The purpose of this study is to morphologically evaluate the results of arthroscopic meniscal repair by sec- ond-look arthroscopy. We performed the arthroscopic meniscal repair in 40 menisci of 39 knees between March 1994 and August 1997. Among them, 18 menisci of 17 knees were evaluated by second-look arthroscopy at 3 rnonths postoperatively. Lateral meniscus was 9 and medial meniscus was 9. The morpho- logical results were classified with completely healed, incompletely healed, and failed. The overall results showed that 13 menisci completely healed, 3 menisci incompletely healed, 2 menisci failed. The type of tear was 14 peripheral longitudinal tears, 1 oblique tear(incompletely healed), 1 transverse tear(completely healed with augmentation of fibrin clot), 1 tear at posterior tibial attachment, and 1 complex tear(completely healed). 3 menisci had associated lesions that had not been treated, of which 1 incompletely healed, 2 failed. Chronic cases, in which time interval between injury and repair was 6 weeks later, were 8 menisci(4 completely healed, 2 incompletely healed, and 2 failed). 10 long peripheral longitudinal tears of more fhan 2.5cm were resulted in 6 completely healed, 2 incompletely healed, and 2 failed. 5 longitudinal tear with a wide peripher- al rim(>2mm) were resulted in 1 completely healed, 2 incompletely healed, and 2 failed. The good result was expected when the tear was repaired in acute phase after injury and associated lesion was treated. For chronic tears, tears of avascular zone and wide longitudinal tears, the healing enhancement techniques such as fibrin clot insertion, abrasion of meniscus and synovium, and trephination must be taken into consideration.
Arthroscopy* ; Fibrin ; Knee ; Logic ; Menisci, Tibial ; Synovial Membrane ; Trephining

No abstract available.
Fluoroimmunoassay* ; Immunoenzyme Techniques*

Rheumatoid arthritis is considered to be a collagen disease which mainly involves articular structures, sometimes has extraarticular manifestations. It is generally accepted now that periarticular osteoporosis develops in early phase of rheumatoid arthritis and generalized osteoporosis in late period. Of several methods of non-invasive measurement of bone mass, single photon absorptiometry was introduced by Cameron and Sorenson(1963) and it has been used for measuring bone mass by many authors with its precision, reproducibility and objective quantification. We tried to observe the quantitative changes of bone mass in rheumatoid arthritis patients with single photon absorptiometry technique. Through the study of bone densitometry in 30 rheumatoid arthritic women compared with age-matched 60 healthy controls, we obtained follow results. 1. Bone mineral density of the rheumatoid arthritis group was lower than that of the control group, but had no significant statistical difference. 2. Bone mineral density of the 40–49-year-old group and 50–59-year-old group was considerablely different in the rheumatoid arthritis group and control group. 3. Bone mineral density of the group whose rheumatoid arthritis history was over 2 year was lower than that of the group below 2 year.
Absorptiometry, Photon ; Arthritis, Rheumatoid ; Bone Density ; Collagen Diseases ; Densitometry ; Female ; Humans ; Osteoporosis

Calcaneus is the largest tarsal bone and serves weight bearing of the body. The calcaneus has a pattern of cancellous bone enclosed with a very thin cortical shell. It is difficult to reduce the bony fragments accurately when there are comminution and displacement on the calcaneal fractures. Retrospective study was carried out of 18 patients(21 feet) of calcaneus fractures after axial fixation in Soonchunhyang University Hospital from July, 1982 to July, 1988. Minimum follow up period was 8 months(average 2 years 6 months). The clinical analysis of them are reported with a review of the literature and the results are follows:l. According to the Rowe's unit system, the results of treatment were excellent or good in 9 cases of 13 tongue types and 5 cases of 8 joint depression types. 2. The results were satisfactory in the calcaneal fractures of well reestablished Bohler angle to 21-30 degrees. 3. The results were excellent or good in 5 cases operated within post-trauma 1 week and in 9 cases operated from 1 week to 2 weeks. 4. The results were poor in the 2 joint depression type with severe comminution. And subtalar joint fusion was performed on the previous 2 cases. Then pain on the lateral malleolar area was subsided.
Calcaneus ; Depression ; Follow-Up Studies ; Joints ; Retrospective Studies ; Subtalar Joint ; Tarsal Bones ; Tongue ; Weight-Bearing

No abstract available.
Pregnancy*

An 18-Year-old male hemophiliac with high titer of factorVIII inhibitor, stage V hemophilic arthropathy in right knee joint and a history of hematuria and retroperitoneal hemorrhage was admitted because of acute and massive bleeding of epistaxis, pulmonary hemorrhage and intestinal bleeding. The bleeing was not controolled by massive infusion of factorVIII concentrates but by prothrombin complex concentrates and high dose of factorVIII concentrates. He showned symptoms of sustained fever and diffuse pulmonary infiltration which was diagnosed as pulmonary hemosiderosis by MRI. We suppressed his immune reaction by prednisolne to prevent the formation of factorVIII inhibitor. He has been followed up for 3 years and shown no massive bleeding there-after.
Adolescent ; Epistaxis ; Fever ; Hematuria ; Hemophilia A* ; Hemorrhage ; Hemosiderosis* ; Humans ; Knee Joint ; Magnetic Resonance Imaging ; Male ; Prothrombin

