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

No abstract available.
Animals ; Dogs*

PURPOSE: Interleukin-12, produced by tissue macrophages and B lymphocytes, stimulates proliferation of Th1-type cells, while inhibiting the generation of Th2- type cytokines and IgE production. The mice were sensitized and challenged with ovalbumin as an allergen to study the effect of IL-12 on the immune responses and the pathologic findings in allergic rhinitis mouse model. METHODS: The animal models were divided into three groups according to the time point of IL-12 trestment intraperitoneally. We measured IL-4, IL-5, and IFN-gamma levels before and after IL-12 treatment. Also we examined the changes of histopathologic findings of mice nasal mucosa. RESULTS: 1) In allergic rhinitis mouse model sensitized and challenged with ovalbumin, IL-4 and IL-5 began to increase on 14 th day and then reached at peak. 2) In pathologic findings, the number of inflammatory cells were increased in the nasal mucosa of allergic rhinitis mice as control without IL-12 treatment, whereas significantly decreased in both IL-12 treated groups than the allergic rhinitis group. 3) The concentration of IL-4 and IL-5 were decreased and IFN-gamma was increased in both IL-12 treated groups than the allergic rhinitis group. And there were no differences of the concentraion of IL-4, IL-5, and IFN-gamma between two groups of mice trested with IL-12 in early and late sensitizing phase. CONCLUSION: These results suggested that both early and late IL-12 treatment inhibited the infiltration of inflammatory cells in nasal mucosa and decreased IL-4 and IL-5 production. Early IL-12 treatment could enhance the allergn specific Th1 immune reactions and late IL-12 treatment could convert Th2 cells to Th1 cells. Finally IL-12 could be applied as an allergen specific immune therapy for allergic rhinitis.
Animals ; B-Lymphocytes ; Cytokines ; Immunoglobulin E ; Interleukin-12* ; Interleukin-4 ; Interleukin-5 ; Macrophages ; Mice* ; Models, Animal ; Nasal Mucosa ; Ovalbumin ; Rhinitis* ; Th1 Cells ; Th2 Cells

BACKGROUND: Chronic cough is a common symptom that requires the systematic diagnostic approach for proper evaluation. Postnasal drip syndrome(PNDS), bronchial asthma, gastroesophageal reflux disease(GERD), and chronic bronchitis are among the common causes. This study was conducted to evaluate the spectrum and the frequency of the causes of chronic cough. METHODS: We prospectively evaluated 93 patients who had chronic cough despite normal chest radiographic finding. History and physical examination were done along with paranasal sinus radiograph, spirometry, bronchoprovocation test and 24-hours' ambulatory aesophageal pH monitoring as necessary. RESULTS: Forty-nine(52%) of the 93 patients had PNDS, 15 patients(16%) bronchitis, 10 patients(11%) asthma, 4 patients(4%) GERD, 7 patients(8%) both PNDS and asthma, 4 patients(4%) undiagnosed condition and 4 patients(4%) were taking ACE inhibitor. Sixty-nine percent of the patients with PNDS improved after follow up, 73% patients with bronchitis, 80% patients with asthma, 50% patients with GERD, 100% patients with both PNDS and asthma, and 100% patients with ACE inhibitor. CONCLUSION: PNDS was the most common causes of chronic cough. Bronchitis was the second and asthma the third in frequency. The etiology of chronic cough can be determined easily by history and physical examination, successful therapy initiated in most patients. The response to specific therapy also was important in evaluation of chronic cough.
Asthma ; Bronchitis ; Bronchitis, Chronic ; Cough* ; Diagnosis ; Follow-Up Studies ; Gastroesophageal Reflux ; Humans ; Hydrogen-Ion Concentration ; Physical Examination ; Prospective Studies ; Radiography, Thoracic ; Spirometry

