PURPOSE: To analysis clinical results after arthroscopic ACL reconstruction between bioabsorbable interference screw fixation and metallic interference screw fixation. MATERIALS AND METHODS: We evaluated the results of arthroscopic ACL reconstruction with patellar tendon autograft between two groups, of which group 1 is used metallic interference screw, group 2 is used bioabsorbable interference screw. All of 53 patients underwent arthroscopic patellar tendon auto-grafts with one incision technique. A minimum 12 months follow-up is available on 31 patients in group 1 and 22 patients in group 2. The average age was 28.4 years(19 to 47 years) in group 1 and 29.7 years(18 to 55 years) in group 2. The average period, from trauma to operation, was 20.7 months in group 1 and 24.6 months in group 2. The average follow-up period was 24.1 months in group 1 and 13.1 months in group 2. In terms of the results of pivot shift test, Lachman test, anterior drawer test, Lysholm score, Arthrometer(KT-2000), Cybex test, simlpe X-ray and MRI findings of group 1 compared with group 2. RESULTS: At the final follow-up, KT-2000 test showed that average maximum manual side-to-side dif-ference(STSD) was 2.7mm for group 1 and 2.7mm for group 2. Average muscle power of injured quadri-ceps muscle compared with normal leg by Cybex test was average 82% for group 1 and 79% for group 2. Lysholm score was average 90 for group 1 and 89 for group 2. 3 cases of group 1 and 2 cases of group 2 were showed instability in physical examination, but there were no evidence of synovitis of knee joint or rerupture of anterior cruciate ligament in the follow-up MRI. CONCLUSIONS: No statistical difference was found between the bioabsorbable interference screw fixation group and the metallic interference screw fixation group. Short-term data support that bioabsorbable interference screw is a reasonable alternative to metallic interference screw.
Anterior Cruciate Ligament ; Autografts ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Leg ; Magnetic Resonance Imaging ; Patellar Ligament ; Physical Examination ; Synovitis

The sensitivity and specificity of ST segment change on ECG for detection of coronary artery disease(CAD) by pacing stress test were assessed. Among 28 cases with chest pain(mean age 52, M/F : 21/7), 10 patients had normal coronary angiographic finding(Group I), and 18 had coronary artery disease(Group II). Pacing stress test showed high specificity(100%), but low sensitivity(61%) for the diagnosis of CAD. Especially in patients with 1 vessel disease, the sensitivity was only 50%, and positive results were not attained unless there was at least 90% or more stenosis in any of the major branches(LAD, RCA or LCX). But in patients with multivessel disease, the sensitivity was much higher(83%). Lateral(V4-6) or inferior leads(2, 3, aVF) showed ischemic ST segment depression most commonly. Therefore one of the inferior lead and V5 may be a minimum requirement for monitoring pacing-induced ST segment changes. Time constant during isovolumic relaxation showed statistically significant prolongation after pacing only in CAD patient group, suggesting pacing-induced impairment of early left ventricular relaxation.
Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Depression ; Diagnosis* ; Electrocardiography ; Exercise Test ; Humans ; Relaxation ; Sensitivity and Specificity ; Thorax

Acinar Cells ; Adult ; Carcinoma, Acinar Cell ; Classification ; Female ; Hemangioma ; Humans ; Palate, Hard ; Prognosis ; Vascular Malformations

Cephalosporins are well-known agents that may cause occupational asthma and there have been a few reports suggesting that the pathogenesis may be IgE-mediated. To the best of our knowledge, this is the first report of cefteram pivoxil-induced occupational asthma and detection of serum specific IgE to cefteram-HSA (human serum albumin) conjugate. A 28-year-old woman who had been occupied in a pharmaceutical company for 3 years began to experience rhinorrhea, nasal obstruction, cough, and dyspnea one year after she started work. She was involved in the filling of vials with cefteram pivoxil powder. The patient had no history of previous allergies. Skin prick test (SPT) to 80 common allergens showed negative responses and methacholine bronchoprovocation test (BPT) showed a positive response after inhalation of 0.15mg/ml. Skin prick test with cefteram pivoxil showed a strong positive response and specific BPT with cefteram demonstrated an early asthmatic response. Serum specific IgE to cefteram -HSA conjugate was detectable by ELISA. In conclusion, an IgE-mediated mechanism may be involved in the pathogenesis of cefteram pivoxil-induced bronchoconstriction in an exposed patient. Further studies will be needed to investigate if serum sIgE may be used as a useful marker to screen susceptible individuals.
Adult ; Allergens ; Asthma, Occupational* ; Bronchoconstriction ; Cephalosporins ; Cough ; Dyspnea ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Inhalation* ; Methacholine Chloride ; Nasal Obstruction ; Skin

