To verify the effect of subgingival calculus on the periodontal tissues in periodontitis and the effectiveness of supragingival scaling to remove the calculus, 30 teeth from healthy group (Probing pocket depth:PPD< or =mm: HP group), 15 teeth from moderate group (4< or =PD<7mm: MP group), 30 teeth from advanced group (PPD>7mm: AP group) were selected and supragingival scaling was performed before extraction of all experimental teeth. After careful extraction, the teeth were cleaned with saline and disclosed with toluidine blue and carefully examined the relationship and distance between the calculus attached on the root surface and periodontal tissues. As a result, it was; 1. The calculus was not discovered on the root surface of teeth in HP group, but was in MP and AP group, mostly on interproximal surface and furca area. The shape of the attached calculus was ovoid, trepazoid and polygonal and the calculus was distributed randomly over the root surface. 2. PPD was more than the distance between the gingival margin to the level of attached connective tissue in AP group rather than in HP and MP group. 3. The length of calculus was 2.7mm+/-.44mm in HP group and 4.1+/-.89in AP group. 4. The distance between the apical margin of calculus and the level of attached connective tissue was 2.4+/-.33mm in MP group and 3.4+/-.89mm in AP group. 5. The length of subgingival calculus was tended to increase in relation to the probing pocket depth. Therefore, it can be concluded, the calculus in periodontal pocket can not be removed completely with supragingival scaling. As the terminal part of calculus was far away with limited distance from the periodontal tissue, it can be said that the calculus was not a direct factor in destroying the periodontal tissue. In this study, the extent of the plaque was not verified but the location of calculus can be used in clinical practice for complete removal of calculus when the distance relation bewteen calculus and plaque will be known.
Calculi* ; Connective Tissue ; Dental Scaling ; Periodontal Pocket ; Periodontitis* ; Tolonium Chloride ; Tooth

Patients with achondroplasia manifest various neurologic symptoms including megaencephaly, hydrocephalus, and progressive myelopathy or radiculopathy secondary to spinal stenosis. However, only anecdotal postmortem reports proved ruptured aneurysm or vascular malformation as a source of intracranial hemorrhage. We herein report a case of a 26-year-old woman with achondroplasia who underwent uneventful surgical treatment for the aneurysmal subarachnoid hemorrhage. In this literature, we review the pathophysiologic mechanism and emphasize the necessity of considering the possibility of sudden mental deterioration in achondroplastic patient.
Achondroplasia* ; Adult ; Aneurysm* ; Aneurysm, Ruptured ; Female ; Humans ; Hydrocephalus ; Intracranial Aneurysm ; Intracranial Hemorrhages ; Neurologic Manifestations ; Radiculopathy ; Spinal Cord Diseases ; Spinal Stenosis ; Subarachnoid Hemorrhage* ; Vascular Malformations

BACKGROUND AND OBJECTIVES: Imidapril, one of the ACE inhibitor, has been used to treate hypertension, congestive heart failure, diabetes mellitus and renal disease. ACE inhibitor, however often causes dry cough and this adverse effect affects the compliance rate negatively. This report aimed to examine the incidence rate of coughing caused by Imidapril treat-ment. And we compared the results with the incidence and tendency of dry cough caused by the other ACE inhibitors. MATERIALS AND METHOD: This study enrolled 38 patients who followed up at internal medicine and took Imidapril from the period of May 9, 1997 to December 17, 1997. We tested its effectiveness, safety and tolerance. The initial dosage of it was 5mg/day and the maximum dosage according to blood pressure was 10mg/day for 8 weeks. The tendency and the incidence of dry cough have been analyzed and compared with recently published Korean reports. RESULTS: The 5 mg dosage of Imidapril showed 68.1% in lowering blood pressure rate and it went up to 81.8% during the 8 weeks treatment perriod. The blood pressure regularity rate was 36.3% after the 8 weeks treatment. The overall rate of adverse effect occurrence was 26.1% (6/23) and 8.7% of them were likely to cough. One of the patients who showed nausea stopped medication. The recent articles reported that the incidence of dry cough had been reduced: Enalapril (33.8%), Fosinopril (16%), Ramipril (15%), Imidapril (7.8 - 8.7%), Losartan (4.3%). CONCLUSION: Imidapril is as safe and effective as other ACE inhibitors. Various ACE inhibitors that were newly developed show their effectiveness in lessening incidence rate of dry cough, and Imidapril is thought to be an excellent drug for this matter. Even though Losartan shows the lowest incidence rate of dry cough, it needs to more regular usages since it is still on the stage of its medical adaptation.
Angiotensin-Converting Enzyme Inhibitors ; Angiotensins* ; Blood Pressure ; Compliance ; Cough* ; Diabetes Mellitus ; Enalapril ; Fosinopril ; Heart Failure ; Humans ; Hypertension ; Incidence* ; Internal Medicine ; Losartan ; Nausea ; Peptidyl-Dipeptidase A* ; Ramipril

