PURPOSE: The objective of the study was to evaluate the characteristic findings in tears of the anterior cruciate ligament(ACL) and associated injury at MR imaging. MATERIALS AND METHODS: We reviewed the findings of MR images and the corresponding arthroscopic results of 32 patients with ACL tears. we evaluated the signal intensity and contour of ACL surrounding bony structures, menisci and associated injury of the knee joint. RESULTS: Complete ACL tears were present in 25 patients and partial ACL tears were in 7 patients. Complete ACL tears showed heterogenously increased signal intensity with contour bulging of the ACL in 14 patients (56%) and without bulging or absence in 11 patients(44%). Most patients torn ACL with contour bulging(12/14) had bone bruise, but only one patient torn ACL without bulging contour had bone bruise. ACL with thin continuous low signal band surrounding heterogenously increased signal intensity suggests partial tear, which was seen in three patients of seven proved partial ACL tears. Combined bone injury in ACL tear were in 23 patients (73%) and most of these(22/23) were at midportion of lateral notch of femur and/or posterior portion of lateral tibial plateu. Deepening of lateral notch of femur were noted in 17 patients(53%). Associated injuries of the other ligaments of knee joint were buckling of the posterior cruciate ligament(16/32, 50%) and tears of the medial collateral ligament(11/32, 34%). Posterior horns of menisci were more frequent site of combined injury within menisci in patients with ACL tear. CONCLUSION: Acute tearing of ACL in MRI is seen as heterogenously increased signal intensity with contour bulging of ACL and combined bone bruises. Patients with torn ACL frequently have various combined injury. In patient with knee injury, these associated or ancillary findings suggest that ACL tear is present.
Animals ; Anterior Cruciate Ligament* ; Contusions ; Femur ; Horns ; Humans ; Knee Injuries ; Knee Joint* ; Knee* ; Ligaments ; Magnetic Resonance Imaging*

PURPOSE: To evaluate the sensitivity of MR imaging in determining tear sites and degrees in acute anterior cruciate ligament tear. MATERIALS AND METHODS: MR imagings were undertaken in 19 patients who had trauma on their knee joints. All imaging studies were performed within 2 weeks after trauma and compared with operative findings. The degrees of ligament tear were divided into complete and incomplete, and sites of tears were divided into superior middle and inferior portions. MR findings were compared with operative findings. RESULTS: There were 14 cases of complete ligament tear and 5 cases of partial ligament tear. We could diagnose correctly in all 14 cases with complete tear and in 3 of 5 cases with partial tear. The tear sites were correctly predicted in 10 of 14 cases with complete tear(71%) and 1 of 5 cases with par In complete tears, MR findings were transversely or obliquely coursed band-like high signal intensity within the ACL or abrupt Switch over to as indistinct signal intensity. In partial tears, the tear sites could not be evaluated mostly and the tear appeared as linear low signal intensity lesions in posterolateral bundles of AC/. CONCLUSIONS: MR revealed higher sensitivity in determining the degree and sites of ACL tear in complete tear as compared with partial tear.
Anterior Cruciate Ligament ; Humans ; Knee Joint ; Ligaments ; Magnetic Resonance Imaging*

The morpologic change in the lens epithelial cell, which is metabolically the most active part of the lens, are closely related with the formation of the cataract. To evaluate the morphologic changes of lens epithelial cells in electric cataracts, the central 5-6mm of anterior lens capsule and adherent lens epithelial cells were obtained from patients with an electric cataract. One-half of the anterior lens capsule was examined with a light microscope using flat preparation, while the other half was examined with a transmission electron microscope. In the light microscopic findings, the lens epithelial cell, which has a hexagonal shape with monolayer in normal, lost its normal shape and was superimposed in pathologic areas. The electron microscopic findings showed that the number of mitochondria in the cytoplasm was increased. The rough endoplasmic reticulum in the cytoplasm was dilated and microfilaments were enriched. The dense bodies seen in the myofibrotic changes were observed lens capsule were also shown. The intracelluar vacuoles were seen in dying cells and growing of the cytoplasmic processes into the widened intercellular spaces were observed The authors recognized that the abnormal lens epithelial cells had altered cellular activity and that the cells in the patholoic areas had proliferated and degenerated.
Actin Cytoskeleton ; Cataract* ; Cytoplasm ; Endoplasmic Reticulum, Rough ; Epithelial Cells ; Epithelium* ; Extracellular Space ; Humans ; Mitochondria ; Vacuoles

