Spontaneous rupture of the quadriceps tendon has heen rarely reported. We experienced four knees of 3 patients. Two patients with chronic renal failure(CRF) had been treated with peritoneal dialysis and the other patient was healthy without significant medical problem. In the CRF patients, laboratory studies were coincided with secondary hyperparathyoidism. Radiologic and operative findings suggested that the repeated minor trauma caused avulsion fracture of the bone near the insertion site of the tendon. Histologic findings revealed no elastosis of the tendon and no deposit of amyloid in the quadriceps tendon. In the non-CRF case, there was normal lahoratory data, and the rupture occurred at the musculotendinous junction, suggesting sudden contracture of the muscle causing failure without trauma history. All cases were treated successfully with open repair of the quadriceps tendon. It could be summarized that the site of spontaneous rupture in the CRF and normal patient were different.
Amyloid ; Contracture ; Humans ; Kidney Failure, Chronic ; Knee* ; Peritoneal Dialysis ; Rupture ; Rupture, Spontaneous* ; Tendons*

The purpose of this study was to evaluate the effect of estrogen receptor on the degenerative change of articular cartilage by observation of different changes of histology, matrix glycosaminoglycan and chondrocyte proliferation. In sixty-four Newzealand rabbits, experimental instability was made to induce degenerative changes by sectioning the anterior cruciate ligament, medial collateral ligament and medial meniscus of the left knees. In the oophorectomy group (32 rabbits), knee surgery was performed at 6 weeks following bilateral oophorectomy. In the non-oophorectomy group (32 rabbits), knee surgery was performed without oophorectomy. Four rabbits were killed at 0, 1, 2, 4, 8, 12, 16, 20 weeks, respectively, after the knee operation. Total immunohistochemical scores of estrogen receptor were evaluated between the two groups. Histologic evaluation of H-E staining was conducted by alcian blue staining. Evaluation of chondrocyte proliferation was carried out by immunohistochemistry using monoclonal antibody to 5-bromo-2 -deoxyuridine. The stainability of each staining was calculated using semi-quantitative analysis and statistical differences were evaluat- ed by ANOVA test and LSD multiple comparison test. Total immunohistochemical scores of estrogen receptor in the non-oophorectomy group were higher than the oophorectomy group (P<0.05). In the non-oophorectomy group, the histologic scores and the histochemical scores of glycosaminoglycan were lower than the oophorectomy group after 4 weeks and 8 weeks respectively (P<0.05). The immunohistochemical score of BrdU was the highest at 2 week and then decreased after 4weeks in both groups. The immunohistologic scores of non-oophorectomy group was significant higher than oophorectomy group between 1 and 4 weeks (P<0.05). Our results suggested that the estrogen might aggravate the degenerative change of the knee joint in rabbits by decreasing matrix glycosaminoglycan and increasing chondrocyte proliferation.
Adult* ; Alcian Blue ; Anterior Cruciate Ligament ; Bromodeoxyuridine ; Cartilage, Articular* ; Chondrocytes ; Collateral Ligaments ; Estrogens* ; Female ; Humans ; Immunohistochemistry ; Knee Joint ; Knee* ; Lysergic Acid Diethylamide ; Menisci, Tibial ; Ovariectomy ; Rabbits

Fracture of the metal base of tihial components of total knee arthroplasty has heen occasionally reportecl. The most common cause of the failure of the metal hase plate was known to be a fatigue fracture around the screw hole where the strength of the metal hase plate was the weakest. We experienced a case of the fracture of the metal hase plate secondary to the t'racture of the posteromedial corner of the metal tihial condyle which was weakened due to the shoil peg hole for the base plate of MG II implant. Since the proximal portion of the posterior tihial condyle was normally thin, cutting the hone for the base plate made it thinner and wcaker than normal. Therefore stress fracture of the bone occurred and the overlying metal plate was subsequently hroken. From this experience. we concluded that the posterior peg hole may cause unwanted failure of the posteromedial corner of the tibial base plate.
Arthroplasty* ; Fractures, Stress ; Knee*

