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Effect of Release of the Superficial Medial Collateral Ligament in Repair of the Posterior Medial Meniscus Root Tear (내측 반월상 연골 후각 부착부 봉합술 시 표층 내측측부인대 유리술의 효과)

  • Yang, Byung Se;Lee, Dhong Won;Nam, Sang Wook;Ha, Jeong Ku;Kim, Jin Goo
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.2
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    • pp.114-120
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    • 2012
  • Purpose: The purpose of the study was to evaluate the usefulness and the stability of the superficial medial collateral ligament (MCL) release in posterior medial meniscus root repair. Materials and Methods: We compared 20 patients who underwent posterior medial meniscus root repair with superficial MCL preserved (PM) and 32 patients who underwent posterior medial meniscus root repair combined with superficial MCL release (RM) from April 2006 to September 2010. We excluded the patients combined with other surgery. To evaluate the postoperative valgus instability in RM group, we examined direct tenderness on MCL insertion, the subjective feeling of instability and valgus stress test at 3 months and 1 year follow-up. We compared the tourniquet time between PM group and RM group, and the clinical results were assessed by Lysholm score and International Knee Documentation Committee (IKDC) for the usefulness. Results: All patients had no clinically significant complication related to the superficial MCL release. Three months and 1 year follow-up, there were no positive tenderness test, no subjective symptoms and no significant increase of valgus instability although 5 patients examined grade I valgus instability. The mean tourniquet time was $41.3{\pm}12.7$ minutes in RM group and $53.5{\pm}13.6$ minutes in PM group. There was a significant difference in the tourniquet time between the two groups (P<0.05). Average Lysholm score was $56.8{\pm}5.5$ (range, 44-70) preoperatively and $85.1{\pm}5.8$ (range, 77-94) postoperatively in PM group, and was $56.2{\pm}5.4$ (range, 45-67) preoperatively and $87.4{\pm}3.9$ (range, 82-95) postoperatively in RM group (P<0.001). No significant difference of Lysholm score was found in both groups (P<0.05). Average IKDC scores was $42.6{\pm}3.9$ (range, 30-53) preoperatively and $77.2{\pm}6.3$ (range, 68-92) postoperatively in PM group, and was $42.7{\pm}5.7$ (range, 30-53) preoperatively and $89.6{\pm}2.9$ (range, 84-95) postoperatively in RM group (P<0.05). There was also no significant difference of IKDC score in both groups (P<0.05). Conclusion: The superficial MCL release in posterior medial meniscus root repair is useful to gain a wide surgical field and reduces the tourniquet time and does not lead to postoperative valgus instability. It can be considered clinically useful and safe procedure in medial meniscus posterior root repair.

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Observations of Oxygen Administration Effects on Visuospatial Cognitive Performance using Time Course Data Analysis of fMRI (뇌기능 자기공명영상의 시계열 신호 분석에 의한 공간인지과제 수행시 산소 공급의 효과 관찰)

  • Sohn Jin-Hun;You Ji-Hye;Eom Jin-Sup;Lee Soo-Yeol;Chung Soon-Cheol
    • Investigative Magnetic Resonance Imaging
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    • v.9 no.1
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    • pp.9-15
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    • 2005
  • Purpose : This study attempted to investigate the effects of supply of highly concentrated $(30\%)$ oxygen on human ability of visuospatial cognition using time course data analysis of functional Magnetic Resonance Imaging (fMRI). Materials and Methods : To select an item set in the visuospatial performance test, two questionnaires with similar difficulty were developed through group testing. A group test was administered to 263 college students. Two types of questionnaire containing 20 questions were developed to measure the ability of visuospatial cognition. Eight college students (right-handed male, average age of 23.5 yrs) were examined for fMRI study. The experiment consisted of two runs of the visuospatial cognition testing, one with $21\%$ level of oxygen and the other with $30\%$ oxygen level. Each run consisted of 4 blocks, each containing control and visuospatial items. Functional brain images were taken from 37 MRI using the single-shot EPI method. Using the subtraction procedure, activated areas in the brain during visuospatial tasks were color-coded by t-score. To investigate the time course data in each activated area from brain images, 4 typical regions (cerebellum, occipital lobe, parietal lobe, and frontal lobe) were selected. Results : The average accuracy was $50.63{\pm}8.63$ and $62.50{\pm}9.64$ for $21\%\;and\;30\%$ oxygen respectively, and a statistically significant difference was found in the accuracy between the two types of oxygen (p<0.05). There were more activation areas observed at the cerebellum, occipital lobe, parietal lobe and frontal lobe with $30\%$ oxygen administration. The rate of increase in the cerebellum, occipital lobe and parietal lobe was $17\%$ and that of the frontal lobe, $50\%$. Especially, there were increase of intensity of BOLD signal at the parietal lobe with $30\%$ oxygen administration. The increase rate of the left parietal lobe was $1.4\%$ and that of the right parietal lobe, $1.7\%$. Conclusion : It is concluded that while performing visuospatial tasks, high concentrations of oxygen administration make oxygen administration sufficient, thus making neural network activate more, and the ability to perform visuospatial tasks increase.

