PURPOSE: Ionizing radiations have been reported as an apoptosis initiating stimulus in various cells and it has established that sustained elevations in [Ca2+] can lead to DNA fragmentation by Ca2+-dependent endonucleases, ultimately resulting in apoptotic cell death. The previous experiments have been reported by using primarily thymocytes and lymphocytes and the change of [Ca2+] was measured only by minutes or hours respectively. We need to evaluate [Ca2+] in both several minutes and hours after irradiation of radiation of radiation therapy and verify the apoptotic cells. MATERIALS AND METHODS: We have measured [Ca2+] in human gingival epitheloid cancer cell with 10 Gy irradiation, at minutely intervals and hourly intervals using digitized video-intensified fluorescence microscopy and the fluorescent Ca2+ indicator dye, fura-2. In order to find out that the transient rise in [Ca2+] could induced apoptosis, cells were incubated for 1 hour at 37 degrees C with TdT enzyme, rinsed and resuspended containing fluorescence and observed under a confocal fluorescence microscope. MTT assay was done to determine cell activity and LDH assay was done to determine the amount of necrotic cells. RESULTS: After irradiation, the transient and temporal increasing of [Ca2+] in the KB cells was founded. Though, there was no change in the intracellular [Ca2+] at 30 minutes and 2 hours after irradiation. We could detect of DNA fragmented cells at 4 hours after 10 Gy irradiated cells. There were no significant differences between 4 hour, 1 day, 3 day cells. There were no significant differences in MTT and LDH assay between the irradiated group and the control group after 4 hours and 1 day. Though after 3 days there were differences in MTT and LDH assay between the irradiated group was significantly decreased than the control group, in LDH assay the number of necrotic cell death of the irradiated was higher than the control group. CONCLUSION: In KB cells there were incipient and temporal increasing of the [Ca2+] with 10 Gy irradiation and the apoptosis was founded from 4 hours later which was earlier than seeing of the change of the amount of the cellular ability and necrosis.
Apoptosis* ; Cell Death ; DNA ; DNA Fragmentation ; Endonucleases ; Fluorescence ; Fura-2 ; Humans ; KB Cells* ; Lymphocytes ; Microscopy, Fluorescence ; Necrosis ; Radiation, Ionizing ; Thymocytes

PURPOSE: To evaluate the diagnostic ability in differentiating between ameloblastoma and odontogenic keratocyst according to the imaging modalities and observers. MATERIALS AND METHODS: We evaluated thirty-six cases of ameloblastomas and forty-seven cases of odontogenic keratocysts all histologically confirmed. Six oral and maxillofacial radiologists diagnosed the lesions by 3 methods: using panoramic radiograph, using computed tomograph (CT), and using panoramic radiograph and CT. The observers were classified by 3 groups: group 1 had experienced over 10 years in oral and maxillofacial radiologic field, group 2 had experienced for 3-4 years, and group 3 was in the process of residentship. After over 2 weeks, the observers diagnosed them by the same methods. RESULTS: The ROC curve areas except for group 3 were the highest with interpretation using panoramic radiograph and CT, followed by interpretation using CT only, and the lowest with interpretation using panoramic radiograph only. The overall difference was not found in diagnostic ability among groups in using panoramic radiograph only, but there was difference in diagnostic ability of group 1 and 2 vs 3 in using CT only, and combination panoramic radiograph and CT. CONCLUSIONS: To differentiate between ameloblastoma and odontogenic keratocyst more accurately, the experienced oral and maxillofacial radiologist should diagnose with combination of panoramic radiograph and CT.
Ameloblastoma* ; Diagnosis, Differential* ; Odontogenic Cysts* ; ROC Curve