No abstract available.
Kidney Transplantation*

OBJECTIVES: The purpose of this study is to analyze the previously unreported effect of fetal sex on the fetal heart rate and to measure its magnitude in relation to the effects of other independent clinical variables. METHODS: Three hundred and seventeen pregnant women who were able to provide electronic fetal heart rate monitoring were evaluated. On the basis of fetal sex after birth, 167 pregnant women who delivered male neonate were for males group and 146 examples who delivered female neonate were for female group. We analyzed fetal heart rate data using the Catholic Computer Assisted Obstetric Diagnosis System(CCAOD). RESULTS: Female fetuses had significantly faster basal heart rate(140.51+/-12.43bpm) than male fetuses(137.64+/-13.68 bpm).(P=0.007) Percent acceleration time(PAT) increased significantly for males(6.10+/-4.00bpm), comparing to females(4.90+/-3.34bpm).(P=0.001) Also percent deceleration time(PDT) was significantly higher in male fetuses(7.50+/-8.70bpm) than female fetuses(6.18+/-7.70bpm).(P=0.039) But there was no differences in standard deviation(SD)(8.84+/-10.11bpm, 8.11+/-3.56bpm), long term variation(LTV)(80.38+/-62.79msec, 73.65+/-54.60msec), and short term variation(STV)(14.06+/-9.79msec, 13.33+/-12.32msec) between male and female fetuses. CONCLUSION: The fetal heart rate of female fetuses differ from that of male fetuses. Computerized linear analysis and nonlinear analysis of antepartum fetal heart rate will need to take into account the multiple factors that influence the fetal heart rate to identify precisely which pattern predict clinical outcome.
Acceleration ; Deceleration ; Diagnosis ; Female ; Fetal Heart* ; Fetus ; Heart ; Heart Rate, Fetal* ; Humans ; Infant, Newborn ; Male ; Parturition ; Pregnancy ; Pregnant Women

Three-dimensional computed tomographic angiography (CTA), a representative noninvasive radiologic technique, is being widely used for detecting vascular lesions in specific intracranial bleeding under a certain circumstance (acute nontraumatic subarachnoid hemorrhage). We encountered a case of extravasation of the contrast medium on CTA images that appeared as ribbon-like high-attenuation lesion from an aneurysm at the distal anterior choroidal artery in a young adult moyamoya patient. As CTA is used more frequently, it is imperative to understand such unusual but, potentially lethal image findings to conduct a prompt intervention.
Aneurysm* ; Angiography* ; Arteries* ; Choroid* ; Hemorrhage ; Humans ; Moyamoya Disease ; Young Adult

Trisomy 18 is the second most common chromosomal anomaly that reach to live birth after Down syndrome. Several methods were proposed to screen patients on the risk of Edward syndrome like maternal serum levels using total human chorionic gonadotropin (hCG), alpha-fetoprotein (AFP) and unconjugated estriol (uE3), or free beta hCG with AFP, but the serum screening has only 50-60% detection rate with a 1-2% of false positive rate. So to cover the limitations that serum marker has, detailed ultrasound examination is also necessary and sensitivities of 65-70% were reported. We report a case of trisomy 18 fetus in which second trimester triple markers of maternal serum was normal, but by detailed ultrasound examination, unilateral radius aplasia was diagnosed cytogenetic study confirmed the fetus as trisomy 18.
alpha-Fetoproteins ; Biomarkers ; Chorionic Gonadotropin ; Cytogenetics ; Down Syndrome ; Estriol ; Female ; Fetus ; Humans ; Live Birth ; Mass Screening ; Pregnancy ; Pregnancy Trimester, Second ; Radius* ; Trisomy ; Ultrasonography

