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Double-bundle Anterior Cruciate Ligament Reconstruction using Autogenous Hamstring Grafts (이중 다발 자가 슬괵건을 이용한 전방십자인대 재건술)

  • Choi, Nam-Yong;Nam, Won-Sik;Yang, Young-Jun;Han, Chang-Hwan;Moon, Chan-Woong;Kwon, Jae-Young;Song, Hyun-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.2
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    • pp.112-117
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    • 2008
  • Purpose: Double-bundle reconstruction of anterior cruciate ligament(ACL) has the advantage of restoring the isometry and original function of ACL. The purpose of this study is to evaluate the clinical results following double-bundle reconstruction of ACL using autogenous hamstring grafts through an accessory anteromedial portal. Materials and Methods: From January 2005 to July 2006, sixty patients(52 males, 8 females) underwent double-bundle ACL reconstruction using autogenous hamstring tendons..The mean age was 31.7 years($20{\sim}51$ years). The mean follow up period was 13.4 months($12{\sim}16$ months). We made a horizontal-oblique skin incision just medial to tibial tuberosity and harvested semitendinosus and gracilis tendon. Tibial tunnel for posterolateral bundle was made near its anatomical position. By modifying an anatomic reconstruction of ACL by Yasuda et al., we made a femoral tunnel for posterolateral bundle through accessory anteromedial portal. Tunnels for anteromedial bundle were made with conventional method. We reconstructed anteromedial bundle with semitendinosus tendon and posterolateral bundle with gracilis tendon. Clinical results at last follow up were evaluated by range of motion, extent of anterior displacement(KT-1000 arthrometer), pivot-shift test. Functional evaluation of clinical outcomes were evaluated by Lysholm score and modified Feagin Scoring System. Results: There was no limitation of motion of knee joint at last follow up. Mean side to side difference of anterior displacement of tibia by KT-1000 arthrometer was improved from 8.4 mm preoperatively to 1.7 mm postoperatively(p<0.05). Average Lysholm score was improved from 64.1 preoperatively to 92.2 postoperatively(p<0.05). In modified Feagin Scoring System, 90% of cases were rated as good or excellent. Conclusion: Double-bundle reconstruction of ACL using autogenous hamstring grafts through accessory anteromedial portal results in good clinical outcomes.

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Sow Transfer of Cultured Freezing Embryos by Open Pulled Straw(OPS) Methods : Preliminary Results (Open Pulled Straw(OPS) 방법에 의한 체외배양 동결수정란의 경산돈 이식 : 예비실험 결과)

  • Kim, I.-D.;Ahn, M.-H.;Hur, T.-Y.;Hong, M.-P.;Seok, H.-B.
    • Journal of Embryo Transfer
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    • v.19 no.2
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    • pp.155-163
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    • 2004
  • The aims of this study are 1) to test oocytes and embryos collected from in-vitro to achieving the valuable protocol by culturing, vitrifying and thawing of oocytes/embryos, and 2) to transfer them to recipient, and finally have resulted in pregnancies from recipient females after surgical or nonsurgical transfer. In vitro maturation and fertilization were performed according to Funahashi et al (1994). Glucose-free NCSU 23 supplemented with 5 mM sodium pyruvate, 0.5 mM sodium lactate and 4 mg/ml bovine serum albumin for 2 days at $39^{\circ}C$, and 10% fetal bovine serum albumin was added to the culture medium thereafter. Embryos were treated with 7.5 ${\mu}g/ml$ cytochalasin-B for 30 min, centrifuged at 13,000 rpm for 13 min and then exposed sequentially to an ethylene glycol(EG) vitrification solution, aspirated into OPS, and plunged/thawed into/from liquid nitrogen. In vivo embryos were surgically collected from three dornors after AI for control group. Forty-nine embryos were washed 3 times in mPBS + 10% FBS, followed treatments : cultured, centrifuged, vitrified, recovered and transferred to recipients as in vitro prepared embryos. Three recipients were transferred individually with 100, 100 frozen embryos derived from abattoir and 34 fresh embryos by surgically, and another three recipients were transferred individually with 150, 150 frozen embryos and 100 fresh embryos by nonsurgically, respectively. all recipient sows exhibited delayed returns to estrus. To our knowledge, theses results suggest that required an improved techniques, more vigorous embryos preparation and substitute to gilt with cleaner uterous condition.