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A STUDY ON NEWCASTLE DISEASE VACCINATION: The Immunological Response to Inactivated and Attenuated Virus Vaccines (Newcastle병(病)의 예방접종(豫防接種)에 관한 연구(硏究); 사독(死毒)백신 및 감독(減毒)된 생독(生毒)백신에 대한 면역학적(免疫學的) 반응(反應))

  • Chung, Gill Taik
    • Korean Journal of Veterinary Research
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    • v.2 no.1
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    • pp.27-36
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    • 1962
  • Immune response to two methods of Newcastle disease virus vaccine, one inactivated and the other attenuated was observed and the data presented. (1) Administration of inactivated virus vaccine in an amount of 1.0 ml. by intramuscular route gave an appreciable immunity to Newcastle disease for a period of at least three-and-half months. (2) The chickens given attenuated virus vaccine in the drinking water produced satisfactory immunity as manifested by the fact that immunized birds showed resistance when challenged 105 days after the vaccination and maintained high degree of HI titer for a period of 75 days. (3) Vaccination with the attenuated virus vaccine in drinking water is very simple and time saving in procedure, although the duration of immunity seems to be slightly shorter than that proced by inactivated virus vaccine. The author wishes to express his appreciation, to Drs. Kyu Myung Lee, Chang Koo Lee, and Ryong Sook Kee of their suggestions and help. The author is also indebted to Dr. Chang Hi Lee, Director of Anyang Veterinary Laboratory, who allowed the use of the facilities of the laboratory, whitout which this experiment could not have been undertaken.

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Is Preventive Bilateral Surgery Needed in Case of Bilateral Bullae on HRCT at Unilateral Primary Spontaneous Pneumothorax (일차성 자연기흉의 고해상 CT에서 보이는 반대편 기포의 예방적 기포절제술이 필요한가?)

  • Han, Jong-Hee;Kang, Min-Woong;Yu, Jeong-Hwan;Kim, Yong-Ho;Na, Myung-Hoon;Lim, Seung-Pyung;Lee, Young;Yu, Jae-Hyeon
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.215-219
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    • 2007
  • Background: Due to the advancement of video assisted thoracoscopic techniques, an operation for primary spontaneous pneumothorax is now considered a common procedure. However, whether a preventive operation is necessary when a contralateral bulla is found on High Resolution Computed Tomography (HRCT) at the time of the first primary spontaneous pneumothorax attack is still unknown. In this retrospective study, it was our intension to find whether contralateral bullae are related to the occurrence of pneumothorax. Material and Method: Between January 1999 and April 2006, 550 patients were admitted to the Chungnam University hospital with primary spontaneous pneumothorax, which was confirmed by the HRCT scans in 190 patents. In these 190 patients, 159 had not received a bilateral operation after their first primary spontaneous pneumothorax attack. In these 159 patients, the relationship between the presence of contralateral bullae and the occurrence of pneumothorax was measured. Result: In these 159 patients, 67 had contralateral bullae confirmed inform the HRCT scan, and 92 had no visible contralateral bullae, During the follow up period, 6 patients (8.9%) with contralateral bullae had an occurrence of contralateral pneumothorax, and 5 patients (5.4%) without contralateral bullae had an occurrence of contralateral pneumothorax. (p=0.529 [Fisher's exact test]) Conclusion: In patients with unilateral primary pneumothorax, an HRCT scan is a useful way of confirming contralateral pulmonary bullae. However, the presence of bullae is not a significant predictive sign of an occurrence of contralateral pneumothorax. Also, surgery for pneumothorax is not completely uncomplicated, and bilateral surgery is still doubtful. A further prospective study will be required to find the relationship between the bullae found on HRCT and the occurrence of pneumothorax.

