For prevention of limitation of range of motion due to arthrofibrosis of the knee joint after anterior cruciate ligament reconstruction, it is accepted in general that the operation should be delayed for about three weeks after injury. We studied the duration form operation to time of full range of motion, and analized the results in forty-eight patients who had undergone arthroscopic anterior cruciate ligament recostruction using the autologous bone-patella tendon-bone graft and early CPM, range of motion exercise during Feb. 1991 and June 1994. The results were as follows: 1. The average interval from injury to operation were 1.3 weeks in acute injury group, 6 weeks in subacute injury group and 20.7 months in chronic group. The average interval from operation to full range of motion were 7.1 weeks in acute injury group, 5.7 weeks in subacute injury group and 3.0 weeks in chronic group. 2. In acute injury group, 14(93.3%) of 15 cases showed full extesion and only 1 case(6.7%) showed the limitation of extension less than 5 degrees. In subacute injury group, 6(85.7%) of 7 cases showed full extension but1 case(14.3%) showed the limitation of extension less than 5 degrees. On the other hand in the chronic injury group, all the 26 cases(100%) of the patients showed full extension. 3. In acute injury group, 14(93.3%) of 15 cases showed full flexion and only 1 cases(6.7%) showed the limitatin of flexion less than 5 degrees. In subacute injury group, 6(85.7%) of 7 cases showed full flexion but 1 case(14.3%) showed the limitation of flexion less than 5 degrees. On the other hand in the chronic injury group, 23(88.5%) of 26 cases could flex to full range of flexion, and 3 cases(11.5%) revealed limitation of flexion less than 5 degrees. 4. The limitation of ROM mainly due to arthrofibrosis can be prevented by early range of motion execise and active rehabilitation in the acute or chronic anterior cruciate ligament reconstruction using the autograft bone-patella-bone graft. Although in acute patients the interval from operation to full ROM can be prolonged, the full ROM can be achieved after all.
Anterior Cruciate Ligament Reconstruction ; Anterior Cruciate Ligament ; Autografts ; Hand ; Humans ; Knee Joint ; Patella ; Patellar Ligament ; Range of Motion, Articular ; Rehabilitation ; Transplants

Spontaneous testicular hemorrhagic necrosis is a rare disease usually associated with testicular torsion. Partially involved and suspicious testis tumor cases are also defined from orchiectomy specimens. Herein, a spontaneous hemorrhagic necrosis, without any testicular torsion, but with involvement of the whole testicle and epididymis, is reported. A 21 year old patient, who presented with a painless left testicular enlargement of several days duration was believed, based on physical examination, ultrasonography and elevation of serum LDH, to have a testicular tumor. Diagnosis was made only after radical orchiectomy and histopathological examination.
Diagnosis ; Epididymis ; Hemorrhage ; Humans ; Male ; Necrosis* ; Orchiectomy ; Physical Examination ; Rare Diseases ; Spermatic Cord Torsion ; Testis* ; Ultrasonography ; Young Adult

Testicular torsion is the most common cause of acute scrotal pain in prepubertal and adolescent boys. The overall testicular salvage rate with acute torsion is only 20 to 50 per cent. However, up to 50 percent of the patients with acute torsion have experienced previous episodes of acute testicular pain. Intermittent testicular torsion is a separate entity that should be considered in all young males with a history of scrotal pain and swelling. interspersed with long interval without symptoms. Most males with testicular torsion have aberrant anatomy for the testes to be more susceptible to torsion. Bell-clapper deformity and long mesorchium have been typically described at exploration. On reviewing the medical records. elective orchiopexy was performed on l2 patients under the diagnosis of intermittent testicular torsion during the recent 5 years at Yonsei University Hospital. The features and pathological anatomy of intermittent testicular torsion in these l2 patients are described. Awareness of intermittent testicular torsion as a definite entity and early elective orchiopexy will improve testicular salvage rate.
Adolescent ; Congenital Abnormalities ; Diagnosis ; Humans ; Male ; Medical Records ; Orchiopexy ; Spermatic Cord Torsion* ; Testis

