The purpose of this study is to evaluate the prognostic significance of argyrophilic nucleoalr organizer regions (AgNORs) and proliferating cell nuclear antigen (PCNA) by using DMBA hamster buccal pouch carcinogenesis which provides a good experimental model in reproducing steps from precancerous lesions to invasive squamous cell carcinomas. The buccal pouches of 50 Syrian hamsters were applied with 0.5% DMBA in mineral oil three times a week to reproduce various lesions from precancerous ones such as hyperkeratosis or epithelial dysplasia to invasive squamous cell carcinomas. Their sections were stained with H & E, and silver colloid, and processed immunohistochemically by being applied with monoclonal antibody to PCNA. The histopathologic examainations were done and the counts of AgNORs were evaluated. The PCNA labelling indices on each lesions were evaluated. The correlation between histopathological grades and counts of AgNORs or PCNA labelling indices were evaluated. The number of AgNORs was 2.22+/-0.22 in control group, 3.46+/-0.72 in carcinoma in situ (CIS), 3.78+/-0.63 in squamous cell carcinoma (SCC), respectively. AgNORs significantly increased in severe epithelial dysplasia, CIS, and SCC compared with normal tissue (P<0.05). The PCNA Labeling Index (LI) was 39.47+/-6.68% in control group, 79.61+/-4.14% in CIS, and 85.43+/-6.25% in SCC, respectively. PCNA LI also significantly increased in epithelial dysplasia, CIS, and SCC compared with normal tissue (P<0.05). The number of AgNORs, AgNOR area, and PCNA LI slightly increased in the advancing front than in the center of SCC, but, it was not statistically significant. It appeared that there were a good correlation between the number of AgNORs and PCNA LI (Pierson correlation coefficient : 0.649, P<0.001). These results suggested that the number of AgNORs and the PCNA LI could be useful markers for evaluating the risk of malignant transformation and prognosis of SCC. It was thought that the clinical usefulness of these markers should be verified by using human tissue specimens.
9,10-Dimethyl-1,2-benzanthracene ; Animals ; Carcinogenesis* ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Colloids ; Cricetinae* ; Humans ; Mesocricetus ; Mineral Oil ; Models, Theoretical ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Silver

Quadricuspid aortic valve is a rare congenital malformation of the aortic valve. A case is reported of a 51 year old woman with quadricuspid aortic valve associated with regurgitation. In the past, quadricuspid aortic valve was recognised at surgery or necropsy, but now transthoracic and transesophageal echocardiography play a pivotal role in diagnosing this rare valve malformation. On occasion the transthoracic echocardiogram cannot show the quadricuspid nature of the aortic valve, and transesophageal echocardiography must be performed.
Aortic Valve* ; Echocardiography, Transesophageal ; Female ; Humans ; Middle Aged*

A case of embolic episode resulting in cerebral infarction from an unknown source is reported. This occured in a young male. He had no cardiovascular risk factors. Diagnostic evaluation for identifying the source of embolism revealed a large, pedunculated and mobile thrombus arising from a nonaneurysmatic and nonatheroslerotic descending aorta. The thrombus was identified by transesophageal echocardiography, and was successfully removed by aortic thromboendarterectomy. We emphasize the importnace of transesophageal echocardiography as a reliable method for the diagnosis of thoracic aorta diseases and for identification of aortic thrombi. An aggressive surgical approach is recommended in the low-risk parient to prevent further embolic episodes.
Aorta, Thoracic ; Cerebral Infarction* ; Diagnosis ; Echocardiography, Transesophageal ; Embolism ; Endarterectomy ; Humans ; Male* ; Risk Factors ; Thrombosis*

