Pretwisting the patellar tendon graft has been advocated hy many authors. Lambert has described a 90 degrees pretwist to benifit the fat pad vascular supply as well as to "" simulate the helicoid course of the ACL "". This technique has also been recommended to fascilitate fixation. Jackson has recommended a 90 pretwist to decrease the possibility of abrasive wear on the tunnel edge, and also to fascilitate fixation as much as a 180 degrees pretwist has heen recommended. However, in spite of all these recommendations, little work has been done on the effect of such pretwisting on the biomechanical behavior of patellar tendon grafts. The purpose of this study is to discover, by experiment, the effects of a 360 degrees external rotation pretwist on the following tensile mechanical properties of canine central 1/3 patellapatellar tendon-tibia complex : (a) ultimate stress, (b) ultimate strain, (c) average elastic modulus, and (d) strain energy density. Five groups of each S specimens were divided as group 1 (0 degrees external rotation), group 2 (90 degrees external rotation). group 3 (180 degrees external rotation), group 4 (270 degreesexternal rotation), and group 5 (360 degrees external rotation). The direction of pretwist meant the twist of tibia around patella. The effects of pretwist were analyzed using parameter one-way analysis of variance (ANOVA)(P1) and nonparameter Kruskal-Wallis one-way analysis of variance (ANOVA)(P2) with repeated measures followed by Scheff multiple comparison test. A p values of < 0.05 was considered statistically significant. Among each groups ultimate stress (P1=0.059, P2=0.095), ultimate strain(P1=0.154, P2=0. l65), and average elastic modulus(P1=0.814, P2=0.818) were not statistically significant. Only strain energy density was the statistically significant difference between group 2 and group 5(P1=0.008, P2=0.022). As a result, there were observed that the ultimate stress and strain energy density were decreased and ultimate strain was decreased but there were not statistically significant differences hetween groups because of the small number of samples, and there will be advantages for graft to avoid ahrasive wear on the tunnel edge and lateral femoral condyle. But, more studies are needed for human being in the future.
Adipose Tissue ; Elastic Modulus ; Humans ; Patella ; Patellar Ligament* ; Tibia ; Transplants

PURPOSE: To evaluate the prognostic significances of angiogenesis and bc1-2, and association of each other, we investigated the correlation of microvessel count for angiogenesis and bcl-2 expression in breast cancer. MATERIALS AND METHODS: We analysed immunohistochemistry staining from paraffin blocks in a series of 145 women with breast cancer. Immunohistochemical staining to detect factor VIII-related antigen highlighted the microvessels within primary invasive breast carcinoma. Using light microscopy, we counted microvessels per 200X field in the most active areas of neovascularization. To determine the bcl-2 immunoreactivity, we used a monoclonal antibody directed against the bcl-2 protein. RESULTS: The median of microvessel count (MVC) was 31.5, and the proportions of tumors with low and high MVC were 51% and 49%. Eighty (55.2%) cancers showed the bcl-2 immunoreactivity in the cytoplasm. The microvessel count were correlated with lymph node status (p <0.001), tumor size (p=0.001), and lymphatic invasion around tumor (p=0.009). bcl-2 expressions were corelated with estrogen receptor positivity (p<0.001) and progesterone recepter positivity (p=0.029). The microvessel counts were negatively correlated with bcl-2 expression (p=0.006). CONCLUSION: This study suggest that the angiogenesis which was investigated by micro- vessel counts was negatively correlated with bcl-2 expression.
Breast Neoplasms* ; Breast* ; Cytoplasm ; Estrogens ; Female ; Humans ; Immunohistochemistry ; Lymph Nodes ; Microscopy ; Microvessels ; Paraffin ; Progesterone ; von Willebrand Factor

Sea urchin granuloma is a rare skin disorder, considered to be allergic or foreign body reaction caused by stick of spines of sea urchin. However, detection of the spine in the granuloma is quite difficult. A 27 year-old marine was seen with several asymptomatic hard nodules on the dorsum of hands, fingers, forearrns and knees at the injured site of the spines after a latent period of 6 rnonths. Histolagical examination revealed dermal granulomatous inflamation with hyperkeratotic and acanthotic epidermis. On examination with polarized microscopy, sea urchin spines in the granuloma were seen as bright white fragments in the dark field. Those nodules were regressed with intralesional injection of triamcinoIone.
Adult ; Epidermis ; Fingers ; Foreign-Body Reaction ; Granuloma* ; Hand ; Humans ; Injections, Intralesional ; Knee ; Microscopy ; Sea Urchins* ; Skin ; Spine

Treatment of chronic localized osteomyelitis is the same as the other osteomyelitis, that is, curettage and debridement of all dead tissue which is called saucerization. After saucerization there leaves empty cavity and autogenous bone graft has been used for filling the cavity in lower extremity hecause of weight bearing and avoiding fracture. We treated seven cases of chronic localized osteomyelitis with one-staged saucerization and cancellous chip allograft and retrospective analysis was done. All healed without complication and no recurrence was ohserved. Most orthopaedic surgeons are not willing to use allograft on the site of osteomyelitis because of the fear of recurrence. But. we think that as far as complete removal of infected and dead tissue, allograft could he a good solution in terms of rapid remodelling and early weight hearing. Another advantages of allograft are to get a large amount of bone and no damage of iliac apophysis. In summary, one-staged saucerization and cancellous chip allograft would he very useful treatment for chronic localized osteomyelitis.
Allografts* ; Curettage ; Debridement ; Hearing ; Lower Extremity ; Osteomyelitis* ; Recurrence ; Retrospective Studies ; Transplants ; Weight-Bearing

