No abstract available.
Mood Disorders* ; Temporal Lobe*

No abstract available.
Mood Disorders* ; Temporal Lobe*

Evaluation and management of the anterior cruciate ligament (ACL) deficient knee pose several problems. For acute injuries, the essential factors are diagnosis of the ACL rupture and associated injuries, and selection of the appropriate method of the management. Until recently, the frequency of complete disruption of the ACL was though to be less than that of the medial collateral ligament. However, there is little doubt that the ACL is the most frequently torn ligament in the knee. Diagnosis may be made with a combination of tests: Anterior drawer, valgus or varus stress test, Lachman, and pivot shift. If the patients is unable to relax because of pain or fear, examination under the anesthesia should be performed. Treatment can be surgical or nonsurgical. Since the ACL is vital to normal knee function, surgical intervention is advisable in the majority of cases of acute disruption. Authors analyzed the records of 58 cases of acute knee ligament injuried patients treated at the department of Orthopaedic Surgery, Kang-Nam St. Marys Hospital, Catholic Medical College and Center, from November 1982 to January 1984, with follow-up range from 6 to 20 months. 1. Among 58 cases, 41(71%) had anterior cruciate ligament injury and 39(67%) had medial collateral ligament injury. 2. The causes of injury were mostly traffic accident (77%) and majority of the patients was in their twenties and thirties of age. 3. Among 41 cases of ACL Injury, 5 had isolated anterior cruciate injury, 27 cases (66%) had associated medial collateral injury, 9 (22%) had associated lateral collateral injury, and 7 (17%) had associated posterior cruciate ligament injury. 4. Meniscal injury was found only in 6 cases (15%); 4 medial and 2 lateral menisci. 5. Majority of anterior cruciate injured patients (71%) had more than 5mm joint openning than normal side in valgus or varus stress radiogram with the knee in extension. 6. In all cases of anterior cruciate ligament injured patients, the Lachman test was positive under the general anesthesia, hut anterior drawer test was positive in 80%. 7. In about 90% of the cases, the anterolateral rotatory instability (ALRI) test was positive and this finding was accentuated when the lateral collateral ligament was torn. 8. Among 41 cases, 16 (39%) had failure at the insertion site, 7 (17%) had tibial spine avulsion, and 9 patients each (22%) had tear at the ligament substance level and had grade II sprain. 9. In twenty-three, primary repair was done, in 9, primary intra-articular recopstruction was performed and 9 were treated conservatively. The result was from fair to excellent almost in all cases.
Accidents, Traffic ; Anesthesia ; Anesthesia, General ; Anterior Cruciate Ligament ; Clinical Study ; Collateral Ligaments ; Diagnosis ; Exercise Test ; Follow-Up Studies ; Humans ; Joints ; Knee ; Lateral Ligament, Ankle ; Ligaments ; Menisci, Tibial ; Methods ; Posterior Cruciate Ligament ; Rupture ; Spine ; Sprains and Strains ; Tears

Matrix metalloproteinases (MMPs) play an important role in the normal morphogenesis, maintenance, and repair of matrix and also have important functions in pathologic conditions characterized by excessive degradation of extracellular matrix, such as rheumatoid arthritis, osteoarthritis, periodontitis and in tumor invasion and metastasis. In this study, expression of MMP-1 and -2 mRNA in retrodiscal tissue of the temporomandibular joint (TMJ) was examined and compared with magnetic resonance imaging (MRI) and surgical findings. MMP mRNAs in the retrodiscal tissue samples were detected by reverse transcription - polymerase chain reaction. TMJ internal derangement (ID) was categorized as normal disc position, disc displacement with reduction, early stage of disc displacement without reduction (DDsR) and late stage of DDsR. TMJ osteoarthrosis (OA) was classified with normal, mild and advanced OA. The amount of synovial fluid collection was divided into not detected, small, large and extremely large amount on MR T2-weighted imaging. Perforation and adhesion were examined during open surgery of the TMJ. Six out of 37 samples were excluded because of little amount of extracted total mRNA. MMP-2 mRNA was detected whole joints, and so the MMP-2 mRNA seems to be expressed normally in retrodiscal tissue. However, MMP-1 mRNA was expressed in 8 of 31 joints. Frequencies of MMP-1 mRNA expression according to the TMJ IDs, amount of synovial fluid and surgical findings made no significant difference. MMP-1 mRNA was detected more frequently in OA groups (7/16 joints, 43.8%) than in normal bony structure group (1/15,joints, 6.7%). Expression of MMP-1 mRNA in retrodiscal tissue might be related with OA of the TMJ.
Arthritis, Rheumatoid ; Collagenases ; Extracellular Matrix ; Gelatinases ; Joints ; Magnetic Resonance Imaging ; Matrix Metalloproteinase 1* ; Matrix Metalloproteinases ; Morphogenesis ; Neoplasm Metastasis ; Osteoarthritis ; Periodontitis ; Polymerase Chain Reaction ; Reverse Transcription ; RNA, Messenger* ; Synovial Fluid ; Temporomandibular Joint*

