No abstract available.
Dinoprostone* ; Membranes* ; Rupture* ; Suppositories*

Coronary arteriovenous fistulas (CAVF) are rare malformations of the coronary circulation. They are seen in approximately 0.1% to 0.2% of all patients undergoing selective coronary angiography. We experienced a 58-years old male patient with bilateral coronary AV fistulas whoes diagnosis was confirmed by selective coronary angiography.
Arteriovenous Fistula* ; Coronary Angiography ; Coronary Circulation ; Diagnosis ; Fistula ; Humans ; Male ; Middle Aged

BACKGROUND: Low levels of serum vitamin D is associated with several lung diseases. The production and activation of matrix metalloproteinases (MMPs) may play an important role in the pathogenesis of emphysema. The aim of the current study therefore is to investigate if vitamin D modulates the expression and activation of MMP-2 and MMP-9 in human lung fibroblasts (HFL-1) cells. METHODS: HFL-1 cells were cast into three-dimensional collagen gels and stimulated with or without interleukin-1beta (IL-1beta) in the presence or absence of 100 nM 25-hydroxyvitamin D (25(OH)D) or 1,25-dihydroxyvitamin D (1,25(OH)2D) for 48 hours. Trypsin was then added into the culture medium in order to activate MMPs. To investigate the activity of MMP-2 and MMP-9, gelatin zymography was performed. The expression of the tissue inhibitor of metalloproteinase (TIMP-1, TIMP-2) was measured by enzyme-linked immunosorbent assay. Expression of MMP-9 mRNA and TIMP-1, TIMP-2 mRNA was quantified by real time reverse transcription polymerase chain reaction. RESULTS: IL-1beta significantly stimulated MMP-9 production and mRNA expression. Trypsin converted latent MMP-2 and MMP-9 into their active forms of MMP-2 (66 kDa) and MMP-9 (82 kDa) within 24 hours. This conversion was significantly inhibited by 25(OH)D (100 nM) and 1,25(OH)2D (100 nM). The expression of MMP-9 mRNA was also significantly inhibited by 25(OH)D and 1,25(OH)2D. CONCLUSION: Vitamin D, 25(OH)D, and 1,25(OH)2D play a role in regulating human lung fibroblast functions in wound repair and tissue remodeling through not only inhibiting IL-1beta stimulated MMP-9 production and conversion to its active form but also inhibiting IL-1beta inhibition on TIMP-1 and TIMP-2 production.
Collagen ; Emphysema ; Enzyme-Linked Immunosorbent Assay ; Fibroblasts* ; Gelatin ; Gels ; Humans ; Interleukin-1beta ; Lung Diseases ; Lung* ; Matrix Metalloproteinase 9 ; Matrix Metalloproteinases ; Polymerase Chain Reaction ; Reverse Transcription ; RNA, Messenger ; Tissue Inhibitor of Metalloproteinase-1 ; Tissue Inhibitor of Metalloproteinase-2 ; Trypsin ; Vitamin D* ; Wounds and Injuries

Bisphosphonates (BPs) are a class of agent used to treat patient with osteoporosis or malignant bone metastases. BPs can be categorized into 2 groups: nitrogen-containing and non-nitrogen containing. Nitrogen-containing BPs are considered to have more toxicity. Despite their clinical benefits, bisphosphonate-related osteonecrosis of jaw(BRONJ) is a significant complication to patients receveing these drugs. Since the first description of BRONJ in 2003 by Marx, the number of reports on BRONJ has been rapidly increasing. BRONJ is considered as an emerging problem in oral & maxillofacial surgery. Generally, osteonecrosis in the maxilla is rare, however BRONJ is found both in the maxilla and the mandible. This is an important feature of BRONJ compared to common infectious osteomyelitis of the jaw. Growing number of case reports, suggest that bisphosphonate therapy may cause exposed, necrotic bone. BRONJ has simillar features compared to IORN (infected osteoradionecrosis). BRONJ has meaningful features established through the interestigation on histopathologic and radiographic findings. These features have an impact on treatment plan and prognosis. This presentation contemplates on features of histopathologic and radiographic findings in bisphosphonate-related osteonecrosis of the jaw.
Alendronate ; Bisphosphonate-Associated Osteonecrosis of the Jaw ; Diphosphonates ; Humans ; Jaw ; Mandible ; Maxilla ; Neoplasm Metastasis ; Osteomyelitis ; Osteonecrosis ; Osteoporosis ; Prognosis ; Surgery, Oral