No Abstract Available.
Case-Control Studies*

PURPOSE: Congenital Iobar agenesis of the liver is a rare anomaly. We report five cases (three cases of right Iobar agenesis and two cases of left Iobar agenesis) and discuss the radiologic findings of this congenital anomaly. MATERIALS AND METHODS: Between July, 1992 and February, 1993, three cases of right Iobar agenesis and two cases of left Iobar agenesis of the liver were diagnosed by means of computed tomography(CT) and/or sonography. MR imging was performed in two patients, cholangiography in two, and digital subtraction angiography in one. RESULTS: The main findings of right Iobar agenesis of the liver were nonvisualization of the right portal vein and absence of liver tissue to the right of gallbladder. The findings of left Iobar agenesis were nonvisualization of left portal vein, absence of liver tissue to the left of the gallbladder, and absence of ligamentum teres. The ancillary finding of the Iobar agenesis was visualization of less than three hepatic veins. CONCLUSION: It is important to consider Iobar agenesis of the liver in differential diagnosis when imaging studies reveal abnormal portal vein branches, unusual position of gallblader, absence of ligamentum teres, and visualization of less than three hepatic veins.
Angiography, Digital Subtraction ; Cholangiography ; Diagnosis, Differential ; Gallbladder ; Hepatic Veins ; Humans ; Liver ; Portal Vein

In leprosy, it is generally believed that the defense against Mycobacterium leprae (M. leprae) is largely dependent on cell-mediated immunity (CMI) and there is an accumulating evidence that the patients with lepromatous leprosy have not only defective CMI specific for M. leprae, but also have generalized impairment of CMI. In contrast, the humoral immune reactivity, both specific and nonspecific, have been found to be normal or slightly increased. Recently, several investigators have enumerated the peripheral blood T and B lympocytes in patients with leprosy; however, there is no agreement as to the results. Furthermore, leprosy has been found to differ in its clinicai manifestations and immunological behaviors in different geographic areas and races. Nevertheless, there is yet no report in Korea concerning the T and B lymphocyte enumeration. The authors considered it is necessary to enumerate the peripheral blood T and B lymphocytes in Korean patients with leprosy to evaluate the immune status and the differences in the immunologic reactivity between the lepromatous and the tuberculoid spectrum of leprosy. (countinued..)
B-Lymphocytes* ; Continental Population Groups ; Humans ; Immunity, Cellular ; Korea ; Leprosy* ; Leprosy, Lepromatous ; Lymphocytes ; Mycobacterium leprae ; Research Personnel

No abstract available.
Hand* ; Wrist*

BACKGROUND: Neutropenia can be easily found in previously healthy children associated with various medical conditions, and the clinical course ranges from transient benign to life threatening. This study aimed to investigate the etiology, clinical characteristics, and clinical courses of neutropenia in previously healthy children. METHODS: We evaluated 215 previously healthy children under aged 18 years who diagnosed with neutropenia in two hospitals. Clinical and laboratory features were analyzed retrospectively based on the medical records. RESULTS: Transient infectious neutropenia (TIN) accounted for 97.7% of cases and chronic neutropenia (CN), for 2.3%. An infectious agent was identified in 128/210 (61%) patients with TIN, and the most frequent agents were viruses (46.5%). The most common viral agent was respiratory syncytial virus (RSV) (29%). TIN subgroups exhibited no differences in severity according to infectious agent (virus, bacteria, Mycoplasma); however, neutropenia severity differed among viral agents [mild-to-moderate neutropenia in the RSV group (857.3±293.3/µL) and moderate-to-severe neutropenia in the parainfluenza group (567.3±198.1/µL); P=0.017]. All patients with CN had anti-neutrophil antibody positivity (autoimmune neutropenia, AIN), and moderate-to-severe neutropenia predominated. The median duration of TIN was 8 days (range, 3–286 days), and it was significantly longer for AIN at 330 days (range, 217–730 days) (P=0.000). The median duration of neutropenia was also different according to each viral agent, with 4 days (range, 3–11 days) for the RSV group and longer durations for 3 other groups (influenza, parainfluenza, other respiratory viruses) (P=0.015). CONCLUSION: Neutropenia in previously healthy children is usually of transient infectious origin, with mild-to-moderate severity, and it resolves spontaneously without complications.
Autoimmune Diseases ; Bacteria ; Child* ; Humans ; Medical Records ; Neutropenia* ; Paramyxoviridae Infections ; Respiratory Syncytial Viruses ; Retrospective Studies ; Tin

PURPOSE: The purpose of this study was to evaluate the clinical usefulness of the Critical Patient Severity Classification System (CPSCS) and Glasgow Coma Scale (GCS) for critically ill neurological patients and to determine the applicability of CPSCS and GCS in predicting their mortality. METHODS: Data were collected from the medical records of 187 neurological patients who were admitted to the intensive care unit of C university hospital. The datawere analyzed through chi-square test, t test,Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and receiver operating characteristic curve. RESULTS: In accordance with patients' general and clinical characteristics, patient mortality turned out to be significantly different depending on intensive care unit stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Hosmer-Lemeshow goodness-of-fit tests were applied to CPSCS and GCS. The results of the discrimination test using the receiver operating characteristic curve were CPSCS0, .743, GCS0 .583, CPSCS24, .734, GCS24 .612, CPSCS48, .591, GCS48 .646, CPSCS72, .622, and GCS72 .623. Logistic regression analysis showed that each point on the CPSCS score signifies a 1.034 higher likelihood of dying. CONCLUSION: Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.
Central Venous Catheters ; Critical Illness ; Discrimination (Psychology) ; Glasgow Coma Scale ; Humans ; Critical Care ; Intensive Care Units ; Intubation, Intratracheal ; Logistic Models ; Medical Records ; Neurology ; ROC Curve