• Title/Summary/Keyword: Clinical observation

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Bacteroides fragilis Toxin Induces Cleavage and Proteasome Degradation of E-cadherin in Human Breast Cancer Cell Lines BT-474 and MCF7 (인간 유방암 세포주 BT-474와 MCF7에서 Bacteroides fragilis Toxin에 의한 E-cadherin 분절과 프로테아좀에 의한 분해)

  • Da-Hye KANG;Sang-Hyeon YOO;Ju-Eun HONG;Ki-Jong RHEE
    • Korean Journal of Clinical Laboratory Science
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    • v.55 no.1
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    • pp.37-44
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    • 2023
  • Enterotoxigenic Bacteroides fragilis (ETBF) has been reported to promote colitis and colon cancer through the secretion of B. fragilis toxin (BFT), a zinc-dependent metalloprotease. In colonic epithelial cells, BFT induces the cleavage of E-cadherin into the 80 kDa ectodomain and the 33 kDa membrane-bound intracellular domain. The resulting membrane-tethered fragment is then cleaved by γ-secretase forming the 28 kDa E-cadherin intracellular fragment. The 28 kDa cytoplasmic fragment is then degraded by an unknown mechanism. In this study, we found that the 28 kDa E-cadherin intracellular fragment was degraded by the proteasome complex. In addition, we found that this sequential E-cadherin cleavage mechanism is found not only in colonic epithelial cells but also in the human breast cancer cell line, BT-474. Finally, we report that staurosporine also induces E-cadherin cleavage in the human breast cancer cell line, MCF7, through γ-secretase. However, further degradation of the 28 kDa E-cadherin intracellular domain is not dependent on the proteasome complex. These results suggest that the BFT-induced E-cadherin cleavage mechanism is conserved in both colonic and breast cancer cells. This observation indicates that ETBF may also play a role in the carcinogenesis of tissues other than the colon.

Development of Korean Adult Patients Delirium Screening Tool (한국형 성인 환자 섬망 선별 도구 개발)

  • Jeong, Hye Won;Moon, Sun Hee;Choi, Myoung Lee;Lee, Jung A;Ahn, Shin Hye;Jeon, Ji Hye;You, Ji Na;Kim, Hee Jin;Byeon, Ji Eun;Kim, Sook Young;Sung, In Suk
    • Journal of Korean Clinical Nursing Research
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    • v.29 no.2
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    • pp.198-209
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    • 2023
  • Purpose: The purpose of this study was to develop a Korean Adult Patients Delirium Screening Tool (K-APDS) for those admitted to general wards, and to verify its reliability and validity. Methods: For the development of the tool, 12 items were derived through the results of literature review and focus group interviews with general ward nurses, and the content validity was confirmed by experts. To verify the reliability and validity of the developed tool, 317 adult patients who were admitted to general wards of three tertiary general hospitals from October to November 2022 were evaluated by the attending nurse and data were collected. Results: After factor analysis for construct validity verification, two factors were extracted, which explained 60.1% of the total variance. After the validation of the control group, the difference in the delirium incidence scores calculated using the K-APDS between the delirium group and non-delirium group was very significant (Z=-10.82, p<.001). To verify the criterion validity, K-APDS, Delirium Observation Screening, and Pearson's correlation coefficient were checked and found to be .94 (p<.001). The predictive validity test reported that the sensitivity was 91.1%, specificity was 82.4%, positive predictive value was 52.6%, and negative predictive value was 97.8%. The reliability of K-APDS was found to be high with Cronbach's ⍺=.91. Conclusion: K-APDS can screen for delirium with 2 or more points, excellent validity and reliability have been verified. Therefore, this tool could be applied immediately in the clinical field, and will contribute to the early detection of delirium, enabling rapid interventions.

