We reviewed the post-reconstructive results and complications of arthroscopic anterior cruciate ligament reconsbuction using the patellar bone-tendon-bone autograft in 91 patients who underwent the index surgery at least one year ago. The changes of Lysholm knee score, limitation of motion, instability of the reconstructed ACL, musc)e strength, presence of anterior knee pain and other complications were evaluated at final fol- low-up(mean, 2.6 year). The results were as follows. 1. The mean Lysholm knee score was 65.5+-15.5 preoperatively and improved to 88.5+-7.4 postoperatively(p<0.05), 2. Of all, nine(9.9%) complained anterior knee pain. 3. Three patients(3.3%) showed limited range of motion. 4. Five(3.5%) showed instability of reconstructed ACL during the followup. Two were caused by trauma. Ln other three, no definite causes were found. 5. In 23 patients, cybex isokinetic thigh muscle strength test was perfornied preoperatively and at post-up. One year. The strength of quadriceps of the operated side at the angular velocity of 60 degrees per second showed mean 41.7% deficit of the normal side at postoperative one year. 6. Other complications were one case of chronic click sound in motion, and one case of the fracture which occurred at the autograft donor site of the proximal tibia.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Autografts* ; Follow-Up Studies ; Humans ; Knee ; Muscle Strength ; Postoperative Complications ; Range of Motion, Articular ; Thigh ; Tibia ; Tissue Donors

Any foreign body in the esohagus means an acute danger because of the impending perforation followed by mediastinitis, the impending erosion of bigarteries, and impending aspiration in the care of esorhageal occlusion. Nowadays, foreign body can reliably be removed hy endoscopy, and do not perforate the wall, not changed their form. Complication at the endoscopic extraction of foreign body, that requre surgical intervention are very rare. We presented a case of esophageal foreign body complicated with esophageal ulcer in a 83 years old male.
Aged, 80 and over ; Endoscopy ; Foreign Bodies* ; Humans ; Male ; Mediastinitis ; Ulcer*

We report the CT findings of diffuse esophageal spasm (DES) in a patient with dysphagia. Although an uncommon condition, DES should be included in the differential diagnosis if relatively long and symmetric segmental esophageal wall thickening and an epiphrenic esophageal diverticulum are noted at CT.
Deglutition Disorders ; Diagnosis, Differential ; Diverticulum, Esophageal ; Esophageal Spasm, Diffuse* ; Humans

BACKGROUND: The aim of this study was to assess the relationship between acute physiologic and chronic health examination (APACHE) II and sequential organ failure assessment (SOFA) scores and outcomes of post-cardiac arrest patients treated with therapeutic hypothermia (TH). METHODS: Out-of-hospital cardiac arrest (OHCA) survivors treated with TH between January 2010 and December 2012 were retrospectively evaluated. We captured all components of the APACHE II and SOFA scores over the first 48 hours after intensive care unit (ICU) admission (0 h). The primary outcome measure was in-hospital mortality and the secondary outcome measure was neurologic outcomes at the time of hospital discharge. Receiver-operating characteristic and logistic regression analysis were used to determine the predictability of outcomes with serial APACHE II and SOFA scores. RESULTS: A total of 138 patients were enrolled in this study. The area under the curve (AUC) for APACHE II scores at 0 h for predicting in-hospital mortality and poor neurologic outcomes (cerebral performance category: 3-5) was more than 0.7, and for SOFA scores from 0 h to 48 h the AUC was less than 0.7. Odds ratios used to determine associations between APACHE II scores from 0 h to 48 h and in-hospital mortality were 1.12 (95% confidence interval [CI], 1.03-1.23), 1.13 (95% CI, 1.04-1.23), and 1.18 (95% CI, 1.07-1.30). CONCLUSIONS: APACHE II, but not SOFA score, at the time of ICU admission is a modest predictor of in-hospital mortality and poor neurologic outcomes at the time of hospital discharge for patients who have undergone TH after return of spontaneous circulation following OHCA.
APACHE ; Area Under Curve ; Cardiopulmonary Resuscitation ; Hospital Mortality ; Humans ; Hypothermia* ; Hypothermia, Induced ; Intensive Care Units ; Logistic Models ; Odds Ratio ; Organ Dysfunction Scores* ; Out-of-Hospital Cardiac Arrest* ; Outcome Assessment (Health Care) ; Retrospective Studies ; Survivors

