A histological and electron microscopic study were conducted in order to observe a morphological changing pattern of patellar ligament autograft after endoscopic ACL reconstruction. Seventeen patients among 117 consecutive series which underwent endoscopic ACL reconstruction from January 1990 to March 1995, were involved in this study according to the various follow-up periods. In second-look arthroscopic finding at 6 months follow-up after ACL reconstruction, reconstructed ACL was covered with synovium and round-shaped, and after the biopsy active bleeding could be seen. In histological study, 6 months follow-up, spindle or ovoid shaped fibroblast with hypercellularity, high crmp patterns of collagen fiber, and parallel arrangement of fibroblast to collagen fiber were noted. The cellularity of fibroblast decreased in according to periods of follow up. At 12 months follow up, spindle or ovoid fibroblast, its cellularity and arrangement pattern and crimp pattern of collagen fiber seemed to be almost similar to those of normal ACL. This similaryity continued up to 2 years and 2 months after reconstruction. In EM study, until 6 months follow-up after reconstruction, the graft showed randomly arranged fibroblasts with hypercellularity, which had abundant cytoplasm with marked irregular cytoplasmic borders and prominent nuclear indentation, Collagen fibrils were immature and showed a unimodel distribution with small diameter. At 12 months follow-up, elongated fibroblasts appeared, but these cells contained folded nuclei and abundant cytoplasm. Collagen fibrils had parallel arrangement and sparse cross striation, and comprised of mainly small fibrils and scattered large fibrils. After 24 months follow-up, the cellularity decreased more. The regular arrangement of collagen fibrils with wavy pattern similar to normal anterior cruciate ligament was noted. Two distinctive population of the small and large diameter of fibrils was also observed (bimodal distribution). At 26 months, the large and small collagen fibrils compresed a characteric bimodal pattern with parallel arrangement, but the majority of fibroblasts had irregular cytoplasmic contour, and abundant cytoplasm with increased organelles, which indicated the active function. These findings suggest that the graft are still immature even at 26 months in postoperative follow up despite considerable maturation of collagen fibril.
Anterior Cruciate Ligament ; Autografts ; Biopsy ; Collagen ; Cytoplasm ; Fibroblasts ; Follow-Up Studies ; Hemorrhage ; Humans ; Organelles ; Patellar Ligament ; Synovial Membrane ; Transplants

An experimental study on the effect of the induced dislocation of the femoral head on the femoral anteversion was made in the hips of 55 rabbits, three to four weeks old. The results were as follows; l. In 49 of the 55 operated rabbits, a relative increase of anteversion was observed on the dislocated side, as compared with the nonoperated femur, the differences ranging from 3 to 55 degrees with an average of 20.0 degrees. 2. The anteversion angle of dislocated hip showed steady and gradual increase with the increase of age. 3. The anteversion increase was detected very early after operation; 3 of the 4 rabbits, belonging 4 to 7 days group after operation showed the anteversion increase. 4. The collapse of proximal femoral epiphysis was observed in 42 of the total 55 hips. The incidence of the collapse was higher in postoperative 4 weeks and more groups. 5. The color change, pale discoloration, of the articular cartilage was observed in 32 of the total 55 hips. The icnidence of pale discoloration was higher in the groups within 8 weeks after operation.
Cartilage, Articular ; Congenital Abnormalities ; Dislocations ; Epiphyses ; Femur ; Head ; Hip ; Incidence ; Rabbits

The purpose of this paper was to report clinical results and complications of high tibial osteotomy with fibular shaft osteotomy for medial unicompartmental osteoarthritis with varus deformity of the knee. Especially, the complications related to fibular shaft osteotomy were surveyed and analysed. Among one hundred and thirty-one cases which underwent high tibial osteotomy from Nov 1993 to May 1999, twenty-five cases underwent it combined with fibular shaft osteotomy and followed up at least more than 2 years. Average follow-up period were 47 months. Hospital for special surgery(HSS) knee score and femorotibial angle from weight bearing anteroposterior roentgenography of the knee were evaluated and measured. HSS knee score was improved from average 69 points preoperatively to 93 points in average at the final follow-up. Femorotibial angle was varus 2.9 degrees in average preoperatively and improved to valgus 8.1 degrees in average postoperatively and valgus 6.6 degrees at the final follow-up. Complications were tender- ness near to fibular shaft osteotomy in 9 cases, superficial peroneal nerve injury in 8 cases, non-union of fibu- lar osteotomy in 7 cases, non-union or delayed union of tibia osteotomy in 3 cases. High tibial osteotomy with fibular shaft osteotomy was a effective procedure in improving clinical results of osteoarthritis of the knee. However care must be taken to avoid complications rel#ated to fibular osteotomy
Congenital Abnormalities ; Follow-Up Studies ; Knee ; Osteoarthritis ; Osteotomy* ; Peroneal Nerve ; Radiography ; Tibia ; Weight-Bearing