Correlation Analysis of Clinical Risk Factors and Atherosclerosis Diagnosed by Carotid Artery Ultrasonography (경동맥 초음파로 진단된 죽상동맥경화증과 위험인자의 관련성 분석)

  • Jee-Yeon Park;Sung-Hee Yang
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.465-472
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    • 2023
  • In predicting vascular disease, this study attempted to identify changes in the carotid intima-media thickness in patients who underwent carotid artery ultrasonography and hematological tests and to find out the effect of risk factors on the expression of atherosclerotic plaque. A retrospective analysis was conducted on 469 healthy adults who visited the hospital for the purpose of medical examination and performed carotid artery ultrasonography. As a result, carotid intima-media thickness, age, body mass index, waist circumference, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and glucose were analyzed as significant predictors of atherosclerotic plaque (p<0.001). The risk ratio was calculated based on the cut off value of the risk factors of the atherosclerotic plaque determined through ROC curve analysis, followed by 8.06 times the carotid intima-media thickness, 7.53 times the age, 3.97 times the waist circumference and 2.02 times the glucose. Therefore, in this study it was possible to prepare a Korean standard for clinical risk factors that affect the presence of absence of atherosclerotic plaque and observation of carotid artery ultrasonography is thought to help diagnose or predict cardiovascular disease early.

Single Dose Oral Toxicity Study of Cicadidae Periostracum Extracts in Sprague-Dawley Rats (선퇴 추출물의 Sprague-Dawley rat를 이용한 단회 경구 투여 독성시험)

  • Byung-Suk Jeon;Huiyeong Jeong;Sueun Lee;Yun-Soo Seo;Joong-Sun Kim;Hyeon Hwa Nam;Ji Hye Lee
    • The Korea Journal of Herbology
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    • v.39 no.3
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    • pp.107-114
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    • 2024
  • Objective : Cicadae Periostracum (CP), which is the discarded shell of the Cryptotympana atrata (Fabricius, 1775), is a recognized component of oriental medicine for treatment sore throat, itching, shock, sedation, edema. However, the safety and toxicity of CP have not yet been established. It has been reported that symptoms of addiction or side effects may occur in patients who take high doses of CP or who are hypersensitive to it. Therefore, we investigated the acute toxicity of an CP extracts in Sprague-Dawley (SD) rats. Methods : To study acute toxicity, five SD rats of each sex per group were treated with CP extracts at single doses of 0, 500, 1000, or 2000 mg/kg administrated by oral gavage, and body weight, clinical signs, and mortality were observed after dosing. At the end of 14-day observation period, all animals were sacrificed and complete hematological and macroscopic examinations were performed. Results : There were no dead animal and test article-related effects on body weight change or the gross finding. No toxicologically significant results were observed between control and treated groups in hematology. Although salivation related to stress at the highest dose was observed in clinical signs immediately after administration, it is considered to have no toxicological significance. Conclusion : As the results, we did not find any adverse effect at the dose levels of 500, 1000, or 2000 mg/kg in rats. The minimal lethal dose was considered to be over 2000 mg/kg body weight in rats.