Pigmented villonodular synovitis and synovial chondromatosis are known as a poup of interrelated tumorous disorders that involve the lining of the joints, hursa and tendon sheath. Pigmented villonodular synovitis consists of proliferatin synovia1 tissue containing histiocytes, librohlasts, multinucleated giant cells, and capillaries that can destroy dense fihrous tissue, form soft tissue masses, and invade bone. Synovial chondromatosis consists of hyaline cartilage nodules within the synovium and synovial joint cavities, develop multiple loose fragments of cartilage within the joint. They may represent a reactive inflammatory process or henign neoplasm and usually occur in latge synovial joints, including the knee, hip and ankle. There are some reports stating that pigmented villonodular synovitis has coexisted with synovial chondromatosis. but none have reported that they occurred simultaneously in a large single joint. This is a report on a diagnosed and arthroscopicully treated pigmented villonodular synovitis and synovial chondromatosis that occurred simultaneously in the same ankle joint.
Ankle Joint* ; Ankle* ; Capillaries ; Cartilage ; Chondromatosis, Synovial* ; Giant Cells ; Hip ; Histiocytes ; Hyaline Cartilage ; Joints ; Knee ; Synovial Membrane ; Synovitis, Pigmented Villonodular* ; Tendons

The incidence of synchronous gastric cancer is variously reported to be 2.07%, 5.22%, 6.5%, 8.6%, or 9% and has been increasing recently, probably with advance in the diagnosis of gastric cancer. Our case in presentation is a 70-year-old male patient who had total gastrectomy and esopbagiojunostomy done for synchronous four gastric cancer. Each has different histologic types, Some of these lesions are not suspected before operation and are found almost by chance during histologic examinations after surgery performed only to remove main lesion. So we report this case with a review of literatures.
Aged ; Diagnosis ; Gastrectomy ; Humans ; Incidence ; Male ; Stomach Neoplasms*

Surgical treatment have been gold standard in most cases of ureteral stricture and it`s effects were not satisfactory. Recently nonoperative dilatation offer attractive alternatives to surgery in the treatment of urodynamically significant ureteral strictures. Wide spread acceptance of balloon and other catheter techniques in dilating stenotic blood vessels, biliary tree and urinary tract led us to try these modalities for the treatment of ureteral strictures. So we tried percutaneous balloon dilatation in 5 failed retrograde ureteral dilatation cases. 4 tuberculous ureteritis and 1 postureterolithotomy state. We used the balloon catheter with techniques of percutaneous transluminal manipulation for dilatation of the ureteral stricture under fluoroscopic guidance. The results of dilatation were successful in 4 cases and failed in 1 tuberculous ureteral stricture. In successfu1 4 cases, there was no evidence of symptomatic and radiologic recurrence for 7 to 29 months of follow up period. The percutaneous balloon dilatation can be useful in case of alternative to surgery and failed retrograde balloon dilatation.
Biliary Tract ; Blood Vessels ; Catheters ; Constriction, Pathologic* ; Dilatation* ; Follow-Up Studies ; Recurrence ; Ureter* ; Urinary Tract

Autologous Transfusion, storage of one's own blood for subsequent infusion if needed, is safe and effective in a variety of scheduled operative procedures. Obstetric involvement in such programs in very limited, however, because of concern over the possibility of inducing premature labor or causing fetal distress by blood volume change or vasovagal reactions. We describe our experience with pregnant women in this program. The incidence of vagovagal reactions of autologous donation was 9.5% (2.21). After entry into this program, 17pastients received a total 37pints, which consist of 19 Autologous and 18 Homologous. Homologous transfusion was avoided in 30% of patients receiving blood. The values of the mean hematocrits before and after hpebotomy were 34.1% and 31.8% respectively. It was stastically significant (p<0.01). We recommended that autologous blood donation by pregnant women in third trimester is safe for mothers or infants and it should be strongly encouraged for patient with placenta previa and repeated cesarean section.
Blood Donors ; Blood Volume ; Cesarean Section ; Female ; Fetal Distress ; Hematocrit ; Hemorrhage* ; Humans ; Incidence ; Infant ; Mothers ; Obstetric Labor, Premature ; Placenta Previa ; Pregnancy ; Pregnancy Trimester, Third ; Pregnant Women* ; Surgical Procedures, Operative

