The most commonly used graft source for anterior cruciate ligament reconstruction is the autogenous bone- patellar tendon-bone graft unit. Despite a good success record, intraoperative technical errors and postoperative complications have been known. Author analyzed intraoperative technical errors and postoperative complications, in 44 patients who were treated at the department of orthopaedic surgery, chosun university hospital from Jan. 1994 to Jun. 1996. The most common intraoperative technical errors was screw graft divergency in 5 cases. Other intraoperative technical errors were too anteriorly location of femoral tunnel in 1 case, too anteriorly location of tibial k femora) tunne.l both in 1 case, graft tunnel mismatching in 1 case, graft pullout in 1 case and partial destruction of posterior cortex of femoral tunnel in 1 case, fracture of the bone plug in 1 case. The most common postoperative complication was patellar tendinitis in 20 cases (45.5%). Other postoperative complications were anterior knee pain in 14 case. (31.8%), patellar crepitation in 12 cases (27.3%), quadriceps atrophy in 9 cases (20.5%), arthrofibrosis in 3 cases and graft failure in 2 cases. Author concluded the causes of intraoperative complications were technical errors, and anteriorly location of graft tunnel is most influenced factor to final fuctional results. To eliminate the postoperative complications, intraoperative technical errors should be avoided and also accelerated rehabilitation should be done.
Anterior Cruciate Ligament Reconstruction ; Atrophy ; Humans ; Intraoperative Complications ; Knee ; Patellar Ligament* ; Postoperative Complications* ; Rehabilitation ; Tendinopathy ; Transplants

The incidence of the tuberculous osteomyelitis of bone and joint has been decreasing due to improvements in nutrition and medical treatment. However the resurgence of tuberculosis is observed with more frequency as an opportunistic infection. In Korea the incidence of the tuberculosis has been decreasing with rapid economic development, but it is still one of the common pathological conditions involving bone and joint. Tuberculos osteomyelitis confined only to the long bones without involving joints is very rare. The accurate diagnosis of the turberculos osteomyelitis of long bone is difficult, because of the low incidence, long duration and nonspecific radiological findings. We reviewed retrospectively a total of 521 consecutive bone and joint tuberculosis from March 1985 to December 1994. Thirty-eight cases were involved only long bones without inflicting joints. The mean duration of follow up was 16 months. The disease was most frequent in the third decade. Femur(45%) and metaphysic(79%) were the most commonly involved site of the tuberculous osteomyelitis of the long bone. Significant delay in the diagnosis and the initation of the treatment would have been avoided if the biopsy had been performed early. It was looked like that longer symptom duration, higher ESR, associated with pulmonary tuberculosis and inappropriate treatment resulted in recurrence. But when compared with primarily cured cases, these factors did not affect the recurrence statistically. In conclusion, the better results and prevention of the recurrence were observed in cases with early diagnosis, complete removal of the lesion and continuous antituberculous medication.
Biopsy ; Diagnosis ; Early Diagnosis ; Economic Development ; Follow-Up Studies ; Incidence ; Joints ; Korea ; Opportunistic Infections ; Osteomyelitis ; Recurrence ; Retrospective Studies ; Tuberculosis ; Tuberculosis, Osteoarticular ; Tuberculosis, Pulmonary

The purpose of this review is to provide a comprehensive approach for optimal strategies of upper limb motor rehabilitation after stroke. Stroke is a common, serious, and disabling global health-care problem. Optimal organization of rehabilitation for stroke patients has been extensively documented. However, between 30% and 66% of individuals with stroke do not obtain satisfactory motor recovery of the affected upper limb with rehabilitative interventions. The recovery of the affected upper extremity depends on intensity, task progression, and repetition to neural plasticity, namely, the ability of central nervous system cells to modify their structure and function in response to external stimuli. Recently, constraint-induced movement therapy, motor imagery, action observation, or mirror therapy has emerged as interesting options as add-on interventions to standard physical therapies. In this review, we will discuss to establish a framework by which several promising interventions for neural plasticity.
Central Nervous System ; Humans ; Neuronal Plasticity ; Plastics ; Rehabilitation* ; Stroke* ; Upper Extremity*

PURPOSE: The aim of this study was to examine the relationship between tooth loss and sub-clinical atherosclerosis in Korean adults. MATERIALS AND METHODS: The subjects were part of a cohort study conducted in Ansan city by the Korea University medical school as part of the Korean Genome project. 749 subjects over than 40 years old were evaluated. After taking panoramic radiography, the amount of tooth loss was calculated. The intima-media thickness (IMT) was assessed by using ultrasonography at the common carotid artery. Traditional cardiovascular risk factors for atherosclerosis were also evaluated. The relationship between tooth loss and the IMT was evaluated using ANOVA with Scheffe's multiple comparison method in univariate analysis. Multiple regression analysis was also performed to determine the significance between the IMT and tooth loss. RESULTS: With age, tooth loss increased, but there was no significant increase in other traditional cardiovascular risk factors. Univariate analysis revealed the IMT to be positively related with the amount of tooth loss. Regression analysis of the IMT in the anterior and posterior tooth loss revealed that only the posterior tooth loss was significantly related with the IMT at all sites of the common carotid artery (right far wall, P = .015; left far wall, P = .008; right near wall, P < .001; left near wall, P = .001). CONCLUSION: This study verified the positive relationship between the increased tooth loss at the posterior area and the accumulation of atheroma in arteries.
Adult ; Arteries ; Atherosclerosis ; Carotid Artery, Common ; Carotid Intima-Media Thickness ; Cohort Studies ; Genome ; Humans ; Korea ; Plaque, Atherosclerotic ; Radiography, Panoramic ; Risk Factors ; Schools, Medical ; Tooth ; Tooth Loss

