Temporomandibular (TM) joint pain results from many etiologic factors. The aim of this study was to evaluate the utility of Bone SPECT in patients with TM joint pain. The subjects were 34 patients with TM joint pain. All patients underwent plain radiography, planar bone scan, and Bone SPECT. The intensity of radioisotope uptake at TM joint was graded into three; no increased uptake above three background activity as grade 0, uptake similar to occipital bone as grade I, and uptake similar to maxillary sinus as grade II. Clinical findings and therapeutic methods were reviewed. Twenty-seven patients (80%) out of 34 patients with TM joint pain had increased uptake in bone SPECT. Twenty-one (78%) out of 27 patients had increased uptake in the mandibular condyle and remaining six patients (22%) had uptake in the mandibular and maxillary arch, which proved to be dental problem. Seven patients out of 34 were grade as 0, four (12%) were grade I, 23 (68%) were grade II. Four patients with grade I had clicking sound and symptoms which were subsided with medication in all cases. Among 23 patients with grade II, 7 patients had clicking sound and 14 patients underwent medication and decompression therapy. With Planar bone scan, 11 cases (32%) had increased uptake in TM joint area. Plain radiography revealed narrowing, distension, erosion and limitation of TM joint in 16 cases (47%). Bone SPECT can be valuable for screening and managing the patients with TM joint pain. Patients with grade II needed intensive treatment such as joint aspiration. However degree of the radioisotope uptake did not well correlated with clinical symptoms.
Arthralgia ; Decompression ; Humans ; Joints ; Mandibular Condyle ; Mass Screening ; Maxillary Sinus ; Occipital Bone ; Radiography ; Temporomandibular Joint* ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Abscess*

PURPOSE: To describe the radiographic and MR characteristics of subacute diaphyseal osteomyelitis of the long bone. MATERIALS AND METHODS: We retrospectively analyzed plain radiographs and MR images in nine children and two young adults with surgically-proven diaphyseal osteomyelitis of the long bones. MR imaging was carried out before and after Gd-DPTA administration. Patients charts were reviewed for clinical and laboratory data and histologic correlation was available in all cases. RESULTS: All patients had a history of a minimum of 2 weeks' duration. All presented with an insidious onset of mild pain; they showed apyrexia and normal erythrocyte sedimentation rate. In all patients, plain radiographs showed single or multiple linear periosteal reaction with cortical irregularity. Medullary abnormality was not found except in one case which showed an abscess cavity. MR images revealed thickening or irregularity of the cortex, periosteal reaction, bone marrow signal alteration, and perilesional edema. CONCLUSION: Subacute diaphyseal osteomyelitis of the long bone is broadly based on the cortex, and elicits more sclerosis and periosteal reaction. Familarity with plain radiographs and MR features may be useful in the diagnosis of subacute diaphyseal osteomyelitis.
Abscess ; Blood Sedimentation ; Bone Marrow ; Child ; Diagnosis ; Edema ; Humans ; Magnetic Resonance Imaging* ; Osteomyelitis* ; Periostitis ; Retrospective Studies ; Sclerosis ; Young Adult

PURPOSE: To assess the efficacy of open debridement and polyethylene exchange (ODPE) combined with proper antibiotic therapy in strictly selected patients with infection after total knee arthroplasty (TKA) and analyze factors associated with treatment failure. MATERIALS AND METHODS: From January 2010 to January 2014, 25 cases that underwent ODPE under the diagnosis of infection within four weeks after TKA or acute hematogenous infection within five days of symptom onset were reviewed in this study. RESULTS: Treatment was successful in 22 out of 25 cases (88.0%). Factors associated with failure were accompanying infection (periprosthetic infection in the ipsilateral foot, cervical parotid abscess, and masticator space abscess) and diagnosis of rheumatoid arthritis (RA) before TKA. Resistant bacteria did not entail a risk. On clinical results, the mean postoperative Lysholm score and Korean Knee score were 81.4 and 79.4, respectively, the knee range of motion was 115.4°±12.9°, and duration of hospitalization was 32.3±8.4 days. On radiographic results, 3.47±1.56 mm joint line elevation and a valgus change of 0.61°±2.35° in knee alignment were observed. CONCLUSIONS: ODPE combined with appropriate antibiotics therapy could be a useful treatment method for infection after TKA if the procedure is performed within a symptom duration of five days or less in the absence of accompanying infection in patients whose indication for TKA was not RA.
Abscess ; Anti-Bacterial Agents ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Bacteria ; Debridement ; Diagnosis ; Foot ; Hospitalization ; Humans ; Joints ; Knee ; Methods ; Polyethylene ; Range of Motion, Articular ; Treatment Failure

