PURPOSE: Kissing contusion between the posterolateral tibial plateau and lateral femoral condyle is frequently found in association with a tear of the anterior cruciate liagment (ACL). The purpose of this study was to determine which ligamentous and meniscal tears are associated with kissing contusion. MATERIALS AND METHODS: We retrospectively reviewed the findings depicted by 323 consecutive MR images of the knee and confirmed at arthroscopy. For the diagnosis of disruption, ligaments, medial menisci (MM) and lateral menisci (LM) were evaluated using accepted criteria. We compared the prevalence and location of meniscal and ligamentous tears between group I (44 knees with kissing contusion) and group II (279 knees without kissing contusion). For statistical analysis the chi-square test was used. RESULTS: ACLs were torn in all 44 knees (100%) with kissing contusion, and 78 (28%) of 279 without kissing contusion. There were ten medial collateral ligament (MCL) tears (23%) in group I, and 17 MCL tears (6%), five lateral collateral ligament (LCL) tears (2%) and ten posterior cruciate ligament (PCL) tears (4%) in group II. In group I, meniscal tears were found in 22 MM (50%) and in 19 LM (43%), while in group II, they occurred in 128 MM (46%) and 128 LM (46%). In group I, 17 (77%) of 22 MM tears and 13 (68%) of 19 LM tears were located in the posterior horn, while in group II, the corresponding figures were 97/128 (76%) and 60 of 128 (47%). The differing prevalence of ACL and MCL tears between the groups was statistically significant (p<0.05), but differences in the prevalence and location of meniscal tears were not (p>0.05). CONCLUSION: Although kissing contusion was a highly specific sign of ACL tears, its presence was also significant among MCL tears. There was no signifficant difference in meniscal tears with or without kissing contusion.
Animals ; Arthroscopy ; Collateral Ligaments ; Contusions* ; Diagnosis ; Horns ; Knee ; Lateral Ligament, Ankle ; Ligaments* ; Menisci, Tibial ; Posterior Cruciate Ligament ; Prevalence ; Retrospective Studies

BACKGROUND: It is well known that ischemic preconditioning protects the heart against infarction or arrhythmias from a subsequent ischemic injury. Two phases of the effect of preconditioning has been explored, early protection and second window of protection at 24 hours. The late protection was seen in some animal model, but the precise mechanism is controversal. This study was designed to evaluate the late cardioprotective effect and role of HSP70 in ischemic preconditioning of cat heart. METHODS: Two groups of cats were studied. Control animals were subjected to an episode of 40-min coronary artery occlusion followed by 30-min reperfusion. Experimental animals were subjected to ischemic preconditioning before the 40-min ishcemia/reperfusion. The preconditioning protocol was comprised of three 5-min episodes of ischemia interspersed by 10-min episodes of reperfusion. After sustained ischemia and reperfusion, left ventricular risk area and infart area were measured by injection of Evans blue bye and triphenyltetrazolium staining, and myocardial HSP70 mRNA was examined in risk(left ventricular anterior wall) and nonrisk(left ventricular posterior wall) area using northern blot hybridization. HSP70 mRNA expression was quantified as a percent of GAPDH. The late cardioprotective effects of ischemic preconditioning were determined by infarct size (% area at risk). RESULTS: Infarct size was markedly limited by ischemic preconditioning when compared with the control group (18.5+/-6.9% vs 38.5+/-11.1%; p<0.001). HSP70 mRNA expression in risk area was much higher in preconditioning group than control group(78+/-12% vs 41+/-11%; p<0.01). But, there was no significant difference of HSP70 mRNA expression in the posterior wall between control and ischemic preconditioning group. CONCLUSIONS: These data suggest that ischemic preconditioning have delayed myocardial protective effect from ischemia. The increase in myocardial HSP70 mRNA may be one of the contributing factors to the delayed cardioprotective effects of ischemic preconditioning in cats.
Animals ; Arrhythmias, Cardiac ; Blotting, Northern ; Cats* ; Coronary Vessels ; Evans Blue ; Heart* ; Heat-Shock Proteins* ; Hot Temperature* ; HSP70 Heat-Shock Proteins ; Infarction ; Ischemia ; Ischemic Preconditioning* ; Models, Animal ; Reperfusion ; RNA, Messenger