BACKGROUND: We assessed the effectiveness of arthroscopic capsular release for the treatment of adhesive capsulitis. Further, we tried to ascertain the clinical benefits, if any, of pancapsular release over selective capsular release, where the two differ by performing or not performing a posterior capsular release, respectively. METHODS: Thirty-five consecutive patients with either primary or secondary adhesive capsulitis who failed conservative treatment for more than 6 months were enrolled in the study. A total of 16 patients allocated in group 1 received a pancapsular release that comprises the release of the rotator interval, anteroinferior capsular, and the posterior capsular release, whereas 19 patients in group 2 received a selective capsular release that comprises only the release of the rotator interval release and anteroinferior capsular release. The clinical outcomes, visual analogue scale (VAS) score, Constant score, and range of motion, were assessed preoperative and postoperatively. RESULTS: In both groups, the preoperative VAS score, Constant score, and ROM showed a significant improvement by the 6-month follow-up. We found that the immediate postoperative internal rotation was significantly higher in group 1 than group 2. Despite significant differences seen between the two groups at the initial postoperative period, there were no significant differences in Constant score, VAS score, and the ROM at all the subsequent follow-ups between the two groups. CONCLUSIONS: Arthroscopic capsular release for the treatment of adhesive capsulitis is very effective. However, pancapsular release did not show any advantage over selective capsular release in terms of overall clinical outcome.
Bursitis* ; Follow-Up Studies ; Humans ; Joint Capsule Release* ; Postoperative Period ; Range of Motion, Articular

PURPOSE: The purpose of this study was to investigate the experience of examinees who took the first clinical skill examination in Korea. METHODS: The data were collected by written survey, telephone, and face-to-face interviews with 46 examinees who took a clinical skills examination test at Jeju National University School of Medicine. Thirty-two questionnaires were valid for analysis. RESULTS: Examinees' self-evaluation scores with regard to the level of difficulty of the CPX was 2.83 on average (1 for very easy, 5 for very difficult), and the score on the degree of adequate time for the CPX was 2.69 on average (1 for enough, 5 for very short). Examinees' self-evaluation scores on the level of difficulty of the OSCE was 2.37 on average (1 for very easy, 5 for very difficult), and the score on the degree of adequate time for the OSCE was 2.56 on average (1 for enough, 5 for very short). CONCLUSION: We hope that our study provides useful information on practical questions in the development and review of exams and will be used to develop educational content and teaching methods in medical education.
Clinical Competence ; Diagnostic Self Evaluation ; Education, Medical ; Education, Medical, Undergraduate ; Educational Measurement ; Humans ; Licensure ; Schools, Medical ; Teaching ; Telephone ; Surveys and Questionnaires

BACKGROUND: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for fractures occurring along length of humerus. METHODS: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single incision. Postoperatively, we measured the Mayo elbow performance index (MEPI). RESULTS: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an average 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final follow-up (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. CONCLUSIONS: Our whole humerus with a single incision was effective for the treatment of segmental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation.
Elbow ; Follow-Up Studies ; Fracture Fixation* ; Humans ; Humeral Fractures ; Humerus* ; Muscles ; Peripheral Nervous System Diseases ; Traction ; Transplants ; Treatment Outcome

No abstract available.
Hernia, Diaphragmatic*

No abstract available.
Hyperthyroidism*

Gold preparation had been used frequently in the past in the treatment of rheumatoid arthritis, tuberculosis and lupus erythematosua, etc. It is still used. when other more potent remedies, such as steroid, failed. We report a case of drug eruption following the use of gold preparation. A 38 year-old female was referred to our department from orthopedic surgery because of generalized, multiple, pin head sized, violaceous and flat topped papules of 1 x 2 mm in size and mucosal erosions and ulcers following gold therapy for rheumatoid arthritis. She had received 5 intramuscular injections of gold preparation (Myochrysine'), 220mg in total amounts. Our clinical impression was lichen planus like drug eruption, but histopathological picture disclosed nonapecific dermatitis. The eruption had disappeared gradually following oral administration of antihistaminics and prednisolone and daily starch tub baths.
Administration, Oral ; Adult ; Arthritis, Rheumatoid ; Baths ; Dermatitis ; Drug Eruptions* ; Female ; Head ; Humans ; Injections, Intramuscular ; Lichen Planus ; Orthopedics ; Prednisolone ; Starch ; Tuberculosis ; Ulcer