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

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

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

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

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

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

PURPOSE: To compare cephalometric measurement between measuring methods in digital and conventional lateral cephalometric radiograph. MATERIALS AND METHODS: Twenty digital and conventional lateral cephalometric radiographs were selected. In digital group, cephalometric measurements were performed manually using hardcopies and automatically using VCeph(TM) program on the monitor. In conventional group, the same measurements were performed manually on conventional films, and for automatic measurement conventional films were digitized by scanner. All measurements were performed twice by 4 observers, and 24 cephalometric variables were calculated and the time spent for each measurement was recorded. The differences in measurements data and the time spent for each measurement were compared within each group. Intra-observer and inter-observer comparisons were performed. RESULTS: In both groups, no statistically significant difference between manual and automatic measurements was observed and most of the variables didn't show statistically significant differences between methods. The observer with less experience tended to show statistically significant differences of measurements between methods, and differences from other observers. The differences of measurements between methods in digital group were lesser than those of conventional group with statistical significance in 8 variables out of 24. With automatic method and in digital group, the spent time was shorter. CONCLUSION: With direct digital radiograph, automatic method using manually idenitified landmarks can be preferable in cephalometric analysis.
Cephalometry ; Radiographic Image Enhancement

BACKGROUND: Currently, the cardiopulmonary machine with non-pulsatile pumps, which are low in internal circuit pressure and cause little damage to blood cells, is widely used. However, a great number of experimental studies shows that pulsatile perfusions are more useful than non-pulsatile counterparts in many areas, such as hemodynamic, metabolism, organ functions, and micro-circulation. Yet, many concerns relating to pulsatile cardiopulmonary machines, such as high internal circuit pressure and blood cell damage, have long hindered the development of pulsatile cardiopulmonary machines. Against this backdrop, this study focuses on the safety and effectiveness of the pulsatile cardiopulmonary machines developed by a domestic research lab. MATERIAL AND METHOD: The dual-pulsatile cardiopulmonary bypass experiment with total extracorporeal circulation was conducted on six calves. Extracorporeal circulation was provided between superior/inferior vena cava and aorta. The membrane oxygenator, which was placed between the left and right pumps, was used for blood oxygenation. Circulation took four hours. Arterial blood gas analysis and blood tests were also conducted. Plasma hemoglobin levels were calculated, while pulse pressure and internal circuit pressure were carefully observed. Measurement was taken five times; once before the operation of the cardiopulmonary bypass, and after its operation it was taken every hour for four hours. RESULT: Through the arterial blood gas analysis, PCO2 and pH remained within normal levels. PO2 in arterial blood showed enough oxygenation of over 100 mmHg. The level of plasma hemoglobin, which had total cardiopulmonary circulation, steadily increased to 15.87+/-5.63 mg/dl after four hours passed, but remained below 20 mg/dl. There was no obvious abnormal findings in blood test. Systolic blood pressure which was at 97.5+/-5.7 mmHg during the pre-circulation contraction period, was maintained over 100 mmHg as time passed. Moreover, diastolic blood pressure was 72.2+/-7.7 mmHg during the expansion period and well kept at the appropriate level with time passing by. Average blood pressure which was 83+/-9.2 mmHg before circulation, increased as time passed, while pump flow was maintained over 3.3 L/min. Blood pressure fluctuation during total extracorporeal circulation showed a similar level of arterial blood pressure of pre-circulation heart. CONCLUSION: In the experiment mentioned above, pulsatile cardiopulmonary machines using the doual-pulsatile structure provided effective pulsatile blood flow with little damage in blood cells, showing excellence in the aspects of hematology and hemodynamic. Therefore, it is expected that the pulsatile cardiopulmonary machine, if it becomes a standard cardiopulmonary machine in all heart operations, will provide stable blood flow to end-organs.
Animals* ; Aorta ; Arterial Pressure ; Blood Cells ; Blood Gas Analysis ; Blood Pressure ; Cardiopulmonary Bypass* ; Extracorporeal Circulation ; Heart ; Hematologic Tests ; Hematology ; Hemodynamics ; Hydrogen-Ion Concentration ; Metabolism ; Models, Animal* ; Oxygen ; Oxygenators, Membrane ; Perfusion ; Plasma ; Pulsatile Flow