Femoral Footprint for Anatomical Single-Bundle Anterior Cruciate Ligament Reconstruction: A Cadaveric Study

PURPOSE: To identify the femoral footprint of the anterior cruciate ligament (ACL) in Koreans. MATERIALS AND METHODS: Eighteen embalmed cadaveric knees (mean age, 70 years) were examined. First, the shape of the ACL was determined macroscopically. After the ACL femoral footprint was defined, the ACL was cut from the femur and a Kirschner wire was inserted into the center of the ACL, and the position was verified with a C-arm. The position was quantified on the C-arm field using the quadrant method. The length and width of the ACL were measured. RESULTS: Macroscopically, the ACL is a flat single bundle with an average length of 34 mm and an average width of 9 mm. On average, the center of the ACL insertion site measured with the quadrant method was positioned at 29.5%±2.8% in an anterior direction (from posterior), and at 38.5%±3.2% in a distal direction (from Blumensaat's line). The anterior and posterior margins of the ACL femoral footprint were the resident's ridge and the cartilage margin of the lateral femoral condyle, respectively. CONCLUSIONS: The center of the ACL femoral footprint is positioned more anteriorly and distally than the positions identified in previous studies.

Bone Marrow Derived Kit-positive Cells Colonize the Gut but Fail to Restore Pacemaker Function in Intestines Lacking Interstitial Cells of Cajal

BACKGROUND/AIMS: Several motility disorders are associated with disruption of interstitial cells of Cajal (ICC), which provide important functions, such as pacemaker activity, mediation of neural inputs and responses to stretch in the gastrointestinal (GI) tract. Restoration of ICC networks may be therapeutic for GI motor disorders. Recent reports have suggested that Kit+ cells can be restored to the GI tract via bone marrow (BM) transplantation. We tested whether BM derived cells can lead to generation of functional activity in intestines naturally lacking ICC. METHODS: BM cells from Kit(+/copGFP) mice, in which ICC are labeled with a green fluorescent protein, were transplanted into W/W(V) intestines, lacking ICC. After 12 weeks the presence of ICC was analyzed by immunohistochemistry and functional analysis of electrical behavior and contractile properties. RESULTS: After 12 weeks copGFP+ BM derived cells were found within the myenteric region of intestines from W/W(V) mice, typically populated by ICC. Kit+ cells failed to develop interconnections typical of ICC in the myenteric plexus. The presence of Kit+ cells was verified with Western analysis. BM cells failed to populate the region of the deep muscular plexus where normal ICC density, associated with the deep muscular plexus, is found in W/W(V) mice. Engraftment of Kit+-BM cells resulted in the development of unitary potentials in transplanted muscles, but slow wave activity failed to develop. Motility analysis showed that intestinal movements in transplanted animals were abnormal and similar to untransplanted W/W(V) intestines. CONCLUSIONS: BM derived Kit+ cells colonized the gut after BM transplantation, however these cells failed to develop the morphology and function of mature ICC.

Relationship between Body Composition and Bone Mineral Density in Pre- and Post-menopausal Women / 대한폐경학회지

OBJECTIVES: We analyzed the relationship between body composition, metabolic parameters, and lumbar and femur bone mineral density (BMD) in pre-and post-menopausal women. METHODS: Of 394 females who participated in a medical check-up program, anthropometric measurements and fasting glucose levels and lipid profiles were measured. Body composition analysis was performed using the bioimpedence method and the BMD of the lumbar spine, femur neck, trochanter, ward's triangle, and total were measured by dual energy X-ray absorptiometry. RESULTS: The mean age was 49.5 +/- 9.8 years, and among the subjects, 203 (51.5%) were pre-menopausal and 191 (48.5%) were post- menopausal women. Skeletal muscle mass, fat- free mass, lean body mass, and basal metabolic rate had a positive correlation with the lumbar and femur spine BMD, even after adjustment for age and weight in pre-menopausal women. The abdominal fat ratio, fat mass, waist circumference, percent fat, and total cholesterol had a negative correlation with the lumbar and femur spine BMD, even after adjustment for age and weight in pre-menopausal women. The lean body mass in the legs and trunk, skeletal muscle mass, and fat free mass had a positive correlation with the BMD of the lumbar spine and femur neck, unlike the lean body mass of the arms did not, after adjustment for age and weight in post-menopausal women. CONCLUSION: In pre- and post-menopausal Korean women, body composition, lean body mass, fat -free mass, and skeletal muscle mass were positive correlates, and fat mass and percent fat were negative correlates with the lumbar spine and femur BMD.

