Mid-Term Outcomes of Anterior Cruciate Ligament Reconstruction with Far Anteromedial Portal Technique

PURPOSE: The purpose of this study was to evaluate the mid-term outcomes of anatomic anterior cruciate ligament (ACL) reconstruction using two anteromedial (AM) portals by comparing with short-term follow-up results. MATERIALS AND METHODS: Fifty patients who were treated by ACL reconstruction using a two AM portal technique were evaluated retrospectively. The follow-up period was at least 5 years. The mean follow-up period was 68.5±13.9 months. The mid-term clinical outcomes were compared with short-term (≥12 months) results. For the assessment of knee stability, anterior tibial translation was evaluated using the Lachman test and the KT-2000. Rotational stability was evaluated using pivot shift test. For clinical assessment, the Lysholm and International Knee Documentation Committee scores were used. RESULTS: The average anterior translation was 2.1±1.4 mm at the short-term follow-up and 2.8±1.8 mm at the mid-term follow-up. Stability and midterm clinical outcomes were not significantly improved compared to the short-term follow-up results. At the mid-term follow-up, anteroposterior (AP) instability assessed by the KT-2000 was slightly increased, but still acceptable. On the other clinical physical evaluation, there was no statistically significant difference. CONCLUSIONS: The short-term and mid-term outcomes of ACL reconstruction using the two AM portal technique were not significantly different except for AP stability although the value was less than 3 mm at both follow-ups. Therefore, this operative technique could be considered a satisfactory alternative for ACL reconstruction.

Primary Total Hip Arthroplasty Using Summit® Stems in Korean: Minimum Four-year Follow-up / 대한고관절학회지

PURPOSE: The aim of this study was to assess the mid-term results of primary cementless total hip arthroplasty (THA) using Summit® stems. MATERIALS AND METHODS: One hundred twenty-eight arthroplasties in 121 patients who were performed THA from December 2004 to March 2013, were reviewed retrospectively a minimum of 4 years follow-up (mean age, 60.3 years; mean postoperative follow up period, 86.3 months). For a clinical evaluation, the Harris hip score (HHS) was used to assess outcome. Radiographic evaluation was done through spot welds, subsidence, stress shielding, canal filling. RESULTS: The mean HHS was 69.8 points preoperatively, and it improved significantly to 96.3 points at the final follow-up. Postoperatively, 10 patients experienced thigh pain and 7 patients showed a moderate limping gait. There was not only early stem subsidence but there was no more subsidence at last follow up. One hundred eighteen hips showed radiographic signs of stem bone ingrowth, and 10 hips showed fibrous ingrowth at the last follow-up. Stress shielding occurred in 85 hips and third degree stress shielding was observed in 6 hips. Complication arose in 10 hips due to dislocation. Although revisions due to recurrent dislocations led to acetabular component revision in one hip, no revisions arose due to isolated aseptic loosening of the femoral component. CONCLUSION: The clinical and radiological mid-term results of primary THA using Summit® stems revealed solid initial fixation and bone ingrowth stable fixation. Considering the satisfactory clinical results, Summit® stems may be a good treatment option in Korean patients who were required hip arthroplasty

Direct Cytotoxicity of Interferon-gamma (IFN-gamma) on Renal Cell Carcinoma Cell Line / 대한비뇨기과학회지

No abstract available.

Fas-induced Apoptosis in Renal Cell Carcinoma Cell Line by Interferon-gamma (IFN-gamma) Treatment / 대한비뇨기과학회지

No abstract available.

