The roentgenograms following arthroscopic ACL reconstruction show the enlargement of bone tunnels. Many authors hypothesized the cause of the tunnel enlargement, either mechanical or biological causes. The purpose of this study was to find the factors which affected the enlargement of the tibial tunnel following arthroscopic ACL reconstruction with bone-patellar tendon-bone or hamstring tendon. Sixty patients were reviewed retrospectively for radiographic measurement of tibial tunnel at post-operative one year (27 patients received bone-patellar tendon-bone autograft, 12 patients received bone-patellar tendon-bone autograft and Kennedy LAD-ligament augmentation device, 21 patients received Semitendinosus and Gracilis tendons with Endobutton). Roentgenographic anteroposterior and lateral films were checked and the tunnel was measured by two independent observers using a digital caliper. Statistical analysis was performed using a one-way analysis of variance (ANOVA) and t-test. The tibial tunnel enlargement was only related to the position of the fixation of the tibial tunnel. We concluded that tibial tunnel enlargement following arthroscopic ACL reconstruction is attributed to the mechanical effect rather than the properties of grafts and the clinical results.
Autografts ; Humans ; Retrospective Studies ; Tendons ; Transplants

In anterior cruciate ligament (ACL) deficient knee, several treatment methods were recommended. Recently, arthroscopic reconstruction is widely used as the best treatment method. As the graft materials, bone-patellar tendon-bone (BPB) unit is a gold standard material. Whereas, it has many problems. The purpose of this study was to introduce the new arthroscopic ACL reconstruction technique with quadrupled semitendinosus tendon and Endobutton and to evaluate its results. Twenty one patients were prospectively reviewed after ACL reconstruction with quadrupled semitendinosus tendon and Endobutton at one year post-operation. The surgery was performed in the series of graft tendon harvest, graft preparation, tunnel drilling and Endobutton fixation. The outcomes showed improved knee functions. Endobutton technique with quadrupled semitendinosus tendon is useful method for the arthroscopic ACL reconstruction. Stability and functional outcomes were similar to those with patellar tendon but it showed less donor site morbidity, less pitfall of fixation and simple procedure.
Anterior Cruciate Ligament ; Humans ; Knee ; Patellar Ligament ; Prospective Studies ; Tendons* ; Tissue Donors ; Transplants

Controversies about the posterior cruciate ligament continue with regards to total knee arthroplasty. There has been a long debate regarding PLC and its importance seems to be overrated in total knee arthroplasty. Twenty four patients had twenty six total knee replacements with insertion of the PCL substituting Press Fit Condylar modular total knee system with cement, and they were enrolled in a prospective study to assess the clinicoradiological results and measure the femoral roll-back postoperatively. Follow-up ranged from twenty four months to fifty months with an average of thirty two months. The mean HSS score was 92.1 points and the mean range of motion was 122.7 degrees. Twenty five cases(96.1%) showed excellent and good clinical results. The radiologic evaluation based on Knee Society roentgenographic system revealed proper alignment of all components and one significant radiolucent area. The mean femoral roll-back was 2.3mm posteriorly. In the present series, total knee arthroplasties with the Press Fit Condylar modular knee system resulted in excellent relief of pain, excellent range of motion and restoration of function.
Arthroplasty* ; Arthroplasty, Replacement, Knee* ; Follow-Up Studies ; Humans ; Knee ; Posterior Cruciate Ligament ; Prospective Studies ; Range of Motion, Articular

Congenital cystic adenomatoid malformation (CCAM) of the lung is a rare pulmonary malformation, associated with local aberrations of parenchymal tissue development, which have been classified lung bud anomalies. Lung bud anomalies include infantile lobar emphysema, congenital cyst of the lung, congenital cystic adenomatoid malformation, pulmonary sequestration and bronchogenic cyst. CCAM can enlarge rapidly by ball-valve air entrapment by cysts, lead to mediastinal shift and compression of the heart. compression of opposite lung may result in pulmonary hypoplasia and CCAM causes acute respiratory distress in newborn. We report a neonate with CCAM who were successfuly managed during perioperative period.
Bronchogenic Cyst ; Bronchopulmonary Sequestration ; Cystic Adenomatoid Malformation of Lung, Congenital ; Emphysema ; Heart ; Humans ; Infant, Newborn* ; Lung ; Perioperative Period

