The most commonly used graft source for anterior cruciate ligament reconstruction is the autogenous bone- patellar tendon-bone graft unit. Despite a good success record, intraoperative technical errors and postoperative complications have been known. Author analyzed intraoperative technical errors and postoperative complications, in 44 patients who were treated at the department of orthopaedic surgery, chosun university hospital from Jan. 1994 to Jun. 1996. The most common intraoperative technical errors was screw graft divergency in 5 cases. Other intraoperative technical errors were too anteriorly location of femoral tunnel in 1 case, too anteriorly location of tibial k femora) tunne.l both in 1 case, graft tunnel mismatching in 1 case, graft pullout in 1 case and partial destruction of posterior cortex of femoral tunnel in 1 case, fracture of the bone plug in 1 case. The most common postoperative complication was patellar tendinitis in 20 cases (45.5%). Other postoperative complications were anterior knee pain in 14 case. (31.8%), patellar crepitation in 12 cases (27.3%), quadriceps atrophy in 9 cases (20.5%), arthrofibrosis in 3 cases and graft failure in 2 cases. Author concluded the causes of intraoperative complications were technical errors, and anteriorly location of graft tunnel is most influenced factor to final fuctional results. To eliminate the postoperative complications, intraoperative technical errors should be avoided and also accelerated rehabilitation should be done.
Anterior Cruciate Ligament Reconstruction ; Atrophy ; Humans ; Intraoperative Complications ; Knee ; Patellar Ligament* ; Postoperative Complications* ; Rehabilitation ; Tendinopathy ; Transplants

The incidence of impalpable testis is approximately 20 percent of undescended testis population and some may possess vascular pedicle shortening that prohibits scrotal placement in one stage orchiopexy. From July 1987 through April 1988, 12 patients with 17 impalpable testicles were explored by lower midline incision and the following results were obtained : 1. We could identify and prove the location of testis and/or anorchia without postoperative complication : 10 intraabdominal testes (59%), 3 intracanalicular (18%), 4 anorchia (23%). 2. Among 10 intraabdominal testes 5 testes were brought down by transabdominal orchiopexy, 3 testes by Fowler-Stephens method, and 1 testis by staged orchiopexy and remaining testis were removed. 3. Among 3 intracanalicular testes 2 testes were brought down by transabdominal orchiopexy and one testis was removed. 4. Follow up testicular examination of fixed testes revealed no testicular atrophy in all transabdominal orchiopexed testes and no testicular atrophy in 1 of 3 testes which were performed by Fowler-Stephens method.
Atrophy ; Cryptorchidism ; Follow-Up Studies ; Humans ; Incidence ; Male ; Orchiopexy ; Postoperative Complications ; Testis*

The carpal tunnel syndrome is well known, studied and easily treatable disease as one of the entities of peripheral neuroentrapment disease. This report is based on last ten year of our experience since the January of 1987 by observing 31 hands of 21 surgically treated patients with carpal tunnel syndrome. The age range of patients was from 29 to 61 years old(average 48.70. The peak age group was six decade. Both hands were affected predominantly followed by right and left hand, 18(58%), 9(29%) and 4(13%) respectively. Tingling sensation and pain were presented in all hands followed by Tinel's sign in 21 hands(67.7%), Phalen's sign in 19 hands(61.2%) and thenar muscle atrophy in 9(29%). The postoperative results were excellent in 64.7% of patients, good 23.5%, fair 5.9% and poor 5.9%. There were no postoperative complication. From these results we stress that carpal tunnel syndrome can be treated well by surgery.
Carpal Tunnel Syndrome* ; Hand ; Humans ; Median Nerve ; Muscular Atrophy ; Postoperative Complications ; Sensation

The authors report the result of cryo-extraction of the lens in 50 eyes (44 cases) which were operated in B.N.D. Hospital from January 1978 to April 1980. The results are as follows: 1. The incidences of complication during operation were hyphema(8%), vitreous loss and rupture of the lens capsule(2%). Hyphema was the most common complication during operation. 2. The incidences of early postoperative complication were striate keratitis(26%), hyphema (2%), shallow anterior chamber(2%) and uveitis. 3. The incidences of late postoperative complication were vitreous prolapse into anterior chamber (6%), updrawn pupil(6%), macular edema(4%) and posterior synechia (2%), corneal degeneration with abnormal tissue growth into anterior chamber (2%), iris atrophy (2%) and vitreous opacity (2%). 4. The postoperative final visual acuity more than 0.5 were 37 eyes(74%) and less than 0.1 were 2 eyes(4%).
Anterior Chamber ; Atrophy ; Cataract* ; Hyphema ; Incidence ; Iris ; Postoperative Complications ; Prolapse ; Rupture ; Uveitis ; Visual Acuity

