Tuberculosis can affect the sacroiliac joint. The involvement has been reported in up to 10 percent of patients with osteoarticular tuberculosis. The onset is usually insidious, and early diagnosis requires a high index of clinical suspicion. Lack of awareness of this presently uncommon form of infection often leads to diagnostic delay and increased morbidity. Early diagnosis and proper treatment with anti-tuberculous medication could obtain a satisfactory functional outcome. We report a case of tuberculous sacroiliitis in a 21 year-old male patient including his clinical presentation, radiographic features and outcome of medical treatment.
Early Diagnosis ; Humans ; Male ; Sacroiliac Joint ; Sacroiliitis* ; Tuberculosis ; Tuberculosis, Osteoarticular ; Young Adult

About 50% of renal cell carcinoma patients initially present with a regional or distant metastatic disease. Attempts to treat metastatic renal cell carcinomas have been directed at cytokine-based immunotherapy. Response rates of interleukin-2-based immunotherapy of 5 to 29% have been reported in this disease. Immunization as a mechanism to recruit host antitumor responses is increasingly being described as a potentially effective and less toxic approach for the treatment of metastatic and high-risk primary cancers. An autologous renal cell cancer vaccine has been applied at our institution for the prevention of recurrence or metastasis in locally advanced cases for more than one year. Herein, two metastatic renal cell carcinoma cases, which failed to show a response to initial immunotherapy or chemoradiotherapy, which were successfully treated with IL-2 (Aldesleukin) and interferon-alpha as autologous cancer vaccine adjuvants is reported.
Carcinoma, Renal Cell* ; Chemoradiotherapy ; Humans ; Immunization ; Immunotherapy* ; Interferon-alpha ; Interleukin-2 ; Neoplasm Metastasis ; Recurrence ; Vaccines

PURPOSE: To assess the MR findings of chondromalacia patella and correlate the grade and associated lesionswith the arthroscopic findings. MATERIALS AND METHODS: Twenty-five patients with pain in the anterior part of theknee underwent fat-suppressed axial and coronal T2-weighted, dual echo sagittal proton density-weighted andT2-weighted, and in some cases, T1-weighted and T2*-weighted imaging, using a 10-cm field of view, and a 5-inchgeneral purpose coil. We retrospectively assessed these find dings, and the locations, grades and associatedlesions, and correlated these with the arthroscopic findings. RESULTS: Fourteen cases(56%) of chondromalaciapatellae were arthroscopic grade I / II, nine(36%) were grade III, and two(8%) were grade IV; associated lesionswere medial synovial plicae (16 cases, 64%), meniscus tear (10 ; 40%), cruciate ligament injury (two ; 8%),complete or incomplete discoid meniscus (four ; 16%), bipartite patella (one ; 4%) and Osgood-Schlatter disease(one ; 4%). In 24 cases, MR imaging indicated chondromalacia patella ; 17 cases were grade I / II, five were gradeIII, and two were grade IV. the location of chondromalacia patella was the medial facet (five cases ; 20%), lateralfacet (three ; 12%), junction of the medial and odd facet (13 ; 52%), and diffuse involvement (four ; 16%). Thesensivity and specificity of MR imaging were 72% and 96% respectively. CONCLUSION: We evaluated the exact locationand grade of chondromalacia patella and associated lesions, as seen on MR images. These and the arthroscopicfindings showed close correlation, and in cases involving this condition, MRI is thus a useful indicator of anappropriate surgical method and plan.
Cartilage Diseases* ; Humans ; Ligaments ; Magnetic Resonance Imaging ; Patella* ; Protons ; Retrospective Studies ; Sensitivity and Specificity

OBJECTIVE: Several aspects of female reproduction, from folliculogenesis to corpus luteum function, are related to angiogenesis. The purpose of this study is to measure the concentrations of vascular endothelial growth factor (VEGF) in follicular fluid and serum in patients during In Vitro Fertilization-Embryo Transfer (IVF-ET) cycles. METHODS: In our prospective study, twenty-nine patients who underwent in vitro fertilization by GnRH agonist short protocol were assessed at the our infertility clinic from Aug. 2003 to July 2005. Serum VEGF and follicular fluid VEGF levels were measured in all patients at the time of oocytes retrieval. The assay technique used in this study was ELISA for serum and follicular fluid VEGF. RESULTS: Of 29 cycles, 10 cycles were pregnant (34.5%). A positive correlation existed for follicular fluid VEGF and chronologic age (r=0.428, p-value=0.021). Follicular fluid VEGF concentration showed an inverse relationship with the total number of oocytes retrieved and follicles (r=-0.493, p-value=0.007; r=-0.474, p-value=0.009). But there was no statistically significant relationship between follicular fluid VEGF concentration and serum VEGF concentration (rho=0.347). Follicular fluid VEGF concentration was significantly higher in the non-pregnant group (1468.38+/-727.33 pg/mL) compared to the pregnant group (676.48+/-542.07 pg/mL) (p-value=0.003). CONCLUSION: Our data provide some of the evidences that elevated VEGF concentrations in the follicular fluid are associated with poor conception rates in the IVF-ET cycles.
Corpus Luteum ; Enzyme-Linked Immunosorbent Assay ; Female ; Fertilization ; Fertilization in Vitro ; Follicular Fluid* ; Gonadotropin-Releasing Hormone ; Humans ; Infertility ; Oocytes ; Prospective Studies ; Reproduction ; Vascular Endothelial Growth Factor A*

