No abstract available.
Tinea*

PURPOSE: We investigated the optimal orientation of femoral tunnel in PCL reconstruction. MATERIALS AND METHODS: Five cadaver knees were used for this study. We made the tibial tunnel at the center of foot-print of posterior cruciate ligament, at an angle of 45o to the long axis of the tibia using the Kirschner wire. The femoral tunnel was made 11mm posterior to the articular cartilage margin of medial femoral condyle. The orientation of the femoral tunnel was made on the expolated line between two points, namely the placement of the femoral tunnel on lateral wall of medial femoral condyle and the opening of the tibial tunnel in full extension of knee. We measured the angles between the tunnel and wire on roentgenogram which passed through the femoral and tibial tunnel. RESULT: On the anteroposterior view, the angle of the graft to the long axis of the femur became acute during flexion. The angle of the graft to the long axis of the femur on the coronal plane changed from 12.6o to 154.9o with flexion from 0o to 105o. The angle of the graft to the long axis of the femur on sagittal plane changed from 137.0o to 45.1o with flexion from 0o to 105o. These results suggest that optimal graft-tunnel divergence (GTD) is obtained when the angle of graft to the long axis of the femur are 83.8o on the coronal plane and about 91o on the sagittal plane. CONCLUSION: To obtain optimal orientation of the femoral tunnel, the opening of the femoral tunnel should be located as near as possible to the margin of the articular cartilage of the medial femoral condyle.
Axis, Cervical Vertebra ; Cadaver ; Cartilage, Articular ; Femur ; Knee ; Posterior Cruciate Ligament* ; Tibia ; Transplants

No abstract available.
Child ; Femoral Fractures ; Humans

STUDY DESIGN: Retrospective study. PURPOSE: To investigate the relation between the progression of kyphotic deformity and magnetic resonance imaging (MRI) findings in conservatively treated stable thoracolumbar fractures. OVERVIEW OF LITERATURE: When treated conservatively, excessive progression of kyphotic deformity and vertebral compression can emerge during follow-up. We sought to identify predictors of vertebral body deformation using MR images. METHODS: The presence in MR images of anterior longitudinal ligament (AL) or posterior longitudinal ligament (PL) injury, superior or inferior endplate disruption, superior or inferior disc injury in fractured vertebral bodies, the existence of low signal intensity on T2 weighted images, and bone edema of intravertebral bodies were assessed. RESULTS: The presence of superior endplate disruption and a higher level of bone edema were found to cause the progressions of kyphotic angle (KA), wedge angle (WA), and anterior vertebral compression (AVC) rate. When AL or superior disc injury was observed, only KA increased meaningfully. When low signal intensity was present on T2 weighted images WA and AVC increased significantly, but PL injury, inferior endplate disruption, and inferior disc injury showed no notable correlation with kyphotic deformity progression. The risk factors found to be associated with an increase of KA to >5degrees were AL injury, superior endplate disruption, superior disc injury, and a bone edema level of over 1/3, and their associated risks versus no injury cases were 14.1, 3.7, 6.8, and 10.4-fold, respectively. CONCLUSIONS: AL injury, superior endplate and disc injury, or a high level of bone edema, were critical factors that determine kyphotic deformity progression.
Congenital Abnormalities ; Edema ; Follow-Up Studies ; Kyphosis* ; Longitudinal Ligaments ; Magnetic Resonance Imaging* ; Orthotic Devices ; Retrospective Studies ; Risk Factors ; Spinal Fractures

Acute lymphoblastic leukemia (ALL), in general, can be diagnosed by detecting blasts in peripheral blood or bone marrow. Some of the cases of ALL do not show typical leukemic features, and only manifest as refractory anemia, thrombocytopenia, myelofibrosis and lymphocytic infiltration into bone marrow. Several months after presentation, they may reveal typical leukemic features and are diagnosed as ALL. This kind of leukemia is called ALL with aleukemic prodrome. Although the incidence of ALL with aleukemic prodrome is 1.5~2.2% of childhood ALL cases, it is rarely reported in Korea. We experienced a 6 month-old female infant who presented with refactory anemia and thrombocytopenia, and two serial of bone marrow examination revealed only myelofibrosis. She subsequently developed ALL 3 months later. We report this case with a brief review of related literatures.
Anemia ; Anemia, Refractory ; Bone Marrow ; Bone Marrow Examination ; Female ; Humans ; Incidence ; Infant ; Korea ; Leukemia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Primary Myelofibrosis ; Thrombocytopenia

