Cancer-related facial pain refractory to pharmacologic management or nondestructive means is a major indication for destructive pain surgery. Stereotactic mesencephalotomy can be a valuable procedure in the management of cancer pain involving the upper extremities or the face, with the assistance of magnetic resonance imaging (MRI) and electrophysiologic mapping. A 72-year-old man presented with a 3-year history of intractable left-sided facial pain. When pharmacologic and nondestructive measures failed to provide pain alleviation, he was reexamined and diagnosed with inoperable hard palate cancer with intracranial extension. During the concurrent chemoradiation treatment, his cancer-related facial pain was aggravated and became medically intractable. After careful consideration, MRI-based stereotactic mesencephalotomy was performed at a point 5 mm behind the posterior commissure, 6 mm lateral to and 5 mm below the intercommissural plane using a 2-mm electrode, with the temperature of the electrode raised to 80degrees C for 60 seconds. Up until now, the pain has been relatively well-controlled by intermittent intraventricular morphine injection and oral opioids, with the pain level remaining at visual analogue scale 4 or 5. Stereotactic mesencephalotomy with the use of high-resolution MRI and electrophysiologic localization is a valuable procedure in patients with cancer-related facial pain.
Aged ; Analgesics, Opioid ; Electrodes ; Facial Pain* ; Humans ; Magnetic Resonance Imaging ; Morphine ; Palate, Hard ; Upper Extremity

PURPOSE: This study focused on in vitro cell differentiation and surface characteristics in a magnesium coated titanium surface implanted on using a plasma ion source. MATERIALS AND METHODS: 40 commercially made pure titanium discs were prepared to produce Ti oxide machined surface (M) and Mg-incorporated Ti oxide machined surface (MM). Surface properties were analyzed using a scanning electron microscopy (SEM). On each surface, alkaline phosphatase (ALP) activity, alizarin red S staining for mineralization of MC3T3-E1 cells, and quantitative analysis of osteoblastic gene expression, were evaluated. Actin ring formation assay and gene expression analysis of TRAP and GAPDH performing RT-PCR were performed to characterize osteoclast differentiation on mouse bone marrow-derived macrophages (BMMs). RESULTS: MM showed similar surface morphology and surface roughness with M, but was slightly smoother after ion implantation at the micron scale. M was more hydrophobic than MM. No significant difference between surfaces on ALP activity at 7 and 14 days were observed. Real-time PCR analyses showed similar levels of mRNA expression of the osteoblast phenotype genes; osteopontin (OPN), osteocalcin (OCN), bone sialoprotein (BSP), and collagen 1 (Col 1) in cell grown on MM at 7, 14 and 21 days. Alizarin red S staining at 21 days showed no significant difference. BMMs differentiation increased in M and MM. Actin ring formation assay and gene expression analysis of TRAP showed osteoclast differentiation to be more active on MM. CONCLUSION: Both M and MM have a good effect on osteoblastic cell differentiation, but MM may speed the bone remodeling process by activating on osteoclast differentiation.
Actins ; Alkaline Phosphatase ; Animals ; Bone Remodeling ; Cell Differentiation ; Collagen ; Gene Expression ; Integrin-Binding Sialoprotein ; Macrophages ; Magnesium* ; Mice ; Microscopy, Electron, Scanning ; Osteoblasts* ; Osteocalcin ; Osteoclasts* ; Osteopontin ; Phenotype ; Plasma ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Surface Properties ; Titanium*

Fat can be prominet around the aortic root and within the right atrioventricular (AV) groove (1). At times, the fat can be globular, suggesting a mass especially on echocardiography. Computed tomography (CT) and masnetic resonance (MR) images are well suited for characterization of fat in and around the heart (1, 2). This report illustrates CT and MR findings of a very unusual case of prominent fat lump in the left AV groove.
Echocardiography ; Heart

Localized scleroderma is a connective-tissue disorder that is limited to the skin and subcutaneous tissue, sometimes involving muscles beneath the cutaneous lesions. Although it is usually a self-limiting disease, complications like growth failure, joint contractures, deformities and functional impairment may occur resulting in significant morbidity. Herein we report a 9-year-old girl who presented with hemiatrophy as a major clinical feature associated with widespread multiple hyperpigmented sclerotic plaques. The patient proved to be a relatively rare case of hemiatrophy secondary to extensive generalized morphea also having complicating features of joint contracture and growth failure of involved extremities.
Child ; Congenital Abnormalities ; Contracture ; Extremities ; Female ; Humans ; Joints ; Muscles ; Scleroderma, Localized* ; Skin ; Subcutaneous Tissue

PURPOSE: Alveolar bone develops with tooth eruption and is absorbed following tooth extraction. Various ridge preservation techniques have sought to prevent ridge atrophy, with no superior technique evident. Collagen has a long history as a biocompatible material. Its usefulness and safety have been amply verified. The related compound, atelocollagen, is also safe and displays reduced antigenicity since telopeptides are not present. MATERIALS AND METHODS: The current study evaluated whether the Rapiderm® atelocollagen plug (Dalim Tissen, Seoul, Korea) improves tissue healing of extraction sockets and assessed the sequential pattern of bone regeneration using histology and microcomputed tomography in six beagle dogs. To assess the change of extraction socket, hard tissues were examined 2, 4, 6, and 8 weeks after tooth extraction. RESULT: The experimental groups showed better bone fill with slow remodeling process compared to the control groups although there was no statistical difference between groups. CONCLUSION: The atelocollagen seems to have a tendency to slow bone remodeling in the early phase of healing period and maintain remodeling capacity until late phase of remodeling. Also, use of atelocollagen increased the bone-to-tissue ratio compared to healing of untreated extraction socket.
Animals ; Atrophy ; Bone Regeneration* ; Bone Remodeling ; Collagen ; Dogs* ; Seoul ; Tooth Eruption ; Tooth Extraction ; X-Ray Microtomography