PURPOSE: To evaluate the incidence,. degree, and clinical significance of non-obstructive intrahepatic bile duct di'latation encountered on follow up CT after gastrectomy for gastric carcinoma. MATERIALS AND METHODS: We retrospectively analyzed follow-up abdominal CT of 65 patients who had undergone gastrectomy with truncal vagotomy and subtotal gastrectomy for gastric carcinoma. We classified those patients who showed intrahepatic duct dilatation into non-obstructive or obstructive groups depending on the presence or absence of the lesions obstructing the duct. We also evaluated the incidence, degree and pattern, and appearance time of non-obstructive type of duct dilatation. RESULTS: Non-obstructive and obstructive biliary dilatations were present in 8 cases(12.3%) and 9 cases(13. 8%), respectively. The degree of non-obstructive group was mild in 6 cases(75%) and moderate in 2 cases (25%) who had taken cholecystectomy during the follow up period, and patterns were proportional dilatation of the central and peripheral intrahepatic ducts. It appeared on follow up CT obtained 6 to 12 months after operation in 7 cases and 3.5 months in one case. No statistical significance was noted between the type of surgery and the incidence of non-obstructive dilatation(p>0.05). CONCLUSION: Mild dilatation of the central intrahepatic ducts without evidence of mechanical biliary obstruction can be seen on follow-up CT obtained more than 6 months after gastrectomy for gastric carcinoma, and the incidence is about 12%. We think that this finding is non-obstructive and clinical evaluation is unnecessary.
Bile Ducts, Intrahepatic ; Cholecystectomy ; Dilatation* ; Follow-Up Studies ; Gastrectomy* ; Humans ; Incidence ; Retrospective Studies ; Tomography, X-Ray Computed ; Vagotomy, Truncal

We have experienced a case of bilateral bacterial endophthalmitis after bilateral elevation of intraocular pressure. This patient suffered from meningitis and bacteremia. The enucleation was performed and histopathologic studies revealed severe inflammary change of the anterior segment. The present report described the relation between clinical signs and histopathologic findings of the metastatic endophthalmitis. We should keep in mind the possibility of the metastatic endophthalmitis in case of acute increase of intraocular pressure.
Bacteremia ; Endophthalmitis* ; Humans ; Intraocular Pressure ; Meningitis

BACKGROUND AND PURPOSE: If early middle cerebral artery signs (EMCAS) are present, prognoses are known to be poor, even if interventional therapy is performed. The aim of this study is to evaluate the clinical effect of a superselective intra-arterial urokinase infusion in cerebral infarction patients presenting EMCAS. METHODS: We conducted prospective longitudinal clinical trial and observed patients (n-22) with middle cerebral artery infarctions who manifested EMCAS in precontrast brain CT scans between January 1996 and April 1997. The patients were divided into two groups, one group (n-11) underwent superselective intra-arterial urokinase infusion; and the other (n-11) was treated with classic osmotherapy and heparinization. We evaluated the clinical outcome for each patient using the Canadian Neurological Scale (CNS) and the National Institutes of Health Stroke Scale (NIHSS) on admission (pre-treatment state) and on, the 3rd, 7th, and 30th days. RESULTS: The two patients groups had an even distribution of risk factors, EMCAS, age and the interval from the ictus to the initiation of treatment. The outcome at the 30th day after stroke therapy improved for all patients compared to their status on admission (p<0.01), and there was a significant interaction between the group and the time (p<0.01). This means that the group which underwent superselective intra-arterial urokinase infusion had better clinical outcomes. Hemorrhagic transformation occurred in 5 cases (22.7%), 2 from the superselective intra-arterial urokinase infusion group and 3 from the heparinization group. However, this did not influence the clinical outcome. CONCLUSIONS: Compared to previous reports suggesting the poor prognostic value of EMCAS, even when all patients having these signs, this study showed that the clinical outcomes in the thrombolyic therapy group were better than in the conservatively treated one. Therefore, more aggressive interventional therapies such as superselective intra-arterial urokinase infusion may be considered option.
Brain ; Cerebral Infarction ; Heparin ; Humans ; Infarction ; Infarction, Middle Cerebral Artery* ; Middle Cerebral Artery* ; National Institutes of Health (U.S.) ; Prognosis ; Prospective Studies ; Risk Factors ; Stroke ; Thrombolytic Therapy* ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator

Non-typhoidal Salmonella (NTS) is an important commensal microorganism. The purpose of this study was to determine the epidemiological relation between NTS isolates from livestock and NTS isolates from human by analyzing antimicrobial susceptibilities and performing molecular typing. We determined the serotypes of 36 human clinical isolates and 64 livestock isolates, performed antimicrobial susceptibility testing against 8 antibiotics, and determined the molecular types of isolated NTS spp. by pulsed field gel electrophoresis (PFGE). In human isolates, S. enteritidis was the most common serotype (17 isolates; 47.2%) and S. typhimurium the second most (8 isolates; 22.2%). In livestock isolates, S. typhimurium was the most common serotype (15 isolates; 23.44%), and S. enteritidis was the second most (14 isolates; 21.88%). Ampicillin and tetracycline resistance were 50% (32/64 isolates) each among broiler-chicken NTS isolates. No human or livestock NTS isolates showed resistance to ciprofloxacin, TMP-SMX, or ceftriaxone. However, 19.4% (7/36) and 46.8% (30/64) of the human and livestock NTS isolates were resistant to nalidixic acid (MIC > or =16 mg/mL), respectively. The presence of the three identical PFGE molecular types from human and broiler-chicken NTS isolates suggests the possibility of transmission from livestock to humans.
Adult ; Animals ; Chickens ; Cluster Analysis ; Drug Resistance, Bacterial ; Female ; Humans ; Korea ; Male ; Nalidixic Acid/pharmacology ; Salmonella Infections/epidemiology/metabolism/*microbiology ; Salmonella Infections, Animal/epidemiology/metabolism/*microbiology ; Salmonella enteritidis/metabolism ; Salmonella typhimurium/*metabolism ; Serotyping

It is prerequisite of orthodontists to diagnose malocclusion correctly and make treatment plans accurately for treating maloccluded patients efficiently and earning more stable and better results. Recently computers were introduced in orthodontic diagnosis steps, which enabled orthodontists to get more precise diagnosis, to make more accurate treatment planning and to provide better orthodontic cares for more patients. The authors studied on the diagnostic analysis methods which have been used frequently in Korea and made a diagnostic computer program including the horizontal and/or vertical measurement of length, degrees and proportions in lateral cephalometric radiographs, the analysis of the skeletal and soft-tissue features and the evaluation of the treatment results. We also made a scheduling program for arrangement and management of patients. 40 skeletal and 24 soft-tissue landmarks were selected in a lateral cephalometric radiographs. The available analysis methods in this program are Angular analysis, Linear analysis, Ricketts analysis, Profilogram , Steiner analysis, Tweed analysis, MacNamara analysis, Open bite analysis, Kim's diagnosis, Skeleto-dental cephalometric analysis and Height & weight analysis. We suggested that this diagnostic computer program make it possible for orthodontists to get more rapid and accurate diagnostic analysis and treatment planning and for patient to earn better and more efficient orthodontic service.
Diagnosis* ; Humans ; Korea ; Malocclusion ; Open Bite

Aortic intramural hematoma(AIH) is known as a variant of acute dissection due to rupture of the vasa vasorum without a intimal tear. In elderly hypertension patients patients with aortic dissection but without the characteristic echocardiographic findings of a double-channel aorta, this disease entity should be suspected and attention should be given to find segmental wall thickening of the aorta >0.7cm. AIH may progress to typical dissection or to rupture in considerable number of the patients, so careful follow-up is necessary and the same management principles for the patients with dissection can be applied in this variant. We report two cases of AIH showing typical eccentric mural thickening without dissection membrane with transesophageal echocardiographic follow-up.
Aged ; Aorta ; Echocardiography ; Echocardiography, Transesophageal* ; Follow-Up Studies ; Hematoma* ; Humans ; Hypertension ; Membranes ; Rupture ; Vasa Vasorum

OBJECTIVE: To evaluate the usefulness of serum concentrations of macrophage migration inhibitory factor (MIF) of patients with ovarian cysts for differential diagnosis of endometrioama. METHOD: From Jan. 2003 to Dec. 2004, preoperative serum MIF levels were assessed in 28 women with endometrioma, 32 with benign epithelial tumor, 23 with functional and simple cysts, 22 with benign mature cystic teratoma, and 25 women without ovarian tumor as control. MIF levels were determined using an ELISA (Quantikine Human MIF immunoassay, R&D Systems, Inc., USA). RESULTS: Mean MIF levels were higher in all groups with benign tumors than control (all p<0.01), but there was no significant difference between benign tumor groups (p=0.95). There was no significant correlation between MIF levels and tumor volume, body mass index (BMI) (p=0.635, 0.674 respectively) Serum MIF level had significant correlation with count of WBC and neutrophils (p=0.008, 0.024 respectively), but had no correlation with count of lymhocytes and monocytes (p=0.688, 0.294 respectively). CONCLUSIONS: This study showed a marked increase in MIF concentrations in the peripheral blood of patients with endometrioma, but there was no significant difference with other benign tumors. Serum MIF level had significant correlation with count of WBC and neutrophils. These suggest serum MIF level has no usefulness for differential diagnosis of endometrioma from other benign ovarian cysts.
Body Mass Index ; Diagnosis, Differential* ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoassay ; Macrophages* ; Monocytes ; Neutrophils ; Ovarian Cysts* ; Teratoma ; Tumor Burden