Comparison of Processed Nerve Allograft and Laminin Derived Peptide Incorporated Nerve Conduit for Peripheral Nerve Regeneration / 대한정형외과학회잡지

PURPOSE: To compare a processed nerve allograft, laminin derived peptide incorporated nerve conduit, and autograft in terms of electrodiagnostic testing and nerve histomorphometry for peripheral nerve regeneration in a rabbit sciatic nerve defect model. MATERIALS AND METHODS: Thirty New Zealand white rabbits were divided into three groups, and a unilateral 15 mm sciatic nerve defect was made. Group I, II and III was repaired with a reversed autograft, a processed acellular nerve allograft, and a laminin derived peptide incorporated nerve conduit, respectively. At twelve weeks, the animals were evaluated with the compound muscle action potential, wet muscle weight, and nerve histomorphometric parameters such as nerve area, number of axons, and myelin thickness. RESULTS: At twelve weeks, the compound muscle action potential for group I, II and III was 54.1%, 38.2% and 26.4%, respectively. Significant differences were found between the three groups (p<0.001, group I vs II; p<0.001, group I vs III; p<0.001, group II vs III). The wet muscle weight for group I, II and III was 57.8%, 54.4% and 43.9%, respectively. Group I had significantly more muscle weight than group III (p<0.001), but the difference was not significant with group II (p=0.256). Group II and III showed a significant difference (p=0.002). The number of axons in group III decreased and the shape of the axon was irregular, even though the nerve area and myelin thickness were similar in the three groups. CONCLUSION: An autograft remains the gold standard to repair a segmental nerve defect. Processed allograft demonstrated superior nerve recovery compared to the laminin derived peptide incorporated nerve conduit.

Short-term Efficacy of Topical Immunosuppressive Agents on the Survival of Cultivated Allo-Conjunctival Equivalents

PURPOSE: To investigate the short-term efficacy of topical immunosuppressive agents on the survival of cultivated allo-conjunctival equivalents. METHODS: Twenty-five eyes of New Zealand white rabbits were included. Temporal conjunctivae were trephined to a diameter of 7.5 mm, and then cultured allo-conjunctival epithelial cells on amniotic membrane were transplanted onto them. Various immunosuppressants including steroid, cyclosporine, and rapamycin were applied topically four times a day for a week. Epithelial defects and graft edema were graded daily. Numbers of inflammatory cells were measured in H&E. PKH26 and cytokeratin 4 and 7 were immunostained. RESULTS: Earlier epithelialization was observed in 1% steroid-treated eyes and defects persisted significantly in 0.5% CsA applied eyes. In histology, PKH26 positive cells considered as donor cells were only found in 1% steroid or 0.01% rapamycin applied eyes. 1% steroid- or 0.01% rapamycin-applied eyes both showed positive staining for keratin-4 and -7. Inflammatory cells were less found in 1% steroid or 0.01% rapamycin treated eyes. CONCLUSIONS: Topical steroid or rapamycin can help to suppress acute inflammation and enhance the acute survival of transplanted conjunctival cells.

Relation of the radiologic findings and labeling index of Ki-67, PCNA and cytokeratin in unicystic ameloblastoma, dentigerous cyst and odontogenic keratocyst / 대한구강악안면방사선학회지

PURPOSE: To compare the proliferation potential of the epithelial cells between unicystic ameloblastoma (UA), dentigerous cyst (DC), and odontogenic keratocyst (OKC) and to correlate this proliferation potential with the radiographic features of these three pathoses. MATERIALS AND METHODS: Immunohistochemical expression of PCNA, Ki-67, and cytokeratin as a proliferation marker were assessed for 15 cases of UA, 15 cases of DC, and 15 cases of OKC. The degree of immunochemical expression of three proliferation markers were correlated with the radiographic features, especially cortical expansion (negative and positive) and shape of border (scalloped and round). RESULTS: Using PCNA and Ki-67, OKC showed the highest proliferation potential and UA the lowest. Statistically significant differences were found between the OKC and the UA (p< 0.05). However, no statistically significant difference was present according to the radiographic features in all pathoses. Using cytokeratin, there was no significant differences of proliferation potential among three pathoses. CONCLUSIONS: OKC epithelium has the most intense proliferation potential, followed by the dentigeous cyst and then unicystic ameloblastoma. There is no significant relation between the radiographic features and the proliferation potential of epithelium of these three pathoses.

