Method: One millimeter of three proliferant solutions (20% dextrose water-group A, 5% dextrose water mixed with NaCl-group B, NaCl solution-group C) with the same osmolarity (1,110 mOsm) was injected around the right Achilles tendon of each rat, whereas the left was not injected to be used as control. After six weeks of injection, the injected tendons and controls were obtained. The transverse diameter of gross specimen, the count of fibroblasts on light microscope, and the findings of cross- sectional analysis using electron microscope were compared.

Results: Overall, transverse diameter and the count of fibroblasts increased in the injected specimens compared to controls, however, their significant differences were demonstrated only for the two groups injected with dextrose containing solutions (p＜0.05). However, A and B groups did not show significant differences in all parameters investigated. On electron micrograph, fibril diameters of solution- injected tendon consisted of either extremely large or small sizes with the limited intermediate sizes.

Conclusion: Although high osmolar solution could increase the transverse diameter and fibroblast counts, however, dextrose-containing solution was much more effective as a proliferant solution. (J Korean Acad Rehab Med 2003; 27: 935-940)

Objective: To evaluate the effects of dextrose prolotherapy on knee osteoarthritis.

Method: The patient population consisted of 20 individuals with knee osteoarthritis. Patients have suffered from knee pain for six months or more along with Kellgren's grade 2 or more radiographical change in knee compartment. They were injected monthly with 15% and 25% dextrose on knee joints for 4 months. The outcome was measured by visual analogue scale (VAS) for pain, pain rating score, and WOMAC osteoarthritis index at a month after 4th injection.

Results: Seventeen of the 20 patients achieved significant diminution of pain or disability scores after dextrose prolotherapy compared with pre-treatment status. There were significant reductions in VAS score, pain rating score, and WOMAC osteoarthritis index after dextrose injection (p＜0.05). Three patients dropped out over follow up period due to lack of efficacy.

Conclusion: Prolotherapy injection with dextrose resulted in clinically and statistically significant improvements in knee osteoarthritis. (J Korean Acad Rehab Med 2002; 26: 445-448)

Objective: To assess the effects of intratendinous injection of 12.5% dextrose water on healing of injured Achilles tendon in rat.

Method: Quantification of hydroxyproline concentration in Achilles tendons of 21 Sprague- Dawley rats was performed to assess the concentration of collagen, and hematoxyline-eosin and immunochemistry staining was performed to analyse histopathology.

Results: There was no significant difference in collagen concentration between the three groups (p＞0.05). Light microscopic examination showed irregular arrangement of coarse collagen fibers and decreased number of fibroblasts in sham treatment and dextrose injection group and showed more irregular arrangement of coarse collagen fibers in dextrose injection group than in sham treatment group. The immunochemical staining of sham treatment and dextrose injection group showed more increased immunoreactivity for type I and III collagen than control group, but the same as in sham treatment group and dextrose injection group.

Conclusion: The increase of collagen concentration in injured Achilles tendon of rat treated with hyperosmolar dextrose was not found. This implies that clinical observation of collagen remodelling process may alter biomechanical property other than collagen concentration which should be further investigated.

Objective: To evaluate the usefulness of 10% dextrose swallowing test (DST) to detect aspiration for patient with tracheostomy in comparison with modified blue dye test (MBDT).

Method: Fifteen brain injured patients with tracheostomy were tested by DST and MBDT. The newly developed DST consists of 3 steps. In the first step, 5 cc 10% dextrose solution is fed 3 times by spoon. In the second step, tracheal secretion is sampled by suction catheter just before swallowing, and 30 seconds, 90 seconds after swallowing. In the third step, tracheal secretion is smeared to glucose oxidase test strip to detect aspiration with color change from pink to purple. MBDT with 0.01 % methylene blue solution was also performed in the same order. The tracheal secretion was smeared to the white paper to see the color change to blue. Videofluoroscopic swallowing study (VFSS) was performed for 9 out of 15 patients.

Results: Fourteen out of 15 patients showed the same outcome in DST and MBDT (kappa= 0.815). Seven out of 9 patients showed the same outcome in DST and VFSS (kappa=0.571). Eight out of 9 patients showed the same outcome in MBDT and VFSS (kappa=0.780).

Conclusion: The DST is a reliable method to detect aspiration for patient with tracheostomy.