Functional analysis of seaR protein identified from Saccharopolyspora erythraea (희소방선균의 seaR 단백질 발현을 통한 기능 분석)

  • Ryu, Jae Ki;Kwon, Pil-Seung;Lee, Hyeong Seon
    • Korean Journal of Microbiology
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    • v.51 no.1
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    • pp.39-47
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    • 2015
  • Secondary metabolism in actinomycetes has been known to be controlled by a small molecule, ${\gamma}$-butyrolactone autoregulator, the binding of which to each corresponding receptor leads to the regulation of the transcriptional expression of the secondary metabolites. We expected that expression of an autoregulator receptor or a pleiotropic regulator in a non-host was to be gained insight of effective production of new metabolic materials. In order to study the function of the receptor protein (seaR), which is isolated from Saccharopolyspora erythraea, we introduced the seaR gene to Streptomyces coelicolor A3(2) as host strains. An effective transformation procedure for S. coelicolor A3(2) was established based on transconjugation by Escherichia coli ET12567/pUZ8002 with a ${\varphi}C31$-derived integration vector, pSET152, which contained int, oriT, attP and $ermEp^*$ (erythromycin promotor). Therefore, the pEV615 was introduced into S. coelicolor A3(2) by conjugation and integrated at the attB locus in the chromosome of the recipients by the ${\varphi}C31$ integrase (int) function. Exconjugant of S. coelicolor A3(2) containing the seaR gene was confirmed by PCR and transcriptional expression of the seaR gene in the transformant was analyzed by RT-PCR. In case of S. coelicolor A3(2), a phenotype microarray was used to analyze the phenotype of transformant compared with wild type by seaR expression. After that, in order to confirm the accuracy of the results obtained from the phenotype microarray, an antimicrobial susceptibility test was carried out. This test indicated that sensitivity of the transformant was higher than wild type in tetracycline case. These results indicated that some biosynthesis genes or resistance genes for tetracycline biosynthesis in transformant might be repressed by seaR expression. Therefore, subsequent experiments, analysis of transcriptional pattern of genes for tetracycline production or resistance, are needed to confirm whether biosynthesis genes or resistance genes for tetracycline are repressed or not.

The effects of short-term application of calcium hydroxide on dentin fracture strength (단기간의 수산화 칼슘 적용이 상아질 파절강도에 미치는 영향)

  • Shin, Eun-Jung;Park, Yeong-Joon;Lee, Bin-Na;Jang, Ji-Hyun;Chang, Hoon-Sang;Hwang, In-Nam;Oh, Won-Mann;Hwang, Yun-Chan
    • Restorative Dentistry and Endodontics
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    • v.36 no.5
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    • pp.425-430
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    • 2011
  • Objectives: This in vitro study investigated whether short-term application of calcium hydroxide in the root canal system for 1 and 4 wk affects the fracture strength of human permanent teeth. Materials and Methods: Thirty two mature human single rooted mandibular premolars in similar size and dentin thickness without decay or restorations were hand and rotary instrumented and 16 teeth vertically packed with calcium hydroxide paste and sealed coronally with caviton to imitate the endodontic procedure and the other 16 teeth was left empty as a control group. The apicies of all the samples were sealed with resin, submerged in normal saline and put in a storage box at $37^{\circ}C$ to mimic the oral environment. After 1 and 4 wk, 8 samples out of 16 samples from each group were removed from the storage box and fracture strength test was performed. The maximum load required to fracture the samples was recorded and data were analysed statistically by the two way ANOVA test at 5% significance level. Results: The mean fracture strengths of two groups after 1 wk and 4 wk were similar. The intracanal placement of calcium hydroxide weakened the fracture strength of teeth by 8.2% after 4 wk: an average of 39.23 MPa for no treatment group and 36.01 MPa for CH group. However there was no statistically significant difference between experimental groups and between time intervals. Conclusions: These results suggest that short term calcium hydroxide application is available during endodontic treatment.