Closed Interlocking Intrmedullary Nailing of Metastatic Diaphyseal Fractures of the Humerus (상완골 간부 악성 병적골절의 비관혈적 고합성 골수강내 금속정 고정술)

  • Bahk, Won-Jong;Rhee, Seung-Koo;Kang, Yong-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.1-11
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    • 2003
  • Purpose: To analysis of the result of the treatment of metastatic diaphyseal fracture of the humerus with closed interlocking intrameduallry nailing. Materials and Methods: Among surgically treated 29 patients with pathologic or impending fracture of diaphysis of the humeurs, 13 patients (16 cases) treated with closed intramedullary interlocking nail were selected for the study. The final result of pain relief and functional recovery was evaluated by modified rating system of Perez et al. Results: Primary cancer was diagnosed after fracture was developed in 2 patients and pathologic or impending fracture was occurred average period of 28.9 months after primary cancer was diagnosed. The main primary malignancies were multiple myeloma, lung cancer and breast cancer. Mean survival after humeral metastasis was 11.7 months. The final result was superior to fair in 13 of 16 cases, and poor in 3 cases with progression of tumor spread or distant dissemination to the ipsilateral fingers. Except the latter 3 patients and other 3 patients, who died before 3 months postoperatively, bony union was achieved in 10 cases. There were no complications related to surgery. Conclusion: Closed interlocking intrameduallry nailing is accomplished with brief operative time, small amount of bleeding and provides immediate stability with resultant early return of function to the arm. Additionally it allows early postoperative irradiation. However, some of our cases shows that intramedullary nailing can accelerate tumor spread and metastases elsewhere, so that serious consideration must be given in planning this treatment. In conclusion, the functional status before fracture, life expectancy, type of tumor and extent of involvement should be carefully considered to decide operative treatment of metastatic disease.

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Cold Pressor Response to Seasonal Variation in Winter and Summer (국소한냉자극이 전신 및 국소혈액순환에 미치는 영향 -제 2 보 : 동계 및 하계의 계절변화에 따른 한냉반응-)

  • Park, Won-Gyun;Chae, E-Up
    • The Korean Journal of Physiology
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    • v.17 no.2
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    • pp.93-101
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    • 1983
  • A possibility whether the appearance of adaptation to cold climate during winter could occur or not in Taegu area was evaluated by comparing the data obtained in winter with that obtained by the same method in summer. Circulatory response was induced by the immersion of one hand in the cold water. The systemic and local responses in the blood circulation from the immersed hand and the unimmersed opposite hand were observed simultaneously. In addition Galvanic skin resistance(GSR) that is influenced by the activity of autonomic nervous system and the vascular tonicity was recorded. The experiment was performed by examining sixty healthy college students in winter and fifty in summer, whose mean age was 21.0, mean weight $60.6{\pm}0.90\;kg(male)$ and $48.3{\pm}0.98\;kg(female)$. The cold stimulus was applied by immersing the left hand into the cold water of $5^{\circ}C$ for 3 minutes, and the response was observed on immersed left hand and unimmersed right hand simultaneously. The observation was made through determining mean blood pressure, heart rate, amplitude of photoelectric capillary pulse (APCP) and GSR. The results obtained are as follows: The mean blood pressure was elevated during the cold stimulation. The increase of blood pressure in summer was more remarkable than in winter. At the recovery period the blood pressure was decreased to the control level in winter but the decrease below the control level was observed in summer. The increase of heart rate in summer was more remarkable than in winter during the cold stimulation. At the recovery period heart rate in both winter and summer was decreased below the control level. During the cold stimulation the APCP was decreased on both hands in winter. However it was more prominent on left hand indicating additional direct cold effect on immersed hand. In summer, the decrease of APCP during immersion was less remarkable than that in winter, but the regain of APCP was faster than that in winter at the recovery period. And the prompt increase of APCP over the control level has been obtained at the 3 minutes of the recovery period. The GSR was remarkably increased on immersed hand but slightly decreased on unimmersed opposite hand during the cold stimulation. Thus the finding on immersed hand indicates that the local direct effect of cold water is more prominent than the systemic effect, where as the finding on unimmersed hand indicates that the circulatory response to painful stress elicited by the cold stimulation is more prominent than cold temperature itself. In summary, it seems that the systemic circulatory response to the local cold stimulation of the one hand is arised more from the secondary elicited pain sensation and less from the low water temperature. On the contrary to the report of Kim et $al^{39)}$, the adaptation phenomena in blood pressure to the relatively mild cold climate in winter was not observed in this study. The difference of circulatory response observed in this study between winter and summer may be due to the difference of the magnitude of subjective sensation of the cold water stimulation by the seasonal changes in air temperature.

