No abstract available.
Embryo Transfer* ; Embryonic Structures* ; Estradiol* ; Fertilization in Vitro*

Thyroid acropachy is a rare complication of Graves' disease, manifested by clubbing of the terminal phalanges, periosteal new bone formation and overlying soft tissue swelling, It may occur when the patient is hypothyroid, euthyroid or hyperthyroid. In most cases, it is a part of the syndrome, including exophthalmos and/or pretibial myxedema. The authors have experienced one case of thyroid acropachy and report with a review of the literature review. The patient a 56-year-old female with a characteristic feathery new bone formation on the medial side of the shaft of the left first metatarsal bone and overlying soft tissue swelling. However, there was no pretibial myxedema and clubbing of fingers. She was hypothyroid and treated with systemic corticosteroid for mild pain and persistent swelling. The treatment had temporarily improved the patient's condition.
Exophthalmos ; Female ; Fingers ; Graves Disease ; Humans ; Metatarsal Bones ; Middle Aged ; Myxedema ; Osteogenesis ; Thyroid Gland*

BACKGROUND: The purpose of this study was to investigate the mechanism of endothelium-dependent and independent responses to endothelins (ETs) in porcine coronary artery. METHODS: The vascular rings of left anterior descending artery or left circumflex artery from 7 pigs were suspended in conventional organ chambers for the measurement of isometric force. To evaluate relaxation responses, vascular rings with endothelium were exposed to ET-1 and ET-3. To evaluate contraction responses, vascular rings with and without endothelium were exposed to ET-1 and ET-3 in the presence or absence of BQ 123 (ET(A) receptor antagonist) or TAK-044 (ET(A) and ET(B) receptor antagonist). RESULTS: Transient relaxation responses of vascular rings occurred after exposure of ET-1 and ET-3. These transient responses disappeared after preincubation with N-nitro-L arginine. There was an increased contractions of vascular rings according to increasing concentration of ET-1 and ET-3. The initial responses were enhanced in vascular rings without endothelium in ET-1 and ET-3. In vascular rings with endothelium, the contraction responses were more reduced in vascular rings with preincubation of BQ 123 than in vascular rings without BQ 123 in ET-1. In vascular rings without endothelium, the contraction responses were more reduced in vascular rings with preincubation of TAK-044 than in vascular rings without TAK-044 in ET-1. CONCLUSION: ET(B) receptor on the endothelium might mediate the transient vasodilator responses to ET-1 and ET-3 through release of nitric oxide in porcine coronary artery. ET(A) and ET(B) receptor on vascular smooth muscle cells might mediate vasoconstrictor responses to ETs.
Arginine ; Arteries ; Coronary Vessels* ; Endothelins* ; Endothelium ; Muscle, Smooth, Vascular ; Nitric Oxide ; Receptors, Endothelin ; Relaxation ; Swine

BACKGROUND: Systemic anticoagulation therapy has been recommended to prevent subacute thrombosis after intracoronary stening. Recent data, however, suggest that antiplatelet therapy might be an effective alternative to anticoagulation therapy. We evaluated the effect of antithrombotic regimens on subacute thrombosis and short-term clinical course after successful implantation of Cordis coronary stent, which is a flexible, balloon expandable, radiopaque tantalum stent. METHOD: Two hundred and seventy-five consecutive patients with 290 lesions were treated with 356 Cordis stents implantation. According to post-stent antithrombotic regimen, patients were divided into three groups ; 165 patients with 175 lesions received aspirin 200mg/day, ticlopidine 500mg/day and warfarin for one month(Group 1), 66 patients with 69 lesions received aspirin and ticlopidine(Group 2) and 44 patients with 46 lesions received aspirin alone(Group 3) after successful Cordis stenting. RESULTS: The overall procidural success rates were 97.7% in group 1, 98.6% in group 2 and 100% in group 3. More than 65 percents of the patients were eligible for elective stenting aspirin, ticlopidine and warfarin, 0% in patients with aspirin and ticlopidine, and 6.8% in patients assigned to the treatment with aspirin alone. CONCLUSION: The Cordis coronary stent is an effective endovascular stent in various clinical indications including unstable angina and acute myocardial infarction. Antiplatelet therapy using aspirin and ticlopidine after successful Cordis coronary stenting is promising alternative to anticoagulation therapy to overcome the drawbacks of stenting. However, post-stent antithrombotic therapy with aspirin alone is associated with significant rate of stent thrombosis.
Angina, Unstable ; Aspirin ; Coronary Artery Disease ; Humans ; Korea* ; Myocardial Infarction ; Stents* ; Tantalum ; Thrombosis ; Ticlopidine ; Warfarin

