From June 1994 to December 1995, we perfoimed arthroscopic anterior cruciate ligament reconstruction using B-T-B alIograft in nineteen patients and postoperative aggressive rehabilitation program including early range of motion (ROM) exercise and muscle strengthening exercises in all cases. Except six cases of loss of follow-up, thirteen cases were analyzed. Postoperative results were evaluated by Lysholm knee score and M?ler s criteria at average 14 months (range from 6months to 24 moths). The average Lysholm score improved from 56 to 79. According to the Miijer s criteria, the results were excellent in 7 cases, good in 5 cases and fair in 1 case. We concluded that the reconstruction of the anterior cruciate ligament using B-T-B allograft could be an effective method with many benefits in treatment of anterior cruciate ligament rupture and that the results using B-T-B allograft was as good as those using autograft. But, further evaluation and long teim follow-up should be needed.
Allografts* ; Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Arthroscopy ; Autografts ; Exercise ; Follow-Up Studies ; Humans ; Knee ; Patella* ; Patellar Ligament* ; Range of Motion, Articular ; Rehabilitation ; Rupture

Anthracyclines have been widely used in cancer therapy because of their efficacy in the treatment of various solid tumors and hem -atologic malignancy. Cumulative dose-related cardiotoxicity was a well-known toxicity of anthracyclines. Particularly, at total doses of more than 550 mg/m2, therapy with anthracyclines could produce irreversible cardiac injury. Anthracycline-induced cardiac toxicity was usually manifested by congestive heart failure or arrhythmia. In co- ntrast, acute myocardial infarction is a rare event of anthracycline-induced heart diseases. A 31-year-old man with non-Hodgkin lymphoma(NHL) and single cardiac risk factor, including smoking, was presented with chest pain after receiving 2nd CEOP-BLAM chemo-therapy. An electrocardiogram revealed ST segment elevation in inferior leads consistent with acute myocardial infarction. An echocardiogram revealed an ejection fraction of 60% and severe hypokinesia in inferior and anteroseptal wall. Three days later, coronary angiography revealed 50% of luminal stenosis of right coronary artery(RCA) and near total occlusion with large thrombi in m-RCA. After balloon angioplasty and stent insertion, the patient was transferred to coronary care unit and continuous intravenous heparin infusion was started. On the 10th days, the patient was discharged in good condition. Six months later, follow-up coronary angiography showed no significant lesion in right coronary artery. In a young man with NHL, we report an acute myocardial infarction after 2nd course of CEOP-BLAM chemotherapy with a review of relevant literatures.
Adult ; Angioplasty, Balloon ; Anthracyclines ; Arrhythmias, Cardiac ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Care Units ; Coronary Vessels ; Doxorubicin* ; Drug Therapy* ; Electrocardiography ; Follow-Up Studies ; Heart Diseases ; Heart Failure ; Heparin ; Humans ; Hypokinesia ; Lymphoma, Non-Hodgkin* ; Myocardial Infarction* ; Phenobarbital ; Risk Factors ; Smoke ; Smoking ; Stents

Anthracyclines have been widely used in cancer therapy because of their efficacy in the treatment of various solid tumors and hem -atologic malignancy. Cumulative dose-related cardiotoxicity was a well-known toxicity of anthracyclines. Particularly, at total doses of more than 550 mg/m2, therapy with anthracyclines could produce irreversible cardiac injury. Anthracycline-induced cardiac toxicity was usually manifested by congestive heart failure or arrhythmia. In co- ntrast, acute myocardial infarction is a rare event of anthracycline-induced heart diseases. A 31-year-old man with non-Hodgkin lymphoma(NHL) and single cardiac risk factor, including smoking, was presented with chest pain after receiving 2nd CEOP-BLAM chemo-therapy. An electrocardiogram revealed ST segment elevation in inferior leads consistent with acute myocardial infarction. An echocardiogram revealed an ejection fraction of 60% and severe hypokinesia in inferior and anteroseptal wall. Three days later, coronary angiography revealed 50% of luminal stenosis of right coronary artery(RCA) and near total occlusion with large thrombi in m-RCA. After balloon angioplasty and stent insertion, the patient was transferred to coronary care unit and continuous intravenous heparin infusion was started. On the 10th days, the patient was discharged in good condition. Six months later, follow-up coronary angiography showed no significant lesion in right coronary artery. In a young man with NHL, we report an acute myocardial infarction after 2nd course of CEOP-BLAM chemotherapy with a review of relevant literatures.
Adult ; Angioplasty, Balloon ; Anthracyclines ; Arrhythmias, Cardiac ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Care Units ; Coronary Vessels ; Doxorubicin* ; Drug Therapy* ; Electrocardiography ; Follow-Up Studies ; Heart Diseases ; Heart Failure ; Heparin ; Humans ; Hypokinesia ; Lymphoma, Non-Hodgkin* ; Myocardial Infarction* ; Phenobarbital ; Risk Factors ; Smoke ; Smoking ; Stents