PURPOSE: To assess the frequency, location, associated MR findings, and clinical symptoms of the high levellumbar disc herniation(HLDH). MATERIALS AND METHODS: A total of 1076 patients with lumbar disc herniation wereretrospectively reviewed. MR images of 41 of these with HLDH(T12-L1, L1-2, L2-3) were analysed in terms offrequency, location, and associated MR findings, and correlated with clinical symptoms of HLDH. RESULTS: Theprevalence of HLDH was 3.8%(41/1076). HLDH was located at T12-L1 level in four patients(10%), at L1-2 level in14(34%), at L2-3 level in 21(51%), and at both L1-2 and L2-3 levels in two. The age of patients ranged from 20 to72 years (mean, 44), and there were 26 men and 16 women. In 11(27%), whose mean age was 32 years, isolated discherniation was limited to these high lumbar segments. The remaining 30 patients had HLDH associated with variableinvolvement of the lower lumbar segments. Associated lesions were as follow : lower level disc herniation(14patients, 34%); apophyseal ring fracture(8 patients, 19%); Schmorl's node and spondylolisthesis (each 6patients, each 14%); spondylolysis(3 patients, 7%); and retrolisthesis(2 patients, 5%). In 20 patients(49%) withHLDH(n=41), there was a previous history. CONCLUSION: Patients with HLDH showed a relatively high incidence ofassociated coexisting abnormalities such as lower lumbar disc herniation, apophyseal ring fracture, Schmorl'snode, spondylolysis, and retrolisthesis. In about half of all patients with HLDH there was a previous history oftrauma. The mean age of patients with isolated HLDH was lower; clinical symptoms of the condition were relativelynonspecific and their incidence was low.
Female ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Male ; Spondylolisthesis ; Spondylolysis

Ankylosing spondylitis is a chronic inflammatory multisystem disease that primarily affects the axial joints. Pleuropulmonary involvement is an uncommon extra-articular manifestation of ankylosing spondylitis. There is a wide spectrum of pulmonary parenchymal changes in ankylosing spondylitis, beginning in the early stages of the disease and increasing over time. The lesions are usually asymptomatic, and not visible on chest radiographs in early stages. We reported a case of advanced ankylosing spondylitis in a 56-year-old man with progressive pulmonary bullous fibrocystic changes on both upper lobes that were misdiagnosed as tuberculosis in the early stages of the disease.
Humans ; Joints ; Lung* ; Middle Aged ; Radiography, Thoracic ; Spondylitis, Ankylosing* ; Tuberculosis

Preoperative prediction of patellar tendon length is important during anterior cruciate ligament (ACL) reconstruction using bone-patellar tendon-bone (BPTB) autograft. Three methods of imaging analysis to predict patellar tendon length were compared in this study. One hundred and twenty-three patients who underwent ACL reconstruction using BPTB autograft by single surgeon during October 2002 through April 2011 were included. We measured the patellar tendon length from true and oblique lateral simple radiographs (classified according to degree of rotation) and magnetic resonance image (MRI). These values were compared with actual length measured during operation and assessed accuracy by calculating the coefficient of determination. The mean length of patellar tendon measured during operation and by true lateral and oblique lateral radiographs and MRI were 42.4+/-0.45 mm (range, 32.0-54.0 mm), 41.7+/-0.61 mm (range, 24.2-55.3 mm), 40.7+/-0.57 mm (range, 24.8-51.5 mm), and 41.7+/-0.52 mm (range, 28.7-56.0 mm), respectively. The correlation of patellar tendon length was the most strong between actual length and value from true lateral radiograph (coefficient of determination, r2=0.660) according to simple linear regression analysis. R2 values were 0.361 and 0.332 for oblique lateral radiograph and MRI compared to actual value, respectively. In conclusion, Patellar tendon length measured on true lateral radiograph was the best method to coincide with actual patellar tendon length among various preoperative prediction methods.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Bone-Patellar Tendon-Bone Graft ; Humans ; Linear Models ; Magnetic Resonance Imaging ; Methods ; Patellar Ligament*

