Rupture of the anterior cruciate ligament is a serious injury that can cause severe degenerative change if untreated, and there are many controversies in its treatment. The authors experienced 126 patients of the anterior cruciate ligament rupture in the Department of Orthpaedic Surgery, Chung-Ang university from May 1985 to December 1992. Among them, we performed 36 anterior cruciate ligament reconstructions using bone-patellar tendon-bone autograft reinforced with Trevira ligament, an assumption that the artificial ligament acts as an internal splint during the vulnerable period of healing. Bone-patellar tendon-bone autograft was passed through the transosseous hole in the tibia, then across the knee and through the isometric path of lateral femoral condyle through a bone tunnel. Thereafter, the Trevira ligament was passed through the same tibial tunnel, but over the top route to the lateral femoral condyle. Of the 36 cases, 28patients (Group I: 15 cases of Mini-arthrotomy,Group II: 13 cases of Arthroscopic technique) with average follow up of 23.5 months (minimum 12 months, maximum 40 months) were analyzed. According to the Mullers criteria, the result were excellent in 12 cases (Group I: 5 cases; Group II: 7 cases), good in 14 cases(Group I: 9 cases ; Group II: 5 cases and fair in 2 cases (Group I: 1 case; Group II: 1 case). On stress roentgenograms by Telos arthrometer, the average difference of anterior displacement between the injured and normal sides were decreased to 2.3mm from average 9.1mm preoperatively (Group I: from 9.3mm to 2.6mm; Group II: from 8.8mm to 2.1mm). And subjectively, there was no difference between the injured and normal sides in 8 cases (Group I: 4 cases, Gruop II: 4 cases).
Anterior Cruciate Ligament ; Autografts ; Follow-Up Studies ; Humans ; Knee ; Ligaments ; Patellar Ligament ; Rupture ; Splints ; Tibia

There are many options for the management of osteoarthritis of the knee joint. Recently, arthroscopic surgery has been added to the armamentorium of the treatment modalities in osteoarthritis of the knee which does not respond to conservative treatment. Among 74 arthroscopic pocedures(including partial menisectomy, removal of loose bodies, synovectomy, cartilage drilling and simple lavage) done for osteoarthritis of the knee, 68 patients studied at average 3.1 years after procedure and the results were as follows 1. Seventy-one percent of patients had at least 2.5 years or more relief of pain and symptoms. 2. Fifty-six percent were still good at follow-up of 3.1 years. 3. The best result were obtained after removal of loose bodies and resection of unstable flap tear of a meniscus in association with mild osteoarthritis. 4. The poor result were obtained in patients with severe degenerative changes of both femoral condyle, 5. The results were much better in the normally aligned knee compared with valgus knee.
Arthroscopy ; Cartilage ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Osteoarthritis ; Tears

Transforming growth factor-beta (TGF-beta) has been suspected as a possible gene therapy candidate for orthopedic diseases. We demonstrated that the TGF-beta gene therapy can be applicable to orthopedic patients. After transfection of TGF-beta cDNA sequence to myoblasts [C2 (280)] and fibroblasts (NIH 3T3), stable cell lines with TGF-beta mRNA expression were selected by Northern analysis. To evaluate the possibility of clinical application of these cells to orthopedic diseases, the cells were injected into rabbit achilles tendon. Intratendinous injection was done to evaluate the viability of the cells and to determine the optimal concentration for in vivo expression. At 6 weeks after injection, the injected tendon was thickened with newly formed collagen. The results from this experiment indicates that these cells survived and stimulated matrix formation in rabbit achilles tendon. We concluded that TGF-beta cDNA transfected cells can be useful in the evaluation of TGF-beta biology in vivo.
Achilles Tendon* ; Biology ; Cell Line* ; Collagen ; DNA, Complementary ; Fibroblasts* ; Genetic Therapy ; Humans ; Myoblasts* ; Orthopedics ; RNA, Messenger ; Tendons ; Transfection ; Transforming Growth Factor beta*

The involvement of mucosal mast cells (MMC) in the pathophysiology of irritable bowel syndrome (IBS) is still controversial. We aimed to re-evaluate the role of MMC in visceral hypersensitivity associated with IBS using a rat IBS model that develops the IBS symptom after a subsidence of acetic acid-induced colitis. No significant difference in the number of MMC was observed between normal rat colon and IBS rat colon. (61.7 +/-2.9/mm 2 in normal vs. 88.7 +/-13.3/mm 2 in IBS, p >0.29). However, the degranulation rate of MMC was significantly higher in IBS rat colon (49.5 +/-2.4% in normal vs. 68.8 +/-3.4% in IBS, p >0.05). Pretreatment of a mast cell stabilizer, doxantrazole (5 mg/kg, i.p.), reduced the degranulation rate of MMC and significantly attenuated visceral hypersensitivity to rectal distension in IBS rat, whereas it had no effect on the visceral sensory responses in normal rat. These results suggest that, although the number of MMC is not significantly changed in IBS rat colon, the higher degranulation rate of MMC is responsible for visceral hypersensitivity in this model IBS.
Acetic Acid/toxicity ; Animals ; Cell Count ; Colitis/chemically induced/*pathology ; Hypersensitivity/*pathology ; Image Processing, Computer-Assisted ; Intestinal Mucosa/*pathology ; Irritable Bowel Syndrome/*pathology ; Male ; Mast Cells/drug effects/*pathology ; Models, Theoretical ; Phosphodiesterase Inhibitors/pharmacology ; Rats ; Rats, Sprague-Dawley ; Thioxanthenes/pharmacology ; Viscera/immunology ; Xanthones/pharmacology