BACKGROUND: Chronic cough is a common symptom that requires the systematic diagnostic approach for proper evaluation. Postnasal drip syndrome(PNDS), bronchial asthma, gastroesophageal reflux disease(GERD), and chronic bronchitis are among the common causes. This study was conducted to evaluate the spectrum and the frequency of the causes of chronic cough. METHODS: We prospectively evaluated 93 patients who had chronic cough despite normal chest radiographic finding. History and physical examination were done along with paranasal sinus radiograph, spirometry, bronchoprovocation test and 24-hours' ambulatory aesophageal pH monitoring as necessary. RESULTS: Forty-nine(52%) of the 93 patients had PNDS, 15 patients(16%) bronchitis, 10 patients(11%) asthma, 4 patients(4%) GERD, 7 patients(8%) both PNDS and asthma, 4 patients(4%) undiagnosed condition and 4 patients(4%) were taking ACE inhibitor. Sixty-nine percent of the patients with PNDS improved after follow up, 73% patients with bronchitis, 80% patients with asthma, 50% patients with GERD, 100% patients with both PNDS and asthma, and 100% patients with ACE inhibitor. CONCLUSION: PNDS was the most common causes of chronic cough. Bronchitis was the second and asthma the third in frequency. The etiology of chronic cough can be determined easily by history and physical examination, successful therapy initiated in most patients. The response to specific therapy also was important in evaluation of chronic cough.
Asthma ; Bronchitis ; Bronchitis, Chronic ; Cough* ; Diagnosis ; Follow-Up Studies ; Gastroesophageal Reflux ; Humans ; Hydrogen-Ion Concentration ; Physical Examination ; Prospective Studies ; Radiography, Thoracic ; Spirometry

STATEMENT OF PROBLEM: Porcelain veneers have become a popular treatment modality for aesthetic anterior prosthesis. Fitting porcelain veneers in the mouth usually involve a try-in appointment, which frequently results in salivary contamination of fitting surfaces. PURPOSE: An in vitro study was carried out to investigate the effect of silane treatment timing and saliva contamination on the resin bond strength to porcelain veneer surface. MATERIAL AND METHODS: Cylindrical test specimens (n = 360) and rectangular test specimens (n = 5) were prepared for shear bond test and contact angle analysis. Whole cylindrical specimens divided into 20 groups, each of which received a different surface treatment and/or storage condition. The composite resin cement stubs were light-polymerized onto porcelain adherends. The shear bond strengths of cemented stubs were measured after dry storage and thermocycling (3,000 cycles) between 5 and 55 degrees C. The silane and their reactions were chemically monitored by using Fourier Transform Infrared Spectroscopy analysis (FTIR) and contact angle analysis. One-way analysis of variance (ANOVA) and Dunnett' multiple comparison were used to analyze the data. RESULTS: FT-IR analysis showed that salivary contamination and silane treatment timing did not affect the surface interactions of silane. Observed water contact angles were lower on the saliva contaminated porcelain surface and the addition of 37 percent phosphoric acid for 20 seconds on saliva contaminated porcelain increased the degree of contact angle. Silane applied to the porcelain, a few days before cementation, resulted in increasing the bond strength after thermocycling. CONCLUSION: Within the limitation of this study, it can be concluded that it would be better to protect porcelain prosthesis before saliva contamination with silane treatment and to clean the contaminated surface by use of phosphoric acid.
Cementation ; Dental Porcelain ; Mouth ; Phosphoric Acids ; Prostheses and Implants ; Resin Cements ; Saliva ; Spectroscopy, Fourier Transform Infrared ; Water

The pancreatobiliary ductal system is one of the most frequent areas of anatomic variations. Rcently despite the improvement in diagnosis and management of pancreatobiliary lesion, a lack of s more through knowledge and understanding of these variations is undoubtedly reaponsible for many problems of medical and surgical management. Especially, drainage of the common bile duct and the pancreatic duct at sites other than the second portion of the duodenum is an anotomical curiosity. We report two cases of anomalous termination of the common bile duct and the pancreatic duct into the duodenal bulb diagnosed by ERCP and Gastroscopy.
Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Diagnosis ; Drainage ; Duodenum ; Exploratory Behavior ; Gastroscopy ; Pancreatic Ducts*