A 55 yr -old female patient visited to the OPD of OS department complaining of the lumbago, the radiating pain to right thigh and the swelling of right knee and calf regions. On routine chest and abdominal X -ray and ECG, the dextrocardia was revealed. For further detail examination, Doppler US, lung perfusion scan, MRI images were obtained. As a result, the situs inversus with dextrocardia was confirmed. Other congenital anomalies or diseases were not combined. The patient was cared with conservative treatment of lowback pain via OPD. And she was recovered successfully.
Dextrocardia ; Electrocardiography ; Female ; Humans ; Knee ; Low Back Pain ; Lung ; Magnetic Resonance Imaging ; Perfusion ; Situs Inversus* ; Thigh ; Thorax

Dentin hypersensitivity must be one of the most frequent postoperative complaints in periodontal patients. Obliterating the open dentinal tubules or decreasing the diameter of their orifices would, therefore, be an objective of treatment for hypersensitive teeth. The purpose of this study was to evaluate the effect of a pulsed Nd:YAG laser irradiation on obliteration of dentinal tubules and to determine any difference according to irradiation methods. The 45 posterior teeth that had been extracted due to periodontal disease were initially treated with tetracycline HCl(100 mg/ml, 4 min.) to remove the smear layer after root planing. The root surfaces were then irradiated by a pulsed Nd:YAG laser(EL.EN.EN060, Italy) by different laser beam spot size and different exposure condition; group 1: irradiated group by small spot(beam diameter=1mm, 1W, 2 sec) group 2: irradiated group by large spot(beam diameter=10mm, 1W, 200 sec) group 3: irradiated group by gradual increase of watt(from 0.3W to 1.0W), beam diameter=4mm group 4: irradiated group by fixed watt(1.0 W), beam diameter= 4mm control group: no irradiation but root planing and tetracycline HCl conditioning only. Additionally, the specimens were retreated with tetracycline HCl(100mg/ml, 4min.) to evaluate the stability of obliteration effect by Nd:YAG laser. Specimens were examined under the scanning electron microscope(JEOL, JSM-840A, Japan). Photomicrographs were taken at x4,000 magnification and were analyzed statistically. The results were as follows; 1. Scanning electron micrographs of root surface treated by tetracycline HCl alone(control group) showed widened, funnel-shaped dentinal tubules, while those of the root surface irradiated by various methods showed partially or completely obliterated dentinal tubules and various surface alterations, eg, flat, multiple pitted, melted and resolidified surface at the same energy density. 2. There was no significant difference in the obliteration effect of dentinal tubules between group 1 and group 2, and between group 3 and group 4(p>0.05). 3. The obliteration effect of dentinal tubules by a Nd:YAG laser irradiation was relatively stable to tetracycline HCl. The results demonstrate that a pulsed Nd:YAG laser irradiation within 1.0W, regardless of irradiation methods, can obliterate dentinal tubules effectively.
Dentin Sensitivity ; Dentin* ; Humans ; Periodontal Diseases ; Root Planing ; Smear Layer ; Tetracycline ; Tooth

Coronary involvement of polyarteritis nodosa (PAN) is rarely identified at premortem. Herein, we report a case of PAN presenting as acute myocardial infarction (MI). A 66-year-old man without previous history of heart disease presented with excruciating substernal chest pain of 3 hours duration. On admission, cardiac enzyme and ECG changes were compatible with acute MI of inferior wall. Emergency coronary angiography showed multiple aneurysmal dilatations of both left and right coronary arteries (RCA) and total occlusion with large thrombi at mid-RCA. After balloon angioplasty and intracoronary urokinase, huge coronary aneurysm was defined at mid-RCA and coronary flow partially improved. The patient was transferred to coronary care unit and continous intravenous heparin infusion was started. On the 7th hospitalization day, the patient was discharged in good condition. Two months later, follow-up coronary angiography showed no significant luminal narrowings in RCA with multiple aneurysmal dilatation, but abdominal angiography revealed multiple aneurysms in right renal and superior mesenteric arteries. These findings were compatible with the diagnosis of PAN. The patient was started on prednisone 60mg once daily and cytoxan 125mg bid. At follow-up 8 month later, there was no recurrence of symptoms.
Aged ; Aneurysm ; Angiography ; Angioplasty, Balloon ; Chest Pain ; Coronary Aneurysm ; Coronary Angiography ; Coronary Care Units ; Coronary Vessels ; Cyclophosphamide ; Diagnosis ; Dilatation ; Electrocardiography ; Emergencies ; Follow-Up Studies ; Heart Diseases ; Heparin ; Hospitalization ; Humans ; Mesenteric Artery, Superior ; Myocardial Infarction* ; Phenobarbital ; Polyarteritis Nodosa* ; Prednisone ; Recurrence ; Urokinase-Type Plasminogen Activator

