The development of the arthroscopic surgery technique presented a great method in the reconstruction of anterior cruciate ligament. There were many debates about the timing of reconstruction in the acute anterior cruciate ligament injury. However, it was regarded true that primary reconstruction in the acute phase have higher complication rate of arthrofibrosis than in the chronic phase. Many authors recommended delay of reconstruction at least 3 weeks in acute tear of anterior cruciate ligament. In contrast, some surgeons have tried to suture the ruptured anterior cruciate ligament accompanied by 'over-the-top' augmentation with the hamstring tendon or the artificial ligament arthroscopically. Since Jan. 1992, the authors have implanted the synthetic polyester ligament(ABC ligament; Surgicraft, U.K.) into the substance of ruptured ligament proper and fixed at the 'over-the-top' position without any procedure for repair of the ruptured anterior cruciate ligament. Our indication for this surgery is only acute rupture of anterior cruciate ligament with good stump condition. We report the clinical results of 22 cases at 20.3 months follow-up(mean) preliminarily. l. On measurement of pre-operative and post-operative differences between the normal and the affected side by Telos stress X-ray study and KT-2000 arthrometer. Differences were markedly improved from 5.6mm(mean: pre-op) to 1.9mm(mean: post-op) on Telos stress X-ray study(on 15 Kp stress) and both knee showed minimal differences on KT-2000 study(2.2mm on 9Kp, 2.5mm on maximum stress) at the time of follow-up. 2. The average Lysholm score was 82. By Clancy criteria, the 20 cases(91%) showed good and excellent results. 3. Second look arthroscopy was available in three cases. In two cases, there were marked fibrous proliferation around the ligament. The stability felt good on probing. We could observe healing-like appearance of ruptured ACL with minimal fibrous tissue proliferation in one another case.
Anterior Cruciate Ligament ; Arthroscopy ; Follow-Up Studies ; Knee ; Ligaments ; Methods ; Polyesters ; Rupture ; Surgeons ; Sutures ; Tears ; Tendons

In the treatment of proximal tibial condyle fracture, it should be considered that it can often accompany injuries of the collateral ligament, both cruciate ligament, and the menisci of the knee. Moreover it is necessary to restore anatomical congruity of the articular surface accurately. We performed reduction of the depressed articular fragment under monitoring of arthroscopy and fixed with cannulated cancellous screws and accompanied by bone graft under the control of image intensifier in 2 cases of Type I(Pure cleavage) and 3 cases of type II(cleavage with depression) fractures. The results were very satisfactory. Arthroscopy assisted reduction and fixation are very useful method in the treatment of proximal tibial condyle fracture because of (1) the minimized operative morbidity, (2) the ability to evaluate and manage associated intraarticular pathology simultaneously, (3) the rapid rehabilitation, (4) the achievement of good reduction comparable to open reduction.
Arthroscopy ; Collateral Ligaments ; Knee ; Ligaments ; Methods ; Pathology ; Rehabilitation ; Transplants

The authors report a case of brain abscess associated with pulmonary arteriovenous malformation(AVM). As right to left shunt in systemic circulation can precipitate brain abscess in congenital cyanotic heart disease, arteriovenous fistula in pulmonary AVM is an etiologic factor of brain abscess. Brain abscess associated with pulmonary AVM is very rare and has so far been lacking in previous report in Korea. The pertinent literatures of brain abscess associated with pulmonary AVM are also reviewed.
Arteriovenous Fistula ; Arteriovenous Malformations* ; Brain Abscess* ; Brain* ; Heart Diseases ; Korea

BACKGROUND: A recent case-control study from Finland reported a strong relationship between high antibody titers to Chlamydia pneumoniae , strain TWAR, and both chronic heart disease and acute myocardial infarction. Other studies also suggested an association between C. pneumoniae infection and coronary atherosclerosis, based on the demonstration of increased serologic titers and the detection of bacteria within atherosclerotic tissue, but this association has not been yet regarded as an established theory. The objective of this study was to investigate the relationship between C. pneumoniae immnoglobulin G antibody titers and angiographically diagnosed coronary artery disease. METHOD: Coronary angiography was performed. Controls (n=89) were coronary angiographically normal cases and coronary artery disease (n=115) was diagnosed if coronary artery luminal diameter is obstructed more than 50% in more than one coronary artery. Micro-IF assay was used to measure C. pneumoniae TWAR antibodies. The sera were titrated in two-fold dilutions starting from 1 in 8, and a titre of 1 in 8 or more was judjed positive. RESULTS: The estimated risk of coronary artery disease, adjusted for age and gender, was greater among subjects with high (> or =1:128) antibody titers than with low (< or =1:8) antibody titers (relative risk, 7.9:95% confidence interval, 1.3-47.9). CONCLUSION: These results support an association between infection with >ENGLISH=Ptimes-i< C. pneumoniae and coronary artery disease only in high (> or =1:128) antibody titers.
Antibodies ; Bacteria ; Case-Control Studies ; Chlamydia* ; Chlamydophila pneumoniae* ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Finland ; Heart Diseases ; Myocardial Infarction ; Phenobarbital ; Pneumonia

