Pretwisting the patellar tendon graft has been advocated hy many authors. Lambert has described a 90 degrees pretwist to benifit the fat pad vascular supply as well as to "" simulate the helicoid course of the ACL "". This technique has also been recommended to fascilitate fixation. Jackson has recommended a 90 pretwist to decrease the possibility of abrasive wear on the tunnel edge, and also to fascilitate fixation as much as a 180 degrees pretwist has heen recommended. However, in spite of all these recommendations, little work has been done on the effect of such pretwisting on the biomechanical behavior of patellar tendon grafts. The purpose of this study is to discover, by experiment, the effects of a 360 degrees external rotation pretwist on the following tensile mechanical properties of canine central 1/3 patellapatellar tendon-tibia complex : (a) ultimate stress, (b) ultimate strain, (c) average elastic modulus, and (d) strain energy density. Five groups of each S specimens were divided as group 1 (0 degrees external rotation), group 2 (90 degrees external rotation). group 3 (180 degrees external rotation), group 4 (270 degreesexternal rotation), and group 5 (360 degrees external rotation). The direction of pretwist meant the twist of tibia around patella. The effects of pretwist were analyzed using parameter one-way analysis of variance (ANOVA)(P1) and nonparameter Kruskal-Wallis one-way analysis of variance (ANOVA)(P2) with repeated measures followed by Scheff multiple comparison test. A p values of < 0.05 was considered statistically significant. Among each groups ultimate stress (P1=0.059, P2=0.095), ultimate strain(P1=0.154, P2=0. l65), and average elastic modulus(P1=0.814, P2=0.818) were not statistically significant. Only strain energy density was the statistically significant difference between group 2 and group 5(P1=0.008, P2=0.022). As a result, there were observed that the ultimate stress and strain energy density were decreased and ultimate strain was decreased but there were not statistically significant differences hetween groups because of the small number of samples, and there will be advantages for graft to avoid ahrasive wear on the tunnel edge and lateral femoral condyle. But, more studies are needed for human being in the future.
Adipose Tissue ; Elastic Modulus ; Humans ; Patella ; Patellar Ligament* ; Tibia ; Transplants

No abstract available.
Pancreas*

No abstract available.

Hemorrhagic shock is one of the most common causes of death in patients with multiple trauma and therefore rapid control of bleeding is the main strategy to save these patients. Resuscitative balloon occlusion of the aorta (REBOA) has been applied in several trauma cases and because of the effectiveness of this procedure it has been adopted in the trauma field. Herein, we report the first successful case of REBOA in Korea performed on a 46-year-old man with hemorrhagic shock after a fall from a height of 14-stories. The patient visited our hospital emergency room with hypovolemic shock, we performed Resuscitative Endovascular Balloon Occlusion of the Aorta under bed side blind technique. His vital sign was stabilized after procedure, then we could performed endovascular bleeding control. The patient was discharged on his 33rd in-hospital day without invasive procedure and major scar.
Aorta* ; Balloon Occlusion* ; Cause of Death ; Cicatrix ; Emergency Service, Hospital ; Hemorrhage ; Humans ; Korea ; Middle Aged ; Multiple Trauma ; Shock* ; Shock, Hemorrhagic ; Vital Signs

No abstract available.

A clinical observation was made on 261 cases of transurethral resection of benign prostatic hyperplasia (TURP) by the same operator, admitted during the period of 10 years from January 1984 to December 1993. The objective cases were divided by every 50 cases into 5 groups, and the operation results were compared in each group respectively. The results showed the tendency of increasing weight of resected prostatic tissue and decreasing operating time, consumed time for the resection of l gm of prostatic tissue, blood loss during operation, duration of postoperative gross hematuria and incidence of postoperatively complicated cases, as experiencing more TURP cases. The operation results were markedly improved and stabilized after experience of 150 cases of TURP. Our study suggests that TUR technique of the operator is improving step by step by accumulating experiences of TURP and the expert and stabilized skillful technique will be achieved after experience of more than 150 cases of TURP but the improvement of TUR technique may be accelerated by aid of better TUR instrument and teaching system.
Hematuria ; Incidence ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate

No abstract available.

No abstract available.