BACKGROUND: The purpose is to determine the efficacy of additional intravenous patient-controlled analgesia (IV-PCA) by comparing the analgesic effects between interscalene block (ISB) combined with IV-PCA and single ISB after arthroscopic shoulder surgery. METHODS: A total of 213 patients who underwent arthroscopic shoulder surgery were divided into two groups based on the type of perioperative anesthesia. The single ISB group included 100 patients, while the IV-PCA group included 113 patients. The visual analogue scale for pain (VAS pain) scores were assessed at 12, 24, and 48 hours postoperatively in accordance with shoulder pathology. Postoperative narcotics-related complications and consumption of additional non-steroidal anti-inflammatory drugs between the two groups were compared. RESULTS: VAS pain showed no significant difference between the two groups at most points of the postoperative timeline, regardless of shoulder pathology, except in patients with rotator cuff repair at postoperative 24 hours. Although the IV-PCA group showed a statistically lower VAS pain score than the ISB group at postoperative 24 hours (p=0.04), the difference in the VAS pain score was only 9.0 mm in patients with rotator cuff repair. Narcotics-related complications were observed more frequently in the IV-PCA group than in the ISB group for patients with rotator cuff repair. CONCLUSIONS: Additional IV-PCA demonstrated no booster effect for immediate pain control in patients undergoing arthroscopic shoulder surgery with preoperative single ISB. Furthermore, patients with IV-PCA experienced greater narcotics-related complications.
Analgesia ; Analgesia, Patient-Controlled* ; Anesthesia ; Arthroscopy ; Humans ; Pathology ; Prospective Studies* ; Rotator Cuff ; Shoulder*

Purpose: The purpose of this study was to investigate the effects of the fascia distortion model (FDM), one of the fascia treatments, on unstable ankle subjects. This was done through the chronic ankle instability tool (CAIT) questionnaire on maximum isometric muscle strength, proprioception, dynamic balance, and maximum angle. Methods: An experiment was conducted using the chronic ankle instability tool questionnaire on males and females in their twenties who suffered from ankle instability. Before the experiment, maximum isometric strength, proprioceptive, dynamic balance, and maximum angle were measured. The fascia distortion model was applied and then measurements were taken again to compare and analyze the changes. Analysis was carried out using the paired t-test. Results: After applying the fascia distortion model, maximum isometric strength, proprioceptive, dynamic balance, and maximum angle significantly improved (p < 0.05). Conclusion This study found that the fascia distortion model method was effective in improving maximum isometric strength, proprioceptive, dynamic balance, and maximum angle. The results suggest that the fascia distortion model method is a new intervention that could be used for subjects with chronic ankle instability.

Oral care is easily neglected in patients in an intensive care unit (ICU) because they are often intubated or have altered mental status. Although care workers pay careful attention to the mouth, tooth loss often occurs in the ICU. Here we report 3 cases of dental bridge loss undetected by the ICU staff. One patient was under mechanical ventilation via an endotracheal tube after emergency intubation, whilst 2 patients were drowsy but not intubated. Consecutive chest X-rays revealed dental bridge loss in all 3 cases, but this was not identified immediately. Along with other critical management approaches, these cases demonstrate how an initial evaluation of the oral cavity, with special attention to the number of teeth, and the existence of dental prosthetics is essential to preventing potential deleterious complications. The number of teeth and the existence of dental prosthetics must be documented in ICU patients.

