Radiographic increase in the size of tibial and femoral tunnels has been observed following the reconstruction of the ACL with a bone-patellar tendon-bone autograft. The purpose of this study is to determine if any differences exist in the amount of enlargement of the bone tunnel with the clinical results and to know the factors which affected to the enlargement of the bone tunnels. Total 27 patients were retrospectively reviewed for tunnel enlargement radiographically at one year after operation. Anteroposterior and lateral x-ray were obtained and the tunnel were measured by two independent observers. The measurements were made at the widest part of the tunnel. The distance between tibial interference screw and knee joint line also measured. Correction for magnification was performed by comparing the measured width of the interference screw used for fixation of the graft with its actual width. Statistical analysis was performed with Wilcoxon rank sum test. The radiographic tunnel enlargement was an average of 1.7+/-1.3mm for the femur and 1.9+/-0.8mm for the tibia. The proximal migration of the tibial interference screw was an average of 2.3++/-1.1 mm. There was no statistically significant correlation between the changes in tunnel diameter and either the modified Hughston knee score, Lysholm knee score, or the joint laxity measured by a KT-2000 arthrometer, Lachman test. There were no correlations between the mild proximal migration of the tibial interference screw and the clinical results. Conclusively, the tunnel enlargement and mild proximal migration of the interference screw did not appear to affect the functional outcome adversely. It needs longer follow up for the evaluation of etiology and natural history of this tunnel enlargement.
Anterior Cruciate Ligament Reconstruction ; Autografts ; Femur ; Follow-Up Studies ; Humans ; Joint Instability ; Knee ; Knee Joint ; Natural History ; Patellar Ligament* ; Retrospective Studies ; Tibia ; Transplants*

No abstract available.
Child* ; Humans ; Reye Syndrome*

PURPOSE: To evaluate clinical outcomes of silicone tube intubation according to the site of resistance to lacrimal duct probing in complete or partial nasolacrimal duct obstruction patients. METHODS: This study included 102 eyes of 72 patients who were diagnosed with complete or partial nasolacrimal duct obstruction and who underwent silicone tube intubation. According to the site of resistant to nasolacrimal duct probing, eyes were divided into proximal resistance (Group I), distal resistance (Group II) and both side resistance (Group III). The success rate was estimated based on functional (symptom relief) and anatomical (normalization of tear meniscus) success. RESULTS: The success rates in Group I, Group II, and Group III were 53.1%, 78.8%, and 27.0%, respectively, showing that Group II attained the highest success rate (Pearson chi-square test, p = 0.001). CONCLUSIONS: In cases of only distal resistance to lacrimal probing without dacryocystography, silicone tube intubation should be performed with expectation of good clinical outcomes, even if complete nasolacrimal obstruction was suspected on syringing.
Humans ; Intubation* ; Nasolacrimal Duct ; Silicones*

PURPOSE: To evaluate clinical outcomes of silicone tube intubation according to the site of resistance to lacrimal duct probing in complete or partial nasolacrimal duct obstruction patients. METHODS: This study included 102 eyes of 72 patients who were diagnosed with complete or partial nasolacrimal duct obstruction and who underwent silicone tube intubation. According to the site of resistant to nasolacrimal duct probing, eyes were divided into proximal resistance (Group I), distal resistance (Group II) and both side resistance (Group III). The success rate was estimated based on functional (symptom relief) and anatomical (normalization of tear meniscus) success. RESULTS: The success rates in Group I, Group II, and Group III were 53.1%, 78.8%, and 27.0%, respectively, showing that Group II attained the highest success rate (Pearson chi-square test, p = 0.001). CONCLUSIONS: In cases of only distal resistance to lacrimal probing without dacryocystography, silicone tube intubation should be performed with expectation of good clinical outcomes, even if complete nasolacrimal obstruction was suspected on syringing.
Humans ; Intubation* ; Nasolacrimal Duct ; Silicones*

Laryngeal diseases have a significant impact on quality of life and often require timely and accurate diagnosis for effective management. Conventional methods of diagnosis, such as manual inspection of laryngoscopic images, have limitations in terms of accuracy and efficiency. The integration of artificial intelligence (AI) and machine learning techniques in laryngoscopic image analysis has emerged as a promising approach to enhance diagnostic accuracy, streamline workflow, and improve patient outcomes. This review paper provides an in-depth analysis of the recent advancements in AI-driven laryngoscopic image analysis for the diagnosis of laryngeal diseases, also covering methodologies, challenges, and future prospects.

