The posterior cruciate ligament has been considered the basic stabilizer which performs important functions because of its location and orientation within the knee joint. Therefore, failure to recognize or to repair its tear results in a poorly functioning knee. An isolated injury to the posterior cruciate ligament is believed to be unconmon and is seen most commonly in association with other ligamentous injury and dislocation of the knee joint. But recently its injuries are of frequent occurrence because of increasing traffic accident and sports activities as football, soccer, and skiing. The authors experienced 12 cases of isolated posterior cruciate ligament injury from March, 1978 to February, 1982 at the Department of Orthopaedic Surgery, Capital Arrned Forces General Hospital and the results were as follows: 1. The most common cause of injury was passenger traffic accident (5 cases) and followed by soccer (4 cases), football (2 cases), and skiing (1 case). 2. There were 3 causative mechanisms by which the posterior cruciate ligament was injured; anteroposterior force on the front of the knee joint (5 cases), hyperextension of the knee joint (4 cases), and posteriorly directed rotatory force (3 cases). 3. Tears of the posterior cruciate ligament occured at its tibial attachment (5 cases), with avulsion of a bone fragment at its tibial attachment (3 cases), at its femoral attachment (2 cases), and its mid-portion (1 case). 4. The major findings in this injury included giving-way or instability on walking, abrasion or contusion over the anterior proximal tibial surface, presence of a posterior drawer sign, sagging of the tibia, bloody effusion, and X-ray evidence of avulsion fracture. 5. One case was treated conservatively and 11 cases surgically using screw fixation and direct or pull through suture through a posterior S-shaped incision (5 cases), medial parapatellar and posterior S-shaped incision (3 cases), and medial hockey-stick incision (3 cases) and were immobilized in a long leg cast with 30 to 45 degrees of the knee flexion for 6 to 7 weeks. 6. The results evaluated by Apleys method were excellent in 8 cases; good in 2 cases, and fair in 2 cases.
Accidents, Traffic ; Clinical Study ; Contusions ; Dislocations ; Football ; Hospitals, General ; Knee Joint ; Knee ; Leg ; Ligaments ; Methods ; Posterior Cruciate Ligament ; Skiing ; Soccer ; Sports ; Sutures ; Tears ; Tibia ; Walking

Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of probable autoimmune etiology. The MR images of patients with clinically suspected ADEM were retrospectively reviewed. The clinical symptoms occurred 5 days to 1 month after viral upper respiratory infection (4) and Coxsakie viral infection(1). The symptoms had begun with fever(3), headache(3), sore throat(1), and drowsy mental state (1), which progressed with monophasic course to altered mental change(2), extremity weakness(2), seizure(1) and/or cerebellary symptom(I) MRI findings of ADEM showed patchy(4), nonhemorrhagic(5), asymmetric(5) high signal intensity lesions on T2-weighted images. The number of the lesions was mostly multiple(4). The lesions mainly involved the brain stem(3) and subcortical white matter(3). Follow-up MR images of 13 days to 20 days after high dose steroid therapy showed marked improvement in two of three, which well correlated with clinical manifestations. MR findin of multiple, patchy, nonhemorrhagic and asymmetric lesions in subcortical white matter and brain stem on T2-weighted images seem to be characteristic features of ADEM, but nonspecific. Therefore, clinical correlation is required in evaluating ADEM.
Brain ; Brain Stem ; Demyelinating Diseases ; Encephalomyelitis, Acute Disseminated ; Extremities ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies ; White Matter

