Only a few cases of cyst related to cruciate ligament were reported in the literatrure. It is not only because of rarity but also difficulty of diagnosis by conventional method. Recentely, the precise intraarticular structure of the knee joint became to be seen by introduction of MRI and arthroscope and cycts would bave been found incidentally during the workup of the internal derangement of knee. We have experienced three cases of ganglion around the cruciate ligament in the patients whose symptom was mimic of intemal derangement of knee. We excised the ganglion with good clinical results.
Arthroscopes ; Diagnosis ; Ganglion Cysts ; Humans ; Knee Joint ; Knee ; Ligaments ; Magnetic Resonance Imaging ; Methods

No abstract available.

Recently there has been decreasing trend of high tibial osteotomy in management of the gonarthrotic patients partly due to recurrence of the symptom and, more importantly, due to the relative success of the total knee joint replacement procedure. But there is still room for the high tibial osteotomy, although it may be 'outdated' procedure, in that younger active patients do well postopera- tively for an enough period of time and that even the older have some gain of pain-relief in early postoperative period. The purpose of this study is to detect the affecting factors of the result of the operation. We reviewed 25 valgus high tibial osteotomies in 23 patients who had medial gonarthrosis and could be followed-up more than 1 year among 32 cases between August 1989 and January 1994. The mean length of follow-up was 30 months(ranged twelve to fifty four months). The results were compared according to modified grading of the HSS score. All cases showed the increase of the score from preop. average 65.2 points to postop. 87.8 points, mainly by the decrease of pain and the increase of functional activity. The severity of degenerative change on the radiographs and the degree of varus seemed to be related with the early clinical results of the operation, but the age was not a major affecting factor. These results could be debatable due to some differences from the others', and long term follow-up would be needed.
Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Osteoarthritis ; Osteotomy ; Postoperative Period ; Recurrence

Surgical resection remains the primary choice of treatment and the only potentially curative option for gastric carcinoma, and is increasingly performed laparoscopically. Gastric resection represents a challenging procedure, with a significant morbidity and non-negligible postoperative mortality. The interpretation of imaging after gastric surgery can be challenging due to significant modifications of the normal anatomy. After the surgery, the familiarity with expected imaging appearances is crucial for diagnosis and appropriate management of potentially life-threatening complications in patients who underwent gastric surgery. We review various surgical techniques used in gastric surgery and describe fluoroscopic and cross-sectional imaging appearances of normal postoperative anatomic changes as well as early and late complications after gastric surgery.

BACKGROUND AND OBJECTIVES: The transradial approach for coronary intervention has a lower incidence of access site complications and can increase patient comfort after percutaneus tansluminal coronary angioplasty(PTCA). The purpose of this study is to compare procedural success and complication rates of percutaneous transradial coronary stenting which was performed by four operators in two hospitals with those using transfemoral approach. MATERIALS AND METHOD: From September 1998 to July 1999, one hundred seventy five consecutive patients(201 lesions) treated with coronary stent implantation were enrolled for this study : 84 patients underwent transradial coronary stenting(Radial Group), and 91 patients transfemoral coronary stenting(Femoral Group). RESULTS: Seven patients who failed coronary cannulation via radial artery were crossed over to the Femoral Group. The measurements of the radial artery were not done. Patient demographics were similar in both groups. Procedural success was similar in both group(95.2% in Radial Group vs. 97.8% in Femoral Group, p=S). All transradial coronary stenting were possible using conventional guiding catheters which are used in transfemoral intervention. Local vascular complication rates showed a trend toward a reduction in the Radial Group(2.4% vs. 8.8%, p=.06). CONCLUSION: This study showed the similarity in the safety and efficacy of transradial coronary stenting compared to those of transfemoral approach.
Catheterization ; Catheters ; Demography ; Humans ; Incidence ; Radial Artery ; Stents*

The purpose of this study is to compare the effects of the femoral attachment points of the graft and knee flexion angles at the time of graft fixation on stability of posterior cruciate ligament reconstruction. We analyzed the posterior stability of the knee on 23 patients(24 knees) with posterior cruciate ligament injury whose posterior cruciate ligament had been reconstructed arthroscopically and followed for minimum 1 year period at Asan Medical Center from May 1992 to June 1994. The patients were divided into the two groups according to femoral attachment points of the graft and knee flexion angles at the time of graft fixation. The distance from the junction of the intercondylar notch with trochlear groove of the femoral attachment points and knee flexion angles were 11mm and 0°-30° in group A and 7mm and 70°-90° in group B, respectively. 11 knees were included in group A and 13 knees in group B. Posterior stability was determined by difference in posterior tibial translation between the injured and the opposite knee with Telos device. In group A, 5 cases were at the range of 0-2mm, 3 cases 3-5 mm, 3 cases 6-10mm. In group B, 10 cases were at the range of 0-2mm and 3 cases 3-5mm, respectively. Differences in posterior tibial translation on average were 3.6mm and 1.7mm in group A and B, respectively. Conclusively, arthroscopic postrior cruciate ligament reconstruction with femoral attachment point at 7mm from the junction of interconlylar notch with trochlear groove and 70°
Chungcheongnam-do ; Humans ; Knee ; Ligaments ; Posterior Cruciate Ligament ; Transplants

