BACKGROUND: We analyze the functional evaluation, posterior stability after surgery of acute injuries in the femoral detachment and tibial avulsion fracture of posterior cruciate ligament. MATERIALS AND METHODS: Twenty two patient who underwent primary repair were followed more than one year after operation (mean follow-up 33.7 months). The patients were evaluated with KT 2000 arthrometer and posterior stress test for posterior stability. Lysholm knee score was used for knee function. RESULTS: Lysholm score revealed 85.3 in femoral detachment group and 91.1 in tibial avulsion fracture group (p<0.05). Posterior displacement of the posterior stress test showed 17.2 mm at initial injury and 8.6 mm at last follow up in femoral detachment group. 16.8 mm at initial injury and 7.1 mm at last follow up in tibial avulsion fracture group There revealed the tendency of the improved posterior stability of the tibial avulsion group compared with femoral detachment group, but there showed no statistical significance in KT 2000 arthrometer and posterior stress x-ray. CONCLUSION: Functional results of tibial avulsion fracture group revealed the better outcome compared with femoral detachment group, but the degree of posterior stability in tibial avulsion fracture group showed no statistical significance in posterior stability.
Exercise Test ; Follow-Up Studies ; Humans ; Knee ; Posterior Cruciate Ligament*

BACKGROUND: Photodynamic therapy(PDT) is a type of photochemotherapy that is designed to kill targeted tumor cells. OBJECTIVE: The Clinical effects of PDT were analysed for response rates, post-treatment healing and adverse effects on several cutaneous carcinoma in situ. METHOD: PDT with topical 5-aminolevulinic acid-based irradiation of corresponding 630+5nm light was performed in 6 carcinoma in situ patients who had actinic keratosis, Bowen' disease or cutaneous squamous cell carcinoma. RESULT: In all patients the clinical results were exellent with respect to initial complete responses and cosmetic outcome. CONCLUSION: PDT might be chosen as a first line treament for cutaneous carcimoma in situ.
Carcinoma in Situ* ; Carcinoma, Squamous Cell ; Humans ; Keratosis, Actinic ; Photochemotherapy* ; Skin*

Purpose: We report a patient with presumed ischemic unilateral oculomotor nerve palsy developing after a snake bite on the right finger.Case summary: A 58-year-old male visited our emergency department complaining of right ptosis and binocular diplopia that had developed after a snake bite. He had been bitten on a finger of the right hand by an unidentified snake about 6 hours prior to symptom onset. He lacked neurological symptoms such as headache, nausea, vomiting, or an altered consciousness level. The right hand exhibited severe swelling, oozing, and inflammation. The visual acuity was 20/25 in both eyes. Ptosis was evident in the right eye. Both pupils responded normally to light and near stimulation. Extraocular examination revealed movement limitations in all right-eye gaze fields except abduction. A serological test revealed coagulopathy. Pyridostigmine was prescribed, but the ocular symptoms did not immediately improve; however, they did improve gradually during follow-up. At 8 months after the initial visit, the patient exhibited an ortho primary gaze with an adduction limitation of -1. No aberrant regeneration was apparent. Conclusions Unilateral oculomotor nerve palsy can develop after a snake bite, possibly attributable to microvascular ischemia caused by coagulopathy.

Purpose: In the present study, the efficacy and safety of brolucizumab in refractory polypoidal choroidal vasculopathy (PCV) patients treated with aflibercept were investigated. Methods: The medical records of patients with refractory PCV treated with aflibercept were reviewed. All patients had subretinal fluid or intraretinal fluid followed by at least three consecutive injections of aflibercept on a 4–8-week dosing schedule before switching to brolucizumab. Changes in injection intervals, optical coherence tomography (OCT), and OCT angiography parameters including central macular thickness (CMT), subfoveal choroidal thickness (SFCT), polyp height, lesion area, flow density, and polyp regression rate were evaluated before and 6 months after switching to brolucizumab. Results: The study included 32 eyes of 32 patients with PCV who received brolucizumab injections as switch therapy and were followed at 6 months. After switching to brolucizumab, 53% of eyes had dry macula and the injection interval was extended from 5.4 ± 1.7 weeks to 10.8 ± 2.9 weeks. Best-corrected visual acuity remained stable over the 6 months (p = 0.166). CMT and SFCT were reduced at 6 months after switching to brolucizumab (p = 0.042 and p = 0.023, respectively). Polyp regression was complete in 12.5% and partial in 62.5% of eyes. The largest polyp height and lesion size significantly decreased (p = 0.035 and p = 0.010, respectively). However, significant difference was not found regarding flow density after switching to brolucizumab (p = 0.145). Intraocular inflammation-related adverse events were not reported. Conclusions Brolucizumab could provide additional benefits in refractory PCV treated with aflibercept by reducing leakage from polyps, branching vascular networks, and choroid.

