Antihypertensive effect of an enzymatic hydrolysate from Styela clava flesh tissue in type 2 diabetic patients with hypertension

BACKGROUND/OBJECTIVES: In this randomized, placebo-controlled, double-blind study, we evaluated the antihypertensive effects of enzymatic hydrolysate from Styela clava flesh tissue in patients with type 2 diabetes mellitus (T2DM) and hypertension. SUBJECTS/METHODS: S. clava flesh tissue hydrolysate (SFTH) (n = 34) and placebo (n = 22) were randomly allocated to the study subjects. Each subject ingested two test capsules (500 mg) containing powdered SFTH (SFTH group) or placebo capsules (placebo group) during four weeks. RESULTS: In the SFTH group, systolic and diastolic blood pressure decreased significantly 4 weeks after ingestion by 9.9 mmHg (P < 0.01) and 7.8 mmHg (P < 0.01), respectively. In addition, the SFTH group exhibited a significant decrease in hemoglobin A1c with a tendency toward improvement in homeostasis model assessment of insulin resistance, triglyceride, apolipoprotein B and plasma insulin levels after 4 weeks. No adverse effects were observed in other indexes, including biochemical and hematological parameters in both groups. CONCLUSION: The results of our study suggested that SFTH exerts a regulatory, antihypertensive effect in patients with T2DM and hypertension.

Anti-inflammatory effect of enzymatic hydrolysates from Styela clava flesh tissue in lipopolysaccharide-stimulated RAW 264.7 macrophages and in vivo zebrafish model

BACKGROUND/OBJECTIVES: In this study, potential anti-inflammatory effect of enzymatic hydrolysates from Styela clava flesh tissue was assessed via nitric oxide (NO) production in lipopolysaccahride (LPS) induced RAW 264.7 macrophages and in vivo zebrafish model. MATERIALS/METHODS: We investigated the ability of enzymatic hydrolysates from Styela clava flesh tissue to inhibit LPS-induced expression of pro-inflammatory mediators in RAW 264.7 macrophages, and the molecular mechanism through which this inhibition occurred. In addition, we evaluated anti-inflammatory effect of enzymatic hydrolysates against a LPS-exposed in in vivo zebrafish model. RESULTS: Among the enzymatic hydrolysates, Protamex-proteolytic hydrolysate exhibited the highest NO inhibitory effect and was fractionated into three ranges of molecular weight by using ultrafiltration (UF) membranes (MWCO 5 kDa and 10 kDa). The above 10 kDa fraction down-regulated LPS-induced expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2), thereby reducing production of NO and prostaglandin E2 (PGE2) in LPS-activated RAW 264.7 macrophages. The above 10 kDa fraction suppressed LPS-induced production of pro-inflammatory cytokines, including interleukin (IL)-1beta, IL-6, and tumor necrosis factor (TNF)-alpha. In addition, the above 10 kDa fraction inhibited LPS-induced phosphorylation of extracellular signal-regulated kinases (ERKs), c-Jun N-terminal kinase (JNK), and p38. Furthermore, NO production in live zebrafish induced by LPS was reduced by addition of the above 10 kDa fraction from S. clava enzymatic hydrolysate. CONCLUSION: The results of this study suggested that hydrolysates derived from S. clava flesh tissue would be new anti-inflammation materials in functional resources.

A Case of ACTH-producing Pancreatic Neuroendocrine Tumor Presenting with Cushing Syndrome

Pancreatic neuroendocrine tumors are rare neoplasm arising from pancreatic islet cells. Occasionally they are functioning tumors secreting a variety of hormones such as insulin, gastrin, glucagon, and vasoactive intestinal peptides. Adrenocorticotropic hormone (ACTH) secreting pancreatic neuroendocrine tumors (ACTHomas) are very rare and there have been about 110 case reports worldwide. Due to excessive ectopic ACTH production and resulting hypercortisolemia, patients with ACTHoma usually present with Cushing syndrome. ACTHomas have a poor prognosis with severe and rapidly progressive clinical courses. They often present with unresectable liver metastases and there remains little consensus on its standard treatment. We report a 55-year-old female with ACTH-producing pancreatic neuroendocrine tumor, who was treated with surgical resection of pancreatic tail, spleen, and a portion of stomach. Sixteen months later, abdomen computed tomography scan showed multiple liver metastases, which were treated with transarterial chemoembolization.

