The significance of the posterior cruciate ligament (PCL) in the stability of the knee and the necessity for surgical repair of its tears are still controversial. The purpose of this study is to present the short term results of surgical repair and Kennedy LAD augmentation for 15 cases with PCL injury. In 14 patients (15 knees), the torn PCL was repaired with pullout suture technique and Kennedy LAD augmentation was done from june 1993 to june 1994. The follow-up period ranged from 12 months to 25 months (average, 18months). The main causes of injuries were traffic accidents in 12. Thirteen of the patients were men and one was a woman, ranging in age from 17 to 52 years(average, 35 years). 10 knees were acute injury and repaired at average 9 days after injury. There were 11 cases that had combined injuries(4 ACL injuries, 4 meniscus injuries, 3 MCL injuries etc). In eight knees, the tear was in mid substance area and in five it was near femoral attach site and in two it was near tibial attach site. Postoperative results were evaluated by roentgenographic evaluation of posterior sagging and Lysholm knee score. 11 knee were stable but 4 knees were unstable posteriorly during postoperative follow-up period. 3 chronic injuried knees were included in 4 posteriorly unstable knees. There are 7 combined knee injuries in 11 stable knees and no combined injuries in unstable knees and average Lysholm knee score was 89.7 in stable knees and 90 in unstable knees and there was no significant difference between two groups. On the based of this study, surgical repair with pollout suture technique and augmentation with Kennedy LAD in acute PCL injury is a one of the good method for preventing posterior sagging but more longer follow-up period and more cases must be needed to accept this method.
Accidents, Traffic ; Female ; Follow-Up Studies ; Humans ; Knee ; Knee Injuries ; Lysholm Knee Score ; Male ; Methods ; Posterior Cruciate Ligament ; Suture Techniques ; Tears

Pigmented villonodular synovitis and synovial chondromatosis are known as a poup of interrelated tumorous disorders that involve the lining of the joints, hursa and tendon sheath. Pigmented villonodular synovitis consists of proliferatin synovia1 tissue containing histiocytes, librohlasts, multinucleated giant cells, and capillaries that can destroy dense fihrous tissue, form soft tissue masses, and invade bone. Synovial chondromatosis consists of hyaline cartilage nodules within the synovium and synovial joint cavities, develop multiple loose fragments of cartilage within the joint. They may represent a reactive inflammatory process or henign neoplasm and usually occur in latge synovial joints, including the knee, hip and ankle. There are some reports stating that pigmented villonodular synovitis has coexisted with synovial chondromatosis. but none have reported that they occurred simultaneously in a large single joint. This is a report on a diagnosed and arthroscopicully treated pigmented villonodular synovitis and synovial chondromatosis that occurred simultaneously in the same ankle joint.
Ankle Joint* ; Ankle* ; Capillaries ; Cartilage ; Chondromatosis, Synovial* ; Giant Cells ; Hip ; Histiocytes ; Hyaline Cartilage ; Joints ; Knee ; Synovial Membrane ; Synovitis, Pigmented Villonodular* ; Tendons

