The goals of treatment in the injuries of posterior cruciate ligament(PCL) are restoration of normal tibiofemoral stability and reduction of long term osteoarthrosis of the knee. The purpose of this study is to analyze the factors on posterior stability and functional result after PCL reconstruction. From March 1996 to April 1997, twenty operation on PCL reconstruction were carried out in our hospital. The functional results according to the criteria of the Lysholm knee score and stress radiograph for posterior stability were evaluated. The average functional results evaluated by Lysholm knee score was 87. There was no significant difference in functional result according to selected grafted material, combined knee injury, type of injury and arthrotomy, etc. Difference in posterior tibial translation on average were 2.8mm in acute and 7.7mm in chronic injury. In posterolateral combined injury, average posterior tibial translation in pos- terolateral repair was 3.2mm and in posterolateral reconstruction was 9.4mm. In PCL reconstruction using hamstring with repair of PCL remnant was 2mm. In conclusion, to obtain the good result on posterior sta- bility, early PCL reconstruction using hamstring with repair of PCL remnant, and appropriate treatment on combined posterolateral injury were recommended.
Knee ; Knee Injuries ; Osteoarthritis ; Posterior Cruciate Ligament* ; Transplants

Myotonic dystrophy is a multisystemic disorder inherited as an autosomal dominant trait. The characteristic clinical features include the presence of myotonia, atrophy of the muscles of the face and the sternocleidomastoids and numerous nonmusclar manifestations such as cataracts, frontal baldness, gonadal dysfunctions and cardiac abnormalities. We experienced one case of myotonic dystrophy with prolonged atrial flutter in 30-year-old male who was admitted because of palpitation. We present this case with reviewing literatures.
Adult ; Alopecia ; Atrial Flutter* ; Atrophy ; Cataract ; Gonads ; Humans ; Male ; Muscles ; Myotonia ; Myotonic Dystrophy*

Eccrine porocarcinoma is a rare malignant tumor arising from the intraepidermal ductal portion of the eccrine sweat gland. Seborrheic keratosis is a common epithelial tumor in elderly patients; it is not considered to be precancerous. We report a case of eccrine porocarcinoma associated with seborrheic keratosis in a 69-year-old male. Such a case has not been reported in Korean dermatologic literature. Although reports of seborrheic keratosis transforming into a sweat gland tumor are rare in worldwide literature, the present case suggests that seborrheic keratosis may develop into malignant sweat gland tumors.
Aged ; Eccrine Porocarcinoma* ; Humans ; Keratosis, Seborrheic* ; Male ; Sweat Glands

Skin, as the outermost organ in the human body, continuously confronts the external environment and serves as a primary defense system. The protective functions of skin include UV-protection, anti-oxidant and antimicrobial functions. In addition to these protections, skin also acts as a sensory organ and the primary regulator of body temperature. Within these important functions, the epidermal permeability barrier, which controls the transcutaneous movement of water and other electrolytes, is probably the most important. This permeability barrier resides in the stratum corneum, a resilient layer composed of corneocytes and stratum corneum intercellular lipids. Since the first realization of the structural and biochemical diversities involved in the stratum corneum, a tremendous amount of work has been performed to elucidate its roles and functions in the skin, and in humans in general. The perturbation of the epidermal permeability barrier, previously speculated to be just a symptom involved in skin diseases, is currently considered to be a primary pathophysiologic factor for many skin diseases. In addition, much of the evidence provides support for the idea that various protective functions in the skin are closely related or even co-regulated. In this review, the recent achievements of skin researchers focusing on the functions of the epidermal permeability barrier and their importance in skin disease, such as atopic dermatitis and psoriasis, are introduced.
*Skin Physiology ; Skin Diseases/*metabolism/physiopathology ; Skin/*metabolism ; Permeability ; Humans ; Animals