No abstract available.
Coronary Vessels*

OBJECTIVE: To evaluate the invasive capacity of trophoblastic cells when treated with HGF, and see whether HGF induces c-met expression in vitro. METHODS: HT cell line was treated with recombinant HGF (rHGF) at different concentrations (0, 10, 50 and 100 ng/mL) and cultured for 24 hours. To evaluate according different time of culture, HT cell line was pre-treated with 50 ng/mL rHGF and cultured for 24, 36, 48 and 72 hours. We analyzed the expression of c-met mRNA using reverse transcriptase-polymerase chain reaction and the expression of c-met protein using western blot in each samples. We also observed cellular invasion capacity through the invasion assay under a microscope and confirmed 72 kDa gelatinase and 92 kDa gelatinase expression patterns by zymography assay. RESULTS: The expressions of c-met mRNA and protein were increased in all concentrations of rHGF, compared with that of normal control although it was not in dose-dependent fashion. In invasion assay, the number of invaded HT cells were increased in dose-dependent fashion, compared with that of normal control. In zymography ssay, the expression of 72 kDa gelatinase was increased in dose-dependent fashion, compared with the control. However, 92 kDa eglatinase was not detected in any studied group. CONCLUSION: These results suggests that HGF might be related to upregulation of trophoblast cell invasiveness by activation of c-met and subsequent induction of 72 kDa gelatinase.
Blotting, Western ; Cell Line* ; Hepatocyte Growth Factor* ; Hepatocytes* ; Matrix Metalloproteinase 2 ; Matrix Metalloproteinase 9 ; RNA, Messenger ; Trophoblasts ; Up-Regulation

We report a case of ring chromosome 13 with a distal deletion of 13q32.2-->qter observed in a fetus who was referred to our institution at term due to severe growth restriction and multiple congenital malformations on ultrasonographic examination.This boy was born by vaginal delivery at 39 weeks in gestation. His weight, head circumference and height were less than the 3 percentile of gestational age. Apgar score was 7 at 1 minute and 9 at 5 minutes. He showed microcephaly, large forehead, low set ears, hypertelorism, flat nasal bridge, and micrognathia. The genitalia was ambiguous, showing severe hypoplasia of the penis. The anus was ectopic, displaced anteriorly from its normal position but with a normal opening and function. Neurologic examination was normal. Echocardiogram done at 2 weeks of life showed a persistent foramen ovale and a ventriculoseptal defect (type II) with increased pulmonary hypertension. MRI examination of the brain showed poorly demarcating corpus callosum suspecting agenesis of corpus callosum. Also, cerebellar vermis was small and hypoplastic, mimicking a variant form of Dandy-Walker malformation. MRI of the pelvis showed a tubular structure in pelvic cavity, suspicious of uterine remnant, between urinary bladder and rectum, and a inguinal hernia was noted in the left side. In the abdominal cavity enlarged adrenal glands were noted, and hormonal study showed elevated 17-alpha-OH-progesterone (168.9 ng/ml) with normal 17-KS and 17-OHCS levels. Gastrointestinal and urogenital system were otherwise normal. Cytogenetic analysis of the parents were both normal but the newborn showed 46, XY, r (13), de novo, with deletion points q32.2-->qter. Our findings are in line with previous reports about chromosome 13 deletions, in which loss of the "critical point" leads to major malformations like brain anomalies and ambiguous genitalia.
Abdominal Cavity ; Adrenal Glands ; Agenesis of Corpus Callosum ; Anal Canal ; Apgar Score ; Brain ; Chromosomes, Human, Pair 13 ; Corpus Callosum ; Cytogenetic Analysis ; Dandy-Walker Syndrome ; Disorders of Sex Development ; Ear ; Fetus ; Foramen Ovale ; Forehead ; Genitalia ; Gestational Age ; Head ; Hernia, Inguinal ; Humans ; Hypertelorism ; Hypertension, Pulmonary ; Infant, Newborn ; Magnetic Resonance Imaging ; Male ; Microcephaly ; Neurologic Examination ; Parents ; Pelvis ; Penis ; Pregnancy ; Rectum ; Ring Chromosomes ; Urinary Bladder ; Urogenital System