The antigenic domain of the major surface protein (Nc-p43) of Neospora caninum was examined by polymerase chain reaction of its gene fragments and recombinant expression as GST fusion proteins. The fragments of Nc-p43 were as follow: a total open reading frame (OFR), T; OFR without signal sequence and C-terminal hydrophobic sequence, S; N-terminal 2/3 parts of S, A; C-terminal 2/3 parts, P; N-terminal 1/3 part, X; middle 1/3 part, Y; and C-terminal 1/3 part, Z, respectively. The DNA fragments were cloned into pGEX-4T vector. Recombinant plasmids transformed into Escherichia coli of BL21 pLysS (DE3) strain were induced to express GST or GST fused fragments of Nc-p43 such as 69 kDa protein for T, 66 kDa for S, 52 kDa for A, 53 kDa for P, and 40 kDa proteins for X, Y, and Z, respectively in SDS-PAGE. The Nc-p43 fragments of T, S, and P reacted with a bovine serum of neosporosis while those of A, X, Y, and Z together with GST did not in the western blot. These findings suggest that the antigenic domain of Nc-p43 of N. caninum may be localized in the C-terminal 2/3 parts. Together with A19 clone in SAG1 of Toxoplasma gondii (Nam et al., 1996), the P fragment of Nc-p43 could be used as efficient antigens to diagnose and differentiate those infections with both species.
Amino Acid Sequence ; Animals ; Base Sequence ; Biological Markers/analysis ; Blotting, Western ; Cells, Cultured ; Cercopithecus aethiops ; Coccidiosis/diagnosis ; Neospora/*immunology ; Protozoan Proteins/*analysis/genetics/immunology ; Reverse Transcriptase Polymerase Chain Reaction ; Support, Non-U.S. Gov't ; Vero Cells/parasitology

Multiple cerebral infarction developed in a 36-year-old woman with adenocarcinoma of the right lung with direct cardiac invasion. Neurological examination and brain MRI showed findings of ordinary infarction. Transesophageal echocardiography showed left atrial pedunculated mass which was the potential source of embolism. We report a rare case who had such multiple spontaneous tumor emboli large enough to result in clinically detectable cerebral infarction.
Adenocarcinoma ; Adult ; Brain ; Cerebral Infarction* ; Echocardiography, Transesophageal ; Embolism ; Female ; Humans ; Infarction ; Lung ; Lung Neoplasms ; Magnetic Resonance Imaging ; Neoplastic Cells, Circulating ; Neurologic Examination

PURPOSE: To evaluate whether radial rigidity measured using RigiScan(R) represents the intracorporeal pressure effectively. MATERIALS AND METHODS: From January 1998 to May 1999, total of 23 patients with erectile dysfunction were evaluated by RigiScan(R) and duplex ultrasonography after the intracorporeal injection of prostaglandin E1. Peak systolic velocity and end diastolic velocity were measured by duplex ultrasonography and then the resistance index was calculated as (peak systolic velocity-end diastolic velocity)/(peak systolic velocity). Radial rigidity of penile tip and base was measured by RigiScanR . The results were analyzed statistically by PC-SPSS version 7.5. RESULTS: There were statistically significant correlations between radial rigidity of penile tip and base and the resistance index by Spearman's correlation analysis, respectively (r=0.680, p<0.001)(r=0.703, p<0.001). When radial rigidity of penile tip and base exceeded 60% of maximum, radial rigidity of penile tip and base again correlated well with the resistance index, respectively (r=0.659, p=0.020)(r=0.759, p=0.011). Based on clinically determined degree of erection, radial rigidity of penile tip and base represented the intracorporeal pressure effectively. CONCLUSIONS: Radial rigidity measured by RigiScan(R) represents the intracorporeal pressure effectively.
Alprostadil* ; Erectile Dysfunction ; Humans ; Male ; Ultrasonography

We evaluated MR imaging of spondylolytic spondylolisthesis degenerative spondylolisthesis and retrolisthesis in 14, 9 and 20 patients respectively. Sagittal and axial spin echo and gradient echo images were obtained with 25-30cm FOV and 5mm/0.5mm thickness/gap by using spine surface coil. Sagittal images showed defects of pars interarticularis just inside of the pedicles of spines in all the cases of spondylolytic spondylolisthesis with relatively variable signal intensity. Displaced vertebrae were commonly observed at L5 (8/14) in spondylolytic spondylolisthesis, at L4 (5/9) in degenerative spondylolisthesis and at variable locations in retrolisthesis. The mean length of displacement of vertebrae in spondylolytic spondylolisthesis was about 7mm and less displacement was onserved in degenerative spondylolisthesis and retrolisthesis. Seven, four and six cases of pseudobulging of disk at displaced level were observed in cases of spondylolytic spondylolisthesis, degenerative spondylolisthesis and retrolisthesis respectively. Seven, five and 14 cases of true disk lesions were onserved in cases of spondylolytic spondylolisthesis, degenertive spondylolisthesis and retrolisthesis respectively. Grade II neural foraminal stenoses (obliteration of one half epidural fat of neural foramen) were commonly (8/14) seen in spondylolytic spondylolisthesis, however the other two types showed less severe neural foraminal stenosis. In conclusion, MR imaging is a highly accurate method for the diagnosis and evaluation of spondylolisthesis and associated lesions of spine and disks.
Constriction, Pathologic ; Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Methods ; Spine ; Spondylolisthesis*

