Recently, devices using radiofrequency energy have been developed for arthroscopic soft tissue ablation and shrinkage. The purpose of this study was to evaluate effect of radiofrequency energy on the biomechanical competence of thermal shrinkage of anterior cruciate ligament and was to demonstrate a new approach for radiofrequency energy, applying to ligamentous tissue in a dynamic fashion. Twelve New Zealand White rabbits, were divided into two experimental groups by right and left hindlimbs. Thermal shrinkage of the anterior cruciate ligament of rabbits produced using radiofrequency energy generator(N=12, group I). And untreated control group(N=12, group II). The percent shrinkage was calculated from the change of length of anterior cruciate ligament after radiofrequency energyinduced thermal shrinkage. The maximal tensile stress and linear stiffness of anterior cruciate ligament as biomechanical competence were assessed. The results obtained were as follows: 1. In the group I the percentage of shrinkage was 29.50Fo on the average. 2. The average of maximal tensile stress to failure was 271.24 kN in group I and 283.50 kN in group II. There was no significant difference(p=0.24) in the maximal tensile stress between two groups. 3. The average of linear stiffness in group I(179.16kN/mm) was higher than that of group II(148.20kN/mm). But there was no significant difference(p=0.078) between two groups. This study shows that radiofrequency energy appears to be safe to use on therma1 shrinkage of anterior cruciate ligament, which necessitate a mechanical tensile strength.
Animals ; Anterior Cruciate Ligament* ; Hindlimb ; Ligaments ; Mental Competency ; Rabbits ; Tensile Strength

OBJECTIVES: To assess innate and humoral immune responses in middle ear effusion of obese pediatric patients with otitis media with effusion (OME). METHODS: We evaluated 219 children with OME, of whom 21 were obese and 198 were non-obese. We compared the expression in middle ear effusion of mRNAs encoding toll-like receptors (TLR) 2, 4, 5, and 9; nucleotide-binding oligomerization domains (NOD) 1 and 2; retinoic acid-inducible gene (RIG)-I; interleukins (IL)-6, -10, and -12; interferon (IFN)-gamma; and tumor necrosis factor (TNF)-alpha mRNAs. We also compared the expression of immunoglobulins IgG, IgA, and IgM and the bacterial detection rate in the two groups. RESULTS: TLR2-mediated expression of IL-6 mRNA, TLR4-mediated expression of IL-6 and IL-10 mRNA, TLR5-mediated expression of IL-6, IL-10, and TNF-alpha mRNA, TLR9-mediated expression of IL-6 mRNA, and NOD2-mediated expression of IL-6, IL-12, and TNF-alpha mRNA were significantly lower in obese than in non-obese children (P<0.05). However, concentrations of IgG, IgA, and IgM in middle ear effusion were lower in obese than in non-obese children, but none of these differences was significant (P>0.05). CONCLUSION: Mean body mass index was higher and pattern-recognition receptor-mediated cytokine mRNA expression was lower in obese than in non-obese children with OME.
Bacteria ; Body Mass Index ; Child* ; Humans ; Immunity, Humoral ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Interferons ; Interleukin-10 ; Interleukin-12 ; Interleukin-6 ; Interleukins ; Obesity ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; RNA, Messenger* ; Toll-Like Receptors ; Tumor Necrosis Factor-alpha

rpoB, which encodes the B subunit of RNA polymerase, is related to rifampin resistance of Mycobacterium tuberculosis and Escherichia coli. We determined the nucleotide sequences (346 bp) of rpoB gene from 25 Korean isolates of Helicobacter pylori. These nucleotide sequences were aligned and compared with H. pylori 26695 strain. No insertions or deletions were observed in all H. pylori strains. In the phylogenetic tree constructed by UPGMA method, 26 strains of H. pylori were separated into four clusters. Deduced amino acid sequences of amplified rpoB DNA comprised 115 amino acid residues. Twenty six H. pylori strains could be divided into 5 groups by the signature amino acid sequences. Two strains isolated from the same patient showed different nucleotide sequences. These results suggest that the sequences of rpoB are also highly divergent in H. pylori isolates and are useful for the epidemiologic study.
Amino Acid Sequence ; Base Sequence ; DNA ; DNA-Directed RNA Polymerases ; Escherichia coli ; Helicobacter pylori* ; Helicobacter* ; Humans ; Mycobacterium tuberculosis ; Rifampin

