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Hemorrhagic cystitis is potentially life-threatening sequellae of chemotherapy using oxazaphosphorine alkylating agents (cyclophosphamide and ifosfamide). Mesna contains a sulfhydryl group that is believed to bind acrolein within the urinary collecting system and reduce the hemorrhagic cystitis without affecting the chemotherapeutic potential. To date, about thirty cases of hypersensitivity or allergic reactions of the delayed and urticarial type associated with mesna have been reported. We reported two patients with systemic lupus erythematosus who developed facial rash and flushing associated with mesna which imitate malar rash.
Acrolein ; Alkylating Agents ; Cyclophosphamide ; Cystitis ; Drug Therapy ; Exanthema* ; Flushing ; Humans ; Hypersensitivity* ; Lupus Erythematosus, Systemic ; Mesna*

BACKGROUND AND OBJECTIVES: Overcorrection is defined as obvious deviation of the septum to the opposite direction after septoplasty and it is not infrequently developed in young patients. We investigated the rate of its incidence, especially in relation to age. MATERIALS AND METHODS: We retrospectively studied 1,124 patients undergoing septoplasty operation for septal deviation between 1994 and 1999. The operations and postoperative observation were performed by a single surgeon. We reviewed the medical records for age, sex, symptoms, combined operations, direction of deviation before and after septoplasty. RESULTS: Out of 1,124 patients, 22 (2.0%) had their septum overcorrected after septoplasty and 21 (95%) complained of nasal obstruction of the newly deviated side. The incidence of overcorrection was 7.3% (16/218) in teens, 1.7% (5/294) in twenties, 0.4% (1/250) in thirties, and 0% in older ages. The incidence in teens and early twenties was 5%. Patients of teenagers revealed significantly higher incidence as compared to other age groups (p<0.05). CONCLUSION: Overcorrected septum as a complication of septoplasty develops at the incidence rate of 5% in patients of teens and early twenties. Authors suggest that the depth of cross-hatching incision on the cartilage should be superficial or half-thickness to avoid overcorrection in young patients. And the possibility of overcorrection or revision septoplasty should be informed preoperatively.
Adolescent ; Cartilage ; Humans ; Incidence ; Medical Records ; Nasal Obstruction ; Retrospective Studies

PURPOSE: To evaluate the diagnostic value of radiologic studies in the Cushing's disease MATERIALS AND METHODS: We analyzed retrospectively the CT(n=19, dynamic CT was not perfomed), MR (n=23, dynamic MR in 2 cases), and the results of inferior petrosal sinus sampling(IPSS)(n=13) in 25 patients(19 women, 6men, age range 16-58, mean 32.2) with pathologically-confirmed ACTH secreting pituitary adenoma. We analyzed the radiologic findings and determined how accurately each method could detect and lateralize the lesion within the pituitary gland. The results were compared with the surgical findings and with each other. RESULTS: Seven patients(28%) out of 25 had macroadenomas and the lesions were detected and correctly diagnosed by CT and MR in all. Eighteen patients(72%) had microadenoma. In patients with microadenoma the sensitivity was 38.5%(5/13) in CT, 64.7%(11/17) in MR, 90.9%(10/11) in IPSS. In two patients with dynamic MR, in whom the conventional Gd-enhanced MR showed false negative results, the lesions were detected as low signal intensity mass and correctly lateralized. Considering the results of both MR and IPSS, the sensitivity increased up to 94.1%(17/18). CONCLUSION: Considering the invasiveness of IPSS, Gd-enhanced MR, preferably dynamic, seems to be an imaging modality of choice in Cushing's disease. Combined use of IPSS in selected patients further increases the accuracy of diagnosis and lateralization.
ACTH-Secreting Pituitary Adenoma ; Diagnosis ; Female ; Humans ; Pituitary Gland ; Retrospective Studies