BACKGROUND: A few reports of transudative malignant effusion on a small number of patients have suggested the need to perform routine cytologic examination in all cases of transudative pleural effusion, whether encountered for malignancy or not. The purpose of this study was to investigate whether cytologic examination should be performed in all cases of transudative pleural effusion for the diagnosis of malignancy. METHODS: We performed a retrospective study of 229 consecutive patients with malignant pleural effusion, proven either cytologically or with biopsy. In patients with transudative pleural effusion, we reviewed medical records, results of transthoracic echocardiography, fiberoptic bronchoscopy, chest X-ray, chest CT scan, and ultrasonogram of the abdomen. These data were examined with particular attention to identifying whether or not the malignancy was suggested on chest X-ray, examining the involvement of the superior vena cava, great vessels, and lymph nodes, determining the presence of pericardial effusion, and observing the endobronchial obstruction. RESULTS: Transudative malignant pleural effusion was observed in seven (3.1%) of the 229 patients, and was caused either by the malignancy itself (6 patients) or by coexisting cardiac diseases (1 patient). All the patients showed evidence suggesting the presence of malignancy at the time of initial thoracentesis, which facilitated the decision of most clinicians on whether to perform cytologic examination for the diagnosis of malignancy. CONCLUSION: Therefore, in all cases of transudative pleaural effusion, no clinical implications indicating malignancy were found on cytologic examination.
Biopsy ; Carcinoma/classification/*pathology/*secondary ; Exudates and Transudates ; Human ; Lung Neoplasms/*pathology ; Lymphatic Metastasis ; Neoplasm Staging ; Neoplasms, Unknown Primary/*pathology ; Pleural Effusion, Malignant/metabolism/*pathology ; Retrospective Studies ; Support, Non-U.S. Gov't

BACKGROUND: Immediate early gene (IEG) is supposed to be linked in the continuous seizure induced long-term changes of specific neurons. We tried to investigate the effects of focal interictal epileptiform discharges on the c-JUN expression in the rat brain which is not clearly understood. METHODS:Epidural electrodes were placed on a male Sprague-Dawley weighing 150~230 g and benzathine penicillin (Pc) was applied cortically. After focal interictal epileptiform discharges were successfully identified, EEG was recorded regularly. Cardiac perfusion and extraction of the brain was done at 2, 4, 24 hours and 1 week after the Pc application. Sixteen rats were evenly distributed into 4 groups. Immunocytochemical staining with specific antisera (Santa Cruz) was performed. RESULTS: The epileptiform discharges were induced within an hour after topical Pc applications. At 2 hours after Pc application, c-JUN was moderately expressed in the dentate gyrus (DG) and weakly expressed in the CA3 pyramidal cell, amygdala, pyriform cortex, thalamus, and neocortex. At 4 hours, c-JUN was minimally expressed in DG and other regions. Whereas, at 24 hours, c-JUN was maximally expressed in the DG and also in the CA3 pyramidal cell, amygdala, pyriform cortex, thalamus, and neocortex. One week after Pc application, c-JUN was moderately expressed in the DG and weakly expressed in the CA3 pyramidal cell, amygdala, pyriform cortex, and neocortex. CONCLUSIONS: This data showed that even focal interictal epileptic activity can induce IEG encoded c-JUN protein in the specific distant brain regions of a rat until a late period and the expression pattern showed a synchronous and bimodal pattern.
Amygdala ; Animals ; Brain* ; Dentate Gyrus ; Electrodes ; Electroencephalography ; Humans ; Immune Sera ; Male ; Neocortex ; Neurons ; Penicillin G ; Penicillin G Benzathine ; Perfusion ; Pyramidal Cells ; Rats* ; Rats, Sprague-Dawley ; Seizures ; Thalamus

Common variable immune deficiency (CVID) is the most common primary immune deficiency, which is manifested as chronic recurrent respiratory infections and hypoglobulinemia. CVID usually presents in the second or third decade of life. A 33-year-old woman was admitted with recurrent pneumococcal pneumonia with bacteremia and had very low levels of serum immunoglobulin G, M and A. This case emphasized a high index of suspiciousness for diagnosis of CVID in a mid-adulthood patient presenting with recurrent pneumonia with hypoglobulinemia.
Adult ; B-Lymphocytes ; Bacteremia ; Common Variable Immunodeficiency ; Female ; Humans ; Immunoglobulin G ; Pneumonia ; Pneumonia, Pneumococcal ; Respiratory Tract Infections