BACKGROUND: P wave dispersion(PWD) is defined as the difference between the maximum and minimal P wave duration in any of the 12 leads of the surface ECG. The prolongation of atrial conduction time and the inhomogeneous propagation of sinus impulse are known electrophysiologic features in patients with paroxysmal atrial fibrillation(PAF). The purpose of this study was to determine the role of P wave dispersion for the prediction of PAF and to evaluate the effectiveness of prophylactic antiarrhythmic therapy. MATERIALS AND METHODS: The study population included 20 patients with a history of idiopathic PAF and 20 age and sex matched healthy control subjects. We measured the maximum P wave duration(P maximum) and P wave dispersion from 12 lead ECG. RESULTS: P maximum and P dispersion in idiopathic PAF were significantly higher than normal control group(97.2+/-12, 48.5+/-9msec vs, 76.5+/-11, 21+/-8msec, respectively p<0.001, <0.001). After 12-month follow up period P maximum and P dispersion were significantly reduced than those of initial state(77.2+/-13, 26.4+/-9msec vs. 97.2+/-12, 48.5+/-9msec, respectively p<0.001,<0.001). CONCLUSION: P dispersion and P maximum were significantly different between patients with idiopathic PAF and healthy control group. Those are easily accessible, non-invasive simple electrocadiographic markers that could be used for the prediction and prognostic factors of idiopathic PAF.
Atrial Fibrillation* ; Electrocardiography ; Follow-Up Studies ; Humans

A clinical observation was done on random 42 cases of acute and uncomplicated bacterial pyelonephritis. The following results were obtained: 1. All cases were female. 2. The most common age group was 2nd decade (47.6%). 3. All isolated organisms were Gram negative bacteria and E. coli was most common (90%). 4. On excretory urogram, 3 cases (7%)were abnormal and one of them showed acute segmental pyelonephritis. 5. The right side was affected 3 times more than left and 8 cases were bilateral.
Female ; Gram-Negative Bacteria ; Humans ; Pyelonephritis*

BACKGROUND AND OBJECTIVES: QT dispersion (QTd) is defined as the difference between the maximum and minimum QT interval in any of the 12 leads of the surface ECG. QTd has been shown to reflect regional variations in ventricular repolarization. Ischemic dilated cardiomyopathy (DCM) may lead to more spatial and temporal dispersion in ventricular repolarization than idiopathic DCM. The purpose of this study was to determine the difference of QTd between patients who had ischemic and idiopathic DCM. MATERIALS AND METHODS: The study population included 30 patients with ischemic DCM and 30 with idiopathic DCM. All standard 12-lead ECGs were examined prospectively by two observers who were unware of the patient's details. RESULTS: QTd in ischemic DCM was significantly higher than that in idiopathic DCM (63+/-32 vs. 44+/-26 msec, p=0.012) and JTd in ischemic DCM was significantly higher than that in idiopathic DCM (48+/-21 vs. 36+/-22 msec, p=0.036). Results did not change when Bazett's QTc and JTc was substituted for QT (QTcd:69+/-33 vs. 52+/-28 p=0.039) and JT (JTcd:56+/-21 vs. 41+/-25 p=0.043). CONCLUSION: Ischemic DCM has increased spatial inhomogeneity of repolarization probably due to more regional myocardial damages compared with idiopathic DCM. The value of QT dispersion as an easily accessible, non-invasive method in predicting the risk of life threatening arrhythmia and overall mortality in patients with dilated cardiomyopathy must be confirmed in prospective trials.
Arrhythmias, Cardiac ; Cardiomyopathy, Dilated* ; Electrocardiography ; Heart Failure ; Humans ; Mortality ; Prospective Studies