Hemodialysis is a major mode of renal replacement therapy in children as well as CAPD. PermCath , a dual lumen silicone atrial catheter with a dacron cuff, has been used as vascular access for hemodialysis. Between Aug. 1, 1994 and Mar. 31, 1996, 29 children had been received PermCath catheter implantation for hemodialysis in the Department of Pediatrics, Seoul National University Children's Hospital. Their medical records were analyzed retrospectively. The mean age and weight of the patients were 9.8+/-4.6years (6months-17years) and 25.7+/-11.0kg (6.2kg-40kg), respectively. For short-term use (60days) users, mean life span of the catheter was 230.8 +/-158.6days (61-591days) and the actuarial catheter survival rate at 1 year was 44 %. The mean recirculation rate checked in 5 patients was 9.6+/-4.0%. The rate of thrombotic occlusion was 1.5/1,000 catheter days. Most of the clots except one could be lysed with local urokinase therapy. The rate of catheter associated fever was 0.6/1,000 catheter days. One catheter needed revision due to malposition and local bleeding developed during the procedure. PermCath catheterization was immediate, durable and relatively safe vascular access in childhood hemodialysis.
Arteriovenous Fistula ; Catheterization* ; Catheters* ; Child ; Fever ; Hemorrhage ; Humans ; Kidney Transplantation ; Medical Records ; Pediatrics ; Peritoneal Dialysis, Continuous Ambulatory ; Polyethylene Terephthalates ; Renal Dialysis* ; Renal Replacement Therapy ; Retrospective Studies ; Seoul ; Silicones ; Survival Rate ; Thrombosis ; Urokinase-Type Plasminogen Activator

PURPOSE: The aim of this study was to develop a quality of life scale for children on chronic peritoneal dialysis(QOL-CPD). METHODS: Thirty children on chronic PD at Seoul National University Children's Hospital participated. A healthy control group included 47 elementary school children. Other patients groups are 32 children from the department of pediatric orthopedics and 28 children from the department of child psychiatry. The age range of all children was 7 to 16 years. Preliminary items of the QOL-CPD were developed and administered along with the Korean version of the Children's Depression Inventory(CDI) to all children. RESULTS: The final QOL-CPD was constructed by excluding those items with a factor loading of less than .20, and the principal axis factor analysis was performed again. The QOL-CPD demonstrated a good internal consistency with a value of .87. The dialysis and child-psychiatric groups showed significantly lower QOL scores compared to the healthy control group. In addition, the dialysis and child-psychiatric groups showed greater difficulties on physical and academic functions. For the CDI, the PD group showed a mild level of depression. CONCLUSION: The results of this study demonstrate the clinical utility of a newly developed self-report QOL scale specific for children on chronic PD.
Axis, Cervical Vertebra ; Child ; Child Psychiatry ; Depression ; Dialysis ; Humans ; Orthopedics ; Peritoneal Dialysis ; Quality of Life

Renal tubular dysgenesis (RTD) is a rare fatal disorder in which there is poor development of proximal tubules, leading to oligohydramnios and the Potter sequences. RTD occurs secondary to renin-angiotensin system (RAS) blockade during the early stages of fetal development or due to autosomal recessive mutation of genes in the RAS pathway. A boy born at 33+1 weeks due to cord prolapse was found to be anuric and hypotensive. Pregnancy was complicated by severe oligohydramnios from gestational age 28+4 weeks. Abdominal sonography revealed diffuse globular enlargement of both kidneys with increased cortical parenchymal echogenicity. Infantogram showed a narrow thoracic cage and skull X-ray showed large fontanelles and wide sutures suggestive of ossification delay. Basal plasma renin activity was markedly elevated and angiotensin-converting enzyme was undetectable. Despite adequate use of medications, peritoneal dialysis, and respiratory support, he did not recover and expired on the 23rd day of life. At first, autosomal recessive polycystic kidney disease was suspected, but severe oligohydramnios along with refractory hypotension, anuria, skull ossification delay and high renin levels made RTD suspicious. ACE gene analysis revealed compound heterozygous pathogenic variations of c.1454.dupC in exon 9 and c.2141dupA in exon 14, confirming RTD. Based on our findings, we propose that, although rare, RTD should be suspected in patients with severe oligohydramnios and refractory hypotension.

The calcium sensing receptor (CaSR) plays an important role in calcium homeostasis. Activating mutations of CaSR cause autosomal dominant hypocalcemia by affecting parathyroid hormone secretion in parathyroid gland and calcium resorption in kidney. They can also cause a type 5 Bartter syndrome by inhibiting the apical potassium channel in the thick ascending limb of the loop of Henle in the kidney. This study presents a patient who had autosomal dominant hypocalcemia with Bartter syndrome due to an activating mutation Y829C in the transmembrane domain of the CaSR. Symptoms of hypocalcemia occurred 12 days after birth and medication was started immediately. Medullary nephrocalcinosis and basal ganglia calcification were found at 7 years old and at 17 years old. Three hypercalcemic episodes occurred, one at 14 years old and two at 17 years old. The Bartter syndrome was not severe while the serum calcium concentration was controlled, but during hypercalcemic periods, the symptoms of Bartter syndrome were aggravated.
Bartter Syndrome* ; Basal Ganglia ; Calcium ; Extremities ; Homeostasis ; Humans ; Hypocalcemia* ; Kidney ; Loop of Henle ; Nephrocalcinosis ; Parathyroid Glands ; Parathyroid Hormone ; Parturition ; Potassium Channels ; Receptors, Calcium-Sensing*