Purpose: To evaluate the efficacy of switching to faricimab (VabysmoTM; Roche/Genentech) treatment for patients with neovascular age-related macular degeneration (nAMD) that was resistant to other anti-vascular endothelial growth factor (VEGF) therapies by assessing outcomes after 6 months. Methods: We conducted a retrospective chart review of 102 nAMD patients who were switched to faricimab due to suboptimal responses to prior anti-VEGF treatments. Patients who showed persistent fluid on optical coherence tomography despite prior anti-VEGF injections every 4 to 8 weeks were treated with faricimab. We assessed changes in best-corrected visual acuity (BCVA), central subfield thickness (CST), subfoveal choroidal thickness, maximum pigment epithelial detachment (PED) height, and fluid status at baseline and 1, 3, and 6 months after switching to faricimab. Treatment intervals before and after switching were compared. Results: Six months after switching to faricimab, the mean BCVA improved (0.50 ± 0.12 logMAR to 0.45 ± 0.10 logMAR, p = 0.030), while the mean CST decreased from 353.3 ± 40.5 μm at baseline to 311.4 ± 35.4 μm (p = 0.012). The mean choroidal thickness did not significantly decrease after switching. The mean PED height decreased from 309.1 ± 32.1 μm at baseline to 279.1 ± 30.8 μm at 6 months (p = 0.040). The mean treatment interval extended from 5.7 ± 1.4 to 10.4 ± 1.8 weeks after switching (p = 0.001). Additionally, dry macula was achieved in 43.1% of patients, while 76.5% were classified as good responders, 6.5% as partial responders, and 17% reverted to other anti-VEGF treatments due to non-response. Conclusions Switching nAMD patients to faricimab for 6 months produced substantial improvements in visual acuity and anatomical outcomes, together with extended treatment intervals, reducing the injection burden. Faricimab could be an effective treatment option for nAMD, particularly for patients with inadequate responses to previous therapies.

Pancreas lipomatosis is definde as fatty replacement of pancreatic acinar cells. Of the nine cases evaluated, seven cases (77.8%) of lipomatosis were limited inbody and tail, one case (11.1%) showed total lipomatosis excluding uncinate process and the remaining one case (11.1%) only in tail. As to the severity of lipomatosis, complete fat replacement in body and tail was found in four cases (44.4%), incomplete body and complete tail involvement in two (22.2%), incomplete body and tail, complete all except uncinate process, and complete tail involvements were found in one case (11.1%) each. Associated or predisposing factors included three diabetes mellitus (33.3%) combined with pancreas divisum, pancreas lithiasis and cholelithiasis respectively, hepatitis (22.2%) in two, and pseudocyst (11.1%) in one case, but in three cases (33.3%) nothing was found. In conclusion, pancreas lipomatosis was easily diagnosed by the abdominal CT and it was associated or predisposed by several e tities but had no major clinical symptoms, such as pancreatic insufficiency.
Acinar Cells ; Causality ; Cholelithiasis ; Diabetes Mellitus ; Exocrine Pancreatic Insufficiency ; Hepatitis ; Lipomatosis* ; Lithiasis ; Pancreas* ; Tail ; Tomography, X-Ray Computed

Actinomycosis is an oppoturnistic infection of actinomyces, which are relatively avirulent endogenous oral commensals. After trauma or infection, they breach the normally protective mucosal barriers to invade adjacent soft tissue structures. Lesions routinely contain other bacteria, the normal resident flora at the site of primary infection, which act synergistically with actinomyces species to provoke this unique infection, which range from an acute suppurative process to a chronic fibrotic process. According to epidemic studies about pelvic actinomycosis, it should be significantly related to IUD(intrauterine device). It is accounted that IUD cause chronic intrauterine infection, tissue injury and act as nucleus for parasitic infestation. Here we present a case of pelvic actinomycosis related to IUD with brief review of the concerned literature.
Actinomyces ; Actinomycosis* ; Bacteria

