encephalopathy during perinatal period. Selective dorsal rhizotomy (SDR) involves selective division of posterior nerve roots to reduce spasticity and improve function in children with spastic cerebral palsy. Anesthesia during SDR must preserve muscle contraction in response to direct electrical stimulation of the dorsal nerve roots. We did this study to get the better management of anesthesia for SDR. Methods: Anesthetic records were reviewed for 16 patients who underwent SDR during January 1996 to August 1997. Demographic data; anesthetic drugs and doses; changes of vital signs and end tidal CO2; dorsal root stimulation; postoperative pain control were analysed. Results: The mean age of patients was 4.9+/-1.7 years old. The mean weight was 16.3+/-4.0 kg. The under 1 MAC concentration of isoflurane and 2~3 mcg/kg/hr fentanyl did not interfere with electrophysiologic monitoring. Esophageal temperature was increased significantly during electrical stimulation of dorsal roots. End tidal CO2 concentration had a tendency to increase after electrical stimulation too. Direct installation of 10~15 mcg/kg intrathecal morphine prior to dural closure, and postoperative 0.5 mcg/kg/hr fentanyl had a good postoperative analgesia without complication. Conclusions: Isoflurane and fentanyl during anesthesia, and intrathecal morphine with continuous infusion of fentany postoperatively are suggested a good anesthetic method for SDR.
Analgesia ; Anesthesia ; Anesthetics ; Cerebral Palsy ; Child ; Electric Stimulation ; Fentanyl ; Humans ; Isoflurane ; Morphine ; Muscle Contraction ; Muscle Spasticity ; Pain, Postoperative ; Rhizotomy* ; Spinal Nerve Roots ; Vital Signs

Erythema multiforme is a self-limited, usually mild and relapsing exanthematic intolerance reaction of the skin that is etiologically most often related to recurrent herpes simplex virus infection. Until now, despite its increasing incidence, varicella zoster virus has rarely been considered as an etiologic agent. We herein report a case of erythema multiforme following herpes zoster. A 52-year-old man complained of multiple targetoid lesions with central bullae which developed 1 day ago and were progressively spreading to his whole body. He had suffered from the thoracic herpes zoster along the right T11-, and T12-dermatomes for 10 days. He had no history of HSV infection. He had been intermittently taking analgesics such as acetaminophen for 1 year because of low back pain, but had no history of drug eruption due to analgesics. Histopathologic examination showed subepidermal bulla with necrotic keratinocytes and vacuolization of the basal layer. Based on the clinical morphology and the histopathologic findings, our case could be presumptively diagnosed as a bullous erythema multiforme following herpes zoster.
Acetaminophen ; Analgesics ; Drug Eruptions ; Erythema Multiforme* ; Erythema* ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Incidence ; Keratinocytes ; Low Back Pain ; Middle Aged ; Simplexvirus ; Skin

Phacomatosis pigmentovascularis (PPV) is a rare syndrome characterized by concurrent nevus flammeus (capillary malformation) and pigmentary nevus. According to current research, the major pathophysiologic mechanism in PPV is venous dysplasia with resultant compensatory collateral channels and venous hypertension. Arterial involvement is rare. We herein report our experience on renovascular hypertension, intermittent claudication, and severe rhabdomyolysis due to diffuse stenosis of multiple arteries in a patient with PPV type IIb associated with SWS.
Arteries ; Constriction, Pathologic ; Humans ; Hypertension ; Hypertension, Renovascular ; Intermittent Claudication ; Intracranial Aneurysm ; Neurocutaneous Syndromes* ; Nevus ; Port-Wine Stain ; Rhabdomyolysis* ; Sturge-Weber Syndrome* ; Vascular Diseases

Phakomatosis pigmentova.scularis is a disease complex with dermal melanocyto sis such as nevus of Ota, nevus of Ito, or Mongolian spots and extensive hemangiomatous change such as nevus flammeus, which are associated with systemic organ involvement. We report a 23-year-old female, who showed bilateral nevus of Ota and nevus of Ito with widespread nevus flammeus and Mongolian spots since birth. She was also associated with megalocornea due to congenitol glaucoma and cataract.
Cataract ; Female ; Glaucoma ; Humans ; Mongolian Spot ; Neurocutaneous Syndromes* ; Nevus ; Nevus of Ota ; Parturition ; Port-Wine Stain ; Young Adult

Allergic contact dermatitis that is attributable to contact with environmental sensitizers boine by a second individual, especially in marital or sexual relationships, has been described as connubial contact dermatitis. Severely pruritic multiple erythematous plaques, vesicles and bullae in a 35-year-old woman occurred on the face, posterior area of the neck, breasts, buttock, and both upper arms. No direct contact to allergens was obtained. However her husband had eaten some cooked sprouts from a lacquer tree for lunch at a restaurant the day before her eruption, then he caressed her that night. A patch test with extracts of lacquer tree in ethanol(2%), crushed extracts of lacquer tree (as is), and urushiol(0.002% pet.) on the patients back showed strong positive reactions.
Adult ; Allergens ; Arm ; Breast ; Buttocks ; Dermatitis, Allergic Contact ; Dermatitis, Contact* ; Female ; Humans ; Lacquer ; Lunch ; Neck ; Patch Tests ; Restaurants ; Rhus* ; Spouses ; Trees

POEMS syndrome is an unusual plasma cell dyscrasia with multisystemie manifestations featuring polyneuropathy, organomegaly, endocrinopsthy, M protein and skin changes. We have seen a 49-year-old woman presenting with hyperpigmentation, hypertrichosis, hyperhidrosis, and taut thickened skin of the extremities as a skin manifestation of this syndrome. We review the literature and report a case.
Extremities ; Female ; Humans ; Hyperhidrosis ; Hyperpigmentation ; Hypertrichosis ; Middle Aged ; Paraproteinemias ; POEMS Syndrome* ; Polyneuropathies ; Skin ; Skin Manifestations

Maligant melanomas of the oral or nasal cavity, and the vulvovaginal area are relatively common among the melanomas of non-ocular mucosa. But, primary malignant melanoma arising in the mucosa of the palatine tonsil is rare. We present a case of primary malignant melanoma arising in the mucosa of the palatine tonsil. A 36-year-old male was admitted for evaluation of a recurrent sore throat. Tonsillectomy was performed on the basis of clinical suspicion of chronic tonsillitis. Grossly, the left tonsil was focally dark. Microscopically, the tonsillar mucosa was diffusely infiltrated with tumor cells. Tumor cells revealed numerous melanin pigments. Intraepithelial nests of tumor cells were noted, but pagetoid spread of tumor cells was not found. Tumor cells were positive for S-100 protein and HMB45 stain. There was no evidence of melanoma in the skin or eye.
Male ; Humans

Ectopic pregnancy refers to gestation in which the fertilized ovum implants on any other tissure than tbe mucus membrane lining the uterine cavity. Cornual (intertitial) pegnancy is a relatively uncommon but potentially catastrophic form of ectopic pregnancy, defined as implantation in the intramural portion of a fallopian tube. A hydatidiform mole usually occupies the uterine cavity but it's occurrence in the uterine tube is extremely rare. Only a few cases of primary hydatidifm mole of the tube have been reported. We experienced a case of ectopic hydatidiform mole in the uterine cornua and so present it with brief review of literatures.
Fallopian Tubes ; Female ; Hydatidiform Mole* ; Membranes ; Mucus ; Pregnancy ; Pregnancy, Ectopic ; Zygote