The rupture of anterior cruciate ligament has been diagnosed by stress test, radiogram and diagnostic arthroscopy, but these methods have several disadvantages of lack of objectivity, exposure to radiation and risk of anesthesia. To eliminate these difficulties, the K-T 1,000 knee ligament arthrometer was used for the objective diagnosis in the injury of anterior cruciate ligament. We performed instrumented measurement of anterior-posterior laxity of the knee in 100 normal subjects by using the K-T 1,000 knee ligament arthrometer under the 15 lb., 20 lb. and maximum anterior pulls, and 20 lb. posterior push. The following results were obtained: 1. The mean anterior displacement at 20 lb.: 4.43mm The mean posterior displacement at 20 lb.: 2.30mm 2. The mean right knee-left knee difference in anterior displacement: 0.89mm 3. The mean anterior compliance index: 1.16mm So, we believed that a right knee-left knee difference and a anterior compliance index are sensitive measures of the integrity of the anterior cruclate ligament. And this test method was helpful for the diagnosis and objective recording in the injury of anterior cruciate ligament. This test method has following advantages: 1. There is no anesthesia risk. 2. The patient and examiner undergo no radiation exposure. 3. Diagnostic arthroscopy may be avoided. 4. Due to patient comfort, there is minimal muscle guarding.
Anesthesia ; Anterior Cruciate Ligament ; Arthroscopy ; Compliance ; Diagnosis ; Exercise Test ; Humans ; Knee ; Ligaments ; Methods ; Radiation Exposure ; Rupture

Since 1856, Mayer13) coined the term “osteotomy” for a tibial resection for an angular deformity, various shapes and designs of osteotomies in long bone or pelvis have been popularized to treat the malunion, osteoarthritis of hip and knee, bow leg, L.C.P., or C.D.H. etc. The purpose of corrective osteotomy for tibia is so different from that of upper extremity because it must be restored the weight bearing alignment, and equalize or minimize the leg length discrepancy. We respectively reviewed 14 cases with various angular deformities on tibia who were treated at Dept. of Orthopaedic Surgery, Catholic Medical College from Jan. 1976 to Dec. 1984. The results obtained were as follows: 1. Causes of angular or rotational deformities of tibia were malunion in 11, bow leg in 2 and partial closure of distal tibial epiphysis in l. 2. Ten cases of tibial deformities exceeded over the 10° of medial or lateral angulation and 15° of anterior or posterior bowing were corrected for normal weight-bearing alignment in lower leg. And a rotational deformity may be so disabling to walk as to require surgery. So four cases of tibial angular deformities combined with more than 20° of external rotation and 5° of internal rotation were corrected for normal good looking walks. 3. The maximum length that can be gained by an opening wedge osteotomy was near the point of maximum angluation, but it could be changed by the cause of deformity and patient's age. We've done 4 cases of opening and 10 cases of closing wedge osteotomy. 4. Angular deformity in one plane due to fracture in children under 10 years of age may be corrected spontaneously by growth, but deformities due to bow leg or epiphyseal injury cann't be expected any spontaneous correction of deformity by growth. So three cases of tibial deformities due to bow leg or epiphyseal injury in children were corrected in earlier after recognition of that deformities because of possible damage to articular cartilage and the combined rotational deformities. 5. A slight deformity if the angulation involves near a joint, knee or ankle could be seriously disabling and so must be correctcd earlier. 6. Functional results of the corrective wedge osteotomy in angular and rotational deformities of tibia were excellent, good, fair in 4, 7 and 3, respectively.
Ankle ; Cartilage, Articular ; Child ; Congenital Abnormalities ; Epiphyses ; Genu Varum ; Humans ; Knee ; Knee Joint ; Leg ; Numismatics ; Osteoarthritis, Hip ; Osteotomy ; Pelvis ; Tibia ; Upper Extremity ; Weight-Bearing

Hospital transfusion service should be directed toward the optimization of transfusion therapy, but in practice the hospital transfusions, especially of fresh frozen plasma(FFP), were practiced inappropriately against the real need. So we evaluated the usage pattern of fresh frozen plasma in the Capital Armed Forces General Hostal during the period of January through December in 1994. And then, from 1995, after education of the clinician upon the basis of the survey in 1994, we regulated the use of FFP, by adapting the transfusion control program. We compared the result of 1995 to those of 1994, including the total used FFP number, the usage pattem in various disease and the combined use with other blood components. The results were as follow. 1. About 50% of total FFP was used inappropriately at 1994, and the main misuse was done to the patients who were suffering from renal disease and bum. About 14% of FFP usage combined with the packed RBCs was also seemed to be inappropriate in 1994. 2. In 1995, with the transfusion control program, there was 72% fall in the total hospital's usage of FFP and the misused conditions such as bum and nephrotic syndrome were virtually corrected. We concluded that the education, guideline and regulation by the director of the transfusion service could remarkably correct the inappropriate use of FFP without any special costs.
Arm ; Education ; Humans ; Nephrotic Syndrome ; Plasma*

