Objective: To evaluate the effects of local triamcinolone (TAC) injection and weight bearing on healing process of the injured Achilles tendon.

Method: The right Achilles tendons in 54 rats, Sprague- Dawley (about 200 g), were each sutured after transection and allocated into three groups according to the amount of the local injection of TAC (none, 0.25 mg, and 1.25 mg respectively), and subsequently each group divided into three subgroups by the type of weight bearing {normal weight bearing (NWB), treadmill exercise (7∼8 m/min, 10 min/day) from day 7 for 7 days, and hind limb immobilization respectively}. On 15th day rats were sacrificed, and then diameters of both injured and uninjured tendon, numbers of fibroblasts on injured tissues and

the percentage of matured fibroblasts by microscopy were evaluated.

Results: The diameter of the hypertrophied neotendon in groups injected with TAC 1.25 mg was significantly decreased, but not in the others. There were no differences in numbers of fibroblast. As the amount of TAC increased in groups done with NWB and treadmill exercise, the percentages of matured fibroblasts significantly decreased.

Conclusion: The local TAC injection on acute tendon injuries had deleterious effects on healing process of tendon, and follow- up study about the types of weight bearing is needed. (J Korean Acad Rehab Med 2002; 26: 215-222)

Objective: The effect of the local steroid injection for the carpal tunnel syndrome (CTS) is well known, but there have been a few report of electrophysiologic evaluation for the effect of the local steroid injection. So this study was done to reveal the effect of local injection with triamcinolone acetonide (TA) into the carpal tunnel using the electrophysiologic changes and the improvement in symptoms.

Method: The triamcinolone acetonide (40 mg/ml) was injected to 43 patients (70 wrists) with the CTS diagnosed clinically and electrophysiologically. And the patients were reevaluated with the visual analogue scale and the electrophysiologic study every month. The mean duration of follow-up was 6 months, and the mean number of the injection was two times.

Results: The improvement of symptoms was noted in 90% of the cases, and most of the electrophysiologic parameters revealed significant improvement after the local injection of TA. The number of injection did not correlate with the visual analogue scale and the electrophysiologic parameters.

Conclusion: The local injection of TA into the carpal tunnel in the patients with CTS may be an effective therapeutic modality to improve the symptoms and the electrophysiologic parameters.

Objective: To evaluate the effectiveness of nonsurgical treatment and to evaluate the usefulness of ultrasonographic assessment in postburn hypertrophic scar.

Methods: The subjects were twenty-seven burn patients with hypertrophic scar. Hypertrophic scars were treated by four different methods: triamcinolone acetonide injection (Group I), pressure garment application (Group II), combination treatment of triamcinolone acetonide and garment (Group III) and no treatment (Group IV). To assess the effectiveness of each treatment method, ultrasonographic measurement of scar thickness and punch biopsy of scar were done before and after treatment.

Results: After 4 weeks treatment, the scar thickness decreased by 14.9⁑9.4% in Group I, 4.7⁑8.4% in Group II and 20.5⁑13.2% in Group III. However the scar thickness increased by 10.0⁑13.5% in Group IV (no treatment). The pathologic findings didn't show significant change.

Conclusion: The TA solution injection therapy and pressure garment therapy were effective methods for the treatment of the postburn hypertrophic scar, but the combinations of both therapies was more effective than each single therapy. The ultrasonography can be used as objective measure to assess effectiveness of therapy.

Objective: Several kinds of steroids had been used epidurally for the treatment of low back pain, but there were few available medical reports as to the effects of each steroid. The purposes of this study were to evaluate the effects of epidural steroid injections and to investigate the factors affecting the results.

Method: Forty four backache patients were randomly assigned to one of three groups: Group 1, epidural saline as a control group(n=12); Group 2, epidural triamcinolone and 1% lidocaine(n=13); Group 3, epidural dexamethasone and 1% lidocaine(n=19). The effects of epidural injections were measured by pain self-assessment scale(pain score) and Rubin scale(success rate).

Results: The pain scores of steroid groups after one to seven days after the injections were significantly lower than those of the control group(p＜0.05), but there were no statistical differences(p＞0.05) between two steroid groups. The overall success rate of the steroid groups was 68.8%. Although there were no statistically significant differences between the steroid groups with respect to sex, age and duration, the younger age group seemed to respond better to the treatment.

Conclusion: We founded that epidural steroid injection could be a valuable adjunct to the management of low back pain but its effective duration was relatively short. Physicians should keep in mind that comprehensive treatment including rest, medication, physical therapy, exercise and education ought to be provided for the better clinical results.