A Case of Pulmonary Sclerosing Hemangioma with an Increased Size and Chest Discomfort on 10 Years' Follow-up

Pulmonary sclerosing hemangioma is a relatively rare neoplasm of the lung with polymorphic histologic features of 2 unifying cellular components including surface cuboidal cells and interstitial round cells. Pulmonary sclerosing hemangioma typically occurs in middle aged women with asymptomatic, peripheral, solitary, well-circumscribed lesions. Although it is pathologically benign, it reveals size growing and chest symptom. We here report a case of pulmonary sclerosing hemangioma in a 72-year-old woman. She presented chest discomfort. A chest radiography and a chest computed tomography scan showed growing size from 3.2x3.1 cm to 6.0x5.3 cm in left upper lung during 10 years' follow-up period. Surgical resection of lung revealed a distinct constellation of findings including 2 epithelial cell types, surface cells, and round cells, which form 4 architectural patterns, papillary, sclerotic, solid, and hemorrhagic. She was diagnosed as pulmonary sclerosing hemangioma and chest discomfort disappeared.

Relationship between Serum Leptin Levels and Atherosclerosis in Type 2 Diabetes Patients

OBJECTIVE: Many studies have suggested that leptin is a possible cause of atherosclerosis and is proposed as a cardiovascular risk factor in obese patients. Several studies have shown that serum leptin is associated with pulse wave velocity (PWV) and carotid intima-media thickness (IMT). But the relevance of serum leptin levels for predicting incident cardiovascular disease is less clear. In this study, we investigated the relationship between serum leptin levels and aortic PWV, carotid IMT in type 2 diabetes (T2DM) patients. METHODS: Patients with end-stage renal disease or advanced atherosclerosis, systemic infection were excluded. A total of 116 patients (60 male/56 female; age, 59+/-14 years) were included. Serum leptin levels, aortic PWV and carotid IMT were measured. RESULTS: Aortic PWV was significantly associated with age (r=0.28, P<0.005). Carotid IMT was significantly related to age (r=0.46, P<0.001), low density lipoprotein (LDL) cholesterol (r=0.22, P<0.05), lipoprotein (a) (r=0.23, P<0.05) and estimated glomerular filteration rate (r=-0.348, P<0.01). There was no correlation between leptin and aortic PWV or carotid IMT. In multivariate analyses, aortic PWV was associated with age (P=0.007). Carotid IMT was significantly related to age (P<0.001), LDL cholesterol (P=0.01). CONCLUSION: Serum leptin was not associated with aortic PWV or carotid IMT in T2DM patients.

Relationship between Serum Cystatin C and Arterial Stiffness in Type 2 Diabetes Patients with Normal Renal Function

OBJECTIVE: Several studies showed that increased arterial stiffness is an independent risk factor for cardiovascular disease. Pulse wave velocity (PWV) is known as a marker for large vessel stiffness. Recent studies show that serum cystatin C is associated with PWV and may predict future cardiovascular events, even in subjects with normal renal function. However, there have been few studies for the relationship between cystatin C and arterial stiffness in patients with type 2 diabetes (T2DM). In this study, we investigated the relationship between serum cystatin C and branchial-ankle PWV in T2DM patients with normal renal function. METHODS: Patients with urinary albumin/creatinine ratio (ACR) higher than 300 microg albumin/mg creatinine, estimated glomerular filtration rate (eGFR) less than 60 mL/min were excluded. A total of 88 patients (47 male/41 female; age, 59+/-2 years; ACR, 33+/-5 microg/mg) were included. Doppler-derived aortic PWV and serum cystatin C were measured. RESULTS: Cystatin C is significantly related to age (r=0.51, P<0.001), hemoglobin A1c (r=-0.23, P<0.05), high density lipoprotein-cholesterol (r=-0.22, P<0.05), apoprotein A (r=-0.22, P<0.05), and eGFR (r=-0.56, P<0.001). Aortic PWV is significantly associated with age (r=0.29, P<0.01), cystatin C (r=0.33, P<0.005), and eGFR (r=-0.24, P<0.05). In multiple regression analysis, there is significant association between aortic PWV and serum cystatin C levels. CONCLUSION: Serum cystatin C is significantly associated with arterial stiffness in T2DM patients with normal renal function. Our results suggest that cystatin C could be a marker for early atherosclerosis in T2DM patients.

