Various methods have been described for surgical treatment of recurrent shoulder dislocation. Arthroscopic techniques for stabilizing the shoulder have the theoretical advantage of reduced complication, decreased discomfort, and improved motion. The arthroscopic Bankart procedure was performed in 23 cases at Department of Orthopaedic Surgery, Yonsei University College of Medicine, from January, 1991 to December, 1993. This study is an attempt to evaluate results of arthroscopic Bankart procedure by Caspari's technique. Results of this study were as follows: l. According to the clinical evaluation of Rowe, results were excellent in 18 cases, good in 2 cases, fair in 1 cases and poor in 2 case. The prognosis was related to the size of Hill-Sachs lesion. 2. Complication after treatment included 5 cases of knot problem, 1 case of subluxation, and 2 cases of redislocation. Redislocation was developed in one patient who played ice hockey at 2 months after operation and in one patient who played soccer at 8 months after operation. Subluxation was developed in one patient who had psychologic problem. Among 5 patients who had knot prob- lem, two patients had a operation of removal. In conclusion, Caspari's suture technique in arthroscopic Bankart procedure needs some modification on the insertion point of the guide pin and suturing technique. And arthroscopic Bankart procedure by Caspari's technique offers good cosmetic results, low perioperative morbidity, low complications except knot irritation, and excellent results by the Rowe's criteria for patients with anterior shoulder instability.
Arthroscopy ; Hockey ; Humans ; Prognosis ; Shoulder ; Shoulder Dislocation ; Soccer ; Suture Techniques

PURPOSE: To evaluate CT features of metastatic ureteral tumors. MATERIALS AND METHODS: CT findings in 16 patients with ureteral metastases were evaluated retrospectively ;there were eight cases of bilateral ureteral involvement. Primary tumors metastatic to the ureter were advanced gastric cancer (n=13), breast cancer (n=l), colon cancer (n=l), or adenocarcinoma of unknown primary (n=l). We analysed CT findings with regard to the site of ureteral obstruction, configuration of obstructed sites of ureter, presence or absence of periureteral soft tissue density, and status in other organs. RESULTS: Among 24 ureters involved, ureteral wail thickening was noted in 15, periureteral soft tissue density in 13. Small nodular enhancing lesions less than lcm, within the retroperitoneal space around the involved ureters were noted in seven patients, and four of them were multiple lesions. CONCLUSION: Among various primary tumors, gastric cancer was the most common cause of ureteral metastasis. The common CT findings of ureteral metastases were thickening of ureteral wall, periureteral soft tissue density, and small periureteral enhancing nodular lesions. The constellation of these CT findings may be helpful in making the diagnosis of ureteral metastases.
Adenocarcinoma ; Breast Neoplasms ; Colonic Neoplasms ; Diagnosis ; Humans ; Neoplasm Metastasis* ; Retroperitoneal Space ; Retrospective Studies ; Stomach Neoplasms ; Ureter* ; Ureteral Obstruction

No abstract available.
Posterior Cruciate Ligament*

A specimen of Beauveria bassiana was collected from Yang-yang of Gangwon province, Korea in October 2006. Conidial isolates were prepared from the specimen by the dilution method and inoculated in brown rice medium for fruiting body production. After nearly two months incubation for perithecial stromata developed from single isolates as well as from their combinations. They were determined as Cordyceps bassiana by observing the stromatal characters and their conidial structures. This is the first report of the development of C. bassiana from B. bassiana cultures.
Beauveria ; Cordyceps ; Fruit ; Korea

PURPOSE: The disinsertion of the phalangeal tendon distal insertion has difficulties in ordinary tenorrhaphy operation for the anatomical features, and still has controversy between non-surgical and surgical management. The purpose of this study is to select treatment for the injury of the phalangeal tendon distal insertion, as we've had a good results from operation treatment with Pull-in suture technique. METHODS: We reviewed the hospital records of 12 patients treated with Pull-in suture technique with disinsertion of the phalangeal extensor or flexor tendon distal insertion from June 2006 to June 2007. Eight patients were involved with the tendon disinsertion without bone fracture, and 4 patients were involved with the fracture of the phalangeal tendon distal insertion site. After removal of the K-wire in week 6, active physical exercises were commenced immediately. The mean follow-up period was 12.4 months. RESULTS: All the patients who had tendon disinsertion with bone fracture had IIB, by Wehbe and Schneider's classification 2, and we evaluated the results comparing the same finger of the other hand according to Crawford's evaluation criteria 5. The nine excellent and three good results were obtained and there were no limitation of motor for the patient who had operation for the rupture of flexor tendon as well. There were no particular complications during the follow-up period. CONCLUSION: The most important thing for the disinsertion of the phalangeal tendon distal insertion is to maintain an accurate and durable reduction state keeping the tension of tendon. At this point, after removal of the K-wire, the Pull-in suture technique allows accurate realignment of the tendon-bone unit without any specific instrumentation under the more stable state. The Pull-in suture technique seems to be a strong alternative for the treatment of disinsertion of the phalangeal tendon distal insertion, with successful treatment outcome(rapid functional recovery and high patient satisfaction).
Exercise ; Fingers ; Follow-Up Studies ; Fractures, Bone ; Hand ; Hospital Records ; Humans ; Rupture ; Suture Techniques ; Sutures ; Tendons