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Evaluation of Sperm Penetration Ability according to Various Morphological Characteristics of Spermatozoa (정자의 여러가지 형태학적 특징에 따른 정자 침투능의 평가)

  • Kim, J.H.;Jung, K.W.;Lew, Y.O.;Kwon, D.J.;Lim, Y.T.;Kim, J.H.;Nha, D.J.;Lee, J.W.
    • Clinical and Experimental Reproductive Medicine
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    • v.21 no.1
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    • pp.31-41
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    • 1994
  • Morphological estimation of human spermatozoa is complicated by the fact that there is great natural variation in shape. This natural variation in shapes makes it difficult to say which forms are associated with infertility and which are normal variations. Possibly post coital test or in vitro cervical mucus penetration tests will help to clarify this question by showing which sperm are capable of penetration. The purpose of this investigation was performed to assess distribution of various morphological abnormalities according to the ability of sperm to penetrate cervical mucus. The sperm-mucus penetration using hen's egg white as substituting mucus for human cervical mucus was done in 45 fertile men with normal semen analysis and 122 infertile men with abnormal seminal parameters more than one. The female partners of 122 infertile couples showed normal results in the female fundamental test for fertility. Conventional semen analysis was evaluated according to the WHO standard normal(l980). The detailed classification of the abnormal sperm was made according to David et al(l975). The vitality of the sperm samples determined by eosin yellow-nigrosin stainig according to the method of Eliasson(l977). Results were as follw; 1. The patients had significantly lower total sperm count, motility (%), normal morphology (%), viability and total functional sperm fractions(TFSF) than fertile donors. 2. The mean value of sperm penetration distance of the patients(28.69${\pm}$11.02mm) showed significantly lower than fertile donors(37.33${\pm}$5.49mm). And 43/45 fertile donors(95.5%) as well as 57/122 patients(46.7%) had over 30mm in sperm penetration distance respectively. While 2/45 fertile donors(4.5 %) and 65/122 patient(53.3%) had under 30mm in sperm penetration distance respectively. 3. The morphological abnormalities in fertile donors were significantly lower 23.04${\pm}$5.83% (head = 12.89${\pm}$4.98, neck=6.11${\pm}$3.83%, and tail=3.43${\pm}$2.65%), compared to 36.03${\pm}$14. 40% in patients(head = 15.98 8.60%, neck 11.20${\pm}$6.56% and tail=8.70${\pm}$6.55%). Also, 3 types of sperm abnormalities including head, neck and tail were significantly lower in patient than fertile donors, respectively. Both the patients and fertile donors showed higher distribution of sperm with abnormal head than abnormal neck and tail. 4. The mean morphological abnormalities(SP>30mm) of the patients(30.68 11.64%; head = 15.95${\pm}$9.35%, neck=8.14${\pm}$4.21 %, tail=6.56${\pm}$5.64%) were significantly lower compared to patients(40.72${\pm}$15.01 %; head=16.02${\pm}$7.69%, neck 13.89${\pm}$7.82%, tail=1O.58${\pm}$6.75%) under 30mm in sperm penetration distance. Also, both groups over 30mm and under 30mm in sperm penetration showed distance higher distribution of sperm with abnormal head than abnormal neck and tail. The morphological abnormalities of head did not show significant difference but abnormal neck and tail were significant difference between the over 30mm and under 30mm group in sperm penetration distance.