There have been many reports to date regarding the role of GnRH as a local regulatory factor of ovarian function as studies of human and rat ovaries revealed GnRH and its receptor. In recent studies it has been shown that GnRH directly causes apoptosis in the granulosa cells of the rat ovary, and such results leads to the suggestion that the use of GnRH agonist for more stable long term ovarian hyperstimulation in human IVF-ET programs causes granulosa cell apoptosis which may lead to follicular atresia. Therefore this study attempts to determine if granulosa-luteal cell apoptosis occurs in patients during IVF-ET programs in which GnRH agonist is employed for ovarian hyperstimulation. The quality of oocyte-cumulus complexes obtained during ovum pickup procedures were assessed morphologically and then the fertilization rate and developmental rate was determined. Apoptotic cells among the granulosa-luteal cells obtained during the same procedure were observed after staining with Hematoxylin-rosin. The fragmentation degree of DNA extracted from granulosa-luteal cells was determined and comparatively analyzed. There was no difference in the average age of the patients, the number of oocytes retrieved, and fertilization and developmental rates between the FSH/hMG group and GnRH-long group. There was also no difference in the apoptosis rate and pyknosis rate in the granulosa-luteal cells between the two groups. However, when the oocyte-cumulus complexes were morphoogically divided into the healthy group and atretic group without regard for the method of hyperstimulation, the results showed that the number of oocytes obtained averaged 11.09+/-8.75 and 10.33+/-4.53 per cycle, respectively, showing no significant difference, but the fertilization rate (77.05%, 56.99%, respectively, p<0.01) and developmental ,ate (65.96%, 41.51%, respectively, p<0.01) was significantly increased in the healthy group when compared to the atretic group. The degree of apoptosis in the granulosa-luteal cells showed that in the healthy group it was 2.25% which was not significantly different from the atretic group (2.77%), but the pyknosis rate in the atretic group (27.81%) was significantly higher compared to the healthy group (11.35%, p<0.01). The quantity of DNA fragmentation in the FSH/hMG group was 32.22%, while in the GnRH-long group it was 34.27%, showing no significant difference. On the other hand the degree of DNA fragmentation was 39.05% and 11.83% in the healthy group and atretic group, respectively, showing significantly higher increase in the atretic group (p<0.01). The above results suggest that death of granulosa-luteal cells according to the state of the oocyte-cumulus complex is more related to pyknosis rather than apoptosis. Also, the GnRH agonist used in ovarian hyperstimulation does not seem to directly affect the apoptosis of retrieved oocytes and granulosa-luteal cells, and which is thought to be due to the suppression of the apoptogenic effect of GnRH agonist as a result of the high doses of FSH administered.
Animals ; Apoptosis* ; DNA ; DNA Fragmentation ; Female ; Fertilization ; Follicular Atresia ; Gonadotropin-Releasing Hormone* ; Granulosa Cells ; Hand ; Humans* ; Luteal Cells ; Oocytes ; Ovary ; Ovum ; Rats

Hydroxyapatite particle(HA) impregnated polymethylmethacrylate(PMMA) bone cement was fabricated in order to induce bony tissue ingrowth into the pores left behind by the resorption of the HA. The amount of HA was 0, 10, and 30% by weight. After mixing the HA with bone cement it was cast in a 4mm inside diameter glass under(10mm long). Each specimen was cut into half and used for in vitro and in vivo experiment. Diametral and compressive mechanical test were made to evaluate it's mechanical properties. SEM(scanning electron microscope) and ESCA(electron spectroscopy for chemical analysis) were used to evaluate the surface characteristics of the specimen. Push-out test and histologic studies were made after implanting the specimens for 6 weeks in the distal portion of rabbit femur. The mechanical test results show that the average flexural and diametral strength decreased linearly with the increased amount of HA significant(p < 0.05). The SEM and qualitative analysis using ESCA of the implant specimens showed no definite exposure of HA particles due to PMMA covering the surface. The surface of the implanted specimens were ground for histologic comparative analysis and the halves of each sample were decalcified. The interfacial shear strength of the implanted specimens showed significant increases in the 30% HA specimens compared with the 0% ones but the 10% specimens did not show any difference. However, there was also no statistically significant(p>0.05) difference between nondecalcified and decalcified specimens in each 10% and 30%, although the latter showed higher interfacial shear strength. Histologic observation showed little evidence of bone ingrowth into HA, but not remarkable. In conclusion, this study could not confirm the earlier results of the bone particle impregnated bone cement without surface grinding since the HA particles were not exposed at the surface by casting it into a glass tube.
Durapatite ; Femur ; Glass ; In Vitro Techniques ; Polymethyl Methacrylate ; Shear Strength ; Spectrum Analysis

Atrial flutter, a common rhythm disturbance, was first described over 80 years ago. Despite extensive investigations, several important issues remain unresolved concerning its exact mechanism and management. Present therapeutic strategies often appear effective to prevent and terminate atrial flutter. However, controlled trial and definitive studies comparing the various treatment options are surprisingly scarce. Here we report on a study of 9 episodes of spontaneous atrial flutter(AF)(flutter wave cycle length 224+/-39 msec) treatedd by transesophageal atrial pacing(TAP) in 9 patients(7 men and 2 women; mean age 56.9 yrs). TAP was effective in 5 patients : sinus rhythm resumption was immediate in 3 patients and followed a short period of atrial fibrillation in 2 patients. TAP was unsuccessful in 4 patients. All the patients tolerated the procedure well. These data strongly support the immediate first choice use of TAP in AF therapy.
Atrial Fibrillation ; Atrial Flutter* ; Female ; Humans ; Male