PURPOSE: To evaluate the therapeutic efficacy of intra-arterial infusion of Cis-Diamminedichloroplatinum (C-DDP) for the treatment of hepatocellular carcinomas with widespread involvement. MATERIALS AND METHODS: We retrospectively analyzed 22 patients who between July 1994 and June 1996 had undergone intra-arterial c-DDP infusion therapy for the treatment of hepatocellular carcinomas with widespread involvement. The hepatomas involved both lobes in ten, portal venous obstructions in fourteen, arterio-portal shunts in nine, and arterio-venous shunts in two. Proper hepatic artery was selected for infusion of 100mg/BSA of C-DDP. The same procedure was repeated every 3 to 4 weeks, and the total number of infusions was 65. On the basis of WHO criteria, response was classified as complete remission, partial remission, stable, or progression of the disease. Six-month and one-year survival rates were estimated, and adverse reactions were evaluated. RESULTS: Complete remission was noted in one patient (4.5%) and partial remission in three (13.6%), while 18 showed no response or progression after treatment. The six month survival rate was 59.1%, and the one-year survival rate was 32.1%. Adverse reactions included nausea/vomiting (59.8%), abdominal pain (9.2%), fever (8.0%), acute renal failure (2.3%) and hepatic encephalopathy (1.1%). These adverse reactions were, however, transient and reversible. CONCLUSION: Although the response rate is not high, intra-arterial C-DDP infusion therapy can be used as an alternative treatment for hepatocellular carcinomas with widespread involvement; adverse reactions are tolerable.
Abdominal Pain ; Acute Kidney Injury ; Carcinoma, Hepatocellular* ; Cisplatin* ; Fever ; Hepatic Artery ; Hepatic Encephalopathy ; Humans ; Infusions, Intra-Arterial ; Retrospective Studies ; Survival Rate

BACKGROUND: To report the results of an arthroscopic percutaneous repair technique for partial-thickness tears of the anterosuperior cuff combined with a biceps lesion. METHODS: The inclusion criteria were evidence of the upper subscapularis tendon tear and an articular side partial-thickness tear of the supraspinatus tendon, degeneration of the biceps long head or degenerative superior labrum anterior-posterior, above lesions treated by arthroscopic percutaneous repair, and follow-up duration > 24 months after the operation. American Shoulder and Elbow Surgeons (ASES) score, constant score, the pain level on a visual analogue scale, ranges of motion and strength were assessed. RESULTS: The mean (+/- standard deviation) age of the 20 enrolled patients was 56.0 +/- 7.7 years. The forward flexion strength increased from 26.3 +/- 6.7 Nm preoperatively to 38.9 +/- 5.1 Nm at final follow-up. External and internal rotation strength was also significantly increased (14.2 +/- 1.7 to 19.1 +/- 3.03 Nm, 12.3 +/- 3.2 to 18.1 +/- 2.8 Nm, respectively). Significant improvement was observed in ASES and constant scores at 3 months, 1 year and the time of final follow-up when compared with preoperative scores (p < 0.001). The mean subjective shoulder value was 86% (range, 78% to 97%). CONCLUSIONS: The implementation of complete rotator cuff repair with concomitant tenodesis of the biceps long head using arthroscopic percutaneous repair achieved full recovery of normal rotator cuff function, maximum therapeutic efficacy, and patient satisfaction.
Aged ; Arthroscopy/adverse effects/*methods ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Muscle, Skeletal/*injuries/*surgery ; Pain Measurement ; Range of Motion, Articular ; Rotator Cuff/*injuries/pathology/*surgery ; Statistics, Nonparametric ; Treatment Outcome

PURPOSE: The aim of this study was to compare the drainage amount, total blood loss, and clinical results between two different positions of suction drainage after total knee arthroplasty. MATERIALS AND METHODS: A total of 100 patients who underwent one stage bilateral total knee arthroplasty were enrolled. In experiment 1 with 50 patients, we compared the drainage amount, pain, range of motion, and complications of the leg whose suction drain was inserted into the joint cavity with those of the contralateral leg whose suction drain was inserted in subcutaneous tissue. Another 50 patients of experiment 2 had suction drainage in the joint cavity of both legs and the total blood loss (sum of drainage output, exudates, and hematoma of subcutaneous tissue and joint) was calculated and compared with that of experiment 1. RESULTS: In experiment 1, the drainage amount was less in the leg with suction drainage in subcutaneous tissue compared with the contralateral leg with suction drainage in the joint cavity (p<0.001). However, the postoperative joint pain was significantly different only on post-operative day 2 between two legs. In experiment 2, there was no significant difference in the total blood loss between the two groups. CONCLUSION: Although the drainage amount was less in the leg whose suction drain was kept in subcutaneous tissue compared with the contralateral leg whose suction drain was in the joint cavity, the total blood loss and the clinical results were not significantly different according to the position of the suction drain. Therefore, we can conclude that the subcutaneous position of the suction drain did not yield superior results.
Arthralgia ; Arthroplasty* ; Drainage ; Exudates and Transudates ; Hematoma ; Humans ; Joints ; Knee* ; Leg ; Range of Motion, Articular ; Subcutaneous Tissue ; Suction*