Desmoplastic ameloblastoma is a rare histologic variant of ameloblastoma. It shows important differences in anatomic distribution, histologic appearance, and radiographic findings compared with the general type of ameloblastoma. It is histologically characterized by an abundance of densely collagenous stroma and radiographically a mixed radiolucent-radiopaque lesion. We present three cases of desmoplastic ameloblastoma. All the patients complained on buccal swelling with or without pain and the sites of occurrence were the anterior and the premolar region. Plain radiographs showed mixed radiopaque-radiolucent lesion with ill-defined or diffuse sclerotic margin and no external root resorption. Additionally, CT scans revealed buccal expansion and relatively well-defined margin of the lesions. The clinical and radiographic features of the presented cases were compared with those of the desmoplastic ameloblastoma in the previous literatures.
Ameloblastoma* ; Bicuspid ; Collagen ; Humans ; Radiography, Panoramic ; Root Resorption ; Tomography, X-Ray Computed

BACKGROUND/AIMS: To investigate the efficacy and longterm outcome of esophageal variceal ligation (EVL) plus propranolol in comparison with propranolol alone for the primary prophylaxis of esophageal variceal bleeding. METHODS: A total of 504 patients were retrospectively enrolled in this study. 330 patients were in propranolol group (Gr1) and 174 patients were in EVL plus propranolol group (Gr2). The endpoints of this study were esophageal variceal bleeding and mortality. Association analyses were performed to evaluate bleeding and mortality between Gr1 and Gr2. RESULTS: EVL was more applied in patients with high risk, such as large-sized varices (F2 or F3) or positive red color signs. Total 38 patients had bleeds, 32 in Gr1 and 6 in Gr2. The cumulative probability of bleeding at 120 months was 13% in Gr1 versus 4% in Gr2 (P=0.04). The predictive factors of variceal bleeding were red color signs (OR 2.962, P=0.007) and the method of propranolol plus EVL (OR 0.160, P=0.000). 20 patients died in Gr1 and 12 in Gr2. Mortality rates are similar in the two groups compared, 6.7% in Gr1 and 6.9% in Gr2. The cumulative probability of mortality at 120 months was not significantly different in the two groups (7% in Gr1, 12% in Gr2, P=0.798). The prognostic factors for mortality were age over 50 (OR 5.496, P=0.002), Child-Pugh class B (OR 3.979, P=0.001), and Child-Pugh class C (OR 10.861, P=0.000). CONCLUSIONS: EVL plus propranolol is more effective than propranolol alone in the prevention of the first variceal bleeding in patients with liver cirrhosis.
Adrenergic beta-Antagonists/*therapeutic use ; Adult ; Aged ; Esophageal and Gastric Varices/*pathology ; Female ; Follow-Up Studies ; Gastrointestinal Hemorrhage/*drug therapy/mortality/surgery ; Humans ; Ligation ; Liver Cirrhosis/etiology ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Proportional Hazards Models ; Propranolol/*therapeutic use ; Retrospective Studies ; Severity of Illness Index ; Survival Rate

Cholesterol granuloma is an unusual clinical entity described as an inflammatory granulation in response to the deposit of cholesterol crystals. It can develop in any portion of air cells within the temporal bone as a result of a lack of aeration and inadequate drainage, especially in the middle ear cavity. Here, we report very unusual three cases of cholesterol granuloma developed in mandible. In the first case a 68-year-old male with a large mass arising from the mandible was observed. Panoramic radiograph and computed tomography scans revealed a huge expanding lesion in the mandible. In the second case a 47-year-old female with a cystic lesion in the mandible was observed. And in the third case a 19-year-old male complaining atypical facial pain had a large lesion in the mandibular ramus. The histopathologic examinations of the cases showed numerous cholesterol crystals surrounded by ultinucleated foreign body giant cells.
Aged ; Cholesterol* ; Diagnostic Imaging ; Drainage ; Ear, Middle ; Facial Pain ; Female ; Giant Cells, Foreign-Body ; Granuloma* ; Humans ; Male ; Mandible* ; Middle Aged ; Temporal Bone ; Young Adult

Infiltrating lipoma is a rare mesenchymal neoplasm that, in spite of benign nature, characteristically infiltrates adjacent tissues and tends to recur after surgery. It has a predilection for the extremities and the trunk and is extremely rare in the head and neck region. We present a case of congenital infiltrating lipoma of the face, describing the intrabony invasion and osseous dystrophy as well as the soft tissue changes seen on plain radiographs and magnetic resonance imaging.
Extremities ; Head ; Lipoma* ; Magnetic Resonance Imaging ; Maxilla* ; Neck