Skin, as the outermost organ in the human body, continuously confronts the external environment and serves as a primary defense system. The protective functions of skin include UV-protection, anti-oxidant and antimicrobial functions. In addition to these protections, skin also acts as a sensory organ and the primary regulator of body temperature. Within these important functions, the epidermal permeability barrier, which controls the transcutaneous movement of water and other electrolytes, is probably the most important. This permeability barrier resides in the stratum corneum, a resilient layer composed of corneocytes and stratum corneum intercellular lipids. Since the first realization of the structural and biochemical diversities involved in the stratum corneum, a tremendous amount of work has been performed to elucidate its roles and functions in the skin, and in humans in general. The perturbation of the epidermal permeability barrier, previously speculated to be just a symptom involved in skin diseases, is currently considered to be a primary pathophysiologic factor for many skin diseases. In addition, much of the evidence provides support for the idea that various protective functions in the skin are closely related or even co-regulated. In this review, the recent achievements of skin researchers focusing on the functions of the epidermal permeability barrier and their importance in skin disease, such as atopic dermatitis and psoriasis, are introduced.
*Skin Physiology ; Skin Diseases/*metabolism/physiopathology ; Skin/*metabolism ; Permeability ; Humans ; Animals

Kommerell diverticulum is a rare congenital anomaly of the aortic arch characterized by dilation at the proximal descending aorta, which gives rise to an aberrant subclavian artery. Kommerell diverticulum is usually asymptomatic, but can also be associated with symptoms due to compression of the esophagus or trachea, and can rarely be fatal due to dissection or rupture of the diverticulum. Here, we report a rare case of dysphagia caused by compression of the esophagus by Kommerell diverticulum originating from the right-sided aortic arch.

Demineralized dentin matrix (DDM) has been used as a recombinant human bone morphogenetic protein-2 (rhBMP-2) carrier in many clinical trials. To optimize the clinical safety and efficacy of rhBMP-2 with DDM, efforts have been made to improve the delivery of rhBMP-2 by 1) lowering the administered dose, 2) localizing the protein, and 3) prolonging its retention time at the action site as well as the bone forming capacity of the carrier itself. The release profile of rhBMP-2 that is associated with endogenous BMP in dentin has been postulated according to the type of incorporation, which is attributed to the loosened interfibrillar space and nanoporous dentinal tubule pores. Physically adsorbed and modified, physically entrapped rhBMP-2 is sequentially released from the DDM surface during the early stage of implantation. As DDM degradation progresses, the loosened interfibrillar space and enlarged dentinal tubules release the entrapped rhBMP-2. Finally, the endogenous BMP in dentin is released with osteoclastic dentin resorption. According to the postulated release profile, DDM can therefore be used in a controlled manner as a sequential delivery scaffold for rhBMP-2, thus sustaining the rhBMP-2 concentration for a prolonged period due to localization. In addition, we attempted to determine how to lower the rhBMP-2 concentration to 0.2 mg/mL, which is lower than the approved 1.5 mg/mL.
Bone Morphogenetic Proteins ; Collagen ; Dentin ; Humans ; Osteoclasts

Demineralized dentin matrix (DDM) has been used as a recombinant human bone morphogenetic protein-2 (rhBMP-2) carrier in many clinical trials. To optimize the clinical safety and efficacy of rhBMP-2 with DDM, efforts have been made to improve the delivery of rhBMP-2 by 1) lowering the administered dose, 2) localizing the protein, and 3) prolonging its retention time at the action site as well as the bone forming capacity of the carrier itself. The release profile of rhBMP-2 that is associated with endogenous BMP in dentin has been postulated according to the type of incorporation, which is attributed to the loosened interfibrillar space and nanoporous dentinal tubule pores. Physically adsorbed and modified, physically entrapped rhBMP-2 is sequentially released from the DDM surface during the early stage of implantation. As DDM degradation progresses, the loosened interfibrillar space and enlarged dentinal tubules release the entrapped rhBMP-2. Finally, the endogenous BMP in dentin is released with osteoclastic dentin resorption. According to the postulated release profile, DDM can therefore be used in a controlled manner as a sequential delivery scaffold for rhBMP-2, thus sustaining the rhBMP-2 concentration for a prolonged period due to localization. In addition, we attempted to determine how to lower the rhBMP-2 concentration to 0.2 mg/mL, which is lower than the approved 1.5 mg/mL.