Clinical observation for the Geriatric C.V.A. (노인(老人) 뇌졸중(腦卒中)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Seo, Un-Kyo;Jeong, Ji-Cheon;Lee, Won-Chul
    • The Journal of Internal Korean Medicine
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    • v.14 no.2
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    • pp.50-70
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    • 1993
  • Clinical observation was done on 92 cases of Occlusive CVD, Cerebral hemorrhage (Subarachnoid hemorrhage) which were confirmed by Brain CT scan and observed for over 4 weeks, among the 121 cases which were more than 65 years of age. they admitted to the Dept. of Internal Medicine, Oriental Medical Hospital in Dong Guk Univ. from July 1992 to June 1993. The result were as follows; 1. In this study, Occlusive CVD was 74 cases, Cerebral hemorrhage (Subarachnoid hemorrhage was 2 cases) was 18 cases. 2. The ratio of male to female was 1.09:1. The age distribution showed the large number in the 65-69 year group(52.2%), 7th decade was 44.5% over 8th decade was 3.3% in ratio. 3. The site of Occlusive CVD was most common at MCA. the site of Cb-hemorrhage was most common at Basal ganglia. 4. The most common preceding disease was hypertension(47.8%) and the next were diabetes mellitus(14.1%), heart desease(14.1%). 5. Recurrence rate was 33.7% and 2nd attack was 20.7%, 3rd attack was 8.7%, 4th attack was 4.3% 6. Predisposing factors in Occlusive CVD were initiated usually during resting and sleeping, and that in Cb-hemorrhage were represented chiefly exercising(66.6%). 7. The smoker was 52.2%, the drinker was 32.6% in whole group. the drinker was 61.1% by the Cb-hemorrhage. 8. The ratio of the season distribution was as follow, fall 35.8%, winter 29.3%, spring 19.6%, summer 15.3%, that of the month distribution was november 15.2%. 9. Duration from on set in Occlusive CVD, 60.8% was within 5 days, that in Cb-hemorrhage, 77.8% was within 5 days. 10. Level of consciousness on attack was clear 42.2%, lethargy and mental change(dull, stupid etc.) 41.3%. The common symptoms were motor disturbance(90.2%), verbal disturbance(65.2%), headache(43.5%). 11. The physical theraphy of Occlusive CVD has been performed 75.7% in whole group and the average beginning time was 6.4 days, and that of Cb-hemorrhage has been performed 61.1% in whole group and the average beginning time was 13 days. 12. Duration of hospitalization was noted 11-20 days was 31.5%, over 21 days was 46.8%, and the average admission was 22.7 day(Occlusive CVD), 32days (Cb-hemorrhage). 13. The main complication were observed in the studies; urinary tract infection and pneumonia were noted in 6.5%, bed sore in 5.4%. 14. The ratio of systolic blood pressures in admission and discharge decreased from 58.7% to 28.3% in over 160 mmHg, that of diastolic blood pressures in admission and discharge decreased from 72.8% to 51.1% in over 90 mmHg. In 31(33.7%) of the 92 cases it showed the glucose levels of more than normal. 15. The patients have done family history of hypertension and C.V.A were 32.6% of all 16. Occlusive CVD In 83.8% and Cb-hernorrhage in 72.2% were improved 17. The herb medications were various Sunghyanggeonggisan, Sopungtang, CHunmagudeungeum were used most frequently and Gamidaebotang, Boyangwhanotang, Gagamyunjotang, Mangeumtang etc. were used as discharge.

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Clinical Observation of Pleural Effusion (늑막염의 임상적 고찰)

  • Kim, Choon-Sup;Ju, Kee-Joong;Lee, Chang-Hwan;Park, Sung-Min;Shim, Young-Woong;Song, Kap-Young
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.584-594
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    • 1993
  • Background: Among the respiratory diseases, there are a lot of cases of pleural effusion. The most common cause is tuberculosis. But the other cause such as lung malignancy is in an increasing tendency because of the development of diagnostic procedure, the decrease of the prevalence of the tuberculosis and the increase of the longevity. We need to know the accurate diagnosis as soon as possible for the correct therapy. Method: A clinical observation was made on 315 cases of pleural effusion seen at Pusan Adventist Hospital, from Jan, 1989 to Dec, 1992. For diagnostic procedure, thoracentesis, lymph node biopsy, bronchoscopy and percutaneous biopsy of the parietal pleura with Cope needle were performed. The following are parameters used in seperating the exudate from the transudate: pleural protein 3.0 g/dl, pleural protein/serum protein ratio 0.5, pleural LDH 200 IU, pleural LDH/serum LDH ratio 0.6, pleural cholesterol 60 mg/dl and pleural cholesterol/serum cholesterol ratio 0.3. Each parameters were compared, and misclassified rate and diagnostic efficiency were calculated. Results: The most common cause of exudate pleurisy was tuberculosis (82.3%) and malignancy was next (12.2%). The chief complaints of pleural effusion were noted as dyspnea (58.7%), chest pain (54.9%), coughing (50.2%) and fever (36.2%). Location of pleural effusion was noted as right side (51.4%), left side (41.3%) and both sides (7.3%). Amount of pleural effusion of the chest X-ray was minimum (46.8%), moderate (40.5%) and maximum (12.7%). Misclassified rates for each parameters in seperating the exudates from the transudates were as follows; protein: 5.2%, pleural protein/serum protein:7.6%, LDH: 13.9%, pleural LDH/serum LDH: 6.9%, cholesterol: 8.0%, pleural cholesterol/serum cholesterol: 5.6%. On the pleural biopsy, the tuberculosis granuloma was 60.8%, malignancy was 13.6%, infection was 2.3% and nonspecific inflammatory reaction was 23.3%. Conclusion: on the basis of the above results, the most common cause of exudative pleurisy was tuberculosis. We think that the plerual cholesterol/serum cholesterol ratio is the most useful supportive parameter in separating the exudates from the transudates. For accurate diagnosis, the pleural biopsy is the first procedure and repeated pleural biopsy of nonspedcific inflammatory reaction is required.