Giant cell myocarditis(GCM) is a rare inflammatory heart disease which is characterized by multinucleated giant cells and a granulomatous reaction. It usually progresses rapidly and results in a fatal course. We report a patient with giant cell myocarditis who was treated by cardiac transplantation. A 35-year-old male was admitted with dyspnea which had developed 4 months before. On echocardiography, the right and left ventricles were markedly dilated and severe global hypokinesia was noted. He was diagosed with dilated cardiomyopathy with secondary severe mitral regurgitation. His cardiac function deteriorated progressively. He underwent orthotopic heart transplantation. Grossly the heart was enlarged, weighing 420gm and round with a blunt apex. Both right and left ventricles were markedly dilated. There were numerous white patches, measuring up to 4cm, throughout the epi- and myocardium. Microscopically, extensive fibrosis and multiple exuberant granulomas with numerous scattered multinucleated giant cells were seen. Lymphocytes and eosinophils were also frequent. Coronary arteries were unremarkable. Neither microorganisms nor foreign materials were found. By serial endomyocardial biopsies of the transplanted heart, only mild perivascular lymphocytic infiltration was occasionally observed without any evidence of rejection or recurrence of giant cell myocarditis. The patient's postoperative course has been uneventful so far(postoperative 21 months). The etiology of GCM remains to be clarified, although various factors are suspected. No matter what the cause, our experience suggests that this grave disease might be treated well by heart transplantation.
Male ; Humans ; Biopsy

OBJECTIVES: Despite remarkable development of pharmacotherapy for schizophrenia, some patients continuously have had violence problems. The violence of psychotic patients is recently becoming the focus of the attention. The aim of this study is to investigate the influence of Cognitive Behavioral Therapy (CBT) on patients with schizophrenia having violence related history. METHODS: 15 Patients with schizophrenia spectrum disorder of crime history were treated with individual CBT for 12 sessions, and assessed with 4 scales (Korean version of Aggression Questionnaire, Korean version of the Barratt Impulsiveness Scale-11-Revised, Beck Cognitive Insight Scale and Positive and Negative Syndrome Scale) to evaluate anger, impulse, insight and clinical symptoms respectively at baseline and post treatment. The comparison group consisted of 15 patients with schizophrenia spectrum disorder of crime history. They were also assessed with the same scales during the same period. RESULTS: Although impulsivity is not changed significantly after treatment, but there was significant improvement in clinical symptom, insight and aggression, especially self-reflectiveness and anger respectively. CONCLUSION: CBT can be one of the good therapeutic tools for patients with schizophrenia having violence problems in that it reduces aggression and enhances insight of patients with schizophrenia spectrum disorder.
Aggression ; Anger ; Case-Control Studies* ; Cognitive Therapy* ; Crime* ; Drug Therapy ; Humans ; Impulsive Behavior ; Surveys and Questionnaires ; Schizophrenia* ; Violence ; Weights and Measures

PURPOSE: To compare the detectability and conspicuity of focal hepatic lesions among conventional spin echo techniqueniques and fast scanning techniqueniques in MR imaging. MATERIALS AND METHOD: 36 patients (24 men and 12 women, mean age of 54 years) with suspected liver mass on CT scan and US underwent MR imaging at 1.5 T system. Conventional spin echo T1, T2 weighted imaging, T2 weighted fast spin echo, T1 weighted fast multiplanar spoiled gradient recalled(FMPSPGR) imaging and Gd-enhanced FMPSPGR(Gd-FMPSPGR) were performed. 16 cases of hepatocellular carcinoma, 13 cases of hemangioma, 3 cases of metastasis, 3 cases of cholangiocarcinoma, and 1 case of lymphoma were included. Lesion conspicuity and number of detected hepatic masses were compared among the MR sequences. RESULTS: Overall 63 hepatic lesions were detected in 36 patients. Lesion detection' was 63(100%) with Gd-FMPSPGR, 62(98%) with non-enhanced FMPSPGR, 58(92%) with SE T2WI, 56(89%) with SE T1WI and 54 (86%)with FSE. For solid tumors, the contrast to noise ratio was greatest on Gd-FMPSPGR which was significantly higher than any other sequences. For hemangiomas it was greatest on SE T2WI and was significantly higher than SE T1WI. In the qualitative assessment, Gd-FMPSPGR was preferred for both solid mass lesion and hemangioma. FSE was inferior to SE T2WI for lesion detection and conspicuity without statistical significance. CONCLUSIONS: For the evaluation of focal hepatic lesions, breath-hold FMPSPGR with and without contrast enhancement may replace the conventional SE T1WI. Because FSE was inferior to SE T2WI when the later is used with respiratory compensation in some cases, it is difficult to replace the SE T2WI with FSE. But FSE, FMPSPGR and Gd-FMPSPGR images, when combined, may replace SE T1WI and SE T2WI.
Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Compensation and Redress ; Female ; Hemangioma ; Humans ; Liver ; Lymphoma ; Magnetic Resonance Imaging ; Male ; Neoplasm Metastasis ; Noise ; Tomography, X-Ray Computed