Mitral ring motion and indices of left ventricular diastolic filling were measured by M-mode and Doppler echocardiography in apical 4 chamber view in 11 dilated cardiomyopathy patients and 9 normal subjects without clinical evidence of heart disease. The mean age of patients was 52 years and average heart rate was 76 beats/min. The parameters of mitral annulus motion include earley relaxation amplitude(ER), late atrial contraction amplitude(AC) and A2-peak excursion(A2-PE). Transmitral flow velocity parameters include peak flow velocity of early diastolic flow velocity(PFVE), peak flow velocity of late atrial contraction(PFVA), the ratio between early and late peak flow velocity(PFVE/PFVA), Acceleration rate of early diastolic peak flow(AR), deceleration rate of early diastolic peak flow(DR), time velocity integral of early diastolic flow velocity(TVIE), time velocity integral of late atrial contraction flow velocity(TVIA) and ratio between early diastolic and late atrial flow velocity integral(TVIE/TVIA). In patients with dilated cardiomyopathy, ER(4.5+/-2.3mm) and AC(2.3+/-1.6mm) were significantly decreased than normal(10.7+/-2.6mm, 6.6+/-1.6mm, p<0.01, p<0.01, respectively), whereas ER/AC(1.7+/-0.7) was not significantly different than normal subjects(1.6+/-0.5). A2-PE(100+/-80 msec) was significantly delayed in dilated cardiomyopathy patients than normal subjects(35+/-25 msec, p<0.01). In analysis of transmitral flow velocities, PFVE, PFVA and PFVE/PFVA, etc were not significantly different compared to normal subjects in patients with dilated cardiomyopathy. Mitral ring motion amplitude was decreased and A2-peak excursion time interval(A2-PE) was delayed in patients with dilated cardiomyopathy, but transmitral flow velocities were not significantly different from normal subjects in patients with dilated cardiomyopathy. These results reflect the facts that early diastolic relaxation amplitude is decreased by the change of compliance of LV and late atrial contractin amplitude is decreased by decrease of atrial contractility and increased stiffness of LA and LV. Despite of decreased mitral ring motion, transmitral flow velocity is not significantly different compared to normal subjects in patients with dilated cardiomyopathy. From these evidences, not only transmitral flow velocity affected by multiple factors but also mitral ring motion affected by LA and LV function are considered in assessment of LV diastolic dysfuction.
Acceleration ; Blood Flow Velocity* ; Cardiomyopathy, Dilated* ; Compliance ; Deceleration ; Echocardiography, Doppler ; Heart Diseases ; Heart Rate ; Humans ; Relaxation

BACKGROUND: Among the various methods for chemical peeling, it is possible to select a wide range of peeling agents for particular patients. OBJECTIVES: The objective of present study was to investigate the effects of various chemical peeling agents on the epidermal permeability barrier of hairless mice skin and to clarify the histologic alteration in epidermal structure, thus to apply in the clinical practices. METHODS: We have applied 35% and 70% glycolic acid (GA) aqueous solutions, 30% of salicylic acid (SA) solution of PEG400, Jessner's solution and 15%, 30% and 50% of trichloroacetic acid (TCA) aqueous solution to the flank of hairless mice. TEWL (trans-epidermal water loss) values were measured before and immediately after the application and 3, 6, 12 and 24 hours following treatment. Biopsy specimens were evaluated with light and electron microscopy for epidermal structural changes. RESULTS: There were no significant changes in TEWL for the GA and SA solution treated skin, regardless of their concentration. For the TCA and Jessner's solution, TEWL increased immediately after treatment and recovered the basal levels about 90% after 24 hours for Jessner's solution and low concentrated TCA solution, but did not recovered for high concentrated TCA solution. On light and electron microscopic examination, exfoliating effect was seen in every case and as for SA and Jessner's solution treated skin, keratolysis at hair follicles was also seen. Slight epidermal necrosis was seen in every case, except in GA treated skin. CONCLUSION: The present results suggest that using topical agents such as glycolic acid can induce the change in the architecture of the epidermis without disrupting the skin barrier.
Animals ; Biopsy ; Epidermis ; Hair Follicle ; Humans ; Mice ; Mice, Hairless ; Microscopy, Electron ; Necrosis ; Permeability ; Salicylic Acid ; Skin* ; Trichloroacetic Acid