Influence of progestrone receptor and vascularity in leiomyoma to the growth and clinical symptoms / 대한산부인과학회지

OBJECTIVE: Myoma is the most frequent benign tumor in women's pelvic cavity. Myoma causes a lot of symptoms that degrade the life quality of the patients. If the patient with leiomyoma does not require the treatment, regular follow-up is recommended. However, there is no definite method to predict the clinical outcome of leiomyoma patients. So we evaluate if the hormone receptors and vascular viability can predict the clinical outcomes in leiomyoma patients. METHODS: We perform the leiomyoma biopsy and ultrasonogram in leiomyoma patients who are symptomatic, premenopaused, and unnecessary to receive treatment. The patients were grouped into two as the results of progesterone receptor status of leiomyoma ; strong positive (> or = 75% positive to progesterone receptor), trace and negative (<25% positive to progesterone receptor). Also, we evaluates the vascular state and the resistance index (RI) of feeding arteries of myoma with doppler ultrasonogram. The severities of clinical symptoms are interpreted by using Uterine fibroid symptom and health-related quality of life questionnaire (UFS-QOL). RESULTS: After 8 months, the strong positive group shows the greater increasement of myoma volume than the trace and negative group. Also, the patient's symptoms and scores of life-quality decrease in strong positive group. In contrast, the trace and negative group show the improvement in clinical symptoms and life-quality. CONCLUSION: As a result, we concluded the status of hormonal receptor and feeding arteries can predict the clinical change of leiomyoma.

A case of full term normal spontaneous vaginal delivery after radiofrequency myolysis / 대한산부인과학회지

Radiofrequency (RF) myolysis is a minimally invasive treatment by create thermal energy in targeted uterine fibroid and cause the aseptic necrosis of leiomyoma cells. Unlike hysterectomy which is considered to be the most common treatment of uterine leiomyoma, RF myolysis can preserve the uterus, and unlike myomectomy which can preserve the uterus but requires the hospitalization and general anesthesia, it can be performed as outpatient procedure using only sedation for pain relief without additional need for medication. There are many published studies reporting the pregnancy complications and outcomes after myomectomy, but few studies regarding pregnancy and myolysis are available. We have experienced a full term vaginal delivery after RF myolysis of subserosal myoma and hereby we report our case with a brief review.

Correlation of transvaginal radiofrequency myolysis and estrogen, progesteron receptor in uterine myoma / 대한산부인과학회지

OBJECTIVE: The aim of this study was to investigate the changes in hormone receptors of myoma cells and volume decrement of myoma after radiofrequency myolysis. METHODS: From 2005 January to 2006 January, thirty patients who have had high-frequency myolysis were included in this study. Needle aspiration biopsy was done at the central portion of myoma pre- and 6 months post-operation. Radiofrequency myolysis were done for 20 minutes until discoloration of myoma was accomplished to 80%. The stain intensity of estrogen receptor (ER) and progesterone receptor (PR) was classified into "negative", "trace", "weak", "moderate" and "strong". RESULTS: The volume decrement was 96.4% in the group that showed trace to week stain intensity (under 50% stain intensity), but it decreased to 66.6% in the group that showed strong stain intensity (over 50%, moderate to strong)(P<0.05). ER showed moderate to strong positive response in 79% of patients before operation, but it showed negative to week response in 83% of patients after the operation. Also, PR showed moderate to strong positive response in 80% of patients before operation, but it showed negative to week response in 86% of patients after the operation. CONCLUSIONS: To coagulate entire myoma, we suggested that controlling the intensity of operation by lengthening the time or expanding the extent of operation was more effective in treatment, because the volume decrement of myoma was larger in case that ER and PR was under 50% before the operation.

A familial case report of paroxysmal kinesigenic dyskinesia in three brothers / 소아과

Paroxysmal kinesigenic dyskinesia (PKD), previously referred to as movement-provoked seizures, is a rare neurological condition that is characterized by short duration dystonic or choreoathetotic movements precipitated by sudden movement, a change in position or hyperventilation. It can be difficult to distinguish this syndrome from seizures. We reported on three brothers in one family all of whom developed abnormal involuntary dystonic or choreoathetotic movement with a tingling or stiffness sensory aura. Evaluations of the patients included general physical examinations, endoclinologic, metabolic studies, chromosomal analysis, video electroencephalograms and brain MRI imaging. All of these studies were normal except for an arachnoid cyst found in one patient. All symptoms showed excellent response to oxcarbamazepine (Trileptal(R)) or carbamazepine. Use of the video electroencephalogram can help differentiate familial PKD from seizures.

