The purposes of this study were to evaluate the diagnostic modalities of the acute rupture of anterior cruciate ligament(ACL) and to know the differences hetween complete and partial ACL rupture preoperatively, analyzing the methods of physical examimation and the clinical features in acutely injured patient. We analyzed the anterior drawer test, Lachman test, KT-2000 arthrometer, MRI findings and associated injuries in the 35 patients who were confirmed to have ACL rupture by arthroscopy of the knee joint, performed within a month after trauma. We divided the patients by arthroscopy into 2 groups: complete rupture group and the partial rupture group. Among the 35 cases of ACL rupture, there were 10 cases of partial rupture and 25 cases of complete rupture. The Lachman s test was the most sensitive method of the physical examinations in detecting acute ACL injuries, with 90% and 92% positive rate in each group retrospectively. KT-2000 arthrometer with more than 3mm side-to-side difference showed all positive findings except one. The findings of ACL rupture in MRI were discontinuity, increased signal intensity, ahnormal course of ACL fibers and so on. The sensitivity of MRI in diagnosing the acute injuries of ACL was 97.2% hut had difficulties in differentiating the complete from partial rupture. Associated injuries of the ACL injured knee were medial and lateral meniscus tear and medial collateral ligament injury. The diagnosis of acute ACL rupture was made possihle hy physical examinations and with use of the KT-2000 arthrometer and MRI was useful in detecting the ACL rupture or associated injuries but not in differentiating complete from partial rupture of the ACL.
Anterior Cruciate Ligament* ; Arthroscopy ; Collateral Ligaments ; Diagnosis* ; Humans ; Knee ; Knee Joint ; Magnetic Resonance Imaging ; Menisci, Tibial ; Physical Examination ; Retrospective Studies ; Rupture

PURPOSE: To describe the magnetic resonance (MR) findings of intracranial dural arteriovenous fistulae (DAVF) and associated venous hypertensive diseases, and to determine their diagnostic value. MATERIALS AND METHODS: MR Imagings of twelve cases of angiographically-proven intracranial DAVF were analyzed. The presence of signal voids, dilatation of involved dural sinus, the dilatation of the extra/intradural venous system, high signal intensity on T2 weighted image, cerebral edema, intracranial hemorrhage, and hydrocephalus were retrospectively analyzed. MR findings and angiographic classification were compared. RESULTS: In 11 of 12 patients (92%), MR revealed the location of DAVF. In five cases, these were cavernous, and in six, they were extracavernous; the locations of the latter were as follows: superior sagittal sinus (SSS), 4: torcula, 1; lateral sinus & SSS, 1. Except for the lateral sinus lesion, all the DAVF seen in thses 11 patients showed the presence of signal voids and dilatation of the involved dural sinus. Findings of associated venous hypertensive disease, namely dilatation of the superior ophthalmic vein and cortical venous system, cerebral edema, and high signal intensity on T2-weighted images were observed in three cavernous lesions (50%), but all extracavernous DAVF (100%) showed associated venous hypertensive disease. When the grade of angiographic classification was high and reflux of sinus blood to the cortical vein was seen on angiography, the MR findings of intracranial venous hypertension showed good correlation. CONCLUSION: The MR findings of DAVF include dilatation of the dural sinus and signal voids of feeding arteries and draining vein. Other findings which suggest intracranial venohypertensive disease are dilatation of the cortical and medullary vein, hydrocephallus, cerebral edema and intracranial hamorrhage. These and the angiographic findings correlate well and suggest that in the diagnosis of DAVF and the detection of intracanial venohypertension, MR is a non-invasivse technique which can be use be usefully employed before final diagnosis by angiography.
Angiography ; Arteries ; Arteriovenous Fistula ; Brain Edema ; Central Nervous System Vascular Malformations* ; Classification ; Diagnosis ; Dilatation ; Humans ; Hydrocephalus ; Hypertension ; Intracranial Hemorrhages ; Magnetic Resonance Imaging* ; Retrospective Studies ; Superior Sagittal Sinus ; Transverse Sinuses ; Veins