BACKGROUND: A recent case-control study from Finland reported a strong relationship between high antibody titers to Chlamydia pneumoniae , strain TWAR, and both chronic heart disease and acute myocardial infarction. Other studies also suggested an association between C. pneumoniae infection and coronary atherosclerosis, based on the demonstration of increased serologic titers and the detection of bacteria within atherosclerotic tissue, but this association has not been yet regarded as an established theory. The objective of this study was to investigate the relationship between C. pneumoniae immnoglobulin G antibody titers and angiographically diagnosed coronary artery disease. METHOD: Coronary angiography was performed. Controls (n=89) were coronary angiographically normal cases and coronary artery disease (n=115) was diagnosed if coronary artery luminal diameter is obstructed more than 50% in more than one coronary artery. Micro-IF assay was used to measure C. pneumoniae TWAR antibodies. The sera were titrated in two-fold dilutions starting from 1 in 8, and a titre of 1 in 8 or more was judjed positive. RESULTS: The estimated risk of coronary artery disease, adjusted for age and gender, was greater among subjects with high (> or =1:128) antibody titers than with low (< or =1:8) antibody titers (relative risk, 7.9:95% confidence interval, 1.3-47.9). CONCLUSION: These results support an association between infection with >ENGLISH=Ptimes-i< C. pneumoniae and coronary artery disease only in high (> or =1:128) antibody titers.
Antibodies ; Bacteria ; Case-Control Studies ; Chlamydia* ; Chlamydophila pneumoniae* ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Finland ; Heart Diseases ; Myocardial Infarction ; Phenobarbital ; Pneumonia

Despite the major advances in diagnostic technology and improvements in antimicrobial selection and monitoring accompanied by parallel advances in surgical techniques, the morbidity and mortality of infective endocarditis(IE) still remain high. Because of this high mortality rate, it is worthy of investigating the clinical features of IE and it's complications thoroughly. The main causes of mortality in IE are congestive heart failure and septic embolization. In 9% of active IE, acute myocardial infarction(AMI) developed. AMI caused by coronary artery obliteration by occlusion or embolization is a rare but recognized complication of aortic valve endocarditis with annular abscess. We reported a case of aortic valve endocarditis with aortic root abscess which was complicated by AMI and death.
Abscess* ; Aortic Valve ; Coronary Vessels ; Endocarditis ; Heart Failure ; Mortality ; Myocardial Infarction*

BACKGROUND: Early diagnosis and treatment of hypertension is imperative to prevent the complications associated with this condition. The development of accurate and convenient methods of blood pressure measurement, therefore, is indispensible. At present, the JNC V has acknowledged the use of automatic sphygmomanometer that can be used without the help of someone else. We compared automatic oscillometric sphygmomanometers manufactured by Sein Electronics, korea(SE-7000 and SE-5000) with the standard Korotkoff auscultatory mercuy sphygmomanometer meter. The correlation between these two methods were calculated to determine whether these products could actually be used in clinical practice. This study was undertaken to ensure the clinical evaluation of these two products and standardization of an antomatic sphygmomanometer in korea before it is actually used. METHODS: The study included eighty-three patients, ranging in age from 14 to 81 years, who were admitted to Hanyang University Hospital in October, 1995. The blood pressure measured by the automatic oscillometric sphygmomanometer(SE-7000) in the right arm and was compared with that measured by the standard mercury sphygmomanometer(baumanometer) in the left arm. Also the blood pressure measured by the automatic oscillometric sphygmomanometer(SE-5000) at the wrist was compared by the baumanometer in the same side arm. The correlation between these methods were determined by the paired Student`s t-test and by the simple liner regression method. RESULTS: The p value of systolic blood pressure between two methods(SE-7000 and baumanometer) in the both arms was 0.896 and correlation coefficient was 0.8286. The p value of diastolic blood pressure between this two methods was 0.352 and correleation coefficient was 0.7455. The p value of systolic blood pressure between two methods(SE-5000 and baumanomter) by the arm and the wrist was 0.00018 and correlation coefficient was 0.8588, the p value of diastolic blood pressure between this two methods was 0.000048 and correlation coefficient was 0.5944. CONCLUSION: The blood pressure measured by the SE-5000 at the wrist was statistically different from that measured with the baumanometer in the arm. Further studies are necessary to use this product in clinical practice. However, the systolic and diastolic blood pressures measured with the SE-7000 in the arm were relatively similar to those measured by the baumanometer enabling this products to be effectively used in clinical practice.
Arm ; Blood Pressure ; Early Diagnosis ; Humans ; Hypertension ; Korea ; Sphygmomanometers* ; Wrist