Factors affecting the satisfaction rate of radiofrequency myolysis: 18 months follow up / 대한산부인과학회지

OBJECTIVE: To report 18 months follow up results of radiofrequency myolysis and analysis the factors which effect the success rate of myolysis. METHODS: 153 patients who took radiofrequency myolysis between October 2004.~June 2006 in this hospital were enrolled this retrospective study. Except 14 patients which had incomplete data, total 139 patient's charts were reviewed. Sonographic evaluations were checked after a week, 1 month, 3 months, 6 months, 12 months, and 18 months after myolysis. Questions about complications like vaginal bleeding, abdominal pain, feber and vaginal discharge were asked to patients in every visits. Volume of the myoma were checked via 3D ultrasonography. RESULTS: Reduction rate of the volume of myoma after 18 months were 73% and reoperation rate were 4.3%. Improvement rates of patients symptom were 87% (menorrhagea 95%, dysmenorrheal 75%, pelvic pain 60%) The patients who had myomas sized over 100 ml before treatments showed statistically higher rate of reoperation, and decreased rate of satisfaction. Reoperation rate and reduction rate of myoma showed no difference through pathologic diagnosis. The patients who had initial symptoms showed higher rate of satisfaction after myolysis. Total satisfaction rate were 62%, and no serious complications like bowel injury, bladder injury, sepsis and peritonitis were not reported. CONCLUSION: Satisfaction rate after radiofrequency myolysis was increased in symptomatic leiomyoma especially smaller than 6.5 cm in diameter.

A case of adenofibroma of uterine cervix / 대한산부인과학회지

Adenofibromas of the uterine cervix, which are classified as benign tumors of mixed epithelium and mesenchymal cells, are extremely rare. Most common symptom is usually abnormal genital bleeding. It is very difficult to diagnose preoperatively. Recommended method of treatment is total hysterectomy, because it usually recurs. We experienced a case of adenofibroma of the uterine cervix with increased CA125, so report it with a review of the literature.

Infracoccygeal sacropexy for the management of prolapse uteri: Short term results / 대한산부인과학회지

OBJECTIVE: To investigate the short term results of infracoccygeal sacropexy for the management of uterine prolpase or stump prolapse. METHODS: Thirty-four Women who underwent infracoccygeal sacropexy for the management of uterine prolapse or stump prolpase were enrolled this study. Intraoperative or postoperative complications and results of the operation were evaluated and the recurrence rate of pelvic organ prolapse was checked 6 months after operation. RESULTS: Changes of hemoglobin after infracoccygeal sacropexy was 1.7+/-0.9, mean duration of bladder drainage was 3.1+/-1.0 (days). After 2.1 days of operation, foley catheter was removed. Mean inpatient day was 5.2+/-1.0, patient discharged 3.2 days after operation. Recurrence rate after 6 months was 2.9%. Preoperative mean stage of prolapse was 2.7+/-0.7 (stage) and it decreased to 0.4+/-0.6 (stage) 6 months after operation. CONCLUSIONS: Infracoccygeal sacropexy was effective method for the management of uterine/ stump prolapse.

Radiofrequency myolysis: New conservative management of myoma / 대한산부인과학회지

OBJECTIVE: To evaluate the clinical efficacy of radiofrequency myolysis which is new developed uterine preserving management of myoma. METHODS: 17 patinets (27 myomas) who done radiofrequency myolysis between Oct. 2004-Dec. 2004 were participated this study. Preoperatively, Hemoglobin and subjective symptoms were checked and size of myoma was checked using ultrasonogram or computed tomogram (CT). Radiofrequency was applied to myoma for 10 to 40 minutes per one. Follow up sonogram or CT were done 7 days, 1 month, 2 month and 3 month after myolysis. RESULTS: Average age of patients was 42.7+/-8.6 (yr) and average size of myoma was 4.9+/-2.3 cm. We followed 27 nodules. After 3 months, reduction of volume was observed 65%, from 30% to 94%. 3 nodule, which was followed only 2 months, reduced by 46%. About subjective symptoms, 80% reduction was reported after 3 months (50-100%). Menorrhagia reduced 91% in average and pressure symptoms reduced 71% in average. No severe complication like bowel injury, bladder injury, infection and pulomonary embolism was not observed. Serious vaginal bleeding was reported for 3 patients, and their hemoglobin decreased from 10.8 mg/dL preoperatively to 8.7 mg/dL postopertively. CONCLUSION: Radiofrequency myolysis decreased myoma 65% in average. No serious complication were reported.