No Abstract Available.
Arthroplasty* ; Knee Joint* ; Knee*

No abstract available.
Suction* ; Tonsillectomy*

OBJECTIVE: The purpose of this study was to compare the longitudinal treatment effects of facemask with rapid maxillary expansion (FM/RME) and chincup (CC) therapy followed by fixed orthodontic treatment (FOT) in Class III malocclusion (CIII) patients. METHODS: The samples consisted of twenty-one CIII patients who had similar skeletal and dental characteristics before FM/RME or CC therapy and good retention results (Class I molar/canine relationship and positive overbite/overjet) after FOT (Group 1, FM/RME, n = 11; Group 2, CC, n = 10). Lateral cephalograms were taken before (T0) and after FM/RME or CC therapy (T1), and after FOT and retention (T2). Skeletal and dental variables were measured. Mann-Whitney U-test and Wilcoxon signed-rank test were used for statistical analysis. RESULTS: During T0-T1, FM/RME therapy induced forward movement of point A, and labioversion of the upper incisors. Both groups showed posterior repositioning of the mandible. FM/RME resulted in increase of the vertical dimension; however, CC caused an increase in articular angle and decrease in gonial angle. During T1-T2, both groups exhibited forward growth of point A. Group 1 showed forward growth and counterclockwise rotation of the mandible and increase of IMPA; however, Group 2, showed increase of ANS-Me/N-Me and decrease of overbite. CONCLUSIONS: The key factor for successful FM/RME and CC therapy and good retention results might be a harmonized forward growth of the maxilla that could keep pace with the growth and rotation of the mandible.
Humans ; Incisor ; Malocclusion ; Mandible ; Maxilla ; Overbite ; Palatal Expansion Technique ; Retention (Psychology)

Magnetic resonance imaging(MRI) is accepted as a useful tool for the diagnosis of injury of the knee recently. The anterior cruciate ligament tear is accompanied by the damage of the osseous and soft tissue of the knee. The occult osseous lesion is found on magnetic resonance imaging as bone density change that is not found on the simple radiograph. From Jan. 1992 to Apr. 1994, magnetic resonance imaging was performed on 44 patients with acute anterior cruciate ligament tears. MRI was done within 6 weeks of the index anterior cruciate ligament injury. The criteria of decreased signal intensity on the Tl weighted image and increased signal intensity on the T2 weighted image was applied for the incidence assessment of the occult osseous lesion. After arthroscopy with or without ACL reconstruction, follow-up simple radiograph was checked every 3 months. Occult osseous lesions were documented in 32(73%) of the 44 patients. Of the 32 patients with bony lesion, 81% had lesions of the lateral compartment. Lateral femoral condyle was involved in 15 cases(46.9%), and lateral tibial plateau in 22 cases (68.8%). Follow-up X-ray revealed no joint deperession in all of the 32 patients with the occult osseous lesion. This result suggests that there is a high correlation between the occult osseous lesion of lateral compartment of the knee on magnetic resonance imaging and anterior cruciate ligament tear. The presence of the occult osseous lesion in the patient with acute anterior cruciate ligament tear did not affect rehabilitation and weight bearing.
Anterior Cruciate Ligament ; Arthroscopy ; Bone Density ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Joints ; Knee ; Magnetic Resonance Imaging ; Rehabilitation ; Tears ; Weight-Bearing

After Photorefractive keratecto my[PRK]and Laser in situ keratomileusis[LASIK]for myopic astigmatism correction, we evaluated the change of myopic and astigmatic refraction and analyzed the results. Toric PRK[20 eyes]and Toric LASIK [45 eyes], total 65 eyes were performed using Toric PRK program of Summit Apex Plus and erodible mask and followed up for one year. We analyzed the change of uncorrected visual acuity, best corrected visual acuity, myopic refraction and astigmatic refraction.Mean spherical refraction had decreased from preoperative -4.36 +/-1.19D [PRK]&-8 .83 +/-2.20D[LASIK]to postoperative 12 month -0.25 +/-0.52D[PRK]&-0.21 +/-0.87D[LASIK].Cylindrical refraction had changed from preoperative -1.62 +/-1.09D[PRK]&-2.07 +/- 0.96D[LASIK]to postoperative 12 month -0.16 +/-0 .3 9 D [PRK]& 0.29 +/-0.69D[LASIK].Twelve months after Toric PRK, 64.0% of mean spherical equivalent was included within +/-0.5D and 92.0%was included within +/-1.0D.Twelve months after Toric LASIK, 57.5%of mean spherical equivalent was included within +/-0.5D and 77.5%was included within +/-1.0D.Uncorrected visual acuity was 0.7 or better in 100%of the Toric PRK group and 80.0%of the Toric LASIK group.No eyes in Toric PRK group lost two or more Snellen lines of best corrected visual acuity at postoperative 12 month, while 2 eyes[5.0%]in Toric LASIK group did. We concluded that myopic astigmatism correction using erodible mask was satisfactory.
Astigmatism* ; Cytochrome P-450 CYP1A1* ; Keratomileusis, Laser In Situ ; Masks* ; Visual Acuity

