PURPOSE: To determin whether radiographic assessment of patella position abnormalities (such as patella altaor baja) using the 'patellar tendon : patella ratio' (Insall & Salvati's method) can be applied to flexion andextension sagittal MR images of the knee MATERIALS AND METHODS: Both flexion (55-90 degrees, mean 62 degrees) and extensionT2-weighted sagittal images of 58 knees (54 patients;age:19-72 years:M:F=40:18 were obtained and reviewed by meansof routine lateral radiographs (flexion of knees:30-60 degrees). Patellar tendon and diagonal length were measured onroutine radiographs and on flexion and extension MR images;length was measured by sagittal T2-weighted MR imagingfrom the inner aspect of patellar insertion to the inner asspect of tibial insertion, an approach whichdemonstrated the even thickness of the patellar tendon and the greastest diameter of the patella. Usingcorrelation analysis, the ratio of patellar tendon to diagonal length was compared between examination methods andbetween the non-wavy and wavy forms of patellar tendon. RESULTS: The mean length of the respectirely, 'patella,patellar tendon and patellar tendon to patella ratio' were 4.15+/-0.38, 4.04+/-0.49 and 0.9+/-0.12, respectively, onroutine radiographs; 4.32+/-0.36, 3.8+/-0.47 and 0.89+/- 0.12, respectively, on flexion MR images;and 4.3+/-0.36,3.93+/-0.44 and 0.92+/-0.12, respectively on extension MR images. Between these three different modes of assessment,a high degree of correlation of mean patella length (r=0.89-0.92) and of mean patellar tendon length (r=0.71=0.85)were found. In addition, correlation of 'patella to patellar tendon ratios' was excellent : radiographs andflexion MRimages(r=0.76);radiographs and extension MR images(r=0.76);flexion and extension MR images(r=0.84).According to the form of patellar tendon, radiographs correlated better with extension MR images (r-0.71) thanwith flexion images (r=0.62) in the non-wavy form of patellar tendon, whereas in the wavy form, correlation withflexion images (r=0.83) was better than with extension images(r=0.78). CONCLUSION: MR asessment of 'patellartendon to patella ratio's correlated well with radiographic assessment, and the latter can therefore be used forthe evaluation of abnormal patellar position. Radiographs correlated better with extension MR images in thenon-wavy form of patellar tendon, whereas in the wavy form, correlation with flexion images was better.
Knee ; Magnetic Resonance Imaging* ; Patella* ; Patellar Ligament* ; Tendons

No abstract available.
Bandages* ; Gentian Violet* ; Gentiana* ; Methicillin-Resistant Staphylococcus aureus* ; Wounds and Injuries*

To investigate frequency of painful and/or silent myocardial ischemia(SMI) determined by ECG ST-segment depression(more than 1.0mm depression for 0.08 second after J point over 60 seconds) during unrestricted daily activities, 24-hour dynamic ECG was performed in 19 patients(11 males, 8 females) with chronic stable angina pectoris, aged 57.4 years(44 to 73 years). During 456 hours of recording, there were 154 episodes of SMI. Of these, 139 episodes(90.3%) were silent and 15 episodes(9.7%) accompaned chest pain. The higher incidence of SMI than previously published data is probably influenced by 1 patient who disclosed 56 episodes (excluding this, SMI 84.7%). Sixty one percent of episodes of SMI occurred during light activities such as slow walk, hand labor, eating or at rest(sitting at ease), smoking and sleep, and 39% during more strenuous activites such as walk, climbing stairs and physical exercise. In contrast, most of the painful myocardial ischemia(PMI) developed during climbing stairs, walk and physical exercise. Heart rate during episodes of SMI varied ranging from 85.2+/-13.7/min at rest to 115.5+/-19.2/ min druing climbing stairs. Mean ST-segment depressions during episodes of SMI and PMI were 2.0(1.0-4.0)mm and 2.6(1.2-7.0)mm, respectively, in 6 patients who disclosed both SMI and PMI on 24-hour ECG recordings. However, frequency of ischemic episodes was higher(9.0 vs 2.5/day) and duration was longer(13.8min vs 3.0min) in SMI. These findings indicate that transient SMI in patients with chronic stable angina pectoris occurs more frequently than painful myocardial ischemia. In addition, SMI develops during activities that increase heart rate(increased O2 demand) as well as during activites that do not increase heart rate(decreased O2 supply). Therefore, both O2 demand and supply mechanisms may be involved in the pathogenesis of transient SMI in Patients with chronic stable angina pectoris.
Angina, Stable* ; Chest Pain ; Depression ; Eating ; Electrocardiography ; Exercise ; Hand ; Heart ; Heart Rate ; Humans ; Incidence ; Male ; Myocardial Ischemia* ; Smoke ; Smoking

