The medial collateral ligament is the most commonly injured ligamentous structure of the knee and it has been demonstrated that this ligament is the prime static stabilizer of the medial side of the knee joint. The management of the medial collateral ligament injuries were divided into surgical and conservative treatment. Many investigators reported consistently good to excellent results following surgical treatment. More recently, other investigators reported that isolated medial collateral ligament injuries did equally well under non-operative as operative treatment. For accurate diagnosis, arthroscopic examination of the knee to rule out other intraarticular pathologic conditions such as cruciate ligament injuries, maniscal tears and bony injuries is essential. From October 1988 to January 1991, we treated 76 cases of isolated medial collateral ligament injuries which was confirmed by diagnostic arthroscopy. Among them, we analyzed 31 cases that minimum follow-up was over 1 year and could be re-examed, 20 cases were treated with surgery and 11 cases were not. With comparision between initial and final follow-up stress X-ray, 5.45 ± 3.17mm in non-operative group had improved in medial laxity(P < 0.05). The Marshall scores which checked at final follow-up, averaged 40.3 ± 7.299 in operative and 37.364 ± 6.485 in non-operative group (P>0.05). In conclusion, medial stability was improved in operative than in non-operative group, however functional score was equally well under non-operative as operative treatment.
Arthroscopy ; Collateral Ligaments ; Diagnosis ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Ligaments ; Research Personnel ; Tears

IgA nephropathy usually presents as asymptomatic microscopic hematuria or proteinuria or episodic gross hematuria after upper respiratory infection. It is an uncommon cause of end-stage renal failure in childhood. Pulmonary hemorrhage associated with IgA nephropathy is an unusual life-threatening manifestation in pediatric patients and is usually treated with aggressive immunosuppression. Pulmonary hemorrhage and renal failure usually occur concurrently, and the pulmonary manifestation is believed to be caused by the same immune process. We present the case of a 14-year-old patient with IgA nephropathy who had already progressed to end-stage renal failure in spite of immunosuppression and presented with pulmonary hemorrhage during oral prednisone treatment. His lung disease was comparable to diffuse alveolar hemorrhage and was successfully treated with plasmapheresis followed by oral prednisone. This case suggests that pulmonary hemorrhage may develop independently of renal manifestation, and that plasmapheresis should be considered as adjunctive therapy to immunosuppressive medication for treating IgA nephropathy with pulmonary hemorrhage.
Adolescent ; Glomerulonephritis, IGA* ; Hematuria ; Hemorrhage* ; Humans ; Immunoglobulin A* ; Immunosuppression ; Kidney Failure, Chronic ; Lung Diseases ; Plasmapheresis ; Prednisone ; Proteinuria ; Renal Insufficiency

Metronidazole is an antimicrobial agent widely used for the treatment of trichomoniasis, giardiasis, amebiasis, and anaerobic bacterial infections. It has been reported that metronidazole-induced neurotoxicity is associated with responsible lesions on brain MRI. We report 2 patients with metronidazole-induced neurotoxicity, who had no responsible lesions on brain MRI for their neurological deficits. The pathogenic mechanisms are discussed.
Amebiasis ; Bacterial Infections ; Brain ; Giardiasis ; Humans ; Magnetic Resonance Imaging ; Metronidazole

No abstract available.
Carcinoma, Small Cell* ; Prognosis*

The aim of this study was to measure the immediate pull-out strengths by increasing the number of suture loops and to compare the immediate pull-out strengths of three different suturing techniques. In one group, the number of suture loops increased from 2 to 9 and the suturing technique of multiple loops through the proximal ligament stumps was used. The other group, the three different techniques were transverse, vertical, and criss-cross suture. The ultimate strength for the 2 loops was 16.62 (+/-6.7)N, for the 3 loops was 34.45 (+/-12.5)N, for the 4 loops was 54.80 (+/-17.7)N, for the 5 loops was 74.30 (+/-21.4)N, for the 6 loops was 102.49 (+/-13.5)N, for the 7 loops was 105.05 (+/-24.8)N, for the 8 loops was 129.50 (+/-76.1)N, for the 9 loops was 229.50 (+/-48.7)N. The transverse suture had a mean ultimate strength of 47.38 (+/-14.8)N, where-as the vertical suture failed at 76.94 (+/-26.4)N and the criss-cross suture at 101.82 (+/-25.7)N. Consequently, their strength can be improved by increasing the number of loops and we suggest that the criss-cross suture technique is reliable method for clinical use, because of high failure strength and wider apposition area of bone to ligament.
Ligaments* ; Suture Techniques ; Sutures

The morphology and location of the pterion was investigated in total of 149 Korean skulls (298 pteria). The most common form of the pterion was a sphenoparietal articulation in the incidence of 76.5%. The most common location of the pterion was in an area which covers 5 mm from the supraorbital horizontal line parallel to Frankfurt line and the incidence was 81.8%. The metric location of the pterion was on 36.9 +/-3.8 mm above the upper margin of the zygomatic arch and 26.8 +/-4.5 mm behind the posterior margin of the frontozygomatic suture. The average length of the pterion was 12.2 +/-4.4 mm. The most common form of the epipteric bone was a single bone which articulated with the frontal, parietal, temporal and sphenoid bone, and the incidence was 40.3%. The most common location of the epipteric bone was in an area which covers 5 mm from the supraorbital horizontal line parallel to Frankfurt line and the incidence was 45.2%. Morphological analysis of the pterion, when combined with some other non -metric and metric variants, may become useful physical anthropologic tools for the identification of the Korean skull.
Incidence ; Rabeprazole ; Skull ; Sphenoid Bone ; Sutures ; Zygoma