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STUDY OF THE EFFECT OF COMPREHENSIVE NURSING CARE ON THE ADJUSTMENT OF CHILDREN TO HOSPITALIZATION (유.소아를 위한 포괄적 간호가 그들의 병원생활 적응에 미치는 영향에 관한 연구)

  • 이자형
    • Journal of Korean Academy of Nursing
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    • v.3 no.3
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    • pp.97-110
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    • 1973
  • The goal of modern nursing is to provide comprehensive nursing care to patients. If comprehensive nursing care to children (within the hospital setting) is to be provided, consideration of the stage of growth and development of the child is especially important. From clinical observation, it appeared that nurses often disregarded individual requirements of children in giving nursing care. Therefore, the purpose of this study is to show that comprehensive nursing care which is based on an understanding of the growth and development of the child contributes to both the child and the mother's adaptability to the child's hospitalization. Method: Sixty children, three to three year of age, hospitalized at the Yonsei University Pediatric Ward ware studied. From April 1, 1973 to May 5, 1973, children admitted to the hospital were assigned to either an experimental or a compare groups. There were 30 children in each group. The sex and age of the children in each group was similar. In both groups were more male than female children. In the experimental group, each mother stayed with hot child continuously during his hospitalization. In the compare groups, the mother or some other member of the family stayed with the child. Each day on the child's admission the investigator visited the ward from 1-2 P.M. to 9-10 P.M., in order to provide comprehensive care for the experimental -group. The assistance given the nurses by the investigator was in the form of conferences regarding care and in giving direct care to the child and his mother. The compare group of children received nursing care as usually provided by the hospital. The instruments used to obtain the data for analysis were as follows: 1. The fear and anxiety reaction of the child was recorded by observation of the investigator for four areas: 1) separation from parent and relatives 2) reaction to Doctor and Nurse with white gowns 3) reaction to nursing care 4) reaction to injection and tests, etc. 2. Regression in area of eating, sleeping, and elimination were recorded by the investigator by questioning the mother and by observation. 3. Adaptability to the hospitalization was recorded by direct questioning of the children for areas of emotional and social adjustment. For children older than 3 years of age or children not seriously ill, using the simple I. Q. test this was possible for only 35 of the total 60 children. Result: 1. 55 percents of the total 60 children had been prepared by their parents for hospitalization. The children who had received prior preparation accepted hospitalization more readily than those who had received no preparation. (χ²=4.6 Ρ<0.05) 2. On admission 31.7 percent of the children expressed verbal fear of their discase or treatment. 25 percent felt that the disease was due to their mistake. 3. There was a significant difference in the reaction of the child to separation from the parent or relatives between the two groups. The experimental groups showed less anxiety due to separation than the compare group. (χ²=4.34 Ρ<0.05) In both groups there was less anxiety due to separation among school age (6-12 years) children than among preschool age (3-5 years) children. (χ²=9.22 Ρ<0.05) 4. More than half of the children in both groups reacted with fear and avoidance to doctor and/or nurses wearing white gowns. (χ²=0.06 Ρ<0.05) 5. The experimental group reacted more favorably to nursing in general than the compare group. (χ²=4.8 Ρ<0.05) 6. There was no difference in the fear and refused reaction to special tests and/or such as X-rays and injections, etc. between the groups. (χ²=3.77 Ρ<0.05) 7. More children in the compare group showed regressive tendencies in eating, sleeping, and elimination habits than in experimental groups. (χ²=2.3 Ρ<0.05 χ²=3.88 Ρ<0.05 χ²=4.9 Ρ<0.05) 8. There was a significant difference in the adaptability to hospitalization between the two groups. The experimental groups adapted more readily. (χ²=2.02 Ρ<0.05) 9. For children who had higher I.Q. s the adaptability to hospitalization was better regardless of the group. (χ²=5.03 Ρ<0.05) However, because of the small number of cases (60), this finding cannot be extrapolated without further verification. The date demonstrates that there was a greater adaptability to hospitalization by the child when comprehensive nursing care was given. By planning care and applying knowledge of growth and development to meet, nurses are in a position to prevent some of the psychological trauma associated with hospitalization.