No abstract available.
Hemangioma*

BACKGROUND: Multidrug-resistant tuberculosis(MDR-TB) in patients is mainly caused by acquired drug resistance, However, a small proportion of MDR-TB is caused by initial drug resistance(IDR), which may be somewhat different from acquired drug resistance. This study analyzed the clinical characteristics of IDR in MDR-TB patients to use the results as basic data in managing the disease. METHODS: A retrospective study of 30 IDR cases in MDR-TB patients from Jan. 1995 to Dec. 1998 was perormed. In order to analyzed the clinical charcteristics, the age, sex, family history, duration of negative conversion, number of resistant drugs, treatment regimens, duration of treatment, extent of disease and cavitary lesion on the chest X-ray was examined. In order too analyzed the level of improvement, the extent of the disease and cavitary lesion on the chest X-ray, tested by Wilcoxon signed rank sum test, and the disease free interval rate of 1-year and 4-year was examined using the Kaplan-Meier method. RESULTS: The mean age of the patients was 46.6 years and the sex ratio 1:1. Six(20%) patients had a family history. The mean negative conversin of the sputum AFB stain was 2.6 months. The number of resistant drugs was 7.6 and the number of used drugs 3.6. Twenty-three(67%) patients were treated for less than 12months and 28(93%) patients were treated with first-line drugs. The extent of the disease and the cavitary lesion on the chest X-ray improved after treatment(p<0.05). Among 13 patients who were followed up for 22.6 months, 2(15%) patients relapsed and the disease free interval rate of 1-year and 4-year was 85%. CONCLUSION: It is recommended that the duration of treatment of IDR in MDR-TB with first-line drugs be 9-12 months even if the extent of disease and cavitary lesion on the chest X-ray improves.
Drug Resistance* ; Humans ; Retrospective Studies ; Sex Ratio ; Sputum ; Thorax ; Tuberculosis, Multidrug-Resistant

No abstract available.
Carcinoma, Hepatocellular* ; Collagen* ; Liver Cirrhosis* ; Liver*

OBJECTIVES: The aim of this study was to examine the relationship between personality of parent and offspring, and offspring's psychological adaptation. METHODS: We examined temperament and character of 65 parents and their offspring (measured using the Junior Temperament and Character Inventory and Temperament and Character Inventory) and offspring's internalizing (anxiety, depression) and externalizing (delinquency, hyperactivity) problems. RESULTS: The internalizing problems of offspring were positively associated with harm avoidance (HA) of offspring and parent, and negatively associated with self-directedness (SD) of offspring and parent. The externalizing problems of offspring were positively associated with novelty seeking of offspring, and were predicted by SD of parent. The interaction between parent's HA and offspring's HA predicted higher levels of anxiety of offspring. CONCLUSION: The association between the offspring's personality and internalizing and externalizing problems can depend on the personality of the parent.
Adaptation, Psychological* ; Anxiety ; Humans ; Parents ; Temperament

No abstract available.
Foreign Bodies* ; Skull Base* ; Skull*

Severe irradiation on head may result functional alterations of central nervous system. In this study, the irradiation effect on the cerebellar cortex following heavy X-irradiation on head was studied ultrastructurally. Radiation was produced with the linear accelerator ML-4MV[Mitshubishi Co.], and rats weighing about 200gm each were exposed their heads within the radiation areas of 30cm x 30cm, under the radiation distance of 80cm, and with the radiation depth of 1.2 cm. Radiation doses were 3,000rads or 6,000rads, respectively. Animals were sacrificed on 6 hours, 2 days or 6 days following the radiation. Under anesthesia, animals were perfused with 1% glutaraldehyde-1% paraformaldehyde solution. Two hours after the perfusion, brain were taken out and refixed over night in the perfusion fixative. Small blocks of cerebellar hemispheric cortices were refixed 2 hours in 2% osmium tetroxide solution. Fixed tissues were dehydrated in alcohol, embedded in araldite mixture, and cut with ultratome. Ultrathin sections were contrasted with uranyl acetate and lead citrate solutions, and observed with electron microscope. The results obstained were as follow : 1. On 6th hour following X-irradiations, many cerebellar cortical neurons showed increased electron densities, more complicated nuclear infoldings, depletion of synaptic vesicles, expansion of astroglial territories, etc. 2. On 2nd day following X-irradiations, many organelle-rich cells such as Purkinje cells and Golgi cells were darkly degenerated. Numerous myelin figures formed by the cisternal fusions of Golgi apparatus or granular endoplasmic reticula were observed. Cytoplasmic processes of activated astroglial cells were expanded around capillaries and between granule cells. 3. On 6th day following X-irradiations, morphology of neuropil and neurones in the cerebellar cortex was generally restored, except the expanded territories of astroglial cells. From the above results, it was concluded that the release ofneurotransmitters and transcapillary leakage of blood substance were occurred on 6 hours after heavy X-irradiations. And severe alterations were produced on 2 day after X-irradiation, but the condition was generally restored on 6th day following X-irradiation.
Anesthesia ; Animals ; Brain ; Capillaries ; Central Nervous System ; Cerebellar Cortex* ; Citric Acid ; Cytoplasm ; Golgi Apparatus ; Head ; Myelin Sheath ; Neurons ; Neuropil ; Osmium Tetroxide ; Particle Accelerators ; Perfusion ; Purkinje Cells ; Radiation Effects* ; Rats* ; Synaptic Vesicles