Laparoscopic finding of Acute Pelvic Inflammatory Disease / 대한산부인과학회지

OBJECTIVE: To analyze physical, laboratory and laparoscopic findings of suspicious cases of pelvic inflammatory disease (PID) and compare the group shown positive findings during laparoscopic surgery with that shown negative findings. METHODS: We selected 42 doubtful cases of PID that were treated by diagnostic laparoscopic surgery in St. Paul hospital of Catholic Medical Center from Jan. 2001 to Jun. 2003 and evaluated symptoms, duration of pain, and physical, laboratory, laparoscopic and histological findings. RESULTS: Of the 42 patients, we classified 22 patients shown pelvic inflammatory findings at laparoscopic surgery into the positive group and 20 patients shown non-specific or free-inflammatory findings into negative group. Between two groups, there were no significant differences in ages, parities and histories of PID. Number of intrauterine device (IUD) users was 5 and all of the five patients were positive group though none was belonged to negative group. Mean duration for developing acute pain was much shorter in positive group (3.1 days) than negative group (22.3 days). There were no meaningful differences in rise of body temperature and CRP level, but the degree of leukocytosis was greater in positive group (10,581/mm3) than negative group (7,720/mm3). Ratio of polymorphonuclear (PMN) leukocytes was higher in positive group (73.3%) than in negative group (59.7%) and number of cases those erythrocyte sedimentation rate (ESR) above 30 mm/Hr was larger in positive group (n=17) than in negative group (n=10). CONCLUSION: Of the suspicious cases of PID based on patient's symptoms and physical findings, the rate of the cases shown positive findings in laparoscopic surgery was 52.3%. Distinctive factors between two groups were usage of IUD, urgency of symptom, degree of leukocytosis, increase in ratio of PMN leukocytes and ESR. We suggest the exploration of more sensitive and specific diagnostic tools.

Correlation between the duration of labor and leptin concentration in cord blood / 대한산부인과학회지

OBJECTIVE: To evaluate the correlation of level of leptin in cord blood and duration of labor. METHODS: Eighty-four pregnant women who had delivered during Jan. 2004-Jun. 2004. at the delivery unit of St. Mary's Hospital of Catholic University Medical College. We checked the level of leptin in cord blood, total duration of labor (cervix 3 cm-delivery of placenta), age of pregnant women, body weight before pregnancy, body weight before delivery, weight of the baby and placenta, head circumference, abdominal circumference, and height of the baby. Leptin was checked by ELISA. RESULTS: Cord blood leptin was in proportion to one's pregnancy duration (umbilical vein p<0.01, umbilical artery p<0.05), change of body weight (p<0.05), weight of placenta (p<0.01), weight of newborn (umbilical artery p<0.01, umbilical vein p<0.05), baby's abdominal circumference (umbilical vein p<0.01, umbilical artery p<0.05). Leptin was in inverse proportion to head circumference of new born infant in umbilical artery (p<0.01) and in umbilical vein (p<0.05). Level of leptin in umbilical vein was in proportion to duration of labor (p<0.05). When the labor duration exceeded 8 hours, leptin in cord blood decreased suddenly, but within 8 hours, their correlation coefficient showed a strong relationship (p<0.01) between the labor duration and leptin level in cord blood. CONCLUSION: Duration of labor affects the level of leptin in cord blood.

The role of ceramidase in murine ovarian granulosa cell death / 대한산부인과학회잡지

OBJECTIVE: One of the models we study is the ovarian granulosa cell (GC), a somatic cell lineage that is critically important for maintenance of the female germ line and many endocrine functions of the ovaries. The objective of this study is to clarify the significance of ceramide and the role of ceramide metabolism in dictating the fate of cells exposed to stress. METHODS: We first treated GC with a C8-ceramide analog or an amine derivative of ceramide that cannot be metabolized by ceramidase (C8-ceramine). Northern blot analysis was performed to evaluate mRNA of acid ceramidease expression regualted by gonadotropin and in situ hybridization was done to identify the mRNA expression of acid ceramidase in ovaries. RESULTS: After 6 hours, C8-ceramide (50 micro M) triggered apoptosis in only 28 +/- 6% of the cells, whereas C8-ceramine (50 micro M) induced apoptosis in all cells (LD50=1 micro M). These data suggested that ceramidase activity is a critical determinant of GC survival. In situ hybridization showed that mRNA of acid ceramidase was highly expressed in GC in growing follicle. mRNA of acid ceramidase was expressed abundantly in granulosa cells and ovaries and its expression was significantly increased by gonadotropin in granulosa cells in in situ hybridization. Forty two hour after gonadotropin treatment, mRNA expression of acid ceramidase in granulosa cells was two fold increased cells comparing with no treatment control in northern blot analysis (P<0.05). In copora lutea, elevated mRNA expression of acid ceramidase was decreased. CONCLUSION: We concluded that GC possess inherently high levels of ceramidase activity, and that ceramidase has important for metabolizing ceramind to maintain GC survival in the ovary.

Clinical experiences of osseous genioplasty

No abstract available.

A case of thanatophoric dwarfism / 대한산부인과학회잡지

No abstract available.

Effect of cell-free human amniotic fluid on the develpment of 2-cell stage mouse embryos in vitro / 대한산부인과학회잡지

No abstract available.

Effect of cell-free human amniotic fluid on the develpment of 2-cell stage mouse embryos in vitro / 대한산부인과학회잡지

No abstract available.

A case of dysgerminoma in combination with mature solid teratoma / 대한산부인과학회잡지

No abstract available.

A case report of successful replantation of the amputated ear

No abstract available.