The treatment of acutely torn anterior cruciate ligament(A.C.L) remains a controversial subject. The purpose of this paper is to show the arthroscopic technique of A.C.L. primary repair with or without augmentation with semitendinosus tendon. Twenty-one patients with acute A.C.L. tear were treated with repair or augmented repair under arthroscopic control from April 1989 to August 1993. Five A.C.L. torn at femoral attachment with intact distal stump were treated with arthoscopic repair alone & 16 A.C.L. torn at substance near the femoral attachment with arthroscopic repair & augmentation with semitendinosus tendon. The patient population included of 16 males and 5 females with an average age 28.3 years. Fifteen patients injuried during sports activity. Postoperative results were evaluated by Lysholm knee score & Hospital for Special Surgery knee scale in average 26 months (range from 12 months to 64 months). All patients were rated as good or excellent result except one patient who had fair result. At follow-up study, testing with KT1000 arthrometer revealed 17 patients had less than 3mm of side to side difference. Second look arthroscopy was performed in 15 patients from 4 to 29 months after repair or augmented repair. Eleven out of these 15 A.C.L. were well healed with good tension 8r. revascularization of graft. Remaining 4 A.C.L. were healed with scar tissue. On the based of this study, arthroscopic repair or augmented repair is very effective treatment for acutely torn A.C.L. near the femoral attachment.
Anterior Cruciate Ligament ; Arthroscopy ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Knee ; Lysholm Knee Score ; Male ; Sports ; Tears ; Tendons ; Transplants

We reviewed 24 patients who had performed arthroscopic meniscal repair for the treatment off discoid lateral meniscal tear between january 1989 and December 1992. The follow up ranged from 1 year 6 month to 4 year 6 month(average 32month). The mean age was 17.9(range,8-50)years, the patients under 20 years old were 17(cases,71%).Common preoperative clinical symptom was pain on the knee joint(21 cases,87.5%) and click(19 cases,79%).Positive McMurry test was the most common physical examination finding(19 cases, 79%). All the lateral discoid meniscal tears were confirmed by arthroscopy. The mean interval between symptom onset and operation was 18.7 months(range 1 month to 10 year). The types of tear were peripheral (14cases, 58%), complex tear(4cases), longitudinal tear(2cases), transverse tear(2cases), horizontal tear(2cases)and the most common location of tear was posterior horn(1 1cases, 45%). The mean number of suture was four. In operative method, Scases(33%) were performed only meniscorrhaphy and meniscorrhaphy combined with partial meniscectomy was done in 16 cases(67%). According to Ikeuchi's grading system, the result was satisfactory in 21cases, fair in three cases. Second look arthroscopy was done in eleven cases(46%) between post operative 4 months to 2 years(mean, 8.3 months). The arthroscopic examination revealed complete healing of repaired meniscus in eight cases(73%). The remained three cases which were not completely healed was fair result.
Arthroscopy ; Follow-Up Studies ; Humans ; Knee ; Methods ; Physical Examination ; Sutures ; Tears

PURPOSE: Septic arthritis of the knee is a relative rare complication of the arthroscopic anterior cruciate ligament reconstruction, but inadequate treatment of this complication may lead to a devastating conse- quence of a chronic infection. Moreover, no guidelines have been proposed for the treatment of patients with knee infections after the anterior cruciate ligament reconstruction. To determine the optimal diagno- sis and treatment recommendation, we performed this study. MATERIALS AND METHODS: We performed retrospective study of the knee joint infections after the arthroscopic anterior cruciate ligament reconstruction between August 1993 and August 1998, Of the 420 patients who reviewed arthroscopic ACL reconstruction during this period from one surgeon, we experi- enced 4 cases(0.95%) of postoperative deep infections of the knee. RESULTS: All 4 patients were male, and the average age was 32 years(range from 19 to 43). Two patients had acute(< 2 weeks), two patients had subacute infections(2 weeks to 2 months). The acute cases had more severe symptoms, and positive cultures from knee joint aspirates. All patients underwent immediate open(1 case), or arthroscopic irrigation and debridement. One patient underwent repeat irriga- tion and debridement. The graft was removed from all patients in acute cases. CONCLUSION: The clinical symptoms, and the infected organism were more helpful than the peripheral blood counts in the diagnosis of a deep infection of the knee. Arthroscopic lavage, and debridement com- bined with intravenous antibiotics were effective treatment options. Clinical symptoms were more severe in acute cases, and early graft removal is an adequate method of surgical treatment.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Anti-Bacterial Agents ; Arthritis, Infectious* ; Debridement ; Diagnosis ; Humans ; Knee Joint ; Knee* ; Male ; Retrospective Studies ; Therapeutic Irrigation ; Transplants