Comparison of the Efficacy and Safety between Transradial and Transfemoral Percutaneous Coronary Intervention in Patients with Ischemic Heart Disease

OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of transradial percutaneous coronary intervention (TRI) compared with transfemoral percutaneous coronary intervention (TFI) in patients with ischemic heart disease. METHODS: We reviewed retrospectively the medical records including imaging data of the patients with ischemic heart disease who underwent TRI or TFI from January 2007 to December 2009 in Soonchunhyang University Seoul Hospital. We compared major adverse cardiac and cerebrovascular events (MACCEs) including death, myocardial infarction, revascularization, stent thrombosis, and cerebrovascular accident during follow-up period. We also compared procedure related vascular complications including hematoma, arteriovenous fistula, pseudoaneurysm, and infection. RESULTS: Total number of patients was 347 (256 patients of TRI and 91 patients of TFI). There were no significant differences in the rate of MACCEs between two groups. There were significantly less procedure-related vascular complications in TRI group (3.1% vs. 11.0%, P=0.010). CONCLUSION: TRI is as effective as TFI with no difference in the rate of MACCEs in patients with ischemic heart disease. TRI is superior to TFI in safety with reduction of vascular complications.

Long-term Follow-up Results of Tilt Training in Patients with Neurocardiogenic Syncope

BACKGROUND AND OBJECTIVES: Tilt training as a non pharmacological therapy was recently introduced to treat the patients with neurocardiogenic syncope. Tilt training has been known to prevent neurocardiogenic syncope by desensitizing abnormal autonomic reflex. Herein, the early effect of tilt training and the preventive effect on the relapse of syncope were studied during a long-term follow-up period. SUBJECTS AND METHODS: Fifteen patients (11 males) who experienced recurrent syncope, despite drug treatment or were intolerant to drug treatment, among those diagnosed as neurocardiogenic syncope by the head-up tilt test at Samsung Medical Center between March 2000 and May 2003 were recruited. Each patient underwent tilt training after admission and was educated to continue self-tilt training after discharge. Data for recurrences after discharge were obtained via questionnaires on outpatient visits or by telephone interviews. RESULTS: Eleven (73%) of the 15 who underwent tilt training on admission showed therapeutic effects. The mean follow-up period was 21+/-10 months (5-40 months). Only one patient was excluded due to follow-up loss. Ten of the above patients underwent training by themselves for an average of 4 months after discharge, and experience no relapse of syncope during the follow-up period. CONCLUSION: Tilt training maintained its therapeutic effect during long-term follow-up. This could be a new treatment for patients non responsive or intolerant to medical therapy.

Correlation between Vascular Compliance and Increase of Blood Pressure on Exercising in Normotensive Group

BACKGROUND AND OBJECTIVES: Vascular compliance is known to be decreased in hypertension, even at an early stage. The blood pressure response to exercise reflects the future risk of developing hypertension. A study was performed on the relationship between the vascular compliance and blood pressure response to exercise, to evaluate whether the vascular compliance is decreased in normotensive persons with a relatively higher future risk of developing hypertension. SUBJECTS AND METHODS: The subjects of the study were adults with normal blood pressure (SBP<120 mmHg, DBP<80 mmHg), who had undergone health screening and both echocardiography and treadmill test. Those patients with a history of diabetes mellitus or clinical cardiovascular diseases were excluded form the subjects. An index of overall vascular compliance (SVI/PP) was calculated using echocardiography. The relationship between the peak systolic blood pressure during exercise and vascular compliance was also investigated. RESULTS: The subjects were 77 patients, 54 male and 23 female, with a mean age of 47.6+/-7.7 years. The measured vascular compliance and average of peak systolic pressure on exercising were 1.08+/-0.24 L/m2/mmHg and 154+/-21 mmHg, respectively. The peak systolic pressure was correlated with the vascular compliance (r=-0.24, p<0.05). The peak systolic pressure at stage 3 was also correlated with the vascular compliance (r=-0.24, p<0.05). This relationship persisted after adjustment for age, gender, basal systolic blood pressure and maximal oxygen consumption (p<0.05). CONCLUSION: The vascular compliance was lower in subjects with a larger increase in blood pressure during exercise whose basal blood pressure was even below 120/80 mmHg. This finding may suggest that a decreased vascular compliance precedes the changes of hypertension. A longitudinal follow-up study is warranted.