Background: The association between low-density lipoprotein (LDL-C) levels and cardiovascular disease (CVD) risk in different age groups within the diabetes mellitus (DM) population remains unclear. The cohort study was conducted to investigate this relationship. Methods: We assessed the 2009 to 2012 Korean National Health Screening and National Health Insurance Service records, with follow-up to the primary outcome (myocardial infarction [MI] or stroke) or December 2018. After excluding the participants with a history of MI or stroke, 2,227,394 participants with DM were included and categorized according to baseline LDL-C levels and age. Cox proportional hazards modeling was conducted. The CVD risk of age <40 years and LDL-C <70 mg/dL was set as the reference. In each age group, LDL-C <70 mg/dL was used as a reference for the subgroup analysis. Results: The cut-off LDL-C value for increased MI risk in each age group varied (<40 years old, LDL-C ≥160 mg/dL: hazard ratios [HR], 2.03; 95% confidence interval [CI], 1.644 to 2.506) (40–49-year-old, LDL-C <115 mg/dL: HR, 1.245; 95% CI, 1.04 to 1.489) (50–59-year-old, LDL-C <115 mg/dL: HR, 1.21; 95% CI, 1.014 to 1.445) (60-69-year-old, LDL-C <145 mg/dL: HR, 1.229; 95% CI, 1.022 to 1.479) (≥70 years old group, LDL-C <100 mg/dL: HR, 1.238; 95% CI, 1.018 to 1.504). The cut-off LDL-C values for increased stroke risk varied in each age subgroup (<40 years old, LDL-C ≥160 mg/dL: HR, 1.395; 95% CI, 1.094 to 1.779) (40–49-year-old, LDL-C <145 mg/dL: HR, 1.13; 95% CI, 1.019 to 1.253) (50–59-year-old, LDL-C <160 mg/dL: HR, 1.079; 95% CI, 1.008 to 1.154) (60–69-year-old, LDL-C <130 mg/dL: HR, 1.07; 95% CI, 1.022 to 1.119) (≥70 years old, LDL-C <115 mg/dL: HR, 1.064; 95% CI, 1.019 to 1.112). Conclusion The effect of LDL-C on the risk of CVD differs depending on the age of the population with DM.

Background: The association between low-density lipoprotein (LDL-C) levels and cardiovascular disease (CVD) risk in different age groups within the diabetes mellitus (DM) population remains unclear. The cohort study was conducted to investigate this relationship. Methods: We assessed the 2009 to 2012 Korean National Health Screening and National Health Insurance Service records, with follow-up to the primary outcome (myocardial infarction [MI] or stroke) or December 2018. After excluding the participants with a history of MI or stroke, 2,227,394 participants with DM were included and categorized according to baseline LDL-C levels and age. Cox proportional hazards modeling was conducted. The CVD risk of age <40 years and LDL-C <70 mg/dL was set as the reference. In each age group, LDL-C <70 mg/dL was used as a reference for the subgroup analysis. Results: The cut-off LDL-C value for increased MI risk in each age group varied (<40 years old, LDL-C ≥160 mg/dL: hazard ratios [HR], 2.03; 95% confidence interval [CI], 1.644 to 2.506) (40–49-year-old, LDL-C <115 mg/dL: HR, 1.245; 95% CI, 1.04 to 1.489) (50–59-year-old, LDL-C <115 mg/dL: HR, 1.21; 95% CI, 1.014 to 1.445) (60-69-year-old, LDL-C <145 mg/dL: HR, 1.229; 95% CI, 1.022 to 1.479) (≥70 years old group, LDL-C <100 mg/dL: HR, 1.238; 95% CI, 1.018 to 1.504). The cut-off LDL-C values for increased stroke risk varied in each age subgroup (<40 years old, LDL-C ≥160 mg/dL: HR, 1.395; 95% CI, 1.094 to 1.779) (40–49-year-old, LDL-C <145 mg/dL: HR, 1.13; 95% CI, 1.019 to 1.253) (50–59-year-old, LDL-C <160 mg/dL: HR, 1.079; 95% CI, 1.008 to 1.154) (60–69-year-old, LDL-C <130 mg/dL: HR, 1.07; 95% CI, 1.022 to 1.119) (≥70 years old, LDL-C <115 mg/dL: HR, 1.064; 95% CI, 1.019 to 1.112). Conclusion The effect of LDL-C on the risk of CVD differs depending on the age of the population with DM.