Anomalies of the lumbosacral nerve roots, in which conjoined nerve roots are most common, are occasionally accompanied by herniated nucleus pulposus. Most of these anomalies were incidental findings from operations, and recent advances in diagnostic imaging techniques have increased the number of cases of lumbosacral root anomalies reported. All these anomalies are congenital, unilateral and almost exclusively situated at the L5-S1 segment. Diagnostic techniques, such as myelography, CT and MRI detect conjoined nerve root. Conjoined nerve root may be confused with a dumbbell tumor or extruded free disc fragment on CT scans. Surrounded by high-signal intensity epidural fat, a conjoined nerve root is more clearly depicted on MR images than on CT scans. Although the size of disc herniation was small, the symptom was magnified by a relatively fixed conjoined root. At surgery, it is necessary for a larger surgical exposure by means of hemi-laminectomy because of the fixation of the nerve roots, and difficulty in retraction. Recently, we experienced two cases of conjoined nerve root and presented them with a review of the literature.
Diagnostic Imaging ; Incidental Findings ; Magnetic Resonance Imaging ; Myelography ; Tomography, X-Ray Computed

BACKGROUND: Malnutrition is a frequent nutritional problem among ICU patients, and their nutritional status is known to affect clinical prognosis. We conducted this study to examine nutritional status and actual nutrition delivery in the ICU patients and its relations to clinical outcomes. METHODS: This study was a multicenter retrospective observational study based on the medical records of 163 patients admitted to ICU of tertiary teaching hospitals in Korea. We included the patients who were treated with mechanical ventilation for 3 or more days and received enteral or parenteral nutrition. RESULTS: According to albumin and total lymphocyte count levels, 54.6% of the subjects were moderately or severely malnourished. Mean percentage of calorie and protein delivery to estimated needs for 10 days were 55.8 +/- 29.3% and 46.1 +/- 30.1%, respectively. While parenteral nutrition (PN) started at 1.6 +/- 1.4 days after admission, enteral nutrition (EN) did at 3.6 +/- 2.1 days. Days to PN and EN start, the calorie and protein amount via EN or PN were significantly different among 6 hospitals. No clinical outcomes differed by the levels of calorie or protein delivery. In-hospital mortality was significantly higher in the severely malnourished group at admission as compared to the other 2 groups (54.3% vs. 31.2% vs. 27.7%, p < 0.05) CONCLUSIONS: Malnutrition prevalence is high among Korean intensive care unit patients, but current nutritional therapy practice is inconsistent across institutions and far below the international guidelines. Systematic efforts should be made to develop nutritional support guidelines for Korean ICU patients.
Critical Illness ; Enteral Nutrition ; Hospital Mortality ; Hospitals, Teaching ; Humans ; Critical Care ; Intensive Care Units ; Korea ; Lymphocyte Count ; Malnutrition ; Medical Records ; Nutritional Status ; Nutritional Support ; Parenteral Nutrition ; Prevalence ; Prognosis ; Respiration, Artificial ; Retrospective Studies

PURPOSE: Traditional transcutaneous incision and transconjunctival incision methods are commonly used in the lower blepharoplasty. The transconjunctival method leaves no visible scars nor does it change the shape of lower eyelid contour and the surgical technique is not difficult. However removal of excess baggy skin is not possible through this method. Therefore, the transconjunctival incision method is useful only for patients who still have normal elasticity of the lower eyelids and fat that is protruding only anterocaudally. The Author will introduce a technique, which complements the limitations of these two methods mentioned above. METHODS: The author combined the transconjunctival approach and lower blepharoplasty with only the excised skin flap method. This method does not go beyond the previous methods but does apply the advantages of them. RESULTS: From March 2007 to October 2010, this new technique was performed in a total of 62 patients. Fat was removed and repositioned through transconjunctival incision. Drooped skin was excised as in the traditional blepharoplasty but only the skin flap was elevated. This prevents post-operative complications such as ectropion, sclera show, and deformation of the shape of the lower eyelids or under-resection of fat. All patients were satisfied with the post-operative appearance. CONCLUSION: The author was able to get satisfactory results while avoiding complications of traditional transcutaneous technique with this combined technique of the transconjunctival approach and the lower blepharoplasty method of skin flaps only.
Blepharoplasty ; Cicatrix ; Complement System Proteins ; Ectropion ; Elasticity ; Eyelids ; Humans ; Sclera ; Skin