PURPOSE: Residual head tilt has been reported in patients with superior oblique muscle palsy (SOP) after surgery to weaken the inferior oblique (IO) muscle. The treatments for these patients have not received appropriate attention. In this study, we evaluated the superior rectus (SR) muscle recession as a surgical treatment. METHODS: The medical records of 12 patients with SOP were retrospectively reviewed. Each of these patients had unilateral SR muscle recession for residual head tilt after IO muscle weakening due to SOP. The residual torticollis was classified into three groups on the basis of severity: mild, moderate, or severe. Both IO muscle overaction and vertical deviation, features of SOP, were evaluated in all patients. The severity of the preoperative and postoperative torticollis and vertical deviation were compared using a paired t-test and Fisher's exact test. RESULTS: The torticollis improved in nine of 12 (75%) patients after SR muscle recession. The difference between the preoperative and postoperative severity of torticollis was statistically significant (p = 0.0008). After surgery, the mean vertical deviation was significantly reduced from 12.4 prism diopters to 1.3 prism diopters (p = 0.0003). CONCLUSIONS: Unilateral SR muscle recession is an effective method to correct residual head tilt after IO muscle weakening in patients with SOP. This surgical procedure is believed to decrease head tilt by reducing the vertical deviation and thereby the compensatory head tilt.
Adolescent ; Adult ; Child ; Child, Preschool ; Diplopia/*surgery ; Female ; Head Movements ; Humans ; Infant ; Male ; Oculomotor Muscles/*surgery ; Retrospective Studies ; Strabismus/*surgery ; Torticollis/*surgery ; Treatment Outcome ; Trochlear Nerve Diseases/*surgery

PURPOSE: It is not easy to determine the cause of pulmonary consolidative lesion. Even without any definite mass, malignancy cannot be ruled out. And sometimes, it is difficult to differentiate tuberculosis from pneumonia. To differentiate malignant consolidative lesion from benign one, we studied patterns of air bronchogram, mucoid impaction, and computed tomographic anglogram etc. MATERIALS AND METHODS: Fifty seven cases of pulmonary consolidative lesions(23 cases of malignancy,34 cases of benign lesion) were retrospectively reviewed by three radiologists. RESULTS: Among the 28 cases which showed a little air bronchogram(less than 1/3 of the whole lesion in volumetric measure with the eye) 19 cases were malignancy and nine cases were benign lesions. All of the 12 cases which showed profound air bronchogram over 2/3 of the whole lesion were benign lesions. Bronchiectasis was detected in 31 cases(four of malignancy and 27 of benign lesions). Among the 20 cases which didn't show the mucoid impaction five cases were malignancy and 15 cases were benign lesions. Out of eight cases with mucoid impaction filling the long segments(branching tree shape), seven cases were malignancy and one case was benign lesion. So called CT anglogram was detected in nine cases of malignancy and two cases of benign lesions. All of nine cases of malignancy showed CT anglogram which was like arborizing tree. CONCLUSION: Scanty air bronchogram, profound arborizing mucoid impaction and/or CT angoigram within consolidative lesion could suggest malignancy.
Bronchiectasis ; Pneumonia ; Retrospective Studies ; Thorax* ; Tomography, X-Ray Computed* ; Tuberculosis