BACKGROUND: The neuropathy disability score (NDS) is a type of clinical grading method for diabetic polyneuropathy. In clinical practice, a nerve conduction study (NCS) is routinely employed as a non-invasive test for the evaluation of polyneuropathy. However, the consensus regarding the degree of abnormalities in NCS as a parameter for the severity of the disease is lacking. The objective of our study is to assess the relation between NDS and NCS parameters and thus verifying the reliability of our new NCS grading method in the representation of objective neurological defects. METHODS: Seventy three patients (man 31, women 42) with diabetes mellitus were included in the study. The NDS was scored in each patient by a single examiner and a NCS was performed on one side of extremities by an experiencedtechnician. Also, the gastrocnemius-soleus H-reflex was performed and analysed for the representation of a deep tendon reflex. The observed values of CMAP and CNAP were transformed into square root and log values. The transformed individual amplitudes and nerve conduction velocities were graded in relation to the mean normal values and standard deviations of our control group study. Then, the sum of the graded score was calculated in each individual and was correlated to the NDS using correlational analysis. RESULTS: There has been a significant linear relationship between NDS and our new NCS scoring system (Pearson's correlation coefficient r=0.703, p<0.01) CONCLUSIONS: The study showed significant correlations between NDS and our new grading system for NCS. Thus, NCS appears to reliably represent theobjective neurologic findings. In asddition, the quantititive grading of NCS would be useful in determining the grade of peripheral polyneuropathy in diabetic patients.
Consensus ; Diabetes Mellitus ; Diabetic Neuropathies* ; Extremities ; Female ; H-Reflex ; Humans ; Neural Conduction ; Neurologic Manifestations ; Polyneuropathies ; Reference Values ; Reflex, Stretch

A 42-year-old man presented with severe pancytopenia and uncontrolled epistaxis. The diagnosis of SLE was made and the pancytopenia was found to be due to myelofibrosis. The pulse therapy with methylprednisolone and maintenance therapy with prednisolone reversed both pancytopenia and myelofibrosis. Although myelofibrosis has been described in SLE, this coexistence must be very rare since there has been only 19 cases showing this combination. We report a case of SLE with myelofibrosis which was reversed by the treatment with glucocorticoid.
Adult ; Diagnosis ; Epistaxis ; Humans ; Lupus Erythematosus, Systemic* ; Methylprednisolone ; Pancytopenia ; Prednisolone ; Primary Myelofibrosis*

Several extraction cases with advanced bone loss as a result of periodontal disease, root or labial bone fracture, extensive caries, and periapical lesions occur esthetic, functional problems and severe bone loss. Therefore, to treat these cases used several surgical methods and socket preservation among this therapies have been evaluated simple, effective and good prognosis in the implant placement. Socket preservation therapy have been used with barrier membranes or/and graft materials. Deproteinized bovine bone mineral have been evaluated ideal grafting materials. Recently, calcium-phosphate thin film coated bovine bone powders were developed in our country, but the study for these material wasn't reported. When two types of xenograft materials were implanted in extraction sockets of Beagle dogs, the effects of these were analyzed after 4 weeks and 8 weeks histological views. The results of this study were as follows. 1.In control groups, 4 weeks after implantation, the extraction sockets were filled with connective tissue which has dilated vessels and epithelial growth. And after 8 weeks, irregular connective bundles were observed. But new bone formation was not seen. 2.In Bio-Oss groups, epithelial growth was not seen and bone powder was covered with connective tissue fiber. New bone formation was found around the interproximal bone. There was no special change seen after 8 weeks, connective tissue fibers became more regular, and bone growth near bone powder was not made well. 3.In Ca-P BBP groups, epithelial cells didn't grow in the extraction sockets, there was a lot of new bone made around the bone powder after 8 weeks, new bone around bone powder was replaced with mature bone. It is thought that bone powder grafting into the extraction sockets is very useful for conservation of ridge, and Ca-P BBP is more effective in bone formation than Bio-Oss.
Animals ; Bone Development ; Connective Tissue ; Dogs* ; Epithelial Cells ; Fractures, Bone ; Heterografts ; Membranes ; Osteogenesis ; Periodontal Diseases ; Powders ; Prognosis ; Transplants