PURPOSE: We investigate biases in the assessments of left ventricular function (LVF), by compressed sensing (CS)-cine magnetic resonance imaging (MRI). MATERIALS AND METHODS: Cardiovascular cine images with short axis view, were obtained for 8 volunteers without CS. LVFs were assessed with subsampled data, with compression factors (CF) of 2, 3, 4, and 8. A semi-automatic segmentation program was used, for the assessment. The assessments by 3 CS methods (ITSC, FOCUSS, and view sharing (VS)), were compared to those without CS. Bland-Altman analysis and paired t-test were used, for comparison. In addition, real-time CS-cine imaging was also performed, with CF of 2, 3, 4, and 8 for the same volunteers. Assessments of LVF were similarly made, for CS data. A fixed compensation technique is suggested, to reduce the bias. RESULTS: The assessment of LVF by CS-cine, includes bias and random noise. Bias appeared much larger than random noise. Median of end-diastolic volume (EDV) with CS-cine (ITSC or FOCUSS) appeared −1.4% to −7.1% smaller, compared to that of standard cine, depending on CF from (2 to 8). End-systolic volume (ESV) appeared +1.6% to +14.3% larger, stroke volume (SV), −2.4% to −16.4% smaller, and ejection fraction (EF), −1.1% to −9.2% smaller, with P < 0.05. Bias was reduced from −5.6% to −1.8% for EF, by compensation applied to real-time CS-cine (CF = 8). CONCLUSION: Loss of temporal resolution by adopting missing data from nearby cardiac frames, causes an underestimation for EDV, and an overestimation for ESV, resulting in underestimations for SV and EF. The bias is not random. Thus it should be removed or reduced for better diagnosis. A fixed compensation is suggested, to reduce bias in the assessment of LVF.
Bias (Epidemiology) ; Compensation and Redress ; Diagnosis ; Magnetic Resonance Imaging ; Magnetic Resonance Imaging, Cine ; Noise ; Stroke Volume ; Ventricular Function, Left ; Volunteers

BACKGROUND: Although patients may present with typical chest pain and exhibit ischemic changes on the cardiac stress test, they are frequently found to have a normal coronary angiogram. Thus, we wanted to determine which procedures should be performed in order to make an adequate diagnosis of the cause of chest pain. METHODS: 121 patients (males: 42, 34.7%) who had a normal coronary angiogram with typical chest pain were included in this study. All the patients underwent upper endoscopy, Bernstein's test and esophageal manometry. RESULTS: Among the 121 patients, clinically stable angina was noted in 107 (88.4%). Stress testing was done in 82 (67.8%); it was positive in 52 (63.4%). Endoscopic findings were erosive gastritis in 18 (14.8%), gastric ulcer in 4 (3.3%), duodenal ulcer in 5 (4.1%), and reflux esophagitis in 16 (13.2%). Positive results were observed on Berstein's test for 68 patients (56.2%); 59 (86.8%) of them had non-erosive reflux disease. On the esophageal manometry, 35 (28.9%) of these patients had motility disorders. Nutcracker esophagus was observed in 27 patients (22.3%), nonspecific esophageal motility disorder was observed in 5 (4.1%), and hypertensive lower esophageal sphincter was observed in 3 (2.5%). Among the 52 patients with positive cardiac stress testing and a negative coronary angiogram (this clinically corresponded to microvascular angina), 46 patients (85.1%) showed abnormal findings on the gastro-esophageal studies. CONCLUSIONS: In our study, 85.1% of the patients with microvascular angina revealed positive results of gastric or esophageal disease. In spite of any existing evidence of microvascular angina or cardiac syndrome X, it would be more advisable to perform gastro-esophageal studies to adequately manage chest pain.
Stomach Diseases/*complications/epidemiology ; Retrospective Studies ; Middle Aged ; Male ; Incidence ; Humans ; Female ; Esophageal Diseases/*complications/epidemiology ; Coronary Angiography ; Chest Pain/diagnosis/*etiology/radiography ; Aged ; Adult

A case of metastatic malignant melanoma of ovary with malignant melanoma of skin is rare. The tumor was discovered 17months following excisional biopsy of left hand for malignant melanoma of the skin. Primary ovarian malignant melanomas are extremely rare and are thought to originate in teratomas. Ovarian melanoma without evidence of residual teratoma must be considered metastatic even in the absence of a previously identifiable cutaneous or mucocutaneous lesion. We had experienced a case of metastatic malignant melanoma of ovary and presented with a brief review of literature.
Biopsy ; Female ; Hand ; Melanoma* ; Neoplasm Metastasis ; Ovary* ; Skin ; Teratoma