PURPOSE: To evaluate the differential features of complete and partial- thickness tears of the posterior cruciate ligament(PCL) and to describe associated knee injuries at magnetic resonance imaging(MRI). MATERIALS AND METHODS: Twenty-four subjects were studied, including 15 with complete PCL tears and 9 with partial PCL tears. The PCL status was determined at arthroscopy in all cases. Knee MRI were perfomed at 1.0 Tesla using a dedicated knee surface coil. Two radiologists retrospectively reviewed MR images and correlated MRI findings to results of arthroscopy. RESULTS: There was no statistically significant difference between complete tears and partial tears with regard to thickness, margination, and signal intensity of the PCL. However, complete tears were more likely to show focal areas of ligamentous discontinuity(13/15:3/9, p=0.0073). Associated knee injuries were seen in 22 (92%) patients and were seen more frequently in patients with complete PCL tears, which were bony injuries (n=16, 67%), tears of the medial collateral ligament(n=12, 50%) and menisci(n--11, 46%), and stage III joint effusion(n=17, 71%). CONCLUSION: The most useful MRI criteria for distinguishing complete from partial PCL tear is focal area of ligamentous discontinuity, that is, complete tears are more likely to show focal areas of discontinuity, whereas partial tears are more likely to show at least some intact fibers.
Arthroscopy ; Humans ; Joints ; Knee ; Knee Injuries ; Ligaments ; Magnetic Resonance Imaging* ; Posterior Cruciate Ligament* ; Retrospective Studies

PURPOSE: Anorectal manometry is a way of investigation for anti-rectal sphincters. In this paper we evaluated the usefulness of anorectal manometry in constipation patients and compared the anal spnincter function in control, constipation and encopresis patients. METHOD: We analysed the data of anorectal function studies in normal children (control, n=11), children with constipation (constipation group, n=20) and children with encopresis (encopresis group, n=16). RESULTS: The specific manometric parameters in normal children were like as follows; external anal sphinter pressure 21.0+/-8.00 mmHg, internal anal sphicter pressure 30.0+/- 14.57 mmHg, conscious rectal sensitivity threshold 11.4+/-4.52 mmHg. The above results were not different from that of previous studies except conscious rectal sensitivity threshold, which was slightly lower than that of others. Internal and external anal sphincter pressure were elevated significantly in constipation and encopresis groups than in control, which results was the same in conscious rectal sensitivity threshold. But the values of rectoanal inhibitory threshold and percent relaxation of rectoanal inhibitory reflex were not different among control group, constipation group and encopresis group. External sphincter activity was increased during the act of bearing down for defecation in none of the child in control group, in 6 of 17 children in constipation group and 5 of 12 children in encopresis group. CONCLUSION: With the results of above we could say that complete history taking and physical examination are important in diagnosis of constipation, and we could say also that the anorectal manometry was a valuable tool to understand the physiology of normal defecation and the pathophysiology of constipation and encopresis.
Anal Canal ; Child* ; Constipation* ; Defecation ; Diagnosis ; Encopresis ; Humans ; Manometry* ; Physical Examination ; Physiology ; Reflex ; Relaxation

PURPOSE: We wanted to evaluate if metabolic syndrome X affects voiding symptoms and erectile function in those patients suffering with benign prostatic hyperplasia(BPH). MATERIALS AND METHODS: Between January 2003 and May 2006, we analyzed 68 patients suffering with both BPH and metabolic syndrome X and 112 patients suffering with BPH, but not metabolic syndrome as controls. The diagnosis of metabolic syndrome was made according to the recent consensus report of the National Cholesterol Education Program's Third Adult Treatment Panel. The blood pressure, obesity, maximal flow rate, residual volume, International Prostate Symptom Score(IPSS), and the International Index of Erectile Function(IIEF) were all measured. The biochemical analyses included determining the levels of serum glucose, total cholesterol, triglycerides, low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C) and prostate-specific antigen (PSA). The total prostate volume and transitional zone volume were measured via transrectal ultrasound. Statistical analysis was performed by using Student's t-test. RESULTS: There were statistical differences between the two groups with respect to total cholesterol(p=0.045), triglycerides(p<0.001), HDL-C(p<0.001), glucose(p<0.001), blood pressure(p<0.001) and obesity(p<0.001), respectively. However, there was no significant difference on comparison of the total prostate volume and transitional zone volume, the maximal flow rate, the residual volume, IPSS, IIEF, PSA and LDL-C. CONCLUSIONS: The results of this study suggest that BPH patients with metabolic syndrome X have higher total cholesterol, triglycerides, glucose, blood pressure and obesity, and lower HDL-C. Yet there was no significant difference in the voiding symptoms and erectile function between the patients with BPH who had or didn't have metabolic syndrome X.
Adult ; Blood Glucose ; Blood Pressure ; Cholesterol ; Consensus ; Diagnosis ; Education ; Erectile Dysfunction ; Humans ; Lipoproteins ; Male ; Metabolic Syndrome X* ; Obesity ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia* ; Residual Volume ; Triglycerides ; Ultrasonography