BACKGROUND: The aging of the patient population is one of rhe most important factirs influencing health care delivery. Currently 5% of the Korean population is elderly, defined as older than 65years of age, with this group projected to increase to 13.1% by the year 2021. Cardiovascular disease is the leading cause of death and of disability in the elderly age group. mong them, coronary heart disease is the most importane. METHOD: Study population composed of 216 patients who were admittied to the hospital with first acute myocardial infarction and they were divided into two groups according to the age(older than 65 years of age vs younger). Clonical features, risk factors of coronary heart disease, in-hospital outcome and complication were compared in elderly patients and others group. Results : 1) The risk factors of coronary heart disease is similar to younger patients but pattern of chest pain is less typical than younger patients. 2) Clinical presentation of elderly patients is similar to younger patients except Killip class on admission.(1.66vs 1.91,P=0.04) 3) In-hospital mortality of elderly patients in higher than younger patients. In addition to an increased incidence of death, recurrent ischemia, stroke, AV block, ventricular arrythmia, pulmonary edema occured more frequently with advanced age. 4) Especially in the thrombolytic therapy group, in-hospital death, reinfarction and recurrent ischemia is higher than primary PTCA group in elderly patients. CONCLUSIONS: Diagnosis of acute chest pain is difficult in elderly patients and in-hospital mortality and morbidity is higher than in younger patients. Thus more accurate diagnosis and discriminative therapeutic modality is needed.
Aged ; Aging ; Arrhythmias, Cardiac ; Atrioventricular Block ; Cardiovascular Diseases ; Cause of Death ; Chest Pain ; Coronary Disease ; Delivery of Health Care ; Diagnosis ; Hospital Mortality ; Humans ; Incidence ; Ischemia ; Myocardial Infarction* ; Pulmonary Edema ; Risk Factors ; Stroke ; Thrombolytic Therapy

We had experienced 2 cases of acute phlegmonous gastritis confirmed by endoscopy, microbiological study and surgical pathologic findings. The first was a 61- year-old female who had been diagnosed as the communicating hydrocephalus and the other was a healthy 60-year-old female. Enterococcus fecalis & Klebsiella pneumoniae, Enterococcus fecalis & E.coli were cultured from the gastric tissue and juice obtained by endoscopy in each patient. In both patients, endoscopic findings showed numerous large ulcers and edema with necrotic material and exudate over the whole stomach. Operation findings were markedly edematous and overall ulcerative mucosa in one patient, and hyperemic outlet stricture in the other. Pathologic findings were acute necrotizing inflammation, involving the mucosa and submucosal layer, consistent with acute phlegmonous gastritis. After operation and antibiotics therapy, the patients were rapidly improved. We reported 2 cases of acute phlegmonous gastritis with the review of literature.
Anti-Bacterial Agents ; Cellulitis* ; Constriction, Pathologic ; Edema ; Endoscopy ; Enterococcus ; Exudates and Transudates ; Female ; Gastritis* ; Humans ; Hydrocephalus ; Inflammation ; Klebsiella pneumoniae ; Middle Aged ; Mucous Membrane ; Stomach ; Ulcer