By recent advance of immunologic techniques, it made possible to measure the immune cells and NK cell activity in peripheral blood of various immune altered eonditions. NK cell activity is related not only to malignancies but also to viral infectiona. The facts that the impairment of cell mediated immunity inducea the herpes zoster infection and frequent association with herpes zoster in the patienta with malignancy promote author to atudy the alteration of immune cells and NK cell activity in peripheral block. So author evaluated irnmune cells and NK cell activity of 18 patients with berpes zoster. The results are as follows; 1. The mean value of T cells, T cells showed significant differences between patients group(58.4-i-6.9%, 33.7-+11.7%) and normal healthy control group (68. 6+ 4. 7yo, 44. 2+-7. 0%) but T,' and B cells showecl no significant between patientagroup(6.9-+2.4%, 12.5+-5.7%) and.controlgroup(7.8-1.5%, 13.9-+2.3g%), statistically. 2. The mean value of NK cell activity in patients with herpes zoster group (62. 9+-ll. 2%) showed no significance cornpaired with the mean value of normal healthy control group(57. 9+-l4. 8%), statiatically.
B-Lymphocytes ; Herpes Zoster* ; Humans ; Immunity, Cellular ; Immunologic Techniques ; Killer Cells, Natural* ; T-Lymphocytes

No abstract available.
Dermatitis, Atopic* ; Killer Cells, Natural*

BACKGROUND: Handgrip and cold pressor test may increase the afterload of the heart. And in left ventricular hypertrophy, it is known that mitral flow pattern is affected by decreased left ventricular compliance. We investigated the effects of handgrip and cold pressor test on mitral flow pattern in patients with left ventricular hypertrophy. METHODS: Handgrip and cold pressor test were performed in 12 subjects with left ventricular hypertrophy and in 14 healthy normal subjects. In supine position, blood pressure, heart rate and Doppler echocardiographic parameters(early peak flow velocity : E, atrial peak flow velocity : A) were obtained at rest, 1 and 3 minutes after the onset of tests respectively. RESULTS: In both groups, handgrip and cold pressor test increased blood pressure slightly without a statistical significance. In left ventricular hypertrophy group, there were significant increments in heart rates at 1 minute of handgrip (78+/-12min-1, p<0.001) and cold pressor test(77+/-7min-1, p<0.05) as compared to that at rest (73+/-12min-1). Mitral flow velocities did not show significant change after the tests in control group. A waves after 1 minute of handgrip(85.2+/-18.4cm/sec, p<0.05) and cold pressor test (87.3+/-17.8cm/sec, p<0.001) showed significant increases as compared to that at rest (79.1+/-14.9cm/sec) in left ventricular hypertrophy group whereas E waves did not. CONCLUSION: Although handgrip and cold pressor tests did not affect the mitral flow significantly in control group, each test raised A waves in left ventricular hypertrophy group. These results suggest that increased A waves may be due to a rise in afterload and decreased left ventricular compliance caused by handgrip and cold pressor test in left ventricular hypertrophy group.
Blood Pressure ; Compliance ; Echocardiography ; Heart ; Heart Rate ; Humans ; Hypertrophy, Left Ventricular* ; Supine Position

We evaluate the water content, hygroscopicity and water holding capacity in 40 healthy individuals and 17 leprosy patients by skin surface hydrometer(IBS Inc, Japan), and the correlation between the nerve destruction and the hydration state. In Eiealthy individuals the measuring sites were the flexor and extensor surfaces of the arm, forearm, thigh and leg, In leprosy patients we measured on the extensor surface of forearm with shows abnormal sensation, and opposite ar neighboring skin which shows normal sensation. The results are as follows: 1. The water content of healthy individuals is highest in the flexor surface af arm (49. 50 + 18.38ug ) and lowest in the extensor surface of leg(30.75 -12.09ug) 2. The hygrosccpicity of healthy individuals is highest in the flexor surface of arm(296. 30 + 70.75ug ) and lowest in the extensor surface of leg(24$. Q7+5) 5ppg) 3. The water content of the extensor surface of lorearm in leprosy patients, which .hows abnormal sensation, is decreased(16. 35 +20. 82 ug) and it is statisti calli significant when compared with healthy individuals(p<0.005). 4. The hygroscopicity of the extensor surface of forearm in leprosy patients. which shows abnormal sensation, is decreased(94. 29 + 71. 62 ug) and it is statistically significant when compared with opposite or neiphboring skin and healthy individuals(p<0. 005)
Arm ; Forearm ; Humans ; Leg ; Leprosy* ; Sensation ; Skin ; Thigh ; Water* ; Wettability