Serum Level of G-CSF and GM-CSF and CFU-GM Response to Hematopoietic Growth Factors in a Patient with Cyclic Neutropenia

PURPOSE: Serum levels of G-CSF and GM-CSF were measured and CFU-GM assay using G- CSF, GM-CSF and SCF was conducted to evaluate the influence of hematopoietic growth factor on the precursor cells of cyclic neutropenia. METHODS: A 7-year-old male with cyclic neutropenia was studied. Marrow mononuclear cells were isolated at neutrophil nadir and recovery and cultured in methylcellulose media with or without G-CSF, GM- CSF and SCF. CD34 positive cells were evaluated using flow cytometry. Serum levels of G-CSF and GM-CSF were measured by ELISA. RESULTS: The Numbers of CFU-GM without growth factors were 50 at neutrophil nadir and 33 at the recovery phase in the patient and show increased colony forming capacity. CD34 positive cells were 9.32% at nadir and 14.17% at recovery. Increasement of CFU-GM with G-CSF at nadir and recovery were 46% and 118% and those with GM-CSF were 70% and 78% respectively, compared with 54.4% and 78.2% in control groups. In contrast, the presence of SCF did not enhance CFU-GM number in the patient, but in the control group, increasement with SCF was 28.9 %. There an was inverse relationship between serum G-CSF levels and peripheral neutrophil count whereas those of GM-CSF were constant. CONCLUSION: Serum G-CSF level showed inverse relationship with neutrophil counts. The response of progenitor cells to G-CSF and GM-CSF was not impaired. The presence of SCF did not enhance CFU-GM number in the patient. This result suggests that the abnormality in hematopoiesis in cyclic neutropenia may involve more immature progenitor cells responsive to SCF.

Acute Cholecystitis: Two-Phase Spiral CT Finding

PURPOSE: To describe the two-phase spiral CT findings of acute cholecystitis. MATERIALS AND METHODS: CTscans of nine patients with surgically-proven acute cholecystitis were retrospectively reviewed for wallthickening, enhancement pattern of the wall, attenuation of the liver adjacent to the gallbladder, gallstones,gallbladder distention, gas collection within the gallbladder, pericholecystic fluid and infiltration ofpericholecystic fat. RESULT: In all cases, wall thickening of the gallbladder was seen, though this was moredistinct on delayed images, Using high-low-high attenuation, one layer was seen in five cases, nd three layers infour. On arterial images, eight cases showed transient focal increased attenuation of the liver adjacent to thegall bladder;four of these showed curvilinear attenuation and four showed subsegmental attenuation. One caseshowed curvilinear decreased attenuation between increased attenuation of the liver and the gallbladder, andduring surgery, severe adhesion between the liver and gallbladder was confirmed. Additional CT findings wereinfiltration of pericholecystic fat (n=9), gallstones (n=7), gallbladder distension (n=6), pericholecystic fluid(n=3), and gas collection within the gallbladder (n=2). CONCLUSION: In patients with acute cholecystisis,two-phase spiral CT revealed wall thickening in one or three layers ; on delayed images this was more distint. Inmany cases, arterial images showed transient focal increased attenuation of the liver adjacent to the gallbladder.

Sonographic Findings of Coccygeal Abscess in the Neonates

PURPOSE: The purpose of this study was to report the sonographic findings of neonatal coccygeal abscess,previously not described. MATERIALS AND METHODS: Eighteen neonates (5-18 days old) presented with swelling in thecoccygeal area and by either open drainage (n=13) or follow-up after antibiotic therapy (n=5), this was diagnosedas coccygeal abscess. We retrospectively reviewed the size, shape, location, echo pattern and marginalcharacteristics of the abscesses, as seen on sonography, as well as their intradural content and relationship withthe spine. Additional MR images (n=5) were separately reviewed. RESULTS: Mean longest diameter of the abscesseswas 1.5cm (range, 0.8-2.3); they were oval or round and located in the subcutaneous fat layer. Echogenicitycompared with surrounding fat varied: in nine patients it was isoechoic, and in nine, hypoechoic. Internalechogenicity was homogenous in 14 patients and heterogeneous in four, and in seven cases, the margin of theabscess was well demarcated. Intradural structure and bony spines were normal, and the possibility of spinaldysraphism, could thus be excluded. All cases except one were correctly diagnosed by sonography and clinicalfindings; on sonography, the echogenicity of one lesion was exactly the same as that of lipoma, and it was thusmisdiagnosed. In cases where sonography revealed an isoechoic mass, the use of MR excluded the possibility oflipoma. Three of five cases showed marginal or diffuse enhancement on contrast enhanced MR images. CONCLUSION: Coccygeal absesses were confined to the subcutaneous fat layer and were either iso- or hypoechoic compared. withsurrounding fat. In neonates, abscess formation in the coccygeal area is possible, and coccygeal abscess shouldtherefore be included in the differentiation of coccygeal masses.

