Heart failure is a recognized, although uncommon, cause of massive liver cell necrosis, the clinical consequence of which are intermingled with those of cardiac insufficiency in most case. But, hepatic coma is rerely caused by hepatic congestion only. We report the three cases with heart failure resulted in massive liver cell necrosis and fulminant hepatic failure. The manifestations of fulminant hepatic failure were hepatic encephalopathy, jaundice, marked increase of prothrombin time and serum transaminase and there were no evidences of viral hepatitis and toxic hepatitis as a cause of liver failure.
Drug-Induced Liver Injury ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Hepatic Encephalopathy ; Hepatitis ; Jaundice ; Liver ; Liver Failure ; Liver Failure, Acute* ; Necrosis ; Prothrombin Time

Purpose: This retrospective study evaluated the radiographic and clinical outcomes of osteotome sinus floor elevation (OSFE) without bone grafts, and analyzed the factors influencing endosinus bone remodeling.Materials and Methods: Radiographic and clinical data from 44 implants in 36 patients were collected after a follow-up period of 6 months to 6.5 years (mean, 2.04 years). Mean residual bone height (RBH) was 5.0 ± 1.3 mm. The length of the implant protruding into the sinus and endosinus bone gain (ESBG) on radiographs were measured. Results: All the 44 implants survived until the final follow-up period. Groups were divided according to an RBH of 5 mm at the time of implant placement, with 22 implants per group. Mean ESBG was 2.40 ± 1.48 mm in an RBH < 5 mm group and 2.01 ± 0.87 mm in an RBH ≥5 mm group. Endosinus bone gain was significantly higher in the RBH < 5 mm group for up to one year after the implant placement; however, there was no significant difference between the two groups at the final follow-up period. Conclusion Osteotome sinus floor elevation without bone grafting is a predictable procedure for achieving endosinus bone remodeling when RBH is < 5 mm.

Purpose: This retrospective study evaluated the radiographic and clinical outcomes of osteotome sinus floor elevation (OSFE) without bone grafts, and analyzed the factors influencing endosinus bone remodeling.Materials and Methods: Radiographic and clinical data from 44 implants in 36 patients were collected after a follow-up period of 6 months to 6.5 years (mean, 2.04 years). Mean residual bone height (RBH) was 5.0 ± 1.3 mm. The length of the implant protruding into the sinus and endosinus bone gain (ESBG) on radiographs were measured. Results: All the 44 implants survived until the final follow-up period. Groups were divided according to an RBH of 5 mm at the time of implant placement, with 22 implants per group. Mean ESBG was 2.40 ± 1.48 mm in an RBH < 5 mm group and 2.01 ± 0.87 mm in an RBH ≥5 mm group. Endosinus bone gain was significantly higher in the RBH < 5 mm group for up to one year after the implant placement; however, there was no significant difference between the two groups at the final follow-up period. Conclusion Osteotome sinus floor elevation without bone grafting is a predictable procedure for achieving endosinus bone remodeling when RBH is < 5 mm.

Purpose: This retrospective study evaluated the radiographic and clinical outcomes of osteotome sinus floor elevation (OSFE) without bone grafts, and analyzed the factors influencing endosinus bone remodeling.Materials and Methods: Radiographic and clinical data from 44 implants in 36 patients were collected after a follow-up period of 6 months to 6.5 years (mean, 2.04 years). Mean residual bone height (RBH) was 5.0 ± 1.3 mm. The length of the implant protruding into the sinus and endosinus bone gain (ESBG) on radiographs were measured. Results: All the 44 implants survived until the final follow-up period. Groups were divided according to an RBH of 5 mm at the time of implant placement, with 22 implants per group. Mean ESBG was 2.40 ± 1.48 mm in an RBH < 5 mm group and 2.01 ± 0.87 mm in an RBH ≥5 mm group. Endosinus bone gain was significantly higher in the RBH < 5 mm group for up to one year after the implant placement; however, there was no significant difference between the two groups at the final follow-up period. Conclusion Osteotome sinus floor elevation without bone grafting is a predictable procedure for achieving endosinus bone remodeling when RBH is < 5 mm.