BACKGROUND AND OBJECTIVES: Myocardial bridge is congenital coronary anomaly and cause myocardial ischemia by milking effect. The general study of myocardial bridge is to be weak, so we examined a clinical study of myocardial bridge. MATERIALS AND METHOD: This study included 36 bridge cases out of 1048 patients who underwent coronary angiography due to chest pain from Jan. 1993 to Jul. 1998. Angiographic film, medical records and interview by telephone were reviewed retrospectively. Total follow-up duration was mean 27 months (1 month to 62 months). RESULTS: Incidence of myocardial bridges diagnosed by angiography was 3.4%. Angiography showed normal in 32, 1 vessel disease in 3 and 2 vessel disease in one patient. Mean reference diameter was 2.97+/-0.36mm, bridge diameter was 2.75+/-0.33mm in diastole, 1.12+/-0.47mm in systole. Myocardial bridge length was 12.50+/-7.44mm, mean % diameter stenosis was 59.26+/-17.7%. Myocardial bridge location was 80.6% in mid LAD and 13.9% in mid & distal LAD and 5.5% in distal LAD. There was no statistically significant correlation with sex, risk factor of coronary heart disease, resting electrocardigraphy, treadmill test, diameter and angulation of coronary artery, clinical symptom in the severity of myocardial bridge. But the severity of myocardial bridge correlated with bridge length(r=.5033). CONCLUSION: Clinical outcomes of bridge patients were relatively good during the mean follow up periods of 27 months. Myocardial bridge was more severe in younger age and longer bridge length.
Angiography ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Diastole ; Exercise Test ; Follow-Up Studies ; Humans ; Incidence ; Medical Records ; Milk ; Myocardial Ischemia ; Retrospective Studies ; Risk Factors ; Systole ; Telephone

OBJECTIVES: The purpose of this study was to evaluate changes in the pharyngeal airway space and hyoid bone position after mandibular setback surgery with bilateral sagittal split ramus osteotomy (BSSRO) and to analyze the correlation between the amount of mandibular setback and the amount of change in pharyngeal airway space or hyoid bone position. MATERIALS AND METHODS: From January 2010 to February 2013, a total of 30 patients who were diagnosed with skeletal class III malocclusion and underwent the same surgery (BSSRO) and fixation method in the Division of Oral and Maxillofacial Surgery, Department of Dentistry at the Ajou University School of Medicine (Suwon, Korea) were included in this study. Lateral cephalograms of the 30 patients were assessed preoperatively (T1), immediately postoperatively (T2), and 6 months postoperatively (T3) to investigate the significance of changes by time and the correlation between the amount of mandibular setback and the amount of change in the airway space and hyoid bone position. RESULTS: Three regions of the nasopharynx, oropharynx, and hypopharynx were measured and only the oropharynx showed a statistically significant decrease (P<0.01). A significant posterior and inferior displacement of the hyoid bone was found 6 months after surgery (P<0.01). Analysis of the correlation between the amount of mandibular setback and the amount of final change in the airway space and hyoid bone position with Pearson's correlation showed no significant correlation. CONCLUSION: In this study, the oropharynx significantly decreased after mandibular setback surgery, and changes in the surrounding structures were identified through posteroinferior movement of the hyoid bone during long-term follow-up. Therefore, postoperative obstructive sleep apnea should be considered in patients who plan to undergo mandibular setback surgery, and necessary modifications to the treatment plan should also be considered.
Dentistry ; Follow-Up Studies ; Humans ; Hyoid Bone* ; Hypopharynx ; Malocclusion ; Nasopharynx ; Oropharynx ; Osteotomy, Sagittal Split Ramus ; Retrospective Studies* ; Sleep Apnea, Obstructive ; Surgery, Oral

PURPOSE:This study was performed to determine the clinical course of BCG lymphadenitis. METHODS:Between May 2005 and April 2009, the medical records of 33 patients with BCG lymphadenitis were retrospectively reviewed. If needed, needle aspiration was recommended without surgical resection or antituberculous medication. RESULTS:Of the 33 patients who were identified, 21 were males and 12 were females. Among the 33 patients, 32 were full-term babies. The mean age was 6 months (range, 2-35 months) and the most prevalent site of the lesion was the left axilla. BCG lymphadenitis was observed 1-34 months after BCG vaccination, mostly 1-6 months after vaccination. The size of the enlargement was generally 1-3 cm. The strains were identified as French (n=14), Danish (n=7), and Tokyo (n=12). BCG lymphadenitis regressed spontaneously in 19 patients. After 1-5 needle aspirations, 14 patients recovered completely. Complete regression of lymphadenitis was recorded over an average period of 4 months. CONCLUSION:Clinicians need to be aware of the clinical features of BCG lymphadenitis. For management of BCG lymphadenitis, regular follow-up with observation should be the mainstay. Needle aspiration is a safe and easy treatment for suppurative BCG lymphadenitis.
Aspirations (Psychology) ; Axilla ; BCG Vaccine ; Female ; Follow-Up Studies ; Humans ; Lymphadenitis ; Male ; Medical Records ; Mycobacterium bovis ; Needles ; Retrospective Studies ; Tokyo ; Vaccination