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An analysis of one-year experience of pediatric observation unit: The first report in Korea (소아 관찰병실 운영에 대한 분석)

  • Lee, Jee Young;Choi, Ui-Yoon;Lee, Soo Young;Lee, Ji-Young;Lee, Byong Chan;Hwang, Hui Sung;Mok, Hye Rin;Jeong, Dae Chul;Chung, Seung Yun;Kang, Jin Han
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.622-628
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    • 2007
  • Purpose : While pediatric observation units (POU) have become a common practice in hospitals throughout developed countries, there has been no report about POUs in Korea so far. The aims of this study were to analyze our one-year's experience of the POU and to decide which disease entities are suitable for the POU. Methods : All children admitted from March 2006 to February 2007 to the POU at the Department of Pediatrics in Our Lady of Mercy Hospital were included in this study. Data were collected from retrospective reviews of their medical records. Results : There were a total of 1,076 POU admissions. Median age of patients was 2.4 years and median length of hospital stay 14.0 hours. The most common diagnoses were gastroenteritis (42.7%), pharyngotonsillitis (19.1%), bronchiolitis (7.8%), pneumonia (5.5%) and febrile seizure (5.2%). Overall, 7.5% of the POU patients required subsequent inpatient admissions due to hospital stays of longer than 48 hours. The disease entities that were most likely to require inpatient admission were pneumonia (17.0%), febrile seizure (12.5%) and asthma (11.5%). Diseases that allowed successful discharge from the POU were gastroenteritis (4.6%), upper respiratory tract infection (5.8%), such as otitis media and pharygnotonsillitis and seizure disorder (6.4%). Compared with the previous year when the POU was not in operation, there was a statistically significant reduction in the average length of hospital stays (from 4.69 to 3.75 days), as well as a rise in the bed turnover rate (from 78.8 to 98.2 patients/bed). Conclusion : Our study shows that the POU is efficient for the management of children with certain acute illnesses. Based on this study, we suggest that the POU be used as a new modality which links between the outpatient, inpatient, and emergency departments in the field of pediatrics in Korea.

Studies on Anisakis Type Larvae (Anisakis 형(型) 유충(幼蟲)에 관한 연구(硏究))

  • Lim, Jung Teck
    • Korean Journal of Veterinary Research
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    • v.15 no.2
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    • pp.293-307
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    • 1975
  • As it has been known recently that anisakis type larvae harbouring in marine fishes are a causal agent of zoonosis to human and probably to land living mammal animals, attention was focused on the study on the larvae in an aspect of epidemiology or epizootiology. The present work was conducted from 1966 to 1975 for i) survey on the harbouring status of anisakis type larvae in marine fishes of this country, ii) observation on the response to the experimental infestation of the larvae to the pigs, in the reason that they could well fetid raw fish viscera occasionally containing the larvae as a high protein source of swine food, and iii) observation on the larval resistance and response to vermicidal agents for the purpose of prevention of the larval infection to the mammal animals. The data obtained in the studies were summarized as follows: 1. In the survey on the status of larvae harbouring in main species of marine fishes of this country, 15 species, a total of 1,940 fishes, were observed and the result was summarized in table 2. Average number of larvae, in upper rank of 5 out of all 15 species of fishes, were as highest as 156 larvae ranging 74 to 450 in Pseudosciaena manchurica (chamjogi), 54.5 ranging 15 to 240 in Trichiurus haumela (kalchi), 35.6 ranging 8 to 112 in Trachurus japonica (junggengi), 30.6 ranging 4 to 65 in Parapristipama trilineatum (benjari) and 20.5 ranging 3 to 48 in Nibea argentata (boguchi) respectively. In morphological observation, size of the larvae in the fishes were varied, ranging from 2 to 32mm long, and a tendency to larger size and number of larvae in the fishes, which were wider sea migration, higher age and lager bodily size, was observed The favorite places harbouring the larvae in fishes were mainly around the intraperitoneal viscera such as mesentery, omentum, liver, pyloric suspensory, fat tissue and cloaca, and rarely in body muscles of fish. Fishes heartily infested with the larvae showed stunted growth decreased egg formation and severe damage of liver. 2. In the experimental infestation of the larvae to normal pigs, as illustrated in table 3, a group with large dose of larvae (a total of 1,800 larvae, 300 larvae Per dose, twice in a dart for 3 days) showed acute clinical syndrome terminatine death with a week course, whereas two groups with less dose of larvae (a total of 180~360 larvae, 10 larvae per dose, at 5 days interval for 70~180 days) showed subclinical syndrome with remarkably stunted growth as. much as approximately one half of body size in contest to the control pigs. In the pathological findings, a group with large dose of larvae showed macroscopically larvae penetrating to the gastric wall with severe gastroenteritis, and histopathologically various acute lesions caused by active larvae penetration into the wall of stomach and interstine, whereas two groups with less dose of larvae showed chronic lesions such as hypertrophy and verminous granulomatous swelling of gastric wall, suggesting strongly the possibility of natural infestation of larvae to swine. 3. In the resistance of the larvae to the chemical solutions, the larvae tolerated for 2 days in 15 percent solution of sodium chloride and acetic acid, and for 7 days in 70 percent solution of ethyl alcohol. In the resistance to the temperature, the larvae died within 1 second at $62^{\circ}C$ and tolerated for 24 hours at $-3^{\circ}C$, 12 hours $-5^{\circ}C$ respectively. 4. For the experiment on the vermicidal effect to larvae, general vermicidal drugs such as Neguvon, Combantrin, antimony Potassium, piperazine adipate and piperazine dihydrochloride, oxidizer such as potassium permanganate and potassium chlorate, and dyes such as gentian violet and crystal violet were used, and among them, as illustrated in table 6, potassium permanganate was proved as the best. In the successive test for the practical use of potassium permanganate, vermicidal effect in seawater solution of potassium permanganate and common-water solution of potassium permanganate were compared, and then retested by dipping the fish viscera including the larvae into the two different solutions of potassium permanganate. The result through these tests indicated that 0.01 percent common water and sea-water solution of potassium permanganate could be apparently recommended as a preventive vermicidal solution, having 90 to 100 percent vermicidal effect by dipping for 12 to 24 hours even though sea-water solution of potassium permanganate had a tendency to slightly less effect than the common-water solution of potassium permanganate (Table 8).