Necrotizing sialometaplasia (NS) is a rare, benign, self-limiting lesion, but it mimics carcinoma both clinically and histologically. Authors present a case of NS on the right posterior hard palate in a 16-year-old boy. This case showed underlying erosive bone change on CT images. We supposed this lesion resulted from the local anesthesia for dental treatment. Presented NS is the only one case from approximately 1, 500 oral and maxillofacial biopsies (0.07%) at Chonnam National University Hospital during the period from 1999 to 2004.
Adolescent ; Anesthesia, Local ; Biopsy ; Humans ; Incidence* ; Jeollanam-do ; Male ; Palate, Hard ; Sialometaplasia, Necrotizing

BACKGROUND: Residual pleural thickening is frequently seen following treatment for tuberculous pleurisy, and pleural decortication is performend occasionally in patients with severe residual pleural thickening. However, predictive factors for the development of residual pleural thickening are uncertain at the initial diagnosis of the tuberculous pleurisy. Therefore, the purpose of this study was to identify the associated factors for residual pleural thickening at initial diagnosis. METHODS: We separated 63 patients diagnosed as tuberculous pleurisy into two groups; group 1 consisted of patients without residual pleural thickening and group 2 comprised patients with residual pleural thickening at the end of tuberculous pleurisy treatment. We analyzed the clinical characteristics, radiological findings, pleural biopsy and characteristics of pleural fluid between group 1 and group 2. RESULTS: The study population and clinical symptoms of the two groups were not significantly different and the duration of symptoms before treatment and the peripheral WBC were similar between the two groups. The presence of pulmonary tuberculosis, pleural fluid loculation or the amount of pleural effusion sid not differ significantly between the thwo groups. The incidence of positive AFB staining(group 1 : 8%, group 2 : 38%) and granuloma(group 1 : 30%, group 2 : 62%) on pleural biopsy specimens was significantly higher in group 2 than in group 1. Pleural fluid WBC and differential count, adenosine deaminase level, pH, preotein level or glucose level did not differ between the two groups. However, group 2 had higher LDH levels (1370±208mg/dl) than group 1 (860±71mg/dl, p<0.05). CONCLUSION: In tuberculous pleurisy, patients with residual pleural thickening following treatment demonstrated a higher incidence of posivive AFB staining and granuloma on the pleural biopsy specimens or higher LDH level in the pleural fluid than patients wihtout residual pleural thickening From these results, we speculate that the amonut of tuberculous bacilli and granuloma are probably correlated with residual pleural thickening in the tuberculous pleurisy.
Adenosine Deaminase ; Biopsy ; Diagnosis ; Drug Therapy* ; Glucose ; Granuloma ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Pleural Effusion ; Pleurisy* ; Sudden Infant Death ; Tuberculosis, Pleural ; Tuberculosis, Pulmonary

PURPOSE: To report the incidence of radiological findings from screening panoramic radiographs and verify the validity of the panoramic radiography for screening purposes. MATERIALS AND METHODS: Six thousand one hundred and sixty panoramic radiographs taken from the patients visiting the Health Promotion Center of CNUH were selected for this retrospective study. Panoramic radiographs were examined into the following pathologic conditions : the presence of periodontal bone loss, dental caries, periapical radiolucencies, retained roots, impacted supernumerary teeth, impacted third molars, odontoma, cystic lesions other than radicular cyst, sialoliths, and mixed radiolucent-radiopaque lesions. Number of pathologic conditions and Prevalence values were recorded. RESULTS: The prevalences of pathologic conditions were 72.9% of periodontal bone loss, 32.2% of dental caries, 11.9% of periapical radiolucencies, 10.8% of retained roots, 0.4% of root fracture, 1.0% of impacted supernumerary teeth, 1.0% of impacted third molars, 0.06% of odontoma, 0.08% of cystic lesion other than radicular cyst, 0.2% of prolonged retention of deciduous tooth, 0.1% of sialolith, and 0.04% of mixed radiopaque and radiolucent lesion. CONCLUSIONS: Although the panoramic radiograph should not be used to replace intraoral radiographic and clinical examinations, this study showed that many dental pathologic conditions could be detected on panoramic radiographs. The panoramic radiograph might serve as a diagnostic aid in dental health evaluation programs.
Alveolar Bone Loss ; Dental Caries ; Health Promotion* ; Humans ; Incidence ; Mass Screening* ; Molar, Third ; Odontoma ; Prevalence ; Radicular Cyst ; Radiography ; Radiography, Panoramic ; Retrospective Studies ; Salivary Gland Calculi ; Tooth, Deciduous ; Tooth, Supernumerary

