During the period of 1960 to Aug. 1973, 85 cases of stiff knee Joints are experienced in this department. 27 out of 85 cases were surgically treated by means of quadricepsplasty, and 15 cases are followed for one year on average. Besides, 5 cases had the intra-articular adhesion in addition to quadriceps contracture. 3 of them were children with resultant stiff knee after intramuscular injection of antibiotics in the thigh for several weeks. After operation, an average 69° of fIexion were increased from 20° flexion mobility preoperatively. Eventually 89° of flexion were possible actively and passively. 7 cases had extension defect, which tends to develope in the case of severe rectus tightening at operation field and required lengthening. Immediate post-operative exercise is not supposed to promote better function compared to the cases with 2 weeks of immobilization in flexed position.
Anti-Bacterial Agents ; Child ; Contracture ; Humans ; Immobilization ; Injections, Intramuscular ; Knee Joint ; Knee ; Thigh

PURPOSE: To evaluate the pattern of distant lymph node metastasis in colorectal carcinoma and its correlation with distant organ metastasis. MATERIALS AND METHODS: We retrospectively reviewed abdominal CT scans of 46 patients with pathologically proven colorectal carcinoma. RESULTS: The incidence of distant lymphadenopathy in colorectal carcinoma was 30.4%(14/46). The most commonly involved distant lymph node was the left paraortic lymph node below the renal hilum(9/25). The most common type of distant lymphadenopathy was solitary type(7/14) and all of these lymphadenopathies were noted in the left paraortic lymph node below the renal hilum. Six cases of left sided colorectal carcinoma showed left paraortic lymphadenopathy with solitary type. The incidence of distant organ metastasis was 17. 4%(8/46) and markedly increased if distant lymphadenopathy was multiple and confluent, or confluent type(5/7). CONCLUSION: The incidence of distant lymphadenopathy in colorectal carcinoma was not high and the most common lymphadenopathy was the left paraaortic lymph node with solitary type below the renal hilum. The possibility of distant organ metastasis was high if distant lymphadenopathy was multiple and confluent, or confluent type.
Colorectal Neoplasms* ; Humans ; Incidence ; Lymph Nodes* ; Lymphatic Diseases ; Neoplasm Metastasis* ; Retrospective Studies ; Tomography, X-Ray Computed

Recently, CT scan, CT sialogram, radionuclide imaging and ultasonogram are widely applicated in conjuctionwith conventional studies such as plain film, sialogram and arteriogram for the diagnosis of salivary glanddisease. Among them, ultrasonogram porvides safe, noninvasive, and reliable way to diagnose salivary glanddisease. Authors evaluated ultrasonographic and sialographic findings of patients with suspected salivary glanddisease in 16 cases at Korea University Hosital for 8 months. (from Dec. 1983 to Aug. 1984). The following resultsare observed. 1. Final diagnosis of 16 cases were 2 cases of stone, 1 case of pleomorphic adenoma, 2 cases ofneurilemmoma, 3 cases of chronic sialademitis, 1 case of abscess, 2 cases of Retention cyst, 1 case of psendocyst,1 case of tuberculous lymphadenopathy, and 3 cases of normal finding. 2. Diagnostic ultrasonogram providesaccurate information for the size, location and character of the lesion, and differentiates intragladular lesionsfrom extraglandular ones. 3. Ultrasonogram is one of convenient, reliable and initial modality for the diagnosisof salivary gland disease.
Abscess ; Adenoma, Pleomorphic ; Diagnosis ; Humans ; Korea ; Lymphatic Diseases ; Radionuclide Imaging ; Salivary Gland Diseases ; Salivary Glands ; Tomography, X-Ray Computed ; Ultrasonography