A retrospective review of 36 patients with infective endocarditis by strict case definition was performed from 1972 through April of 1984. Male to female ratio was 1:1.25, with mean age of 19.1. Thirty of the 36 patients(83.3%) had the history of predisposing heart diseases: congenital heart disease was most frequent one below the age of 20, rheumatic heart disease between the age of 20-39 and degenerative heart disease above the age of 40. The commonest presenting symptoms were fever, dyspnea, and malaise, and the commonest signs were fever, murmur, and hepatomegaly. Average hemoglobinand hematocrit were 10.1g/dl and 30.8% respectively, showing moderate degree of anemia. White cell count was 11,600+/-5400/mm3 and erythrocyte sedimentation rate was 46+/-18mm/hr. Over four fifths of the patients demonstrated proteinuria and elevated C-reactive protein. Two thirds of the patients showed microscopic hematuria and one third showed positive rheumatoid factor. Eight patients(22.2%) showed arrhythmia and 4(11.1%) showed conduction abnormalities on electrocardiography. The commonest etiologic microorganisms were alpha-hemolytic streptococcus(30.6%) and staphylococcus aureus(22.2%). Abacteremic cases were found in 38.9% of the patients. To compared with alpha-hemolytic streptoccus endocarditis the cases caused by staphylococcus aureus showed the shorter duration of symptoms before admission, the less frequent complication, the higher fever, and the more elevated white cell counts. To penicillin, alpha-hemolytic streptococcus was sensitive in most cultures and staphylococcus arueus was resistant in half of them, and to aminoglycosides vice versa. To cefazolin, both microorganisms were sensitive in most cultures. In 18 of 24(75%) patients vegetation was visualized by echocardiography. The most frequent site of involvement was the mitral valve. And in vegetation detected group complication rate by embolism was found to be higher. The common complications were congestive heart gailure in 24(66.75%), embolism in 8(22.2%), and metastatic infection in 6(16.7%). The mortality rate of infective endocarditis was 25%, and the causes of death were cerebral embolism in 3(8.3%), septic septic shock in 3(8.3%), congestive heart failure in 2(5.6%), and mycotic aneurysmal rupture in 1(2.8%). Conclusively in infective endocarditis the author observed the increasing prevalence of degenerative heart disease as a prdisposing heart disease and increasing incidence of staphylococcus aureus as a causative microorganism. Adn the differences of clinical characteristics between staphylococcus ureus and alpha-hemolytic streptococcus endocarditis would be helpful in diagnosis and treatment of infective endocarditis as well as recognition of prognosis.
Aminoglycosides ; Anemia ; Aneurysm, Infected ; Arrhythmias, Cardiac ; Blood Sedimentation ; C-Reactive Protein ; Cause of Death ; Cefazolin ; Cell Count ; Diagnosis ; Dyspnea ; Echocardiography ; Electrocardiography ; Embolism ; Endocarditis* ; Estrogens, Conjugated (USP) ; Female ; Fever ; Heart ; Heart Defects, Congenital ; Heart Diseases ; Heart Failure ; Hematocrit ; Hematuria ; Hepatomegaly ; Humans ; Incidence ; Intracranial Embolism ; Male ; Mitral Valve ; Mortality ; Penicillins ; Prevalence ; Prognosis ; Proteinuria ; Retrospective Studies ; Rheumatic Heart Disease ; Rheumatoid Factor ; Rupture ; Shock, Septic ; Staphylococcus ; Staphylococcus aureus ; Streptococcus

No abstract available.
Pregnancy*

BACKGROUND: Estrogens act on estrogen receptors distributed in articular cartilages, synovial membrane, and ligaments, which are thought to be related with degenerative changes. Meanwhile, progesterone is known to have a weak anabolic action on bone formation This study evaluates the effects of estrogen and progesterone hormone on bone/cartilage turnover in ovariectomized (OVX) rats. METHODS: Thirty-five 7-month-old female Sprague-Dawley rats were randomly divided into 5 groups and then ovariectomized bilaterally except the sham control group. The first and the second group acting as controls did not receive hormonal therapy, the third group received estrogen, the fourth group received progesterone, and the fifth group received combination of both hormones 10 weeks after surgery. Evaluations were done using the serum levels of cartilage oligomeric matrix protein (COMP) for cartilage turnover, collagen type I C-telopeptide (CTX-1) and osteocalcin (OC) for bone turnover at 11, 15, 19 weeks after OVX and histology using the Osteoarthritis Research Society International (OARSI) osteoarthritis (OA) cartilage histopathology assessment system. RESULTS: Significantly less cartilage degradation (decreased levels of COMP) was found in the combined hormone treated group in comparison with OVX group. Similarly, both hormonal treatment resulted in increased bone formation and decreased bone resorption i.e., a low overall bone turnover status (decrease in the serum OC and CTX-1 levels). CONCLUSIONS: Combined estrogen and progesterone therapy was found to be convincing in terms of reducing the severity of OA in this experimental model.
Animals ; Biological Markers/blood/metabolism ; Bone Remodeling/*drug effects ; Bone and Bones/chemistry/drug effects ; Cartilage/chemistry/*drug effects ; Collagen Type I/blood/metabolism ; Disease Models, Animal ; Estrogens/*pharmacology ; Extracellular Matrix Proteins/blood/metabolism ; Female ; Glycoproteins/blood/metabolism ; Histocytochemistry ; Hormone Replacement Therapy/*methods ; Osteoarthritis/blood/*drug therapy ; Osteocalcin/blood/metabolism ; Ovariectomy ; Progesterone/*pharmacology ; Rats ; Rats, Sprague-Dawley

