Evaluation and management of the anterior cruciate ligament (ACL) deficient knee pose several problems. For acute injuries, the essential factors are diagnosis of the ACL rupture and associated injuries, and selection of the appropriate method of the management. Until recently, the frequency of complete disruption of the ACL was though to be less than that of the medial collateral ligament. However, there is little doubt that the ACL is the most frequently torn ligament in the knee. Diagnosis may be made with a combination of tests: Anterior drawer, valgus or varus stress test, Lachman, and pivot shift. If the patients is unable to relax because of pain or fear, examination under the anesthesia should be performed. Treatment can be surgical or nonsurgical. Since the ACL is vital to normal knee function, surgical intervention is advisable in the majority of cases of acute disruption. Authors analyzed the records of 58 cases of acute knee ligament injuried patients treated at the department of Orthopaedic Surgery, Kang-Nam St. Marys Hospital, Catholic Medical College and Center, from November 1982 to January 1984, with follow-up range from 6 to 20 months. 1. Among 58 cases, 41(71%) had anterior cruciate ligament injury and 39(67%) had medial collateral ligament injury. 2. The causes of injury were mostly traffic accident (77%) and majority of the patients was in their twenties and thirties of age. 3. Among 41 cases of ACL Injury, 5 had isolated anterior cruciate injury, 27 cases (66%) had associated medial collateral injury, 9 (22%) had associated lateral collateral injury, and 7 (17%) had associated posterior cruciate ligament injury. 4. Meniscal injury was found only in 6 cases (15%); 4 medial and 2 lateral menisci. 5. Majority of anterior cruciate injured patients (71%) had more than 5mm joint openning than normal side in valgus or varus stress radiogram with the knee in extension. 6. In all cases of anterior cruciate ligament injured patients, the Lachman test was positive under the general anesthesia, hut anterior drawer test was positive in 80%. 7. In about 90% of the cases, the anterolateral rotatory instability (ALRI) test was positive and this finding was accentuated when the lateral collateral ligament was torn. 8. Among 41 cases, 16 (39%) had failure at the insertion site, 7 (17%) had tibial spine avulsion, and 9 patients each (22%) had tear at the ligament substance level and had grade II sprain. 9. In twenty-three, primary repair was done, in 9, primary intra-articular recopstruction was performed and 9 were treated conservatively. The result was from fair to excellent almost in all cases.
Accidents, Traffic ; Anesthesia ; Anesthesia, General ; Anterior Cruciate Ligament ; Clinical Study ; Collateral Ligaments ; Diagnosis ; Exercise Test ; Follow-Up Studies ; Humans ; Joints ; Knee ; Lateral Ligament, Ankle ; Ligaments ; Menisci, Tibial ; Methods ; Posterior Cruciate Ligament ; Rupture ; Spine ; Sprains and Strains ; Tears

The 56-kilodalton protein genes of Orientia tsutsugamushi TA678, TA686, TA716, TA763 strains were amplified by PCR. The amplified products were sequenced and cloned into pIH821 vector. The recombinant proteins were expressed in Escherichia coli as fusion proteins with maltose binding protein. The recombinant proteins were purified and used for the sensitization of sheep RBCs and the reactivity of the recombinant 56-kDa proteins of Orientia tsutsugamushi TA 678, TA686, TA716 strains were analyzed with 40 sera from scrub typhus patients in Korea, 40 sera from scrub typhus in Thailand, Malaysia and Philippines. The 56-kDa protein coding DNA sequence of Orientia tsutsugamushi TA678, TA686, TA716 show 70 to 88% homology with other known strains and four variable regions are also observed. 39 of 40 sera from scrub typhus patients in Korea showed the strongest reactivity to the recombinant protein of Boryong strain and one sera showed the strongest reactivity to the recombinant protein of Gilliam strain. 14 of 40 sera from patients in Thailand, Malaysia and Philippines showed the strongest reactivity to the recombinant protein of TA686 strain and 12 sera showed the strongest reactivity to the recombinant protein of TA716 strain. No serum from patients in Thailand, Malaysia and Philippines showed the strongest reactivity to the recombinant protein of Boryong strain.
Asian Continental Ancestry Group* ; Base Sequence ; Chungcheongnam-do ; Clinical Coding ; Clone Cells ; Cloning, Molecular* ; Escherichia coli ; Hemagglutination Tests* ; Hemagglutination* ; Humans ; Korea ; Malaysia ; Maltose-Binding Proteins ; Orientia tsutsugamushi* ; Philippines ; Polymerase Chain Reaction ; Recombinant Proteins ; Scrub Typhus ; Sheep ; Thailand

