Since Palmer's introduction of the torn medial collateral ligament, many clinical and anatomical studies were performed. But any reconstructive procedure of the medial collateral ligament of the knee known to us, has not solved the problem completely yet. The purpose of present study is to describe a technique of reconstruction, socalled Tatsuzawa's tenodesis surgery of transposed semitendinosus tendon, and is to report the clinical results of 45 cases treated by his procedure between April 1976 and June 1981. In addition, significance of the procerdure was compared with the result of primary closure group of the torn ligament. Tatsuzawa's procedure consists of reinforcement surgery of the repaired or unrepaired torn medial collateral ligament with forwardly transposed semitendinosus. The semitendinosus tendon was brought forward to lie adjacent to deep layer of the medial collateral ligament. The transposed part of the tendon was sutured throughout its length to the medial collateral ligament and to the medial aspect of the tibia and femoral condyle. Because the direction of transposed tendon as similar to the direction of fibers of medial collateral ligament, the procedure was very simple and anatomical one, and had some functional advantages. In this series some old cases are treated only with tendon reinforcement operation without repairing the laxed torn ligament. The results of the surgery were evaluated by the Asais modification of the Feltons evaluation criteria. Results obtained were as follows: 1. In semitendinosus tenodesis with or without primary repair of the torn ligament, satisfactory results were obtained (excellent and good) in 33 cases (73.3%). But in 20 cases of the primary repair group, the satisfactory results were obtained in 11 cases (55%). More satisfactory results were obtained with the semitendinosus tendon reinforcement operation of the torn ligament than only with primary repair. 2. In 29 cases with fresh injury of the medial collateral ligament in which the primary repair together with the tendon reinforcement procedure was performed, satisfactory (excellent and good) results were obtained in 72.4% (21 cases), and in 16 untreated old cases in which only the tendon reinforcement procedure were done, satisfactory results were obtained in 75%. 3. In 5 cases having medial collateral and anterior cruciate ligaments tear, excellent results were obtained in 3. This explains that semitendinosus tendon reinforcement procedure is the key one of the reconstructive operative procedures. It is thought that the procedure is also effective for the anterior cruciate tear to provide the anterior instability.
Anterior Cruciate Ligament ; Clinical Study ; Collateral Ligaments ; Knee ; Ligaments ; Surgical Procedures, Operative ; Tears ; Tendons ; Tenodesis ; Tibia

Cutaneous manifestations of sarcoidosis are highly variable and can be devided into the specific lesions which reveal noncaseating granuloma and the nonspecific lesio is which are referred to as cutaneous changes. Among speciific lesions, annular lesions may be foimied from coalescing papular lesions that may clear centrally and elevate peripherally. We report a case of sarcoidosis with multiple annular lesions on the face in a 33-year-old female who had systemic involvements in the intrathoracic organs and eyes. The main histopathologir. findings were well-demarcated islands of epitheloid cells with a few giant cells in the dermis. In addition, a slight admixfure of lymphoid cells was present at the margins of the epitheloid cell granulomas. Complete regression of t!he skin lesions was obtained with systemic cortiocosteroid therapy and no recurrence has been found for 2 1/2years.
Adult ; Dermis ; Female ; Giant Cells ; Granuloma ; Humans ; Islands ; Lymphocytes ; Recurrence ; Sarcoidosis* ; Skin