Intraarticular ganglion of the knee joint is a cystic mass found around cruciate ligaments in infrapatellar fat pad or under patellar tendon. The first report on intraarticular ganglion of the knee joint along with some intermittent case reports or ganglion around the cruciate ligaments were in 1924 by Caan. Ganglion under the patellar tendon or in the patellar fat pad was first reported in 1972 by Muckle and Monahan. The two cases were treated with open arthotomy and mass excision. There was been no report on ganglion under patellar tendon since then. We managed two cases of ganglion under the patellar tendon with arthroscopic debridement. After 16 months of treatment, there has no recurrence of symptom. We report two cases of ganglion under patellar tendon with the review of the literature.
Adipose Tissue ; Debridement ; Ganglion Cysts* ; Knee Joint ; Ligaments ; Patellar Ligament* ; Recurrence

PURPOSE: To present our treatment protocol and surgical outcome for patients with congenital brachymetatarsia in which treatment was decided according to the number of affected rays. MATERIALS AND METHODS: Sixty-nine metatarsals in 44 patients with single or multiple congenital brachymetatarsia were included in the study. When a single ray was affected in a foot, we performed a one-stage lengthening using an intercalary autogenous iliac bone graft. We overcame excessively short rays by the double level lengthening at the metatarsal and proximal phalanx as one stage. When multiple rays were affected in one foot, we performed a one-stage combined shortening and lengthening procedure without an iliac bone graft. RESULTS: All patients were satisfied with the cosmetic and functional results. The average length gain by one-stage lengthening in 56 metatarsals of 38 patients was 14 (6-21) mm. Six patients with a combined shortening and lengthening procedure regained a nearly normal parabola of the involved foot. Neurovascular complication was not identified. CONCLUSION: Satisfactory results were achieved for the treatment of patients with congenital brachymetatarsia, by individualizing the surgical options according to the number of affected rays and general foot appearance.
Clinical Protocols ; Foot ; Humans ; Metatarsal Bones ; Transplants

OBJECTIVES: We tried to evaluate the agreement of the Charlson comorbidity index values (CCI) obtained from different sources (medical records and National Health Insurance claims data) for gastric cancer patients. We also attempted to assess the prognostic value of these data for predicting 1-year mortality and length of the hospital stay (length of stay). METHODS: Medical records of 284 gastric cancer patients were reviewed, and their National Health Insurance claims data and death certificates were also investigated. To evaluate agreement, the kappa coefficient was tested. Multiple logistic regression analysis and multiple linear regression analysis were performed to evaluate and compare the prognostic power for predicting 1 year mortality and length of stay. RESULTS: The CCI values for each comorbid condition obtained from 2 different data sources appeared to poorly agree (kappa: 0.00-0.59). It was appeared that the CCI values based on both sources were not valid prognostic indicators of 1-year mortality. Only medical record-based CCI was a valid prognostic indicator of length of stay, even after adjustment of covariables (beta = 0.112, 95% CI = [0.017-1.267]). CONCLUSIONS: There was a discrepancy between the data sources with regard to the value of CCI both for the prognostic power and its direction. Therefore, assuming that medical records are the gold standard for the source for CCI measurement, claims data is not an appropriate source for determining the CCI, at least for gastric cancer.
Aged ; Comorbidity ; Female ; Humans ; Insurance Claim Review ; *Length of Stay ; Male ; Medical Records ; Middle Aged ; Neoplasm Staging ; Prognosis ; Severity of Illness Index ; Stomach Neoplasms/diagnosis/*mortality

PURPOSE: The aim of this study was to determine the effectiveness of a community-based muscle and joint self-management program with muscle stretching and muscle strengthening exercises for community-dwelling older adults. METHODS: The study was a pre-and-post design in a single group, which examined the effects after the intervention of muscle and joint self-management program for 6 weeks, on the 42 subjects of the elderly who registered in a Community Senior Center in J city. Data analyses were conducted with paired t-test by using a SAS (version 9.2 for Windows) program. RESULTS: The effectiveness of muscle and joint self-management program on shoulder flexibility and right knee extension (flexibility) were significantly improved (t=2.72, p=.010; t=−2.26, p=.029). Joint symptoms (pain, stiffness), physical functioning, depression, fatigue, and left knee extension were not significantly improved after the muscle and joint self-management program. CONCLUSION: The results showed the possibility of this 6-week exercise program in improving shoulder and knee flexibility for community-dwelling older adults.
Adult* ; Aged ; Depression ; Exercise ; Fatigue ; Humans ; Joints* ; Knee ; Muscle Strength ; Pliability ; Self Care* ; Senior Centers ; Shoulder ; Statistics as Topic