The diverse effects of antidepressants on sleep are mediated by their agonistic or antagonistic properties on specific neurotransmitters: the catecholamine, serotonergic, cholinergic, and histaminergic neurotransmitter systems, which also regulate the timing and cycling of sleep. Therefore, antidepressants can have both class- and compound-specific effects on sleep/wake dynamics, sleep stages, and on motor control during sleep. For these reasons, the sedating or wake-promoting effects of these medications are important factors influencing specific drug selection. As these sleep-related effects may in turn influence both medication compliance as well as the course of the disease state itself, it is important for clinicians to understand and predict the possible effects of antidepressants on sleep. Some antidepressants, such as amitriptyline, doxepine, trazodone, and mirtazapine, possess sedating properties and improve sleep continuity via alpha-1 adrenoceptors and histamine H1 receptor blockade, combined with 5HT(2A/2C) receptor blockade. Other antidepressants, such as SSRI, SNRI and MAOIs, worsen sleep and may cause insomnia, an effect which may be linked to facilitation of 5HT(2A/2C) receptors. The majority of antidepressants are REM (rapid eye movement) suppressants, though some, such as nefazodone, bupropion, and mirtazapine, lack REM-suppressing effects. On the other hand, the effects of antidepressants on slow wave sleep (SWS) are much less consistent than their effects on REM sleep. Available data suggest that antidepressants, including some TCAs, and trazodone, increase SWS, possibly as a function of their 5-HT(2A/2C) receptor antagonism. In contrast, antidepressants lacking 5-HT(2A/2C) receptor antagonist effects, including SSRIs, SNRIs and MAOIs, may produce no change or even decrease in SWS. Knowledge of the effects of antidepressants on sleep will be helpful in estimating the sleep disturbance caused by these compounds, and can thus help in the selection of appropriate compound for individual patients.
Amitriptyline ; Antidepressive Agents* ; Bupropion ; Doxepin ; Hand ; Humans ; Medication Adherence ; Neurotransmitter Agents ; Receptors, Adrenergic ; Receptors, Histamine H1 ; Sleep Initiation and Maintenance Disorders ; Sleep Stages ; Sleep, REM ; Trazodone

Various anatomical defects have been described in the surviving twin who had a stillborn, macerated monozygotic co-twin with Disseminated Intravascular Coargulation. The etiology is thought to be placental transfer of emboli or thromboplastic material through placental vascular anastomoses. We experienced a case of monozygotic twin with deceased co-twin at 30 weeks of gestation and confirmed to have antenatal periventricular germinal matrix and intraventricular hemorrhage, multicystic periventricular leukomalacia and diffuse encephalomalacia by neurosonography on first day of life despite of no clinical evidence of brain damage. The pathologic findings of placenta revealed infarct with massive fibrin deposition. A brief review of related literature is presented.
Brain* ; Encephalomalacia ; Fibrin ; Hemorrhage ; Humans ; Infant, Newborn ; Leukomalacia, Periventricular ; Placenta ; Pregnancy ; Twins ; Twins, Monozygotic*

No abstract available.
Gene Expression* ; Microscopy, Electron, Scanning* ; Virulence*

PURPOSE: To identify the changes of bony landmarks with rotation and to compare the reliability and accuracy of Perdriolle's method before and after training on the exact bony landmarks. MATERIALS AND METHODS: Simple A-P radiographs were taken with rotation from 5 degree to 50 degree at 5 degree interval using 10 dry human vertebrae (2 sets of T3, T6, T9 8 L3) with no bony abnormality. Axial rotation was measured before and after training on the exact bony landmarks by three observers, twice for each radiographs. Repeated measures of ANOVA were used for inter- < intraobserver variance and regression analysis for root mean square error and deviation of differences. RESULTS: Mamillary process, inner margin of lamina, proximal and distal costovertebral joints, upper margin of concave pedicle and tip of the transverse process on the convex side confused the exact outline of the pedicle, while neural foraminal margin was helpful in identifying the location of the indistinct convex pedicle and concave vertebral border. Of the 660 measurements before and after training 372 and 397 errors were made, respectively, of which 88.9% and 88.5% were within +/-5 degree(P > 0.05). Incidence of error greater than 5 degree was high at upper thoracic vertebra and 20 degree-40 degree of rotation regardless of training. The effects of training, however, was greatest at T3 and 20 degree-40 degree of rotation. Inter- < intraobserver variance was diminished at T3 and at the rotation between 20 degree-40 degree after training. CONCLUSIONS: We could conclude that training on the exact bony landmarks did not reduce the overall error incidence. Accuracy and reliability, however, was increased at T3 after training and the efficacy of training was more evident in moderate vertebral rotation than in small or large vertebral rotation.
Humans ; Incidence ; Joints ; Spine

Vascular ingrowth is essential for the survial of the graft tissue. The purposes of this study were to evaluate any changes in signal intensity of cqropreserved meniscal allograft with time in the magnetic resonance images(MRI) and to demonstrate the viability of the grafts. Eight patients underwent meniscal transplantation with cryopreserved allcgrafts using the bone block technique. MRIs of the knee were taken at 3 days, 3 weeks, 6 weeks, 3 month, 6 months. And I year after the implantation. A second-look arthroscopy and a small meniscal biopsy(sized 2mm x 2mm1 at the peripheral and central part of the meniscus were conducted at 3 months and 1 year. Three days after the operation, the signal intensity of the implanted meniscus revealed a homogenrous low signaJ intensity that could not be differentiated from that of' a contralateral normal meniscus. At 3 weeks, a high signal intensity appeared at the periphery of the meniscus. This signal, which did not communicate into the joint space, fuither intensified at 6 weeks. The high signal intensity of the meniscus, though still higher than that of the normal meniscus, decrexsed slightly at 3 months and continued to decrease progressively even a year after the implantation. The second-look arthroscopy revealed that the grafts were viable and that there was no tearing or shrinking of the meniscus. Cellular proliferation was also found at the central edge oi' the meniscus at 3 months. This cellular pattern differentiated from that of a nonmal meniscus in that the d stribution of cells was not in an even, but in a clonal pattem. The cellularity after a year, however, was sirnilar to that of normal meniscus except some area with deficiency of cells. It can be concluded that increased signal intensity of' the implanted meniscus with time indicates hypervascularity caused by vascular ingrowth, similar to the high signal intensity ot>tained from normal meniscus in young children. Increasecl signal intensity in the chronological postoperative MRls demonstrates the viability of the implanted cryopreserved meniscal allograft.
Allografts* ; Arthroscopy ; Cell Proliferation ; Child ; Humans* ; Joints ; Knee ; Magnetic Resonance Imaging* ; Transplants