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*

No abstract available.
Neuroma*

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*

The purpose of this study is to evaluate the morphologic findings of the labrum and capsuloligamentous structures in the normal and unstable shoulders and to compare the effectiveness of double contrast arthrographic findings which were taken with supine and prone position. We reviewed the computerized tomographic arthrogram in 9 cases of normal shoulder and l3 cases of shoulder instability. We evaluated the shape of the labrum, the attachment of anterior capsule and the amount of capsular laxity. Capsular laxity was compared each others in normal, the unidirectional instability and the multidirectional instability. Among these materials, we simultaneously performed CT arthrogram with supine and prone position and evaluated which is more reliable and accurate. Scapular inclination was ahout 25 degrees in the supine position and ahout 60 degrees in the prone position. Normal glenoid labrum varied in size and shape, so its lack of a classic appearance might not indicate a labral tear. Variations existed in the anterior capsular attachment onto the glenoid. The anterior capsule was used to attach far away from the glenoid rim. but it might not indicate an anterior instability. With the prone position, the labral lesion took more excellent visualization due to the contrast coating on the glenoid labrum in both anterior and posterior. Anterior capsular expansion was seen well with prone position in anterior instability. In summary, for proper interpretation of the instability, awareness of the morphologic variations of the labrum and capsuloligamentous structure is important. CT double contrast arthrography with prone position has made a significant contribution to improving and easing the documentation of variety of anatomic abnormalities. Now we recommend the prone position in CT arthrogram for imaging glenoid labrum pathology in shoulder instability.
Arthrography ; Pathology ; Prone Position ; Shoulder* ; Supine Position

Purpose: This study aimed to construct and test a hypothetical model to explain the predictive factors and causal pathways for exercise levels in patients with ankylosing spondylitis based on the self-determination theory. A conceptual framework was constructed assuming that autonomy support by health care providers would satisfy the three basic psychological needs of patients, which would increase their autonomous motivation for exercise, resulting in its initiation and continuation. Methods: This cross-sectional study included 221 patients with ankylosing spondylitis who were visiting rheumatology clinics in two tertiary hospitals. Health Care Climate Questionnaire-exercise regularly, Basic Psychological Needs Satisfaction scale, Behavior Regulation in Exercise Questionnaire-2, and exercise level were used to collect data. Results: The fitness of the hypothetical model met the recommended level (χ2/df ≤ 3, SRMR ≤ .08, RMSEA ≤ .08, GFI ≥ .90, AGFI ≥ .85, NFI ≥ .90, TLI ≥ .90, CFI ≥ .90). The model effect analysis revealed that autonomy support by health care providers had a positive effect on patients' autonomy, competence, relatedness, autonomous motivation, and exercise level. Competence and relatedness had positive effects on autonomous motivation and exercise level, respectively. Autonomous motivation had a positive effect on exercise level. Conclusion The predictive factors of exercise level in patients with ankylosing spondylitis were autonomous motivation, health care providers' autonomy support, competence, and relatedness. Considering these factors, we recommend the development of an effective program for improving exercise levels in these patients.

OBJECTIVES: The purpose of this study is to evaluate the incidence of complications accompanying tracheostomy, and in addition, to suggest ways to prevent serious complications. MATERIALS AND METHODS: We performed tracheostomy in 168 patients and their data were analyzed retrospectively. RESULTS: Twenty one patients (12.5%) had complications directly related to tracheostomy. The most common complication was postoperative bleeding which accounted for 11 cases (6.7%). Others complications included pneumothorax which claimed 3 cases (1.8%) with reduced morbidity, cannula dislodgment claimed 3 cases (1.8%), cannula obstruction 2, wound infection 2 and tracheal stenosis 2. Among them, two patients died of tracheostomy complications. Decannulation was tried in 44 patients, but it fell short since only 11 patients were decannulated without difficulty. The rest of patients could not be decannulated because of various reasons including death, underlying disease, subglottic stenosis, tracheal stenosis or vocal cord palsy. CONCLUSION: In order to avoid complications of tracheostomy, it is important to treat preoperatively the tendency to bleeding, and meticulously control it during the operation as well. Also, the use of longer cannulas and tracheal fenestration technique is helpful for patients with short and stocky neck. Positive pressure applied through the cannula can make serious complications such as pneumothorax when cannula-obstruction or cannuladislodgment is suspected and the high volume-low pressure cuff is useful to prevent the decannulation difficulties by longterm cannulation, especially in patients using ventilator.
Catheterization ; Catheters ; Constriction, Pathologic ; Hemorrhage ; Humans ; Incidence ; Neck ; Pneumothorax ; Retrospective Studies ; Tracheal Stenosis ; Tracheostomy* ; Ventilators, Mechanical ; Vocal Cord Paralysis ; Wound Infection