Inflammatory demyelinating diseases are usually diagnosed based on characteristic clinical and radiological findings. However, some demyelinating diseases have been presented as growing large mass-like lesions, and it is difficult to differentiate those demyelinating lesions from brain tumors. We report three cases of demyelinating diseases mimicking brain tumors. These cases suggest that the inflammatory demyelinating diseases have a wide spectrum and they can present with the same radiological features of brain tumors.
Brain Neoplasms* ; Demyelinating Diseases* ; Multiple Sclerosis

Estimation of biological profile for skeletal remains by forensic anthropological examination would be possible based on physical anthropological studies which were statistically analyzed. However, physical anthropological studies for Korean population are not enough to establish biological profile for Korean because there is lack of documented osteological specimens in Korea. Recent study suggested that physical anthropological examination could be possible on the three dimensional data which were reconstructed from computed tomography, instead of preparing skeletal specimen by defleshing bone. One of the aim of this study is to evaluate Digital Korean database which were composed of computed tomographic images of 100 cadavers. The other is to perform statistical analysis on morphometrics for segmented atlas whether the results could be helpful to estimate sex in Korean. We measured 100 segmentation atlases (male 51, female 49) from the Digital Korean database which were under the control of Catholic Institute for Applied Anatomy, The Catholic University of Korea. Measurements of segmented atlas were carried out by using Mimics software (Simulation module, Version 13.0, Materialise NV, Belgium), and values of measurement were performed statistical analysis by IBM(R) SPSS(R) (version 20.0, Armonk, New York). Among 19 measurements, the width of atlas showed most crucial element for estimating sex, which was consistent with the result using dried bones of atlas and hit ratio of discriminant functions was 88.0%. 76.7 was the cut-off score of discriminant functions. This results showed that morphometrics for segmented atlas could be helpful in estimating sex using the Digital Korean database. In the future, we expect that the other researchers could more actively use the Digital Korean database as a good specimen for physical and forensic anthropological study.
Cadaver ; Female ; Human Body* ; Humans ; Korea

This study was designed for the facial reconstruction of Father Dae -Gun (Andrea) Kim, who is the first priest in Korea. The study was entrusted by Seoul great parish, Myeongdong Cathedral and was conducted during 15 months from September 1999. To reconstruct the face of Father Dae -Gun (Andrea) Kim, we used photographs and metric data of Father Dae -Gun (Andrea) Kim's skull, which was measured by Department of Anatomy, Catholic Medical College at 1971. Based on above data, we found a skull similar to Father Dae -Gun (Andrea) Kim, replicated it, and modified it to be consistent with that of Father Dae -Gun (Andrea) Kim measured at 1971. The face of Father Dae -Gun (Andrea) Kim was reconstructed on the modified replica of Father Dae -Gun (Andrea) Kim's skull using the forensic anthropological data about the average skin depth and the relationships of skull morphology to facial features of Korean. The average skin depth of Korean face was obtained from direct measurement of cadavers and indirect measurement of live Korean using ultrasonography. The result of facial reconstruction of Father Dae -Gun (Andrea) Kim was made as the bronze bust. The forensic anthropologic method such as facial reconstruction is one of the methods to identify unidentified -skull. This study is the first facial reconstruction on the base of Korean physical anthropological data and is thought to be helpful to the facial reconstruction for identification.
Cadaver ; Fathers* ; Forensic Anthropology ; Humans ; Korea ; Seoul ; Skin ; Skull ; Ultrasonography

Heart failure unresponsive to bed rest, low sodium diet, digitalis, diuretics, vasodilators and cardiac inotropic agents is a difficult therapeutic problem. Although remission was achieved with such treatment, its duration was short and easily recurred. We present a report of severe refractory congestive heart failure in three patients successfully treated with Continuous Ambulatory Peritoneal Dialysis (CAPD). These patients were admitted to the hospital many times and treated by conventional methods but cannon maintain their condition for a long time. In all three patients, edema, pulmonary congestion, electrolyte abnormalities, decreased ejection fraction and fractional shortening of myocardioum were eliminated or improved by CAPD. All three patients improved from Class IV congestive heart to Class II, as defined by the New York Heart Association, and experienced a define improvement in their sense of well being We conclude CAPD as an effective and the useful treatment for servere congestive heart failure refractory to conventional medical treatments.
Bed Rest ; Diet ; Digitalis ; Diuretics ; Estrogens, Conjugated (USP)* ; Heart ; Heart Failure* ; Humans ; Peritoneal Dialysis, Continuous Ambulatory ; Pulmonary Edema ; Sodium ; Vasodilator Agents