PURPOSE: The aim of this case report is to present the longitudinal results of sinus grafting using a new demineralized bovine bone material (DBBM) in human cases. METHODS: A patient with a resorbed maxilla was treated by maxillary sinus grafting using a new deproteinized bovine bone material. After a healing period of 6.5 months, three implants were placed and restored. The patient was periodically recalled and followed up for 5 years after restoration. RESULTS: Twelve partially edentulous patients (average age, 55.7 years) were followed up. All patients had insufficient residual height in their maxillary posterior area and underwent maxillary sinus graft surgery to increase the height of their maxilla. In all, 27 fixtures were placed in the augmented bone area. On average, 8.6 months later, implants were loaded using provisional or final restorations. The observation period ranged from 27 to 75 months (average, 43.3 months), and the patients did not show any severe resorption of the graft material or any infection during this time. CONCLUSIONS: Our results show that the new DBBM is useful for a maxillary sinus graft procedure. Good healing responses as well as reliable results were obtained for an average follow-up period of 43.3 months.
Bone Substitutes ; Follow-Up Studies ; Humans ; Maxilla ; Maxillary Sinus* ; Sinus Floor Augmentation ; Transplants*

Visual disturbances are common among women with pre-eclampsia. The obstetricians should have an understanding of the various conditions associated with visual impairments. We report a case of Purtscher-like retinopathy developed after pre-eclampsia combined with acute pancreatitis. A 33-year-old primigravida with twin pregnancy was admitted to the department of obstetrics and gynecology for preterm labor and pre-eclampsia at 36+4 weeks gestation. After a cesarean section, she complained of abdominal pain and visual acuity loss. She was diagnosed with Purtscher-like retinopathy combined with acute pancreatitis after ophthalmologic examination and an abdominal computed tomography scan. Purtscher-like retinopathy, most often observed after trauma, is very rare in pre-eclampsia. In addition, while visual disturbances from other conditions are transient, it can result in persistent visual impairments. Thus, when a patient with pre-eclampsia complains of visual problems for a long period of time, obstetricians should consider an ophthalmologic evaluation and treatments during the earliest stage of the disease.
Abdominal Pain ; Cesarean Section ; Female ; Gynecology ; Humans ; Obstetric Labor, Premature ; Obstetrics ; Pancreatitis ; Pre-Eclampsia ; Pregnancy ; Pregnancy, Twin ; Retinal Diseases ; Vision Disorders ; Visual Acuity

Transmission electron microscopy of an Acanthamoeba isolate (KA/L5) from a contact lens case revealed bacterial endosymbionts within cytoplasm of the amoebae. The Acanthamoeba isolate belonged to the morphological group II. Based on the polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) of 18S ribosomal RNA coding DNA (rDNA), the isolate was identified as A. lugdunensis. Strain typing by isoenzyme analysis using isoelectric focusing (IEF) and mitochondrial (Mt) DNA RFLP revealed that the isolate was closely related with KA/L1, the most predominant type of isolates from contact lens storage cases, KA/E2, a clinical isolate, KA/W4, previously reported to host endosymbionts, and L3a strains of A. lugdunensis. The endosymbionts were similar to those of KA/W4 in aspects that they were randomly distributed in both trophozoites and cysts, and were rod-shaped bacteria measuring approximately 1.38 x 0.50 microns. But the number of endosymbionts per amoeba was significantly lower than that of KA/W4. They were neither limited by phagosomal membranes nor included in lacunaelike structure.
Acanthamoeba/microbiology* ; Acanthamoeba/cytology ; Animal ; Bacteria/isolation & purification* ; Colony Count, Microbial ; Contact Lenses* ; Cytoplasm/microbiology ; Symbiosis*