Cephalosporins are well-known agents that may cause occupational asthma and there have been a few reports suggesting that the pathogenesis may be IgE-mediated. To the best of our knowledge, this is the first report of cefteram pivoxil-induced occupational asthma and detection of serum specific IgE to cefteram-HSA (human serum albumin) conjugate. A 28-year-old woman who had been occupied in a pharmaceutical company for 3 years began to experience rhinorrhea, nasal obstruction, cough, and dyspnea one year after she started work. She was involved in the filling of vials with cefteram pivoxil powder. The patient had no history of previous allergies. Skin prick test (SPT) to 80 common allergens showed negative responses and methacholine bronchoprovocation test (BPT) showed a positive response after inhalation of 0.15mg/ml. Skin prick test with cefteram pivoxil showed a strong positive response and specific BPT with cefteram demonstrated an early asthmatic response. Serum specific IgE to cefteram -HSA conjugate was detectable by ELISA. In conclusion, an IgE-mediated mechanism may be involved in the pathogenesis of cefteram pivoxil-induced bronchoconstriction in an exposed patient. Further studies will be needed to investigate if serum sIgE may be used as a useful marker to screen susceptible individuals.
Adult ; Allergens ; Asthma, Occupational* ; Bronchoconstriction ; Cephalosporins ; Cough ; Dyspnea ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Inhalation* ; Methacholine Chloride ; Nasal Obstruction ; Skin

BACKGROUND/AIMS: Pleuropulmonary paragonimiasis produces no specific symptoms or radiologic findings, allowing for the possibility of misdiagnosis. We evaluated the specific clinical and pleural fluid features of pleuropulmonary paragonimiasis masquerading as pleural tuberculosis. METHODS: We retrospectively analyzed the clinical and radiologic characteristics of 20 patients diagnosed with pleuropulmonary paragonimiasis between 2001 and 2011. RESULTS: In total, 17 patients presented with respiratory symptoms, including dyspnea (30%), hemoptysis (20%), cough (20%), and pleuritic chest pain (15%). Chest radiographs revealed intrapulmonary parenchymal lesions, including air-space consolidation (30%), nodular opacities (20%), cystic lesions (15%), ground-glass opacities (10%), and pneumothorax (5%). A pleural f luid examination revealed eosinophilia, low glucose levels, and high lactate dehydrogenase (LDH) levels in 87%, 76%, and 88% of the patients, respectively. These traits helped to distinguish pleuropulmonary paragonimiasis from other pleural diseases such as parapneumonic effusion, malignancy, and pleural tuberculosis. CONCLUSIONS: Pleuropulmonary paragonimiasis is often initially misdiagnosed as other pleural diseases. Therefore, it is important to establish the correct diagnosis. In patients with unexplained pleural effusion living in paragonimiasis-endemic areas, pleural fluid obtained by thoracentesis should be examined to distinguish pleuropulmonary paragonimiasis. When marked eosinophilia, high LDH levels, and low glucose levels are identified in pleural fluid, physicians could consider a diagnosis of pleuropulmonary paragonimiasis.
Adolescent ; Adult ; Aged ; Animals ; Biological Markers/analysis ; Child ; Child, Preschool ; Diagnosis, Differential ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia/diagnosis/parasitology ; Female ; Glucose/analysis ; Humans ; L-Lactate Dehydrogenase/analysis ; Lung Diseases, Parasitic/*diagnosis/metabolism/parasitology/radiography ; Male ; Middle Aged ; Paracentesis ; Paragonimiasis/*diagnosis/metabolism/parasitology/radiography ; Paragonimus westermani/*isolation & purification ; Pleural Effusion/*diagnosis/metabolism/parasitology/radiography ; Predictive Value of Tests ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis, Pleural/*diagnosis ; Young Adult

PURPOSE: We investigate the outcomes of treatment of patients with severe comminuted distal radius fractures with volar plate fixation using a pronator-preserving approach. MATERIALS AND METHODS: Fourteen patients with severe comminution of the distal radius fractures for whom anatomical reduction of the fractures was deemed difficult to achieve with traditional approaches were enrolled. The gender ratio was 8 males to 6 females, and the average age of the patients was 64.9 years. According to the AO/OTA classification of fractures, 2 patients had 23-A3 fractures, 7 patients had 23-C2, and 5 patients had 23-C3. Radial length, radial inclination, and volar tilt were measured for radiologic evaluation. Modified Mayo wrist score (MMWS) was used for clinical outcome. RESULTS: Bony union was achieved in all 14 patients without signs of complications. The average time-to-union was 4.3 months (3-6 months). The radiological findings at the final follow-up were as follows: the average radial inclination was 20.5degrees; the average volar tilt, 7.57degrees; and the average radial length, 11.8 mm. At the final follow-up, the results of the MMWS were 'Fair' in 1 patient, 'Good' in 4, and 'Excellent' in 9. CONCLUSION: We propose that a pronator-preserving approach is an effective treatment for severe comminuted distal radius fracture.
Classification ; Female ; Follow-Up Studies ; Humans ; Male ; Radius Fractures* ; Palmar Plate ; Wrist