Since Paget`s first description in 1874 of what is presently known as Paget`s disease of the nipple, similar lesions have been reported rarely on the penis and scrotum, vulva, perineum, axilla and the eyelids. Because it is often associated with a subjacent or visceral malignancy and recurrence, extramammary Paget`s disease(EPD) is considered as malignant condition. This case report describes two patients with extramammary Paget`s disease of the penoscrotal area. One of them had renal cell carcinoma in left kidney and was managed by radical nephrectomy. Treatments for EPD were initiated by CO2 laser 3 or 4 times, but failed and then we excised the lesion widely and closed primarily with split thickness skin graft in one of the cases.
Axilla ; Carcinoma, Renal Cell ; Eyelids ; Humans ; Kidney ; Lasers, Gas ; Male ; Nephrectomy ; Nipples ; Penis ; Perineum ; Recurrence ; Scrotum ; Skin ; Transplants ; Vulva

PURPOSE: Kawasaki disease is the most common cause of systemic vasculitis in children less than 5 years of age. Recent immunohistochemistry findings suggest that many vascular growth factors play a role in the formation of the coronary artery lesions. Active remodeling of the coronary artery lesions in Kawasaki disease continues in the form of intimal proliferation and neoangiogenesis for several years after the onset of the disease. Intravenous immunoglobulin (IVIG) and corticosteroid have been used in the treatment of Kawasaki disease but the exact mechanism is not clear. We have investigated that IVIG and corticosteroid inhibited vascular endothelial growth factor (VEGF)- induced tube formation of endothelial cells in vitro on Matrigel assay. METHODS: Human umbilical vein endothelial cells (HUVECs) were cultured and seeded on Matrigel coated 24 well plates in medium with or without the following agents: VEGF, VEGF plus IVIG, VEGF plus VEGF antibody, VEGF plus methylprednisolone, VEGF, IVIG plus methylprednisolone for 18 hours. The total length of tube structures in each photograph was quantified. RESULTS: IVIG significantly inhibited the proliferation of HUVECs. The inhibitory effect of IVIG was also reversible. In the meantime, VEGF induced the differentiation of HUVECs into capillary like structures on Matrigel, which was inhibited by VEGF antibody in a dose-dependent manner. Interestingly, IVIG and methylprednisolone inhibited VEGF-induced tube formation of HUVECs. IVIG was more effective in inhibition than methylprednisolone alone. CONCLUSION: We revealed that VEGF induced the differentiation of HUVECs and this effect was inhibited by IVIG and methylprednisolone.
Capillaries ; Child ; Coronary Vessels ; Endothelial Cells* ; Human Umbilical Vein Endothelial Cells ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; Methylprednisolone* ; Mucocutaneous Lymph Node Syndrome ; Systemic Vasculitis ; Vascular Endothelial Growth Factor A

PURPOSE: Respiratory syncytial virus (RSV) which is the most common cause of bronchiolitis in infants is an important triggering factor of asthma exacerbation in children. This virus stimulates chemokine such as regulated on activation normal T-cell expressed and secreted (RANTES) production by human airway epithelial cells in vitro. Corticosteroids are effective medications for prevention of asthma exacerbation. We examined whether the inhibitory effect of corticosteroid on RANTES production in human bronchial epithelial cells (BEAS-2B) infected with RSV varies according to the kinds of corticosteroids and the timing of corticosteroid treatment in vitro. METHODS: In the pretreatment group, BEAS-2B cells were pretreated with budesonide (BUD), fluticasone propionate (FP), or methylprednisolone (MP), and then the cells were infected with RSV. The supernatants of the cell culture were collected after virus infection. In the posttreatment group, BEAS-2B cells were infected with RSV, and then treated with corticosteroid, and the supernatants of the cell culture were collected. RANTES levels in each of the collected supernatant were determined. RESULTS: In the pretreatment group, the strength of each corticosteroid's inhibitory effect on RANTES product was not significantly different. In the posttreatment group, the strength of the inhibitory effect on the production of RANTES was in the order of BUD> MP=FP. BUD have more inhibitory effect on RANTES production at posttreatment group. CONCLUSION: The inhibitory effect of corticosteroid on the production of RANTES in BEAS-2B cells infected with RSV varied widely according to the kinds of corticosteroids and the timing of the corticosteroid treatment.
Adrenal Cortex Hormones* ; Asthma ; Bronchiolitis ; Budesonide ; Cell Culture Techniques ; Chemokine CCL5* ; Child ; Diethylpropion ; Epithelial Cells* ; Humans* ; Infant ; Methylprednisolone ; Respiratory Syncytial Viruses* ; T-Lymphocytes ; Fluticasone