The radiation exposure has multiple complication of various organs. Especially, the Food and Drug Administration has recently issued a bulletin warning of the risks of acute skin injury occurring during fluoroscopically guided procedures. Physicians need information about typical radiation doses during fluoroscopically guided various procedures and estimates of entrance skin dose must be monitored using thermoluminescent dosimetry, film badge dosimetry, pocket dosimetry and on-line computer system. Current National Council on Radiation Protection and Measurements recommended are that yearly total body dose should not exceed 50 mSv (5 rem) and that life time dose measured in millisieverts should not exceed one's age in years multiplied by 10. Types of skin injury are erythema, alopecia, dry desquamation, invasive fibrosis, dermal atropy, telangiectasia, moist desquamation, skin necrosis and secondary ulcer. Also, long-term exposure caused skin cancer. We experienced personally pigmentation on the finger nail and the hand after repeated fluoroscopically guided procedures. Thus, we report this case for giving warning to the physiatrist by the complications due to frequent exposure during procedures.
Alopecia ; Computer Systems ; Erythema ; Fibrosis ; Film Dosimetry ; Fingers ; Fluoroscopy ; Hand ; Humans ; Necrosis ; Pigmentation ; Radiation Protection ; Skin Neoplasms ; Skin* ; Telangiectasis ; Thermoluminescent Dosimetry ; Ulcer ; United States Food and Drug Administration

BACKGROUND: Hypercalcemia is an important metabolic emergency condition in cancer patients. Bisphosphonate is the treatment of choice for hypercalcemia, whereas calcitonin and hydration with furosemide are recommended for acute supportive therapy. However, data regarding real-world treatment patterns and outcomes of pharmacological treatments are limited. Therefore, we aimed to investigate the treatment patterns and clinical outcomes of hypercalcemia treatment in solid tumor patients. METHODS: Electronic medical records of 123 adults with solid cancers and albumin-corrected calcium levels >10.5 mg/dL or ionized calcium levels >1.35 mmol/L were reviewed. We retrospectively analyzed the pharmacological treatment and recovery rate according to the severity of hypercalcemia. RESULTS: A total of 177 cases were identified, of which 49 were not treated and 30 were treated with hydration only. In moderate-to-severe cases, 86.5% received pharmacological treatment. Thirty-four cases (19.2%) were treated with bisphosphonate alone and 58 cases (32.8%) were treated with bisphosphonate and calcitonin. In mild hypercalcemia cases, the recovery rate was higher for those receiving hydration only or pharmacological treatment (79.7%) than for those receiving no treatment (61.4%, p = 0.041). Most moderate-to-severe cases were treated with medication and of those treated, 56.3% recovered. The recovery rate was lower in those treated with bisphosphonate alone (38.2%) than in those who underwent calcitonin combination treatment (73.7%, p = 0.001). CONCLUSIONS: Bisphosphonate combined with calcitonin was found to be more effective than bisphosphonate alone for the treatment of moderate-to-severe hypercalcemia. Considering the current shortage of calcitonin, further efforts are required to ensure its stable supply.
Adult ; Calcitonin ; Calcium ; Electronic Health Records ; Emergencies ; Furosemide ; Humans ; Hypercalcemia ; Retrospective Studies

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe, diffuse mucocutaneous reactions that can be elicited by drugs, infection, malignancy, and herbal supplements. A wide variety of mucocutaneous events, such as systemic contact dermatitis, have been reported to be elicited by Rhus chicken, although cases of SJS and TEN are rare. Here, we present a case of SJS caused by Rhus-chicken ingestion. A 48-year-old man who wanted to improve his health and treat a gastrointestinal problem ingested Rhus chicken in the traditional manner. Twenty-four hours later, he developed a multiple erythematous maculopapular skin rash with vesicles and bullaes on 30% of the body surface and multiple erosions on the lips. He was diagnosed with SJS/TEN and showed characteristic clinical findings induced by Rhus chicken. After the patient stopped Rhus-chicken ingestion and received methylprednisolone and antibiotics, his symptoms, signs, and laboratory findings improved. With this case, we emphasize that SJS and TEN can occur after ingesting Rhus chicken, although the incidence is very low.
Acute Kidney Injury ; Anti-Bacterial Agents ; Blister ; Chickens ; Dermatitis, Contact ; Eating ; Epidermal Necrolysis, Toxic ; Exanthema ; Humans ; Incidence ; Lip ; Methylprednisolone ; Middle Aged ; Rhus ; Stevens-Johnson Syndrome