SEDATION EVALUATION USING BIS INDEX ASSESSMENT WITH AND WITHOUT THE ADDED SUBMUCOSAL MIDAZOLAM (점막하 Midazolam의 병용투여 시 BIS 분석을 이용한 진정 평가)

  • Lee, Young-Eun;Park, Mi-Kyung;Kim, So-Young;Kim, Yun-Hee;Jung, Sang-Hyuk;Baek, Kwang-Woo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.1
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    • pp.91-98
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    • 2007
  • The aim of this study was to examine the difference of the depth of sedation using the Bispectral index assessment with and without the added submucosal Midazolam to oral Chloral hydrate and Hydroxyzine for pediatric patients. Twenty seven sedation cases were performed in this study Selection criteria included good health(ASA I), 2 to 6 years of age, the need for sedation to receive dental treatment including anesthesia, and restorative procedure over at least two teeth. Patients were randomly classified into one group taking oral Chloral hydrate(60 mg/kg) and Hydroxyzine(1 mg/kg) and the other group recieving Chloral hydrate(60 mg/kg), Hydroxyzine(1 mg/kg) and submucosal Midazolam(0.1 mg/kg). Nitrous Oxide(50%) was used for both group during sedation. Patients were monitored using a pulse oximeter and a Bispectral monitor. A behavior scale was rated as quiet(Q), crying(C), movement(M), or struggling(S) every 2 minutes watching a recorded videotape. Analysis showed a significant difference in mean Bispectral index and SD during sedation across two groups(P<0.001). The group of patients injected with submucosal Midazolam in addition to oral Chloral hydrate and Hydroxyzine showed a lower mean Bispectral index and a narrower SD. PR and SpO2 for both groups remained within the normal values. Submucosal Midazolam improved the sedation quality by deepening sedation depth without compromising safety and enabled the sedation pattern to be kept more stable.

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Ultrasonographic Utility for Arthroscopic Examination of Knee (슬관절 관절경 검사 시 초음파 검사의 유용성)

  • Byun, Ki-Yong;Rhee, Kwang-Jin;Kim, Kyung-Cheon;Kim, Dong-Kyu;Kim, Bo-Kun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.1
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    • pp.18-23
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    • 2009
  • Purpose: To evaluate the relationship between the real pathology & abnormal finding found by ultrasonography. Without an MRI test being done beforehand, an arthroscopy is done after an ultrasonography to show abnormal lesions during a knee abnormality. Materials and Methods: The subjects were 42 patients out of 49 cases, excluding those with rheumatoid arthritis, septic arthritis and patients suspected with a ligament tear, which were examined by ultrasonography alone before receiving a knee arthroscopy in our hospital from July 2007 to July 2008. In every case, a physical examination, simple X-ray and knee ultrasonography was done. An arthroscopy was performed when there was ultrasonographic abnormal finding. Before the procedure, a MRI test was not performed and when abnormal findings were found by an arthroscopy, an appropriate surgery was done. Results: During the ultrasonographic examination, there were various sized effusions in the suprapatellar pouch. Also, in addition there were eleven cases of medial meniscus abnormalities, sixteen cases of lateral meniscus abnormalities, and two cases of cystic lesions. Throughout the arthroscopic examination, there were 14 cases of medial meniscus abnormalities, 20 cases of lateral meniscus abnormalities, 15 cases of cartilage damages, 9 cases of medial pathologic plica, 2 cases of intra-articular loose bodies, 5 cases of chondromalacia, 2 cases of cyst, and 2 cases of synovitis. When an effusion abnormality was found by the ultrasonography in a suprapatellar pouch, there was a 100% probability of knee pathology. When a medial meniscus abnormality was found with an ultrasonography, there was a 90.9% probability of a real pathology. When a lateral meniscus abnormality was found there was 81.2% probability of a real pathology. Ultrasonography was 100% accurate when it came to cystic lesions. Conclusion: Knee ultrasonography performed before an arthroscopy seems to be a very useful examination method when suspecting intra-articular lesions.

