No abstract available.
Hallermann's Syndrome*

We designed a study to evaluate the change of the proprioceptive function with joint position sense (JPS) during 1 year follow-up period after anterior cruciate ligament (ACL) reconstruction using hamstring autograft. Thirty-eight men who underwent ACL reconstruction were tested for International Knee Documentation Committee subjective knee score, Tegner activity score, Lysholm score, KT-2000 arthrometer, isokinetic strength test, functional performance test (carioca, co-contraction, shuttle run test, one-hop test) and JPS at preoperation, 6 months, and 12 months postoperation. The contralateral healthy knee was used as control. There were no significant differences of JPS between the involved knee and healthy knee at any time period. Repeated measures analysis of variance of the active JPS revealed that there was no significant difference during the follow up periods. The change patterns of passive JPS of extension and flexion were out of accordance with the improving clinical status following ACL reconstruction. Most of the clinical parameters did not show the significant correlation with active and passive JPS at any time period. In conclusion, JPS does not reflect the change of proprioceptive function following ACL reconstruction.
Anterior Cruciate Ligament ; Anterior Cruciate Ligament Reconstruction ; Follow-Up Studies ; Humans ; Joints ; Knee ; Male ; Proprioception

No abstract available.
Tracheoesophageal Fistula*

Many complications have been reported during or after anterior cruciate ligament (ACL) reconstruction, including infection, bleeding, tibial tunnel widening, arthrofibrosis, and graft failure. However, arterial injury has been rarely reported. This paper reports a case of an anterior tibial arterial injury during bicortical tibial drilling in arthroscopic ACL reconstruction, associated with an asymptomatic occlusion of the popliteal artery. The patient had a vague pain which led to delayed diagnosis of compartment syndrome and delayed treatment with fasciotomy. All surgeons should be aware of these rare but critical complications because the results may be disastrous like muscle necrosis as in this case.
Adult ; Anterior Cruciate Ligament Reconstruction/*adverse effects ; *Compartment Syndromes ; Fasciotomy ; Humans ; *Iatrogenic Disease ; Male ; Necrosis ; *Postoperative Complications ; Republic of Korea ; Tibia/*surgery ; Tibial Arteries/*injuries

No abstract available.

A case of syndrome of inappropriate secretion of antidiuretic hormome (SIADH) associated with herpes zoster ophthalmicus is reported. A 77-year-old man was admitted for treatment of left facial pain and vesicular lesions during 7 days. On admission, physical examination revealed vesicular eruptions on the left face and on neurologic examination, he revealed an alert, well-oriented mentality. Neither sensory disturbance nor nuchal rigidity was noted. Further investigation revealed hyponatremia 115mEq/L, low serum osmolality, high urine osmolarity, high urinary sodium secretion, normal renal function, normal adrenal and thyroid function. Cerebrospinal examination revealed a pleocytosis, mild protein elevation, normal glucose. No malignant cells were present and microorganism examinations were negative. Only water restriciton was started. But he revealed confusional mentality and aggravation of hyponatremia(110m2q/L). Intravenous hypertonic saline also was started, and the patient's sensorium was improved in accordance with the increase in serum sodium concentration. In the absence of other recognized causes we suggest that the two conditions(SIADH and Herpes Zoster Infection) may have related and speculate on possible mechanisms. In this report, we postulate that the hyponatremia was due to SIADH and that SIADH was caused by the infection of varicella-zoster virus(VZV) in central nervous system.
Aged ; Central Nervous System ; Facial Pain ; Glucose ; Herpes Zoster Ophthalmicus ; Herpes Zoster* ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome ; Leukocytosis ; Muscle Rigidity ; Neurologic Examination ; Osmolar Concentration ; Physical Examination ; Sodium ; Thyroid Gland ; Water

Metamorphopsia of different types have been noted in patients with posterior cerebral artery infarction, especially when the lesion is bilateral or occipitotemporal. Micropsia (objects appearing reduced in size) is commonly due to retinal disease, which causes displacement of the receptor cells. It can be hysterical in origin, but rarely micropsia is accompanied by occipitotemporal lesion. We present here a case of micropsia due to bilateral occipital infarction after coronary angiography (CAG). A 55 year-old male had experienced cortical blindness due to cerebral infarction following CAG. Brain CT reveals poorly defined low density lesions in bilateral occipital cortices. Brain SPECT shows perfusion defect in both occipital lobes with markedly decreased perfusion in left temporal area. Two weeks later, as he regains visual acuity, he complains of micropsia, I.e., his hands and fingers look small and the people outside the window looks very small like ants. This perverted visual illusion lasts about 15 days.
Ants ; Blindness, Cortical ; Brain ; Cerebral Infarction ; Coronary Angiography* ; Fingers ; Hand ; Humans ; Illusions ; Infarction* ; Infarction, Posterior Cerebral Artery ; Male ; Middle Aged ; Occipital Lobe ; Perfusion ; Retinal Diseases ; Tomography, Emission-Computed, Single-Photon ; Vision Disorders* ; Visual Acuity