Infective endocarditis is a life-threatening condition caused by microbial infection of the heart's endocardial surface. This condition can also be associated with bacterial infections of other organs. We experienced an unusual case of recurrent infective endocarditis associated with pyogenic spondylodiskitis. A 70-year-old man presented with persistent fever and lower back pain visited our hospital. The patient had a past history of recurrent infective endocarditis. He was diagnosed with infective endocarditis again based on clinical symptoms and echocardiographic findings. Magnetic resonance imaging was used to evaluate lower back pain, which showed acute spondylodiskitis on L3 and L4 vertebrae. The patient completely recovered following four weeks of antibiotic therapy.
Aged ; Bacterial Infections ; Discitis ; Endocarditis ; Fever ; Humans ; Low Back Pain ; Magnetic Resonance Imaging ; Spine

The coronary artery-left ventricular microfistula is an extremely rare congenital anomaly. Little is known about their epidemiologic and clinical features. Moreover, to our knowledge, only two cases of coronary artery-left ventricular microfistulae demonstrated by transthoracic doppler echocardiography have been reported in the literature. Recently we experienced a case of coronary artery-left ventricular microfistulae demonstrated by transthoracic doppler echocardiography, who was a 63 year old woman and visited for evaluation of chest pain. Herein, along with a review of the pertinent literature regarding this disorder, we report a case of coronary artery-left ventricular microfistulae demonstrated by transthoracic doppler echocardiography.
Chest Pain ; Echocardiography, Doppler* ; Female ; Humans ; Middle Aged

BACKGROUND AND OBJECTIVES: Left ventricular hypertrophy (LVH) is a well known cardiovascular prognostic predictor. Osteoporosis has been suggested to be associated with cardiovascular disease. According to studies of primary hyperparathyroidism, a pathophysiological association between calcium metabolism and LVH has been suggested but is not yet fully understood. This study was performed to investigate the association between bone mineral density (BMD) and left ventricular mass index (LVMI) in a general population. SUBJECTS AND METHODS: Data from 460 subjects among 543 subjects sampled from a general population in a rural area in Korea were analyzed. BMD, echocardiography, brachial-ankle pulse wave velocity (baPWV), carotid intima-media thickness (IMT) measurement as well as the measurements of blood pressure, blood chemistry and metabolic parameters were analyzed. BMD was measured using the Sahara Clinical Bone Sonometer (Hologic Inc., Mass., USA). RESULTS: Age of the subjects was 59.4+/-12.4 years. Males were 42.2% (n=194). In a simple correlation analysis on female subjects, age and waist circumference showed negative correlation, and body mass index (BMI) showed positive correlation with BMD. However, only age showed negative correlation with BMD in male subjects. After adjusting baPWV and carotid IMT, we found that BMD was an independent determinant of LVMI in female subjects (beta=-13.703, p=0.016), but not in male subjects (beta=-1.235, p=0.841). CONCLUSION: BMD is a consistent and independent determining factor of LVMI, BMI and carotid IMT in postmenopausal women.
Africa, Northern ; Blood Pressure ; Body Mass Index ; Bone Density ; Calcium ; Cardiovascular Diseases ; Carotid Intima-Media Thickness ; Echocardiography ; Female ; Heart Ventricles ; Humans ; Hyperparathyroidism, Primary ; Hypertrophy ; Hypertrophy, Left Ventricular ; Korea ; Male ; Osteoporosis ; Pulse Wave Analysis ; Waist Circumference