PURPOSE: The purposes of this study were to analyze the MR findings of medulloblastoma, and to evaluate the subarachnoid dissemination and the significance of contrast enhanced MR of brain and spine for tumor.. MATERIALS AND METHODS: The preoperative brain MR studies of 18 patients (9 males, 9 females;mean age, 9.4 years) with surgically proved medulloblastomas were retrospectively reviewed to characterize these neoplasms with regard to their location, size, MR signal intensity, appearance after contrast enhancement, presence of cyst and necrosis, subarachnoid dissemination, and other associated findings. In 14 patients postoperative spine MR studies were evaluated for staging and therapeutic planning. RESULTS: The most frequent location of medulloblastoma was the inferior vermis and the mean tumor size was 4.1 x 3.6 x 3.9 cm. On Tl-weighted image, medulloblastomas generally had low to intermediate signal, predominantly hypointense relative to white matter. On T2-weighted image, medulloblastomas showed modetately high signal, hyperintense relative to white matter. Inhomogeneous contrast enhancement was demonstrated in 13 patients(72.2%) after injection of gadopentetate dimeglumine(Gadolinium). Cyst and necrosis within the tumor were visualized in 15 patients(83.3%). Subarachnoid disseminations of medulloblastomas were noted in 11 patients(61.1%), of which 6 demonstrated intracranial and 2 intraspinal dissemination. Three had both intracranial and intraspinal dissemination. In nine cases with intracranial lesions, there were intraparenchymal mass formation(7), subarachnoid nodules(5), infundibular lesions(2) and diffuse gyral enhancement(I). In five cases with intraspinal lesions, there were extramedullary intradural small nodules(3), central canal nodules(2), intradural masses(I)and fine nodular and sheet-like leptomeningeal enhancement(1). Other associated findings included intratumoral hemorrhage(11.1%), per/tumoral edema(44.4%), tonsillar herniation(44.4%), hydrocephalus(88.9%) and calcification(44.4%). CONCLUSION: Medulloblastomas revealed low to intermediate signal intensity on Tl-weighted image and intermediate to moderately high signal intensity on T2-weighted image, relative to cerebellar white matter. Medulloblastomas were solid tumors with cystic necrosis, which showed inhomogeneous enhancement and subarachnoid disseminations to the intracranial and intraspinal spaces after Gd-DTPA enhancement. Gd-enhanced MR of brain and spine was an useful diagnostic modality in preoperative diagnosis and in staging of postoperative cases of medulloblastomas, which was superior to postcontrast CT or precontrast MR.
Brain* ; Diagnosis ; Gadolinium DTPA ; Humans ; Male ; Medulloblastoma ; Necrosis ; Retrospective Studies ; Spine*

PURPOSE: The purpose of this study is to describe Magnetic Resonance(MR) findings of two epidural cavernous malformations of the spine. MATERIALS AND METHODS: MR imaging was performed in 2 patients(29-year-old man and 54-year-old woman). Sagittal T1 -, T2-weighted images and Gadolinium (Gd)-enhanced axial and sagittal images were acquired. Two patients had surgery and MR findings were compared with surgical and histopathological findings. RESULTS: MR imaging showed high- and low-signal intensity components of these lesions that were characteristic of an epidural cavernous malformation in one case. The other case showed a high signal intensity on T2- and strong enhancement on Gd-enhanced T1 -weighted images. We think that the former may be due to mixed subacute and chronic hemorrhage and the latter may be due to blood within the endotheliumlined sinusolds without hemorrhage. CONCLUSION: These findings were well correlated with the surgical and histo-pathological findings of cavernous malformation.
Gadolinium ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Middle Aged ; Spine*