Eighteen cases of double outlet right ventricle were observed during past six years at the department of pediatrics, Seoul National University Hospital. 1. Therw were 13males and 5 females. Sex ratio showed male predominance with the ratio of 2, 6:1. 2. According to the Sondheimer's classification, 6 cases were in group l, none in group ll, 10cases in group lll and 2 cases in group lV. 3. Presenting symtoms and signs were cyanosis(18/18), dyspnea(17/18), growth retardtion(10/18), and cyanotic spell(6/18). 4. The range of hemoglonin concentration was 14 to 21 gm%(mean 18.2gm%). Simple chest X-ray showed cardiomegaly in 10 patients. On routine ECG examination, RVH were noted in all 18 cases. 5. In group l patients, mean oxygen saturation of the aorta was 74.5%, mean oxygen saturation of the pulmonary artery was 86.7%. But on group lll, the results were variable. And in guoup lV, oxygen saturation difference were negligible in both great arteries. 6. Pulmonic outflow obstruction were noted in 12 cases in which 8 cases were combined type. 7. Operation was done in 8 cases. Out of the 6 cases who were receive corrective surgery, 3 cases died of the right heart failure. 8. Associated anomalies were as follows : bilateral SVC in 6 cases, PDA in 5 cases, ASD in 4 cases and dextrocardia in 4 cases.
Aorta ; Arteries ; Cardiomegaly ; Classification ; Dextrocardia ; Double Outlet Right Ventricle* ; Electrocardiography ; Female ; Heart Failure ; Humans ; Male ; Oxygen ; Pediatrics ; Pulmonary Artery ; Seoul ; Sex Ratio ; Thorax

No abstract available.
Humans ; Pericardial Effusion* ; Rheumatic Fever*

The ankle is an important joint supporting the entire musculoskeletal system during standing and walking. Current opinion has emphasized necessity of anatomical reduction and rigid internal fixation for a displaced or unstable fracture of the ankle. The purpose of this study was to evaluate the correlation of the adequate surgical operative methods and postoperative care with prognosis. The authors analysed 104 cases of ankle fracture, treated operatively in Department of Orthopedic Surgery of Dae-Han Hospital from January 1991 to December 1994, followed up more than one year. The results were as follows: 1. According to the classification of Lauge-Hansen and Danis-Weber, the most common type was supination-external rotation and type B, respectively. 2. The most common cause of injury was slip down and the others were traffic accident, fall down and direct trauma. 3. According to the criteria of Meyer, the result of treatment was good or excellent in 94 cases (90.4%) radiologically and in 91 cases (87.5%) clinically. 4. The complications were 5 cases of traumatic arthritis, 3 cases of malunion, 2 cases of non-union and 1 case of infection. 5. The early ROM exercise after accurate reduction and rigid internal fixation was very important in treatment of fracture of the ankle.
Accidents, Traffic ; Ankle Fractures ; Ankle* ; Arthritis ; Classification ; Joints ; Musculoskeletal System ; Orthopedics ; Postoperative Care ; Prognosis ; Walking

Treatment modalities for herniated lumbar intervertebral disc are the conservative method, chemonucleolysis, percutaneous diskectomy and operation. Conservative treatment is effective in 70–80% of the acute stage and the other 20% requires chemonucleolysis, percutaneous diskectomy or operation. Indications for operation are cases not improved after conservative treatment, recurrent cases and cauda equina syndrome. Mixter and Barr(1934) demonstrated that laminectomy and surgical removal of disc material could relieve symptoms, but spinal segmental instability, incomplete removal of the disc and postoperative adhesion of the nerve root caused low back pain after long-term follow up. Thus, the authors evaluated the plain X-ray and computed tomographic findings in 21 cases of failed laminectomy to determine the cause of failure. The results were as follows ; 1. Among 21 cases, 18 cases complained of low back pain with sciatica and 3 cases complained of low back pain. 2. In all cases, disc space narrowing was detected on plain X-ray. Total laminectomy and diskectomy promote insufficiency and instability of the lumbar and lumbosacral spine. Whenever one attempts to do total laminectomy and diskectomy, it is recommended that spine fusion be performed in same operating field. 3. Several findings were detected on CT scan : 8 disc protrusions in the operation site, 6 disc protrusions in the operation site and spinal stenosis, 4 extradural scars, 1 extradural scar and other site disc protrusion and 2 cases of spinal stenosis and spondyloisthesis. 4. Computed tomography in cases of failed laminectomy offers more information than has been available by any other imaging method.
Cicatrix ; Diskectomy ; Diskectomy, Percutaneous ; Follow-Up Studies ; Intervertebral Disc ; Intervertebral Disc Chemolysis ; Laminectomy ; Low Back Pain ; Methods ; Polyradiculopathy ; Sciatica ; Spinal Stenosis ; Spine ; Tomography, X-Ray Computed

No abstract available.
Infarction*

The current paradigm holds that ulcerative colitis occurs in genetically predisposed individuals because of dysregulated immune responses against intraluminal bacterial antigens. Recently, numerous new genes have been identified as involved in the genetic susceptibility to ulcerative colitis, including IL-23R, MST1, IL-12B (p40), NKX2-3, and STAT3. Experimental studies of ulcerative colitis point to an excessive T-cell response to antigenic stimulus resulting in damage to host intestinal tissue. The T-cell response in ulcerative colitis appears to be TH2 dominant (IL-5, IL-13) and mediated by specialized cells, such as NK T-cells. The characterization of these novel genes and immunologic basis should lead to the identification of therapeutic agents and a better clinical assessment of phenotype and prognosis in patients with ulcerative colitis.
Antigens, Bacterial ; Colitis, Ulcerative ; Genetic Predisposition to Disease ; Humans ; Phenotype ; Prognosis ; T-Lymphocytes ; Ulcer

No abstract availble.
Aged ; Chronic Disease ; Colonoscopy ; *Enema ; Female ; Humans ; Proctitis/*drug therapy/pathology ; Radiation Injuries/*drug therapy/pathology ; Sucralfate/*administration & dosage