Purpose: Many studies have been conducted on the cause of the medial meniscus posterior horn root (MMPHR) tears. A previous study reported that the relatively large size of the medial femoral condyle (MFC) compared to the size of the medial tibial condyle (MTC) could cause a tear of the MMPHR. The authors conducted a study to confirm that this was correct. Materials and Methods: Patients who underwent magnetic resonance imaging of the knee at our Hospital from March 2011 to April 2019 were divided into a group with a tear of MMPHR and a control group without a tear. The size (MFC, MTC) and relative size ratio of the MFC and the MTC (MFC/MTC) were measured and compared to determine if there was any correlation with the tear of MMPHR. Results: The mean MFC size of the 175 patients with MMPHR tear was 24.6±2.1 mm (0°), 23.5±2.1 mm (30°), 24.1±2.2 mm (60°), and the mean MTC size was 28.2±2.2 mm. The mean size of the MFC of the 147 control subjects was 25.2±2.4 mm (0°), 23.9±2.3 mm (30°), and 24.5±2.6 mm (60°), and the mean size of the MTC was 29.0±2.6 mm. The mean ratios (MFC/MTC) of the 175 patients with MMPHR tears were 0.87±0.05 (0°), 0.83±0.04 (30°), and 0.85±0.05 (60°) for each location. The corresponding mean ratios (MFC/MTC) of the 147 control subjects were 0.87±0.05 (0°), 0.83±0.04 (30°), and 0.85±0.05 (60°). There was no significant difference between the patient group and the control group. Conclusion The size and relative ratio of MFC and MTC do not appear to be related to a tear of the MMPHR.

In the course of immunoscreening of Clonorchis sinensis cDNA library, a cDNA CsRP12 containing a tandem repeat was isolated. The cDNA CsRP12 encodes two putative peptides of open reading frames (ORFs) 1 and 2 (CsRP12-1 and -2). The repetitive region is composed of 15 repeats of 10 amino acids. Of the two putative peptides, CsRP12-1 was proline-rich and found to have homologues in several organisms. Recombinant proteins of the putative peptides were bacterially produced and purified by an affinity chromatography. Recombinant CsRP12-1 protein was recognized by sera of clonorchiasis patients and experimental rabbits, but recombinant CsRP12-2 was not. One of the putative peptide, CsRP12-1, is designated CsPRA, proline-rich antigen of C. sinensis. Both the C-termini of CsRP12-1 and -2 were bacterially produced and analysed to show no antigenicity. Recombinant CsPRA protein showed high sensitivity and specificity. In experimental rabbits, IgG antibodies to CsPRA was produced between 4 and 8 weeks after the infection and decreased thereafter over one year. These results indicate that CsPRA is equivalent to a natural protein and a useful antigenic protein for serodiagnosis of human clonorchiasis.
Amino Acid Sequence ; Animals ; Antigens, Helminth/*genetics/isolation & purification ; Base Sequence ; *Cloning, Molecular ; Clonorchis sinensis/genetics/*immunology ; DNA, Helminth ; Gene Library ; Human ; Molecular Sequence Data ; Rabbits ; Recombinant Proteins ; *Repetitive Sequences, Nucleic Acid ; Support, Non-U.S. Gov't

PURPOSE: Inidence of recurrent common duct stones reported approximately 20% for a second operation, and with even higher rate following subsequent reoperation. However, the factors contributing to recurrent stones have not well defined. Some authors have reported on association of juxtapapillary diverticula with recurrent biliary stones. We have studied to assess the clinical significance of coexisting PAD on recurrent common bile duct stones and to establish the rational operative procedure in primary or recurrent common duct stones with coexisting PAD. METHODS: Medical records of 456 consecutive patients (Feb. 1993~Aug. 2002) who performed ERCP for biliary symptoms were reviewed. We comparative study retrospectively have done between patients with and without PAD on recurrence of common duct stones and outcome of treatment. RESULTS: Incidence of PAD was 15.1% on ERCP, and increased in the old aged patients. Incidence of biliary stone in PAD group was higher than that of non-PAD group (73.9% vs. 50.6%), and gall stone involving common duct was more prevalent in PAD group than non-PAD group. PAD group showed higher stone recurrence rate (23.5% vs. 6.1%) and earlier recurrence following conventional treatment, and needs more multiple treatments, compared with non-PAD group. Intradiverticular papillae (IDP) type showed higher stone recurrence, compared with juxtapapillary diverticula (JPD) type (36.8% vs. 15.6%). CONCLUSION: PAD would be one of important contributing factors for development and recurrence of common bile ductstones. So rational operative procedure for primary or recurrent common duct stones with coexisting PAD should include extirpation of PAD, particulary in IDP type.
Bile ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Diverticulum* ; Gallstones ; Humans ; Incidence ; Medical Records ; Recurrence ; Reoperation ; Retrospective Studies ; Surgical Procedures, Operative

