• The Korean Journal of Physiology
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• v.21 no.2
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• pp.191-200
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• 1987

The activation mechanism of the sustained contractions induced by norepinephrine and K-depolarization was studied in renal vascular muscle. Helical strips of arterial muscle were prepared from rabbit renal arteries. All experiments were performed in Tris-buffered Tyrode solution which was aerated with 100% $O_2$ and kept at $35^{\circ}C$. Renal arterial muscles developed a contracture rapidly when exposed to a 40 mM K-Tyrode solution. In the absence of external $Ca^{2+}$, however, no K-contracture appeared. The contracture induced by K-depolarization was abolished by the treatment with $Ca^{2+}-antagonist\;(verapamil)$ or lanthanum $(La^{3+})$. From these results, it is obvious that K-contracture of renal arterial strip required $Ca^{2+}$ in the medium and this contracture was developed by the increased $Ca^{2+}-influx$ due to K-depolarization. Noradrenaline (5 mg/l) induced also a similar sustained contraction rapidly in all strips. Even on the K-contracture and in $Ca^{2+}-free$ Tyrode solution and also in the Tyrode solution pretreated with verapamil or $La^{3+}$, noradrenaline produced a contraction. However, the contraction in $Ca^{2+}-free$ Tyrode solution was not sustained and decreased gradually. The amplitude of noradrenaline-induced contracture was dependent on external $Ca^{2+}$; The contracture increased dose-dependently, but over 3 mM $Ca^{2+}$, decreased. The results of this experiment suggest that K-contracture was developed by an increased $Ca^{2+}-influx$ due to membrane depolarization, while noradrenaline-induced contracture was developed by both transmembrane $Ca^{2+}-influx$ and the mobilizaiton of cellular $Ca^{2+}$

• Archives of Reconstructive Microsurgery
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• v.10 no.2
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• pp.137-142
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• 2001

This study evaluated the results of reconstructions of thumb web space in the patients with adduction contracture of thumb. Between February 1990 and April 2000, 28 patients with thumb web space adduction contracture were treated with various reconstruction methods. We divided the patients according to the severity; mild$(41^{\circ}{\sim}80^{\circ})$, moderate$(21^{\circ}{\sim}40^{\circ})$, severe$(20^{\circ}less)$ contracture. The number of patients with mild contracture was 5, moderate; 12, severe; 11. We performed Z-plasty in 15, free flap in 8, local flap in 3, abdominal flap in 1 and scar release only in 1 case. The mean follow-up period was 5.7 years, ranged from 1.5 to 11.2 years. The results of web reconstruction were evaulated by thumb web space angle. There were excellent in 9, good in 16, fair in 3 cases. Z-plasty was performed in the 5 cases with mild contracture, and all the results were excellent. Especially, free flap was performed in the 6 cases with severe contracture, and all the results were good or excellent. in the reconstruction of thumb web space contracture, we recommend Z-plasty for a mild contracture, and free flap for large soft tissue defect created by release of a severe contracture.

• Archives of Reconstructive Microsurgery
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• v.13 no.2
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• pp.117-122
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• 2004

Purpose : The aim of this study was to evaluate the efficacy of arterialized venous flap in finger flexion contracture correction. Materials and methods : From 2002 to 2004, we have performed 10 arteriaized venous flap for treatment of severe flexion contracture in digit. The duration of flexion contracture was from 1 year to 50 years. The cause of contracture were bum scar(7 cases), postoperative contracture(2 cases) and other(l case). We evaluated the survival of flap, flap size, recovery of flexion contracture and subjective satisfaction. Results : All arterialized venous flap survived. The marginal minimal skin necrosis developed in 2 cases. The flap size was average $5.2{\times}3.5cm$. The recovery of flexion contracture was 87% compared with non affected side. 9 patients(90%) satisfied the results of operation. Conclusion : Arterialized venous flap is one of the useful procedure in treatment of finger flexion contracture because it has many advantages such as thin and good quality, variable length of pedicle, preservation of major vascular pedicle, less operation time and in addition possibility of various modifications.