A clinical review of 212 cases of tuberculous cervical lymphadenitis during the past 6 years from January 1990 to December 1995 was made at the Department of General Surgery, Eul ji Medical College Hospital,Taejeon. The results are as follows: 1) The age of peak incidence was the 3rd decade (43.3%), and females predominated over males by 3.1 : 1. 2) The time interval from the onset of symptoms to the first visit was less than 3 months in 53.3% of the patients. 3) The location of lymphadenitis was the right neck in 59.9%, the left neck 38.7%, and bilateral in 1.4% of the patients. 4) Signs on the first visit were a mass, a cold abscess and/or a discharge. A palpable mass was the most frequent symptom (86.8%). 5) The incidence of associated pulmonary tuberculosis was 26.9%. 6) Seventy patients (33.0%) had a past history of tuberculosis. Among them, 55.7% had lymphadenitis, 28.6% pulmonary tuberculosis, and 15.7% medical problems at other sites. 7) Treatments of tuberculous cervical lymphadenitis were chemotherapy alone (68.4%) or surgical management combined with chemotherapy (31.6%). The surgical treatments included excision, incision and drainage, and neck dissection in 17.5%, 13.2%, and 0.9% of the patients, respectively. 8) The rate of recurrence was 3.1% (5 cases) for 160 cases, among them, 1.2% (2 cases) involved chemotherapy alone and 1.9% (3 cases) surgery with chemotherapy. The other 52 cases were lost from follow up.
Abscess ; Drainage ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Incidence ; Lymphadenitis* ; Male ; Neck ; Neck Dissection ; Recurrence ; Tuberculosis ; Tuberculosis, Pulmonary

Autism spectrum disorder (ASD) is a neurodevelopmental disorders that is characterized by complex behavioral phenotype and deficits in both social and cognitive functions and has been gradually increasing for the past 20 years. However, practically there are some difficulties in diagnosis and treatment due to a limited number of specialist and considerable cost. Emerging technology, especially socially assistive robotics (SAR), has expanded into the evaluation and intervention for children with ASD. SAR refers to a robot that provides assistance to the user in a social interaction setting. SAR becomes a tool that can teach or demonstrate socially desirable behaviors to help children who have trouble expressing themselves to others owing to their underdeveloped communication and social skills as a result of ASD. This paper reviews the use of SAR to assist in the therapy of children with ASD and the extent to which the robots were successful in helping the children in their social, emotional and communication deficits was investigated. The study investigates the different roles that these robots were observed to play with children with ASD by categorizing and the outcome of studies that have been conducted in Korea. Despite the fact that SAR research is still in its formative stages, if rigorous research plans are developed based on clinical usefulness and effectiveness, and if a clinician with specialized knowledge of ASD participates in or evaluates the results of the research, there is the possibility to create a new paradigm for the treatment of ASD.
Autistic Disorder* ; Child ; Autism Spectrum Disorder* ; Diagnosis ; Humans ; Interpersonal Relations ; Korea ; Mental Health Services ; Phenotype ; Robotics* ; Specialization

It is well known that anatomic variations affecting the ostiomeatal unit (OMU) become one of the causes of mucosal abnormalities of paranasal sinuses (PNS). Findings of coronal plane CT scans of PNS were analyzed in 95 patients with sinusitis or sinusitis-like complaints. Anatomical variations were seen in 88 cases of 60 patients. Mucosal abnormalities were seen in 27 of 47 cases with concha bullosa, 23 of 37 cases with enlarged ethmoid bulla, 8 of 33 cases with Agger nasi, 20 of 26 cases with nasoseptal deviation, 7 of 8 cases with Haller cell, 3 of 6 cases with duoble middle turbinate, 4 of 6 cases with medially bent uncinate process, 1 cases with laterally bent uncinate process, and 33 of 40 cases with mixed variations. Mucosal abnormalities in cases with antomical variations were detected in 61 cases, including maxillary sinus(51 cases), anterior ethmoid sinus (26 cases), frontal sinus (4 cases), and mixed (32 cases). Mucosal abnormalities without anatomical variations were detected in 13 cases involving maxillary sinuses (7 cases), anterior ethmoid sinuses (5 cases), and frontal sinus(1 cases). In conclusion, as coronal plane CT scan has the capability of dolineating anatomical variations and mucosal abnormalities of PNS, it is considered useful in evaluating the treatment and prognosis of chronic or recurrent sinusitis.
Ethmoid Sinus ; Frontal Sinus ; Humans ; Maxillary Sinus ; Meperidine ; Paranasal Sinuses ; Prognosis ; Sinusitis ; Tomography, X-Ray Computed ; Turbinates