This study was performed to evaluate the influence of the possible preoperative prognostic factors on the results of pyeloplasty and to predict the postoperative prognosis according to these factors. Of 56 cases under the age of 15 years admitted to Yonsei University Medical Center from 1979 to 1988 with the diagnosis of ureteropelvic junction obstruction, 30 cases, who could be followed up after dismembered pyeloplasty, were analyzed for the preoperative prognostic factors. The possible preoperative prognostic factors affecting postoperative results after pyeloplasty are the age at the time of surgery. the length of obstruction and the state of growth and development. But the pyuria, the urinary tract infection, the severity of hydronephrosis, the presence of extrarenal pelvis, the function and degree of obstruction of the diseased kidney on renography, the thickness of renal parenchyme and the presence of the obstruction of contralateral kidney did not affect the postoperative results after pyeloplasty.
Academic Medical Centers ; Child* ; Diagnosis ; Growth and Development ; Humans ; Hydronephrosis ; Infant* ; Kidney ; Pelvis ; Prognosis ; Pyuria ; Radioisotope Renography ; Urinary Tract Infections

No abstract available.
Lymphangioma, Cystic*

Pigmented lesions of palmar and plantar skin may cause diagnostic problems, because some features of benign lesions in these sites may raise the suspicion of melanoma if considered alone. Transepidermal elimlnation is a mechanism by which a substance is eliminated through the epidermis, and it is apt to be confused with a feature of melanoma that tumor cells are located at all layers of the epidermis. We report a case of transepidermal elimination of nevus cells in acral letiginous nevus which needs a differential dignosis of melanoma.
Epidermis ; Melanoma ; Nevus* ; Skin

The diagnosis of hydronephrosis has been increasing in compared to other organs anomaly since the advent of the prenatal ultrasonography, and it is important to differentiate between physiologic and pathologic hydronephrosis. We retrospectively reviewed the follow up of the postnatal ultrasonography and tried to determine the course of prenatal hydronephrosis. The pyeloplasty was indicated 27.1% of patients, in where the diameter of renal pelvis ranged from 18 to 68 mm with a mean of 41 mm and all patients had severe calyceal dilatation. Normal group in which no obstruction pattern on DTPA renal scan were 55.9% and the diameter of renal pelvis ranged from 6 to 23 mm with a mean of 13 mm. The cases of normal, close observation and indicated pyeloplasty were less than 50% and in all cases of vesicoureteral reflux, revealed urinary tract infection. The study revealed that prenatal ultrasonography alone is inadequate in determining the consistent prognostic factors of prenatal hydronephrosis. However, we determined that Pyeloplasty indicated in cases with severe dilatation of calyx and severe renal pelvis dilation. In cases with urinary tract infection. regardless of calyceal dilation and in cases with severe calyceal dilatation, voiding cystourethrogram should be performed to rule out vesicoureteral reflux. In the cases with mild to moderate dilatation, renal scan indicated to exclude a possible urinary tract obstruction. Minimal calyceal dilation can be regarded as free of urinary tract obstruction.
Diagnosis ; Dilatation ; Follow-Up Studies* ; Humans ; Hydronephrosis* ; Kidney Pelvis ; Pentetic Acid ; Prognosis* ; Retrospective Studies ; Ultrasonography ; Ultrasonography, Prenatal ; Urinary Tract ; Urinary Tract Infections ; Vesico-Ureteral Reflux