Transforming growth factor (TGF)-beta1 conjugated chitosan film for enhanced osteoblastic activity / 대한치주과학회지

No abstract available.

Effect of Both Lateral Rectus Recession in Large Angle Exotropia

PURPOSE: To evaluate of the effect of both lateral rectus recession according to the amount of the recession in the patients who showed large angle (>or=35 prism diopter, PD) exotropia. METHODS: The 120 patients who underwent both lateral rectus recession and followed up more than 1 year between 1996 to 2002 at Chung-nam university hospital, were reviewed. The effect of both lateral rectus recession was compared according to the amount of recession and preoperative angle of deviation. Successful outcome was defined as esotropia

Long Term Surgical Results after Early Surgery for Infantile Esotropia Before and After 1 year of Age

PURPOSE: To analyze the long term surgical results after early surgery for infantile esotropia before and after 1 year of age and to investigate postoperative eye alignments. METHODS: This retrospective study included 46 patients with infantile esotropia who underwent surgery before 2 years of age and were followed up for a minimum of 5 years. Subjects were divided into 2 groups: those who underwent surgery before 1 year of age (n=22, group 1), and the ones who underwent surgery between 1 year of age and 2 years of age (n=24, group 2). RESULTS: Long term postoperative alignment between two groups was not statistically significant. In postoperative stereopsis test, 11 patients (78.6%) of group 1 and 7 patients (41.2%) of group 2 had stereopsis and the patients of group 1 had more favorable stereoacuity than the patients of group 2. These differences were statistically significant, respectively (p=0.039). In postoperative eye alignment, patients of group 1 showed tendency to become exodeviated to esodeviated and patients of group 2 showed tendency to become esodeviated to exodeviated. These differences were statistically significant, respectively (p=0.023, p=0.042). CONCLUSIONS: To achieve better binocular function, early surgical alignment before 1 year of age is more recommended. Because early surgery before and after 1 year of age displays contradictory postoperative eye alignment, close follow up and careful consideration at reoperation is recommended.

Effect of Both Lateral Rectus Resection for Residual Esotropia

PURPOSE: To investigate the surgical outcome of both lateral rectus resection in the treatment of residual esotropia with previous both medial rectus recession METHODS: The medical record of 30 patients who had underwent both lateral rectus resection from 1996 to 2001 for residual esotropia occurred after bilateral medial rectus recession and who had followed up for more than one year, were analysed retrospectively. Successful outcome was defined as esotropia 0.05), but it was not significant statistically. Postoperative angle of deviation in group II was increased from 8.1+/-4.6PD at postoperative 1 day to 13.8+/-7.9PD at postoperative 1 year (p<0.001). CONCLUSIONS: Both lateral rectus resection is an effective method in the treatment of residual esotropia less than 40 PD.

Effect of Both Medial Rectus Recession in Large Angle Infantile Esotropia

PURPOSE: To evaluate of the effect of bilateral medial rectus recession in the patients who showed large angle (>50 prism diopters, PD) infantile esotropia as comparing small angle (50 PD, 14 patients) and small angle group (

Effect of Unilateral Lateral Rectus Recession for Intermittent Exotropia under 25 PD