• Archives of Plastic Surgery
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• v.39 no.4
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• pp.426-430
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• 2012

Dupuytren's contracture is a condition commonly encountered by hand surgeons, although it is rare in the Asian population. Various surgical procedures for Dupuytren's contracture have been reported, and the outcomes vary according to the treatment modalities. We report the treatment results of segmental fasciectomies with multiple transverse incisions for patients with Dupuytren's contracture. The cases of seven patients who underwent multiple segmental fasciectomies with multiple transverse incisions for Dupuytren's contracture from 2006 to 2011 were reviewed retrospectively. Multiple transverse incisions to the severe contracture sites were performed initially, and additional incisions to the metacarpophalangeal (MCP) joints, and the proximal interphalangeal (PIP) joints were performed if necessary. Segmental fasciectomies by removing the fibromatous nodules or cords between the incision lines were performed and the wound margins were approximated. The mean range of motion of the involved MCP joints and PIP joints was fully recovered. During the follow-up periods, there was no evidence of recurrence or progression of disease. Multiple transverse incisions for Dupuytren's contracture are technically challenging, and require a high skill level of hand surgeons. However, we achieved excellent correction of contractures with no associated complications. Therefore, segmental fasciectomies with multiple transverse incisions can be a good treatment option for Dupuytren's contracture.

• Archives of Plastic Surgery
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• v.42 no.5
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• pp.532-543
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• 2015

Capsular contracture is the most common complication following implant based breast surgery and is one of the most common reasons for reoperation. Therefore, it is important to try and understand why this happens, and what can be done to reduce its incidence. A literature search using the MEDLINE database was conducted including search terms 'capsular contracture breast augmentation', 'capsular contracture pathogenesis', 'capsular contracture incidence', and 'capsular contracture management', which yielded 82 results which met inclusion criteria. Capsular contracture is caused by an excessive fibrotic reaction to a foreign body (the implant) and has an overall incidence of 10.6%. Risk factors that were identified included the use of smooth (vs. textured) implants, a subglandular (vs. submuscular) placement, use of a silicone (vs. saline) filled implant and previous radiotherapy to the breast. The standard management of capsular contracture is surgical via a capsulectomy or capsulotomy. Medical treatment using the off-label leukotriene receptor antagonist Zafirlukast has been reported to reduce severity and help prevent capsular contracture from forming, as has the use of acellular dermal matrices, botox and neopocket formation. However, nearly all therapeutic approaches are associated with a significant rate of recurrence. Capsular contracture is a multifactorial fibrotic process the precise cause of which is still unknown. The incidence of contracture developing is lower with the use of textured implants, submuscular placement and the use of polyurethane coated implants. Symptomatic capsular contracture is usually managed surgically, however recent research has focussed on preventing capsular contracture from occurring, or treating it with autologous fat transfer.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.8 no.4
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• pp.233-238
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• 2014

In this paper, we developed a finger robot simulating spasticity and contracture which can be used as a testing bed for evaluating performance of hand rehabilitation devices while it can be also used to train clinicians for improving reliability of clinical assessment. The robot is designed for adult finger size and for independent control of Metacarpophalangeal Joint and Proximal Interphalangeal Joint. Algorithm for mimicking spasticity and contracture is implemented. By adjusting the parameters related to contracture and spasticity, the robot can mimic various patterns of responses observed in fingers with spasticity and contracture.

• Journal of Korean Physical Therapy Science
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• v.8 no.1
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• pp.727-734
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• 2001

Contracture is defined as the lack of full passive range of motion resulting from pint, muscle or soft tissue limitationprolonged Pint immobilization will result in stress and stretch deprivation and gradual development of contracture. the tissue changes caused by immobilization may be categorized as cellular modeling, ground substance and collagen response, and tissue response. contracture can be divided into three categories according to the anatomical location of pathological changes :arthrogenic, myogenic, soft tissue contractures Therapeutic approach of contracture is thermal or cold agents application, stretch or restoration of length, traction, manipulation, mobilization positioning and restoration of function. The purpose of this article is to review current concepts of mechanical properties and synthesis of collagen tissue and the underlying pathomechanics as it relates to evaluation and treatment of contracture.

• The Korean Journal of Physiology
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• v.13 no.1_2
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• pp.41-50
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• 1979

The activation mechanism of K-induced contracture was studied in renal vascular muscle which does not generate an action potential readily and in taenia coli which generates a spike potential spontaneously. Helical strips of arterial muscle from rabbit renal arteries and longitudinal strips of taenia coli from guinea-pig's colons, respectively, were prepared. All experiments were performed in Tris-buffered Tyrode solution which was aerated with 100% $O_2$ and kept $35^{\circ}C$. Renal arterial muscles developed the contracture rapidly, which was composed of a small phasic and a large tonic components, when exposed to a 40 mM K-Tyrode solution. In the absence of external $Ca^{++}$, however, no K-contracture appeared. The contracture induced by K-depolarization was abolished by the treatment with verapamil, which is known to be a selective $Ca^{++}-blocker$ through potential-sensitive $Ca^{++}-channel$. K-contracture of taenia coli showed the contracture composed of a large phasic and a small tonic components. In the $Ca^{++}-free$ Tyrode solution, only the tonic component was abolished and almost no change in the phasic component was observed. The amplitude of tonic component was dependent on the external $Ca^{++}$; The tonic component increased dose-dependently by a stepwise increase of the external $Ca^{++}$, and this component decreased in parallel with the increase of verapamil in the external medium. The results of this experiment suggest that K-contracture of rabbit renal artery is the direct result of the influx of the external $Ca^{++}$, while that of taenia coli is the result of both $Ca^{++}$ influx and the release of sequestered $Ca^{++}$.