Dental restorative materials must have the physical properties to withstand wear and corrosion. Base metal alloys possess better mechanical properties and lower price than the gold alloys. For these reason such alloys have largely replaced the precious metal alloys. One aspect to consider is the release of metal substances to oral environment. The release of elements from dental alloys is a continuing concern because the elements may have the potentially harmful biological effects on local tissue. The purpose of this study was to minimize metal release on the nonprecious metal surfaces by ion bea assisted deposition(IBAD) of titanium nitride (TiN). Ni-Cr-Be alloys with and without TiN coatings were secured in an wear test machine opposing ruby ball to determine their relative resistance to wear with 100m, 200m, 300m and 400m sliding distance. And the corrosion behavior of the Ni-Cr-Be alloys with and without TiN coating and 3 dental noble alloys have been studied. Potentiodynamic curves were used to analyse the corrosion characteristics of the alloys. The measurement of the released Ni and Ci ions was conducted by analysis of the electrolyte solution with atomic absorption spectroscopy. The results were as follows : 1. The critical sliding distance that wore down TiN coating of 2.5micrometer thickness in this study condition was 300m. 2. Ion beam assisted deposition of TiN showed a good surface modification with respect to the properties of wear and corrosion resistance. 3. X-ray diffraction showed that the strongest peak of TiN(111) in the coatings. 4. The release of Ni and Cr ions from alloys measured by means of atomic absorption spectroscopy was reduced by ion beam assisted deposition of TiN.
Absorption ; Alloys* ; Corrosion ; Dental Alloys ; Gold Alloys ; Ions ; Spectrum Analysis ; Tin* ; Titanium ; X-Ray Diffraction

PURPOSE: Pilocytic astrocytoma is a benign tumor predominantly arising from cerebellum in pediatric age. But it occasionally arises in supratentorium. We describe radiologic findings of supratentorial pilocytic astrocytoma. MATERIALS AND METHODS: Eleven CT and 7 MR examinations in 11 patients were retrospectively reviewed with attention to location, CT density, MR signal intensity, and degree and pattern of contrast enhancement on CT and MR. RESULTS: The tumors were located around the third ventricle (hypothalamus in three cases, optic chiasm in three cases) and in cerebral hemisphere (temporal lobe in three cases, frontal lobe in one case, thalamus in one case). On CT, the tumors were all sharply demarcated and rarely associated with edema. The tumors showed moderate to strong contrast enhancement. Necrosis appeared frequently in tumors around the third ventricle in contrast to frequent cyst formation in hemispheric masses. On MR, the tumors appeared hypo- or isointense on T1- weighted images and hyperintense on T2- weighted images. After administration of contrast agent, the tumors showed intense enhancement more than that of CT. CONCLUSION: The typical location and radiologic findings described above are helpful in the diagnosis of the supratentorial pilocytic astrocytoma.
Astrocytoma* ; Cerebellum ; Cerebrum ; Diagnosis ; Edema ; Frontal Lobe ; Humans ; Necrosis ; Optic Chiasm ; Retrospective Studies ; Thalamus ; Third Ventricle

BACKGROUND: To clarify the clinical significance of CEA and CA19-9 in patients with gastric cancer, we evaluated the correlation between tissue expression, the peripheral and the portal levels of these tumor markers, and ten clinicopathological factors, as well as the prognosis. METHODS: Surgical specimens from 40 patients with gastric cancer were examined by using immunohistochemical staining with anti-CEA and anti-CA19-9 monoclonal antibodies. Serum levels of CEA and CA19-9 in the portal and the peripheral blood were measured by using immunoradiometric assays. RESULTS: Positive values of the portal venous CEA were more common in patients with lymph-node metastasis, distant metastasis, and lymphatic invasion than in those without these factors. Curative surgery was performed in 50.5% of the patients with high portal CEA levels and in 90.6% of the patients with low portal CEA levels. Positive values of the peripheral venous CEA were significantly higher in cases with lymph-node metastasis. The positive rate of CA19-9 immunohistochemistry was significantly higher in patients with distant metastasis and in non-curative surgery. The positive rate of peripheral venous CA19-9 was higher in cases with distant metastasis. The three-year survival rate of patients with negative tissue CEA was significantly higher than that of patients with a positive result. The peripheral venous levels of CEA and CA19-9 reflected the portal venous levels accurately. CONCLUSIONS: These results suggest that immunohistochemical examination of CEA in patients with gastric cancer is useful for the evaluation of the biological aggressiveness and progression of the disease and can be used for making a prognosis.
Antibodies, Monoclonal ; Biomarkers, Tumor ; Humans ; Immunohistochemistry ; Immunoradiometric Assay ; Neoplasm Metastasis ; Prognosis ; Stomach Neoplasms* ; Survival Rate

