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: To determine the frequency of diseases of the hip and pelvis, as seen of plain radiography of the lumbar spine in patients with suspicious lumbar disease, and to evaluate the methods used for lumbar spine radiography in Korea. MATERIALS AND METHDOS: Sixty university and training hospitals were randomly selected and asked to describe the projections, film size and radiographic techniques employed for routine radiography in patients with suspected disease of the lumbar spine. Plain radiographs of 1252 patients, taken using 14"x17"film and depicting both hip joints and the lumbar region, were analysed between March 1999 and February 2000. RESULTS: In 15 patients (1.2%), the radiographs revealed hip or pelvic lesions, confirmed as follows: avascular necrosis of the femoral head (n=11, with bilateral lesions in four cases); sustained ankylosing spondylitis (n=2); acetabular dysplasia (n=1); and insufficiency fracture of the pubic rami secondary to osteoporosis (n=1). In 11 of the 20 hospitals which responded, 14"x17"film was being used for lumbar radiography, while in the other nine, film size was smaller. CONCLUSION: Plain radiography of the lumbar spine including both hip joints, may be a useful way to simultaneously evaluate lesions not only of the lumbar spine but also of the hip and/or pelvis.
Acetabulum ; Fractures, Stress ; Head ; Hip Joint* ; Hip* ; Humans ; Korea ; Lumbosacral Region ; Necrosis ; Osteoporosis ; Pelvis* ; Radiography ; Spine ; Spondylitis, Ankylosing

BACKGROUND: An association between diabetes and tuberculosis has long ken implied. The severity of diabetes appears to correlate with the degree of tuberculous activity. METHODS: A retrospective chart review of 82 patients with active pulmonary tuberculosis in diabetics(DMTB) and 83 patients with active pulmonary tuberculosis in nondiabetios (Non-DMTB) admitted to the Kyung Hee Medical Center between January 1995 and December 1996 was undertaken. RESULTS: The sex ratio of DMTB was 58 : 24, and that of Non-DMTB was 62 : 21. Male patients predominated in both groups. The highest incidence of DMIB was 6th and 7th decades and that of Non-DMTB was 3rd and 4th decades. In case which the tuberculosis developed after diagnosis of diabetes, the prevalence of pulmonary tuberculosis was the highest in diabetes for 5 -10 years. On chest X-ray findings, the moderate advanced tuberculosis cases were the most common (60.9% in DMTB and 50.6% in Non-DMTB). There was no relation between the degree of tuberculosis activity on chest x-ray(minimal, moderata awl far advanced tuberculosis) and presence of diabetes. The incidence of lower lung field tuberculosis in DMTB was significantly higher than Non-DMTB(p<0.05). The multiple lobe involvement was the predominant chest roentgenograpflc finding in both groups. There was no significant difference of treatment response between DMTB and Non-DMTB. There was no relationship between initial HbA1c and the stverity of pulmonary tuberculosis on chest X-ray. During treatmenu of pulmonary tuberculosis in excellently and well controlled diabetes, the cure rate of pulmonary tuberculosis was sigrificantly higher than the pcorly controlled diabetes and the rate of treatment failure was significantly lower than poorly controlled diabetes. (p<0.05). CONCLUISON: Poor control of blood glucose is related with increased rate of treatment failure in pulmonary tuberculosis with diabetes mellitus. Further investigation will be needed to study the mechanisms of treatment failure in poorly controlled diabetics with pulmonaiy tuberculosis.
Blood Glucose ; Diabetes Mellitus ; Diagnosis ; Humans ; Incidence ; Lung ; Male ; Prevalence ; Retrospective Studies ; Sex Ratio ; Thorax ; Treatment Failure ; Tuberculosis ; Tuberculosis, Pulmonary*

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

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

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