Bone remodeling is characterized by the coupling of osteoclast-mediated bone resorption and osteoblast-mediated bone formation. The process is tightly regualted at the local level by an incompletely known netwotk of peptide and non-peptide fators. Nitric oxide(NO), synthesized by nitric oxide synthetase(NOS) from L-arginine, is becoming recognized as an important bioregualtory molecule in a variety of tissue, but little is known about its possible role in periodontal tissue. The purpose of this study is to investigate the expression of nitric oxide synthetase(NOS) in inflamed gingiva and the effects of cytokine on the expression of NOS protein. The expression of NOS in gingival tissue was evaluated by immunohistochemical staining for NOS1, NOS2, NOS3. The effect of cytokine on the expression of NOS in human periodontal ligament cells and osteoblast-like HOS cells by western blot analysis. Further, we studied that NO functions in periodontal ligment cells as a regulatory molecule. PDL cells incubated with NOS inhibitor and donor. The protein expression, type I collagen & non-collagenous protein, nitrate production and cell proliferation were evaluated The results were as follows. 1. NOS1, NOS2, NOS3 was rarely distributed in healthy gingiva, but stronger stained in gingival epithelium, endothelial cells, and mononuclear cells of inflammed gingiva. 2. The cytokine stimulated NOS1, and NOS3 protein were not inducing or inhibitory effect to compared with control in PDL and HOS cells. 3.Incubation of cells with combination of TNF-alpha, IFN-gamma, LPS result in a time dependant increase in NOS2 expression, reaching a maximal level after 24 hours of stimulation. 4. The osteonectin protein inhibitory effect of NMA, inhibitor of NOS, was reversed by Larginine in dose dependant manner. 5. NMA decreased cell proliferation and nitrate production, but the inhibitory efffect of NMA was also prevented by the NO donor, sodium nitropruiside. These results suggest that exogenously synthesized NO was playing a stimulating effect on cell proliferation or on non-collagenous protein expression. Therefore NO have an important role in mediation of localized bone destruction associated inflammatory bone disease such as periodontitis
Arginine ; Blotting, Western ; Bone Diseases ; Bone Remodeling ; Bone Resorption ; Cell Proliferation ; Collagen Type I ; Endothelial Cells ; Epithelium ; Gingiva ; Humans ; Negotiating ; Nitric Oxide Synthase* ; Nitric Oxide* ; Osteogenesis ; Osteonectin ; Periodontal Ligament ; Periodontitis ; Sensitivity and Specificity* ; Sodium ; Tissue Donors ; Tumor Necrosis Factor-alpha

We observed a 51-year-old male, who developed depigmented patches on the lower abdomen after photochemotherapy(PUVA) of psoriasis without evidence of phototoxic reaction. The depigmented patches did not orginate from the sites of previous psoriatic lesions. Fontana-Masson stain of the biopsy specimen revealed nearly absent melanin pigments in the epidrmis of the hypopigmented patch, while lots of pigments were obsereved on the surrounding hyperpigmented area. Electron micrograph showed no melanocytes in the hypopigmented patch. Thus we report this case as having vitiliginous patches induced by photochemotherapy of psoriasis.
Abdomen ; Biopsy ; Humans ; Male ; Melanins ; Melanocytes ; Middle Aged ; Photochemotherapy* ; Psoriasis* ; Vitiligo

PURPOSE: To investigate which spectral domain optical coherence tomography (SD-OCT) findings predict visual outcome after anti-vascular endothelial growth factor (VEGF) treatment in neovascular age-related macular degeneration (NV-AMD). METHODS: We reviewed the medical records of patients with treatment-naive NV-AMD who underwent three or more consecutive anti-VEGF injections. The patients were divided into three groups according to their changes of visual acuity (VA); improved (group I), static (group S), or worsened (group W). We assessed the incidences and values of all available SD-OCT findings of these groups, compared these findings between the three groups and compared the initial values with the post-treatment values. RESULTS: Better initial VA and longer external limiting membrane (ELM) length were associated with less change in VA after anti-VEGF treatment. The initial VA was mildly correlated with initial photoreceptor inner and outer segment junction (IS/OS) length and initial ELM length. The final VA was also mildly correlated with the final IS/OS length and the final ELM length. VA was significantly changed after anti-VEGF treatment in groups W and I. With regard to incidence, disruption of the IS/OS (IS/OS-D), disruption of the ELM (ELM-D) and ELM length differed significantly between the three groups, particularly ELM-D. The incidences of IS/OS-D and ELM-D in group I were significantly lower than those in groups S and W, and those in group S were also lower than those in group W. The ELM length in group I was significantly longer than it was in groups S and W, and the ELM length in group S was longer than that for group W. However, these three findings did not change after the anti-VEGF treatment. CONCLUSIONS: Initial IS/OS-D, ELM length and particularly ELM-D can be useful predictors of the visual outcome after anti-VEGF treatment in NV-AMD patients.
Aged ; Aged, 80 and over ; Angiogenesis Inhibitors/*therapeutic use ; Choroidal Neovascularization/*drug therapy/physiopathology ; Female ; Humans ; Intravitreal Injections ; Male ; Middle Aged ; Ranibizumab/*therapeutic use ; Retinal Photoreceptor Cell Inner Segment/pathology ; Retinal Photoreceptor Cell Outer Segment/pathology ; Tomography, Optical Coherence ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity/*physiology ; Wet Macular Degeneration/*drug therapy/physiopathology