BACKGROUND/OBJECTIVES: The long-term health impacts of dietary sugar have begun to be reported. The committee on the 2020 Dietary Reference Intakes for Koreans for sugar intended to update the scientific evidence on the association of added sugar intake with health outcomes, including mortality. This study evaluated the evidence on the association of dietary sugar with the all-cause and cardiovascular disease mortality from cohort studies. SUBJECTS/METHODS: The PubMed and ScienceDirect databases were searched until July 2021. The search terms were based on multiple combinations of keywords, such as added sugar, beverage, and mortality, included in the title or abstract. Two authors independently assessed the eligibility criteria of study selection and extracted the information from each selected article for this systematic review. RESULTS: The literature search identified 276 articles. Seventeen cohort studies met the inclusion criteria and were included in this systematic review. This study extracted information on the cohort and participants, dietary assessment methods, exposure and its comparison groups, health outcomes, and risk measures. Five articles reported added sugar intake, and 15 articles reported the food sources of the added sugar in the association with mortality. Increased mortality was observed in higher added sugar intake and a lower intake of less than 5% of energy, while higher discrepancies between gender, age groups, and countries were noted. In addition, nutritious sugary foods and beverages did not increase mortality. CONCLUSIONS A ‘U’ or ‘J’ shaped relationship between the added sugar intake and mortality was estimated. The observed discrepancy indicated the need for more evidence to establish the dose-response relationship for Koreans.

PURPOSE: This study is a comparative evaluation of the incidence of parenteral nutrition-associated liver disease (PNALD) when administering intravenous fat emulsions containing fish oil. METHODS: The medical records of patients who were in the neonatal intensive care unit at Severance Hospital from January, 2012 to December 2015, were reviewed retrospectively. Patients who were administered either soybean oil (SO) or SMOF (containing soybean oil, medium chain triglycerides, olive oil, and fish oil) more than 14 days were included. The patients were excluded if they were administered both agents or had underlying hepatic disease. An increase in bilirubin to 2 mg/dL was defined as PNALD. RESULTS: PNALD occurred in only 8 out of a total of 77 patients: 6 out of 31 (19.4%) in the SO group and 2 out of 46 (4.3%) in the SMOF group (P=0.055). The number of patients, whose lab values, such as direct bilirubin, total bilirubin, asparate aminotransferase (AST), alanine amino-transferase, gamma-glutamyl transpeptidase, C-reactive protein, serum triglyceride, and alkaline phosphate, exceeded the normal range, were similar in both groups. The gestational age, birth body weight, and APGAR score at 1 min and 5 min were significantly higher in the SO group and the PN duration was significantly long in the SMOF group. Considering only term infants, there were no significant differences in baseline characteristics and incidence of PNALD. The number of patients whose AST exceeded the normal range was significantly higher in the SO group (P=0.034). CONCLUSION: The incidence of PNALD was similar in both groups. On the other hand, considering the tendency, there was a high correlation between the type of lipid emulsion and an increased direct bilirubin level in the SO group.
Alanine ; Apgar Score ; Bilirubin ; Body Weight ; C-Reactive Protein ; Emulsions* ; Fat Emulsions, Intravenous ; Fish Oils ; gamma-Glutamyltransferase ; Gestational Age ; Hand ; Humans ; Incidence ; Infant ; Infant, Newborn* ; Intensive Care, Neonatal ; Liver Diseases* ; Liver* ; Medical Records ; Olive Oil ; Parenteral Nutrition ; Parturition ; Reference Values ; Retrospective Studies ; Soybean Oil ; Triglycerides

PURPOSE: This study was conducted to develop an integrated undergraduate course including a PBL based on a blended learning strategy, and evaluate learners' responses. METHODS: The learning contents of cardiovascular, respiratory, and musculoskeletal medical systems, and nursing diagnoses of 'activity and rest' domain (NANADA's classification II, 2005) were analyzed. Six clinical scenarios with the clients in different life cycles were developed for PBL. Classical lecture and group presentation with on-line self learning were implemented in addition to PBL. The developed course was implemented on 84 junior nursing students in a university for 7 weeks with 5 hours per day, two days per week. Students were asked to complete structured questionnaires including problem solving, critical thinking, and nursing diagnosis differentiation abilities. RESULTS: Learner's evaluation was positive in problem solving skills and in the differentiation ability of nursing diagnoses relevant to an 'activity and rest' functional health pattern. CONCLUSION: Development and implementation of integrated courses based on a blended learning method need to be continued to enhance students' thinking and self-directed learning abilities. Supporting strategies for individual learners should be added for successful blended learning such as individual on-line feedback and consideration of individual learning outcomes.
Classification ; Humans ; Learning ; Life Cycle Stages ; Nursing Diagnosis ; Problem Solving ; Problem-Based Learning ; Students, Nursing ; Thinking ; Surveys and Questionnaires