INTRODUCTION: Bone regeneration of cystic defects of the jaws after a cyst treatment requires lengthy healing periods. Generally, the bony changes are observed periodically through a visual radiographic reading as well as by the clinical opinion and radiographic images (panorama, periapical view), but it is difficult to compare the objective bony changes using only the radiographic density. In addition, it is difficult to observe minute bony changes through a visual radiographic reading, which can lead to a subjective judgment. This study exmined the bone density after the enucleation of a jaw cyst by fractal analysis. MATERIALS AND METHODS: Eighteen patients with a cystic lesion on the jaw were assessed. Panoramic radiographs were taken preoperatively, immediately postoperatively, and 1, 3, 6 and 12 months after cyst enucleation. The images were analyzed by fractal analysis. RESULTS: The mean fractal dimensions increased immediately after surgery and 3, 6 and 12 months postoperatively. The postoperative 6 and 12 months fractal dimension was similar to the controls. CONCLUSION: Fractal analysis was used to overcome the limit of a subjective reading during an assessment of bone regeneration after cyst enucleation.
Bone Density ; Bone Regeneration ; Fractals ; Humans ; Jaw ; Jaw Cysts ; Judgment

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused significant changes. This study aimed to investigate the impact of COVID-19 on patients with chronic pain. Methods: Patients with chronic pain from 23 university hospitals in South Korea participated in this study. The anonymous survey questionnaire consisted of 25 questions regarding the following: demographic data, diagnosis, hospital visit frequency, exercise duration, time outside, sleep duration, weight change, nervousness and anxiety, depression, interest or pleasure, fatigue, daily life difficulties, and self-harm thoughts. Depression severity was evaluated using the Patient Health Questionnaire-9 (PHQ-9). Logistic regression analysis was used to investigate the relationship between increased pain and patient factors. Results: A total of 914 patients completed the survey, 35.9% of whom had decreased their number of visits to the hospital, mostly due to COVID-19. The pain level of 200 patients has worsened since the COVID-19 outbreak, which was more prominent in complex regional pain syndrome (CRPS). Noticeable post-COVID-19 changes such as exercise duration, time spent outside, sleep patterns, mood, and weight affected patients with chronic pain. Depression severity was more significant in patients with CRPS. The total PHQ-9 average score of patients with CRPS was 15.5, corresponding to major depressive orders. The patients’ decreased exercise duration, decreased sleep duration, and increased depression were significantly associated with increased pain. Conclusions COVID-19 has caused several changes in patients with chronic pain.During the pandemic, decreased exercise and sleep duration and increased depression were associated with patients’ increasing pain.

Idiopathic intracranial hypertension, a syndrome of obscure origin, occurs particularly in fat adolescent girls and young women. The usual symptoms are headache, blurred vision, a vague dizziness, horizontal diplopia and transient visual obscurations etc., and ophthalmoscopic examination reveals papillederma, due to increased ICP. Visual field testing usually shows slight peripheral constrictions with enlargement of the blind sports. CSF pressure is elevated in the range of 250 to 450 mm of water. Radiological or the other laboratory tests show no specific abnormalities. Treatment for idiopathic intracranial hypertension is focused on early detection and prevention of vision loss, the only permanent morbidity. Many different modes of medical treatment, including weight reduction, repeated lumber puncture, corticosteroids, diuretics, glycerol or carbonic anhydrase inhibitors, have successfully been tried up to 90% of the patients. In the remaining patients, particularly in those with measurable impairment of vision that does not respond to conventinal medical therapies, surgical procedure should be considered. We report a case of idiopathic intracranial hypertension successfully treated with optic nerve sheath fenestration.
Adolescent ; Adrenal Cortex Hormones ; Carbonic Anhydrase Inhibitors ; Constriction ; Diplopia ; Diuretics ; Dizziness ; Female ; Glycerol ; Headache ; Humans ; Optic Nerve* ; Pseudotumor Cerebri* ; Punctures ; Sports ; Visual Field Tests ; Water ; Weight Loss