PURPOSE: The p16(INK4A) gene encodes a specific inhibitor of cell cycle progression. In recent years, genetic deletion and altered expression of p16(INK4A) gene were frequently showed in many human cancers. So, the p16(INK4A) gene is considered as tumor suppressor gene. However, there has been a few data for the p16(INK4A) in gastric cancer, colon cancer, and hepatoma.So.we investigated the genetic deldtion and altered expression of p16(INK4A) in gastric cancer, colon cancer and hepatoma cell lines. MATERIALS AND METHODS: The homozygous deletion of p16(INK4A) was examined by using PCR and the protein expression of p16(INK4A) by using Western blotting in cancer cell lines established from Korean patients: stomach cancer, colon cancer and hepatoma cell lines. RESULTS: Homozygous deletion of p16(INK4A) was detected only 1 stomach cancer cell line out of 13 cell lines examined. The p16(INK4A) was detected in 3 of 13 cancer cell line. These results showed the low frequency of p16(INK4A) homozygous deletion and high frequency of p16(INK4A) expression alteration in stomach cancer, colon cancer and hepatoma cell lines. CONCLUSION: In this study, it may be suggested that the altered pl6(INK4A) expression as well as p16(INK4A) gene deletion play important role in oncogenesis. Further studies to determine the mechanism of p16(INK4A) gene inactivation are expected.
Blotting, Western ; Carcinogenesis ; Carcinoma, Hepatocellular* ; Cell Cycle ; Cell Line* ; Colon* ; Colonic Neoplasms* ; Cyclin-Dependent Kinase Inhibitor p16 ; Gene Deletion ; Gene Silencing ; Genes, Tumor Suppressor ; Humans ; Polymerase Chain Reaction ; Stomach Neoplasms* ; Stomach*

BACKGROUND: In the present study, we aimed to compare clinical and radiographic outcomes between hook plate fixation and coracoclavicular (CC) ligament reconstruction for the treatment of acute unstable acromioclavicular (AC) joint dislocation. METHODS: Forty-two patients who underwent surgery for an unstable acute dislocation of the AC joint were included. We divided them into two groups according to the treatment modality: internal fixation with a hook plate (group I, 24 cases) or CC ligament reconstruction (group II, 18 cases). We evaluated the clinical outcomes using a visual analog scale (VAS) for pain and Constant-Murley score, and assessed the radiographic outcomes based on the reduction and loss of CC distance on preoperative, postoperative, and final follow-up plain radiographs. RESULTS: The mean VAS scores at the final follow-up were 1.6 +/- 1.5 and 1.3 +/- 1.3 in groups I and II, respectively, which were not significantly different. The mean Constant-Murley scores were 90.2 +/- 9.9 and 89.2 +/- 3.5 in groups I and II, respectively, which were also not significantly different. The AC joints were well reduced in both groups, whereas CC distance improved from a mean of 215.7% +/- 50.9% preoperatively to 106.1% +/- 10.2% at the final follow-up in group I, and from 239.9% +/- 59.2% preoperatively to 133.6% +/- 36.7% at the final follow-up in group II. The improvement in group I was significantly superior to that in group II (p < 0.001). Furthermore, subluxation was not observed in any case in group I, but was noted in six cases (33%) in group II. Erosions of the acromion undersurface were observed in 9 cases in group I. CONCLUSIONS: In cases of acute unstable AC joint dislocation, hook plate fixation and CC ligament reconstruction yield comparable satisfactory clinical outcomes. However, radiographic outcomes based on the maintenance of reduction indicate that hook plate fixation is a better treatment option.
Acromioclavicular Joint/injuries/radiography/*surgery ; Acute Disease ; Adult ; Arthroscopy ; Bone Plates ; Dislocations/radiography/*surgery ; Female ; Humans ; Ligaments, Articular/surgery ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