PURPOSE: To evaluate value of superparamagnetic iron oxide (SPIO) as a negative oral contrast agent in MR cholangiopancreatography (MRCP). MATERIALS AND METHODS: Forty-eight patients with suspected biliary tract or pancreatic diseases and six healthy volunteers were enrolled in this study. All MR images were obtained using a 1.5 T MR unit. MRCP using fat-suppressed half-Fourier acquisition single-shot turbo spin echo (HASTE) and turbo spin echo (TSE) techniques were performed and reconstructed with maximal intensity projection (MIP). To determine the most optimal concentration of SPIO to obliterate the high signal intensity of water, a phantom experiment was conducted with various concentrations of SPIO-water mixture. Two radiologists evaluated pre- and postcontrast MRCPs. The contrast enhancement was assessed on the basis of loss of signal intensity in the stomach and duodenum. RESULTS: In the phantom experiment, a significant increase of percentage of signal intensity loss (PSIL) occurred in concentration of 22.4 ugFe/ml (Feridex 1 ml diluted with water 500 ml). Postcontrast MRCP showed an improved image quality compared with precontrast images. The rate of improvement in the diagnosis of diseases of the common bile duct and pancreatic duct was 25% (12/48). CONCLUSION: In patients with suspected biliary tract and pancreatic diseases, the SPIO is useful as a negative oral contrast agent for MRCP and provides an improvement of image quality.
Biliary Tract ; Common Bile Duct ; Diagnosis ; Duodenum ; Healthy Volunteers ; Humans ; Iron* ; Pancreatic Diseases ; Pancreatic Ducts ; Stomach ; Water

Lesch-Nyhan syndrome is an inborn error of purine metabolism resulting from hypoxanthine-guanine-phosphoribosyltransferase (HGPRT) deficiency and leading to excess purine production and uric acid over-production. It is a very rare X-linked recessive disorder, characterized by movement disorder, cognitive deficits, and self-injurious behavior. However, because of the high incidence of calculi, patients may present for surgery of urinary tract, and have increased risk of difficult intubation, aspiration pneumonia, renal insufficiency or sudden death. We report the case of a 5-year-old boy with Lesch-Nyhan syndrome who underwent successive extracorporeal shockwave lithotripsy under general anesthesia.
Anesthesia, General ; Calculi ; Child ; Death, Sudden ; Humans ; Incidence ; Intubation ; Lesch-Nyhan Syndrome ; Lithotripsy ; Movement Disorders ; Pneumonia, Aspiration ; Preschool Child ; Purines ; Renal Insufficiency ; Self-Injurious Behavior ; Uric Acid ; Urinary Tract

PURPOSE: A survey was performed to identify the level of mouthguard use, awareness, wearability issues and attitude toward mouthguard among elite Korean Taewondo athletes. MATERIALS AND METHODS: Survey questionnaires were given to 152 athletes participating in the Korea National Taekwondo team selection event for the 2010 Guangzhou Asian Games. Questionnaires consisted of three sections, mouthguard awareness, reasons for not wearing mouthguard and the last section to test the level of acceptance on current mouthguard and when the identified problems were resolved. For analyzing difference among response, chi2 test was used and significant level (alpha) was set up as 0.05. RESULTS: Responses in each of items showed significant difference (P<.001). Majority of response regarding each question: Majority of respondents believed that mouthguard were effective in preventing injuries (36.4%) but the result suggested that the provision of information on mouthguard to athletes was inadequate (44.0%) and the result showed that respondents were not greatly interested or concerned in relation to the mandatory mouthguard rule (31.6%). Although the responses on the level of comfort and wearability of mouthguard were negative (34.8%), athletes were positively willing to wear mouthguard if the problems rectified (51.2%). CONCLUSION: Considering the high level of willingness to wear mouthguard if the problems rectified, it is thought that together with efforts in providing more mouthguard information, the work of sports dentistry to research and improve mouthguard will be invaluable in promoting mouthguard to more athletes.
Asian Continental Ancestry Group ; Athletes ; Dentistry ; Humans ; Korea ; Martial Arts ; Mouth Protectors ; Sports ; Surveys and Questionnaires

Allergic contact dermatitis that is attributable to contact with environmental sensitizers boine by a second individual, especially in marital or sexual relationships, has been described as connubial contact dermatitis. Severely pruritic multiple erythematous plaques, vesicles and bullae in a 35-year-old woman occurred on the face, posterior area of the neck, breasts, buttock, and both upper arms. No direct contact to allergens was obtained. However her husband had eaten some cooked sprouts from a lacquer tree for lunch at a restaurant the day before her eruption, then he caressed her that night. A patch test with extracts of lacquer tree in ethanol(2%), crushed extracts of lacquer tree (as is), and urushiol(0.002% pet.) on the patients back showed strong positive reactions.
Adult ; Allergens ; Arm ; Breast ; Buttocks ; Dermatitis, Allergic Contact ; Dermatitis, Contact* ; Female ; Humans ; Lacquer ; Lunch ; Neck ; Patch Tests ; Restaurants ; Rhus* ; Spouses ; Trees

No abstract available.
Aneurysm* ; Renal Artery*