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

Brachycephaly is a kind of craniosynostosis. Because of premature closure of the coronal suture, the skull is shorter in the anteroposterior diameter but is widened with a high vault and the occiput and forehead are flattened. Diabetes insipidus had been reported in oxycephaly. We have experienced a case of central diabetes insipidus associated with brachycephaly. A brief review of related literatures is included in this report.
Craniosynostoses* ; Diabetes Insipidus ; Diabetes Insipidus, Neurogenic* ; Forehead ; Skull ; Sutures

Cyclic heterotropia represents an interesting ocular motility problem in which the ocular deviation is present on a rhythmic basis. Usually this appears in a regular 48-hour cycle, although 72-and 96-hour cycles have also been reported. On the strabismic day, constant heterotropia is large and associated with suppression and no diplopia. On the nonstrabismic day, no deviation or only a small heterophoria is present with good binocular function. In this paper, we present two cases of cyclic esotropia which demonstrated regular 48-hour cycles and were treated with surgery.
Diplopia ; Esotropia* ; Telescopes

Accommodative esodeviation is the result of either the need to clear the blurred vision caused by hypermetropia or a high accommodative convergence to accommodation(AC/A) ratio. In 1958, Parks showed that there were three origins of accommodative convergence to accommodation(AC/A), and a combination of the two. The authors experienced 71 cases of accommodative esotropia which were treated with hyperopic glasses, executive bifocals, and surgery on nonaccommodative component. Accommodative esotropia was subdivided into 3 types as refractive, nonrefractive and combined type. The refractive type was 59.1%, nonrtfractive type 8.5%, and combined type 32.4%. Among all 71cases, partially accommodative esotropia was 32.4%. The onset was at the age between 2 and 4 years in 50.8%. In most cases the sphero-equivalent of refractive error was +4.00 to less than +6.00 D in the refractive type with a normal AC/A ratio, less than +2.00 D in the nonrefractive type with a high AC/A ratio, and +2.00 to less than +4.00 D in the combined type with a high AC/A ratio. The cases with a normal AC/A ratio showed more hypermetropia. The amount of esodeviation controlled by hyperopic glasses was 24.4 to 25.0 delta at distance; by executive bifocals 26.2 delta in the nonrefractive type and 18.6 delta in the combined type at near. Stereoacuity was tested in 34 cases who understood the test, was better in the refractive type with normal AC/A ratio than in nonrefractive and combined type with a high AC/A ratio, and was absent in 26.4%. In many cases without stereopsis, the interval between onset and institution of therapy was too long and the age at treatment was too old. The longer the eyes are not aligned the greater chance for the development of amblyopia and sensory motor misalignant. Therefore early recognition and early initiation of treatment should be emphasized.
Amblyopia ; Depth Perception ; Esotropia* ; Eyeglasses ; Glass ; Hyperopia ; Refractive Errors

No abstract available.
Diagnosis, Differential*

The tendency toward significantly higher mean tensions in myopic eyes compared with eyes with emmetropia and hyperopia has been believed. The patients with high myopia have an unusually high risk of the development of open angle glaucoma. But there is little information in the literature concerning the range of refractive error in relation to intraocular pressure. This study was designed to provide this information in Koreans and to assess the possible prognostic value of the refraction in glaucoma. The results of this study were as follows: 1. The mean IOP of all the patient were 15.29 +/- 2.61mmHg. 2. The mean IOP of emmetropic patients with +2.0 to -2.0 diopters, myopic patients with -2.25 to -4.75 diopters, and high myopic patients with greater than -5.0 diopters were each 14.99 +/- 2.62mmHg, 5.64 +/- 2.38mmHg, 16.21 +/- 2.56mmHg, respectively, suggesting that as the degree of myopia became higher, so did the IOP became greater, as supported by a statistical analysis showing significance(p<0.001). 3. The mean IOP of hyperopic patients with greater than +0.5 diopters, emmetropic patients with +0.25 to -0.25 diopters, and myopic patients with greater than -0.5 diopters were each 14.41 +/- 2.61mmHg, 14.94 +/- 2.57mmHg, and 15.60 +/- 2.56mmHg, respectively, suggesting that as the refractive error showed a myopic status, it was accompanied by an increase of IOP, as was also supported by the statistical analysis showing significance(p<0.001). 4. In correlating sex with IOP, it was found that both sexes showed an increase of IOP as the refractive status changed from hyperopia to myopia, also supported by a significant statistical analysis(p<0.001). 5. In correlating age with IOP, each age group showed a general increase in IOP as the refractive status changed from hyperopia to myopia. As the age increased, however, it was not accompanied by an increase in IOP(p<0.001). 6. As the Cup/Disk ratio increased the mean IOP also tended to increase; this finding, however, showed no significance in the statistical analysis(p>0.01).
Emmetropia ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Hyperopia ; Intraocular Pressure* ; Myopia ; Refractive Errors