BACKGROUND AND OBJECTIVES: The Angio-Seal(r) (a St. Jude Medical Co., USA) hemostatic puncture closure device produces direct femoral arterial hemostasis, by anchoring a collagen plug to the anterior vascular wall, through a sheath delivery system. The rapid and effective hemostasis leads to earlier ambulation, minimized hospital stay, patient discomfort and vascular complications. This study was performed to evaluate the efficacy and complications of an Angio-Seal in patients undergoing coronary angiography and angioplasty. SUBJECTS AND MEHTODS: A total 228 consecutive patients, admitted to our hospital for percutaneous coronary intervention, between October 2001 and May 2002, were enrolled and randomized into 2 groups. 116 patients were treated with an Angio-Seal and the other 112 with manual compression only (control group). The clinical characteristics, procedure related factors, time to ambulation, times to outpatient discharge and complications were analyzed in each patient. All the clinical and procedure-related factors, leading to oozing and delayed bleeding, were also analyzed in the 113 patients who had a successfully completed Angio-Seal deployment. RESULTS: The times to ambulation (7.96+/-5.81 hours vs. 23.32+/-3.35 hours) and times to outpatient discharge (2.00+/-0.94 days vs. 3.47+/-3.61 days) were significantly shorter in the Angio-Seal compared to the control group (p=0.001 & p=0.001, respectively). There was oozing in 20 patients (17.7%) and delayed bleeding in 6 (5.3%) of the successful Angio-Seal deployment group. The occurrence of oozing was significantly higher in the heparin infusion cases (40%. 18.3%, p=0.034), and was correlated with a later hematoma formation rate and the size of the hematoma (30% vs. 9.7%, 0.68+/-1.26 cm vs. 0.17+/-0.70 cm, p=0.015 & p=0.001, respectively). Delayed bleeding was correlated to the hematoma occurrence rate (50% vs. 11.2%, p=0.006). CONCLUSION: The Angio-Seal resulted in earlier ambulation and shorten the patients' hospital stay. Oozing, delayed bleeding, hematomas were noted as complications. Oozing and delayed bleeding were correlated with a high hematoma occurrence rate. Careful inspection of the puncture sites, following an Angio-Seal deployment, should be performed.
Angioplasty* ; Cardiac Catheterization ; Collagen ; Coronary Angiography* ; Hematoma ; Hemorrhage ; Hemostasis ; Heparin ; Humans ; Length of Stay ; Outpatients ; Percutaneous Coronary Intervention ; Punctures ; Time Factors ; Walking

Primary cardiac lymphoma defined as involving only the heart and pericardium, is very rare and is diagnosed predominantly late in the course of illness or autopsy. This tumor is commonly fatal and until recently were rarely diagnosed antemortem. Recently, it was reported in patients with acquired immunodeficiency syndrome. We report a case of primary cardiac lymphoma in a 56 year old female who showed progressive exertional dyspnea. On echocardiogram and CT scan, large ill defined mass was demonstrated in right atrial and ventricular wall. It was diagnosed as B-cell type lymphoma on open cardiac biopsy.
Acquired Immunodeficiency Syndrome ; Autopsy ; B-Lymphocytes ; Biopsy ; Dyspnea ; Female ; Heart ; Heart Neoplasms ; Humans ; Lymphoma* ; Middle Aged ; Pericardium ; Tomography, X-Ray Computed

Background: Recent studies suggest that acanthosis nigricans (AN) is associated with insulin resistance in obese children. However, very few studies have assessed insulin resistance and obesity according to the degree of AN. Therefore, this study aimed to investigate the correlation between the degree of obesity and insulin resistance according to the severity of AN. Methods: A total of 141 participants (83 boys and 58 girls) aged 6−17 years were recruited for the Intervention for Childhood and Adolescents obesity via Activity and Nutrition study between 2016 and 2017. The participants were categorized into four groups according to the severity of AN: grade 0 (n=69), grade 1 (n=19), grade 2–3 (n=35), and grade 4 (n=18). All participants underwent physical examination and blood tests. We compared the mean homeostatic model assessment (HOMA-IR) and body mass index Z score (BMI Z-score) in each group using ANCOVA and linear regression model. Results: The HOMA-IR, which represents insulin resistance, increased with increasing AN severity (grade 0 group: 3.25±0.070; grade 1 group: 3.97±0.103; grade 2–3 group: 4.76±0.079; AN grade 4: 6.40±0.107; P for trend<0.001). Similarly, the BMI Z-score, which represents the degree of obesity, increased with increasing AN severity (grade 0 group: 2.29±0.052; grade 1 group: 2.42±0.080; grade 2–3 group: 2.44±0.062, grade 4: 2.67±0.089; P for trend<0.001). Conclusion Insulin resistance and the degree of obesity increase with the severity of AN in Korean obese children.