• The Korean Journal of Physiology
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• v.16 no.1
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• pp.25-30
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• 1982

The in vitro experiments for isometric contraction were done to investigate the different action mechanism of calcium ion on phasic and tonic components of K-contracture in guinea pig's taenia coli. The results were as follows: 1) The degrees of K-contracture were increased gradually from 4 mM to 15, 20, 40 & 100 mM of$[K^+]_0$. The maximal developed tension in tonic component was observed in 100 mM of $[K^+]_0$. 2) The phasic components were not so affected by 2, 4, 8 & 16 mM of $[Ca^{++}]_0$ in 100 mM K-contracture, but the tonic components were gradually increased in a dose-responsive manner. 3) The K-contracture was not influenced by norepinephrine, 1 mg/l, but was completely abolished by verapamil, 2 mg/l. 4) The phasic component was little affected by verapamil, 0.01 mg/l, 0.1 mg/l, and 1 mg/l, but the tonic component was completely disappeared at the concentration of verapamil 1 mg/l. The above results suggest that $[Ca^{++}]_0.$ primarily affected the tonic component than the phasic component of K-contracture in guinea pig's taenia coli.

• The Korean Journal of Physiology
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• v.20 no.1
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• pp.31-41
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• 1986

The sufficient myoplasmic $Ca^{++}$ to react with the contractile proteins is necessary to induce contraction of a cardiac muscle. These $Ca^{++}$ for the production of muscle contraction are supplied from the three recognized $Ca^{++}$ sources; internal $Ca^{++}$ release via the sarcoplasmic reticulum(SR), $Ca^{++}$ influx through a gated Ca-channel in the membrane as a Isi, and $Ca^{++}$ transport by the mechanism of Na/ca exchange. However, it is still controversial which $Ca^{++}$ sources act as a main contributor for myoplasmic $Ca^{++}$, Therefore, this study was undertaken in order to examine the $Ca^{++}$ sources for the contraction of frog ventricle. There is evidence that the SR is sparse in frog ventricular fibers, and that T-tubules are absent. Isolated ventricular strips of frog, Rana nigromaculata, were used in this experiment. Isometric tension was recorded by force transducer, and membrane potentials of ventricular muscles were measured through the intracellular glass microelectrodes, which were filled with 3M KCI and had resistance of $30{\pm}50M{\Omega}$. All experiments were performed at room temperature in a tris·buffered Ringer solution which was aerated with 100% $O_2$. Isotonic high K, low Na solution was used to induce K-contracture, K-contracture appeared at the concentration of 20 to 30mM-KCI and was potentiated in parallel with the increase in KCI concentration. The contracture had two components: an initial rapid phasic and a subsequent slow tonic contractile responses. Membrane Potentials measured at normal Ringer solution(2.5mM KCI) was -90 to -100 mV, and decreased linearly as the KCI concentration increased; -55mV at 20mM.KCI, -45mV at 30 mM.KCI, -30 mY at 50 mM.KCI, and -12 mV at 100 mM.KCI. K-contracture was evoked firstly at the membrane potential of -45 mV. The contracture was potentiated by the increase of bathing extracellular $Ca^{++}$ concentration. However, in the absence of $Ca^{++}$ the contracture was almost not induced by 50 mM.KCI solution. Caffeine(20mM) in normal Ringer solution, which is known to release $Ca^{++}$ from SR without substantial effects on the $Ca^{++}$ fluxes across the surface membrane, did not affect membrane potential and also not initiate contracture, but the caffeine in 20 mM-KCI Ringer solution produced a contracture. Above results suggest that the main $Ca^{++}$ source for the K·contracture of frog ventricle is $Ca^{++}$ influx through the voltage-dependent Ca-channel, and that in the K-contracture at the concentration of 100 mM-KCI, the mechanism of Na/ca exchange also partly contributs, in addition to the $Ca^{++}$ influx.