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*

Limbic encephalitis is a rare paraneoplastic syndrome characterized by prominent memory impairment, affective and behavioral disturbances, and progressive intellectual deterioration. Among many different neoplasm known to cause limbic encephalitis, a small cell lung cancer is certainly the most frequently reported. We experienced a 64-years old male patient presented with clinical features consistent with limbic encephalitis. He was subsequently found to have small cell lung cancer and showed characteristic evolutional MRI features ; increased signal intensity on T2 weighted image in the bilateral medial temporal regions during early stage and progressive severe atrophy in the late stage.
Atrophy ; Humans ; Limbic Encephalitis* ; Magnetic Resonance Imaging* ; Male ; Memory ; Middle Aged ; Paraneoplastic Syndromes ; Small Cell Lung Carcinoma*

No abstract available.
Hypopituitarism*

Microscopic calcification within the basal ganglia was reported by Virchow and Bamberger in 1855. The description of symmetrical cerebral calcification, particularly of the basal ganglia and often of the dentate nuclei, associated with hypoparathyrodism as related by Eaton, Camp and Love(1939) was a significant development in the field of calcification. Calcification of the basal ganglia has been visualized by skull radiography and computed tomography(CT) scan, and in two-third of cases, it has been associated with metabolic and endocrine abnormalities. Computed tomography is more sensitive to detect the intracranial calcification than plain skull radiography. The purpose of our report was evaluate the significance of basal ganglia calcification as visualized by CT, discusses on pathogensis of calcification, clinical significance and management under the hypocalemia.
Basal Ganglia* ; Hypoparathyroidism* ; Radiography ; Skull

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*