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The Clinical Results of ACL Reconstruction with Tibialis Allograft Using Hybrid Femoral Fixation and $Retroscrew^{(R)}$ (Hybrid 대퇴 고정과 $Retroscrew^{(R)}$를 사용한 동종 경골건 이용 전방 십자 인대 재건술의 임상적 결과)

  • Kim, Doo-Sub;Rah, Jung-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.8-13
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    • 2009
  • Purpose: We used tibialis allograft for the reconstruction of ACL and used Hybrid femoral fixation utilizing $Endobutton^{(R)}$ and $Rigidfix^{(R)}$ for femoral fixation, and used $Retroscrew^{(R)}$ and additional fixation for tibial fixation to evaluate the clinical results. Materials and Methods: The ACL reconstruction were performed from February 2004 to February 2007 utilizing Hybrid femoral fixation and $Retroscrew^{(R)}$ and 32 patients, 32 cases which were available for year-long observation (12 to 25 months). The clinical results (Lysholm knee score, IKDC grade) and the radiologic results(bone tunnel expansion, Telos anterior displacement test) were evaluated. Results: The Lysholm knee score was improved from the average of $67.9{\pm}5.4$ points (range: 51~77) before operation and to $94.1{\pm}6.8$ points (range: 68~98) at the last follow up (p<0.05). 22 cases (69%) were evaluated normal (A), 9 cases (28%) were evaluated nearly normal (B) and only 1 case (3%) was evaluated not normal (C) at IKDC final evaluation and no case was evaluated abnormal. From $Telos^{(R)}$ stress x-ray evaluation, difference from the opposite knee was improved average 13.2 mm{\pm}5.8 (range: 6~21 mm) to average $3.4\;mm{\pm}2.8$ (range: 0~11 mm) after operation (p<0.05). The femoral and tibial tunnel were widened by 18.7% and 9.6% in the AP view and 12.4% and 8.5% in the lateral view, respectively (p<0.05). However, any statistic significance was not observed between bone tunnel expansion and knee joint functions (p>0.05). Conclusion: An ACL reconstruction with tibialis allograft using Hybrid femoral fixation and $Retroscrew^{(R)}$ enabled anatomical fixation of the graft tendon with satisfactory clinical results.

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