BACKGROUND: Acute and persistent pain are the most significant clinical manifestations of herpes zoster. It has been suggested that the demographic and clinical characteristics of patients with herpes zoster at the time of presentation predict the duration and severity of pain on long-term follow-up. However, the association between pain in herpes zoster and emotional factors such as depression and anxiety has been less well investigated. OBJECTIVE: The purpose of this study was to correlate the characteristics of pain with clinical, demographic, and emotional factors in herpes zoster patients. METHODS: Ninety-seven patients with herpes zoster and 105 healthy controls were recruited from the department of dermatology at a university-affiliated hospital. Depression and anxiety levels were assessed using the Beck Depression Inventory and Beck Anxiety Inventory. We compared severity of initial pain and duration of pain by age, depression, and anxiety. RESULTS: The levels of depression and anxiety were higher in herpes zoster patients compared to controls (p <0.05). There were no significant differences by age, depression, or anxiety. The duration of pain increased with increasing age, depression, and anxiety (p <0.05). Stratified analyses showed that the association between pain duration and increasing depression and anxiety was significant in the young age group (p <0.05), but not significant in the old age group. CONCLUSION: This study suggests that age, depression, and anxiety are the main correlates of pain duration in patients with herpes zoster. Therefore, depression and anxiety should not be ignored in the management of herpes zoster patients.
Anxiety ; Depression ; Dermatology ; Follow-Up Studies ; Herpes Zoster ; Humans

OBJECTIVE: To evaluate the morphometry of the anterior thalamoperforating arteries (ATPA). METHODS: A microanatomical study was performed in 79 specimens from 42 formalin-fixed adult cadaver brains. The origins of the ATPAs were divided into anterior, middle, and posterior segments according to the crowding pattern. The morphometry of the ATPAs, including the premammillary artery (PMA), were examined under a surgical microscope. RESULTS: The anterior and middle segments of the ATPAs arose at mean intervals of 1.75+/-1.62 mm and 5.86+/-2.05 mm from the internal carotid artery (ICA), and the interval between these segments was a mean of 3.17+/-1.64 mm. The posterior segment arose at a mean interval of 2.43+/-1.46 mm from the posterior cerebral artery (PCA), and the interval between the middle and posterior segments was a mean of 3.45+/-1.39 mm. The mean numbers of perforators were 2.66+/-1.19, 3.03+/-1.84, and 1.67+/-0.98 in the anterior, middle, and posterior segments, respectively. The PMA originated from the middle segment in 66% of cases. A perforator-free zone was located >2 mm from the ICA in 30.4% and >2 mm from the PCA in 67.1% of cases. CONCLUSION: Most perforators arose from the anterior and middle segments, within the anterior two-thirds of the posterior communicating artery (PCoA). The safest perforator-free zone was located closest to the PCA. These anatomical findings may be helpful to verify safety when treating lesions around the PCoA and in the interpeduncular fossa.
Adult ; Arteries* ; Brain ; Cadaver ; Carotid Artery, Internal ; Crowding ; Humans ; Passive Cutaneous Anaphylaxis ; Posterior Cerebral Artery

Ewing's sarcoma is rarely found occurs in the bones of the hands and feet. We report a case of Ewing's sarcoma of the left calcaneus in a 15-year-old girl who complained of left heel pain and swelling. An open biopsy was performed and histological examination showed the proliferation of uniform small round cells. Immunohistochemical staining for CD99 showed diffuse strong positivity in the cytoplasmic membrane of the tumor cells. After preoperative chemotherapy, a below knee amputation was performed.
Adolescent ; Amputation ; Biopsy ; Calcaneus* ; Cell Membrane ; Drug Therapy ; Female ; Foot ; Hand ; Heel ; Humans ; Knee ; Sarcoma, Ewing*

