PURPOSE: To compare the clinical? results and stability of acute and chronic reconstruction of anterior cruciate ligament (ACL). MATERIALS AND METHODS: Patients who had ACL reconstruction with a quadruple hamstring tendon and ligament anchor (LA) screw with a minimum 2-year follow-up were included in this study. Acute (within 4 weeks) reconstruction group was composed of 27 knees and chronic (over 3 months) group was 44 knees. We compared the two groups with regard to Lysholm knee score, range of motion, thigh circumference, Lachman test, Tegner activity scale, associated meniscal injuries, and anterior laxity difference by Telos stress arthrometer. RESULTS: At last follow-up, no significant differences were found between the acute and chronic groups for Lysholm score, range of motion, Lachman test, Tegner activity scale, and instrumental laxity. 16 cases (59%) of acute and 33 cases (75%) of chronic patients had a meniscal injuries of which were reparable in 5 cases (28%) and 7 cases (17%). CONCLUSIONS: Acute reconstruction of ACL had excellent clinical and radiologic results as good as the chronic group without motion problem.
Anterior Cruciate Ligament* ; Follow-Up Studies ; Humans ; Knee ; Ligaments ; Range of Motion, Articular ; Tendons ; Thigh

No abstract available.
Heart* ; Thoracic Surgery*

Background and Objectives: Menkes disease (MNK) is a rare X-linked recessive disease, caused by mutations in the copper transporting ATP7A gene that is required for copper homeostasis. MNK patients experience various clinical symptoms including neurological defects that are closely related to the prognosis of MNK patients. Neural stem cells (NSCs) in the hippocampal dentate gyrus (DG) produce new neurons throughout life, and defects in DG neurogenesis are often correlated with cognitive and behavioral problems. However, neurodevelopmental defects in the DG during postnatal period in MNK have not been understood yet. Methods: and Results: Mottled-brindled (Mo Br/y ) mice (MNK mice) and littermate controls were used in this study. In vivo microCT imaging and immunohistochemistry results demonstrate that blood vasculatures in hippocampus are abnormally decreased in MNK mice. Furthermore, postnatal establishment of NSC population and their neurogenesis are severely compromised in the DG of MNK mice. In addition, in vitro analyses using hippocampal neurosphere culture followed by immunocytochemistry and immunoblotting suggest that neurogenesis from MNK NSCs is also significantly compromised, corresponding to defective neurogenic gene expression in MNK derived neurons. Conclusions Our study is the first reports demonstrating that improper expansion of the postnatal NSC population followed by significant reduction of neurogenesis may contribute to neurodevelopmental symptoms in MNK. In conclusion, our results provide new insight into early neurodevelopmental defects in MNK and emphasize the needs for early diagnosis and new therapeutic strategies in the postnatal central nerve system damage of MNK patients.

Diarrhea-associated hemolytic uremic syndrome(D+ HUS) is induced by enterohemorrhagic Escherichia coli(EHEC) and is characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. The disease is usually transmitted by meat and water contaminated by excreta of domestic animals. We report a son and his mother with diarrhea-associated hemolytic uremic syndrome that spread within the family.
Acute Kidney Injury ; Anemia, Hemolytic ; Animals, Domestic ; Enterohemorrhagic Escherichia coli ; Escherichia ; Hemolytic-Uremic Syndrome* ; Humans ; Meat ; Mothers ; Thrombocytopenia

Hemobilia is a cause of obscure gastrointestinal hemorrhage. Most cases have an iatrogenic or traumatic origin but cases of hemobilia with non-traumatic causes are rare. The non-traumatic causes of hemobilia are inflammation, gallstones, neoplasm and vascular lesions. Currently, various therapeutic options are available for hemobilia, and transarterial embolization is now the first line of intervention used to stop the bleeding of hemobilia, which shows a high success rate of approximately 80% to 100% with a lower morbidity and mortality rate than with surgery. We report a rare case of non-traumatic hemobilia caused by a pseudoaneurysm of the hepatic artery that was successfully treated with transarterial embolization.
Aneurysm, False* ; Gallstones ; Gastrointestinal Hemorrhage ; Hemobilia* ; Hemorrhage ; Hepatic Artery* ; Inflammation ; Mortality

Peutz-Jeghers syndrome is an autosomal dominant inherited disease that manifests as a combination of mucocutaneous pigmentation and gastrointestinal hamartomatous polyps that usually cause intussusception and intestinal hemorrhage. We report the case of a 40-year-old male patient who was diagnosed 20 years ago and had previously undergone 3 intestinal resection surgeries. This time, with the use of combined operative and endoscopic polypectomy, more than 100 polyps were removed. This technique is useful for providing a "clean" small intestine that allows the patient a long interval between laparotomies and reduces the complications associated with multiple laparotomies and resections.
Adult ; Endoscopy ; Hemorrhage ; Humans ; Intestine, Small ; Intussusception ; Laparotomy ; Male ; Peutz-Jeghers Syndrome* ; Pigmentation ; Polyps*