Total 352 materials were obtained from the endocervix of prostitutes residing in Taegu area and 22 cases N, gonorrhoeae were isolated through T-M media culture, oxidase test, carbohydrate degradation test, Gram stain. Following results were obtained : 1. Among 22 isolates, 8 strains showed positive reaction to beta-lactamase test (36.4%). 2. Antimicrobial susceptibility test showed different MIC ranges between PPNG and non-PPNG group to penicillin, ampicillin. But, cephalosporins, quinolone derivatives showed similar MIC range between the PPNG and non-PPNG group. 3. MRH test which was available to detect pili of uropathic E, coli was not useful to evaluate adherence of N. gonorrhoeae. 4. In electrophoregram, 14 strains represented 2.6 megadalton cryptic plasmid and 2 strains of PPNG had both 4.5 and 3.2 megadalton plasmids. Therefore, further study is needed for demonstration of concurrent expression of both type (Asia and Africa) of plasmids.
Ampicillin ; beta-Lactamases ; Cephalosporins ; Daegu* ; Humans ; Neisseria gonorrhoeae* ; Neisseria* ; Oxidoreductases ; Penicillins ; Plasmids* ; Sex Workers

OBJECTIVES: Psychological distresses and complaints in sleep, in addition to physical distresses such as pruritus and bone pain, are common in patients with hemodialysis. The purposes of this study were to investigate 1)the severity of physical distresses, 2)the severity of depression and anxiety, 3)the sleep disturbances, and 4)the correlation of the above variables in patients with hemodialysis. METHODS: The patients with hemodialysis (male 87, female 66)and controls (male 58, female 55)completed a self-administered questionnaire package, which included Beck Depression Inventory, Spielberger's State-Trait Anxiety Inventory, and questions characterizing the reported sleep problems and quantitating the severity of the self-perceived physical and psychological conditions with linear visual analogue scales. RESULTS: The results indicated that patients with hemodialysis complained of more physical distresses, more depressed mood, and more sleep disturbances suggesting insomnia, restless legs syndrome, periodic limb movement disorder, nightmare and obstructive sleep apnea syndrome, etc. There were significant positive correlations of physical distresses, depressed mood and sleep disturbances. However, there were no significant differences in state and trait anxiety between both groups. CONCLUSIONS: The authors suggest that the quality of life in patients with hemodialysis will be improved if their emotional and sleep disturbances are properly ameliorated.
Anxiety* ; Depression* ; Dreams ; Female ; Humans ; Nocturnal Myoclonus Syndrome ; Pruritus ; Quality of Life ; Surveys and Questionnaires ; Renal Dialysis* ; Restless Legs Syndrome ; Sleep Apnea, Obstructive ; Sleep Initiation and Maintenance Disorders ; Weights and Measures

Human cytomegalovirus (HCMV) isolated from Korean patients is different in the antigenic and genomic structure of gB from the laboratory-adapted strain. To dissect the reactivity to HCMV glycoprotein B (gB) domains, each domain gene of gB of HCMV SNUCH1, Korean isolate, was amplified from the extracted DNA of the virus-infected fibroblasts with the specific primers by polymerase chain reaction (PCR). Amplified DNA was cloned into pcDNA3. Immunofluorescent staining and western blot analysis revealed that the expressed gB in mammalian cells was immunoreactive and equivalent to the naturally expressed gB in virus-infected fibroblasts. The antigenic component reactive with monoclonal antibodies, MCMVA 57, 88, and 98 appeared at the D3 domain of gB molecule, and that with MCMVA 66 and 135 at the D2b domain. Antibody titer was measured with HCMV-infected fibroblasts and the domains of gB expressed in mammalian cells. There was no correlation between the antibody titer to the whole HCMV and neutralizing antibody titer, and between the antibody titer to whole HCMV and whole gB. It was more reasonable to use whole gB than whole HCMV in the comparison with the neutralizing antibody titer. D3 was representative domain in gB molecule in the anti-gB reactivity. Conclusively it is highly recommendable to use the representing isolates in Korea and its domains for the detection of antibody or the analysis of antigen in the aspect of immunological properties and molecular structures.
Antibodies, Monoclonal ; Antibodies, Neutralizing* ; Blotting, Western ; Clone Cells ; Cytomegalovirus* ; DNA ; Epitopes* ; Fibroblasts ; Glycoproteins ; Humans* ; Korea* ; Molecular Structure ; Polymerase Chain Reaction