Kun Sang Kim

Medial collateral ligament injuries of the knee: ultrasonographic findings.

The aims of our study were (1) to describe the ultrasonographic findings of the injured medial collateral ligament of the knee and (2) to assess the usefulness of ultrasonography in both evaluating the presence and location of the medial collateral ligament injuries and predicting the prognoses for the patients. The study group consisted of 16 patients with the clinical diagnosis of medial collateral ligament injury. We also examined 20 knee joints in 10 volunteers who had no history of injury to the knee. To predict prognoses, we divided the patients into two groups on the basis of the location of medial collateral ligament injuries. A thickened and heterogeneously hypoechoic appearance of the medial collateral ligament was considered abnormal. The normal medial collateral ligament was a thin and moderately homogeneous hypoechoic band with an average thickness of 4.3 mm (range, 3.3 to 5.6 mm) at the femoral attachment and of 2.3 mm (range, 1.3 to 3.2 mm) at the tibial attachment. All injured medial collateral ligament structures were thickened and heterogeneously hypoechoic. According to the criteria for grading of medial collateral ligament injury with stress view, 10 patients had grade III medial collateral ligament tears, three had grade II tears, and none had grade I injuries. In 15 (94%) of 19 knees, a correct diagnosis could be made with ultrasonography. Ultrasonography is useful in evaluating isolated medial collateral ligament injuries and in predicting patient outcome on the basis of the location of the medial collateral ligament injuries.

Recanalization of obstructed Tenckhoff peritoneal dialysis catheter: wire/stylet manipulation combined with endoluminal electrocauterization.

We report the results of fluoroscopically guided wire/stylet manipulation combined with endoluminal electrocauterization in seven patients with obstructed Tenckhoff peritoneal dialysis catheters. In preparation for clinical application, electrocauterization was performed using a stone basket to recanalize surgically removed Tenckhoff catheters obstructed with omental fat ingrowing through the side holes. All ingrowing omental fat was removed easily by electrocauterization with the rotating movement of a stone basket. The technique was then applied in vivo in seven cases with ingrowing omental fat and malpositioned catheter; six (86%) were successfully recanalized. Among those six cases with initial success, four maintained good catheter function with durable patency (mean 261.3 days). No significant complication was noted.

Gallbladder contractability before and after extracorporeal shock-wave lithotripsy

The purpose of this study was to determine whether extracorporeal shock wave lithotripsy (ESWL) of gallstones a lters contractability and volume of the gallbladder in response to a fatty mea l. The gallbladder was examined by ultrasonography before and after ESWL. Eight patients with gallstones a nd seven healthy volunteers were included in the study. Gallbladder contractbility was not altered in all of the patient after ESWL , although gallbladder contraction was already delayed and less complete in gallstone patients , compared with healthy controls (residual volume ‘ 33 .8% :t 18.3% VS 10.0% :t 3.7% ‘ half contraction time: 37.8 :t 21. 7min VS 23.1 :t 6.9min) . These findin gs suggest that ESWL has no immediate adverse effects on gallbladder motility. The residura l volume a nd half contraction t ime in gall s tone patients were 33. 8% :t 18.3 0/0 and 37.8 %:t 2 1. 7min. ln the healthy control group the two values were 1O.0% :t 3.7% and 23.1 :t 6.9min.