PURPOSE: The purpose of this study was to investigate the validity of in vivo experimental models to evaluate the therapeutic potentials of drugs for the treatment of premature ejaculation. MATERIALS AND METHODS: Male Sprague-Dawley rats (250-300gm) were divided into 8 groups based on the experimental agent administered: serotonergic agents (serotonin, clomipramine, fluoxetine, sertraline, paroxetine) and alpha-adrenergic blockers (prazosin, terazosin, tamsulosin). Various concentrations of the agents were intravenously injected 20 minutes prior to the electrical stimulation of the hypogastric nerve. Intraluminal pressures of seminal vesicle and vas deferens were measured on each side in the same animal. The concentration-response curves for each drug were obtained, and the inhibitory effects of the drugs on the contractile response of the seminal vesicles and vasa deferentia to the electrical stimulation of the hypogastric nerve were compared. RESULTS: All the serotonergic agents resulted in dose-dependent inhibition of the intraluminal pressure of the seminal vesicle to electrical stimulation (clomipramine>serotonin>fluoxetine>sertraline>paroxetine). The vasal pressure responses were also effectively inhibited by serotonin, clomipramine and sertraline, in that order. Fluoxetine and paroxetine showed no inhibitory effects on the vasal pressure. The pressure responses of both the seminal vesicles and the vasa deferentia were inhibited in a dose-dependent manner by all the alpha-adrenergic blockers. CONCLUSIONS: This in vivo model was not able to demonstrate the established clinical effects of various serotonergic agents widely used in the treatment of premature ejaculation. Conversely, the alpha-adrenergic blockers showed marked dose-dependent inhibition of the seminal tract pressure responses. Therefore, this in vivo model has limitations for the proper evaluation of therapeutic potentials of drugs for the treatment of premature ejaculation.
Adrenergic alpha-Antagonists ; Animals ; Clomipramine ; Electric Stimulation ; Fluoxetine ; Humans ; Male ; Models, Theoretical* ; Paroxetine ; Premature Ejaculation* ; Rats, Sprague-Dawley ; Seminal Vesicles ; Serotonin ; Serotonin Agents ; Sertraline ; Vas Deferens

We report herein a case of primary cutaneous diffuse large B-cell lymphoma with multiple skin lesions in a Korean woman. A 56-year-old woman presented with rapidly growing multiple sub-cutaneous nodules in her right flank and right upper arm. Microscopic examination of skin biopsy specimen showed diffuse infiltrates of large atypical lymphocytes with vesicular nuclei, prominent nucleoli and moderate degree of mitotic figures in deep dermis and subcutis. Immunophenotypic studies revealed the lymphoid infiltrates reacted with CD45, CD20 and bcl-2 protein, but none of the sections expressed CD3, bcl-6 protein and CD30. In physical examination and staging work-up, we could not find any other extracutaneous or systemic involvement. She was treated with 2 cycles of high-dose multiagent chemotherapy with the Vanderbilt and the BEAM regimen combined with the autologous peripheral blood stem cell transplantation. Until now, 10 months after termination of treatment, she has shown improvement of all skin lesions and no development of extracutaneous disease.
Arm ; B-Lymphocytes* ; Biopsy ; Dermis ; Drug Therapy ; Female ; Humans ; Lymphocytes ; Lymphoma, B-Cell* ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; Physical Examination ; Skin