To investigate the nature of artifacts caused by air and chemical shift by fat, a test tube phantom study was performed in 2.0T and 0.5T superconducting magnetic resonance imaging systems in various imaging sequences. Spatial mismapping and signal change made image distortion in spin echo images of the air-column and severe signal voids in gradient echo images. Chemical shift artifacts appeared in the planes of frequency-encoding axis as crescent-shaped signal voids and summated bright signals, Both artifacts were more prominent in high field strength, Images at 0.5T showed more severe artifacts in the T2-weighted images than those in the other sequences. As the acquisition matrix increased, truncation artifacts decreased and susceptibility artifacts in gradient echo images diminished. Familiarity with causes, appearances and mechanisms of various artifacts will help radiologists for interpretation of MRI.
Artifacts* ; Magnetic Resonance Imaging* ; Recognition (Psychology)

Bacterial, fungal, and viral infections of the skin with extended skin involvement can occur during the early phase of human immunodeficiency virus infection. A significant reduction in circulating CD4+ lymphocytes in the late stage of the disease may cause tumors of the skin such as Kaposi's sarcoma. A 40-year male patient, a former sailor who had multiple sexual contact with native African women, presented with multiple tender follicular pustules and fibrotic brown patches on both his legs. these had been present for 6 months. The skin lesions were healed leaving brown pigmentation. Laboratory examinations revealed the presence of leukopenia, thromocytopenia and a reversed T4/T8 ratio. The ELISA and Western blot analysis to human immunodeficiency virus were positive. A skin biopsy from a brown patch showed early stages of scar tissue and perivascular hemosiderin deposition. We herein report a case of acquired immunodeficiency syndrome patient with atypical dark brown scarring atrophic patches on the lower legs following purulent bacterial folliculitis. This may have been an early manifestation of Kaposi's sarcoma from a preceding skin lesion.
Acquired Immunodeficiency Syndrome ; Biopsy ; Blotting, Western ; Cicatrix* ; Enzyme-Linked Immunosorbent Assay ; Female ; Folliculitis* ; Hemosiderin ; HIV ; Humans ; Leg ; Leukopenia ; Lymphocytes ; Male ; Military Personnel ; Pigmentation ; Sarcoma, Kaposi ; Skin

Gastric cancer is the most common gastrointestinal malignancy in Korea. Identification and evaluation ofgastric mass lesions and regional-distant metastases by abdominal CT scan are important for the treatment planningand prognostic implications of gastric cancer patients. Author reviewed CT scan are important for the treatemntplaning and prognostic implications of gastric cancer patients. Author reviewed CT scan of 61 cases of pathologyproven gastric cancer, retrospectively, for recent 20 months from July 1983 to Feb. 1985 at department ofradiology, Korea University, Hae Wha Hospital. The results were as follows: 1. There were 50 cases of advanced adenocarcinoma, 8 cases of early gastric cancer, 2 cases of leiomyosarcoma, and 1 case of lymphoma in total 61cases. 2. The sex ratio of male to female was 2:1. Age distribution was from 24 to 75 year old and peak incidencewas in 6th decade. 3. The most frequent site of involvement with gastric cancer was gastric antrum in 51%. 4. 48of the 50 patients with advanced gastric adenocarcinoma(96%) had a wall thickness greater than 1 cm, and all of 8cases of early gastric cancer had a wall thickness less than 1 cm. Regional lymph node tumor infiltration wasfound in 100% of gastric wall thickness greater than 2.0cm, in 64% of cases of 1.5 to 2.0cm, in 50% of cases of1.9 to 1.5cm, and 12.5% of cases of less than 1.0cm. 5. In a comparison of enlargement of reginal lymph node by CTscan to tumor infiltration of regional lymph node by histology, senitivity was 52%, specificity was 87%, and reliability was 66%. 6. The structures involved by distant metastases of these cases were the retroperitoneallymph node in 15, liver in 8, and pancrease in 3. 7. The diagnostic accuracy of CT staging was considered about68% by correlation of the surgical and histological findings. 8. The CT scan is one of the accurate and simpletool for evaluation of size, shape, extent, as well as distant metastases in the cases of gastric malignancies.
Adenocarcinoma ; Age Distribution ; Female ; Humans ; Korea ; Leiomyosarcoma ; Liver ; Lymph Nodes ; Lymphoma ; Male ; Neoplasm Metastasis ; Pancreas ; Pancrelipase ; Pyloric Antrum ; Retrospective Studies ; Sensitivity and Specificity ; Sex Ratio ; Stomach Neoplasms ; Tomography, X-Ray Computed