BACKGROUND AND OBJECTIVES:Traditionally, down beat nystagmus is regarded as a sign of central nervous system dysfunction. But, several years has passed since Herdman et al reported the down beat nystagmus developed during treatment maneuvers for posterior semicircular canal benign paroxysmal positional vertigo(BPPV). We undertook this study to evaluate the character and clinical analysis of the positional or positioning down beat nystagmus, to discuss the clinical significance of positional or positioning down beat nystagmus as a diagnostic criteria of superior semicircular canal BPPV, and to propose the new treatment method. MATERIALS AND METHOD:From November 1999 to March 2004, we sampled the 103 patients with positional or positioning down beat nystagmus. Of these patients, we selected 16 patients except for the patients with central nervous system dysfunction, nonspecific or artifact result, idiopathic origin. RESULTS:All of 16 patients had no sign and radiologic result of central nervous system disorder. 10 patients was reported or suspected the diagnosis of posterior semicircular canal BPPV. Fatigability was reported in 9 patients and reversibility was reported in 1 patient. Average latency was checked less than 2 seconds. CONCLUSION:Although the diagnostic criteria of superior semicircular canal BPPV that we reported was not controversial, we expect that this criteria is useful in diagnosis for patients with atypical positional or positioning down beat nystagmus. And the new treatment method that we reported will has the better results than previous method.
Artifacts ; Central Nervous System ; Diagnosis ; Humans ; Semicircular Canals ; Vertigo*

Objectives: This study examined regional differences in the intake of dietary total fat and saturated fatty acid (SFA) and their food sources among Korean adults. We also investigated the associations of SFA intake with metabolic diseases by region. Methods: This study included 13,926 adults ( 19y) who participated in the 2016 ~ 2019 Korea National Health and Nutrition Examination Surveys. The regions were divided into urban and rural areas according to the administrative districts where the participants lived. Using dietary data obtained from a 24-h recall, intake of total fat and SFA and their food sources were assessed by region. Metabolic diseases included obesity, abdominal obesity, and elevated total cholesterol and their association with SFA intake by region were examined using multiple logistic regression. Results Of the participants, 19.6% lived in rural areas. In urban areas, the total fat and SFA intakes were higher than in rural areas: 21.2% of energy (%E) came from total fat and 6.9%E from SFA in urban areas, whereas 18.0%E came from total fat and 5.8%E from SFA in rural areas. The percentage of participants who exceeded the dietary reference intakes for total fat and SFA in urban areas was 16.5% and 41.9%, respectively, but 43.4% of participants in rural areas showed lower intake levels for total fat compared to the reference level. Young adults did not show regional differences in fat intake, and the percentage of subjects who exceeded the reference for SFA was high both in urban (58.5%) and rural (55.7%) areas. Among middle-aged and older adults, intake of fatty acids except for n-3 fatty acid was significantly higher in urban areas than in rural areas. About 69% of older adults in rural areas showed a lower intake of total fat compared to the reference level. The food sources for total fat and SFA were meat, soybean oil, eggs, and milk in both areas. The intake of fat from eggs, milk, mayonnaise, and bread was higher in urban areas, but the intake of fat from white rice and coffee mix was higher in rural areas. The SFA intake was positively associated with elevated serum total cholesterol in urban areas (4th quartile vs. 1st quartile, OR: 1.22, 95% CI: 1.06-1.40, P for trend: 0.043), but not in rural areas.

No abstract available.

PURPOSE: To compare the effects of pulsed lavage versus bulb syringe irrigation on cement penetration into metaphyseal cancellous bone. MATERIALS AND METHODS: Bone slabs, about 1 cm in thickness, taken from the distal metaphysis of 10 femurs of adult pigs were used. Slaps were sectioned in the sagittal and transverse planes, and divided into two groups. One half of the specimens was irrigated with saline by pulsed lavage, while the other half was irrigated with saline using bulb syringes. Bone cement was pressurized into the cut surface using a cement gun. Trimmed bone blocks were fixed in formaldehyde, dehydrated in ethanol, and embedded in plastic resin (Spurr's low-viscosity medium). Contiguous sectioning was done and the sections surfaces were ground. The depth of cement penetration, and the total area of cement-bone interdigitation were analyzed using image analysis software. RESULTS: The average total area of cement-bone interdigitation was 34.9 mm2 in the pulsed lavage group and 20.2 mm2 in the bulb syringe group. The average penetration depth of cement was 4.4 mm in the pulsed lavage group, and 2.5 mm in the bulb syringe group. CONCLUSION: The penetration of cement during arthroplasty is significantly increased by pulsed lavage, which could reduce late complications and aseptic loosening.
Adult ; Arthroplasty ; Ethanol ; Femur ; Formaldehyde ; Humans ; Plastics ; Swine ; Syringes ; Therapeutic Irrigation*