Background: Successful liberation from mechanical ventilation is one of the most crucial processes in critical care, because it is the first step through which a respiratory failure patient begins to transition out of the intensive care unit, and return to normal life. Therefore, when devising appropriate strategies for removing mechanical ventilation, it is essential to consider scientific and systematic approaches, as well as the individual experiences of healthcare professionals. Recently, numerous studies have investigated methods and tools to identify when mechanically ventilated patients are ready to breathe on their own. The Korean Society of Critical Care Medicine therefore provides these recommendations to clinicians for liberation from the ventilator. Methods: Meta-analyses and comprehensive syntheses were used to thoroughly review, compile, and summarize the complete body of relevant evidence. All studies were meticulously assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method, and the outcomes were presented succinctly as evidence profiles. These evidence syntheses were discussed by a multidisciplinary committee of experts in mechanical ventilation, who then developed and approved the recommendations. Results: Recommendations for nine questions on ventilator liberation about Population, Intervention, Comparator, and Outcome (PICO) are presented in this document. This guideline presents seven conditional recommendations, one expert consensus recommendation, and one conditional deferred recommendation. Conclusion We developed these clinical guidelines for mechanical ventilation liberation to provide meaningful recommendations. These guidelines reflect the best treatment for patients seeking liberation from mechanical ventilation.

Background: Successful liberation from mechanical ventilation is one of the most crucial processes in critical care, because it is the first step through which a respiratory failure patient begins to transition out of the intensive care unit, and return to normal life. Therefore, when devising appropriate strategies for removing mechanical ventilation, it is essential to consider scientific and systematic approaches, as well as the individual experiences of healthcare professionals. Recently, numerous studies have investigated methods and tools to identify when mechanically ventilated patients are ready to breathe on their own. The Korean Society of Critical Care Medicine therefore provides these recommendations to clinicians for liberation from the ventilator. Methods: Meta-analyses and comprehensive syntheses were used to thoroughly review, compile, and summarize the complete body of relevant evidence. All studies were meticulously assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method, and the outcomes were presented succinctly as evidence profiles. These evidence syntheses were discussed by a multidisciplinary committee of experts in mechanical ventilation, who then developed and approved the recommendations. Results: Recommendations for nine questions on ventilator liberation about Population, Intervention, Comparator, and Outcome (PICO) are presented in this document. This guideline presents seven conditional recommendations, one expert consensus recommendation, and one conditional deferred recommendation. Conclusion We developed these clinical guidelines for mechanical ventilation liberation to provide meaningful recommendations. These guidelines reflect the best treatment for patients seeking liberation from mechanical ventilation.

Background: Successful liberation from mechanical ventilation is one of the most crucial processes in critical care, because it is the first step through which a respiratory failure patient begins to transition out of the intensive care unit, and return to normal life. Therefore, when devising appropriate strategies for removing mechanical ventilation, it is essential to consider scientific and systematic approaches, as well as the individual experiences of healthcare professionals. Recently, numerous studies have investigated methods and tools to identify when mechanically ventilated patients are ready to breathe on their own. The Korean Society of Critical Care Medicine therefore provides these recommendations to clinicians for liberation from the ventilator. Methods: Meta-analyses and comprehensive syntheses were used to thoroughly review, compile, and summarize the complete body of relevant evidence. All studies were meticulously assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method, and the outcomes were presented succinctly as evidence profiles. These evidence syntheses were discussed by a multidisciplinary committee of experts in mechanical ventilation, who then developed and approved the recommendations. Results: Recommendations for nine questions on ventilator liberation about Population, Intervention, Comparator, and Outcome (PICO) are presented in this document. This guideline presents seven conditional recommendations, one expert consensus recommendation, and one conditional deferred recommendation. Conclusion We developed these clinical guidelines for mechanical ventilation liberation to provide meaningful recommendations. These guidelines reflect the best treatment for patients seeking liberation from mechanical ventilation.