No abstract available.
Carbamazepine* ; Haloperidol*

Although the chronic prostatitis is the most common infectious disease in the urinary tract in male, it is confusing us to diagnose and treat thoroughly. It is usually diagnosed by careful history, urinalysis, rectal palpation, and wet smear of prostatic secretions. But sometimes these findings are not identical to the true conditions of patients. 53 patients suspected of chronic prostatitis were studied by cultures of prostatic secretion and semen. And they compared to each other. The results were as follows: 1. Semen cultures, in 10 cases of the control group, showed positive findings in two cases. One was staphylococcus epidermis and the other was Gram(+) bacillococcus, but their colony counts were less than 100. 2. The positive findings on prostatic secretion culture were 37 cases (69. 8%) and on semen culture were 28 cases(52. 9%) 3. The etiologic organisms of chronic prostatitis by semen and prostatic secretion cultures revealed staphylococcus epidermis, staphylococcus aureus, streptococcus, Gram(-) diplococcus and Gram(+) bacillococcus in order of frequency. 4. Pathologic findings on prostatic biopsy according to different etiologic organisms revealed nothing remarkable except nonspecific chronic inflammation in each group. 5. Although there is no evidence the semen culture is superior to the prostatic secretion culture for diagnosis of the chronic prostatitis, it is more useful in the patient who may have an acute exacervation of chronic prostatitis, the patient whose prostatic juice can't be obtained by massage, and the patient who can't endure pain because of rectal pathology such as anal fissure or severe hemorrhoids.
Biopsy ; Communicable Diseases ; Diagnosis ; Digital Rectal Examination ; Epidermis ; Fissure in Ano ; Hemorrhoids ; Humans ; Inflammation ; Male ; Massage ; Pathology ; Prostatitis* ; Semen* ; Staphylococcus ; Staphylococcus aureus ; Streptococcus ; Urinalysis ; Urinary Tract

Kaposi's sarcoma is a neoplasm of multifocal origin which manifest primarily as vascular nodules in the skin and other organs. We report a case of Kaposis sarcoma of classic type in a 17-year-old boy, who had a 4 x 5cm sized, dusky erythematous plaque with multiple spots of acupuncture on the left foot for 1 year. Histopathologic examination showed dilated, bizarre-shaped vessels, ndothelial cell proliferation, and spindle cell formation with vascular slits throughout the dermis. He was treated with 3000 rads of radiation(300 rad per day for l0 successive days). Six months after radiotherapy, gross findings were much improved and histopathologic findings showed only fibrosismc hemosiderin deposits in the dermis.
Acupuncture ; Adolescent ; Cell Proliferation ; Dermis ; Foot ; Hemosiderin ; Humans ; Male ; Radiotherapy* ; Sarcoma, Kaposi* ; Skin

The authors report two cases of successful reconstruction in infected nonunion of the femur involving marked shortening by compression and gradual distraction at the nonunion site using Ilizarov external fixator. At first, infection was controlled by radical excision & the administration of systemic antibiotics for four weeks and we also started compression at the nonunion site 3 days after operation. Autogenous iliac bone graft was added to strengthen the site of new bone formation lastly. In this report, the role of the compression seems to provide a good environment for distraction osteogenesis by focal necrosis and triggering inflammation. Compression and gradual distraction may be one of the treatment mordalities for nonunion of a long bone with massive bone loss or shortening, even infected.
Anti-Bacterial Agents ; External Fixators ; Femur* ; Inflammation ; Necrosis ; Osteogenesis ; Osteogenesis, Distraction ; Transplants

The trochanteric fracture occurs through the wide metaphyseal area, giving it high potential for healing and results in low incidence of non union. Even in the treatment of unstable trochanteric fracture, the results are relatively good with the advancement of fixation devices and reduction methods. The authors experienced 10 cases of non-union of trochanteric fractures from 1975 to 1984 and followed them up for more than 1 year at Orthopaedic department of National Medical Center. The results are as follows, l. Of reduction methods in primary operation, anatomical reduction was performed in 6 cases, medialization in 2 cases. Of fixation devices, compression hip screw was used in 2 cases, Jewett nail in 3 cases and others in 3 cases. 2. The probable causes of non-union were fixation failure in 6 cases, inadequate immobilization in 2 cases, infection in 2 cases and trauma in 1 case. The other 2 cases were not treated. 3. In secondary operation, anatomical reduction was performed in 3 cases, valgus reduction in 3 cases and valgus with medialization in 2 cases. Of fixation devices, compression hip screw was used in 3 cases, Judet plate in 3 cases and Jewett nail in Z cases. 4. The time interval between the last operation and bony union was 4.2 months clinically and 6.6 months radiologically in average. 5. During follow-up, hip pain was noted in 2 cases. Limited range of motion of hip and knee in 4 cases.
Femur ; Follow-Up Studies ; Hip ; Hip Fractures ; Immobilization ; Incidence ; Knee ; Range of Motion, Articular

