We assessed the accuracy of clinical evaluation, arthrography and arthroscopy in the diagnosis of meniscal lesions in ninty knees in which arthrotomy was performed for disabling symptoms after evaluation by these three methods. At surgery, ninty-two menisci were removed, of which seventy-two were abnormal and twenty were normal. In these ninty-two menisci, correct diagnostic rate was made clinically 78%, arthrographically 70% and arthroscopically 86%. Arthrographic diagnosis was least accurate for lesions of the lateral meniscus and arthroscopic diagnosis was least accurate for lesions of the posterior horn of the medial meniscus and peripheral lesions. Based on this study, it was concluded that both the arthrography and arthroscopy are valuable technique for diagnosis of meniscal lesions.
Animals ; Arthrography ; Arthroscopy ; Diagnosis ; Horns ; Knee ; Menisci, Tibial

A case of intraneural ganglion, 5cm×2cm×1.5cm, which was located between the funiculi of the common peroneal nerve was excised completely under the operative microscope. There was no communication with adjacent bursa or joint.
Ganglion Cysts ; Joints ; Peroneal Nerve

PURPOSE: Although PSA(prostate specific antigen) is an excellent tumor marker, it is not prostate cancer-specific but organ-specific. The objective of this study is to assess the efficacy of prostate specific antigen adjusted for the transition zone voume(PSATZ) in diagnosing prostate cancer in men with intermediate PSA levels of 4.1 to 10.0 ng/ml. MATERIALS AND METHODS: Between March 1997 and September 1998, PSATZ was obtained from 67 patients who underwent ultrasound-guided systemic sextant biopsies and had a PSA of 4.1-10.0ng/ml. PSATZ was compared with PSA, PSAD(PSA density) and free-to-total PSA ratio(F/T ratio) via receiver operating characteristic(ROC) curves. RESULTS: Of 67 patients, 22(32.8%) had prostate cancer and 45(67.2%) had benign prostatic hyperplasia on pathologic examination. Mean PSA, F/T ratio, PSAD and PSATZ were 7.96+/-2.01ng/ml 0.10+/-0.06, 0.28+/-0.14ng/ml/cc and 0.70+/-0.28ng/ml/cc in patients with prostate cancer and 6.39+/-1.68ng/ml, 0.15+/-0.05, 0.16+/-0.06ng/ml/cc and 0.29+/-0.11ng/ml/cc in patients with benign prostatic hyperplasia, respectively. ROC curve analysis demonstrated that PSATZ, F/T ratio and PSAD predicted the biopsy outcome significantly better than PSA in all 67 patients(p<0.01, respectively). In a subset of 45 men with normal digital rectal examination, PSATZ predicted the biopsy outcome better than PSAD or F/T ratio significantly(p<0.01, respectively). With cutoff value of 0.35ng/ml/cc, PSATZ had a sensitivity of 86% and a specificity of 89% for predicting prostate cancer. With cutoff value of 0.12, F/T ratio had a sensitivity of 73% and a specificity of 71% for predicting prostate cancer. CONCLUSIONS: These results suggest that PSATZ is more specific and more accurate than PSA, PSAD or F/T ratio in distinguishing benign prostatic disease from prostatic cancer in men with intermediate PSA levels of 4.1 to 10 ng/ml. But large prospective studies are requested to assess the precise role of PSATZ in early prostate cancer detection.
Biopsy ; Digital Rectal Examination ; Humans ; Male ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Diseases ; Prostatic Hyperplasia ; Prostatic Neoplasms* ; ROC Curve ; Sensitivity and Specificity

Wilson s disease is an autosomal recessive disorder characterized by degenerative changes in the brain, liver, and cornea. Treatment includes D-penicillamine, trientine, and zinc sulfate. D-penicillamine has been used frequently as first line therapy for Wilson s disease. However, nephrotoxicity can occur after D-penicillamine treatment. Among them membranous glomerulopathy is the most common histological abnormality but minimal change lesions have also been reported. Nephrotic syndrome is a late complication of D-penicillamine treatment but very rarely can occur within 2 months after treatment of D-penicillamine. We report the early development of minimal change nephrotic syndrome in a 3-year-old girl with Wilson s disease 3 weeks after initiation of D-penicillamine.
Brain ; Child, Preschool ; Cornea ; Female ; Glomerulonephritis, Membranous ; Humans ; Liver ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Penicillamine* ; Trientine ; Zinc Sulfate

Anomalous left pulmonary artery(pulmonary artery sling) is a congenital anomaly in which the vascular structure arises either from the posterior surface of the right pulmonary artery, or from the main pulmonary artery and courses to the left lung between the posterior surface of the trachea and the anterior surface of the esophagus. It may compress on the tracheobronchial tree causing significant symptoms on the part of the respiratory system such as dyspnea, stridor, or cyanosis. It is a rare condition leading to death in the first months of life, if it is not corrected. We present a case of pulmonary sling who was suffering from recurrent lower respiratory tract diseases, expiratory wheezing, and intermittent dyspnea since birth, thus she was treated for bronchial asthma. We confirmed the diagnosis with computerized tomography, especially with three dimensional reconstruction, which provided information regarding the spatial relationship between the anomalous pulmonary artery branch and the trachea and bronchi.
Arteries ; Asthma* ; Bronchi ; Cyanosis ; Diagnosis ; Dyspnea ; Esophagus ; Lung ; Parturition ; Pulmonary Artery* ; Respiratory Sounds ; Respiratory System ; Respiratory Tract Diseases ; Trachea

Recently, percutaneous epidural neuroplasty has become widely used to treat radicular pain caused by spinal stenosis or a herniated intervertebral disc. A 19-year-old female patient suffering from left radicular pain caused by an L4-L5 intervertebral disc herniation underwent percutaneous epidural neuroplasty of the left L5 nerve root using a Racz catheter. After the procedure, the patient complained of acute motor weakness in the right lower leg, on the opposite site to where the neuroplasty was conducted. Emergency surgery was performed, and swelling of the right L5 nerve root was discovered. The patient recovered her motor and sensory functions immediately after the surgery. Theoretically, the injection of a large volume of fluid in a patient with severe spinal stenosis during epidural neuroplasty can increase the pressure on the opposite side of the epidural space, which may cause injury of the opposite nerve by barotrauma from a closed compartment. Practitioners should be aware of this potential complication.
Barotrauma ; Catheters ; Constriction, Pathologic ; Emergencies ; Epidural Space ; Female ; Hemiplegia ; Humans ; Intervertebral Disc ; Leg ; Lower Extremity* ; Sensation ; Spinal Stenosis ; Young Adult

PURPOSE: To evaluate the usefulness of CT angiography and to compare SSD(Shaded Surface Display) andMIP(Maximum Intensity Projection) in the diagnosis and preoperative evaluation of the cerebral aneurysms. MATERIALS AND METHODS: Twenty-six aneurysms in 20 patients were diagnosed on conventional angiography and surgerywas performed. For preoperative evaluation, all patients underwent CT angiography, with spiral CT for preoperativeevaluation. Using SSD and MIP techniques, the results were proccessed and compared; three radiologistsretrospectively analysed detectability, size, neck visualization, delineation of shape, direction, therelationship with surrounding vessels-including the feeding artery of the aneurysm-and intraluminal thrombicontaining calcification. RESULTS: Twenty five of 26 aneurysms (96.2%) were detected by CT angiography, while MIPand SSD depicted 25 (96.2%) and 24 (92.3%), respectively. The largest diameter of the aneurysms was 11-15mm infour cases, 6-10mm in ten, and 3-5mm in 12 (mean 7.38mm, SD=3.34). With regard to detectability, MIP led to onefalse negative result, and SSD to two false negative and one false-positive results. Aneurysm neck assessment byMIP was clear in 96.0% of cases (24/25), and by SSD in 83.3% (20/24). For the depiction of directions and feedingvessels of the aneurysms, and intraluminal thrombi containing calcification, MIP was superior to SSD, while fordepicting shape and the relationship with surrounding structures, SSD was superior to MIP. CONCLUSION: For theassessment of cerebral aneurysms, MIP is somewhat superior to SSD. The characteristics of aneurysms and theirrelationship with surrounding structures can, however, be better evaluated by combining the two techniques.
Aneurysm ; Angiography* ; Arteries ; Diagnosis* ; Humans ; Intracranial Aneurysm* ; Neck ; Silver Sulfadiazine* ; Tomography, Spiral Computed

PURPOSE: To demonstrate the MRI findings of olivopontocerebellar atrophy. MATERIALS AND METHODS: We retrospectively reviewed the MRI findings of eight patients who had been diagnosed by clinical manifestation and the peculiar pattern of atrophy and signal change on MRI. RESULTS: Seven patients had an atrophy of the olive, pons and cerebellum and increased signal change of the transverse pontine fiber, median raphe and middle cerebellar peduncle on T2WI. Of these, six patients had severe atrophy of the olive, pons and cerebellum and decreased signal change of the basal ganglia, red nucleus, substantia nigra or dentate nucleus on T2WI. Additionally, four of six patients had a cerebral atrophy. Except one patient who had an urinary incontinence, these 5 patients had not been associated with extrapyramidal or autonomic symptom. The other patient with relatively short duration of the disease had only cerebellar atrophy without signal change on T2WI . CONCLUSION: With progressing of the olivopontocerebellar atrophy, cerebral atrophy and decreased signal change of the basal ganglia, red nucleus, substantia nigra or dentate nucleus on T2WI is combined. Thus, MRI is essential in establishing the diagnosis and evaluating the severity of olivopontocerebellar atrophy.
Atrophy ; Basal Ganglia ; Brain* ; Cerebellar Nuclei ; Cerebellum ; Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Olea ; Olivopontocerebellar Atrophies* ; Pons ; Red Nucleus ; Retrospective Studies ; Substantia Nigra ; Urinary Incontinence

OBJECTIVE: The aim of the this study was to compare the effects of clonidine (a alpha2-adrenoceptor and imidazoline receptor agonist), yohimbine (a selective alpha2-adrenoceptor antagonist) and idazoxan (a alpha2-adrenoceptor and imidazoline receptor antagonist) on extracellular monoamines and their metabolites by using the awakening animal microdialysis and high-performance liquid chromatography with electrochemical detection (HPLC-ECD) in brain regions, which are suggested to have regulatory role in depression. METHODS: We used intracerebral microdialysis in awakening rats by inserting probe through the dorsal hippocampus and occipital cortex especially in primary visual cortex, We studied respective effects of 2.0 mg/kg of clonidine, 5.0 mg/kg of yohimbine, and 5.0 mg/kg of idazoxan on the release of MHPG (a major metabolite of norepinephrine), norepinephrine (NE), DOPAC (a major metabolite of dopamine), and 5-HIAA (a main metabolite of serotonin) by intraperitoneal administration. RESULTS: Clonidine decreased the release of MHPG, NE, DOPAC, and 5-HIAA in both dorsal hippocampus and occipital cortex regions, and there were no significant differences in releasing pattern of all monoamines and their metabolites. Both yohimbine and idazoxan enhanced the release of MHPG, NE, DOPAC, and 5-HIAA in both brain regions, but there were significant differences in releasing pattern of NE and 5-HIAA. Idazoxan induced the delayed and higher efflux of NE and 5-HIAA in the primary visual cortex than yohimbine, but not in the hippocampus. CONCLUSION: This study shows that the selective alpha2-adrenoceptor antagonists increase basal monoamine output and enhance the metabolism of them in the hippocampus and primary visual cortex, and the imidazoline receptor has modulatory role in the regulation of monoamine release in primary visual cortex than hippocampus. It also suggests that high turnover rate of serotonin and norepinephrine in primary visual cortex may contribute to the pathophysiological role in depression.
3,4-Dihydroxyphenylacetic Acid ; Animals ; Brain ; Chromatography, Liquid ; Clonidine ; Depression ; Hippocampus* ; Hydroxyindoleacetic Acid ; Idazoxan ; Metabolism ; Methoxyhydroxyphenylglycol ; Microdialysis ; Norepinephrine ; Rats* ; Serotonin ; Visual Cortex* ; Yohimbine

Penile fracture is known as a rupture of the tunica albuginea occurring during erection. Diagnosing a penile fracture is usually not difficult, and often is based on the patients history and a physical examination. However, patients with atypical clinical findings may require an accurate diagnostic procedure. Immediate surgical intervention is normally used for treating a penile fracture due to the high risk of complications associated with conservative management. The authors recently experienced 2 cases of a penile fracture and the superiority of magnetic resonance imaging (MRI) over ultrasonographic imaging for diagnosing a suspected penile fracture was shown. Therefore, MRI is recommended for diagnosing a suspected atypical penile fracture.
Diagnosis* ; Humans ; Magnetic Resonance Imaging* ; Male ; Penis ; Physical Examination ; Rupture