An Evaluation of the Effectiveness of Hyaluronidase in the Selective Nerve Root Block of Radiculopathy: A Double Blind, Controlled Clinical Trial

STUDY DESIGN: Prospective, double-blind, randomized controlled trial. PURPOSE: To determine the ability of hyaluronidase to provide longer lasting pain relief and functional improvement in patients with lumbar radiculopathy. OVERVIEW OF LITERATURE: Selective nerve root block (SNRB) is a good treatment option in lumbar radiculopathy. We studied the effectiveness of hyaluronidase when added to the traditional SNRB regimen. METHODS: A sample size of 126 patients per group was necessary. A sample of 252 patients who underwent an injection procedure with or without hyaluronidase due to radiculopathy was included in this study. The patients were randomly divided into two groups: the control (C) group and the hyaluronidase (H) group. After SNRB due to radiculopathy, the visual analog scale (VAS) was compared at 2, 4, 6, 8, and 12 weeks between the two groups, and the Oswestry disability index (ODI) was compared at 12 weeks between the two groups. RESULTS: Both groups seemed to have general improvement in VAS, but in C group, the VAS was higher than the H group 2 and 4 weeks after the surgery, and the difference in time-group change between 2 groups was statistically significant (p 0.05). CONCLUSIONS: The rebound pain (the re-occurrence of pain within 2-4 weeks after injection) that occurs within 2-4 weeks after the injection of the routine regimen can be reduced when hyaluronidase is added to the routine SNRB regimen.

Effect of Fermented Yacon (Smallanthus Sonchifolius) Leaves Tea on Blood Glucose Levels and Glucose Metabolism in High-Fat Diet and Streptozotocin-Induced Type 2 Diabetic Mice

The aim of this study was to investigate the hypolgycemic activity of water extract of fermented yacon (Smallanthus sonchifolius) leaves tea (Yacon LWE) in high-fat diet (HFD)/streptozotocin (STZ)-induced diabetic mice. Male ICR mice were fed with a HFD (37% calories from fat) for 4 weeks prior to intraperitoneal injection with STZ (100 mg/kg body weight). Diabetic mice were supplemented with two doses of Yacon LWE (0.16% and 0.8%, wt/wt) for 6 weeks. The supplementation of high-dose Yacon LWE significantly lowered blood glucose levels and plasma ALT and AST activities compared with the control group. High-dose Yacon LWE also improved the insulin tolerance without any changes in plasma and pancreatic insulin concentrations in HFD/STZ-induced diabetic mice. Yacon LWE supplementation increased the insulin staining of pancreatic beta-cells in a dose-dependent manner. Both 0.16% and 0.8% of Yacon LWE significantly elevated plasma leptin concentration, hepatic glucokinase activity and glucokinase/glucose-6-phosphatase ratio compared with the control group. However, glycosylated hemoglobin concentration was not different among the groups. These results suggest that high-dose Yacon LWE lowers the blood glucose level partly by enhancing insulin sensitivity and hepatic glucose metabolism in type 2 diabetic mice.

The Outcome after Arthroscopic Massive Rotator Cuff Repair according to the Repair Technique - Comparison of Tendon to Tendon Repair versus Tendon to Tendon and Bone to Tendon Repair - / 대한정형외과학회잡지

PURPOSE: We evaluated the functional outcomes after arthroscopic repair of a massive tear between the tendon to tendon (TT) repair technique and the tendon to tendon and bone to tendon (TTBT) repair technique. MATERIALS AND METHODS: From March, 2002 to January, 2007, 43 cases of arthroscopic massive rotator cuff repair were evaluated. 12 were repaired by TT repair and 31 were repaired by TTBT repair. At 1year follow-up, the functional results were assessed by the KSS, ASES, UCLA and Constant scoring system and the P-VAS (Pain visual analogue score). Post-operative integrity was evaluated by an ultrasound examination 6 months after the operation. RESULTS: In TTBT repair group, the improvement of the KSS, ASES, UCLA and Constant scores were 15.4 (50.5 to 65.9), 28 (55.6 to 83.6), 9.6 (21.1 to 30.7) and 11 (40.7 to 51.7), respectively. The pain improvement was 2.7 (VAS, 3.8 to 1.1) and the retear rate was 62%. In the TT repair group, the functional improvements were 29.2 (33.7 to 62.9), 42.7 (38.6 to 81.3), 13.4 (16.4 to 29.8) and 19.7 (29.6 to 49.3), respectively. The pain improvement was 4.2 (VAS, 5.5 to 1.3) and the retear rate was 75%. CONCLUSION: Arthroscopic repair of a massive tear could afford good functional results and pain relief in spite of a high retear rate. The TT repair technique was comparable to the TTBT repair technique.

Sacral Fracture Dislocation of Suicidal Jumper (Suicidal Jumper's Fracture): 4 Cases Report / 대한척추외과학회지

Displaced fractures of the upper sacrum are a rare type of high energy injury, such as a fall, with similar neurological symptoms and fracture patterns. The authors treated 4 patients with these fracture patterns surgically or conservatively and followed them up for at least 1 year. We report these 4 cases with a review of the relevant literature.

An experimental study on the mandibular condylar growth following lateral displacement in rabbit / 대한치과교정학회지

The purpose of this study was to evaluate the effect of the lateral displacement on the mandibular condylar growth in the rabbit. The experimental animals were twenty White NewZealand rabbits of 4-week old. Ten of them was used as control group, and experimental animal was composed of remaining ten. Laterodeviation appliance was made of cast base metal and appliance was cemented with resin in permanent fashion. Experimental group were sacrificed at 1, 2, 4, 6, 8 weeks form beginning of the experiment. Both of temporomandihular joint were prepared for histologic study. The conclusions are: 1. In control group, there was slight increase of proliferative zone and hypertrophic zone at 2-week control animal and slight reduction at 4-week, 6-week and 8-week control animal were similar to 1-week control animal. 2. In right mandibular condyle of experimental group, 2-week experimental animal showed marked increase of proliferative zone and hypertrophic zone at posterior surface of condylar head. In 8-week experimental animal marked increase at anterior surface of anticular surface is observed. 3. In left mandibular condyle of experimental group, proliferative zone and hypertrophic zone were reduced at 1-week experimental animal and slight increase at 2-week. Proliferative zone and hypertrophic zone were reduced at 4-week experimental animal and were slightly increased at 6 week. 4. After 8 weeks, right and left condyle were not different in experimental group. The condylar cartilage was stabilized 8 weeks after the experiment. No marked traumatic change was seen, but minute focal bleeding was seen at articular cavity in 1-week, 2-week and 4-week experimental animal. 6-week and 8-week experimental animal did not show bleeding tendency in articular cavity.