BACKGROUND: To specify what patients want and worry preoperatively is important in orthopedic practice. The aim of the current study was to analyze the patient characteristics of rotator cuff disease in Korean population who were willing to undergo arthroscopic surgery, and to evaluate the differences in expectations and concerns by age and gender. METHODS: We prospectively enrolled 303 patients who underwent rotator cuff surgery between April 2004 and August 2008. Three questionnaires were completed before surgery: the first one addressing preoperative patient's expectation, the second one focusing on concerns by covering 64 items using a visual analogue scale, and the third one evaluating patient's demographic characteristics. The characteristics of preoperative expectation, concern, and demographic data were evaluated according to gender and age group. RESULTS: Female patients had lower level of sports activity (p = 0.007) and lower levels of information (p = 0.028). Gender specific worries are about a caregiver during hospital stay, operating on the working side, fear about ugly scars, postoperative pain, applying makeup or combing hair. The older group responded that they can't be willing to change activities of daily living (p = 0.001), are not living with a spouse (p = 0.002), had previous shoulder operation history (p = 0.008), and had a lower level of information (p = 0.007). They especially worried about medical bills, worried about the physician being too young and inexperienced, postoperative pain, loss of arm function, and hospital food. CONCLUSIONS: Our data showed what Korean patients wanted and were concerned about prior to rotator cuff surgery. This can empower patients to formulate realistic expectations and make informed decisions. We feel that we can achieve higher levels of postoperative satisfaction by analyzing expectations and concerns in depth and addressing these proactively.
Activities of Daily Living/psychology ; Adult ; Aged ; Aged, 80 and over ; Arthroscopy/*psychology ; Female ; Humans ; Joint Diseases/surgery ; Male ; Middle Aged ; *Patient Satisfaction ; Perioperative Period/*psychology ; Prospective Studies ; Questionnaires ; Republic of Korea ; Rotator Cuff/*surgery ; Shoulder/surgery ; Shoulder Pain/etiology/psychology ; Stress, Psychological/etiology/psychology

PURPOSE: To compare retrospectively the antegrade and retrograde nailing in the management of ipsilateral femoral neck and shaft fractures. MATERIALS AND METHODS: Thirty-two patients (thirty-three injuries) were included in this study. Mean age of patients was 38 years-old in the antegrade nailing group (16 injuries) and 44 years-old in the retrograde nailing group (17 injuries). We compared the union of fractures and complications between two groups, and investigated the influencing factors. RESULTS: Femoral shaft fracture was united in 10 cases (63%) of antegrade group and 12 cases (71%) of retrograde group, at 28.2 and 27.3 weeks respectively. Nonunion was more prevalent in Winquist-Hansen III and IV (5 in antegrade nailing, 3 in retrograde nailing) than I and II. Femoral neck fracture was united with 1 case of nonunion in each group. Nonunion developed from Garden stage IV, but fractures of Garden stage I and II united regardless of methods. CONCLUSION: In ipsilateral femoral neck and shaft fractures, the kinds of methods did not affect the results of shaft fractures. Minimally displaced neck fractures also were not influenced by kinds of methods, but retrograde nailing may have a benefit in fixing the displaced neck fractures
Agriculture ; Femoral Neck Fractures ; Femur Neck ; Humans ; Methods* ; Neck* ; Retrospective Studies

Malignant lymphomas of the female genital tract are rare. When it involves the female genital tract, information in the literature regarding the classification, treatment and diagnosis of malignant lymphoma are few. Non-Hodgkin lymphomas (NHL) of the female genital tract occurs primarily in the ovary (49%), uterus (11%), vagina (7%), and vulva (4%). The vulva as the primary location is a very rare occurrence. However, autopsy studies have shown that about 40% of women who die of non-Hodgkin's lymphoma had involvement of the uterus or ovaries. There have been many cases of high-stage lymphomas presenting as secondary involvement of the female genital tract, but when the primary involvement site is the vulva, the stage of lymphoma was most commonly stage IE or IIE. Therefore, physicians should keep in mind the possibility of the presence of a malignant neoplasm when the suspected Bartholin's gland tumor does not respond to treatment. The authors propose that thorough gynecological evaluation should be conducted as a routine screening method in female patients with suspected lymphoma. We represent a case of primary non-Hodgkin's lymphoma patient who was relatively young in age and who was consequently determined to be of a high stage.
Autopsy ; Classification ; Diagnosis ; Female ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Mass Screening ; Ovary ; Uterus ; Vagina ; Vulva*