The posterior cruciate ligament is an anatomically and biomechanically complex structure. PCL injuries are reported to occur in 1-40% of acute knee injuries, with isolated PCL tear, less common than PCL tears combined with other Iigament injuries. Controversy exists concerning the geatment of the PCL injures. Recently, arthroscopic techniques of PCL reconstruction are becoming nore refined and reproducible. Between July 1993 and May 1995, 25 operations for PCL rupture were performed in our hospital. At the follow-up examinations we noted mild to moderate posterior instablilty which was not noted at the time of operation and during the immediate postoperative period. We reviewed type (if injuries, amplitude of initial posterior tibia1 translation, surgical techniques, which seemcd to be in relation ivith the postoperative instabilities. At final follow-up, the mean Lysholm knee score was 86 points, and the posterior tibial translation 6.5mm on posterior stress radiographs. The ligament augmentation device provided no benefit. The ideal positioning and fixation of the graft and protection of the graft from abrasion seemed to be important to get a good results.
Follow-Up Studies ; Knee ; Knee Injuries ; Ligaments ; Patellar Ligament* ; Posterior Cruciate Ligament ; Postoperative Period ; Rupture ; Transplants*

OBJECTIVES: We performed anterior spinal fusion and instrumentation in treatment of spinal tuberculosis. The clinical results of this operation and metal-related complications were evaluated to determine the rationale of anterior instrumentation in active tuberculous lesion. METHODS: From July 1989 to February 1993, we treated twenty-one patients with spinal tuberculosis by radical resection of the tuberculous lesion and bone grafting, followed by anterior instrumentation using Zielke rod system. The changes in spinal deformity were measured from lateral spinal radiographs obtained preoperatively and postoperatively at 3 months, 6 months, 1 year, 2 years and final follow-up. The recurrence of infection and possible complications were also observed clinically and radiologically. RESULTS: The mean kyphotic angle was decreased preoperatively from 21 degrees to 16 degrees at final follow-up in patients with thoracolumbar tuberculous lesions. The mean deformity angle was corrected 7 degrees in thoracolumbar tuberculosis and 12 degrees in lumbar tuberculosis compared with the preoperative deformity angle. There was not any persistence or recurrence of infection possibly related to the instrumentation. All patients were allowed early ambulation with the aid of a light brace. CONCLUSION: The clinical and radiological results suggested that the anterior instrumentation seemed to be one of the rational approaches for providing immediate stability in treating severe spinal tuberculosis without any significant risk of persistence or recurrence of infection.
Bone Transplantation ; Braces ; Congenital Abnormalities ; Early Ambulation ; Follow-Up Studies ; Humans ; Recurrence ; Spinal Fusion ; Tuberculosis ; Tuberculosis, Spinal*

The spleen is the most common intraabdominal organ injured in blunt trauma, Although physical signs andsymptoms, coupled with abdominal paracentesis & peritoneal lavage confirm intraabdominal injury, but isolatedsplenic injury especially delayed rupture, the diagnosis and clinical course is variable. We are reevaluation ofplain roentgenologic findings for the light of early diagnosis of isolated splenic injury. 24 patiens of theautopsy and surgically proven isolated splenic injury at Chosun University Hospital in the period from 1980January to 1986 June were analyzed plain roentgenogram retrospectively. The results were as follows: 1. Malepatients predominate, constitution 87.5%. Incidence has been greatest in second to fourth decade. 2. Mode oftrauma causing isolated splenic injury is most common in motor vehicle accident and others are fall down, struckby fist, blow to object, uncertain blunt trauma. 3. Delayed rupture of spleen occured in 2 cases(8.3%). 4. Commonpatterns of splenic injury is simple laceration that involves both the capsule and the parenchyma and a lacerationthat involves the splenic pedicle. 5. Plain chest roentgenographic findings were abnormal in 4 cases (16.7%). Themost common plain abdominal roentgenographic findings was the evidence of intraabdominal fluid in 21 cases(87.5%).The others are included in order of frequency: gastric dilatation, prominent mucosal folds on greater curvature ofthe stomach, evidence of pelvic fluid, displacement of stomach to the right or downward, mass density in theregion of spleen. 6. No relationship can be shown between patterns of injury, time lapse after trauma and plainroentgenological findings. But the evidence of intraabdominal fluid is most important in the light of earlydiagnosis. 7. Diagnosis of splenic injury may be most helpul that in combination with clinical history, clinicalsymptoms & signs and plain film findings. In delayed rupture, diagnostic value of serial examination and surgicalobservation is emphasized.
Constitution and Bylaws ; Diagnosis ; Early Diagnosis ; Gastric Dilatation ; Incidence ; Lacerations ; Motor Vehicles ; Paracentesis ; Peritoneal Lavage ; Retrospective Studies ; Rupture ; Spleen ; Stomach ; Thorax