PURPOSE: To investigate the surgical outcome of unilateral lateral rectus recesssion in the treatment of intermittent exotropia under 25 prism diopter (PD). METHODS: The 62 patients who had underwent unilateral lateral rectus recession and followed up for 6 months or larger, were reviewed. Following inferotemporal fornix incision, 8.5 mm or 9.5 mm recession from the insertion of lateral rectus was performed in 20 PD or in 25 PD intermittent exotropia respectively. RESULTS: Mean age of patients was 8.8 years (5-14 years) and follow up time was 11.5 months (6-34 months) on average. Postoperative deviation and success rate were as followings: -0.2+/-2.1 PD, 91.9% at postoperative 1 day, 0.5+/-2.3 PD, 95.2% at postoperative 1 week, 2.5+/-3.9 PD, 96.8% at postoperative 1 month, 3.7+/-5.0 PD, 91.9% at postoperative 6 month and 4.3+/-5.5 PD, 85.7% at postoperative 1 year. The average divergent shift was 4.5 PD during whole examination period and this shift showed significant change during same period (Repeated measures, p=0.000). The occurrence rate of undercorrection was 1.6% at postoperative 1 week, 3.2% at postoperative 1 month, 8.1% at postoperative 6 month and 14.3% at postoperative 1 year. The occurrence rate of overcorrection was 8.1% at postoperative 1 day and 3.2% at postoperative 1 week. All cases of overcorrection were orthophoric after postoperative 1 month. The limitation of abduction was not discovered in all cases at postoperative 1 year. CONCLUSIONS: Unilateral recession of lateral rectus is an effective method in the treatment of intermittent exotropia under 25 PD. However long term follow up should be considered since undercorrection seems to be increasing.

Surgical Results of Classic Harada-Ito Procedure with Intraoperative Adjustment for Excyclotorsion

PURPOSE: We evaluated the efficacy of classic Harada-Ito procedure with intraoperative adjustment for excyclotorsion. METHODS: This study represents a retrospective review of 22 patients surgically treated for the diagnosis of excyclotorsion with abnormal head posture between January 1995 and August 2001. Head tilt, facial asymmetry, diplopia and excyclotorsion were measured preoperatively and postoperatively. Intraoperative adjustment was made by observing the torsional position of the fundus with indirect ophthalmoscopy. Cyclotropia was measured with the Maddox double-rod test or fundus photography with the eyes in primary and down gaze. RESULTS: Causes of excyclotorsion were congenital (7 patients, 32%), trauma (11 patients, 50%)and idiopathic (4 patients, 18%). Of the 22 patients, 19 patients had a head tilt toward the nonparetic side and the others paretic side. Head tilt was uniformly eliminated in 19 of 22 patients (86%). Six of 22 patients had facial asymmertry. After surgical correction, facial asymmetry gradually disappeared in 2 congenital patients. Preoperatively fourteen of 22 patients had diplopia. Postoperatively, eighth of patients had no diplopia and the others had improved of the symptom except one case. The median measured value change of excyclotorsion before and after the surgery in the primary position was reduced from 7.2+/-5.2degrees to 1.7+/-2.8degrees (76%) and 5.3+/-2.2degrees to 0.4+/-1.1degrees in congenital patients, from 8.9+/- 6.6degrees to 1.5+/-2.6degrees in trauma and from 6.0+/-3.4degrees to 4.3+/-4.2degrees in idiopathic. In downgaze, the median measured value change from 10.9+/-5.3degrees to 2.9+/-3.3degrees (73%) and 7.0+/-3.9degrees to 1.1+/-3.0degrees in congenital patients, from 13.2+/-5.7degrees to 3.2+/-3.0degrees in trauma and from 11.5+/-1.0degrees to 5.0+/-4.1degrees in idiopathic. CONCLUSIONS: Intraoperative adjustable classic Harada-Ito procedure was an effective treatment in correcting head tilt, facial asymmetry and diplopia.

Surgery for Presbyopia

No abstract available.

The Effect of Alginic Acid Sodium Salt on Delayed Adjustable Strabismus Surgery

The purpose of this study was to evaluate the effect of the alginic acid sodium salt on the delayed adjustable strabismus surgery by preventing the post operative tissue adhesion. 30 eyes of 15 rabbits had received an adjustable suture surgery. The alginic acid sodium salt of 4% was used during operation in 16 eyes among them by injecting it around the muscle, between the sclera and the conjunctiva. In the 3rd, 5th, 7th, 10th, and 14th day postoperatively, we measured the pulling forces and the moving distances of the muscles during the adjustment. Then the eyes were enucleated and the histopathologic changes of the eyes were determined using the light microscope. The pulling forces and the moving distances of the muscles during the adjustment were significantly different between the alginic acid sodium salt free group and the alginic acid sodium salt used group. In the alginic acid sodium salt used group, the pulling forces were decreased and the moving distances were increased than those of the alginic acid sodium salt free group. The light microscopic examination showed more fibrosis in the alginic acid sodium salt free group than in the alginic acid sodium salt used group. These results suggest that the alginic acid sodium salt is an effective substance for the delayed adjustable suture surgery.