A giant abdominal aortic aneurysm (AAA) renders surgical treatment much more difficult by deforming the proximal infrarenal aortic neck (shortened length and disturbed angulation), by altering the iliac arteries (marked tortuosity and aneurysmal dilatation), and by displacing abdominal organs. Because the retroperitoneal rupture of giant AAA makes the mesentery more elongated and deformed, compromising its blood flow and thus increasing the risk of mesenteric ischemia such as colon ischemia. We describe here the surgical repair of a large infrarenal AAA with a ruptured huge left common iliac artery aneurysm of 13.5 cm in diameter, accompanied by colostomy due to colon ischemia which occurred during the operation. We discuss the pathophysiology and preventive strategy of colon ischemia during ruptured giant AAA repair.
Aneurysm* ; Aneurysm, Ruptured ; Aortic Aneurysm, Abdominal ; Colitis, Ischemic ; Colon* ; Colostomy ; Iliac Artery ; Ischemia* ; Mesentery ; Neck ; Rupture

BACKGROUND: There are reviews with regard to the treatment of pigmented nevi present on the palms, soles, and genitalia. One advocated that pigmented nevi on thesa locations should be prophylactically removed to avoid their tuture development into malignant melanoma, while the other believes that this is not practicable. OBJECTIVE: Our purpose was to determine the incidence rates and clinical characteristics and to discuss the management of pigrnented nevi, developed on these areas of the Korean men. METHOD: We examined 1,537 Korean men, between 19 and 21 rears old, to evaluate the pigmented nevi on their palms, soles, and genitalia. RESULTS: Atleast 1 pigmented nevus appeared in 314(20.4%) men on the palms, 189(12.3%) on the soles, and 117(7.6%) on the genitalia. The sizes(mean diameter) of nevi on genitalia, soles, and palms were 4.5mm, 3.1mm, and 2.3mm respectively. The color of the nevi was darkest on the penile shaft(4.3 point) and then glans penis(3.9 points), soles(3.2 points), palms(2.5 points) in decreasing orders of the points. Most of the nevi was consistent with type 1 by Levers clinical classification and their incidence were 357 on palms, 211 on soles, and 128 on genitalia. Among the 21 nevi of type 2, 13 nevi appeared on the soles, and noine of type 3 and type 5 were found. The distribution of the nevi on the palms was of a rather uniform and scattered pattern, whereas, on the soles, they were distinctly concentrated in the midfoot. Tkie nevi on the glans penis appeared larger and more irregular in outline than those on the penile shaft. CONCLUSION: The plantar nevi were larger, darker, and had greater incidence of elevated type compared with the palmar nevi. From this observation, particular attenticn should be paid to the presence of pigmented nevi on the soles.
Classification ; Genitalia* ; Humans ; Incidence ; Male ; Melanoma ; Nevus* ; Nevus, Pigmented ; Penis

We herein report a 28-year-old woman with typical marginal keratoderma of the palms of 4 years duration. She denied any chronic pressure or trauma. Histological findings disclosed marked hyperkeratosis, parakeratosis, acanthosis, elongation of rete ridges, edema and capillary dilatations of papillary dermis, and infiltration of chronic inflammatory cells. There was no changes in collagenous and elastic fibers. Treatment with oral 13-cis retinoid and topical application of 0.02% flumethasone ointment containing 3%, salicylate resulted in only transit effect.
Adult ; Capillaries ; Collagen ; Dermis ; Dilatation ; Edema ; Elastic Tissue ; Female ; Flumethasone ; Humans ; Parakeratosis

Flavimonas oryzihabitans is a gram-negative, glucose non-fermentative bacillus, and is rarely reported as a pathogen in human. In recent years, reports of infection due to F. oryzihabitans, especially in immunocompromised patients with indwelling catheter or peritoneal Tenckhoff catheter have increased. We report two cases of F. oryzihabitans peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
Bacillus ; Catheters ; Catheters, Indwelling ; Glucose ; Humans ; Immunocompromised Host ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Pseudomonas*