BACKGROUND: Recently authentic human growth hormone(hGH) has produced in the E coli K-12, W3110 by recombinant DNA tecbnology in Korea In this paper, the clinical efficacy and immunogenicity of this GH was shdied in 38 children with growth hormone deficiency during therapy of 1 year. METHODS: The subjects of this study were aged 4.9-13.9 years, diagnosed by failure of plasma GH to respond to insulin-induced hypoglycemia, arginine and/or L-dopa loading and height below -2 standard deviation of mean for their chronological age. Each patient received GH 0.5-0.7IU/kg/week subcutaneously in 6-7 divided doses. During treatment, vital signs, height, body weight and bone age were checked every 3 months. Complete blood count, urinalysis, blood chemistry and thyroid hormone were checked before and every 6 months. The measurement of serum IGF-1 level and antibody against hGH were performed before and every 6 months during therapy of I year. RESULT: The height velocities significantly increased from 3.3 +/- 1.5cm/year to 10.1 +/- 2.5 and 9.0 +/- 1.8cm/year at 6 and 12 months of therapy, respectively. The height standard deviation score for chronological age were significantly improved from -2.141.50 to -1.74 +/- 1.43 and -1.54 +/- 1.38 at 6 and 12 months of therapy with increasing ratio of bone age to chronological age from 0.72 +/- 0.15 at pretreatment to 0.76 +/- 0.15 at 6 month, 0.79 +/- 0.16 at 12 month of therapy. The plasma IGF-1 level significantly increased during treatment. One of 36 patients(2.8%) showed positive antibody against hGH after 1 year of treatment. During therapy of 1 year, unwanted and remarkable clinical side effect were not observed in all subjects. CONCLUSION: These results indicate that this E. coli derived authentic recombinant growth hormone is very effective in stimulating linear growth in children with growth hormone deficiency.
Arginine ; Blood Cell Count ; Body Height ; Chemistry ; Child* ; DNA, Recombinant ; Escherichia coli ; Growth Hormone* ; Human Growth Hormone ; Humans* ; Hypoglycemia ; Insulin-Like Growth Factor I ; Korea ; Levodopa ; Plasma ; Thyroid Gland ; Urinalysis ; Vital Signs

Superior gluteal artery rupture without pelvic fracture is extremely rare, but the rupture of this vessel is a well-known complication of pelvic fractures. This vessel appears to be at risk at the time of pelvic fracture because of its vulnerable anatomical position in the sacrosciatic notch. The rupture of this vessel causes profound hypotension and compartment syndrome of the gluteal or thigh region. Embolization is the most effective treatment. We report an unusual case of a superior gluteal artery rupture without pelvic fracture in blunt trauma.
Arteries* ; Compartment Syndromes ; Hypotension ; Hypovolemia* ; Rupture* ; Shock* ; Thigh

Pneumocephalus is defined as "the presence of air or gas within the cranial cavity." Intracranial air may represent an incidental finding of no clinical significance or more aggressive, life-threatening disease. It is usually associated with head trauma and surgery, tumor, brain abscess, postradiation necrosis, or diagnostic procedures. In the absence of head trauma or surgery, meningitis due to gas-forming organisms is an extremely rare cause of pneumocephalus. We report an unusual case of a localized spontaneous pneumocephalus caused by pneumococcal meningitis in the absence of head trauma, surgery, and brain abscess.
Abscess ; Brain Abscess ; Brain Neoplasms ; Craniocerebral Trauma ; Incidental Findings ; Meningitis ; Meningitis, Pneumococcal* ; Necrosis ; Pneumocephalus* ; Streptococcus pneumoniae