Extensive Penis Paraffinoma: Treatment by Penoplasty Using Various Scrotal Flaps and Radial Forearm Free Flap / 대한남성과학회지

PURPOSE: There is no single method of choice for penoplasty in extensive penile paraffinoma, and surgeons must choose a suitable method according to the condition of each individual patient. Herein, we present 19 cases of extensive penile paraffinoma treated with various scrotal flaps or a new method involving a radial forearm free flap. PATIENTS AND METHODS: We reviewed the 19 cases of penile paraffinoma, which affected the whole penile skin with or without involvement of the scrotal flap 5 cases, an "apron" scrotal flap in 4 cases, and a bipedicle scrotal flap in 3 cases. Because of his underdeveloped scrotum, a new technique, radial forearm free-flap penoplasty, was done in one patient with Klinefelter's syndrome. The postoperative results were satisfactory in all except six cases. One of these was managed by a secondary full-thickness skin graft for partial scrotal flap necrosis, and the others were managed by secondary simple repair for wound disruption and infection. All patients were satisfied with the cosmetic and functional results of the scrotal flap. CONCLUSIONS: Because of their great elasticity, scrotal flaps are extremely advantageous for the repair of an extensively denuded penis. A radial forearm free flap, perhaps including the subcutaneous tissue, a long vascular pedicle, and less hair, is an alternative method when a scrotal flap is not available. Its biggest drawback is the unpleasant appearance of the donor site, which is closed with a split-thickness skin graft.

Epididymal Anomalies in Cryptorchidism and Hydrocele : Association with Patent Processus Vaginalis / 대한비뇨기과학회지

PURPOSE: Epididymal anomalies in boys with an undescended testis have been well documented and most undescended testes are associated with patent processus vaginalis. However, the incidence of epididymal anomalies in descended testes has not well known. We performed a prospective study to determine the relationship between epididymal anomalies and patency of processus vaginalis in boys with hydrocele or cryptorchidism. MATERIALS AND METHODS: From January 1997 to February 1988, epididymal morphologies and the degrees of patency of processus vaginalis(closed, partially closed and open) were examined in 35 boys with hydrocele(37 testes) and 28 boys with cryptorchidism(29 testes) at the surgeries. RESULTS: No epididymal anomaly was found in all 3 hydroceles with closed processus vaginalis. Epididymal anomalies were found in 13 of 22 hydroceles with partially closed processus vaginalis and in 9 of 12 hydroceles with open processus vaginalis. All boys with undescended testes had open processus vagnialis and the epididymal anomalies were found in 27 of 29 undescended testes. The incidence of epididymal anomalies was highest in cryptorchid testes with open processus vaginalis and lowest in descended testes with closed processus vaginalis. Furthermore, epididymal anomalies were found to be more severe in association with more cranially located testes. CONCLUSIONS: The higher incidence of epididymal anomalies were associated with ipsilateral patency of processus vaginalis and testicular position. This finding suggests that the role of the epididymis in testicular descent may not be essential.

Orchidopexy: a 10-year Clinical Experience

We analyzed our experience of orchidopexies performed during last 10 years to evaluate results and to determine the possible approach to the treatment of undescended testes. Between 1988 and 1997, we had treated 420 undescended testes (314 palpable and 106 nonpalpable) in 356 boys. Average patient age at presentation was 4.1 years with 40.2% presenting before the age of 2 years. Of 106 nonpalpable testes, 23 testes were intraabdominal, 32 were preperitoneal and 51 were absent at the surgery. During the period of first 5 years, we had performed the surgery through 31 inguinal and 13 midline transabdominal incisions for 44 patients nonpalpable testes, while during the later 5 years, all 47 patients nonpalpable were treated through inguinal incisions. For the nonpalpable testes, the inguinal approach with or without intraperitoneal extension was successful in defining the location of testes and blind-ending vessels in all patients. Laparoscopy was not helpful in avoiding surgical exploration in all our patients with nonpalpable testes. Of 339 inguinal and midline transabdominal orchidopexies without spermatic vessels ligations, 324 testes were placed in the scrotum, 4 in the upper scrotum and 3 in the inguinal area. Eight were resulted in atrophy. Of 13 Fowler-Stephens orchidopexies, 7 were placed in the scrotum and 6 were resulted in atrophy. Testicular growths were noticed in most patients who underwent orchidopexies and the volume of fixed testes became as large as the contralateral normal testes by the mean duration of 43.3 months postoperatively. In conclusion, orchidopexies were successful in most cases of cryptorchidism in terms of testicular position and growth. However, there were more testicular atrophies in patient in whom spermatic vessels were ligated. In cases of nonpalpable undescended testis, the inguinal approach with or without intraperitoneal extension would be recommended.