In this study, we are to produce the single chain variable fragment (scFv) antibodies against surface protein of hepatitis B virus (HBV) using antibody phage display technique. Balb/c mice were immunized with preS1 and cDNAs of heavy and light chains of splenic B cells from immunized mice were prepared using RT-PCR. Two cDNAs were linked with (64S) linker DNA under recombination PCR to produce single chain Fv DNA. After digestion of scFv DNA with Sp 1 and Not 1, the digested DNA was ligated into pCANTAB 5E and electroporated into E. coli XL1-Blue to prepare scFv-library. The size of library was 1 * 10' pfu/ml. Phage antibodies (phabs) against preS1 were rescued with M13K07 helper phages, and preS1-binders were selected through 3 times of panning using 96 well microtitre plates. Phage antibody clones were assayed directly for the ability to bind preS1 by ELISA. And then 7 phage antibody clones had high ELISA signals against preS1. Phabs from preS1-specific pMsc-17 had the strongest ELISA signal to preS1. Phabs from pMsc-17 were used for Western blot to preS1 and the results revealed that it was specific to preS1. To prepare the soluble scFv antibody, phabs from pMsc-17 were transfected into non-suppressor E. coli HB2151, and grown under 1 mM IPTG. Soluble scFv antibody was mainly accumulated in the periplasmic space, but small amount of antibody was secreted into culture media.
Animals ; Antibodies ; B-Lymphocytes ; Bacteriophages* ; Blotting, Western ; Cell Surface Display Techniques ; Clone Cells ; Culture Media ; Digestion ; DNA ; DNA, Complementary ; Enzyme-Linked Immunosorbent Assay ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Isopropyl Thiogalactoside ; Mice* ; Periplasm ; Polymerase Chain Reaction ; Recombination, Genetic ; Single-Chain Antibodies*

Human monoclonal antibodies have considerable potential in the prophylaxis and treatment of viral disease. By cloning human Ig gene segments from the B cells of volunteer into pComb3 phagemid vector, antibody library was created of filamentous phage particles displaying Fab fragments on their surface after being rescued with M13KO7 helper phages. The size of library was 7x10' pfu. Phage antibodies (phabs) were panned against biotinylated preS1 using streptavidine coated Dynabead. The soluble Fab antibodies were prepared from phagemid colonies and assayed directly for the ability to bind preS1 by ELISA. And then 3DW and SGW specific to preS1 which have both heavy and light chain to form Fab fragment, were selected. The soluble Fab antibody from 3DW was expressed highly at the concentration of 0.1 - 1.0 mM of IPTG, and 5 hours postinduction. The soluble antibodies from 3DW and SGW showed their relative affinities of 2x10' M ', and Sx10 M ', respectively, and the specificities to preS1 on ELISA. Our results suggest that antibody phage display library is very useful method to generate the human monoclonal antibody and that the human Fab monoclonal antibodies specific to preS1 selected in this study open the way to treat hepatitis B as a component of passive irnmunotherapeutics.
Antibodies ; Antibodies, Monoclonal ; B-Lymphocytes ; Bacteriophages* ; Clone Cells ; Cloning, Organism ; Enzyme-Linked Immunosorbent Assay ; Genes, Immunoglobulin ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans* ; Immunoglobulin Fab Fragments ; Isopropyl Thiogalactoside ; Streptavidin ; Virus Diseases ; Volunteers

Localized pulmonary amyloidosis is a rare disease characterized by a deposition of amyloid limited to the lungs. We report a case of primary tracheobronchial amyloidosis which resulted in collapse of left lung and was confirmed by the Congo-red staining.
Amyloid ; Amyloidosis* ; Lung ; Rare Diseases