Systemic lupus erythematosus(SLE) is autoimmune disease in which involves systemic organs. Hematological manifestations are common in patients with SLE but aplastic anemia is very rare and, although various immunosuppressants have been tried, there is no established treatment in aplastic anemia associated with SLE. Furthermore, disease course and prognosis may be different from other aplastic anemia. A 42-year-old woman presented with fever, chilling, myalgia, general weakness, pancytopenia. Her bone marrow aspirate and biopsy revealed almost acellular bone marrow with rare foci of hematopoietic elements and she was diagnosed with SLE simultaneously. High-dose methyprednisolone, prednisolone and cyclophosphamide therapies had been unsuccessful in controlling pancytopenia. Cyclosproine was started and the aplastic anemia was responded. Now she was free of transfusion with more than 10 g/dL of hemoglobin.
Adult ; Anemia, Aplastic* ; Autoimmune Diseases ; Biopsy ; Bone Marrow ; Cyclophosphamide ; Cyclosporine* ; Female ; Fever ; Humans ; Immunosuppressive Agents ; Lupus Erythematosus, Systemic* ; Myalgia ; Pancytopenia ; Prednisolone ; Prognosis

Blood Pressure ; Body Mass Index ; Cervix Uteri ; Elasticity ; Elasticity Imaging Techniques ; Female ; Hardness ; Heart Rate ; Humans ; Jupiter ; Labor Presentation ; Pregnancy ; Pregnant Women ; Premature Birth ; Reproducibility of Results ; Uterine Artery

OBJECTIVE: To determine the relation between the latency and duration of the cutaneous silent period (CuSP) and ultrasonographic findings of patients with carpal tunnel syndrome (CTS). METHOD: Subjects included 50 hands of 33 patients with CTS with electrophysiologic evidence of CTS and 50 hands of 39 adults with no evidence of CTS. CuSP was measured on abductor pollicis brevis (APB) and adductor digiti minimi (ADM) by stimulation of digit 3. All subjects were examined with ultrasonography (US). Using US, the cross-sectional area (CSA) and flattening ratio (FR) of the median nerve were calculated under carpal tunnel. Analysis of differences between the control group and the CTS group was performed using ANOVA. RESULTS: Differences of CSA, FR, latency, and duration of CuSP in both APB, ADM muscles were observed between the two groups. Correlations were observed in the patient group in latency and duration of the APB muscle and only in duration of the ADM (p=0.048, r=0.159; p=0.035, r=-0.315; p=0.039, r=-0.293) muscle. Correlations were found only in duration of ADM (p=0.011, r=0.358) in the control group with respect to CSA. However, there was no correlation with FR. CONCLUSION: There seems to be a significant correlation between the CSA of the median nerve and the latency and duration of CuSP in patients with CTS. In addition, there seems to be a significant difference of CSA, FR, and latency in both APB and ADM between the two groups. CuSP and CSA might be useful for study that reflects intact small fibers in patients with CTS.
Adult ; Carpal Tunnel Syndrome ; Electromyography ; Hand ; Humans ; Median Nerve ; Muscles

A 52-yr-old male with multiple myeloma underwent autologous stem cell transplantation in June 2002. In August 2004, the multiple myeloma had recurred. The patient received allogenic stem cell transplantation in September 2005. Before undergoing transplantation, the presence of HBsAb and the absence of HBsAg were noted. The patient underwent allogenic peripheral blood stem cell transplantation (PBSCT) from a sibling donor who was hepatitis surface antibody (HBsAb) positive and hepatitis surface antigen (HBsAg) negative. Nineteen months after the PBSCT, the liver function tests showed elevation of the aminotransferases. The patient was HBsAg positive and HBsAb negative. The liver biopsy specimen revealed hepatitis. The reactivation of a hepatitis B virus infection, in a hepatitisB immune patient, referred to as reverse seroconversion, is a rare complication of hematopoietic stem cell transplantation.
Antigens, Surface ; Biopsy ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Hepatitis ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Humans ; Liver ; Liver Function Tests ; Male ; Multiple Myeloma ; Peripheral Blood Stem Cell Transplantation ; Siblings ; Stem Cell Transplantation ; Tissue Donors ; Transaminases ; Transplants