Total vitrectomy and removal of the posterior hyaloid membrane were done in 7 patients who were diagnosed as macular hole with specific causative factors. The causative factor of 2 patients is high myopia and of remainers is trauma. Of the 7 patients treated by removal of the posterior hyaloid membrane during total vitrectomy, 3 patients showed anatomical and functional success, 2 patients only the anatomical success, and 2 patients failure. The postoperative complications included phthisis bulbi, proliferative vitreoreinopathy, optic atrophy, and macular degeneration, and iatrogenic rhegmatogenous retinal detachment. Two patients of the 3 success cases complained of mild diplopia after operation.
Diplopia ; Humans ; Macular Degeneration ; Membranes* ; Myopia ; Optic Atrophy ; Postoperative Complications ; Retinal Detachment ; Retinal Perforations* ; Vitrectomy*

OBJECTIVES: To study the forensic features of diffuse brain atrophy after trauma, the relationship between age and interval time of post-traumatic brain atrophy, and the relationship between the degree of craniocerebral injury and that of brain atrophy. METHODS: The forensic features of 25 cases of diffuse brain atrophy after craniocerebral trauma were retrospectively analyzed from aspects of gender, age, craniocerebral injury characteristics, and imaging characteristics of brain atrophy. Pearson correlation analysis was used for statistical analysis. RESULTS: Diffuse brain atrophy after trauma could occur in any age group, dominated by severe brain injury. The Pearson correlation coefficients （r） between the time interval of brain atrophy and age were 0.442 （ P<0.05）, 0.341 （P>0.05）, and 0.904 （ P<0.05） for the overall cases, the group over age 50, and the group under age 50, respectively. The correlation coefficient between the degree of brain injury and that of brain atrophy was 0.579 （ P<0.05）, and that between severe brain injury and brain atrophy was 0.788 （ P<0.05）. CONCLUSIONS The more serious the brain injury, the more severe the brain atrophy. Various degrees of diffuse brain atrophy can occur in severe craniocerebral injury, and diffuse brain atrophy is usually mild and moderate after mild and moderate craniocerebral injury. In the practice of forensic clinical identification, a comprehensive analysis should be conducted with the combination of case materials when the identified person has high risk factors leading to brain atrophy （e.g., hypertension, diabetes, etc.）, plus injury and illness relationship analysis if necessary.
Atrophy ; Brain/pathology* ; Brain Injuries/complications* ; Craniocerebral Trauma ; Humans ; Retrospective Studies

Objective: To analyze the clinical and genetic characteristics of pediatric patients with dual genetic diagnoses (DGD). Methods: Clinical and genetic data of pediatric patients with DGD from January 2021 to February 2022 in Peking University First Hospital were collected and analyzed retrospectively. Results: Among the 9 children, 6 were boys and 3 were girls. The age of last visit or follow-up was 5.0 (2.7,6.8) years. The main clinical manifestations included motor retardation, mental retardation, multiple malformations, and skeletal deformity. Cases 1-4 were all all boys, showed myopathic gait, poor running and jumping, and significantly increased level of serum creatine kinase. Disease-causing variations in Duchenne muscular dystrophy (DMD) gene were confirmed by genetic testing. The 4 children were diagnosed with DMD or Becker muscular dystrophy combined with a second genetic disease, including hypertrophic osteoarthropathy, spinal muscular atrophy, fragile X syndrome, and cerebral cavernous malformations type 3, respectively. Cases 5-9 were clinically and genetically diagnosed as COL9A1 gene-related multiple epiphyseal dysplasia type 6 combined with NF1 gene-related neurofibromatosis type 1, COL6A3 gene-related Bethlem myopathy with WNT1 gene-related osteogenesis imperfecta type XV, Turner syndrome (45, X0/46, XX chimera) with TH gene-related Segawa syndrome, Chromosome 22q11.2 microduplication syndrome with DYNC1H1 gene-related autosomal dominant lower extremity-predominant spinal muscular atrophy-1, and ANKRD11 gene-related KBG syndrome combined with IRF2BPL gene-related neurodevelopmental disorder with regression, abnormal movement, language loss and epilepsy. DMD was the most common, and there were 6 autosomal dominant diseases caused by de novo heterozygous pathogenic variations. Conclusions: Pediatric patients with coexistence of double genetic diagnoses show complex phenotypes. When the clinical manifestations and progression are not fully consistent with the diagnosed rare genetic disease, a second rare genetic disease should be considered, and autosomal dominant diseases caused by de novo heterozygous pathogenic variation should be paid attention to. Trio-based whole-exome sequencing combining a variety of molecular genetic tests would be helpful for precise diagnosis.
Humans ; Abnormalities, Multiple ; Retrospective Studies ; Intellectual Disability/genetics* ; Bone Diseases, Developmental/complications* ; Tooth Abnormalities/complications* ; Facies ; Muscular Dystrophy, Duchenne/complications* ; Muscular Atrophy, Spinal/complications* ; Carrier Proteins ; Nuclear Proteins