Lower Caliceal Stone Clearance after Shock Wave Lithotripsy: Impact of Lower Pole Radiographic Anatomy / 대한비뇨기과학회지

PURPOSE: We analyzed our experience to determine the influence of infundibulo-pelvoureteral angle, lower calyceal width and length in predicting the clearance of fragments after extracorporal shock wave lithotripsy(ESWL) for lower calyceal stone. MATERIALS AND METHODS: From October 1995 to April 1998, a retrospective analysis of 51 patients with a solitary radiopaque lower pole calyceal stone who underwent excretory urography(IVP) preoperatively were treated ESWL with a Storz Modulith SLX third generation. RESULTS: The overall stone-free rate was 54.9%. Stone-free status after ESWL was significantly related to each anatomical measurement. Of the stone-free and not stone-free groups, with the infundibulo-pelvoureteral angle 40 degree or greater 21 patients were found in stone-free groups(75%) and 5 patients in not stone-free groups(21.7%), with the infundibular width >5mm 22 patients were found in stone-free groups(78.6%) and 11 patients in not stone-free groups(47.8%) and with the infundibular length < or =30mm 16 patients were found in stone-free groups(57.1%) and 5 patients in not stone-free groups(21.7%), respectively. CONCLUSIONS: We recommend that the 3 major radiographic features of the lower pole calix should be assessed during intravenous urography to facilitate the planning of treatment for lower calyceal stones.

Treatment of Radiation Induced Hemorrhagic Cystitis: Angiographic Embolization of Hypogastric Arteries / 대한비뇨기과학회지

PURPOSE: We assessed the long term efficacy and complications of angiographic embolization of hypogastric arteries in treating the intractable bladder hemorrhage induced by radiation. MATERIALS AND METHODS: From January 1990 to December 1997, a total of 43 patients with radiation induced hemorrhagic cystitis were evaluated. Of 43 patients, 5 patients were treated by bilateral selective angiographic embolization of the anterior branches of the hypogastric arteries. The embolic material used in all patients was gelfoam. RESULTS: Five patients with intractable bladder hemorrhage were treated by bilateral selective embolization of the anterior branches of the hypogastric arteries by gelfoam and successful in completely stopping or considerably decreasing intractable bladder hemorrhage in all patients. The average number of treatments was 1.6(range 1 to 2). There was no significant sequelae ocurred as a consequence of simultaneous bilateral occlusion of the hypogastric arteries. CONCLUSIONS: Radiation induced hemorrhagic cystitis that do not respond to irrigations with chemical cauterizing agents or transurethral fulguration of bleeding vessels can be successfully treated with bilateral selective angiographic embolization of the anterior branches of the hypogastric arteries.

A Comparative Study of Visual Internal Urethrotomy and Urethroplasty in the Treatment of Post-Traumatic Complete Urethral Stricture / 대한비뇨기과학회지

Visual internal urethrotomy may be a reasonable initial procedure of complete and incomplete urethral stricture before planning more extensive urethroplasty. We reviewed our experience with 62 complete urethral strictures for 10 years. The outcomes of the treatment of 28 patients who were managed by visual internal urethrotomy were compared with those of 34 patients managed urethroplasty, The overall successful results were 32.1% in visual internal urethrotomy and 85.3% in urethroplasty. When stricture length was less than 1 cm, success rate was 40% in spite of several recurrences in visual internal urethrotomy, comparable to the success rate of 12.5% in case of stricture length more than 1 cm. We recommended that visual infernal urethrotomy as an applicable initial method before urethroplasty, when stricture is less than 1 cm in cases of complete urethral stricture