OBJECTIVE: Using immersive virtual environment technique, we aimed to preliminarily examine whether nicotine affects the interpersonal distance, as the size of personal space, in schizophrenic patients, which have extraordinarily high smoking rate. METHOD: Ten male schizophrenic patients who were at least moderate current smokers smoked a high (0.9 mg nicotine as an active drug) or low (0.1 mg nicotine as a placebo) nicotine-yielding cigarette after overnight-abstinence in randomized, double blind, cross-over design. Following the smoking session, subjects performed the 'self-introduction task' in virtual environment by introducing themselves consecutively to six different avatars, which varied in gender and facial/verbal expressions (neutral, angry, and happy). In the tasks, subjects were asked to step forward to each avatar until they felt most comfortable to greet the avatar first. The distance was measured by the head-tracking device, which was transmitting real-time data to the computer. Affective valence and arousal to each avatar were also rated by subjects following the tasks. RESULTS: The overall interpersonal distance of the drug group was significantly greater than that of placebo group (Z = -2.93, p = 0.022). The distances with emotionally neutral avatars (male/female) of the six were significantly different between the two groups (Z = -2.19, p = 0.028 ; Z = -2.09, p = 0.037). Within-group analysis revealed a significant difference among the distances with the six avatars in the placebo group (x2 = 17.03, df = 5, p = 0.004), but there was no significant within-group difference in the drug group (x2 = 6.11, df = 5, p = 0.295). CONCLUSION: These preliminary findings suggest that nicotine may increase the size of personal space of schizophrenic patients probably by enhancing the social stimuli perception through affecting the patients' cognitive function.
Female ; Male ; Humans

Pacemaker implantation for patients with mechanical tricuspid valve is quite challengeable because lead insertion through prosthetic tricuspid valve may cause valve dysfunction or lead impingement. Also complications due to interrupt of anticoagulation should be considered. A 65 years old woman received AAI (atrium paced, atrium sensed, inhibited) pacemaker for sick sinus syndrome and mechanical mitral valve replacement for severe mitral steno-insufficiency at the same time 16 years before. She needed to undergo mechanical tricuspid valve replacement (TVR) because of severe tricuspid regurgitation despite of medical therapy. Complete atrioventricular block developed during the TVR operation and it was not recovered even after several days of temporary pacing. We decided left ventricular pacing through coronary sinus because ventricular lead could not pass mechanical tricuspid or mitral valve and also planned to continue oral anticoagulation therapy. We could find a place where high pacing output did not pace phrenic nerve with acceptable sensing, pacing threshold. The patient recovered well without any periprocedural complications. Left ventriclcular pacing lead implantation through coronary sinus without interruption of anticoagulation can be an alternative to epicardial pacing for patients with mechanical tricuspid valve.
Atrioventricular Block ; Coronary Sinus ; Female ; Humans ; Mitral Valve ; Phrenic Nerve ; Sick Sinus Syndrome ; Tricuspid Valve Insufficiency ; Tricuspid Valve*

PURPOSE: We assessed the impact of pelvic lymphadenectomy on the survival of patients who had undergone radical cystectomy. MATERIALS AND METHODS: We retrospectively reviewed 107 patients who underwent radical cystectomy for transitional cell carcinoma of the bladder between January 1991 and December 2000. We preoperatively excluded patients with evidence of pelvic lymphadenopathy and distant metastases from the study. Among 107 patients, 61 patients (Group A) underwent pelvic lymphadenectomy while 46 patients (Group B) did not. The clinicopathological parameters were not significantly different in the two groups. RESULTS: In group A, 12 patients (19.6%) were found to have pelvic node metastases. Five-year overall survival and recurrence-free survival rates were 68% and 75% for Group A, respectively. In group B, 5-year overall survival and recurrence-free survival rates were 36% and 56%, respectively. Multivariate analysis revealed that T stage (p=0.004) and lymphadenectomy (p=0.044) were significant prognostic factors for survival. CONCLUSIONS: The overall survival rates between the two groups were significantly different. Our findings suggested that lymphadenectomy may improve the prognosis of patients who underwent radical cystectomy for transitional cell carcinoma of the bladder.
Carcinoma, Transitional Cell* ; Cystectomy* ; Humans ; Lymph Node Excision* ; Lymphatic Diseases ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Survival Rate ; Urinary Bladder Neoplasms ; Urinary Bladder*