No abstract available.
Biopsy* ; Kidney Diseases* ; Kidney*

Primary cardiac tumors are extremely rare and can originate within the heart or be the result of tumor spread from other sites. We report a female patient with a pulmonary vein tumor extending into the left atrium that had a suspicious primary malignant origin with a sacral metastatic carcinoma. The patient was admitted complaining of pain in her buttock area as a result of a sacral tumor. It was believed that the sacral tumor was a metastasis from the imaging study and clinical manifestation. The primary malignant origin was evaluated. The chest CT showed a left atrium thrombus-like lesion without a pulmonary abnormality. After a transesophageal echocardiogram, the patient was diagnosed with a pulmonary vein tumor extending to the left atrium. The patient was given palliative radiotherapy for the sacral pain. Initially, the clinical impression was a metastatic sacral tumor with a thromboembolism of the left atrium. However, this patient was finally diagnosed with a pulmonary vein tumor with a left atrium extension by a transesophageal echocardiogram.
Vascular Neoplasms/*diagnosis/pathology ; Thromboembolism/diagnosis ; Sacrococcygeal Region/pathology ; Pulmonary Veins/*pathology ; Palliative Care ; Humans ; Heart Neoplasms/*diagnosis/pathology ; Heart Atria/*pathology ; Female ; Diagnosis, Differential ; Aged

Neurofibromatosis type 1 (von Recklinghausen's disease, NF-1) is an autosomal-dominant neurocutaneous disorder characterized by abnormal skin pigmentation (cafe au lait spots and axillary freckling), cutaneous and plexiform neurofibromas, skeletal dysplasias, and Lisch nodules (pigmented iris hamartomas). Gastrointestinal stromal tumors (GISTs) are the most common tumors of mesenchymal origin in the gastrointestinal tract, mesentery, omentum, and retroperitoneum. Here, we report a case of GIST in the ileum of a 76-year-old woman previously diagnosed as NF-1. She was admitted due to sudden onset of abdominal pain. Contrast enhanced CT scan revealed a moderately defined, peripherally enhanced soft tissue mass of about 8.8 x 7.3 cm, originating from the small bowel in the left of the abdomen. Surgical excision was performed and the tumor was found to be composed of tumor cells that were positive for c-kit protein. The patient started imatinib treatment a month later, but stopped medication due to dyspepsia after a few months and eventually progressed after 18 months.
Risk Factors ; Neurofibromatosis 1/*diagnosis/pathology/surgery ; Humans ; Gastrointestinal Stromal Tumors/*diagnosis/pathology/surgery ; Female ; Aged ; Abdominal Pain

BACKGROUND: Percutaneous cardiopulmonary support (PCPS) provides passive support of gas exchange and perfusion, allowing the use of other methods of care for organ recovery, and saves lives of patients with severe cardiopulmonary failure in a wide variety of clinical settings with a minimal risk of bleeding and need for chest reexploration. We summarized a single center's experiences with PCPS in patients with cardiogenic shock or cardiac arrest due to the ischemic heart disease. MATERIAL AND METHOD: Among the 20 consecutive patients with cardiogenic shock or cardiac arrest from May 1999 to June 2005, Biopump(r) (Medtronic, Inc, Minneapolis, MN) was used in 7 patients and the self-priming, heparin-coated circuit of EBS(r) (Terumo, Japan) was applied to remaining 13 patients. Most of cannulations were performed percutaneously via femoral arteries and veins. The long venous cannulas of DLP(r) (Medtronic inc. Minneapolis, MN) or the RMI(r) (Edwards's lifescience LLC, Irvine, CA) were used with the arterial cannulae from 17 Fr to 21 Fr and the venous cannula from 21 Fr to 28 Fr. RESULT: The 20 consecutive patients who were severely compromised and received PCPS for the purpose of resuscitation were comprised of 13 cardiac arrests and 7 cardiogenic shocks in which by-pass surgery was performed in 11 patients and 9 ongoing PCIs under the cardiopulmonary support. The mean support time on the PCPS was 38+/-42 hours. Of the 20 patients implanted with PCPS, 11 patients (55%) have had the PCPS removed successfully; overall, 8 of these patients (40%) were discharged from the hospital in an average surviving time for 27+/-17 days after removing the PCPS and survived well with 31+/-30 months of follow-up after the procedure. CONCLUSION: The use of PCPS appears to provide the hemodynamic restoration, allowing the survival of patients in cardiac arrest or cardiogenic shock who would otherwise not survive, and patients receiving PCPS had a relatively long-term survival.
Catheterization ; Catheters ; Emergencies* ; Femoral Artery ; Follow-Up Studies ; Heart Arrest* ; Hemodynamics ; Hemorrhage ; Humans ; Myocardial Ischemia* ; Perfusion ; Resuscitation ; Shock, Cardiogenic* ; Thorax ; Veins