No abstract available.
Bursitis*

Fractures of the tibia are frequently encountered in mordern civilized society. Especially, those in distal 1/3 of the tibia have so many problems, such as angular deformity, osteomyelitis and nonunion because of anatomically scanty soft tissue. Many modalities of the treatment of fracture of distal 1/3 of the tibia were introduced. Among them, interlocking IM nailings were considered as one of the best modality. But, in interlocking IM nail, reaming of the medullary canal which destroys the endosteal circulation and causes thermal necrosis of the inner aspect of the cortical bone results in delayed union. And also, procedure for distal screw fixation is difficult and time-consuming. As for using flexible IM nails for fractures of distal 1/3 of the tibia, it was considered as not so satisfactory method due to lack of stability of fixation. However, the stability of fixation can be strengthened with fanning of the nails in distal fragment, using more than 3 nails and delay the protected weight bearing. Authors studied 25 cases of fractures of distal 1/3 of the tibia treated with closed flexible IM nailing at Sung Ae General Hospital, from July., 1987 to July., 1989, and obtained following results: 1. Among 25 cases, 4th decades were most common and males were more commonly involved. 2. Traffic accidents were the most common causes of injury and majority of 16 open fractures and 19 comminuted fractures, were caused by high energy mechanism. Among open fractures, type II were most common. 3. Two angular deformities less than 10 degrees, one proximal migration and one checkrein deformity were observed as complications, but, no clinically significant complications were noted. 4. The time for radiological union were 14.5 weeks in group without fibular fracture and 15.1 weeks in group with fibular fracture, and 14.0 weeks in closed fracture group and 17.2 weeks in open fracture group, and average in 15.6 weeks.
Accidents, Traffic ; Clinical Study ; Congenital Abnormalities ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Hospitals, General ; Humans ; Male ; Methods ; Necrosis ; Osteomyelitis ; Tibia ; Weight-Bearing

OBJECTIVE: To evaluate the accuracy of combined transvaginal ultrasound and beta-hCG discriminatory zone for diagnosing intrauterine pregnancy, abortion, and ectopic pregnancy in early abnormal pregnancy. METHODS: Initial ultrasound findings and beta-hCG level were compared with final pregnancy outcome in 164 early pregnant women who visit our hospital with vaginal bleeding or abdominal pain. The sensitivity, specificity, and predictive value by the combination of two diagnostic tools were calculated. Statistic analysis of collected data used x2 of SPSS(9.0). RESULTS: Of 90 women with normal outcome, 64(71.1%) had a gestational sac 5mm, and in 47 cases, the hCG level was above 1,800 mIU/ml. Transvaginal ultrasound was non-diagnostic in 47(28.6%) of 164 women, and especially, 43(53.1%) of 81 cases with beta-hCG levels below 1,800 mIU/ml. The portion of accurate ultrasound diagnosis was significantly higher in women above 1,800 mIU/ml (85.5%, 71 of 83 cases) compard with levels below 1,800 mIU/ml (37.0%, 30 of 81 cases) : P < 0.001; Relative Risk(RR) 2.31; CI 95%. Sensitivity of transvaginal ultrasound diagnosis of intrauterine pregnancy, abortion, and ectopic pregnancy was 90.2%, 79.3%, and 66.7% in women who presented with beta-hCG levels above 1,800 mIU/ml, and 41.0%, 23.5%, and 75% below 1,800 mIU/ml, respectively. And, negative predictive value was 83.9%, 89.7%, and 98.8% in each of intrauterine pregnancy, abortion, and ectopic pregnancy above 1,800 mIU/ml, and 64.6%, 60%, and 97.3% below 1,800 mIU/ml, respectively. CONCLUSIONS: The sensitivity, specificity, and predictive value of transvaginal ultrasound for diagnosing abnormal early pregnancy were poor except cases of ectopic pregnancy when beta-hCG levels were low than discriminatory zone. Ultrasound impressions were well related with beta-hCG levels.
Abdominal Pain ; Diagnosis ; Female ; Gestational Sac ; Humans ; Pregnancy Outcome ; Pregnancy* ; Pregnancy, Ectopic ; Pregnant Women ; Sensitivity and Specificity ; Ultrasonography* ; Uterine Hemorrhage