No abstract available.
Female ; Ovary* ; Teratoma*

The effects of epidural anesthesia for normal vaginal delivery on maternal cardiovascular system and boood gas analysis, and newborn umbilical arterial blood gas analysis and Apgar scores were studied in 24 paturients. The paturients were divided into two groups by random sampling, and one group underwent epidurial anesthesia and the other did not. Maternal systolie pressure, heart rate and cardiac output were measured at the time of 4 cm of cervical dilation (preanesthetic), 8 cm of cervical dilation, and immediate postpartum. PH, Pco, Po and bicarbonate levels of maternal atrerial blood were measured at the time of 4 cm and 8 cm of cervical dilation. PH, Pco, Po, and bicarbonate levels of newborn umbilical arterial blood were measured immediately after delivery. One minute and 5 minute Apgar scores of newborn were measured. Systolic blood presssures did not change in both groups. In non-epidural group diastolic and mean blood pressures decreased after delivery. In epidural group its slightly increased at the time of 8 cm of cervical dilation and returned to preanesthetic level after delivery. Heart rate and cardiac output also slightly increased at the time of 8 cm of cervical dilatior. and returned to preanesthetic level after delivery. Maternal pH slightly decreased at the time of 8 cm of cervical dilation in epidural group. Pco2 decreased in both groups, but the rate of decrease was smaller in epidural group. Po increased at the time of 8 cm of cervical dilation in epidural group. Bicarbonate ion level did not changed in both groups. Newborn umbilical arterial blood gas analysis and l minute and 5 minute Apgar scores were not different in both group.
Anesthesia ; Anesthesia, Epidural* ; Bicarbonates ; Blood Gas Analysis ; Cardiac Output ; Cardiovascular System ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn* ; Mothers* ; Postpartum Period

Most currently available statins are associated with an increase with risk of myositis, including rhabdomyolysis. Myopathy is believed to be caused by interference in the cytochrome P450 3A4 enzyme system, which results in a marked increase in reductase activity. Cerivastatin, a new synthetic HMG-CoA reductase inhibitor, is a safe, well-tolerated effective drug for the treatment of patients with dyslipidemia. The drug is metabolized by the cytochrome P450 3A4 and cytochrome P450 2C8 hepatic isoenzymes. Because of this dual metabolic pathway, it has been suggested that cerivastatin is less subject to drug-todrug interactions. We describe a 60-year-old woman with rhabdomyolysis and localized myositis, after she had taken cerivastatin(lipobay, 0.3 mg/day) and gemfibrozil(lopid, 500 mg/day) for 1month.
Cytochrome P-450 Enzyme System ; Dyslipidemias ; Female ; Gemfibrozil ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Isoenzymes ; Metabolic Networks and Pathways ; Middle Aged ; Muscular Diseases ; Myositis ; Oxidoreductases ; Rhabdomyolysis*

OBJECTIVE: There has been some existing problems with the electrical reflex hammer. The occurrence of pressure build up with percussion and change of hammering points is one example. In order to make improvements on this device, we conducted studies with a newly designed percussion instrumental stimulator. METHOD: The data collected from the first group was based on the manual percussion of electrical reflex hammer on the patella ligament. The data collected from the second group by usage of a newly designed instrumental stimulator maintained steady pressure and time and target position on the electrical reflex hammer. Comparisons were made between the two group. RESULTS: Our single measure of latency and amplitude on the manual and instrumental percussion group resulted in the reliability of 84.67%, 91.23%, 73.63%, and 83.29%. The 10 repeated measure of latency and amplitude on the manual and instrumental percussion group resulted in the reliability of 99.95%, 99.97%, 99.90%, and 99.94%. CONCLUSION: From our experiment on the tendon reflex, we found out that it is important to have an instrumental stimulator that can maintain steady pressure while it is applying percussion to accurate data. On manual percussion, it is important to obtain data based on mean value of repeated measurements.
Ligaments ; Patella ; Patellar Ligament* ; Percussion* ; Reflex* ; Reflex, Stretch