Between 1989 and 1993, 31 patients who had undergone ACL reconstruction using autogenous patellar bone-tendon-bone were studied to evaluate the effects on knee joint function. After having harvested the central one third of the patellar tendon, it was positioned isometrically through tunnels of tibia and femur and also central defect of the patellar ligament was sutured loosely. Clinically Hospital for special surgery(HSS) knee socre by Marshall 1997, manual knee test, knee extention and flexion angles, Cybex test, KT-2000 measurments and radiological study were performed for subjective and objective symptoms at the average follow-up 33 months (range 18-72 months). Quadriceps weakness of strength less than 80% of the normal side was present in 61% of patients, patellofemoral joint pain in 15%, AP translation more than 3mm in 23%, flexion contracture of 5 degree or more in 29%. Hospital for special surgery(HSS) knee score was improved from 35 to 46 in average during follow-up period. The height of the patella was increased in 2 cases and decreased in 6 cases within normal variation which was not significant statistically. The above results indicate that importance of postoperative rehabilitation program and extension position of knee joint after surgery place a major emphasis on the avoidance of flexion contracture and on the improvement of joint function.
Contracture ; Femur ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Knee ; Patella ; Patellar Ligament ; Patellofemoral Joint ; Rehabilitation ; Tibia ; Transplants

No abstract available.
Colon

Biliary-tract complications, such as biliary strictures, anastomotic leaks, choledocholithiasis, and biliary casts, can occur after liver transplantation (LT). Of these complications, biliary strictures are regarded as an Achilles' heel. Recently, treatment of anastomotic biliary stricture (ABS) has transitioned from conventional surgical revision to a nonsurgical treatment modality. Endoscopic serial balloon dilatation and/or multiple plastic stent replacements are highly effective and are now regarded as the first-line treatments. However, if the patient has undergone anastomosis by means of a hepaticojejunostomy, percutaneous treatment is performed. With recent technological advances and the rendezvous method, the clinical success rates of endoscopic and percutaneous ABS treatments have increased, but these methods fail in some patients who have total obstruction of anastomotic stricture. For these patients, magnetic compression anastomosis (MCA) has been suggested as an alternative method. Animal and human studies have demonstrated the safety and efficacy of MCA, and advancements in these nonsurgical methods have increased the clinical success rate of ABS. This review focuses on ABSs that develop after LT and discusses the clinical results of various nonsurgical methods and future directions.
Anastomotic Leak ; Animals ; Choledocholithiasis ; Cholestasis ; Constriction, Pathologic ; Dilatation ; Heel ; Humans ; Liver Transplantation ; Liver ; Methods ; Plastics ; Reoperation ; Stents

Biliary drainage is necessary to improve the survival or quality of life of patients with malignant biliary obstruction. In the past, surgery was the primary treatment for biliary drainage, but recently, endoscopic or percutaneous stent implantation has been recognized as the main treatment. Various materials and structures have been devised and developed to increase the patency of the biliary stent. In the development of these stents, drug-eluting biliary stents with an anti-tumoral agent (DES) have emerged to increase the stent patency period by chemically inhibiting tumor growth in the stent through the change of the coating material. The DESs have been proved to be stable through several animal and clinical trials, but their effectiveness has not been demonstrated. We will discuss the development process, problems, and future directions of DES that has been clinically applied.

The papillary cystadenoma in the scrotum is a rare benign tumor. But papillary cystadenoma needs a observation about stigma of malignant combination. We experienced a case of this, which didn't show the evidence of malignancy. We report this rare tumor.
Cystadenoma ; Cystadenoma, Mucinous* ; Cystadenoma, Papillary ; Mucins* ; Scrotum ; Testis

Chronic pancreatitis is a progressive inflammatory disease that destroys pancreatic parenchyma and alters ductal stricture, leading to ductal destruction and abdominal pain. Pancreatic duct stones (PDSs) are a common complication of chronic pancreatitis that requires treatment to relieve abdominal pain and improve pancreas function. Endoscopic therapy, extracorporeal shock wave lithotripsy (ESWL), and surgery are treatment modalities of PDSs, although lingering controversies have hindered a consensus recommendation. Many comparative studies have reported that surgery is the superior treatment because of reduced duration and frequency of hospitalization, cost, pain relief, and reintervention, while endoscopic therapy is effective and less invasive but cannot be used in all patients. Surgery is the treatment of choice when endoscopic therapy has failed, malignancy is suspected, or duodenal stricture is present. However, in patients with the appropriate indications or at high-risk for surgery, endoscopic therapy in combination with ESWL can be considered a first-line treatment. We expect that the development of advanced endoscopic techniques and equipment will expand the role of endoscopic treatment in PDS removal.
Abdominal Pain ; Calculi* ; Consensus ; Constriction, Pathologic ; Endoscopy ; Hospitalization ; Humans ; Lithotripsy ; Pancreas ; Pancreatic Ducts ; Pancreatitis, Chronic ; Shock

A 65 year-old man, who underwent transthoracic esophagectomy for mid-thoracic esophageal squamous cell carcinoma, suffered from an incarcerated herniation of the transverse colon through a defect in the left mediastinal pleura. The patient had a gas collection in the left lower lung field and this then insidiously progressed; the final result was total collapse of the left lung and hemodynamic compromise. The life-threatening herniation of the transverse colon into the pleural cavity after pervious esophagectomy was corrected by emergency laparotomy. Postoperative pulmonary complications after esophagectomy can induce potentially lethal transhiatal herniation because of the danger of intestinal obstruction or strangulation. The optimal approach to transhiatal herniation after esophagectomy is prevention.
Carcinoma, Squamous Cell ; Colon, Transverse ; Emergencies ; Esophageal Neoplasms ; Esophagectomy ; Hemodynamics ; Hernia, Hiatal ; Humans ; Intestinal Obstruction ; Laparotomy ; Lung ; Pleura ; Pleural Cavity

Mixed squamous cell and glandular papilloma is a rare pulmonary neoplasm typically occurring in the central lung area. Herein, we report a case of peripherally located mixed papilloma in a 54-year-old man with a complaint of dyspnea. Chest computed tomography demonstrated an infiltrative peripheral lung mass in the right middle lobe, measuring 1.5 cm in diameter. The resected lung tumor had papillary configuration lined by both squamous cell epithelium and mucin-containing glandular epithelium. The papillary stroma showed a fibrovascular core with inflammatory infiltrates. p63 immunostaining was positive in basal and parabasal tumor cells in papillary fronds.
Dyspnea ; Epithelium ; Lung ; Lung Neoplasms ; Papilloma ; Thorax