Because the most impcetant goal of anesthetic management is patient safety, it is accepted practice that pre-operative patients take nothing by mouth for at least 6 to 8 hours before surgery. However, recent studies have questioned this conventional pre-operative fasting, showing that a fixed volume of water at various time pre-operatively may either improve the characteristics of gastric contents, or else have no effect. The present study was designed to investigate the effect of aUowing patients unlimited access to oral water drinks regardless of time. Fifty-eight fit adult patients scheduled for elective surgery normally requiring endotracheal intubation were recruited. They were randomly allocated to two groups; "Fasters" and "Drinkers", and the effects on plasma osmolality, gastric contents and patient comfort were compared, respectively. This protocol was associated with a reduction in pre-operative anxiety, although the mechanism of this is not clear. No effects were found on plasma osmolality or on the volume or acidity of the gastric contents. No regurgitation occurred during induction and/or emergence in "Drinkers".
Adult ; Anxiety ; Drinking* ; Fasting ; Humans ; Intubation, Intratracheal ; Mouth ; Osmolar Concentration ; Patient Safety ; Plasma ; Water*

Objective: Fatigue is a common, debilitating nonmotor symptom of Parkinson’s disease (PD), but its mechanism is poorly understood. We aimed to determine whether electroencephalography (EEG) could objectively measure fatigue and to explore the pathophysiology of fatigue in PD. Methods: We studied 32 de novo PD patients who underwent EEG. We compared brain activity between 19 PD patients without fatigue and 13 PD patients with fatigue via EEG power spectra and graphs, including the global efficiency, characteristic path length, clustering coefficient, small-worldness, local efficiency, degree centrality, closeness centrality, and betweenness centrality. Results: No significant differences in absolute or relative power were detected between PD patients without or with fatigue (all p > 0.02, Bonferroni-corrected). According to our network analysis, brain network efficiency differed by frequency band. Generally, the brain network in the frontal area for theta and delta bands showed greater efficiency, and in the temporal area, the alpha1 band was less efficient in PD patients without fatigue (p < 0.0001, p = 0.0011, and p = 0.0007, respectively, Bonferroni-corrected). Conclusion Our study suggests that PD patients with fatigue have less efficient networks in the frontal area than PD patients without fatigue. These findings may explain why fatigue is common in PD, a frontostriatal disorder. Increased efficiency in the temporal area in PD patients with fatigue is assumed to be compensatory. Brain network analysis using graph theory is more valuable than power spectrum analysis in revealing the brain mechanism related to fatigue.

Pseudohypoaldosteronism (PHA) is rare herediary salt wasting syndrome due to peripheral resistance to aldostrone. PHA type I, subdivided into isolated renal insensitivity to aldosterone of autosomal dominant inheritance and multiple target organ defect of autosomal recessive inheritance, and PHA type II show similar clinical manifestations except hypertension which is limited to type II. PHA type I is charaterized by hyponatremia, hyperkalemia, high plasma aldosterone and renin activity. Variable degrees, completely asymptomatic to severe fatal, of salt loosing manifestationsdehydration, hypotension, failure to thrive, and renal tubular acidosis usually start during infancy. Sodium loss not only from kidney but also from sweat gland, salivary gland and colon may occur in some cases. Recently we experienced two cases of PHA, a 27 days of age male newborn infant with charateristic clinical symptoms and typical laboratory manifestations of PHA, confirm diagnosed as PHA type I of isolated renal defect by pilocarpin iontophoresis showing normal sodium concentration in sweat gland, and his asymptomatic 6 year-old brother with the history of salt loosing symptoms treated until second year of life diagnosed as PHA type I by markedly elevated plasma aldosterone and renin activity. Brief review and related literatures were also presented.
Acidosis, Renal Tubular ; Aldosterone ; Child ; Colon ; Failure to Thrive ; Humans ; Hyperkalemia ; Hypertension ; Hyponatremia ; Hypotension ; Infant, Newborn ; Iontophoresis ; Kidney ; Male* ; Plasma ; Pseudohypoaldosteronism* ; Renin ; Salivary Glands ; Siblings* ; Sodium ; Sweat Glands ; Vascular Resistance ; Wasting Syndrome ; Wills