PURPOSE: A psoas abscess is a rare, but life-threatening disease. We report 11 cases of a psoas abscess in adults and discuss its clinical presentations, diagnosis, and treatments. METHODS: Retrospective analysis of patients who presented to the emergency department with a psoas abscess from Jan. 2000 to Aug. 2004 was conducted. RESULTS: Of the 11 patients with a psoas abscess, 9 (81.8%) had a secondary psoas abscess. The most common causes of the secondary psoas abscess were various invasive procedures, such as acupuncture, a nerve block, etc. The main clinical presentations were fever (72.7%) and back pain (45.5%). The mean time to presentation was 12.0+/-10.6 days. All patients had leukocytosis and elevated CRP. Computed tomography (81.8%) and magnetic resonance imaging (18.2%) were performed for the diagnosis. The mean diagnostic lag time (from admission to the treatment) was 7.8+/-7.5 days. All patients received intravenous antibiotics. Four patients (36.4%) underwent surgical drainage, and three patients (27.3%) underwent percutaneous drainage. Two patients (18.2%) were treated with simple aspiration, and another two (18.2%) received no procedure. Six patients (54.5%) had complications. Three (27.3%) had a recurrent abscess, and two (18.2%) had a epidural abscess. In one patient, femoral neuropathy developed. The time from clinical presentation to diagnosis in the complication associated group was longer than it was in complication non-associated group (27.5+/-19.6 vs 10.6+/-3.2 days, p=0.03). CONCLUSION: A psoas abscess is difficult to diagnose because of vague clinical symptoms and can have serious complications if the diagnosis is missed or delayed.
Abscess ; Acupuncture ; Adult ; Anti-Bacterial Agents ; Back Pain ; Diagnosis* ; Drainage ; Emergency Service, Hospital ; Epidural Abscess ; Femoral Neuropathy ; Fever ; Humans ; Leukocytosis ; Magnetic Resonance Imaging ; Nerve Block ; Psoas Abscess* ; Retrospective Studies

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a side effect of Bisphosphonates (BPs) use. These days, oral bisphosphonates are normally prescribed to treat osteoporosis. Intravenous BPs are used extensively to treat osteolytic bone lesions related to multiplemyeloma and bone metastasis of solid cancers, breast cancer or prostate cancer. As the prescription of BPs is universalized and the number of people treated with BPs is increasing, an accurate understanding and proper management of BRONJ are required. The aim of this study was to improve the clinicians'understanding of BRONJ by reviewing the literature. To achieve this, this paper introduces case reports as well as the current concept of BRONJ based on the 2009 updates by American Association of Oral and Maxillofacial (AAOMS) including the definition, epidemiology, etiology, diagnosis, treatment and prevention of BRONJ.
Bisphosphonate-Associated Osteonecrosis of the Jaw ; Breast Neoplasms ; Diphosphonates ; Jaw Diseases ; Neoplasm Metastasis ; Osteonecrosis ; Osteoporosis ; Prescriptions ; Prostatic Neoplasms

Becker's nevus is a cutaneous hamartoma characterized by unilateral hairy hyperpigmentation and can be associated with subjacent and distant soft tissue and bony abnormalities. Ipsilateral breast hypoplasia is a rare abnormality in Becker's nevus, suggesting that increased androgenic receptors or early postzygotic mutation may play a role in the pathogenesis of Becker's nevus. We report a case of Becker's nevus associated with ipsilateral breast hypoplasia in a 24-year-old female.
Breast ; Female ; Hamartoma ; Humans ; Hyperpigmentation ; Nevus* ; Young Adult

OBJECTIVE: To evaluate the usefulness of alendronate for prevention and treatment of postmenopausal osteoporosis this study was taken. METHODS: This prospective randomized clinical trial examined the effects of oral alendronate and HRT(conjugated estrogen plus medroxyprogesterone acetate), in combination and seperately, on BMD, biochemical markers of bone turnover in 79 women with low bone mass. Treatment included alendronate(10mg daily) plus HRT(group I, n=38), or HRT(group II, n=41) for 6 months. Bone density measurements were performed at months 0 and 6 at the lumbar spine. Biochemical markers of bone turnover were also measured every three months. RESULTS: Serum Osteocalcin decreased by 19.2% in group I and by 10.0% in group II at 3 months(p<0.05), and by 30.9% in group I and by 19.8% in group II at 6 months(p<0.05). Urinary deoxypyridinoline showed decrease of 19.75%(I) vs. 10.4%(II) at 3 months, 30.1%(I) vs. 20.7%(II) at 6 months, the difference was significant. Percent change of BMD measurements from baseline at 6 months in group I was 6.2% and in group II 0.6% on the lumbar spine(p<0.05). CONCLUSION: The treatment with alendronate is useful to postmenopausal women with osteoporosis by decreasing bone turnover markers, and by increasing the BMD.
Alendronate* ; Biomarkers ; Bone Density ; Estrogens ; Female ; Humans ; Medroxyprogesterone ; Osteocalcin ; Osteoporosis* ; Osteoporosis, Postmenopausal ; Prospective Studies ; Spine