BACKGROUND: It is well known that intracoronary thrombolysis during the early period of acute myocardial infarction leads to the limitation of myocardial necrosis, preserves left ventricular function, and improves survivals. The recanalization rate of intracoronary rrokinase infusion into infarct-related coronary artery was known as 62-94 percents in previos studies. The various factors influence the outcome of intracoronary thrombolysis, including total dose of urokinase, time from onsrt of chest pain to thrombolysis. The purpose of this study was to evaluate whether the occlusion site morphology influences recanalization rates of intracoronary thrombolysis. METHODS: We evaluated infarct-related coronary artery morphology of 56 acute mycardial infarction patients who performed intracoronary thrombolytic therapy within 6-12 hours after the onset of acute myocardial infarction. Intracoronary urokinase infusion was performed at a rate of 25000 IU/minute. The presence of calcification, collaterals, side branches and the stump site morphologies(thrombus type, pencil type, cutting type) were identified on magnified 35mm cine frames. RESULTS: Reperfusion was successed in 34 patients and failed in 22 patients. There were no statistically significant difference in the pressure of calcification, collaterals, and side branches between success and failure groups. Intracoronary thrombus was identified in 21 percent of success group, but not in failure group. The reperfusion rates according to stump site morphology were 76% in thrombus type, 58% in cutting type, and 42% in pencil type(p<0.05). CONCLUSION: Our study indicates the presence of intracoronary thrombus and the morphology of thrombus type is more effective in intracoronary thrombolysis in acute myocardial infarction. The identification of types of the coronary obstruction will be helpful for the selection of intracoronary thrombolysis in acute myocardial infarction patients. And the results suggest that the difference of stump composition show different stump morphologies.
Chest Pain ; Coronary Vessels* ; Humans ; Infarction ; Myocardial Infarction* ; Necrosis ; Reperfusion ; Thrombolytic Therapy ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Ventricular Function, Left

A 69-year-old-male patient was admitted because of left upper quadrant (LUQ) abdominal pain He had hard palpable mass (abaut 15x l0cm) in LUQ abdomen and mild elevated serum alkaline phosphatase (349 IU/L) and amylase (216 U/L) levels at the admission time. Abdominal CT scan revealed huge, well-marginated cystic mass in enlarged spleen with increased densities in dependent portion of cystic mass, about 8x13cm in size. Another small well-capsulated. cystic mass in anterior aspect of spleen was also seen. After ERCP, urgent surgical intervention was done. Final diagnosis was chronic pancreatitis with large intrasplenic (l2x9.5 cm) and retroperitoneal pseudocysts. So we are reporting above case with pertinent review of literatures.
Abdomen ; Abdominal Pain ; Alkaline Phosphatase ; Amylases ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Humans ; Pancreatitis, Chronic* ; Spleen ; Splenomegaly ; Tomography, X-Ray Computed

BACKGROUND: Confluent and reticulate papillomatosis(CRP) of Gougerot and Carteaud is an uncommon disorder of unknown cause for which a variety of treatments have been proposed. OBJECTIVE: We attempted to evaluate the therapeutic effect of oral minocycline for CRP. METHOD: Nine patients(age range, 14 to 38; mean age, 21years) with CRP were included in this study. They took minocycline 100mg daily. The therapeutic effect was evaluated weekly by 5 scoring systems according to the percentage clearing of the skin lesion: poor (score 1), <25% clearing; fair (score 2), 26-50%; good (score 3), 51-75%; excellent (score 4), 76-95%, clear(score 5), >95%. RESULTS: Two out of 9 patients showed complete clearing(score 5) of the skin lesions within 2 weeks. Seven patients revealed incomplete clearing(score 4) within 3 to 8 weeks. The mean scoring for 9 CRP patients was 4.2. Recurrences were noted in two patients at 24 and 26 months, respectively, but they responded to re-treatment with minocycline. The patients did not show any adverse reactions apart from two patients who developed mild pruritus. CONCLUSION: We recommend minocycline as the first choice of treatment for CRP because minocycline is safe, economic and effective.
Humans ; Minocycline* ; Papilloma* ; Pruritus ; Recurrence ; Skin

Pressure sores are common complications in patients with spinal injuries or cerebrovascular accidents. The management of pressure sores requires prolonged hospitalization and repeated surgical interventions with a high recurrence rate. Particularly osteomyelitis following initial pressure sores persistently complicates wound healing and recovery. Furthermore, it may also ultimately result in serious sepsis; thus an early diagnosis of osteomyelitis in pressure sore patients is crucial along with appropriate surgical and antibiotic therapy. Although many diagnostic methods were reported, there is no single 'gold' standard for early diagnosis of pressure sore-associated osteomyelitis. Authors reviewed pre-operative CBC, plain X-ray, Tc-99m bone scan, and post-operative biopsy results in 37 patients who had received surgical treatment for pressure sores in a 5-year period from September 1991 to August 1996. Based on these reviews, authors compared and analyzed the sensitivity and specificity in diagnosing osteomyelitis.The results were as follows: 1. Of 37 patients studied, 25 cases were confirmed histologically as osteomyelitis. Ischial region revealed the highest incidence of pressure sore-related osteomyelitis(78%, 14 out of 18 cases) while the regional incidence was as following in descending order : ischial, sacral, and greater trochanteric area. 2. Tc-99m bone scan had superior sensitivity(100%) and specificity(83%) to other pre-operative studies in diagnosing osteomyelitis.In conclusion, authors suggest that Tc-99m bone scan is the best diagnostic method because of its high sensitivity and specificity if osteomyelitis is clinically suspected in pressure sore patients. And in case the test result is positive, agressive surgical bone resection and appropriate antibiotic therapy based on bacterial culture from deep bone specimen should be combined to prevent complications or recurrences.
Biopsy ; Early Diagnosis ; Femur ; Hospitalization ; Humans ; Incidence ; Osteomyelitis ; Pressure Ulcer* ; Recurrence ; Sensitivity and Specificity ; Sepsis ; Spinal Injuries ; Stroke ; Wound Healing