No abstract available.
DNA Fingerprinting* ; DNA* ; Humans* ; Papilloma*

Peripheral cementifying fibroma is histomorphologically similar to the central cementifying fibroma, but this lesion is unique to the gingival mucosa and is only rarely seen in edentulous area. In most instances, it arise from interdental papilla, with 80% occurring anterior to molar region. This lesion appears to involve the maxilla and mandible equally, demonstrates the highest occurrence rate during the second decade of life, and affects female more frequently than male, with 4.3:1 to 3:2. Peripheral cementifying fibroma presents as firm, pedunculated or sessile mass with an intact or ulcerated surface depending on the presence of trauma. Microscopically, it reveals a highly cellular mass of connective tissue containing numerous plump, proliferating fibrolasts and several forms of calcification. Effective treatment requires deep excision, which includes the ligament and periosteum, followed by a thorough root scaling of the adjacent teeth. A reveiw of the literature and a report of a case of peripheral cementifying fibroma are presented.
Connective Tissue ; Dental Scaling ; Female ; Fibroma* ; Gingiva ; Humans ; Ligaments ; Male ; Mandible ; Maxilla ; Molar ; Mucous Membrane ; Periodontal Ligament* ; Periosteum ; Tooth* ; Ulcer

No abstract available.
Orbit* ; Orbital Cellulitis*

PURPOSE: There are a number of conditions that can lead to a hypercoagulable state, however, protein C and S deficiencies are frequently described as causes of the hypercoagulable states. The aim of this study was to evaluate the clinical features and prognosis of vascular diseases associated with protein C and/or S deficiencies and to determine an adequate treatment modality for such cases. METHODS: We prospectively evaluated 7 cases with vascular disease caused by protein C and/or S deficiencies confirmed with serologic tests. RESULTS: Four patients showed venous thrombosis, 1 peripheral arterial insufficiency, 1 cerebral venous thrombosis and peripheral arterial insufficiency, and 1 portal vein thrombosis. Surgical intervention was required in 5 patients. Full anticoagulation with heparin sodium followed by warfarin sodium was done in all patients. CONCLUSION: Protein C and S deficiencies may influence clinical management. Patients presenting with atypical vascular involvement without evidence of other risk factors should be evaluated for a hypercoagulable state. Once the diagnosis is made, patients should be treated with full anticoagulation.
Diagnosis ; Heparin ; Humans ; Prognosis ; Prospective Studies ; Protein C* ; Risk Factors ; Serologic Tests ; Vascular Diseases* ; Venous Thrombosis ; Warfarin

No abstract available.
Carcinoma, Squamous Cell* ; Head* ; Humans ; Interleukin-2* ; Neck*

BACKGROUND: Because acute cholecystitis in elderly hip fracture is not easily distinguishable from other gastrointestinal symptoms and involves atypical clinical behaviors, it may not be diagnosed in the early stage. However, the exact incidences could not be reported. We utilized data from a nationwide claims database and attempted to assess the incidence of acute cholecystitis in elderly hip fracture patients and how cholecystitis affects mortality rates after hip fracture. METHODS: Study subjects were from the Korean National Health Insurance Service-Senior cohort. From a population of approximately 5.5 million Korean enrollees > 60 years of age in 2002, a total of 588,147 participants were randomly selected using 10% simple random sampling. The subjects included in this study were those who were over 65 years old and underwent surgery for hip fractures. RESULTS: A total of 15,210 patients were enrolled in the cohort as hip fracture patients. There were 7,888 cases (51.9%) of femoral neck fracture and 7,443 (48.9%) cases of hemiarthroplasty. Thirty-six patients developed acute cholecystitis within 30 days after the index date (30-day cumulative incidence, 0.24%). Four of the 36 acute cholecystitis patients (11.1%) died within 30 days versus 2.92% of patients without acute cholecystitis. In the multivariate-adjusted Poisson regression model, hip fracture patients with incident acute cholecystitis were 4.35 (adjusted risk ratio 4.35; 95% confidence interval, 1.66–11.37; P = 0.003) times more likely to die within 30 days than those without acute cholecystitis. CONCLUSION: Incidence of acute cholecystitis in elderly patients after hip fracture within 30 days after the index date was 0.24%. Acute cholecystitis in elderly hip fracture patients dramatically increases the 30-day mortality rate by 4.35-fold. Therefore, early disease detection and management are crucial for patients.
Abdominal Pain ; Aged ; Cholecystitis ; Cholecystitis, Acute ; Cohort Studies ; Femoral Neck Fractures ; Hemiarthroplasty ; Hip Fractures ; Hip ; Humans ; Incidence ; Mortality ; National Health Programs ; Odds Ratio