A Case of Listeria Monocytogenes Endocarditis in Apparently Healthy Adult

About 50 cases of Listeria monocytogenes endocarditis were reported in worldwide literature in 1950-1995. Though clinical and laboratory data suggest a similarity with other types of bacterial endocarditis, the prognosis is more unfavorable and the mortality rate is higher. However, there has not been a report in Korean literature. We report a case of 55 year-old male with rapidly progressive native aortic endocarditis caused by L. monocytogenes. He had neither history of underlying cardiac disease nor definitive predisposing factor. He presented mild dyspnes, chest pain and febrile sensation for a week. Echocardiography showed large vegetation in aortic valve and severe aortic regurgitation. L. monocytogenes grew on blood culture. We underwent artificial aortic valve replacement due to rapidly progessive heart failure. A thromboembolism occured at right femoral artery on postoperative 2nd day was removed successfully. He discharged without any sequellae.

Regulation of Estrogen Receptor mRNA in Rat Anterior Pituitary Gland / 대한내분비학회지

The estrogen receptor (ER) is present in a wide variety of mammalian tissues and is required for the physiological responses of estrogen, including estrogen-induced tissue-specific changes in gene expression. But most of our knowledge on the regulation of ER mRNA levels comes from in vivo steroid replacement experiments or cancer cell lines that express the ER. Thus the present study was attempted to determine 1) the anterior pituitary ER mRNA levels during rat estrous cycle 2) if estradiol itself directly modulates the ER mRNA levels in cultured rat anterior pituitary using RT-PCR method. In rats with 4 day estrous cycle, the ER mRNA levels in anterior pituitary gland reached to maximum at proestrus 11:00h just before serum estradiol concentration showed the highest. From then, the ER mRNA levels gradually declined during the rest of the proestrus. On the other hands, in cultured rat anterior pituitary cells, the ER mRNA levels were significantly decreased by the treatment of estradiol. These results indicate that the surge of estradiol was proceeded by the increase in pituitary ER mRNA levels during the proestrus and in cultured anterior pituitary cells, estrogen might be involved in the down-regulation of the ER mRNA levels.

Craniometaphyseal Dysplasia: A Case Report

Craniometaphyseal dysplasia is a rare genetic bone disorder characterized by cranial hyperostosis, sclerosis, and failure of normal modeling of the tubular bones. Both autosomal dominant and recessive forms have been described. Diagnosis of the craniometaphyseal dysplasia is mode on the basis of characteristic radiographic findings. Radiologic findings are thickening and hyperostosis of the skull, and Erlenmeyer flask deformity of the metaphysis on the long bones. We report a case of the craniometaphyseal dysplasia.

Contrast Enhancement Characteristics of Hepatocellular Carcinoma According to the Tomor Size on Two-Phase Scan with Spiral CT

PURPOSE: To determine the enhancing patterns of hepatocellular carcinoma(HCC) and the difference of enhancing patterns according to the tumor size, using spiral CT. MATERIALS & METHODS: We reviewed 213 lesions in 76patients who had been clinically or histopathologically diagnosed as HCC sufferer. The tumors were divided into three groups, according to size(&3 cm, 3-5cm and >5 cm). The enhancing patterns of tumor and capsule in the earlyand delayed phase were analysed. The enhancing patterns of the tumor were divided into five types(high, peripheralhigh, mixed, iso and low attenuation) in the early phase and four types(central high, mixed, iso, and low attenuation) in the delayed phase. The enhancing patterns of the capsule were divided into three types such asiso, low and high attenuation. RESULTS: High attenuating lesions in the early phase were as follows : below 3cm 72% ; 3-5cm., 60% ; above 5cm., 49%. Mixed attenuating lesions in the early phase were as follows : below 3cm., 1%; 3-5cm., 22% ; above 5cm., 36%. Thus, most HCCs were high attenuation type in the early phase, but as the tumorbecame larger, less high attenuation and more mixed attenuation was demonstrated(p<0.01). There was no difference of enhancing patterns according to the tumor size in peripheral high, iso and low-attenuating lesions. In the delayed phase most of the hepatomas appeared as totally hypodense lesions. For capsules, the results were as follows : below 3cm., 20% ; 3-5cm.,58% ; above 5cm., 73%. As the tumors became larger, more capsules were demonstrated(p <0.01). The capsules were visualized as iso or low attenuating rim in the early phase and high attenuating rim in the delayed phase. CONCLUSIONS: To determine the enhancing patterns of HCC using spiral CT is considered to be helpful in the diagnosis of HCC.