The Surgical Results According to the Amount of Superior Rectus Recession for Dissociated Vertical DeviationDVD

To evaluate the surgical results of superior rectus recession with different amount according to the degree of eyeball deviation.We reviewed the surgical records of 36 eyes in 23 patients who had undergone superior rectus recession and followed up for at least 6 months.Patients were divided into 3 groups according to the degree of deviation : Group 1[8-10PD, 4.0 mm recession], Group 2[11-20PD, 6.0 mmrecession], Group 3[21PD or greater, 8.0 mmrecession].Five PD or less after operation was regarded as acceptable. The success rate of Group 1 was 86.6%at the 6th month, 87.5% at the 12th month, and 83.8%at the 24th onth, respectively.In group 2 those were 87.5%, 75%, and 80%, respectively.In group 3 those were 60%, 50%, and 50%, respectively.The overall success rate as 83.3%at the 6th month, 75% at the 12th month, 75%at the 24th month.These results indicate that superior rectus recession with the different amount according to the degree of eyeball deviation is effective for the deviation under 20PD but not over 21PD.

Consecutive Esotropia Following Surgery for Intermittent Exotropia

Authors reviewed 459 cases which had been followed up over 3 months after surgery to evaluate the incidence of consecutive esotropia and its associated factors. For every case, we investigated the age at the surgery, the methods of surgery, stereopsis, cycloplegic refractive power, the deviation difference between far and near fixation, the deviation before surgery and the results at the postoperative 1 day, 1 week, 1 month, 4 months, 6 months, 1 year and 3 years. The incidence of consecutive esotropia tended to decrease as time passed, and occurred in 21 cases[4.6%] at the last follow-up[averaging 13.1 months]. When the deviation difference between at the distance and the near fixation was above 10 delta and the results at the postoperative 1 day was overcorrection above 10 delta, with significantly higher[p<0.05] incidence of consecutive esotropia. Other factors were not statistically significant. In conclusion, the preoperative factor was the far and near deviation difference above 10 delta and the postoperative factor was the first day postoperative overcorrection above 10 delta. It is considered that the nonsurgical treatment can be desirable for the former cases, and overcorrection above 10 delta should be avoided for the latter.

Effect of Mechanical Stress on the Proliferation and Expression of Cell Cycle Regulators in Human Periodontal Ligament Cells / 대한치주과학회지

No abstract available.

Surgical Results of Duanes Retraction Syndrome

The authors reviewed medical records of 25 patients undergoing treatment for Duanes retraction syndrome. The patients were treated with appropriate horizontal muscle recession with or without posterior fixation suture, transposition procedures, and lateral rectus Y split and recession in order to relieve face turn, significant tropia in primary position, and upshoot or downshoot. The deviation in primary position was reduced by an average or 20.5 prism diopters; 19.5 prism diopters in horizontal muscle recession with or without posterior fixation suture, and 17.4 prism diopters in lateral rectus Y split and recession. The face turn was eliminated in 84%, while 100% in horizontal muscle recession with posterior fixation suture. The upshoot or downshoot was essentially corrected by lateral rectus Y split and recession(100%). Motility of the eye was not increased following each surgical procedures. According to the results, we could obtain appropriate deviation in primary position with each surgery postoperatively. Horizontal muscle recession with posterior fixation suture was effective in eliminating the face turn. Lateral rectus muscle Y-split and recession effectively corrected upshoot and downshoots.

Myopic Progression According to the Age of Onset in Childhoods

It is well known that the myopic progression in myopic children is related with the age of onset, and the amounts of myopia. The authors performed cycloplegic refraction in 75 children, which were less than -1.50 diopters initially. They were divided in 4 groups according to the age of onset of myopia ; group A[less than 3 years], group B[4-6 years] , group C[7-10 years], and group D[11-15 years]. The authors investigated the myopic progression according to the age of onset at one, two, and three years. The overall annual progression was 0.67+/-0.37D per a year. The most rapid progression was noted in group B, 0.92+/-0.33D per a year, and lowest rate in group D, 0.35+/-0.26D per a year. There was most rapid progression with 0.73+/-0.35D per a year during the one year after the onset of myopia. But there was no difference with respect to sex. Therefore, children with age of the onset of myopia in 4-6, and 7-10 years before puberty appeared to show more rapid progression than other groups. And one year after onset of myopia showed the most rapid myopic progression.