PURPOSE: To evaluate the usefulness of comparison of the signal intensity of uterine septum in the differential diagnosis of bicornuate and septate uterus on magnetic resonance (MR) imaging. MATERIALS AND METHODS: Preoperative MR imaging findings of surgically proven 5 bicornuate and 6 septate uteri were retrospectively analyzed. Because preoperative differential diagnosis of both was possible in all cases in terms of the intercornual distance, external contour of uterine fundus, and divergent angle of two uterine cavities, these criteria were excluded in this study. The signal intensity of uterine septum in patients with bicornuate and septate uterus was analyzed on T1-weighted and fast spin echo T2-weighted images obtained in the axial and coronal planes, using a 1.5-T MR scanner. The signal intensity of uterine septum especially on T2-weighted images was compared with that of myometrium or junctional zone. RESULTS: The signal intensity of uterine septum in patients with bicornuate uterus (n=5) and septate uterus (n=6) was similar to that of myometrium in all cases on T1-weighted images. The septum of bicornuate uterus (n=5) on fast spin echo T2-weighted images was isointense with myometrium in three and hypointense in two cases. The uterine septum of septate uterus (n=6) on T2-weighted images was isointense with myometrium in two, hypointense in two, and isointense with or more hypointense than junctional zone in two cases. No patient showed different signal intensity between upper and lower uterine septum. CONCLUSION: Because the MR signal intensity of the uterine septum in bicornuate or septate uterus is variable, it should not be used alone in the differential diagnosis of them. In these clinically important differentiation, therefore, comprehensive analysis of MR findings in terms of the external contour of uterine fundus, intercornual distance, divergent angle of two uterine cavities, in addition to the signal intensity of the uterine septum, should be considered.
Animals ; Diagnosis, Differential* ; Female ; Humans ; Magnetic Resonance Imaging ; Mice ; Myometrium ; Retrospective Studies ; Uterus*

PURPOSE: To assess the accuracy of MR cholangiography(MRC) in the diagnosis of cholelithiasis, and to determine interobserver agreement. MATERIALS AND METHODS: Between March and September 1999, 43 consecutive patients with biliary obstruction [24 men and 19 women aged 25 -85 (mean, 58) years] underwent MRC using the single-shot fast spin-echo technique. Heavily T2-weighted source images(axial and coronal) 3 -5 mm thick and 12 projection images with 15- degree rotation and 5-cm thickness were obtained. All images were reviewed blindly and indepen-dently by two radiologists specialized in the interpretation of abdominal imaging information. Choledocholithiasis was evaluated in eight segments of the intrahepatic duct(IHD), extrahepatic duct(EHD) and gall bladder lumen. Final diagnosis was established on the basis of operative (n=31) and other radiological (n=12) findings. The sensitivity, specificity and accuracy of the MRC findings were assessed, and using kappa measurement (cross-table analysis,SPSS Windows for 8.0), interobserver agreement was determined. RESULTS: Thirty of the 43 patients, had choledocholithiasis (IHD stones in 7 cases, EHD stones in 15, and GB stones in 18). For radiologist 1, sensitivity, specificity and accuracy were 86%, 100% and 98%, respectively, in the diagnosis of IHD stones; 100%, 89% and 93%, respectively, in the diagnosis of EHD stones; and 81%, 96% and 91%, respectively, in the diagnosis of GB stones. For radiologist 2, the corresponding figures were 86%, 94% and 93% (1HD stones); 87%, 89% and 88% (EHD stones); and 81%, 86% and 84% (GB stones). Interobserver agreement for the diagnosis of choledocholithiasis was excellent in all cases. The kappa mesurement was 0.91 for 1HD stones, 0.77 for EHD stones, and 0.70 for GB stones. CONCLUSION: MRC is an excellent imaging modality for the diagnosis of choledocholithiasis, and interobserver agreement was also excellent.
Cholangiography* ; Choledocholithiasis ; Cholelithiasis* ; Diagnosis* ; Female ; Humans ; Male ; Sensitivity and Specificity ; Urinary Bladder

No abstract available.
Brain* ; Hydrocephalus*