We reviewed four patients who underwent posterior C-D occipitocervical loop and autogenous bone graft. The mean postoperative follow-up period was 16 months. The indications for surgery were progressive neurological deficit, atlantoaxial instability and intractable pain. Of the four patients, one had os odontoideum, two rheumatoid arthritis and suboccipital dislocation combined fractures of C1 and C2. Bong union was confirmed in all cases at approximately 4 months postoperatively. Final outcome result was satisfactory in three patients and unsatisfactory in one patient. The cause of unsatisfactory result was recurrent neck pain secondary to swan neck deformity. The neurologic deficit were improved or remained same as preoperative status. Three patient were out of bed on average of the 14th day postoperatively. One patient could not ambulate due to tetraplegia who needed an artificial ventilator. There was no complication related to instrumentation.
Arthritis, Rheumatoid ; Congenital Abnormalities ; Dislocations ; Follow-Up Studies ; Humans ; Neck ; Neck Pain ; Neurologic Manifestations ; Pain, Intractable ; Quadriplegia ; Transplants ; Ventilators, Mechanical

OBJECTIVES: Cord blood stem cells have been widely used as donor cells for bone marrow transplantation recently. These cells can give rise to a variety of hematopoietic lineages to repopulate the blood. Recent observations reveal that some bone marrow cells and bone marrow stromal cells(MSCs) can grow to become either neurons or glial cells. It is, however, unclear whether or not there exists stems cells which can differentiate into neurons in the blood during the early stages of postnatal life. METHODS: Human cord blood stem cells were prepared from human placenta after full term delivery. To induce neuronal differentiation of stem cells, beta-mercaptoethanol was treated. To confirm the neuro-glial characteristics of differentiated stem cells, immunocytochemical stain for NeuN, neurofilament, glial fibrillary acidic protein(GFAP), microtubule associated protein2(MAP2) was performed. RT-PCR was performed for detecting nestin mRNA and MAP2 mRNA. RESULTS: We showed in this experiment that neuro-glial markers(NeuN, neurofilament, MAP2, GFAP) were expressed and axon-like cytoplasmic processes are elaborated in the cultured human cord blood stem cells prepared from new born placenta after full term delivery. Nestin mRNA was also detected in fresh cord blood monocytes. Conclusions: These results suggest that human cord blood derived stem cells may be potential sources of neurons in early postnatal life.
Bone Marrow ; Bone Marrow Cells ; Bone Marrow Transplantation ; Cytoplasm ; Fetal Blood* ; Humans* ; Microtubules ; Monocytes ; Nestin ; Neural Stem Cells ; Neuroglia ; Neurons ; Placenta ; RNA, Messenger ; Stem Cells ; Tissue Donors ; Umbilical Cord*

OBJECTIVE: The transplantation of bone marrow cells into the injured spinal cord improves neurologic functions in experimental animals. However, it is unclear whether bone marrow cells can similarly improve the neurologic functions of complete spinal cord injury patients. To study their therapeutic effects in human spinal cord injury (SCI), we transplante autologous bone marrow cells into the SCI sites and administer granulocyte macrophage-colony stimulating factor (GM-CSF) in three complete SCI patients. METHODS: Bone marrow cell transplantation with GM-CSF administration was performed on two patients (patients1 and 2), wherein concentrated bone marrow cell pastes were injected into the injury area using a sterile 21 gauge fine needle. The total volume of bone marrow cells injected was 1.8ml (cell concentration 1.1X106/ul). Patient 3 was administered GM-CSF only. The follow up periods were 5 months (patient 1), 4 months (patient 2) and 6 months (patient 3). RESULTS: Sensory improvements were followed immediately after the operations. Sensory recovery in the sacral segment was noticed at 3 weeks (patient 1), 13 days (patient 2) and at 2 months (patient 3) postoperatively. Significant motor improvements were noticed at 3 months in patients 1 and 2, and at 4 months in patient 3. All three patients showed neurologic improvements at the last follow up 5, 4 and 6months respectively (Frankel grade C, AIS grade C). CONCLUSION: Treatment of SCI patients with autologous bone marrow cell transplantation and GM-CSF administration shows some beneficial effects during the early postoperative periods. However, long-term and more comprehensive clinical studies are required.
Animals ; Bone Marrow Cells* ; Bone Marrow Transplantation* ; Bone Marrow* ; Follow-Up Studies ; Granulocyte-Macrophage Colony-Stimulating Factor ; Granulocytes* ; Humans ; Needles ; Ointments ; Postoperative Period ; Spinal Cord Injuries* ; Spinal Cord* ; Stem Cells ; Transplantation