• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.53-60
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• 2009

Purpose: Primary osteoarthritis on the elbow is the result of the growth of osteophytes and contracture of the capsule. It often causes disability on joint motion and pain while exercising. As arthroscopy has developed, the arthroscopic diagnosis and treatment of the elbow have recently become more generalized as well. Therefore, we like to report on arthroscopy for treating elbow arthritis and its results. Materials and Methods: This study includes 23 cases of elbow arthritis that were seen between 2005 June to 2007 June and these patients didn't response to conservative treatment. From this we excluded 18 cases that underwent arthroscopic surgery and among these 18 cases, 6 cases underwent ulnar nerve transfer. The average observation time was 21.3 months and the average age was 48.4 years (range: 22-66 years). The pre and post operative pain was evaluated with using the Visual Analogue Scale (VAS) and functional evaluation was done with using the Mayo elbow Performance Score (MEPS) with the range of joint motion. Results: The VAS score at the last follow up was significantly decreased from 3.4 to 1.9 compare to the preoperative score. The range of joint motion was improved by 25 (0-40) to 8.5 (0-20) in extension and 101.7 (80-140) to 125.2 (85-140) in flexion (p<0.05). The MEPS always showed significant improvement by showing an increase from 65.4 (40-85) to 87.9 (55-100). However, 3 cases showed a decreased range of motion after the operation. One case showed ulnar nerve symptoms after surgery. Conclusion: An arthroscopic procedure can treat the pathologic processes associated with arthritis of the elbow and it was safe and effective in this series.

• Clinics in Shoulder and Elbow
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• v.16 no.1
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• pp.33-39
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• 2013

Purpose: The aim of this study is to evaluate the clinical result of intra-articular fractures of the distal humerus (AO type C) in elderly osteoporotic patients treated with double tension band osteosynthesis. Materials and Methods: From January 2006 to December 2010, 10 elderly osteoporotic patients(1 male, 9 females) with intra-articular fractures of the distal humerus (AO type C) were treated with double tension band osteosynthesis. The mean age of patients at the time of surgery was 74.6(66~84) years and the mean follow-up period was 39.2(20~74) months. The fracture union and complications were assessed and the functional result was evaluated by the rating system of Jupiter et al. and the Mayo elbow performance index. Results: Bone union was achieved in all patients with no secondary displacement. The mean time for union was 16.6(13~22) weeks. The average postoperative arc of elbow flexion was 119(100~140) degrees with a mean flexion contracture of 8.5(0~15) degrees. The recovery in two patients was rated as excellent, in 7 as good, and in 1 as fair in terms of the Mayo elbow performance index with average value of 82(70~90) points. Seven patients were rated as excellent, 1 as good, and 2 as fair in terms of the rating system of Jupiter et al. Changing tension band wiring was performed in one patient as skin irritation was noticed due to tension band knots. Heterotopic ossification developed in one patient but had no symptom. Conclusion: Double tension band osteosynthesis in intra-articular fractures of distal humerus (AO type C) in elderly osteoporotic patients can provide sufficient and secure stability to allow early rehabilitation.

• The Korean Journal of Physiology
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• v.21 no.2
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• pp.241-257
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• 1987

The effects of external $Ca^{2+}$ and $Ca^{2+}-antagonists$ on the spontaneous contractions and electrical activities were investigated in guinea-pig stomach in order to clarify the mechanism for the generation of slow waves. Electrical responses of circular smooth muscle cells were recorded using glass capillary microelectrodes filled with 3 M KCl. All experiments were performed in tris-buffered Tyrode solution which was aerated with 100% $O_2$ and kept at $35^{\circ}C$. The results obtained were as follows: 1) The amplitude of spontaneous contractions was maximal at around 2-4 mM $Ca^{2+}$, whereas their frequency was inversely related with external $Ca^{2+}$ within the range of 0.5 to 16 mM $Ca^{2+}$. 2) Verapamil suppressed the amplitude of spontaneous contraction in a dose-dependent manner, while the frequency of spontaneous contractions was almost not changed over the whole concentration of verapamil $(0.01{\sim}5\;mg/l)$. 3) Manganese increased both the amplitude and the frequency of spontaneous contractions dose-dependently in low $Mn^{2+}$ (below 0.05 mM $Mn^{2+}$), while their amplitude and frequency were decreased in high $Mn^{2+}$ (above 0.1 mM $Mn^{2+}$). 4) The ampltude and maximum rate of rise of slow waves were incrased in high $Ca^{2+}$ solution. In $Ca^{2+}-free$ solution, the spontaneous contractions recorded simultaneously with slow waves ceased and tonic contraction ($Ca^{2+}-free$ contracture) was developed in parallel with membrane depolarization and the disappearance of slow waves. 5) Verapamil (1 mg/1) decreased the amplitude and maximum rate of rise of slow waves and it depolarized the membrane by about 6 mV, whereas the frequency of slow waves was not affected by verapamil. 6) Manganese showed different characteristic effects between low and high $Mn^{2+}$ on the slow waves: In low $Mn^{2+}$ (0.05 mM $Mn^{2+}$), the initial rapid increases and the subsequent gradual decreases in three parameters of slow waves (amplitude, rate of rise, and frequency of slow waves) till a new steady state were observed. However, in high $Mn^{2+}$ (0.5 mM $Mn^{2+}$) slow waves disappeared and membrane was depolarized. From the above results, the following conclusions could be made: 1) $Ca^{2+}$ is necessary for a generation of the slow waves, even though it is small amount. 2) Verapamil suppresses the spontaneous contractions of gastric antral strip by the decreases in amplitude and maximum rate of rise of slow waves, while this drug does not block the $Ca^{2+}-channel$ involved in the generation of slow waves. 3) Manganese has dual actions on the $Ca^{2+}-channels$; the $Ca^{2+}-channel$ involved in the generation of slow waves (or Na-Ca exchange system) or the channel for the generation of spike potentials are stimulated by a low concentration of $Mn^{2+}$, while both the $Ca^{2+}$. Channels are blocked by high concentration of $Mn^{2+}$.