Preoperative diagnosis of an aneurysm of the right coronary sinus of Valsalve with rupture into the right ventricle was made by echocardiography in a patient who also had a small ventricular septal defect. In this case of ruptured sinus of Valsalva aneurysm, the cardinal echocardiographic finding is a defect in the anterior aortic root through which the right coronary cusp appeared to prolapse. After surgical correction the echo from the herniated right coronary cusp of the aortic valve and discontinuity in the echo from anterior aortic wall disappeared.
Aneurysm ; Aneurysm, Ruptured* ; Aortic Valve ; Coronary Sinus ; Diagnosis ; Echocardiography* ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Humans ; Prolapse ; Rupture ; Sinus of Valsalva*

Preoperative diagnosis of an aneurysm of the right coronary sinus of Valsalve with rupture into the right ventricle was made by echocardiography in a patient who also had a small ventricular septal defect. In this case of ruptured sinus of Valsalva aneurysm, the cardinal echocardiographic finding is a defect in the anterior aortic root through which the right coronary cusp appeared to prolapse. After surgical correction the echo from the herniated right coronary cusp of the aortic valve and discontinuity in the echo from anterior aortic wall disappeared.
Aneurysm ; Aneurysm, Ruptured* ; Aortic Valve ; Coronary Sinus ; Diagnosis ; Echocardiography* ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Humans ; Prolapse ; Rupture ; Sinus of Valsalva*

Brachytherapy is an essential part of radiotherapy for uterine cervical cancer. The low dose rate (LDR) regimen has been the major technique of intracavitary therapy for cervical cancer. However, there has been an expansion in the last 20 years of high dose rate (HDR) machines using Ir-192 sources. Since 1979, HDR brachytherapy has been used for the treatment of uterine cervical cancer in Korea. The number of institutions employing HDR has been increasing, while the number of low dose rate system has been constant. In 1995, there was a total 27 HDR brachytherapy units installed and 1258 cases of patients with cervical cancer were treated with HDR. Most common regimens of HDR brachytherapy are total dose of 30-39 Gy at point A with 10-13 fractions in three fractions per week, 24-32 Gy with 6-8 fractions in two fractions per week, and 30-35 Gy with 6-7 fractions in two fractions per week. The average fractionation regimen of HDR brachytherapy is about 8 fractions of 4.1 Gy each to Point A. In Korea, treatment results for HDR brachytherapy are comparable with the LDR series and appears to be a safe and effective alternative to LDR therapy for the treatment of cervical carcinoma. Studies from the major centers report the five-year survival rate of cervical cancer as, 78-86% for Stage I, 68-85% for stage II, and 38-56% for Stage III. World-wide questionnaire study and Japanese questionnaire survey of multiple institutions showed no survival difference in any stages and dose-rate effect ratio (HDR/LDR) was calculated to be 0.54 to 0.58. However, the optimum treatment doses and fractionation schemes appropriate to generate clinical results comparable to conventional LDR schemes have yet to be standardized. In conclusion, HDR intracavitary radiotherapy is increasingly practiced in Korea and an effective treatment modality for cervical cancer. To determine the optimum radiotherapy dose and fractionation schedule, a nation-wide prospective study is necessary in Korea. In addition, standardization of HDR application (clinical, computer algorithms, and dosimetric aspects) is necessary.
Appointments and Schedules* ; Asian Continental Ancestry Group ; Brachytherapy* ; Humans ; Korea* ; Surveys and Questionnaires ; Radiotherapy ; Survival Rate ; Uterine Cervical Neoplasms*