Fetal echocardiography is used by means of decleration of fetal cardiac anaztomy, to estabilish the diagnosis of congenital heart disease in utero. We attemped fetal echocardiography to ninty three pregnant women after intra uterine period 24 weeks, and estimated cardiac circumference, cardiac axis, pulmonary atery root diameter, arortic root diameter, diameter of inferior vena cava, diameter of superior ve studied how these estimates associate with following gestational na cava, and fractional shortening of ventricles. We ages. Cardiac axis was on the average 37.28 degree and cardiac apex was located in anterior left side of chest area. Aortic root diameter was 0.227 GA-0.043mm (GA=gestational age) at systolic phase, 0.203 GA+0.421mm at diastolic phase. Pulmonaly root diameter was 0.271 GA-0.029mm at systolic phase, 0.251 GA-0.067mm at diastolic phase. Thoracic aorta diameter was 0.195 GA+0.109mm at systolic phase, 0.198 GA+0.794mm at diastolic phase. Fractional shortening was 0.24 (1 Standard Deviation=0.11) in right ventricle, 0.23(1 SD=0.154) at left ventricle, and so ratio of right and left ventricle was 1.04(1 SD=0.51). Once normal fetal cardiac anatomy is understood, structural defects and/or alternation of function can be evaluated antenatally.
Aorta, Thoracic ; Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Female ; Heart Defects, Congenital ; Heart Ventricles ; Humans ; Pregnant Women ; Thorax ; Vena Cava, Inferior

We experinced a case of 4p+ syndrome in male infant. He had multiple anomalies such as flat occiput, hypertelorism, low set malformed ear, lower anterior hair line, depressed nose, broad nasal bridge, bilateral complete cleft lip and palate, short neck, unusual position of fingers, ventricular septal defect and umblical hernia. He menifested growth and developmental retardation. Karyotype with banding revealed an extra short arm of chromosome 4. The mother's karyotype was normal. His father and father's sister had a translocation between the short arm of chromosome 4 and the short arm of chromosome 9; their karyotypes were 46, XY, t(4;9) and 46, XX, t(4;9), respectively. In this case, trisomy 4p was the result of parental balanced translocatiom. As this is the first case in Korea, it is worthwhile to report with reviewing literature.
Arm ; Chromosomes, Human, Pair 4 ; Chromosomes, Human, Pair 9 ; Cleft Lip ; Ear ; Fathers ; Fingers ; Growth and Development ; Hair ; Heart Septal Defects, Ventricular ; Hernia ; Humans ; Hypertelorism ; Infant ; Karyotype ; Korea ; Male ; Neck ; Nose ; Palate ; Parents ; Siblings ; Trisomy

PURPOSE: To report a case of deterioration of a retinal arterial macroaneurysm after panretinal photocoagulation (PRP) for diabetic retinopathy. CASE SUMMARY: A 70-year-old woman visited our clinic for evaluation of diabetic retinopathy. Fundus examination and fluorescein angiography showed severe non-proliferative diabetic retinopathy and PRP was planned for the patient. In addition, the patient was found to have a retinal arterial macroaneurysm on the superotemporal area of the retina on her right eye. However, the lesion was small and was located far from the macula, causing no symptoms; thus we decided to observe the patient over a period of time. Two months after PRP, the patient revisited the clinic complaining of acute visual loss. Fundus examination showed vitreous and retinal hemorrhage and optical coherence tomography revealed subretinal fluid in the corresponding area. This was considered to be due to aggravation of the pre-existing macroaneurysm. Intravitreal Bevacizumab injection, C₃F₈ gas injection, and pars plana vitrectomy were performed. After absorption of the hemorrhage, barrier photocoagulation was performed around the retinal macroanerysm. The visual acuity improved and the retina remained stable through the most recent follow-up. CONCLUSIONS: We experienced the rupture of a preexisting retinal arterial macroaneurysm in an asymptomatic patient after panretinal photocoagulation. PRP in diabetic patients could aggravate retinal arterial macroaneurysms. Therefore, it is necessary to carefully examine the patient for retinal macroaneurysms when planning a PRP for diabetic retinopathy.
Absorption ; Aged ; Bevacizumab ; Diabetic Retinopathy* ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Hemorrhage ; Humans ; Light Coagulation* ; Retina ; Retinal Hemorrhage ; Retinaldehyde* ; Rupture ; Subretinal Fluid ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

PURPOSE: To evaluate efficacy and the safety of percutaneous catheter drainage in patients with pneumothorax that is difficult to treat with closed thoracotomy. MATERIALS AND METHODS: We retrospectively reviewed effectivenss of percutaneous catheter drainage (PCD) in 10 patients with pneumothorax. The catheter was inserted under fluoroscopic guidance. Seven patients had spontaneous pneumothorax caused by tuberculosis (n=4), ruptured bullae (n=2), and histiocytosis-X(n=l). Three patients had iatrogenic pneumothorax caused by trauma (n=l) and surgery(n=2). All procedures were performed by modified Seldinger's method by using 8F-20F catheter. RESULTS: All catheters were inserted successfully. In 9 of 10 patients, the procedure was curative without further therapy. Duration of catheter insertion ranged from 1 day to 26 days. In the remaining 1 patient in whom multiple pneumothorax occurred after operation, catheter insertion was performed twice. CONCLUSION: Percutaneous catheter drainage under fluoroscopic guidance is effective and safe procedure for treatment of pneumothorax in patients with failed closed thoracotomy.
Catheters* ; Chest Tubes* ; Drainage* ; Fluoroscopy* ; Humans ; Pneumothorax* ; Retrospective Studies ; Thoracotomy ; Thorax* ; Tuberculosis