Allergic reaction to insulin is mediated by several mechanisms; differences in amino acid sequence of animal and human insulin, altered tertiary structure of insulin and the presence of non-insulin protein contaminants or pharmaceutical additives. Anaphylactic reactions to insulin only occur in 0.1 to 2% of patients who stopped insulin therapy and have then resumed treatment. We report a diabetic patient who suffered severe anaphylactic reactions to human recombinant insulin, successfully treated by desensitization. A 19-year-old man with type 1 diabetes receiving Insulatard HM(R) developed generalized urticaria and angioedema with progression to dyspnea, dizziness and syncope. Skin prick test to all kinds of human recombinant insulin products revealed immediate type hypersensitivity and the titer of insulin IgE was increased in serum. The desensitization trial with Velosulin HM(R) using modified desensitization method was performed. Six months after the desensitization he was taking Velosulin HM(R) as well as Insulatard HM(R) without any evidence of systemic allergic reactions.
Amino Acid Sequence ; Anaphylaxis* ; Angioedema ; Animals ; Dizziness ; Dyspnea ; Humans* ; Hypersensitivity ; Immunoglobulin E ; Insulin* ; Insulin, Regular, Pork ; Skin ; Syncope ; Urticaria ; Young Adult ; Isophane Insulin, Human

A multiplex PCR protocol was established to simultaneously detect major bacterial pathogens in olive flounder (Paralichthys olivaceus) including Edwardsiella (E.) tarda, Streptococcus (S.) parauberis, and S. iniae. The PCR assay was able to detect 0.01 ng of E. tarda, 0.1 ng of S. parauberis, and 1 ng of S. iniae genomic DNA. Furthermore, this technique was found to have high specificity when tested with related bacterial species. This method represents a cheaper, faster, and reliable alternative for identifying major bacterial pathogens in olive flounder, the most important farmed fish in Korea.
Animals ; Edwardsiella tarda/genetics/*isolation & purification ; Enterobacteriaceae Infections/diagnosis/microbiology/*veterinary ; Fish Diseases/*diagnosis/microbiology ; Fisheries/*methods ; *Flatfishes ; Multiplex Polymerase Chain Reaction/economics/*veterinary ; Sensitivity and Specificity ; Streptococcal Infections/diagnosis/microbiology/*veterinary ; Streptococcus/genetics/*isolation & purification

PURPOSE: To compare the success rate of two procedures frontalis sling operation and maximal levator resection for recurred congenital ptosis. METHODS: In the 44 eyes in 30 patients who had recurrence after frontalis sling using banked fascia lata, 21 eyes received frontalis sling operation using autogenous fascia lata (Group I), and the other 23 eyes received maximal levator resection with aponeurotic approach (Group II). Follow up was made at one month, three months, six months and one year after the operation. RESULTS: Six months after the operation, Group I showed 81.0% while Group II showed 78.3% in success rate. One year after the operation, Group I had 76.2%, while Group II had 73.9% in success rate. There were no significant statistical difference between the two groups (p=0.744, 0.707). CONCLUSIONS: In cases of recurrence after frontalis sling using banked fascia lata in treating congenital ptosis patients, we found the frontalis sling using autogenous fascia lata to be effective. The maximal levator resection may be used as an alternative procedure.
Fascia Lata ; Follow-Up Studies ; Humans ; Recurrence*