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Usefulness of the Chin Press Maneuver in Assessing the Severity of Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증후군의 진단에 있어 턱 압박술의 유용성)

  • Kim, Moo-Jin
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.22-29
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    • 2001
  • Objectives: Obstructive sleep apnea syndrome (OSA) is a moderately prevalent disorder. Even though much progress has been made in the diagnosis of this disorder, the cost-effectiveness of nocturnal polysomnography is undertermined and physicians and patients are still hesitant to undergo this procedure. The authors wanted to see the validity of chin press/tongue curl maneuver in estimating the severity of OSA which is easy to measure and was originally proposed by Simmons etc. by looking at the correlations between this score and the conventional respiratory disturbance indices. Methods: Forty-three sleep-related breathing disorder patients (28 OSA patients and 15 upper airway resistance syndrome (UARS) patients) who underwent investigation for posssible OSA were studied. Two conventional indices of OSA (apnea/hypopnea index (AHI) and oxygen saturation dip rate (SaO2 dips)), four other sleep variables (lowest SaO2, % of time with SaO2<90% (%SaO2 <90), % of sleep stage 1, mean length of SaO2 dips) and the score of Epworth sleepiness scale (ESS) were compared with the chin press score (CPS) which was newly revised by the author and ranges from 0 to 6. Results: The age of subjects was $45.95{\pm}12.47$ (range 14-76) and their average BMI was $25.98{\pm}3.61$ (range 19.65-37.64). There were no significant differences in age, sex and BMI except repiratory disturbance indices and ESS (p<0.05) between OSA and UARS group. Grouped median CPS of the all subjects was 4.14 (range 1-6). There was a remarkable relationship between CPS and diagnosis category (Likelihood Ratio $X^2$ test; $X^2$=17.41, df=5, p=0.004) and measures of association (Somers' $d=0.65{\pm}0.12$, t=4.83, p=0.000) indicated that CPS increased when the diagnosis changed from UARS to OSA. Spearman's rank correlations between CPS and SaO2 dips (R=0.83), between CPS and AHI (R=0.77) were good (p<0.001). Other variables except mean length of SaO2 dips showed good correlations with CPS as well (p<0.05). Regression analysis indicated that when CPS is 3 there is a provability of 0.35 to have AHI of less than 5. Conclusion: Chin press scores that can be measured easily is well correlation with the conventional sleep apnea indices. They may therefore provide a useful guide in diagnosing obstructive sleep apnea synrome.

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The Effects of Modafinil on Clinical Features and Sleep Structure of Narcolepsy Patients and Healthy Controls (모다피닐이 기면병 환자와 대조군의 임상 양상과 수면구조에 구조에 미치는 영향)

  • Shin, Hong-Beom;Jeong, Do-Un;Kim, Eui-Joong
    • Sleep Medicine and Psychophysiology
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    • v.13 no.2
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    • pp.67-74
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    • 2006
  • Introduction: Excessive daytime sleepiness and cataplexy are key features of narcolepsy. Modafinil is psychostimulant used in the treatment of narcolepsy. In this study, we evaluated effects of modafinil on nocturnal sleep structure and sleep latency in multiple sleep latency test and clinical features. Methods: Twelve narcoleptic patients (7 male, age: $22.9{\pm}2.6\;yrs$) were participated in the study. All of them had done nocturnal polysomnography (nPSG), multiple sleep latency test (MSLT), clinical symptoms scales and have repeated same procedure after taking 200 mg of modafinil. We have done linear mixed model analysis to describe effects of group, medication and nap time on these measures. Results: Modafinil did not affect clinical scales except PSQI which had been reduced after medication. In this study, Modafinil reduced total sleep time, sleep efficiency and increased wake after sleep onset and percent of arousal during sleep in nocturnal polysomnography and prolonged mean sleep latency in multiple sleep latency tests in both group. Discussion: Modafinil has stimulant effect of central nervous system but its effect on night sleep is less than other psychostimulants such as methylphenidate. We ascertained that modafinil affected total sleep time, sleep efficiency and percent of wake during sleep but did not effect on sleep structure. Modafinil was effective in the management of day time sleepiness. Modafinil can enhance alertness of control group without day time sleepiness.

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