Rehabilitation of young children with hearing impairment can be defined as a teaching/learning process where the role of the clinician is to facilitate the acquisition of listening, speech and language in a normal developmental order. The young children with hearing impairment are helped by hearing aids and cochlear implants to learn language. Auditory (re)habilitation in young children with hearing impairment is to acquire auditory skills at four stages : sound detection, sound identification through imitation, sound discrimination, and comprehension. Without appropriate auditory training and early intervention, children with hearing impairment cannot develop spoken language. Speech acquisition is a perceptual as well as an oral process. To maximize the speech acquisition in children with hearing impairment, indepth understanding of the characteristics of the children, the parents' motivation and cooperation, a well-designed educational program, and the high competence of the health care professionals are important. Therefore, listening is not an isolated skill, and the auditory development in children with hearing impairment should be achieved in a comprehensive approach. Young children with hearing impairment need supports and guidance from health care professionals whose holistic approach balances auditory learning with the parallel development of the children's other learning processes.
Child* ; Cochlear Implants ; Comprehension ; Correction of Hearing Impairment* ; Delivery of Health Care ; Discrimination (Psychology) ; Early Intervention (Education) ; Hearing Aids ; Hearing Loss* ; Humans ; Learning ; Mental Competency ; Motivation ; Rehabilitation ; Speech Perception*

No abstract available.
Child* ; Humans ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma*

The distribution of enkephalin, dynorphin, substance P and neurotensin in the periaqueductal gray[PAG] has been well established by immunohistochemical methods. However, there is little information about the regional distribution of these neuropeptide mRNA-containing neurons in the PAG. The present study was undertaken [1] to elucidate the distribution of these neuropeptide mRNA-containing neurons and to determine of the PAG, [2] to know how peptide expression relates to the proposed functional subdivisions of the PAG and [3] to know how neuropeptide mRNA levels in the PAG change following peripheral neuropathy The results obtained are as follows ; 1. Preproenkephalin[pENK] mRNA-containing neurons are found mostly in the ventrolateral portion at all levels of the PAG. 2. Prodynorphin[pDYN] mRNA-containing neurons are concentrated mostly in the ventrolateral portion at the caudal level of the PAG. 3. Preprotachykinin[pTAK] mRNA-containing neurons are localized mainly in the ventrolateral portion at all levels of the PAG. There is small numbers of pTAK mRNA-containing neurons in the dorsolateral and dorsal portion at all levels of the PAG. 4. Proneurotensin[pNT] mRNA-containing neurons are concentrated mostly in the medial part of ventrolateral portion of the caudal and mid PAG. 5. Peripheral neuropathy induces an increase of pNT mRNA levels in the PAG, while pENK, pDYN and pTAK mRNAs levels show no change. The present results indicate that the pENK, pDYN, pTAK or pNT mRNA-containing neurons are found mainly in the ventrolateral PAG, the area where analgesia is most easily produced and that neurotensin in the PAG may play an important role in modulating chronic neuropathic pain.
Analgesia ; Animals ; Dynorphins ; Enkephalins ; Gene Expression* ; In Situ Hybridization ; Neuralgia* ; Neurons* ; Neuropeptides* ; Neurotensin ; Periaqueductal Gray* ; Peripheral Nervous System Diseases ; Rats* ; RNA, Messenger ; Substance P