Prostaglandin(PG) E has been shown to affect renal function by influencing renal blood flow and perfusion pressure and to have immunosuppressive properties. Positive effects of PG-E on kidney allograft hemodynamics and function have previously been, but not without controversy. This study was therfore designed to evaluate the long-term effect of misoprostol on blood pressure, CsA level, graft survival, renal function and histological change in first- time renal transplant recipients treated with cyclosporine. Eighty kidney transplant(KT) recipients were randomly se parated into three groups according to the duration of misoprostol treatment. Group C(n=50) was control; group M1(n=13) recieved misoprostol for less than 6 months and group M2(n=17) for more than 6 months after KT. The results were as follows. 1)Serum CsA levels at 24 months after KT were not significantly different among the three groups [groupC 167+/-58ng/ml; group M 163+/-75ng/ml (group M1 171+/-70ng/ml, group M2 155+/-81ng/ml)]. Group M2 required higher dosage of CsA than group C or M1 to maintain the proper serum levels (group M2 4.27+/-1.07mg/kg/day vs. group C 4.04+/-0.90mg/ kg/day or group M1 4.08+/-1.03mg/kg/day). But these results were not statistically significant. 2) Mean arterial pressures at 24 months after KT were not different among the groups[group C 101+/-11 mmHg; group M 103+/-10mmHg(group M1 108+/-11 mmHg, group M2 100+/-7mmHg)]. 3) Incidence of acute rejection was no different between group C(10 cases; 20%) and group M(12 cases; 40%). 4) Serum creatinine levels at 24 months after KT were not significantly different among the groups [group C 1.30+/-0.37mg/dl; group M 1.43+/-0.41mg/dl (group M1 1.51+/-0.47mg/dl, group M2 1.36+/-0.37mg/ dl)]. 5) Routine biopsy of transplanted kidney performed at 2 weeks after KT showed more abnormal findings in group C(9 cases; 49%) than group M(4 cases; 28.5%), but there was no statistical significance. In conclusion, long-term misoprostol treatment in renal transplant recipients was not effective in preventing the acute rejection, maintaining the renal fucntion, and decreasing blood pressure. Still, studies in patients receiving CsA are needed to determine the effect of misoprostol in CsA bioavaility and the histologic change of graft kidney.
Allografts* ; Arterial Pressure ; Biopsy ; Blood Pressure* ; Creatinine ; Cyclosporine* ; Graft Survival ; Hemodynamics ; Humans ; Incidence ; Kidney ; Kidney Transplantation ; Misoprostol ; Perfusion ; Renal Circulation ; Transplantation ; Transplants

In order to evaluate the role of anti-endothelial cell antibody (AECA) in acute rejection in renal transplantation, serum AECA IgG titers were measured in 68 healthy controls, 111 chronic hemodialysis (HD) patients and 58 first renal transplant recipients. The AECA titer in hemodialysis patients was higher than in healthy controls (13.9+/-5.0 vs. 4.8+/-2.3 U/mL, p<0.01). In transplant recipients, AECA titers were not affected by dialysis mode (HD vs. CAPD vs. non-dialysis ; 9.6+/-7.6 vs. 7.9+/-3.9 vs. 11.9+/-3.1 U/mL, p>0.05). After renal transplantation, AECA titer was decreased significantly (vs. 4.7+/-3.6 U/mL, p<0.01). The serum AECA IgG titers increased significantly in recipients with acute rejection (6.9+/-3.1 vs. 13.5+/-9.9 U/mL, p<0.01), but decreased to 5.6+/-3.0 U/mL (p<0.01) after formal rejection therapy. In the recipients with acute rejection (n=27), the pre-renal transplant AECA titer was higher than in that without acute rejection (14.0+/-8.6 vs. 7.7+/-3.8 U/mL, p<0.01). The results of this study lead us to conclude that pre- and post-renal transplant AECA titer might be a useful predictor for acute rejection and useful for monitoring acute rejection in renal transplant recipients.
Adult ; Aged ; Autoantibodies/analysis* ; Biological Markers/analysis ; Comparative Study ; Enzyme-Linked Immunosorbent Assay ; Female ; Graft Rejection/immunology* ; Human ; Kidney Transplantation/immunology* ; Kidney Transplantation/adverse effects ; Male ; Middle Age ; Probability ; Prognosis ; Reference Values ; Renal Dialysis ; Sensitivity and Specificity ; Statistics, Nonparametric ; Transplantation Immunology/physiology