The spinal fusion is used for correcting malformations, stabilizing unstable segments, and suppressing the progression of disease, but it causes more load on the adjacent segment and as a result, the degenerative changes accelerate. Furthermore, the accelerated changes case spinal stenosis, degradation of nucleus pulposus, degenerative spondylolisthesis, acquired isthmus defect, and arthritis of articular facet, it rarely needs surgical treatment. The purpose of this study is to know the effect of the fusion level and range on the adjacent segment, to be a standard for determining the fusion range prior to operation, and to help to find the complication like degenerative changes by measuring the range of motion on the adjacent segment after the spinal fusion. Authors analyzed the result of 29 cases of posterolateral lumbar spinal fusion which were operated from February 1989 and January 1994. The intervertebral angle was measured on the flexion and extension lateral radiographs, and the calculated angular motion and sagittal plane rotation at follow-up periods were compared with those of preoperative values. The results were as follows; 1. Among the adjacent segm0ent, the increment of angular motion of superior adjacent segment was 2.6°(-5°~15°) which was higher than that of inferior one with 1.5°(-3°~7°) 2. The increment of angular motion of superior adjacent segment for 1 segment rather than 2 or 3 segments was more than two times with 3.9°(-2°~15°) 3. Regardless of level and range of fusion, the increment of angular motion was 3.0°(-2°~8°) on 4.5th lumbar segment which was increased mostly and 1.5°(-3°~7°) on 5th lumbar and 1st sacral segment which was increased leastly. 4. There were 3 cases showed instability at the superior adjacent segment and no cases showed instability at the inferior adjacent segment among all the cases showing stability prior to operations. In conclusion, the sagittal plane rotation was increased in adjacent segment after posterolateral spine fusion. So, we would recommend that the adjacent segment is very important to the decision of fusion extent and level.
Arthritis ; Follow-Up Studies ; Range of Motion, Articular ; Spinal Fusion ; Spinal Stenosis ; Spine ; Spondylolisthesis

The medial collateral ligament(MCL) of the knee is the well established secondary restraint to the anterior displacement of the knee joint. However, there has been no report about the estimation of the anterior displacement in combined ACL(anterior collateral ligament) and MCL injures according to period when they were treated with conservative measures. This prospective study evaluated the changes of anterior displacement over time in combined ACL/MCL injury as the MCL injury heals after initial conservative measures. 19 patients who had combined ACL/MCL injury were followed during twelve months after injury. All patient had a positive Lachman test and were evaluated the side to side differences on KT-2000 knee arthrometer(Medmetric, San Diego, California) testing under 20 Ibs anterior tibial loading at 30 degree knee flexion. The stability of the knee was assessed using KT-2000 knee arthrometer every 8 weeks with clinical examination prospectively. They were treated with CI (Combined instability) brace (Smith & Nephew, Carlsbad, California) as conservative measures. Overall, Initial side to side difference of the anterior displacement was averaged 5.21mm (range,4.0-7.0mm) and 3.30mm (range,2.0-5.5mm) finally. According to the classification of MCL injury, in Grade III groups, they had the greatest initial anterior displacement about 6.4mm, but tight- ened the most to 3.08mm finally. In Grade II and Grade I groups they showed 2.97mm and 2.13mm side to side difference (p>0.01). However in Grade I, the anterior displacement were decreased by 4 months after injury but, it were increased at 6 months after injury. In Grade II and III, the decrement of the anterior displacement were continued by 6 months after injury, but they were not changed after that. The data was analyzed by General Linear Model Procedure method. Conclusively, the anterior displacement of knee in patients with combined ACL/MCL injury was diminished with the time in the majority of patients as the MCL healed. It means that the MCL was the stabilizer to the anterior displacement of the knee under the anterior tibial loading.
Braces ; Classification ; Humans ; Knee Joint ; Knee* ; Linear Models ; Prospective Studies