PURPOSE: The objectives of this study were to estimate myocardial functions in patients with chronic renal failure by pulsed Doppler echocardiography, and investigate correlation between Doppler and disease parameters. METHODS: We studied 13 patients with chronic renal failure whose creatinine clearance rate less than 25ml/min. Using pulsed Doppler echocardiography with curve following method, we measured peak velocity, mean velocity, velocity-time integral and peak acceleration of aortic and pulmonic flow velocity curves, and peak velocity, mean velocity, area of rapid filling wave in early relaxation phase(E wave) and filling wave by atrial contraction in late relaxation phase(A wave) and A/E ratios of the peak velocity and area. And we compared these parameters with those of the normal controls, and then those with early chronic renal failure(less than 6 months of disease duration) and those with late chronic renal failure(more than 6 months of disease duration). RESULTS: In patients with early chronic renal failure, peak velocity, flow time and area of E wave of the mitral flow velocity curves were significantly decreased, and those of A wave were markedly increased and resulted in marked increase in A/E ratios of the peak velocity and area compared with those of the normal controls. In patients with late chronic renal failure, mitral A/E ratio of the peak velocity continued to be increased, and peak velocity, velocity-time integral and peak acceleration of the aortic flow velocity curves were significantly decreased but pulmonary velocity- time integral was increased markedly compared with those of the normal controls. CONCLUSIONS: Significant increase of mitral A/E ratio in patients with early chronic renal failure and appearance of significant change in aortic flow velocity curves in patients with late chronic renal failure suggest that abnormalities of myocardial relaxation seem to be present in early phase of the chronic renal failure and continued into late phase but abnormalities of myocardial contraction to appear on late phase of the chronic renal failure.
Acceleration ; Creatinine ; Echocardiography, Doppler, Pulsed* ; Humans ; Intussusception ; Kidney Failure, Chronic* ; Myocardial Contraction ; Recurrence ; Relaxation ; Ultrasonography

BACKGROUND: Korea is an endemic area of viral hepatitis B. In spite of the HBV vaccination program since 1983, the prevalence of HBV antigen had remained high, which was 3.9% in male, 2.7% in female in 1994. But there is no approved management guideline on isolated anti-HBc and the meaning of which is not clear except the evidence of past infection. Therefore, we tried to investigate the factors which influence the seroconversion of anti-HBs during follow-up period. METHODS: Medical records of 239 subject with isolated anti-HBc, who visited a health promotion center from 1995 to 1997 and who were retested at least once during the 1-3 years' follow-up period, were analyzed. RESULTS: The seroconversion rate of anti-HBs was 45.61%(109/239) on the follow-up test. The number of newly vaccinated or non-newly vaccinated subjects during the follow-up period was 156 and 72, respectively. The seroconversion rate of anti-HBs of each group were 57.69%(90/156) and 22.22% (16/72) respectively(p<0.01). The subjects without previous history of HBV vaccination was 103. Among them the seroconversion rate of anti-HBs of the newly vaccinated or the non newly vaccinated group were 59.70%(40/67) and 22.22% (8/36), respectively(p<0.01). Sex, age, BMI, smoking, previous history of HBV vaccination did not influence significantly on the seroconversion rate of anti-HBs among the subjects with isolated anti-HBc. CONCLUSIONS: The seroconversion rate in people with isolated anti-HBc was significantly higher in the newly vaccinated than the non-newly vaccinated regardless of the previous history of HBV vaccination in this study. In spite of the non-differentiation of an-amnestic response from primary antibody response, we can expect to benefit from HBV vaccination in those with isolated anti-HBc.59.70%(40/67) and 22.22% (8/36), respectively(p<0.01). Sex, age, BMI, smoking, previous history of HBV vaccination did not influence significantly on the seroconversion rate of anti-HBs among the subjects with isolated anti-HBc. CONCLUSIONS: The seroconversion rate in people with isolated anti-HBc was significantly higher in the newly vaccinated than the non-newly vaccinated regardless of the previous history of HBV vaccination in this study. In spite of the non-differentiation of an-amnestic response from primary antibody response, we can expect to benefit from HBV vaccination in those with isolated anti-HBc.
Antibody Formation ; Female ; Follow-Up Studies ; Health Promotion ; Hepatitis B ; Humans ; Korea ; Male ; Medical Records ; Prevalence ; Smoke ; Smoking ; Vaccination