Clinical Characteristics of Graves' Disease Patients with Undetectable Thyrotropin Binding Inhibitor Immunoglubulin (TB2) / 대한내분비학회지

Background: Graves disease is an autoimmune disease caused by TSH receptor antibodies. Thyrotropin binding inhibitor immunoglobulins(TBII) are detected in most Graves patients, but some patients have no TBII activities in their sera. It is unknown whether the clinical features of TBII-positive patients are different from those of TBII-negative patients. Methods: To evaluate the prevalence of TBII-negative Graves' patients and its clinical differences from TBII-positive patients, we examined TBII by radioreceptor assay in 686 consecutive untreated Graves patients. We found 84 TBII-negative patients(15 men and 69 women, mean age ±EM: 40.9±.4 years) and compared their clinical characteristics with 87 TBII-positive patients (22 men and 65 women, mean age±EM: 39.9±.5 years) who were selected randomly from the same patients group. Results: In this study, TBII was undetectable in 12.2% of patients with Graves' disease(84 of 686). TBII-negative group had a less weight loss than TBII-positive group. However, there was no significant differences in age, sex ratio, prevalence of ophthalmopathy, duration of illness and positive rate of family history for thyroid diseases between TBII-negative and

A Clinical Study on Hypopitutiarism: Significance of Combined Pituitary Stimulation Test / 대한내분비학회지

Background: Hypopituitarism can be caused by various diseases. Its clinical manifestations vary, depending on the extent and severity of the pituitary hormone deficiency. And some patients may initially present with SIADH-like features. Combined pituitary stimulation test has been used for the diagnosis of hypopituitarism and subsequent hormone replacement therapy. However, the test is laborious, expensive and uncomfortable to the patients, So we performed this study to know whether combined pituitary stimulation test can be replaced with clinical features and simple basal hormone concentrations. Methods: Fifty-four patients who were diagnosed as hypopituitarism by combined pituitary stimulation test were included in this study. Clinical features and basal hormone data were compared with the results of combined pituitary stimulation test for the evaluation of pituitary-gonadal, pituitary-thyroid, and pituitary-adrenal axes, using X2 test. Results: 1) In pituitary-gonadal axis, the evaluation of clinical features and basal gonad hormone concentrations were significantly consistent with stimulation test(p<0.05), 2) In pituitary-thyroid axis, the evaluation of basal thyroid hormone concentrations were more helpful than stimulation test though results of the two tests were not consistent. 3) In pituitary-adrenal axis, all patients whose basal cortisol concentrations were low showed inadequate responses to stimulation test. However, stimulation test revealed adrenal insufficiency in some patients with normal basal cortisol concentrations. 4) 9 patients who presented with SIADH-like features were older than the others and had all corticotropin deficiency. Conclusion: In patients with suspected hypopituitarism, the evaluation of clinical features and basal hormone concentrations can be sufficient for the diagnosis of hypopituitarism and hormone replacement therapy. However, stimulation test is necessary to investigate adrenal function in patients with normal basal cortisol concentrations. And hypopituitarism should be considered in old patients who present with SIADH-like features.

Intraarticular Arthroscopic Finding in Grade III MCL Rupture / 대한정형외과학회잡지

The medial collateral ligament is the most commonly injured ligamentous structure of the knee. The management of the medial collateral ligament injuries were divided into surgical and conservative treatment. More recently, many investigators reported that isolated medial collateral ligament injuries did well under non-operative treatment. So, arthroscopic examination of the knee to rule out other intraarticular pathologic conditions such as cruciate ligament injuries, meniscal tear and osteochondral lesion is essential. From October 1993 to April 1995, we treated 45 cases of Grade III medial collateral ligament injuries and arthroscopic finding for cruciate ligament, meniscus, bony structure were analized in these cases. The result were as follows; 1. Anterior cruciate ligament injury:37.5% in +1 degree, 42.8% in +2 degree, 86.7% in +3 degree 2. Posterior cruciate ligament injury:12.5% in +1 degree, 13.4% in +2 degree, 33.3% in +3 degree 3. Meniscal injury:12.5% in +1 degree, 21.3% in +2 degree, 33.4% in +3 degree 4. Medial capsular ligament injury was more frequent and severe in the meniscofemoral ligament than in the meniscotibial ligament, but that finding was not correlated with degree of medial instability.