Papillary cystadenoma of the epididymis is a rare benign tumor, accounting for only 4 per cent of all epididymal tumors. Histologically, it can be confused with metastatic renal cell carcinoma. This extremely rare lesion may occur sporadically or as a manifestation of von Hippel-Lindau(VHL) disease. The present paper reported a case of papillary cystadenoma accompanied by testicular atrophy with no signs of VHL syndrome or infertility. To date, no similar case was reported in the literature. The tumor measured 5.0 cm x 4.0 cm x 4.0 cm and was located in the right epididymis. Histopathologic examination of a surgically removed specimen indicated a primary papillary cystadenoma. Histomorphologically, these tumors are characterized by cysts with colloid-like contents and papillary formations of light epithelium. Since metastatic renal cell carcinoma may be histologically similar to papillary cystadenoma, the importance of long-term urologic follow-up for possible presentation of renal cell carcinoma is discussed.
Adult ; Atrophy ; etiology ; Cystadenoma, Papillary ; complications ; pathology ; Epididymis ; Genital Neoplasms, Male ; complications ; pathology ; Humans ; Male ; Testis ; pathology

Cockayne syndrome is a rare autosomal recessive disorder of childhood characterized by cachectic dwarfism with senile-like appearance, mental retardation, photosensitive dermatitis, loss of adipose tissue, pigmentary degeneration of retina, microcephaly, deafness, skeletal and neurologic abnormalities. We describe here an 18 year old boy with Cockayne syndrome who had, in addition to the typical features of the disorder, fasting hyperinsulinemia and growth hormone deficiency.
Adolescent ; C-Peptide/blood ; Cockayne Syndrome/*complications/pathology ; Growth Disorders/*complications/pathology ; Growth Hormone/*deficiency ; Humans ; Hyperinsulinism/*complications/pathology ; Insulin/blood ; Male ; Optic Atrophy/pathology ; Retinal Degeneration/pathology

We report a 36-year-old male with the bilateral visual field defect following LASIK was observed. Preoperatively, patient had high myopia(right. -7.25 0.75x18, left. -7.5-0.5x12), normal intraocular pressure(IOP)(right/left: 16/14 mmHg), normal visual field(Humphrey 30-2 visual field)and revealed the tilted discs with symetric optic nerve head cupping(cup-to-disc ratio, 0.70), parapapillary atrophy. Bilateral LASIK keratorefractive surgery was on the same day and intraoperative complication was not noted. After the first operative visit day, examination revealed uncorreted visual acuity right 0.8 and left 0.6 but scotoma was reported. Three months later, Humphrey 30-2 visual field revealed a near-superior altitudinal defect in the right eye and nasal side visual field defect in the left eye. Best corrected visual acuity was 1.0 in the right eye, 0.8 in the left eye. Repeated visual fields over a 11-month period postoperatively showed stability of the defect, with IOP of 12 mmHg to 15 mmHg in each eye. We considered LASIK uses a microkeratome vaccum ring to make a corneal flap, transient elevation of IOP alters the microcirculation of optic nerve head and may have precipitated visual field defect.
Adult ; Atrophy ; Humans ; Intraoperative Complications ; Keratomileusis, Laser In Situ ; Male ; Microcirculation ; Optic Disk ; Scotoma ; Visual Acuity ; Visual Fields*