Congenital pseudarthrosis of the clavicle is a rare condition, which rarely produces functional disabilities except for cosmetic problems. Surgical treatment involves autogenous iliac bone grafts and internal fixation. Few studies have reported long-term results of surgical treatment or morphological changes of the clavicle. We report a patient with a congenital pseudarthrosis of the clavicle, who demonstrated a near normal radiographic appearance of the clavicle and an excellent result 22 years after the operation performed at 4 years of age.
Clavicle ; Cosmetics ; Follow-Up Studies ; Humans ; Pseudarthrosis ; Transplants

PURPOSE: To assess wall motion of the left ventricle in the various forms of congenital heart disease and to select appropriate methods by which to gauge left ventricular wall motion. METHODS: We evaluated left ventricular function, including volume, global ejection fraction, and regional wall motion(Centerline method, Local Ejection Fraction, Curved Perimeter method and Radial method). The evaluation was done on review mode of 30-degree elongated right anterior oblique projection of left ventriculogram by using cardiac analysis program of the DXC Hiline Digital System(GER, USA) in 53 pediatric patients undergoing diagnostic(or therapeutic) cardiac catheterization from June 1995 to July 1996 at Kyung-pook National University Hospital. RESULTS: Cardiac indices calculated by Dodge's and Simpson's methods were 5.76+/-2.13 L/min/ m2, 5.86+/-2.31 L/min/m2 respectively with significant correlation to each other(r=0.99, P<0.01). Global ejection fractions using both methods were 69.81+/-8.33%, and 69.69+/-8.20%, respectively (r=0.99, P<0.01). After dividing the left ventricular outline contour into five regions such as posterobasal, diaphragmatic, apical, anterolateral and anterobasal portions, all four models could ascertain regional wall motion abnormalities well(P<0.01). And among them, the Centerline method and the Curved Perimeter method correlated well in assessing wall motion(for each portion r=0.67, 0.84, 0.94, 0.91 and 0.61 respectively, P<0.01). CONCLUSION: In conclusion, we confirmed regional wall motion abnormalities in the various forms of congenital heart disease in spite of normal global ejection fractions, showing that the Centerline and Curved Perimeter methods are preferable methods in the assessment of wall motion in patiens with congenital heart disease.
Cardiac Catheterization ; Cardiac Catheters ; Child* ; Heart Defects, Congenital* ; Heart Ventricles* ; Humans ; Ventricular Function, Left

BACKGROUND: The quality of cord blood largely depends on cell viability. Viability assessments using trypan blue or 7-aminoactinomycin (7-AAD) staining, which are commonly used methods, may not reflect early apoptosis of cord blood cells. We aimed to investigate early apoptosis in cord blood cells following elapsed time after collection using double staining with annexin V and 7-AAD and to compare the result with that of viability evaluation using trypan blue or 7-AAD staining. METHODS: Umbilical cord blood samples were obtained from 30 pregnant women at the time of delivery between July 2012 and March 2013. Viability of cord blood cells was determined at 0 (T0), 24, and 48 hr after collection by using trypan blue exclusion assay, 7-AAD staining, and 7-AAD/annexin V staining. RESULTS: Viabilities defined by 7-AAD/annexin V staining at T0, 24, and 48 hr after collection were respectively as follows: total nucleated cells, 92.8+/-4.5%, 78.4+/-7.8%, and 65.5+/-8.1%; mononuclear cells, 94.4+/-1.7%, 90.8+/-4.2%, and 84.2+/-6.7%; and CD34-positive cells, 92.4+/-3.0%, 90.7+/-4.7%, and 89.3+/-7.0%. The viability using trypan blue was more than 90% until 48 hr after collection. CONCLUSIONS: The mean viability of total nucleated cells using 7-AAD/annexin V staining decreased to less than 80% at 24 hr after collection; however, the viability of CD34-positive cells was more than 85% until 48 hr. Our study's data will provide useful information for the assessing the quality of cord blood products.
Annexin A5 ; Apoptosis ; Cell Survival* ; Female ; Fetal Blood* ; Humans ; Methods ; Pregnant Women ; Trypan Blue ; Umbilical Cord*