The size of the cisterna magna is still detatable. Robertson13) stated that the cisterna magna varies greatly in capacity and described the large cisterna magna as a separate entity. He also found that in most cases the cisterna magna extended approximately 2.5cm above the foramen magnum and was usually 5mm deep with a variable width. Liliequist8) proposed a mean heigh of 28mm for the normal cisterna magna with a wide variation of 15 to 60mm, and a depth of 6mm at the foramen magnum with a variation of 2 to 10mm:however, he did not quote measurements for the width. Gonsette, et al.5) reported 28 cases of enlarged cisterna magna diagnosed by ventriculography and coined the phrase "mega grande citerne" or mega cisterna magna. All of these cases, however, had symptoms of posterior fossa disease. Our study of the syndrome of the mega cisterna magna without specific syndrome is presented nystagmus, transient syncope in the first & third cases were operated under suboccipital craniectomy and was confimed the large cisterna magna. This paper presents the clinical diagnosis with vertebral angiogrraphy, pneumoencephalography and computed tomography.
Cisterna Magna* ; Diagnosis ; Foramen Magnum ; Numismatics ; Pneumoencephalography ; Syncope

During last 3 years, we experienced 24 cases of acute seizure disorder, showing localized low density on computed tomographic (C-T) scan and having the clinical characteristics, and have analyzed clinically. The results were followings: 1. It was commoner in men, with a ratio of 2:1, and their ages ranged from 4 to 54 years (mean 20.9 years), with the peak incidence in 2nd & 3rd decades. 2. It occurred in any season, but commoner in summer and autumn. 3. This disorder was characterized by sudden onset of convulsion, focal or generalized, in health man, and had no other associated symptoms. 4. C-T brain scan showed decreased density without mass effect on parietal or frontal area, which had usually constrast enhancement such as small ring or nodular type, and disappeared between 3 to 5 months. 5. Other laboratory tests were normal except leukocytosis (11 of 18 cases) and abnormal EEG (9 of 24 cases). 6. This disorder was self limited. The cause was unknown, but it had the possibility of viral infection.
Brain ; Electroencephalography ; Epilepsy* ; Humans ; Incidence ; Leukocytosis ; Male ; Rabeprazole ; Seasons ; Seizures*

The Wada test was performed for lateralization of language and memory function, using intracarotid injection of Sodium Amytal. But, the internal carotid artery(ICA) Wada test has some limitations for testing memory function. The posterior cerebral artery(PCA) Wade test has been designed to modify to modify the ICA Wada test for testing memory function selectively. In our study, 10 patients out of 12 patients with intractable seizure underwent only the ICA Wada test and the other 2 patients underwent both are ICA and the selective PCA Wada test In all 12 patients undergoing the ICA Wada test, we succesfully localized speech and language dominace. Four of 12 patients who underwent the ICA Wada test for evaluation of memory function displayed superior memory functions in one hemisphere, but the other hemisphere also significantly contributed to memory. The selective PCA Wada test, performed in 2 patients, showed successful results of memory function test in both patients. Four of 12 patients underwent temporal lobectomy and there was no major post-operative language or memory deficits. We conclude that the ICA and PCA Wada tests are useful for preoperative evaluation of medically intractable epilepsy, and the PCA Wada test is valuable in memory evaluation in some patients who have hight risk of postoperative global amnesia after temporal lobectomy following equivocal results of memory function by the ICA Wada test.
Amnesia ; Amobarbital ; Drug Resistant Epilepsy* ; Humans ; Memory Disorders ; Memory* ; Passive Cutaneous Anaphylaxis ; Seizures