Malignant tumors have been shown to be a major secondary cause of nephrotic syndrome. They have been associated with different glomerulopathy depending on their type. Membranoproliferative glomerulonephritis (MPGN) rarely develops in solid tumors, although cases have been reported in renal cell cancer, melanoma, lung cancer, and tumors in the urogenital system. However, to our knowledge, there have been no case reported of MPGN associated with thyroid cancer. In the present case, we observed MPGN associated with thyroid cancer in a 44-year-old woman with nephrotic syndrome and renal insufficiency. Her thyroid ultrasound revealed a tumor measuring 1.01x1.14x1.48 cm with an indistinct border that was partially calcified. The tumor was confirmed to be papillary carcinoma by percutaneous needle aspiration biopsy. Renal biopsy showed chronic tubulointerstitial nephritis and MPGN. On day 45 of admission, total thyroidectomy and neck lymphadenectomy were performed. After total thyroidectomy, serum total protein, albumin, C3, and C4 normalized. In conclusion, this case represents the first report of simultaneous development of MPGN and thyroid cancer.
Adult ; Biopsy ; Biopsy, Needle ; Carcinoma ; Carcinoma, Papillary ; Carcinoma, Renal Cell ; Female ; Glomerulonephritis, Membranoproliferative ; Humans ; Lung Neoplasms ; Lymph Node Excision ; Melanoma ; Neck ; Needles ; Nephritis, Interstitial ; Nephrotic Syndrome ; Renal Insufficiency ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Urogenital System

In patients with situs inversus totalis, the superior vena cava is normally positioned on the left side and drains into a left-sided right atrium (RA). If right-side superior vena cava (RSVC) is also present, it should be thought of as a combined congenital anomaly. Here, we report a case of successful pacemaker lead insertion through the RSVC in a patient with situs inversus totalis. The left-side superior vena cava (LSVC) had been already used as a route for the first pacemaker lead insertion 15 years earlier. During the pacemaker lead revision, we found that the LSVC was obliterated, and used the RSVC as a route for a new pacemaker lead insertion.
Heart Atria ; Humans ; Pacemaker, Artificial ; Situs Inversus ; Vena Cava, Superior

No Abstract Available.
Korea* ; Mumps virus* ; Mumps*

Epidemiologic studies were conducted on 31 cases of Salmonella group E infection detected in 2000 through a laboratory-based pathogen surveillance in Gangwon Province, Korea. Data were collected on the environmental exposures and the patients' foods, including the brand (s) of milk consumed before the onset of diarrhea. The patients' medical records were also reviewed. All of the patients were infants under 10 months of age except one 7-year old child. Surprisingly, all of the infants were fed with infant formulas from Company A, although two infants were fed with infant formulas from both Company A and Company B. Antimicrobial susceptibility test and pulsed-field gel electrophoresis (PFGE) were performed in 25 out of 31 isolates from the patients and in 1 isolate from an opened packet of infant formula collected from the home of an infected infant. All of the 26 isolates were Salmonella enterica serovar London. They showed a single PFGE pattern, and all of the isolates were susceptible to the 18 antibiotics tested. The causative agent of the salmonella outbreaks in the Gangwon Province and its surrounding areas was Salmonella London, and the highly likely source of the infection was infant formula from Company A.
Child ; DNA, Bacterial/analysis ; *Disease Outbreaks ; Female ; *Food Contamination ; Human ; Infant ; *Infant Formula ; Infant, Newborn ; Korea/epidemiology ; Male ; Salmonella Infections/*epidemiology/*transmission ; Salmonella enterica/classification/genetics/*isolation & purification

PURPOSE: To determine the value of mammography compared to clinical examination in evaluating residual cancer of locally advanced breast carcinoma treated with neoadjuvant chemotherapy. MATERIALS AND METHODS: Among 67 patients with locally advanced breast carcinoma who were treated with neoadjuvant chemotherapy, 18 patients (age:35-67, mean:48) had taken the mammography before and after neoadjuvant chemotherapy. Those 18 sets of mammography were analyzed retrospectively and compared with the result of clinical examination on the basis of histologic diagnosis. RESULTS: On histologic examinations, 16 of 18 patients (88%) had residual cancer, one of them was diagnosed to have no residual cancer in mammography. On mammographic findings, 16 patients were determined to have residual cancer, and one of them was found not to have residual cancer on histologic examination. Clinically, there were 4 patients showed complete response, 11 patients with partial, and 3 with no response. 3 of 4 patients with complete clinical response were found to have residual cancer in histologic examination. In posttreatment mammographic findings, 11 patients were noted to have measurable mass, 8 patients had microcalcifications. All 11 patients with measurable mass in mammography had residual cancer (positive predictive value:100%). However, 5 of 7 patents who showed no measurable mass in mammography had residual cancer. 7 of 8 patients showing microcalcifications in mammography revealed to have residual cancer (positive predictable value: 88%). Sensitivity of mammography in predicting residual cancer was greater than that of clinical examination (94% vs 81%), even when microscopic residual cancer was considered as a complete response (92% vs 77%). Specificity of mammography were same as those of clinical examination (50% vs 50%, 20 % vs 20%). CONCLUSION: Mammography is more accurate and offers more information than clincal examination in evaluating residual cancer of locally advanced breast carcinoma after neoadjuvant chemotherapy. However, prediction of residual cancer with mammography is not accurate enough to replace histologic examination.
Breast Neoplasms* ; Breast* ; Diagnosis ; Drug Therapy* ; Humans ; Mammography* ; Neoplasm, Residual* ; Retrospective Studies ; Sensitivity and Specificity