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Epizootiology of Perkinsus sp. Found in the Manila Clam, Ruditapes philippinarum in Komsoe Bay, Korea (곰소만에 있어 바지락포자충, Perkinsus sp.의 출현에 관하여)

  • PARK Kyung-Il;CHOI Kwang-Sik;CHOI Jin-Woo
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.32 no.3
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    • pp.303-309
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    • 1999
  • Mass mortality of the Manila clam, Ruditapes philippinarum has been reported all along the west and south coast of Korea for the past several years. As a pathogenic agent, Perkinsus sp., an endoparasitic protozoan has been identified in this study and believed to be responsible for the mass mortalities. Prevalence and infection intensity of Perkinsus sp. was investigated from a Manila clam population inhabiting at Komsoe Bay in the west coast where mass mortality of the clam has been reported. A total of 142 Manila clam, 50 oyster, Crassostrea gigas, 10 ark shell, Scapharca broughtonii, and 5 predatory gastropada, Rapana venosa were examined for the presence and the quantity of Perkinsus sp. Ray's fluid thioglycollate medium method (FTM method) with modified Mackin's infection intensity scale and Choi's quantitative method were used in detecting and quantifying the parasite. All individuals of R. philippinarum examined in this study were infected with Perkinsus sp., indicating $100\%$ prevalence while none of the oysters and the gastropods exhibited the parasite. Six to ten individual hypnospores of Perkinsus sp. were counted from the ark shells. The number of hypnospores in the clam tissues varied from 16,667 to 4,091,667, with a mean number of 1,077,628. Average infection intensity according to Mackin's was 2.87, indicating a moderate infection. A negative correlation was observed between the number of Perkinsus sp. in the tissue and the condition index, a ratio tissue wet weight to shell cavity volume. The clam size and the infection intensity in terms of total number of parasites were positively correlated; the bigger clam, the heavier infection. Such high number of Perkinsus sp. counted in the clams could be enough to cause physiological disturbance of clams, such as retarded growth and reproduction. It is also believed that such a high infection leads mortality of the clam via continuous draining of the energy by metabolic activities and reproduction of the parasites. Correlation between the condition index and the infection intensity observed in this study supports this hypothesis.

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The Consideration about Heavy Metal Contamination of Room and Worker in a Workshop (공작실에서 실내 및 작업종사자의 중금속 오염도에 관한 고찰)

  • Kim Jeong-Ho;Kim Gha-Jung;Kim Sung-Ki;Bea Suk-Hwan
    • The Journal of Korean Society for Radiation Therapy
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    • v.17 no.2
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    • pp.87-94
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    • 2005
  • Purpose : Heavy metal use when producing the block from the workshop. At this time, production of heavy metal dust and fume gives risk in human. This like heavy metal to improve seriousness through measurement and analysis. And by the quest in solution is purpose of this thesis. Materials and Methods : Organization is Inductively Coupled Plasma Atomic Emission Spectrometer, and the object is Deajeon city 4 workshops in university hospital radiation oncology (Bismuth, Lead, Tin and cadmium). Method is the ppb the pumping it does at unit, comparison analysis. And the Calculation heavy metal standard level in air through heavy metal standard level in body and blood, so Heavy metal temporary standard set. Results : Subterranean existence room air quality the administration laws appointed Lead and Cadmium's exposure recommend that it is $3{\mu}g/m^3\;and\;2{\mu}g/m^3$. And Bismuth and Tin decides $7{\mu}g/m^3\;and\;6{\mu}g/m^3$ through standard level in air heavy metal and standard level in body and blood. Heavy metal measurement level of workshops in 4 university hospital Daejeon city compares with work existence and nonexistence. On work nonexistence almost measurement level is below the recommend level. But work existence case express high level. Also consequently in composition ratio of the block is continuous with the detection ratio. Conclusion : Worker's heavy metal contamination imbrued serious for solution founds basic part. In hospital may operation on local air exhauster and periodical efficiency check, protector offer, et al. And worker have a correct understanding part of heavy metal contamination, and have continuous interest, health control. Finally, learned society sphere administer to establishment standard level and periodical measurement. And it founds basic solution plan of periodical special health checkup.