We examined the possible anti-inflammatory mechanisms of gabapentin in the attenuation of neuropathic pain and the interaction between the anti-allodynic effects of gabapentin and interleukin-10 (IL-10) expression in a rat model of neuropathic pain. The anti-allodynic effect of intrathecal gabapentin was examined over a 7-day period. The anti-allodynic effects of IL-10 was measured, and the effects of anti-IL-10 antibody on the gabapentin were assessed. On day 7, the concentrations of pro-inflammatory cytokines and IL-10 were measured. Gabapentin produced an anti-allodynic effect over the 7-day period, reducing the expression of pro-inflammatory cytokines but increasing the expression of IL-10 (TNF-alpha, 316.0 +/- 69.7 pg/mL vs 88.8 +/- 24.4 pg/mL; IL-1beta, 1,212.9 +/- 104.5 vs 577.4 +/- 97.1 pg/mL; IL-6, 254.0 +/- 64.8 pg/mL vs 125.5 +/- 44.1 pg/mL; IL-10, 532.1 +/- 78.7 pg/mL vs 918.9 +/- 63.1 pg/mL). The suppressive effect of gabapentin on pro-inflammatory cytokine expression was partially blocked by the anti-IL-10 antibody. Expression of pro-inflammatory cytokines was significantly attenuated by daily injections of IL-10. The anti-allodynic effects of gabapentin may be caused by upregulation of IL-10 expression in the spinal cord, which leads to inhibition of the expression of pro-inflammatory cytokines in the spinal cords.
Amines/pharmacology/*therapeutic use ; Analgesics/pharmacology/*therapeutic use ; Animals ; Antibodies/immunology/pharmacology ; Behavior, Animal/drug effects ; Cyclohexanecarboxylic Acids/pharmacology/*therapeutic use ; Cytokines/*metabolism ; Disease Models, Animal ; Injections, Spinal ; Interleukin-10/genetics/immunology/*metabolism ; Male ; Neuralgia/*drug therapy/metabolism/pathology ; Rats ; Rats, Sprague-Dawley ; Recombinant Proteins/biosynthesis/genetics/pharmacology ; Spinal Cord/metabolism ; Up-Regulation ; gamma-Aminobutyric Acid/pharmacology/*therapeutic use

Citalopram and paroxetine are selective serotonin reuptake inhibitors and also have antinociceptive effects. We investigated the antiallodynic and antihyperalgesic effects of intrathecally administered morphine, citalopram, paroxetine, and combinations thereof, in a rat model in which peripheral inflammation was induced by complete Freund's adjuvant (CFA). Drugs were intrathecally administered via direct lumbar puncture. Mechanical allodynia was measured using a Dynamic Plantar Aesthesiometer. Thermal hyperalgesia and cold allodynia were determined by measuring latency of paw withdrawal in response to radiant heat and cold water. Behavioral tests were run before and 15, 30, 45, and 60 min after intrathecal injection. Intraplantar injection of CFA produced mechanical allodynia, thermal hyperalgesia, and cold allodynia. Intrathecally administered morphine (0.3 or 1 microg) had antiallodynic or antihyperalgesic effects (24.0%-71.9% elevation). The effects of morphine were significantly increased when a combination of citalopram (100 microg) and paroxetine (100 microg) was added (35.2%-95.1% elevation). This rise was reversed by naloxone and methysergide. The effects of citalopram and paroxetine were also reversed by naloxone and methysergide. We suggest that the mu opioid receptor and serotonin receptors play major roles in production of the antiallodynic and antihyperalgesic effects of morphine, citalopram, paroxetine, and combinations thereof, in animals experiencing inflammatory pain.
Analgesics, Opioid/administration & dosage/*pharmacology ; Animals ; Behavior, Animal/drug effects ; Citalopram/administration & dosage/pharmacology ; Disease Models, Animal ; Hyperalgesia/etiology ; Inflammation/*chemically induced/pathology ; Injections, Spinal ; Male ; Morphine/administration & dosage/*pharmacology ; Pain/*prevention & control ; Pain Measurement ; Pain Threshold/drug effects ; Paroxetine/administration & dosage/pharmacology ; Rats ; Rats, Sprague-Dawley ; Receptors, Serotonin/*chemistry/metabolism ; Serotonin Uptake Inhibitors/administration & dosage/*pharmacology ; Temperature ; Time Factors