BACKGROUNG AND OBJECTIVES: Diet is the basic and principal therapeutic modality for hyperlipidemia. However, diet therapy alone showed variable responses in lowering lipid levels in different studies. This research is to prove the effect of diet and Apo E polymorphism on the variation of serum lipid profile in Korean males. MATERIALS AND METHODS: To evaluate the gene-diet interation, serum total cholesterol (Chol), triglycerides (TG), HDL-cholesterol and LDL-cholesterol (HDLc, LDLc), lipoprotein (a) (Lp (a)), and fasting blood glucose (FBS) were measured with Apo E genotyping in vegeterians (group A, n=154) and in healthy Korean male adults (group B, n=150) of similar mean age (50.1 vs. 49.3). RESULTS: Lipid profiles showed significantly lower levels in group A compared to group B (Chol 168.3+/-30.5 mg/dL vs. 181.3+/-33.4 mg/dL, p<0.001;TG 131.0+/-62.9 mg/dL vs. 149.4+/-76.7 mg/dL, p=0.023;HDLc 56.0+/-11.0 mg/dL vs. 56.9+/-11.5 mg/dL, p=0.509;LDLc 92.5+/-28.1 mg/dL vs 100.6+/-29.9 mg/dL, p=0.016;Lp (a) 22.1+/-14.6 mg/dL vs. 26.9+/-13.8 mg/dL, p=0.004;FBS 85.1+/-14.1 mg/dL vs. 102.7+/-16.6 mg/dL, p<0.001). The Apo E genotyping showed Epsilon3/3, 64.1%; Epsilon3/4, 20.7%;Epsilon2/3, 11.8%;Epsilon2/2, 1.3%;Epsilon4/4, 0.6% in the combined groups. The distribution was similar in both groups. Chol and LDLc were significantly (p<0.05) higher in Epsilon3/4 allele group compared to other allele groups among non-vegetarians. On the other hand, Chol and LDLc were significantly (p<0.01) lower in vegetarians compared to non-vegetarians only in Epsilon3/4 allele group. CONCLUSION: Vegetarian diet significantly lowered Chol, TG, LDLc, Lp (a) and FBS levels. Significant lipid lowering effect of vegetarian diet was noted in Apo E allele Epsilon3/4 group which had significantly higher Chol and LDLc levels without diet intervention. These data suggest that the influence of diet on serum lipid profiles differ according to apo E genotypes.
Adult ; Alleles ; Apolipoproteins E ; Blood Glucose ; Cholesterol ; Diet Therapy ; Diet* ; Diet, Vegetarian ; Fasting ; Genotype ; Hand ; Humans ; Hyperlipidemias ; Lipoprotein(a) ; Male* ; Triglycerides

We tried to analyze the status of 10 units of frozen thawed apheresis platelet concentration by 6% DMSO method for the evaluation of practical applicability. The platelet concentrations were transferred to PL-732(Baxter, USA) cryopreservation bag, and DMSO is added to those bag at slow rate until expected final 6% concentration is achieved, thereafter those were directly placed to -80 degrees C refrigerator for freezing. Someday later from I week to 1 month, those were thawed at 37 degrees C water bath, and then washed by same volume of ABO matched plasma. In the course of cryopreservation, about 7% of platelets were lost and the mean recovery rate of platelet was 93% compared with those of unfrozen status. LDH, the values of platelet lysis, and pH were within normal limits, whereas platelet aggregation test shows decreased aggregation to collagen and ristocetine compared with those of unfrozen status(p<0.05) but they were clinically acceptable. We suggest that the frozen platelets may be useful in a some clinical situation such as hematologic malignancy and solid tumor by autologous transfusion.
Baths ; Blood Component Removal ; Blood Platelets* ; Collagen ; Cryopreservation* ; Dimethyl Sulfoxide* ; Freezing ; Hematologic Neoplasms ; Hydrogen-Ion Concentration ; Plasma ; Platelet Aggregation ; Ristocetin ; Water

OBJECTIVES: Radiofrequency(RF) ablation is an effective and low risk curative treatment for supraventricular arrhythmias. Catheter ablation produced cardiac lesions primarily through formation of coagulation necrosis. We evaluated the degree of myocardial injury after RF catheter ablation by means of serial measurement of myocardial enzyme. METHODS: Fifty-one patients with symptomatic supraventricular tachycardia were included. There were 32 men and 19 women(mean age. 39.5+/-15.4 years)All patients underwent electrophysiologic study to detect accessary pathway and ablation with radiofreguency current. A mean of 18.3+/-14.2 radiofrequency pulses were delivered. The pulses were at a power of 50 to 60 Volts for a duration of 20 to 30 seconds. Unipolar method and a 6F or 7F catheter with a 4 mm tip electrode was used. LDH, CPK and Ck-MB as a kind of cardiac enzyme were measured before and after ablation. RESULTS: 1) The concentration of LDH and CPK were elecated at 8 hours and 16 hours after ablation (p<0.05). 2) The concentration of CK-MB was elevated at 8 hours, 16 hours, 24 hours and 72 hours after ablation(p<0.05). 3) There was no correlation between the number of applications and amounts of radiofrequency current and rise in LDH, CPK, CK-MB concentration. CONCLUSION: The concentration of LDH, CPK and CK-MB were elevated after ablation but they were within normal limits. RF catheter ablation produced myocardial damage inevitably but were within normal limits. RF catheter ablation produced myocardial damage inevitably but minimally, then RF ablation is an effective and safe therapeutic modality for patients with symptomatic tachyarrhythmias.
Arrhythmias, Cardiac ; Catheter Ablation* ; Catheters ; Electrodes ; Humans ; Male ; Necrosis ; Tachycardia ; Tachycardia, Supraventricular*