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CLINICAL ANALYSIS OF GONIAL ANGLE CHANGE AFTER ORTHOGNATHIC SUGERY IN PATIENTS WITH THE MANDIBULAR PROGNATHISM (하악전돌증환자의 악교정수술후 하악각변화에 관한 임상적 분석)

  • Kwon, Yeong-Ho;Jang, Hyun-Jung;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.2
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    • pp.206-216
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    • 2000
  • Predictional study for lateral change between pre- and post-orthognathic surgery has been emphasized mainly on anterior area of lateral profile; upper lip, lower lip and chin et al. So interest for lateral profile change has been less in posterior area of lateral profile and literature analyzing gonial angle change is rare. The purpose of this study is to make prediction for gonial angle change possible and to offer somewhat treatment guidance for gonial angle to be improved by investigating overall gonial angle change between pre- and post-orthognathic surgery and inquiring into factors influencing on pattern of genial angle change. For this study 35 patients were selected retrospectively. Lateral cephalometric radiographs were taken in just pre-op time, pod 1 day, pod 1 year. They were analyzed and genial angles were measured. The results were as follows : 1. Gonial angle at pod 1 day was decreased about $9.3^{\circ}$ than pre-op and gonial angle at pod 1 year was increased about $4.0^{\circ}$ than pod 1 day. So genial angle at pod 1 year was decreased about $5.3^{\circ}$ than pre-op genial angle(p<0.01). 2. Mean pre-op gonial angle was $129.4^{\circ}$, showing significantly high value than normal and mean gonial angle at pod 1 year was $124.1^{\circ}$, showing value near to normal. 3. Mean gonial angle change between pre-op and pod 1 year was decreased about $5.4^{\circ}$ in female and $5.3^{\circ}$ in male. There was no statistically significant difference between male and female(p>0.05). 4. Principal factor influencing on decreased gonial angle in gonial angle change between pre-op and pod 1 year was amount of mandibular setback. 5. Principal factor influencing on increased gonial angle in gonial angle change between pod 1 day and pod 1 year was % horizontal relapse, and it was thought that resorption and bone remodelling on posterior area in mandibular distal segment also were related to increased gonial angle. 6. It is thought that sagittal split ramus osteotomy in mandibular prognathic patients with high value of gonial angle is effective to improvement of gonial angle, and In patients who have normal range of gonial angle and are required with excessive mandibular setback, short lingual cut method, additional resection of posterior margin of distal segment, Obwegeser II method will be considerd. 7. More prudent operation and careful post-op management will be responsible for maintenance of postoperative stable gonial angle.

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Index Cases in Pediatric Surgery - a National Survey by the Korean Association of Pediatric Surgeons, 2000 - (소아외과의 지수 질환 - 대한소아외과학회 정회원을 대상으로 한 2000년도 전국 조사 -)