No abstract available.
Drug Substitution*

BACKGROUNDS: Pain can occur following acute noxious stimuli and tissue damage. The duration of such pain may outlast the stimulus and its amplitude may be exaggerated (hyperalgesia). This response comes from a sensitization of the peripheral nociceptor. Traditional thought has associated the antinociceptive effects of opiates with the activation of opioid receptors located in the central nervous system. Recently, however, opiate receptors in the peripheral nervous system have led to the hypothesis that analgesic action might, in part, result from a reduction in the response of peripheral nerve fibers thought to be concerned with signaling pain. METHODS: Twenty units were recorded from the strands of the hypogastric nerve innervating the urinary bladder of the cat. Nerve activity and intravesical pressure were monitored before and after the onset of an acute inflammation induced by the intravesical instillation of 2% mustard oil. The responses of afferent units to chemical stimuli by intra-arterially injected bradykinin (10 microgram/0.2 ml., i.a.) and potassium chloride (0.3 M/0.2 ml, i.a.) were compared each time at control, after inflammation, and after administration of morphine (2.5 mg/kg) and naloxone (5 microgram/kg) respectively. RESULTS: Polymodal receptors in the urinary bladder showed excitatory response to algesic substances such as bradykinin, potassium chloride and the urinary bladder contracted simultaneously, both the responses of the nerve impulse and bladder contraction to bradykinin and potassium chloride increased significantly after bladder inflammation induced by 2% mustard oil and the sensitization of the sensory receptors attenuated by morphine and naloxone reversed the effect of morphine. CONCLUSIONS: These observations suggest that morphine might have a peripheral effect.
Action Potentials ; Administration, Intravesical ; Animals ; Bradykinin ; Cats ; Central Nervous System ; Inflammation ; Morphine* ; Mustard Plant ; Naloxone ; Nociceptors ; Peripheral Nerves ; Peripheral Nervous System ; Potassium Chloride ; Receptors, Opioid ; Sensory Receptor Cells* ; Urinary Bladder*

In view of the possible role of portal circulation in hematogenous spread of Candida species, a case of hepatic candidiasis occurred in an eight-year-old child with acute lymphoblastic leukemia (ALL) treated by chemotherapy is presented. Symptoms and signs referable to the hepatic disease in this patient included hepatomegaly, icteric sclera and abdominal pain. There were no particular manifestations suggestive of deep mycotic involvement of any sepcific organs or tissues other than the liver. Culture of the blood was negative for one month. On the 24th hospital day the patient died with the presumptive diagnosis of ALL, disseminated intravascular coagulation, acute renal failure, pulmonary edema, cholecystitis and oral thrush. A needle necropsy was performed and revealed fungal aggregates replacing the large foci of hepatic cell loss. It is suggested that, when the gastrointestinal tract serves as the portal of entry, the liver could be the visceral organ involved first in the course of disseminated candidiasis.
Child ; Male ; Female ; Humans

BACKGROUND: Contact immunotherapy using diphenylcyclopropenone (DPCP) has been used in the treatment of alopecia and warts. DPCP seemed to be a promising agent for viral disease including molluscum contagiosum (MCI). OBJECTIVE: The purpose of this study was to evaluate the effect of DPCP immunotherapy on MC in children. METHODS: Twenty three patients with multiple lesion of MC were treated with DPCP immunotherapy. RESULTS: Twelve patients (52.2%) showed cure, and eleven patients (47.8%) showed treatment failure. No severe side effects were seen. CONCLUSION: DPCP immunotherapy may be an effective treatment in children with MC without serious side effects.
Alopecia ; Child ; Humans ; Immunotherapy* ; Molluscum Contagiosum* ; Treatment Failure ; Virus Diseases ; Warts

Gastrointestinal ganglioneuromatosis is an extremely rare lesion which typically occurs with a significant systemic syndrome. It is known to be a major component of multiple endocrine neoplasia, type 2b. We presented a case of polypoid ganglioneuromatosis of the colon in a 3-year-old female with abdominal pain and diarrhea. She had no clinical evidence of the systemic syndrome or von Recklinghausen's neurofibromatosis, conditions in which intestinal ganglioneuromatosis can occur. Gross examination showed diffuse polypoid masses in ascending and transverse colons with normal-appearing mucosa. Microscopic examination revealed a proliferation of spindle-shaped neuronal cells containing multiple clusters of mature ganglion cells in the mucosa, submucosa and proper muscle. We describe a case of colonic ganglioneuromatosis without any component of multiple endocrine neoplasia or family history.
Abdominal Pain ; Child ; Child, Preschool ; Colon* ; Colon, Transverse ; Diarrhea ; Female ; Ganglion Cysts ; Humans ; Mucous Membrane ; Multiple Endocrine Neoplasia ; Multiple Endocrine Neoplasia Type 2b ; Neurofibromatoses ; Neurons