Background: This study aimed to analyze the prehospital process and reperfusion therapy process of acute ischemic stroke in Busan metropolitan area and examine the impact of living arrangement on the early management and functional outcomes of acute ischemic stroke (AIS). Methods: The patients who diagnosed with AIS and received reperfusion therapy at the Busan Regional Cardiovascular Center between September 2020 and May 2023 were selected. We investigated the patients’ hospital arrival time (onset to door time) and utilization of 119 emergency ambulance services. Additionally, various time matrices related to reperfusion therapy after hospital were examined, along with the functional outcome at the 90-day after treatment. Results: Among the 753 AIS patients who underwent reperfusion therapy, 166 individuals (22.1%) were living alone. AIS patients living alone experienced significant delays in symptom detection (p<0.05) and hospital arrival compared to AIS patients with cohabitants (370.1 minutes vs. 210.2 minutes, p<0.001). There were no significant differences between the two groups in terms of 119 ambulance utilization and time metrics related with the reperfusion therapy. Independent predictors of prognosis in AIS patients were found to be age above 70, National Institutes of Health Stroke Scale score at admission, tissue plasminogen activator, living alone (odds ratio [OR], 1.785; 95% confidence interval [CI], 1.155–2.760) and interhospital transfer (OR, 1.898; 95% CI, 1.152–3.127). Delay in identification of AIS was shown significant correlation (OR, 2.440; 95% CI, 1.070–5.561) at living alone patients. Conclusion This study revealed that AIS patients living alone in the Busan metropolitan region, requiring endovascular treatment, face challenges in the pre-hospital phase, which significantly impact their prognosis.

PURPOSE: To evaluate possible factors affecting urethral stricture development after TURP in patients with BPH. MATERIALS AND METHODS: We reviewed retrospectively medical records of patients who underwent TURP for 6 years. All operations were performed by 2 experienced doctors who have minimum 200 practices. Patients were classified into 2 groups. Group A included patients with urethral stricture required periodic urethral dilation or urethrotomy. Group B included those without urethral stricture development after TURP. We analyzed all possible factors such as resection time, prostate volume, resection volume, resectoscope size, preoperative catheterization duration due to AUR, postoperative catheterization duration, preoperative pyuria, prostate needle biopsy performed preoperatively and PSA level, age and co-morbid systemic diseases. RESULTS: 595 patients underwent TURP between 2000 and 2005. 76 of them were excluded because of preexisting urethral stricture or secondary TURP. 110 were categorized into group A and 409 into group B. There was no statistical difference between group A and B with respect to age, preoperative catheterization duration in patients with AUR, postoperative catheterization duration, prostate volume, resection volume, preoperative PSA level, preoperative pyuria, preoperative biopsy history, resectoscope size(22F vs 24F) and anesthesia method (general vs spinal), respectively. However, there is significant difference between group A and B in comparison of resection time(58.5+/-21.6 min vs 48.5+/-23.2 min, p=0.02). CONCLUSION: Our data demonstrate that the shortening of resection time is the most important single factor to decrease urethral stricture formation after TURP in patients with BPH.
Anesthesia ; Biopsy ; Biopsy, Needle ; Catheterization ; Catheters ; Humans ; Medical Records ; Prostate* ; Prostatic Hyperplasia* ; Pyuria ; Retrospective Studies ; Transurethral Resection of Prostate ; Urethral Stricture*