BACKGROUND: Percutaneous transluminal coronary angioplasty(PTCA) is a widely acceptable treatment for ischemic heart disease. Restenosis after successful PTCA, which develops in 20~30% of all patients, remains a serious late complication. This study was to evaluate the efficacy of cilostazol for the prevention of stent restenosis compared with ticlopidine. MATERIALS AND METHOD: Fifty three patients underwent coronary stent implantation were divided in to as group A(n=25) receiving 100mg aspirin and 200mg cilostazol and group B(n=28) receiving 100mg asprine and 500mg ticlopidine from Sep 1998 and Feb 1999 at Pusan Paik Hospital, Inje University. Clinical and laboratory evaluations were preformed at regular interval. RESULT: There were no differences in baseline characteristics between the two groups. Coronary artery restenosis was observed in 5(20.8%) in group A and 8(26%) in group B respectively, which were not statistically significant (p=NS). Minimal luminal diameter was 2.10+/-0.89mm in group A and 1.93+/-0.65mm in group B (p=NS). Two patients in group A had headache, while 6(21.4%) patients of group B developed side effects including thrombocytopenia in 2 patients, skin rash in 2 patents . There was no cardiac death during the follow-up period. CONCLUSION: Aspirin plus cilostazol may be safer and equally antithrombotic regimen compared results to aspirin plus ticolpidine after elective coronary stent implantation.
Aspirin ; Busan ; Coronary Vessels ; Death ; Exanthema ; Follow-Up Studies ; Headache ; Humans ; Myocardial Ischemia ; Phenobarbital ; Stents* ; Thrombocytopenia ; Ticlopidine*

The congenital absence of the left circumflex artery and a compensatory super-dominant right coronary artery (RCA) is a very rare benign coronary anomaly in the clinic. The presence of a massive thrombus in the super-dominant RCA can lead to fatal results in cases of acute myocardial infarction, unless the thrombus is mechanically removed. Aspiration of the thrombus using a 6 Fr right Judkins guide catheter is useful to extract a massive thrombus and is both safe and effective. We report a case of complete revascularization of the super-dominant RCA after thrombus aspiration using a 6 Fr Judkins right catheter in a patient with acute inferior and inferolateral wall myocardial infarction.
Catheters ; Coronary Thrombosis ; Coronary Vessel Anomalies ; Coronary Vessels* ; Humans ; Inferior Wall Myocardial Infarction ; Lung Neoplasms* ; Myocardial Infarction ; Thrombosis*

Tuberculosis is primarily a pulmonary disease, but extra-pulmonary manifestations are not uncommon, especially in children and adolescents. Ten percent of extra pulmonary tuberculosis localizes to the bones and joints, and 56% of such cases affect the spine. We treated a childhood case of spinal tuberculosis misdiagnosed as muscular dystrophy in a patient without specific constitutional symptoms. We report this case because the patient had an unusual presentation of spinal tuberculosis.
Adolescent ; Child ; Humans ; Joints ; Lung Diseases ; Muscular Dystrophies ; Neurologic Manifestations ; Spine ; Tuberculosis ; Tuberculosis, Pulmonary ; Tuberculosis, Spinal

During percutaneous coronary intervention, guidewire fractures are very exceptionally encountered in medical practice, but can cause fatal complications such as intracoronary thrombus formation, embolization and perforation. Removal of the remnant segments of guidewire is important for the prognosis. There are several methods being recommended for the treatment of fractured guidewire remnants. However, the best treatment of remnant guidewire filament is still unclear. Herein, we present a case where we did not completely remove remnant guidewire filaments that caused fatal coronary thrombosis.
Coronary Thrombosis ; Coronary Vessels* ; Methods ; Percutaneous Coronary Intervention ; Prognosis ; Stents* ; Thrombosis*