BACKGROUND: The neuromuscular blocking effects of a nondepolarizing neuromuscular blocker (NDNM) during a nitroglycerin (NTG) infusion were significantly potentiated and prolonged. NTG reduced the requirement of a NDNM in surgical patients. We investigated the influence of a NTG single bolus injection on a mivacurium nuromuscular blockade. METHODS: We studied 36 adult surgical patients, ASA physical status I or II, between 15 and 53 years old. Neuromuscular monitoring was measured by TOF-GUARD (Biometer Co., Denmark). Anesthesia was induced by thiopental sodium 3-5 mg/kg and fentanyl 3 microgram/kg, and maintained with 3 L/min N2O, 2 L/min O2 and 1 vol.% isoflurane. Patients were randomly assigned to 3 groups: 1) Control group (mivacurium 0.16 mg/kg), 2) N100 group (mivacurium 0.16 mg/kg, NTG 100 microgram), 3) N200 group (mivacurium 0.16 mg/kg, NTG 200 microgram). We measured the train-of-four (TOF) response from the beginning of recovery to the complete regaining of muscle twitch. RESULTS: NTG produced a prolongation of the neuromuscular blocking effect by mivacurium. T1 (contro group: 12.1 +/- 0.5, N100 group: 15.8 +/- 0.4 and N200 group: 11.6 +/- 0.4 min), T25 (16.4 +/- 0.4, 20.5 +/- 0.5 and 14.9 +/- 1.0 min), T75 (22.5 +/- 0.9, 29.4 +/- 0.7 and 20.1 +/- 1.0 min), T95 (27.3 +/- 0.6, 39.6 +/- 0.7 and 24.6 +/- 1.5 min) and the recovery index (6.1 +/- 0.6, 9.0 +/- 0.4 and 5.3 +/- 0.7 min) were significantly prolonged in the N100 and N200 groups (P < 0.05). CONCLUSION: These results suggest that a NTG bolus injection prolonged the neuromuscular blocking effect of mivacurium, dose relatively.
Adult ; Anesthesia ; Fentanyl ; Humans ; Isoflurane ; Middle Aged ; Neuromuscular Blockade ; Neuromuscular Monitoring ; Nitroglycerin* ; Thiopental

Cutaneous endometriosis seems to be more common in women who have had a pelvic or abdominal operation and primary cutaneous endometriosis is very rare. In our hospital we experienced a 41-year-old woman who complained of the appearance at the umbilicus of a nodule and had not had operation. This nodule was responsible for recurrent pain and increasing in size and it was excised. Pathology findings revealed cutaneous endometriosis. So we present a case of primary cutaneous endometriosis with a brief review of literature.
Adult ; Endometriosis* ; Female ; Humans ; Pathology ; Umbilicus

Anomalies of the intestinal rotation mainly produce clinical manifestations in infants and children, but are uncommon in adults. We report three adult patients who presented with a surgical abdomen and the characteristic computed tomographic findings associated with anomalies of the intestinal rotation. Two patients presented with acute appendicitis, and one presented with an intestinal obstruction caused by colon cancer. In all patients, the computed tomographic findings were suggestive and were helpful for making a preoperative diagnosis of the anomalies of intestinal rotation: (1) a left-sided colon and/or (2) mesenteric vascular inversion. A computed tomographic scan is useful not only for providing an accurate diagnosis of a suspected surgical abdomen but also for detecting associated rotational anomalies, which may require a separate surgical correction.
Abdomen ; Adult* ; Appendicitis ; Child ; Colon ; Colonic Neoplasms ; Diagnosis ; Humans ; Infant ; Intestinal Obstruction

Tuberculosis may be difficult to diagnose when it presents in an uncommon extrapulmonary site. Although there has been a resurgence of abdominal tuberculosis in immunocompromised patients, which is largely due to the extensive use of immunosuppressive drugs and the increasing incidence of a human immunodeficiency virus infection, splenic tuberculosis is rare, particularly in the immunocompetent patients. Almost all cases of splenic tuberculosis present as multiple hypoechoic foci on sonography or multiple focal hypodense lesions on contrast enhanced computed tomographic scan. To our knowledge, splenic tuberculosis is an extremely rare condition. An 80-year-old man was found to have a large solitary splenic mass mimicking a splenic neoplasm on sonography and contrast enhanced computed tomographic scan. A diagnostic splenectomy revealed a large solitary mass in the spleen, which was consistent with splenic tuberculosis microscopically. We report a rare case of splenic tuberculosis in an elderly man presenting as a large solitary splenic mass on sonography and contrast enhanced computed tomographic scan.
Aged ; Aged, 80 and over ; HIV ; Humans ; Immunocompromised Host ; Incidence ; Spleen ; Splenectomy ; Splenic Neoplasms ; Tuberculosis ; Tuberculosis, Splenic*