PURPOSE: Prostate biopsies have typically been performed on all patients with prostate specific antigen (PSA) levels above 4 ng/ml, however, the cancer detection rate is low. We would like to predict cancerous conditions of the prostate by developing a new PSA formula. MATERIALS AND METHODS: Between July 2004 and July 2006, 93 patients with serum PSA levels above 4 ng/ml received extended prostate biopsies. The medical records of all patients - age, total/free PSA after/before prostate massage, final diagnoses of prostate biopsies - were reviewed retrospectively. We developed a new formula to calculate the delta PSA: (total/free PSA after prostate massage - total/free PSA before prostate massage) / total/free PSA before prostate massage. RESULTS: The patients were divided into two groups, the prostate cancer group (39 patients) and the benign disease group (54 patients). Mean total/free PSA for the benign disease group were 9.35/1.49 ng/ml (before) and 16.66/5.06 ng/ml (after), while values for the data of prostate cancer group were 21.02/2.43 ng/ml (before) and 24.61/4.40 ng/ml (after). The positive predictive value of the patients with PSA levels between 4 and 10 ng/ml was 32%; the positive predictive value of the patients with PSA levels above 10 ng/ml was 75%. The mean delta total/free PSA values for the benign disease and prostate cancer groups were 0.92/2.42 and 0.28/1.14, respectively. The cut off value of delta total/free PSA was below 0.5/2.0. Sensitivity, specificity, and positive predictive values for delta total PSA were 90% (95% confidence interval (CI), 80.2~99.3), 54% (95% CI, 41.4~67.7) and 58% (95% CI, 45.9~70.8), respectively. Sensitivity, specificity, and positive predictive values based on delta free PSA were 87% (95% CI, 76.7~97.7), 48% (95% CI, 36.7~63.3), and 56% (95% CI, 43.3~68.2), respectively. CONCLUSIONS: We suggest that the use of delta total/free PSA in patients with serum PSA levels above 4 ng/ml may be helpful, not only to better detect prostate cancer, but also to reduce unnecessary prostate biopsies.
Biopsy ; Diagnosis ; Humans ; Male ; Massage ; Medical Records ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms* ; Retrospective Studies ; Sensitivity and Specificity

Profound hypoglycemia results in significant brain injury because glucose is essential for normal brain functioning. We present here a case of transient neonatal hypoglycemia with diffuse brain injury. Magnetic resonance imaging was performed 2 days after onset, and this revealed bilateral regions of restricted diffusion in the parietal, occipital, frontal and temporal lobes. On the T1-weighted images, the regions showed indistinct gray matter-white matter differentiation. There were subtle high signal intensity lesions along the corresponding regions of the FLAIR and T2-weighted images.
Brain Injuries* ; Brain* ; Diffusion ; Glucose ; Hypoglycemia* ; Magnetic Resonance Imaging ; Rabeprazole ; Temporal Lobe

Intradural extramedullary tuberculoma of the spinal cord is a rare manifestation of the spinal tuberculosis, with a few cases described so far. Recently, we have experienced two cases of extensive intradural extramedullary tuberculoma at the thoracic spine. So, we report these cases with review of the literatures.
Spinal Cord ; Spine ; Tuberculoma ; Tuberculosis, Spinal

urpose: Misonidazole is a radiosensitizer that binds in hypoxic cells. The purpose of this study was to find out the feasibility of I-131-Iodomisonidazole (IMISO) for imaging of tumor hypoxia. MATERIALS AND METHODS: Tosyl precursor was dissolved in acetonitrile and I-131-NaI was added to synthesize IMISO. Balb/c mice inoculated with CT-26 adenocarcinoma were injected with IMISO. Mice were sacrificed at 1,2,4,24 hr and % of injected dose per gram of tissue (%ID/g) was determined. For scintigraphy and MRI, mouse bearing CT-26 adenocarcinoma was administered with IMISO and imaging was performed 4 hr after. Then, mouse body was fixed and microtomized slice was placed on radiographic film for autoradiography. RESULTS: %ID/g of tumor was 1.64 (1h), 0.98 (2h), 0.85 (4h) and 0.20 (24h), respectively. At 24h, %ID/g of tumor was higher than that of all other tissues except thyroid. Tumor to muscle ratio increased with time and tumor to blood ratio also increased with time and reached 1.53 at 24 hr. On autoradiogram, tumor was well visualized as an increased activity in central hypoxic area of the tumor which corresponds to the area of high signal intensity on T2-weighted MR image. On scintigraphy, tumor uptake was visualized. CONCLUSION:: This RESULTS suggest that IMISO may have a potential for tumor hypoxia imaging in mouse model. However, further study is needed to improve it's localization in tumor tissue and to achieve acceptable images of tumor hypoxia.
Adenocarcinoma* ; Animals ; Anoxia* ; Autoradiography ; Magnetic Resonance Imaging ; Mice* ; Misonidazole ; Radionuclide Imaging ; Thyroid Gland ; X-Ray Film

Mucoepidermoid carcinoma of the thymus is an extremely rare malignant mediastinal neoplasm, and to our knowledge, only 13 cases have been reported. We report a case of mucoepidermoid carcinoma of the thymus that was seen in a 53-yr-old man with right chest pain. Chest CT scan showed a huge, cystic mass having a focal solid portion with direct invasion of the adjacent anterior chest wall and pericardium in the anterior mediastinum. Mucoepidermoid carcinoma of the thymus should be included in the differential diagnosis for masses of the anterior mediastinum associated with extensive cystic changes, although the carcinoma is exceedingly rare.
Carcinoma, Mucoepidermoid/*diagnosis/pathology ; Fatal Outcome ; Humans ; Male ; Mediastinal Neoplasms/*diagnosis/pathology ; Middle Aged ; Thymus Neoplasms/*diagnosis/pathology