Without traumatic history, spontaneous hemarthrosis of the knee is a relatively rare condition, and there is no report of the diagnosis and treatments in Korea. In this case, magnetic resonance imaging and arthroscopic findings showed hemarthrosis and a lateral meniscus tear. Hemarthrosis of the patient remained after meniscus resection and coagulation; we then, found rupture of the lateral geniculate artery by computed tomography-angiography. We report on a case of successful treatment of spontaneous hemarthrosis with therapeutic embolization with a thorough review of the relevant literatures.
Aged* ; Arteries ; Diagnosis ; Embolization, Therapeutic* ; Hemarthrosis* ; Humans ; Knee* ; Korea ; Magnetic Resonance Imaging ; Menisci, Tibial ; Rupture

PURPOSE: To evaluate the results of arthroscopic contouring surgery and posterolateral meniscal repair for pediatrics with snapping discoid lateral meniscus without tear. MATERIALS AND METHODS: Nine children below 10 years, with snapping discoid lateral meniscus without tear were evaluated in this study. 3 cases had a morphologic deformity of lateral meniscus in MRI and arthroscopic findings, but there was no meniscal tear. Only contouring surgery was performed in 6 cases, and in 3 cases, because of the instability of meniscus over 5mm in traction due to the relaxation of the menisco-capsular junction after contouring surgery, posterolateral repair was performed. The average duration of follow up was 39 months(range, 25 to 72 months). RESULTS: Additional posterolateral repair was done due to remaining snapping, in three cases of six contouring surgery cases. In all cases, snapping was disappeared. The average Lysholm score was improved from 71 in preoperative status to 97 in postoperative status(p=0.008) CONCLUSION: In case of the increased instability of the posterolateral corner of lateral meniscus after contouring surgery in the treatment of snapping discoid lateral meniscus, posterolateral repair is effective to improve the snapping symptom from meniscal subluxation.
Child ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Menisci, Tibial* ; Pediatrics* ; Relaxation ; Traction

PURPOSE: The purpose of this study was to investigate the accuracy of the Pollard method for meniscal sizing of the meniscal allograft by comparison with the MRI dimensions. MATERIALS AND METHODS: The width and length of 50 medial and lateral menisci were measured and compared using the Pollard method and MRI. The meniscal thickness was measured using MRI and we evaluated the individual differences. RESULTS: The measurements of the width of the medial meniscus and the length of the lateral meniscus using the Pollard method and MRI were similar (p=0.459, p=0.108, respectively). However, the measurements of the length of the medial meniscus and the width of the lateral meniscus using MRI were significantly higher that those measured using the Pollard method (p=0.000 and p=0.001, respectively). The medial and lateral meniscal thicknesses were 6.26+/-0.86 mm and 6.47+/-0.84 mm, respectively, and there was no significant individual difference. CONCLUSION: The measurements of the length of the medial meniscus and the width of the lateral meniscus, using the Pollard method and on MRI had significant differences. The Pollard method must be modified for meniscal sizing.
Allografts ; Individuality ; Magnetic Resonance Imaging* ; Menisci, Tibial

BACKGROUND: Adequate nutrition support reduces infectious complications, mortality and length of hospitalizationin intensive care unit. However, there are multi factors like frequent null per os (NPO) due to examination, intolerance to tube feeding, complication of TPN (total parenteral nutrition) and ineffective recognition by medical staff. The purpose of this study is to identify detrimental effects of cumulative energy deficiency in critically ill patients. METHODS: The patients who were received tube feeding or total parenteral nutrition for more than 5 days were investigated. Daily and cumulative energy deficiency was tabulated until oral intake was achieved or until they discharged or died. Patients were divided into two groups, severe energy deficient group (>10, 000 kcal) or mild energy deficient group (<5, 000 kcal). Then we compared clinical outcomes between two groups. RESULTS: Total 150 patients were studied. 48 (32%) patients were severe energy deficient group and 42 (28%) patients were mild energy deficient group. Mortality and nosocomial infection were significantly higher in severe energy deficient group than in mild group. Hospital day and ICU day were significantly higher in severe energy deficient group than in mild group. CONCLUSIONS: Severe energy deficiency was very common in critically ill patients and it deteriorated the clinical outcomes such as mortality, nosocomial infection, hospital day and ICU day.
Critical Illness* ; Cross Infection ; Enteral Nutrition ; Humans ; Intensive Care Units ; Medical Staff ; Mortality ; Parenteral Nutrition, Total

Lung transplantation in the treatment of end-stage emphysema has been increasing in number since the recent rise in the 5 year survival rate. For the shortage of donor lungs, the single lung transplantation or transplantation in ABO compatible, nonidentical recipients has also been increasing. The lung transplantation in compatible, nonidentical recipients show good results as with identical recipients with the proper application of immunosuppressive agents. We transplanted the left lung of a 41 year-old male donor to a 35 year-old female recipient who had been suffering from severe dyspnea due to end-stage emphysema. For postoperative immunosuppression, we applied conventional triple immunotherapy(cyclosporine, azathioprine, prednisolone) and we could suppress the rejection response of transplanted lung by adding the anti-CD3 antibody(OKT3) during the operation. The patient could be discharged without any specific problem at 18th postoperative day.
Adult ; Azathioprine ; Dyspnea ; Emphysema ; Female ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Lung Transplantation* ; Lung* ; Male ; Survival Rate ; Tissue Donors