Clinical Application of N+7 Method for the Solution of Graft: Tibial Tunnel Discrepancy in Anterior Cruciate Ligament Reconstruction

PURPOSE: The purpose of this study is to prevent the graft-tunnel mismatching by N+7 method and to present the experience of the authors in anterior cruciate ligament reconstruction, using the patellar ten- don by N+7 method. MATERIALS AND METHODS: Authors analyzed 34 cases who had taken the anterior cruciate ligament reconstruction from April 1998 to July 1999, at Asan Medical Center, by N+7 method. By measuring the patellar tendon length(N), tibial guide was set an angle of N+7 degree. We analyzed the results by dividing the cases into 3 groups by the degree of extrusion of the bone plug from the tibial tunnel. RESULTS: Clinical results were acceptable in 79.4%(27 cases), protrusion in 8.8%(3 cases) and recession in 11.8%(4 cases). When the angle of tibial tunnel was less than 50 degrees, there wasn't a protruded case in 19 cases. Comparing with 15 cases of the angle which was larger than 50 degrees, there were three protruded cases. CONCLUSION: Clinical results of anterior cruciate ligament reconstruction using the patellar tendon, with N+7 method is superior to empirical methods which was performed by authors, previously at the point of positioning of ideal tibial tunnel and conveniency of the technique. Especially, if the graft tendon length is shorter than 43mm, N+7 method is preferable.

Two Cases of Leukemia Cutis / 대한피부과학회지

We report herein two cases of leukemia cutis. One case is a 54-year-old woman who came to our department with complaints of a solitary ulcerating nodule on her left leg that had been present for 2 months since prior to her visit. Through histopathological studies, the diagnosis of myelocytic leukemia cutis was made before the final diagnosis of acute myelocytic leukemia was made by hematological studies. When combined chemotherapy was finished, she was in a partial remission state and the nodule disappeared after 1 month of chemotherapy. The other case is a 77-year-old man having multiple infiltrative nodules on the right forearm and right thigh for 1 month prior his visit. He was diagnosed as having leukemia cutis for his skin lesions histopathologically. This was redefined as chronic myelomonocytic leukemia of the myelodysplastic syndrome with blastic transfor- mation by hematological examination. He developed septicemia and died 3 weeks after the dermato- logical diagnosis.

A Case of NCAM-positive Nasal Type T/NK-Cell Lymphoma

We herein report a case of nasal type T/natural killer(NK)-cell lymphoma(TNKCL). This lymphoma is characterized by the expression of CD2, CD43 and NCAM(CD56) antigen, an aggressive clinical course, frequent extranodal spreading, a strong association with Epstein-Barr virus(EBV), and the absence of T-cell receptor(TCR) gene rearrangement. NCAM antigen is known to be a possible determinant of extranodal dissemination of peripheral T-cell lymphoma(PTCL). The patient is a 70-year-old male with skin lesion on his forearm. Histopathological and immunohistochemical studies were diagnostic of EBV-associated TNKCL. Untill now, he has failed to respond to anticancer therapy.

Two Cases of the Angioimmunoblastic Lymphadenopathy Type of Peripheral T - cell Lymphoma : Different Clinical Courses According to Positivity to Epstein-Barr Virus

Peripheral T-cel1 lymphoma(PTCL) encompasses histopathologically and clinically various spectra of cutaneous T-cell lymphoma(CTCL). In this report, we describe two cases of PTCL showing diRerent clinical courses according to EBV(Epstein-Barr virus) positivity. The chnical course of case 1 with EBV-associated PTCL was rapidby fatal and refractory to intensive chcmotherapy. However, in case 2, EBV genomes were not found in her lesional tissues and she showed an indolent clinical course withoaat systemic symptoms. Accordingly, serological and immunohistochemical investigations for EBV might be mandatory in cutaneous PTCL to evaluate clinical prognosis.

A Case of Secondary Cutaneous Diffuse Large B-cell Lymphoma

We herein report a case of secondary cutaneous diffuse large B-cell lymphoma(DLBCL) occurring in a 66-year-old woman. The skin lesions were erythematous infiltrative nodules on the right inguinal area. Histologically, the skin lesion disclosed DLBCL mainly composed of immunoblasts. Concurrently, she showed lymph node involvement. Initially, however, we could not define the conclusive temporal sequences between nodal lesions and skin lesions. Finally, additional further studies revealed this case as secondary cutaneous 8-cell lymphoma, and she was managed with systemic chemotherapy.

A Case of Non-T,Non-B Primary Cutaneous Lymphoblastic Lymphoma

We herein present a case of a 2-year-old girl with non-Hodgkin's lymphoma(NHL) of the lymphoblastic type involving cutaneous sites at the time of diagnosis. The histological finding was typical of lymphoblastic lymphoma. However, immunophenotypically, this lymphoma was not of the T-cell or B-cell type, although the vast majority of lymphoblastic lymphomas involving the skin are usually of the pre-B cell or T-ce11 type. Until now, there have been few reports of non-T, non-B primary cutaneous lymphoblastic lymphoma expressing surface CD10 and CD56 antigens as in this case.