We reviewed the clinical features, histrologic patterns and clinical courses of 30 children with lupus nephritis retrospectively, and the results were summerized as follows; 1) The male to female ratio was 1:2.8, and the mean age at the onset was 10 8/12 years. 2) The clinical symptoms were diverse, and malaise, weight loss, anorexia, fever and malar rash were the most frequent findings. 3) Among the immunologic tests, FANA and anti-ds-DNA test revealed the highest sensitivity with positive rates of 97% and 87%, respectively. 4) Clinically, 57% of patients had active nephrotic syndrome at the onset, and 33% showed (?) was the most common findings (70%). 5) During the follow-up period, one children with Class IV lupus nephritis expired. And 8 out of 9 cases with renal insufficiency at the onset showed improvement of renal function after treatment with corticosteroid and cytotoxic agents. In conclusion, the clinical features and histologic findings of lupus nephritis in children were diverse. Early diagnosis and proper treatment can prevent rapid deterioration of renal function and improve long-term survival rate.
Anorexia ; Child* ; Cytotoxins ; Early Diagnosis ; Exanthema ; Female ; Fever ; Follow-Up Studies ; Humans ; Immunologic Tests ; Lupus Nephritis* ; Male ; Nephrotic Syndrome ; Renal Insufficiency ; Retrospective Studies ; Survival Rate ; Weight Loss

BACKGROUND: Phenol is the most commonly used neurolytic agent for the management of intractable somatic pain, but side effects such as motor dysfunction and potential loss of bladder or rectal sphincter function develop following their application. This study observed functional changes of hind limb and neuropathologic changes in the sciatic nerve after phenol application, highlighting the time of nerve regeneration. METHODS: Functional changes in hind limbs were observed for 6 weeks and the distal part of the phenol-injected or dripped sciatic nerve was severed in 3 rats of each group respectively at 10 minutes, 1 hour, 24 hours, 3 days, 1 week, 2 weeks, 4 weeks and 6 weeks. The pathologic changes in the severed nerves were observed under the electron microscope. RESULTS: The phenol-injected or-dripped hind limbs showed more pronounced motor weakness and more obvious gait changes. About 2 weeks after the phenol application, gradual improvement of gait changes began, and after 6 weeks, motor weakness and gait changes were no longer perceptible. In the group with phenol injection, at 10 minutes after injection, destructive lesions were confined to unmyelinated fibers and the myelin sheath of small myelinated fibers. On the 3rd day and at 1 week, pathologic changes on axonal fibers and Schwann cells were in progress with phagocytosis in spite of myelin restitution. From 2 to 4 weeks, axonal regeneration and remyelination appeared concurrent with myelin disintegration and axonolysis, and histologic findings at 6 weeks were similar to those of the control group. In the group with phenol drip, the histologic changes in the sciatic nerve were very similar to the injection group. CONCLUSIONS: These results suggest that histopathologic lesions after a phenol application on the peripheral nerves are not influenced by application methods. The progress of histopathologic changes is obvious according to the time interval following the phenol application. Accordingly, side effectsthat developed following the use of phenol may be improved around the time when the nerve regeneration occurs, between the second and fourth weeks after the injection. The course of histopathologic changes and clinical findings following the application of phenol is very similar to the previous experiment using alcohol.
Animals ; Axons ; Extremities ; Gait ; Myelin Sheath ; Nerve Regeneration ; Nociceptive Pain ; Peripheral Nerves ; Phagocytosis ; Phenol* ; Rats ; Regeneration ; Schwann Cells ; Sciatic Nerve* ; Urinary Bladder

