Comparison of Bioabsorbable and Metallic Interference Screws in Arthroscopic Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Autograft

PURPOSE: To compare the postoperative results between the patient group which used bioabsorbable interference screw and metallic interference screw during ACL reconstruction surgery. MATERIAL AND METHODS: Out of 105 patients for whom the postoperative follow-up was possible for one year, authors took 80 patients who underwent arthroscopic ACL recostruction with bone-patellar tendon-bone autograft between December of 1996 and December of 2000. 60 patients fell into group 1 where the patients received bioabsorbable interference screw for fixation at femur and tibia, and 20 patients were classified as group 2 where the patients received metallic interference screw on both the femur and tibia. KT 2000 arthrometer was performed and Lysholm knee score was taken before and after the operation, and the patients underwent the same examination at 6 weeks. 3 months, 6 months, and 1 year after the operation, and the results were compared. RESULT: The average Lysholm knee score of group 1 was 59, and 57 for group 2. During the final follow up examination, the average score improved to 90 for group 1, and group 2. Compared to the healthy side, KT 2000 arthrometer showed the average in group 1 was 6.9 mm and 7.2 mm in group 2 preoperatively, at the final follow up visit after the operation, the value improved to 3.0 mm for both group 1 and 2. Unlike group 2, there were statistically significant relaxation symptoms in group 1 when the exams were performed up until 6 weeks after the operation(P<0.05). CONCLUSION: The usage of bioabsorbable interference screw has many advantages. However, unlike metallic interference screw, it shows laxity within 3 months after the operation. Therefore, when using bioabsorbable interference screw, one has to consider the patients'activity, occupation, or life-style.

Antimicrobial Resistance of Neisseria gonorrhoeae Isolated in Korea / 감염

BACKGROUND: The aim of this study was to monitor trends in antimicrobial susceptibilities of Neisseria gonorrhoeae isolates, in particular, to examine the possibility of increasing prevalence of fluoroquinolone resistance in Korea and the relationship between patterns of mutations involving gyrA and parC genes and the ciprofloxacin resistance level. METHODS: The antimicrobial susceptibilities of 489 gonoccocal isolates which were nationwide collected from patients visiting Health Centers were determined by NCCLS disk diffusion and agar plate dilution methods. PCR and direct DNA sequencing of the amplicons were performed to identify mutations within the quinolone resistance-determining regions of gyrA and parC genes. RESULTS: The proportion of resistance to penicillin, tetracycline, or both remained as high as 94%. The isolates with ciprofloxacin resistance remarkably increased from 1% in 1999 to 5% in 2000 and also resistance to cefoxitine and ceftriaxone were shown to be increased. The strains resistant to spectinomycin was little reported. Four isolates with 16 microgram/mL of MIC for ciprofloxacin all showed the same alternations of Ser-91 to Phe, Asp-95 to Gly in GyrA and Ser-87 to Arg in ParC, but ciprofloxacin-susceptible strains have little amino acid substitution. CONCLUSION: Considering the increasing prevalence of isolates with resistance to ciprofloxacin and ofloxacin, it is likely that the antibiotics such as spectinomycin, or ceftriaxone are recommended as the first-line treatment for gonoccocal infections in Korea. The results from this study suggest that mutation analysis for quinolone resistance-determining regions of gyrA and parC genes are important in epidemiological studies for the spread of ciprofloxacin resistant strains.

A Case of Ebstein's Anomaly Combined with Patent Foramen Ovale

Ebsteins anomaly is characterized by a downward displacement of the tricuspid valve into the right ventricle. Its anatomical abnormality is displacement of septal and posterior leaflets of tricuspid valve from atrioventricular ring into the body of right ventricle and therefore a portion of right ventricle is atrialized. The primary hemodynamic anomaly producing symptoms in Ebsteins malformation is tricuspid regurgitation. Its natural history and clinical features depend on the drgree of displacement of tricuspid leaflets from atrioventricular ring. Although most patients with Ebsteins anomaly are diagnosed in early children, some patients with a mildly deformed tricuspid valve may remain asympto- matic well into adulthood. Most common complaints adult-onset disease are exertional dyspnea, fatigue, palpitation and cyanosis. In rnost cases the physical exarnination, electrocardiogram, and roentgenogram are sufficiently to allow the diagnosis. But, recently echocardiography has played an important role in the recognition of Ebsteins anomaly because two-dimensional echocardiography provides direct visualization of the abnormally displaced tricuspid valve apparatus. So echocardiography has replaced angiography as the procedure of choice for diagnostic and morphologic assessrnent of patients with Ebsteins anomaly. We experienced a 67-year-old female patient with Ebstein's anomaly that was definitely diagnosed by two-dimentional echocardiography. We report this case with literature review.

Reversal of Dilated Cardiomyopathy with medical therapy in a case of Pheochromocytoma

Dilated cardiomyopathy secondary to pheochromocytoma is rare but has been reported to be partially or completely reversible in some cases. A woman with hypertension and cardiac failure due to pheochromocytoma was found to have a dilated, hypokeinetic left ventricle and a restrictive left ventricular filling pattern on two-Dimensional and Doppler echocardiograms. Left ventricular cavity was normalized after aggressive drug treatment, and after sugery of pheochromocytoma,left ventricular filling pattern and blood pressure as well as left ventricular function in echocardiogram were also completely normalized on follow-up without any drug.

Reversal of Dilated Cardiomyopathy with medical therapy in a case of Pheochromocytoma

Dilated cardiomyopathy secondary to pheochromocytoma is rare but has been reported to be partially or completely reversible in some cases. A woman with hypertension and cardiac failure due to pheochromocytoma was found to have a dilated, hypokeinetic left ventricle and a restrictive left ventricular filling pattern on two-Dimensional and Doppler echocardiograms. Left ventricular cavity was normalized after aggressive drug treatment, and after sugery of pheochromocytoma,left ventricular filling pattern and blood pressure as well as left ventricular function in echocardiogram were also completely normalized on follow-up without any drug.

A Case of Gastric Metastasis of Malignant Melanoma Diagnosed by Gastroscopy / 대한소화기내시경학회지

Gastric metastasis occurs in about 0.7% to 1.7%, of patients dying of solid tumors of extragastrointestinal origin. Metastatic disease involving the stomach is an unusual and difficult clinical problem and presenting symptoms include nonspecific epigastric pain and melena. In most cases of gastric metastasis, the histologic finding of the gastroscopic biopsy suggests the correct diagnosis. There are only a few reports of gastric metastasis from malignant melanoma. We report a case of malignat melanoma of gastric metastasis, which was diagnosed by gastroscopy.

A Case of Gastric Metastasis of Malignant Melanoma Diagnosed by Gastroscopy / 대한소화기내시경학회지

Gastric metastasis occurs in about 0.7% to 1.7%, of patients dying of solid tumors of extragastrointestinal origin. Metastatic disease involving the stomach is an unusual and difficult clinical problem and presenting symptoms include nonspecific epigastric pain and melena. In most cases of gastric metastasis, the histologic finding of the gastroscopic biopsy suggests the correct diagnosis. There are only a few reports of gastric metastasis from malignant melanoma. We report a case of malignat melanoma of gastric metastasis, which was diagnosed by gastroscopy.