  • Lee, M.D.;Kim, S.Y.;Kim, W.K.;Kim, I.K.;Kim, S.C.;Kim, S.K.;Kim, J.E.;Kim, J.C.;Kim, H.H.;Park, K.W.;Park, W.H.;Seo, J.M.;Song, Y.T.;Oh, S.M.;Yoo, S.Y.;Lee, D.S.;Lee, S.K.;Lee, S.C.;Chung, S.Y.;Chung, S.U.;Jung., E.S.;Jung, P.M.;Cho, M.H.
    • Advances in pediatric surgery
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    • v.7 no.2
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    • pp.147-156
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    • 2001
  • Membership qualifications and recognition of the subspecialty training programs by the Korean Association of Pediatric Surgeons(KAPS) have been determined by criteria based on the number of neonatal and total pediatric surgical cases registered, since 1989 (Index cases). The numbers are based on a survey of the 14 founding members of the society by Jung et al. in 1987. The current survey is to review the present status of the index cases from 1997 to 1999 among 36 members of the KAPS. Two surveys were undertaken for this study. In the first survey, cases were collected by the registration form, composed of neonatal(N), important pediatric surgical cases (I), tumor and other similar operations(T) and other common pediatric surgical cases(O). Thirty members responded. and the result was discussed at the Topic Discussion section of the 15th Annual Congress of KAPS, 2000. The second survey analyzed additive data, proposed during discussion at the Congress. Twenty-three members responded. This report is the analysis of the both surveys. The average numbers of the cases/year/surgeon of N, I, T, O and total were 19.5, 51.8, 9.5, 77.1 and 356.5. respectively. The number of index cases(N+I+T)/year/surgeon was 80.8. The ratio of (N+I+T)/total cases was 0.3. Seventeen of 30 members have more than 20 cases of N per year. Twelve members have more than 150 cases, and 13 do more than 100 cases of I per year. Fourteen members have more than 10 cases of T per year. Nineteen and 10 members experienced more than 150 and 100 of index cases(N+I+T) per year. A new list of the index cases and coding system are proposed for the future regular update.

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Recombination and Expression of VP1 Gene of Infectious Pancreatic Necrosis Virus DRT Strain in a Baculovirus, Hyphantria cunea Nuclear Polyhedrosis Virus (전염성 췌장괴저바이러스 DRT Strain VP1유전자의 Baculovirus Hyphantria cunea Nuclear Polyhedrosis Virus에 재조합과 발현)

  • Lee, Hyung-Hoan;Chang, Jae-Hyeok;Chung, Hye-Kyung;Cha, Sung-Chul
    • The Journal of Korean Society of Virology
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    • v.27 no.2
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    • pp.239-255
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    • 1997
  • Expression of the cDNA of the VP1 gene on the genome RNA B segment of infectious pancreatic necrosis virus (IPNV) DRT strain in E. coli and a recombinant baculovirus were carried out. The VP1 gene in the pMal-pol clone (Lee et al. 1995) was cleaved with XbaI and transferred into baculovirus transfer vector, pBacPAK9 and it was named pBacVP1 clone. The VP1 gene in the pBacVP1 clone was double-digested with SacI and PstI and then inserted just behind T5 phage promoter and the $6{\times}His$ region of the pQE-3D expression vector, and it was called pQEVPl. Again, the $6{\times}$His-tagged VP1 DNA fragment in the pQEVP1 was cleaved with EcoRI and transferred into the VP1 site of the pBacVP1, resulting pBacHis-VP1 recombinant. The pBacHis-VP1 DNA was cotransfected with LacZ-Hyphantria cunea nuclear polyhedrosis virus (LacZ-HcNPV) DNA digested with Bsu361 onto S. frugiperda cells to make a recombinant virus. One VP1-gene inserted recombinant virus was selected by plaque assay. The recombinant virus was named VP1-HcNPV-1. The $6{\times}$His-tagged VP1 protein produced by the pQEVP1 was purified with Ni-NTA resin chromatography and analyzed by SDS-PAGE and Western blot analysis. The molecular weight of the VP1 protein was 94 kDa. The recombinant virus, VP1-HcNPV-1 did not form polyhedral inclusion bodies and expressed VP1 protein with 95 kDa in the infected S. frugiperda cells, which was detected by Western blot. The titer of the VP1-HcNPV-1 in the first infected cells was $2.0{\times}10^5\;pfu/ml$ at 7 days postinfection.

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