New Strabismus Surgery with an Absorbable Jaw Clip

The most common complications of the strabismus surgery are related to the muscle sagging, lost muscle in suturing procedure and needle trauma endophthalmitis, retinal detachment, scleral necrosis result from scleral perforation. The authors developed the muscle clamping system with absorbable jaw clip, and operated on 8 rabbits using the clips. The right superior rectus was recessed by conventional recession and the other superior rectus was recessed with an absorbable jaw clip. We examined the conjunctival injection, muscle adhesion power (bond strengths) and light microscopic findings at postoperative I week, 2, 4, and 8 weeks. Conjunctival injection was diminished with time and bond strengths ranged 400-500gm in right eye and 380-600gm in the left eye. Microscopically there were some inflammatory cells and less foreign body reactions in jaw clipped eye. According to these results, muscle clamping method employing the newly invented clip could be an innovatory surgery which may overcome many difficulties of the surgery and avoid any possibility of misleading practice along with convenience.

The Clinical Characteristics of Intermittent Exotropia and Their Relationship

Intermittent exotropia occurs commonly in Korea and its clinical characteristics are relatively well known. We analyzed the clinical characteristics of intermittent exotropia and studied the relationship among them. We examined 229 patients(92 males and 137 females( who first visited three strabismic clinics. The age of onset, frequency, family history and symptoms of intermittent exotropia were examined. The angle and type of deviation were studied and sensory tests were done. The mean age of onset was 32.4 months and frequency ws 39.1% and family history was 8.7%. Photophobia was the most common symptom of intermittent exotropia. The distant angle of deviation was 26.7 prism diopters in average and the near angle was 25.3 prism diopters in average. The most common type of intermittent exotropia was basic type. followed by simulated divergence excess type, convergence insufficiency type, and divergence excess type. In statistical study, there was no significant relationship among clinical characteristics of intermittent exotroia.

Staphylococcus lugdunensis in Acute Oral Infection

To investigate the pathogenicity, genomic pattern, and o-like hemolysin of Staphylococcus lugdunensis (S. lugdunensis) in acute oral infection, S. lugdunensis was isolated from patients with an acute oral infection and from healthy persons. Antibiotic susceptibility, in vitro cellular toxicity, in vivo virulence, and hemolytic activity were tested, and plasmid DNA and restriction pattern of whole genomic DNA were analyzed to characterize the staphylococci. The dot blot and Southern blot hybridization analysis of staphylococcal DNA were performed with o-hemolysin gene probe. The isolation ratio of S. lugdunensis in the patients was higher than that in the healthy persons. S. lugdunensis from the patients with an acute oral infection showed resistance to penicillin, ampicillin, methicillin, cephalothin, and clindamycin. In the analysis of plasmid, there was a clear band about 6.5 kb in three strains of S. lugdunensis isolated from the patients with infection. S. lugdunensis in the patients had cellular toxicity in vitro and virulence in vivo. All strains of S. lugdunensis had o-like hemolysin activity against rabbit erythrocytes. Four of the six strains of S. lugdunensis gave synergistic hemolysis with Staphylococcus aureus (S. aureus) on sheep blood agar plates. In the analysis of genomic pattern, four strains of S. lugdunensis that gave synergistic hemolysis with S. aureus showed a similar genetic pattern with HindIII enzyme digests. In dot blot analysis, all strains of S. lugdunensis showed a positive reaction with the probe of 5-hemolysin gene in S. aureus. In Southern blot analysis, a 7.3 kb HindIII fragment was observed in DNA of S. lugdunensis that gave synergistic hemolysis with S. aureus, and a 2.5 kb band was observed in HindIII digests of S. aureus in the patients. These results suggest that S. lugdunensis may be an important pathogen in an acute oral infection and the 7.3 kb HindIII fragment from S. lugdunensis DNA may contain o-like hemolysin gene.