Osteopetrosis is an uncommon hereditary bone disorder whose prominent radiologic feature characterized by increased bone density. The authors reported a 7-year-old male patient who referred from local dental clinic for dental problems such as early exfoliation of deciduous teeth(#54,73,83) and delayed eruption of permanent teeth(#31,41,36,46). The patient appeared as a poorly developed. Dental X-ray films showed early exfoliation of deciduous teeth, delayed eruption of permanent teeth, and rampant caries. Lateral view of skull demonstrated increased opacity of calvarium, facial bones, and skull base. Generally the skeletal density is greatly increased throughout all bones. Facial CT showed poor development of paranasal sinuses and mastoid air cells. No hematopoietic and neurologic complications such as anemia, thrombocytopenia, blindness and deafness were found. Also mental retardation was not found. The final diagnosis of this case was a osteopetrosis tarda. Sometimes patient with osteopetrosis tarda may be developed dental problems prior to severe systemic symptoms. The dentist can be the first clinician to see the patient. It is very important for the dentist to have the knowledge of the osteopetrosis and to care the patient's dental problems to prevent complication such as osteomyelitis of jaws.
Anemia ; Blindness ; Bone Density ; Child ; Deafness ; Dental Clinics ; Dentists ; Diagnosis ; Facial Bones ; Growth Disorders ; Humans ; Intellectual Disability ; Jaw ; Male ; Mastoid ; Osteomyelitis ; Osteopetrosis* ; Paranasal Sinuses ; Skull ; Skull Base ; Thrombocytopenia ; Tooth ; Tooth Eruption ; Tooth, Deciduous ; X-Ray Film

Cerebral arterial embolism which resulted in total occlusion of right proximal middle cerebral artery was occured in 33 years old female patients with severe mitral stenosis and atrial fibrillation during percutaneous mitral balloon valvuloplasty(PMV). The occluded artery could be detected by transfemoral carotid angiography and recanalized immediately by intra-arterial infusion of urokinase. There were no cerebral hemorrhage by CT scan after intra-arterial urokinase infusion and the patients discharged without any neurologic sequale 7 days after thrombolysis. We report a case of successful recanalization with intraarterial infusion of urokinase in patient with cerebral arterial embolism occurred during PMV.
Adult ; Angiography ; Arteries ; Atrial Fibrillation ; Cerebral Hemorrhage ; Embolism* ; Female ; Humans ; Infusions, Intra-Arterial* ; Intracranial Embolism ; Middle Cerebral Artery ; Mitral Valve Stenosis ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator*

PURPOSE: This study was performed to analyze the position, pattern of impacted mesiodens, and their relationship to the adjacent teeth using Dental cone-beam CT. MATERIALS AND METHODS: Sixty-two dental cone-beam CT images with 81 impacted mesiodenses were selected from about 2,298 cone-beam CT images at Chonnam National University Dental Hospital from June 2006 to March 2009. The position, pattern, shape of impacted mesiodenses and their complications were analyzed in cone-beam CT including 3D images. RESULTS: The sex ratio (M : F) was 2.9 : 1. Most of the mesiodenses (87.7%) were located at palatal side to the incisors. 79% of the mesiodenses were conical in shape. 60.5% of the mesiodenses were inverted, 21% normal erupting direction, and 18.5% transverse direction. The complications due to the presence of mesiodenses were none in 43.5%, diastema in 19.4%, tooth displacement in 17.7%, delayed eruption or impaction in 12.9%, tooth rotation in 4.8%, and dentigerous cyst in 1.7%. CONCLUSION: Dental cone-beam CT images with 3D provided 3-dimensional perception of mesiodens to the neighboring teeth. This results would be helpful for management of the impacted mesiodens.
Cone-Beam Computed Tomography ; Dentigerous Cyst ; Diastema ; Displacement (Psychology) ; Incisor ; Sex Ratio ; Tooth ; Tooth, Supernumerary