There had been total 20 patients with early onset(4 months~2 years) primary nephrotic syndrome in the Department of Pediatrics, Seoul National University Children's Hospital, during the period from March 1987 to February 1993. We analysed clinical courses, response to treatment, pathological findings and prognosis of the patients And the results were as follows; 1) The initial responders to steroid treatment were 10(50%), of whom 3 became late nonresponders. Of the 10 initial nonresponders, 8 revealed continuing nonresponsiveness. 2) Incidence of hypertension was significantly higher in the intial nonresponders than in the initial responders. 3) Renal biopsies were performed in 9 initial nonresponders and 2 late nonresponders. And the results were 6 with minimal change lesion, 4 with focal segmental glomerulosclerosis and 1 with mesangiocapillary glomerulonephritis. 4) Six continuing or late nonresponders received methylprednisolone pulse therapy or cyclophosphamide. And partial remission was induced in 4 of them. 5) The overall 3 year maintenance rate of normal renal function was 81%(100% in the initial responders and 64% in the initial nonresponders). In conclusion, the initial steroid responsiveness and prognosis were poorer in patients with early onset nephrotic syndrome than in patients with usual childhood nephrotic syndrome.
Biopsy ; Cyclophosphamide ; Glomerulonephritis, Membranoproliferative ; Glomerulosclerosis, Focal Segmental ; Humans ; Hypertension ; Incidence ; Methylprednisolone ; Nephrotic Syndrome* ; Pediatrics ; Prognosis ; Seoul

BACKGROUND: To identify the expression patterns and usefulness of various antibodies in making diagnoses and predicting prognoses, an immunohistochemical study was performed on thymic epithelial tumors (TETs). METHODS: Forty-two cases of TETs were reclassified according to the new World Health Organization (WHO) classifications. CD3, CD5, CD79a, CD99, pan-, high- and low-molecular weight cytokeratins, EMA, vimentin, MIB-1 (Ki67) and p53 immunostaining were carried out. RESULTS: There were two, twelve, eight, two, thirteen and one case for type A, AB, B1, B2, B3 and C, respectively. Combined B1/B2 and B2/B3 were 2 cases each. Fourteen cases (33.3%) had myasthenia gravis. CD99 was immunoreactive mainly in cortically derived lymphocytes, while CD3 and CD5 were immunoreactive in medullary-derived lymphocytes. CD5 immunoreactivity was negative in all thymic epithelial cells, except for one case of type B3. MIB-1 indices were highly expressed in cortical lymphocytes and some thymic epithelial cells, but did not show any correlation with grades. p53 in thymic epithelial cells was expressed in 6 (46%) out of 13 cases of type B3 and one case of type C, and it was negative in all other subtypes. CONCLUSIONS: Only p53 was helpful for predicting high grades (B3 and C) (P<0.05). By MIB-1 indices, we could tell how many cortical immature lymphocytes were occupied in TETs, however, grading could not be achieved.
Antibodies ; Classification ; Diagnosis ; Epithelial Cells ; Immunohistochemistry ; Keratins ; Lymphocytes ; Myasthenia Gravis ; Prognosis ; Thymus Gland ; Vimentin ; World Health Organization* ; World Health*

PURPOSE: The purpose of this study was to analyze the characteristic MR findings of childhood metachromatic leukodystrophy. MATERIALS AND METHODS: Five female patients (10--29 months old;mean age, 21.8 months) of biochemically confirmed metachromatic leukodystrophy were included in this study. We evaluated the extent of white matter degeneration, which was shown as high signal intensity on T2-weighted image, and the presence or absence of the enhancement. Result.' All 5 cases showed high signal intensity in periventricular deep white matter and centrum semiovale which were bilateral, symmetric and confluent. Posterior predominace, sparing of subcortical U fibers and immediate periventricular white matter, and the involvement of splenium of corpus callosum were also noted in all cases. There were other manifestations, such as 'tigroid pattern' in centrum semiovale (n=4), the involvement of genu of corpus callosum(n=4), posterior limb of internal capsule(n=4), descending pyramidal tracts (n=3), deep cerebellar white matter(n=1), claustrum(n=2), and diffuse brain atrophy(n=1). In three cases with Gd-infusion, contrast enhancement of the lesion was not seen. CONCLUSION: In childhood metachromatic leukodystrophy, MRI can clearly demonstrate the chracteristic extent of the white matter lesion and other associated findings, facilitating the differential diagnosis from other similar leukodystrophies.
Brain ; Corpus Callosum ; Diagnosis, Differential ; Extremities ; Female ; Humans ; Leukodystrophy, Metachromatic* ; Magnetic Resonance Imaging* ; Pyramidal Tracts