A spontaneous dissecting Aneurysm of the posterior inferior cerebellar artery(PICA) is a very rare cause of subarachnoid hemorrhage(SAH) or ischemic stroke. We report a 53-year-old male patient with left PICA territory infarction due to the spontaneous dissection of the PICA. A Brain MRI revealed an infarction of the left PICA territory and an angiography showed spindle-shaped dilatations of the left PICA followed by an irregular luminal narrowing. An angiography taken 3 months later showed spontaneous resolution of the left PICA dissecting aneurysm. The management of the intracranial dissecting aneurysm is still controversial. Some authors recommend surgical approaches for the prevention of SAH while others present medical management. Our case showed spontaneous regression of the PICA dissecting aneurysm.
Aneurysm, Dissecting* ; Angiography ; Arteries* ; Brain ; Dilatation ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Phenobarbital ; Pica ; Stroke

During the past two decades, mammography has become established as an indispensible addition to complete evaluation of symptomatic women and as a valuable screening method to detect early breast cancer in asymptomatic women. Mammographic microcalcification is a feature in a proportion of breast- cancer paients. So we evaluate the association of mammographic microcalcifications with age, tumor stage, tumor size, axillary lymph-node positivity, estrogen-receptor progesterone-receptor positivity, histology, nuclear grading, and an extensive intraductal component(EIC). The authors retrospectively reviewed and analyzed 181 cases of breast cancer which were diagnosed and operated on from January 1994 to December 1996. We divided the subjects into two groups based on the presence of mammographic microcalcification or the absence of mammographic calcification. In this paper, we report the results of our analysis along with a review of the literature. The results are as follows : 1) Five of the 66 patients with mammographic microcalcifications had intraductal carcinomas wheres only one of the 115 patients without mammographic microcalcifications had such a carcinoma. 2) The two groups were comparable as to primary tumor size : 3.09 cm in the group with microcalcifications and 2.68 cm in the group without microcalcifications. In particular, the group with microcalcifications and axillary lymph-node metastasis showed a primary tumor size of 4.17 cm. A high rate of axillary lymph-node metastasis was noted for patients with T3 tumors and mammographic microcalcifications. 3) The two groups were comparable as to cancer stage : stage 0 0%, stage I 17.2%, stage II 55.2% and stage III 27.5% for mammographic microcalcifications with mass and stage 0 10.8%, stage I 32.4%, stage II 43.2%, and stage III 13.5% for mammographic microcalcifications only. 4) An EIC was present in 6 of the 29 cases(20.6%) with mammographic microcalcifications with mass and in 5 of the 37 cases(13.5%) with mammograhic microcalcifications only. Breast cancer patients with an EIC have a high incidence of local recurrence and a poor prognosis. We must have strict and powerful, primary and systemic management of patients with mammographic microcalcifications with mass.
Breast Neoplasms ; Carcinoma, Intraductal, Noninfiltrating ; Female ; Humans ; Incidence ; Mammography ; Mass Screening ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies