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Biomedical subjects

J M Ahn

Publications and source records attributed to J M Ahn.

At least 19 recordsLinked to original sources

Risk factors of new compression fractures in adjacent vertebrae after percutaneous vertebroplasty.

PURPOSE: To evaluate the risk factors related to the development of new fractures in adjacent vertebrae after vertebroplasty. MATERIAL AND METHODS: The study was conducted on 106 patients in whom 212 vertebroplasties were performed during a period of 3 years. Evaluations of the five vertebrae superior and inferior to the treated vertebra were performed. Consequently, 913 vertebrae were evaluated and the fracture-free interval of the vertebral body adjacent to the treated vertebra was calculated. Survival analysis was performed using the Kaplan-Meier method and Cox proportional hazards regression analysis. RESULTS: Seventy-two (7.9%) new fractures were revealed. The Kaplan-Meier estimate of the 1-year fracture-free rate was 93.1%. The mean fracture-free interval was 32 months (95% CI, 32 to approximately 33 months). The greater degree of height restoration of the treated vertebra, the location of the adjacent vertebra in the TL junction, and the shorter distance between the treated and the adjacent vertebra increased the risk of new vertebral fractures. CONCLUSION: Thoracolumbar junction, shorter distance from the treated vertebrae, and greater degree of height restoration of the cemented vertebrae may increase the fracture risk of vertebrae adjacent to cement vertebrae after vertebroplasty.

Adult↗

Contemporary diagnosis and management of venous and arterio-venous shunting malformation by whole body blood pool scintigraphy.

AIM: Various non- to less-invasive tests have been recently introduced in the management of congenital vascular malformations (CVM) and have become essential for the initial diagnostic work-up, largely replacing the traditional role of invasive tests. Whole body blood pool scintigraphy (WBBPS) was initially adopted as a supplementary test to reinforce other well-established essential diagnostic tests, and has been used extensively together in our Clinic, for years. We have evaluated WBBPS retrospectively for the diagnosis of venous malformation (VM) and arterio-venous malformation (AVM), and also for a further possible role for the interim assessment of treatment results during multistaged embolo/sclerotherapy. METHODS: Of 123 VMs and 48 AVMs selected for various treatments, 80 patients (66 VMs and 14 AVMs) were reviewed. The reliability of WBBPS as an initial diagnostic tool for VMs and AVM was assessed first by comparing its findings with matching MRI and/or duplex scan findings. These 80 patients underwent embolo/sclerotherapy with absolute ethanol mostly for VM, and N-butyl cyanoacrylate for AVM. A total of 251 sessions were performed either as a primary treatment independently or in conjunction with surgical treatment preoperatively. Thirty-six patients were available in terms of the subsequent review of the treatment results, to compare their 72 post-therapy WBBPS findings with matching duplex scan and MRI findings. The WBBPS assessment of treatment response was based on the percentage reduction of abnormal blood pooling over the region of interest (ROI) from baseline (initial) value. Treatment response was also qualitatively and semi-quantitatively assessed according to the degree of abnormal blood pool reduction. RESULTS: Of the 80 CVM (66 VM and 14 AVM) patients, 61 of 66 WBBPS findings of VM on initial diagnosis were confirmed as true-positive. Twelve of 14 AVMs were also confirmed as WBBPS true-positive findings. The sensitivity of WBBPS for the initial diagnosis was 93.8% (61/65) for VM and 92.3% (12/13) for AVM. The positive predictive value was 98.4% (61/62) for VM and 92.3% (12/13) for AVM. Of 72 post-therapy WBBPS performed for follow-up assessment of the results of treatment on 36 patients, 52 WBBPS showed positive findings qualitatively and/or quantitatively, the remaining 20 were negative. Fifty-one of the 52 WBBPS-positive findings were true-positive and 18 of the 20 were true-negative. Hence, WBBPS for follow-up assessment showed a sensitivity of 96% (51/53); a specificity of 95% (18/19); a positive predictive value of 98% (51/52); and a negative predictive value of 90% (18/20). CONCLUSIONS: Contemporary management of CVMs can be improved by using WBBPS, which is a less expensive, simple, and safe non-invasive test, especially for venous and arterio-venous malformations. WBBPS is a cost-effective and practical test with dependable accuracy for the assessment of treatment results, especially for interim measurements during multistage embolo/sclerotherapy.

Adolescent↗

Imaging features of ischial bursitis with an emphasis on ultrasonography.

OBJECTIVE: The aim of this study was to evaluate the imaging features of ischial bursitis with an emphasis on ultrasonography (US). DESIGN AND PATIENTS: Our study included 31 patients with a painful mass or tenderness in their buttock who underwent US (n=27), CT (n=1), or MR imaging (n=4). A needle aspiration (n=6) or a bursal excision (n=5) was performed in those patients who had no clinical improvement in spite of the conservative treatment. Evaluation included lesion location, size, wall of the bursae, and intrinsic characteristics on US, CT and MR imaging. RESULTS: Ischial bursitis was superficial to the ischial tuberosity in all patients (n=31). The lesion ranged from 1.5 cm to 7 cm (average 3.8 cm) in diameter. The bursal wall was identifiable in 25 cases (81%). Internal septa and mural nodules were seen in 12 (39%) and 17 cases (55%), respectively. Sonography showed that fluid within the bursa was hypoechoic (59%), hyperechoic (26%), or of mixed echogenicity (15%). The bursae were compressible by the transducer. Power Doppler examination (n=7) showed hypervascularity of the bursal wall. All lesions imaged with contrast-enhanced CT and MR imaging had an enhancing thin wall and mural nodule. CONCLUSIONS: Ischial bursitis, superficial to the ischial tuberosity, can be clearly demonstrated on sonography and appears as a thin-walled cystic lesion, with or without internal septa and mural nodules.

Adult↗

MR imaging of the neural foramina of the cervical spine. Comparison of 3D-DESS and 3D-FISP sequences.

PURPOSE: To assess whether a single three-dimensional double-echo steady state (3D-DESS) sequence can produce equivalent results when compared to a 3D free induction with steady precession (3D-FISP) sequence for the evaluation of the neural foraminal diameter and structures. MATERIAL AND METHODS: Five phantoms were imaged on CT with 3-mm axial slices followed by reformatted axial 3D-DESS and 3D-FISP sequences. In addition, 3D-DESS and 3D-FISP sequences of 20 healthy subjects were compared with regard to image quality, differentiation between vertebrae and discs, differentiation between discs and neural foramina, and differentiation between vertebrae and neural foramina. RESULTS: Compared with CT, 3D-DESS and 3D-FISP sequences consistently underestimated the diameters of the neural foramina. The mean difference values for the 3D-DESS was 12.8%, compared to 9.5% for the 3D-FISP sequence. Concerning the in vivo studies, the 3D-DESS sequence was superior but not statistical significant to the 3D-FISP sequence with regard to image quality, differentiation between vertebrae and discs, differentiation between discs and neural formina, and identification of the nerve roots. CONCLUSION: The 3D-DESS sequence is moderately accurate in the evaluation of the neural foraminal size. Compared to the 3D-FISP sequence, the 3D-DESS sequence is compatible concerning the image quality, differentiation between the cervical vertebrae and discs, and between the discs and neural foramina.

Adult↗

A new approach to search for the bioactive conformation of glucagon: positional cyclization scanning.

In search for the bioactive conformation of glucagon, "positional cyclization scanning" was used to determine secondary structures of glucagon required for maximal interaction with the glucagon receptor. Because glucagon is flexible in nature, its bioactive conformation is not known except for an amphiphilic helical conformation at the C-terminal region. To understand the conformational requirement for the N-terminal region that appears to be essential for signal transduction, a series of glucagon analogues conformationally constrained by disulfide or lactam bridges have been designed and synthesized. The conformational restrictions via disulfide bridges between cysteine i and cysteine i + 5, or lactam bridges between lysine i and glutamic acid i + 4, were applied to induce and stabilize certain corresponding secondary structures. The results from the binding assays showed that all the cyclic analogues with disulfide bridges bound to the receptor with significantly reduced binding affinities compared to their linear counterparts. On the contrary, glucagon analogues containing lactam bridges, in particular, c[Lys(5), Glu(9)]glucagon amide (10) and c[Lys(17), Glu(21)]glucagon amide (14), demonstrated more than 7-fold increased receptor binding affinities than native glucagon. These results suggest that the bioactive conformation of glucagon may adopt a helical conformation at the N-terminal region as well as the C-terminal region, which was not evident from earlier biophysical studies of glucagon.

Adenylyl Cyclases↗

IFN-gamma induces cell death in human hepatoma cells through a TRAIL/death receptor-mediated apoptotic pathway.

We demonstrated the induction of cell death in a hepatoma cell line by IFN-gamma and its possible mechanism. Among the 2 hepatitis B virus (HBV)-associated hepatoma cell lines, SNU-354 and SNU-368, IFN-gamma induced cell death and increased caspase-3 activity in SNU-368 but not in SNU-354. IFN-gamma induced several changes in the mRNA expression level of apoptosis-regulating genes, e.g., increased expression of Fas, caspase-1 and TNF-related apoptosis-inducing ligand (TRAIL). In particular, IFN-gamma potently increased the mRNA expression of TRAIL in both cell lines. However, it did not change the mRNA expression level of death-mediating TRAIL receptors, e.g., DR4 and DR5, which were constitutively expressed in both cell lines. In contrast, the decoy receptor DcR1 was expressed in SNU-354 but not in SNU-368, and its expression level in SNU-354 was increased by IFN-gamma. Another decoy receptor, DcR2, was constitutively expressed in both cell lines; however, its expression level in SNU-368 was decreased by IFN-gamma. In addition, exogenous recombinant TRAIL reduced viability in SNU-368, but not in SNU-354, cells. From these findings, we speculated that TRAIL up-regulation and the subsequent TRAIL-mediated apoptosis serve as a mechanism of IFN-gamma-induced cell death in SNU-368. To confirm this hypothesis, we demonstrated that soluble DR4-Fc fusion protein, a TRAIL pathway inhibitor, inhibited IFN-gamma-induced cell death in SNU-368. Our results demonstrated that IFN-gamma acts as an inducer of cell death through TRAIL-mediated apoptosis.

Apoptosis↗

In vivo changes in the neuroforaminal size at flexion-extension and axial rotation of the cervical spine in healthy persons examined using kinematic magnetic resonance imaging.

STUDY DESIGN: In vivo flexion-extension and axial rotation magnetic resonance imaging (MRI) studies of the cervical spine were performed inside a positioning device. OBJECTIVE: To determine the functional changes of neuroforaminal size that occur during flexion-extension and axial rotation of the cervical spine in healthy persons. SUMMARY OF BACKGROUND DATA: Kinematic MRI studies of the cervical spine were performed to obtain detailed information about the functional changes that occur in neuroforaminal size during flexion-extention and axial rotation. The results were compared with published data of in vitro functional flexion-extension and axial rotation studies of the cervical spine. METHODS: Inside a positioning device, the cervical spines of 30 healthy persons were examined in a whole-body magnetic resonance scanner from 40 degrees of flexion to 30 degrees of extension at nine different angle positions. In addition, axial rotation was performed at neutral position (0 degrees ) and at 20 degrees and 40 degrees of axial rotation to both sides. The images were analyzed with respect to the neuroforaminal size at each position using a reformatted 3D-FISP sequence. RESULTS: At flexion, widening of the neuroforaminal size of up to 31% (compared with neutral position, 0 degrees ) was observed. Conversely, at extension a decrease in the size of the neuroforamen of up to 20% was recognized. At 20 degrees and 40 degrees of ipsilateral rotation of the head, a reduction in the neuroforaminal size of up to 15% and 23%, respectively, compared with the neutral position was noted. In contrast, a widening of the foraminal size was recognized on the contralateral side of 9% and 20% at 20 degrees and 40 degrees rotation. Statistically significant differences (p <== 0.05) were found in the neuroforaminal size between different degrees of flexion and extension and in addition for axial rotation compared to neutral position (0 degrees ). CONCLUSION: Compared with the results of previous biomechanical studies of human cadaver cervical spines, kinematic MRI provides additional noninvasive data concerning the physiological changes of the neuroforaminal size during flexion-extension and axial rotation in healthy individuals.

Adult↗

Development of potent truncated glucagon antagonists.

In pursuit of truncated glucagon analogues that can interact with the glucagon receptor with substantial binding affinity, 23 truncated glucagon analogues have been designed and synthesized. These truncated analogues consist of several fragments of glucagon with 11 or 12 amino acid residues (1-4), conformationally constrained analogues containing the sequence of the middle region of glucagon (5-15), and truncated analogues containing the sequence of the C-terminal region (16-23). Biological assays of these analogues showed that the truncated glucagon analogues with the sequence of the C-terminal region possess significantly better binding affinity compared to the truncated analogues with the sequence of the middle region, and these analogues (17-23) demonstrated potent antagonistic activity (pA(2) values between 6.5 and 7.5). On the basis of these results, it can be suggested that glucagon interacts with its receptor with two hydrophobic patches located in the middle and the C-terminal regions of glucagon, and both hydrophobic patches are necessary for significant receptor recognition. These two hydrophobic binding motifs, located in two different regions of glucagon, appear to be the reason why the earlier attempts to obtain truncated analogues with good binding affinity did not result in any success. Long peptide hormones such as glucagon seem to require more than one binding pocket on the receptors for maximal interaction.

Adenylyl Cyclases↗

Development of potent glucagon antagonists: structure-activity relationship study of glycine at position 4.

We examined the functional role of glycine at position 4 in the potent glucagon antagonist [desHis(1), Glu(9)]glucagon amide, by substituting the L- and D-enantiomers of alanine and leucine for Gly(4) in this antagonist. The methyl and isobutyl side-chain substituents were introduced to evaluate the preference shown by the glucagon receptor, if any, for the orientation of the N-terminal residues. The L-amino acids demonstrated only slightly better receptor recognition than the D-enantiomers. These results suggest that the Gly(4) residue in glucagon antagonists may be exposed to the outside of the receptor. The enhanced binding affinities of analogs 1 and 3 compared with the parent antagonist, [desHis(1), Glu(9)]glucagon amide, may have resulted from the strengthened hydrophobic patch in the N-terminal region and/or the increased propensity for a helical conformation due to the replacement of alanine and leucine for glycine. Thus, as a result of the increased receptor binding affinities, antagonist activities of analogs 1-4 were increased 10-fold compared with the parent antagonist, [desHis(1), Glu(9)]glucagon amide. These potent glucagon antagonists have among the highest pA(2) values of any glucagon analogs reported to date.

Adenylyl Cyclases↗

Tuberculous versus pyogenic arthritis: MR imaging evaluation.

PURPOSE: To assess magnetic resonance (MR) imaging features in differentiating tuberculous arthritis from pyogenic arthritis. MATERIALS AND METHODS: Findings in 29 patients with tuberculous arthritis were compared with those of 13 patients with pyogenic arthritis. Bone erosion, marrow signal intensity, synovial lesion signal intensity, boundaries (smooth or irregular) for extraarticular extension of infection, and abscess rim enhancement (thin and smooth or thick and irregular) were analyzed. RESULTS: Bone erosion was more common in patients with tuberculous arthritis (24 [83%] of 29) than in those with pyogenic arthritis (six [46%] of 13) (P =.026), while subchondral marrow signal intensity abnormality was seen more frequently in patients with pyogenic arthritis (12 [92%] of 13) than in those with tuberculous arthritis (17 [59%] of 29) (P =.036). On T2-weighted images, there was no significant difference between the synovial lesion signal intensities of tuberculous arthritis and pyogenic arthritis. Lesions in 16 (70%) of 23 patients with tuberculous arthritis and two (17%) of 12 patients with pyogenic arthritis had smooth extraarticular boundaries, while those in seven (30%) of 23 patients with tuberculous arthritis and 10 (83%) of 12 patients with pyogenic arthritis had irregular boundaries (P =.005). Tuberculous abscesses (16 [100%] of 16) had thin and smooth rim enhancement, while most pyogenic abscesses (five [71%] of seven) had thick and irregular rims (P =.001). CONCLUSION: MR imaging of bone abnormalities, extraarticular lesions, and associated abscesses provides useful information in the differentiation of tuberculous arthritis and pyogenic arthritis.

Abscess↗

Design and synthesis of conformationally constrained glucagon analogues.

Glucagon was systematically modified by forming lactam bridges within the central region of the molecule to give conformationally constrained cyclic analogues. Six cyclic glucagon analogues have been designed and synthesized. They are c[Asp(9),Lys(12)][Lys(17,18), Glu(21)]glucagon-NH(2) (1), c[Asp(9),Lys(12)]glucagon-NH(2) (2), c[Lys(12),Asp(15)]glucagon-NH(2) (3), c[Asp(15), Lys(18)]glucagon-NH(2) (4), [Lys(17)-c[Lys(18), Glu(21)]glucagon-NH(2) (5), and c[Lys(12),Asp(21)]glucagon-NH(2) (6). The receptor binding potencies and receptor second messenger activities were determined by radio-receptor binding assays and adenylate cyclase assays, respectively, using rat liver plasma membranes. Most interestingly, analogues 1, 2, 3, and 4 were antagonists of glucagon stimulated adenylate cyclase activity, whereas analogues 5 and 6 were partial agonists in the functional assay. All of the cyclic analogues were found to have reduced binding potencies relative to glucagon. The structural features that might be responsible for these effects were studied using circular dichroism spectroscopy and molecular modeling. These results demonstrated the significant modulations of both receptor binding affinity and transduction (adenylate cyclase activity) that can accompany regional conformational constraints even in larger polypeptide ligands. These studies suggest that the entire molecular conformation, including the flexible middle portion, is important for molecular recognition and transduction at the hepatic glucagon receptor.

Amino Acid Sequence↗

Effect of low back posture on the morphology of the spinal canal.

OBJECTIVE: To define the possible mechanism of posture-dependent symptoms of spinal stenosis by measuring the effect of low back posture on morphologic changes of the intervertebral discs and spinal canal in healthy young people. DESIGN: Twenty healthy young volunteers underwent magnetic resonance imaging while supine with their spine in neutral, flexed, extended, and right and left rotational positions. The axial MR images at the middle of the intervertebral discs of L3-4 and L4-5 were analyzed to measure the difference in the size and shape of the intervertebral discs and spinal canal in each posture. RESULTS: Extension or rotation decreased the sagittal diameters and cross-sectional areas of the dural sac and spinal canal and increased the thickness of the ligamentum flavum, whereas flexion had the opposite effects. The gap between the convex posterior disc margin and the anterior margin of the facet joint on each side, represented as the subarticular sagittal diameter, increased with flexion and decreased with extension or rotation. The direction of rotation did not result in asymmetry of the subarticular sagittal diameter, but right rotation caused thickening of the right ligamentum flavum, and vice versa. The shape and dimensions of the disc did not change significantly according to the positions of the low back. CONCLUSIONS: With extension or rotation, the thickness of the ligamentum flavum increased and the posterior margin of the intervertebral disc was approximated to the facet joint without any change in shape and size of the disc. These phenomena result in a decrease in the size of the spinal canal and dural sac in extension or rotation postures in young healthy people without disc degeneration, and may explain the posture-dependent symptom of spinal stenosis.

Adult↗

Infantile fibromatosis in childhood: findings on MR imaging and pathologic correlation.

AIM: The objective of this study was to analyse the MR imaging findings of infantile fibromatosis of childhood and to correlate them with histopathological features. MATERIALS AND METHODS: Seven patients with histologically proven infantile fibromatosis were included in this study. The findings on MR images were retrospectively evaluated and then correlated with the pathological features. Findings on MR imaging evaluated included signal intensity, extent of hyperintense area on T2-weighted images, margins of the lesion, the degree and pattern of enhancement and the presence of fatty tissue. Pathological features evaluated included cellularity, collagenization, and myxoid change. A five point scale was used for the evaluation of the extent of hyperintense area on MR imaging, and each of pathological features. RESULTS: On T1-weighted images, the lesions were iso-intense in two patients; iso- and hypointense in three; and iso-, hypo- and hyperintense in two. On T2-weighted images, iso-, hypo- and hyperintense areas were mixed in all patients, the hyperintense area being the largest portion of the lesion. The margins of the lesions were infiltrative in four patients (57%), smooth in two (29%) and mixed in one (14%). Enhancement was marked in five patients (72%) and diffuse in five (71%). Regardless of the hyperintense signal intensity on T2-weighted images, the grades of each pathologic feature were variable. CONCLUSION: Infantile fibromatosis on MR imaging causes an enhancing mass, that is largely hyperintense on T2-weighted images. Areas of high signal intensity on T2-weighted images corresponded to variable grades of cellularity, collagenization, or myxoid change.

Child↗

Analysis of patellar cartilage. Comparison of conventional MR imaging and MR and CT arthrography in cadavers.

OBJECTIVE: To compare the sensitivity of conventional MR sequences, MR arthrography, and CT arthrography for the detection of cartilage lesions of the patella in cadavers. MATERIAL AND METHODS: Cartilage lesions in 10 cadaveric specimens were evaluated by MR imaging, including T1-weighted, proton density-weighted and T2-weighted sequences, and fat-suppressed spoiled gradient recalled acquisition in the steady state (SPGR), MR arthrography including T1-weighted and SPGR sequences, and double-contrast CT arthrography including conventional and subtracted images. The sensitivities with regard to detection of lesions were compared to results from morphologic and histologic investigations of sectioned specimens. RESULTS: Twenty-one lesions were detected morphologically. For the detection of these lesions, sensitivities were as follows: T1-weighted images 33.3%; proton density-weighted images 85.7%; T2-weighted images 85.7%; SPGR images 80.9%; MR arthrography with T1-SE sequences 57.1%; MR arthrography with SPGR sequence 90.5%; and CT arthrography, both regular and subtracted images 85.7%. CONCLUSION: For noninvasive techniques, T2-weighted images revealed the highest sensitivity for the detection of patellar cartilage lesions, which was surpassed only by MR arthrography using the SPGR sequence. CT arthrography delineated surface irregularities but failed to demonstrate intrachondral lesions.

Aged↗

Peripheral focal low signal intensity areas in the degenerated annulus fibrosus on T2-weighted fast spin echo MR images: correlation with macroscopic and microscopic findings in elderly cadavers.

OBJECTIVE: To correlate the peripheral focal low signal intensity areas in the degenerated annulus fibrosus on T2-weighted fast spin echo MR images with the macroscopic and microscopic findings in cadavers derived from elderly subjects. DESIGN: Twenty-eight intervertebral disks (16 lumbar and 12 cervical) derived from four nonembalmed cadavers were examined with T1-weighted spin echo and proton density-weighted and T2-weighted fast spin echo MR imaging. The signal intensities of the annulus fibrosus were evaluated on sagittal MR images and correlated with the findings on corresponding sagittal anatomic sections. The MR imaging-histologic correlation was then studied. RESULTS: Peripheral focal low signal intensity areas and adjacent regions of high signal intensity were found in five lumbar intervertebral disks. Peripheral focal low signal intensity regions consisted of disorganized compact annular fibers, tiny fissures, and dense fibrosis. The high signal intensity regions, adjacent to the areas of low signal intensity, consisted of mucoid degeneration, tiny fissures, and chondroid metaplasia. CONCLUSIONS: Awareness of the histologic findings in regions that reveal peripheral focal low signal intensity with adjacent regions of high signal intensity in the degenerated annulus fibrosus on T2-weighted images may facilitate effective interpretation of clinical MR images of the spine.

Aged↗

Intramuscular vascular malformations of an extremity: findings on MR imaging and pathologic correlation.

OBJECTIVE: To analyze the findings of intramuscular vascular malformations of an extremity on MR imaging and to correlate these findings with histopathologic examination. DESIGN AND PATIENTS: The findings on MR imaging and the medical records of 14 patients with an intramuscular vascular malformation of the extremity were retrospectively studied. All patients underwent surgical excision. Diagnoses were based on the results of pathologic examination. Findings on MR imaging were noted and correlated with the histopathologic findings. RESULTS: Intramuscular vascular malformations of an extremity showed multi-septate, honeycomb, or mixed appearance on MR imaging. Multi-septate areas correlated with dilated and communicating vascular spaces with flattened endothelium. Honeycomb areas corresponded to vascular spaces with inconspicuous small lumina and thickened vascular walls. Areas of increased signal intensity on T2-weighted images were found in all intramuscular vascular malformations. Infiltrative margins were more commonly seen in intramuscular lymphaticovenous malformations. Adherence to neurovascular structures and orientation of the lesion along the long axis of the affected muscle were more commonly seen in intramuscular venous malformations. CONCLUSIONS: Intramuscular vascular malformations showed either a multi-septate, honeycomb, or mixed appearance, reflecting the size of the vascular spaces and the thickness of the smooth muscles of the vessel walls. Prediction of the subtype of an intramuscular vascular malformation of an extremity on MR imaging seems to be difficult, although there are associated findings that may be helpful in the differential diagnosis of each subtype.

Adolescent↗

Transverse ligament and its effect on meniscal motion. Correlation of kinematic MR imaging and anatomic sections.

RATIONALE AND OBJECTIVES: To evaluate the effect of the transverse ligament on translation of the menisci. METHODS: Six cadaveric knees were examined by MR imaging inside a positioning device before and after transecting the transverse ligament. The knees were examined at various positions: extension, 30 degrees of flexion, 60 degrees of flexion, and full flexion. Sagittal T1-weighted spin-echo images were generated at each knee position and evaluated for statistical differences with regard to anterior-posterior meniscal excursion. RESULTS: Statistically significant differences in meniscal excursion were found before and after transsecting the transverse ligament for anterior-posterior meniscal motion of the anterior horn of the medial meniscus at 30 degrees of knee flexion. No such significant differences were found, however, at 60 degrees of flexion and full flexion in anterior-posterior meniscal excursion of the anterior or posterior horn of either meniscus before and after transsecting the transverse ligament. CONCLUSIONS: The transverse ligament has a restricting effect on anterior-posterior excursion of the anterior horn of the medial meniscus at lower degrees of knee flexion.

Aged↗

Transforming growth factor-alpha and rhinitis.

OBJECTIVES: Transforming growth factor-alpha (TGF-alpha) has been implicated in diverse physiologic and pathophysiologic functions including immunological, inflammatory, and neoplastic processes. TGF-alpha has been localized in the hyperproliferative, inflammatory environment of chronic otitis media, cholesteatoma, and asthmatic airways. TGF-beta1, which must be present with TGF-alpha to transform fibroblasts, has been found in rhinitic mucosa and in asthma in prior studies. The authors sought to identify whether TGF-alpha also played a role in the inflammatory cascade and fibrosis of rhinitis. STUDY DESIGN: A nonrandomized, prospective study was carried out in which samples of inferior turbinate and nasal polyps from rhinitic and nonrhinitic patients were subjected to immunohistochemistry and Western blotting to determine the presence of TGF-alpha. METHODS: Twenty-seven subjects undergoing surgery for rhinitis, obstructive sleep apnea, nasal fracture, and rhinoplasty were recruited for this study, the latter three groups acting as controls. Immunohistochemical and Western blotting techniques were employed to identify the presence of TGF-alpha in inferior-turbinate and nasal-polyp samples of rhinitic subjects. RESULTS: Immunohistochemistry demonstrated the selective staining of TGF-alpha in the basement membrane and extracellular matrix, including lymphatic, vascular, and glandular structures, in most turbinate samples and the absence of staining in corresponding controls. Further, TGF-alpha was isolated to a discrete 30-kD band in both inferior turbinate and polyp tissues by Western blotting without staining in the corresponding controls. CONCLUSIONS: These results suggest that TGF-alpha may play a role in the inflammatory derangement of rhinitis.

Adolescent↗