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

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

Hyperplasia*

No abstract available.
Funnel Chest*

No abstract available.
Sternotomy*

No abstract available.
Respiratory System* ; Respiratory Tract Infections* ; Roxithromycin*

No abstract available.
Humans ; Parents* ; Siblings*

In addition to premedicants, adjuvants and inhalation of dried anesthetic gas mixture during anesthesia, pain after upper abdominal operation may cause obtundation of cough reflex, limitation of lung function, and decreased movement of respiratory cilia, resulting in postoperative pulmonary complications such as pneumonia and atelectasis. Epidural injection of local anesthetic may produce enough analgesic action without depression of pulmonary function for the majority of upper abdominal surgery cases, while intramuscular injection of analgesic which has been applied for postoperative pain relief might cause depression of pulmonary function and increase of mortality and morbidity of pulmonary complications. This study was designed to compare the effects of above two pain-relief methods on pulmonary function at the postoperative 24 hour and 44 adult patients who have been operated in upper abdomen which were allocated randomly with either epidural injection group (10 of male, 9 of female) or intramuscular injection group (17 of male, 8 of female). The results were as follows; 1) All patients have markedly decreased pulmonary function in the preoperative period, comparing with the predictive values. 2) The results of postoperative pulmonary function test of all patients in intramuscular injection group was similar to the results of preoperative pulmonay function test and not improved. 3) Patients in epidural injection group have markedly improved in nearly all pulmonary functions after operation. The degree of improvement was increased in order as following; MEF50> MEF75> IRV (or TV)> FEV1/FVC. And there was no difference of results between male and female. 4) Vital capacity in epidural injection group was increased to about 25~42% from the preoperative period, while it was decreased to about 22~29% in intramuscular injection group. With the above results, we suggest that single or continuous epidural injection of local anesthetic will be an appropriate way of postoperative pain-relief methods, especially in the patients who has markedly decreased pulmonary function and upper abdominal surgery.
Abdomen ; Adult ; Anesthesia ; Cilia ; Cough ; Depression ; Female ; Humans ; Inhalation ; Injections, Epidural* ; Injections, Intramuscular ; Lung ; Male ; Mortality ; Pain, Postoperative ; Pneumonia ; Preoperative Period ; Pulmonary Atelectasis ; Reflex ; Respiratory Function Tests* ; Vital Capacity

OBJECTIVES: Although verbal and social bullying is more common than physical school violence among secondary students, it's harmful influences have been underestimated. It is essential to investigate the risk factors of clinically referred bullied children with school maladjustment and psychiatric symptoms and the protective factors of the non-referred resilient children despite of being bullied for developing the anti-bullying program. METHODS: The questionnaire asking frequency and severity of being bullied socially, Kovacs Children's Depression Scale, and Piers-Harris Children's Self-Concept Scale were administered to 128 secondary students in Wonju and 65 secondary students referred for their school maladjustment to psychiatric outpatient clinic. Fifty-five students (boys: 19, girls: 36) of bullied non-clinical group and 42 students(boys: 21, girls: 21) of bullied clinical group were compared with their scores of being bullied, depression and self-concept, and the gender difference in those comparisons was studied. RESULTS: More negative self-concept and poorer relationship with family were noticed in the clinical group, despite of no difference in being-bullied score and depression score between the two. Five subscales of the self-concept, behavior, academic status, appearance, popularity and happiness were more negative in clinical group, but not with anxiety subscale. With coping strategy, there was no difference. Multiple regression analysis showed that depression score was accountable by negative self-concept only in the clinical group, and by appearance and anxiety in non-clinical group. And gender differences were not found in those all variables. CONCLUSION: It is suggested that the risk factor for school maladjustment occurred after being bullied socially is the negative self-concept, and the protective factor for resilient children is the supportive relationship within family.
Ambulatory Care Facilities ; Anxiety ; Bullying ; Child ; Depression ; Female ; Gangwon-do ; Happiness ; Humans ; Surveys and Questionnaires ; Risk Factors ; Violence

PURPOSE: The ictal perfusion patterns of cerebellum and basal ganglia have not been systematically investigated in patients with temporal lobe epilepsy (TLE). Their ictal perfusion patterns were analyzed in relation with temporal lobe and frontal lobe hyperperfusion during TLE seizures using SPECT subtraction. MATERIALS AND METHODS: Thirty-three TLE patients had interictal and ictal SPECT, video-EEG monitoring, SPGR MRI, and SPECT subtraction with MRI co-registration. RESULTS: The vermian cerebellar hyperperfusion (CH) was observed in 26 patients (78.8%) and hemispheric CH in 25 (75.8%). Compared to the side of epileptogenic temporal lobe, there were seven ipsilateral hemispheric CH (28.0%), fifteen contralateral hemispheric CH (60.0%) and three bilateral hemispheric CH (12.0%). CH was more frequently observed in patients with additional frontal hyperperfusion (14/15, 93.3%) than in patients without frontal hyperperfusion (11/18, 61.1%). The basal ganglia hyperperfusion (BGH) was seen in 11 of the 15 patients with frontotemporal hyperperfusion (73.3%) and 11 of the 18 with temporal hyperperfusion only (61.1%). In 17 patients with unilateral BGH, contralateral CH to the BGH was observed in 14 (82.5%) and ipsilateral CH to BGH in 2 (11.8%) and bilateral CH in 1 (5.9%). CONCLUSION: The cerebellar hyperperfusion and basal ganglia hyperperfusion during seizures of TLE can be contralateral, ipsilateral or bilateral to the seizure focus. The presence of additional frontal or basal ganglia hyperperfusion was more frequently associated with contralateral hemispheric CH to their sides. However, temporal lobe hyperperfusion appears to be related with both ipsilateral and contralateral hemispheric CH.
Basal Ganglia* ; Cerebellum* ; Epilepsy, Temporal Lobe* ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Perfusion ; Seizures ; Temporal Lobe* ; Tomography, Emission-Computed, Single-Photon