It is well known that anatomic variations affecting the ostiomeatal unit (OMU) become one of the causes of mucosal abnormalities of paranasal sinuses (PNS). Findings of coronal plane CT scans of PNS were analyzed in 95 patients with sinusitis or sinusitis-like complaints. Anatomical variations were seen in 88 cases of 60 patients. Mucosal abnormalities were seen in 27 of 47 cases with concha bullosa, 23 of 37 cases with enlarged ethmoid bulla, 8 of 33 cases with Agger nasi, 20 of 26 cases with nasoseptal deviation, 7 of 8 cases with Haller cell, 3 of 6 cases with duoble middle turbinate, 4 of 6 cases with medially bent uncinate process, 1 cases with laterally bent uncinate process, and 33 of 40 cases with mixed variations. Mucosal abnormalities in cases with antomical variations were detected in 61 cases, including maxillary sinus(51 cases), anterior ethmoid sinus (26 cases), frontal sinus (4 cases), and mixed (32 cases). Mucosal abnormalities without anatomical variations were detected in 13 cases involving maxillary sinuses (7 cases), anterior ethmoid sinuses (5 cases), and frontal sinus(1 cases). In conclusion, as coronal plane CT scan has the capability of dolineating anatomical variations and mucosal abnormalities of PNS, it is considered useful in evaluating the treatment and prognosis of chronic or recurrent sinusitis.
Ethmoid Sinus ; Frontal Sinus ; Humans ; Maxillary Sinus ; Meperidine ; Paranasal Sinuses ; Prognosis ; Sinusitis ; Tomography, X-Ray Computed ; Turbinates

PURPOSE: We report a distinctive lesion in the articular cartilage of the talar dome in anterior bony impingement syndrome of the joint. MATERIALS AND METHODS: Arthroscopic debridement was done in 68 ankles under the diagnosis of anterior impingement syndrome of the ankle joint between October 1994 and June 1996. There were 6 tram track lesions of talar dome of the 68 ankles. We evaluated arthroscopic findings of tramtrack lesion, injury mechanism, and treatment results according to the criteria of Ogilvie-Harris DJ et al. RESULTS: All six male patients were professional or collegiate soccer players. Average age was 29 years (26 to 34). All 6 cases were dorminant ankles. Trauma history was not definite in all 6 cases. All 6 patients were anterior impingement syndrome of the ankle and treated by arthroscopic removal of osteophytes. The cartilage lesions were full thickness defects, located in the anterior half of the medial aspect of the talar dome and were longitudinal with variable widths resembling a tram track, thus named ""tram track lesion"". Tram track lesion and osteophytes were contacted by ankle dorsiflexion. Overall, good and excellent results were achieved in five patients at a mean follow up of twenty-seven months. Two cases had recurrences of osteophytes. CONCLUSIONS: Tram track lesion of talar dome occurred by repeated scratching of the osteophyte of distal tibia and treated effectively by arthroscopic removal of osteophyte and debridement.
Ankle ; Ankle Joint ; Arthroscopy ; Cartilage ; Cartilage, Articular ; Debridement ; Diagnosis ; Diphenhydramine ; Follow-Up Studies ; Humans ; Joints ; Male ; Osteophyte ; Recurrence ; Soccer ; Tibia