No abstract available.
Knee Injuries* ; Knee*

The purposes of this study were to evaluate the cephalometric clv racteristics of Korean female patients with Class II division 2 malocclusion and to compare Korean females with Caucasian females who had same type of malocclusion. All of the samples had Class II division 2 malocclusion with deep overbite (more than 4nun) and fulll permanent dentition. These samples were divided into two groups according to the races: Group 1(N=16; Korean females; average age=18Y 2M) and Group 2 (N=20; Caucasian females; average age=14Y 2M). The pretreatment lateral cephalograms were measured, analyzed and compared by using 38 variables and independent t-test. And the results were as follows: 1. Although there were no differences in Overbite, SN to mandibular plane angle, Palatomandibular plane angle, and FMA between Group 1 and 2, the other vertical relation variables of maxilla and mandible (SN to palatal plane angle, SN to occlusal plane angle, ODD of Group 1 showed more clockwise rotation tendency of occlusal plane and less hypodivergency tendency than those of Group 2. 2. There were no differences in mandibular body length and ramus height between Group 1 and 2 except small upper gonial angle of Group 1. There was less counterclockwise rotation tendency of mandible in Group 1. 3. There were no statistical significant differences in UAFH/LAFH and PFH/AFH between Group 1 and 2. 4. Although there were no differences of overjet and anteroposterior position of mandible between Group 1 and 2, the position of maxilla of Group 1 was more retropositioned than that of Group 2. 5. Except the more protrusion of lower incisor to A-Pog of Group 1, there were no differences of inclination and distance of upper and lower incisors to basal plane between Group 1 and 2. 6. The distance from upper first molar to palatal plane showed no difference between Group 1 and 2. But the distance from lower first molar to mandibular plane of Group 1 was greater than that of Group 2. So it may be partially related to the clockwise rotation of occlusal plane and the less counterclockwise rotation tendency of mandible of Group 1. 7. Group 1 had more protrusive upper and lower lips than Group 2.
Continental Population Groups ; Dental Occlusion ; Dentition, Permanent ; Female* ; Humans ; Incisor ; Lip ; Malocclusion* ; Mandible ; Maxilla ; Molar ; Overbite

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

PURPOSE: To evaluate the usefulness of double injection of a vasoactive drug in penile Doppler ultrasonography for the diagnosis of vasculogenic impotence. MATERIALS AND METHODS: Eighty-four consecutive cases (bilateral sides) of 42 patients with suspected vasculogenic impotence were included in our study. We used computed sonography (Acuson, USA), with a 7 MHz linear array transducer. After the first intracavernosal injection of the vasoactive drug (10 ug of prostagladin E1), peak systolic velocity (PSV) and end diastolic velocity (EDV) were measured three times. According to mean PSV and EDV, the patients were classified into four groups : arteriogenic impotence (AI;N=29), venogenic impotence (VI;N=28), AI associated with VI(N=14), and normal(N=13).After the second injection, PSV and EDV were remeasured, using the same method. Mean velocities of the first injection were compared with those of the second, and the paired t-test was used to analyze the results. the extent to which patients were reclassified after the scecond injection we noted. RESULTS: In all four groups, PSV measured after the second injection was significantly different from PSV after the first (p=0.0001, 0.0001, 0.0010, 0.0072); except in the normal group, EDV measured after the second injection was not different from EDV after the first (P=0.9815, 0.0654, 0.0950, 0.0057). After the second injection, the numbers of patients reclassified into other groups were as follows : AI, 11 (38%); VI, 6 (21%); AI associated with VI, 11 (79%); normal, 1 (8%). CONCLUSION: Double injection of a vasoactive drug affected PSV, and therefore, appears to be a useful adjunctive procedure for the evaluation of patients in whom classification based on the results of the first injection is difficult.
Classification ; Diagnosis ; Erectile Dysfunction ; Female ; Humans ; Impotence, Vasculogenic ; Male ; Transducers ; Ultrasonography, Doppler*