The recent therapeutic advances for treating hematologic neoplasm have improved patients' survival, but these treatments have increased the frequency of neurologic complications and toxic effects. Most of the neurological features of leukemia are divided into three main categories: the primary effects of the disease, the treatment-related side effects and the infectious complications. The purpose of this pictorial assay is to document the radiologic abnormalities seen in the intracranial structures during and after the treatment of leukemia, and to aid in the clinical management of patients.
Hematologic Neoplasms ; Humans ; Leukemia

A 27-year-old man presented at the emergency room with hemoptysis. His blood pressure was 180/100 mm Hg, and he had no history of hypertension. Chest radiographs showed bilateral infiltration, suggestive of alveolar hemorrhage. His laboratory data were consistent with acute kidney injury. His serum creatinine level increased abruptly; therefore, renal biopsy was performed. Steroid pulse therapy was administered because of a strong suspicion of immune-mediated pulmonary renal syndrome. Renal biopsy showed proliferative endarteritis, fibrinoid necrosis, and intraluminal thrombi in the vessels without crescent formation or necrotizing lesions. Steroid pulse therapy rapidly tapered and stopped. His serum creatinine level gradually decreased with strict blood pressure control. Ten months after discharge, his blood pressure was approximately 120/80 mm Hg with a serum creatinine level of 1.98 mg/dL. Pulmonary renal syndrome is generally caused by an immune-mediated mechanism. However, malignant hypertension accompanying renal insufficiency and heart dysfunction causing end-organ damage can create a pulmonary hemorrhage, similar to pulmonary renal syndrome caused by an immune-mediated mechanism. The present case shows that hypertension, a common disease, can possibly cause pulmonary renal syndrome, a rare condition.
Adult ; Glomerulonephritis/*diagnosis ; Hemoptysis/pathology ; Hemorrhage/*diagnosis ; Humans ; Hypertension, Malignant/*diagnosis ; Lung Diseases/*diagnosis ; Male

BACKGROUND/AIMS: Recurrent focal segmental glomerulosclerosis (FSGS) following renal transplantation is relatively common. However, the risk factors and optimal pretransplant treatment preventing recurrence of FSGS remain controversial. METHODS: We retrospectively reviewed 27 adult renal transplant recipients with FSGS over a period of 10 years. We first compared possible risk factors for FSGS recurrence between the recurrence and nonrecurrence groups. Then we evaluated the effect of pretransplant plasmapheresis (PP; n = 4) and PP with rituximab (PP + RTX; n = 5) on recurrence of FSGS after transplantation compared to control patients that were not treated with these modalities. RESULTS: There were seven recurrences in 27 patients (25.9%), but there were no significant differences in possible risk factors for FSGS recurrence between the two groups. Recurrence rates between patients with pretransplant PP or PP + RTX and control patients were not significantly different (22.2% vs. 27.7%, p > 0.05). There was also no significant difference in recurrence between the pretransplant PP and PP + RTX groups (25% vs. 20%, p > 0.05). CONCLUSIONS: Pretransplant PP or PP + RTX do not significantly decrease the recurrence of FSGS in adult renal transplant candidates.
Adult ; Antibodies, Monoclonal, Murine-Derived/*administration & dosage ; Female ; Glomerulosclerosis, Focal Segmental/diagnosis/immunology/*surgery ; Humans ; Immunosuppressive Agents/*administration & dosage ; *Kidney Transplantation/adverse effects ; Male ; Middle Aged ; *Plasmapheresis ; Recurrence ; Retrospective Studies ; Risk Factors ; Treatment Outcome