Infiltrating lipoma is a rare mesenchymal neoplasm that, in spite of benign nature, characteristically infiltrates adjacent tissues and tends to recur after surgery. It has a predilection for the extremities and the trunk and is extremely rare in the head and neck region. We present a case of congenital infiltrating lipoma of the face, describing the intrabony invasion and osseous dystrophy as well as the soft tissue changes seen on plain radiographs and magnetic resonance imaging.
Extremities ; Head ; Lipoma* ; Magnetic Resonance Imaging ; Maxilla* ; Neck

PURPOSE: The purpose of this study was to investigate the effectiveness and safety of monitored anesthesia care (MAC) using dexmedetomidine for its sedative and analgesic effect during varicose vein surgery. METHODS: Forty-two patients, who underwent varicose vein surgery, were divided into the MAC group (n = 20) or the spinal anesthesia group (n = 22) for randomized clinical trial. In the MAC group, dexmedetomidine was administered by a loading dose of 1 microg/kg for 10 minutes, followed by a maintenance infusion of 0.2-1.0 microg/kg/hr. Ketamine was used for intermittent injection. In the spinal anesthesia group, midazolam was used for sedation. Intraoperative vital signs, the number of adverse events, and the satisfaction of patients and surgeons concerning the anesthetic condition were compared between the two groups. RESULTS: Systolic blood pressure was intraoperatively significantly different over time between the two groups. The groups had statistical differences in the change in heart rate with regard to time. In the postanesthetic care unit, patients and surgeons in the MAC group had a lower satisfaction score, compared to patients and surgeons in the spinal anesthesia group. However, in the recovery period, patients had a positive perception concerning MAC anesthesia. In addition, without significant adverse events, the MAC group had a shorter time to possible ambulation, which indicated an early recovery. CONCLUSION: We believe that MAC using dexmedetomidine in combination with ketamine may be an alternative anesthetic technique for varicose vein surgery with regard to a patient's preference and medical condition.
Anesthesia* ; Anesthesia, Spinal* ; Blood Pressure ; Dexmedetomidine* ; Heart Rate ; Humans ; Ketamine ; Midazolam ; Varicose Veins* ; Vital Signs ; Walking

The objective of this study was to compare the efficacy of cardiopulmonary resuscitation (CPR) with 120 compressions per minute (CPM) to CPR with 100 CPM in patients with non-traumatic out-of-hospital cardiac arrest. We randomly assigned patients with non-traumatic out-of-hospital cardiac arrest into two groups upon arrival to the emergency department (ED). The patients received manual CPR either with 100 CPM (CPR-100 group) or 120 CPM (CPR-120 group). The primary outcome measure was sustained restoration of spontaneous circulation (ROSC). The secondary outcome measures were survival discharge from the hospital, one-month survival, and one-month survival with good functional status. Of 470 patients with cardiac arrest, 136 patients in the CPR-100 group and 156 patients in the CPR-120 group were included in the final analysis. A total of 69 patients (50.7%) in the CPR-100 group and 67 patients (42.9%) in the CPR-120 group had ROSC (absolute difference, 7.8% points; 95% confidence interval [CI], -3.7 to 19.2%; P = 0.183). The rates of survival discharge from the hospital, one-month survival, and one-month survival with good functional status were not different between the two groups (16.9% vs. 12.8%, P = 0.325; 12.5% vs. 6.4%, P = 0.073; 5.9% vs. 2.6%, P = 0.154, respectively). We did not find differences in the resuscitation outcomes between those who received CPR with 100 CPM and those with 120 CPM. However, a large trial is warranted, with adequate power to confirm a statistically non-significant trend toward superiority of CPR with 100 CPM. (Clinical Trial Registration Information: www.cris.nih.go.kr, cris.nih.go.kr number, KCT0000231)
Cardiopulmonary Resuscitation* ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Out-of-Hospital Cardiac Arrest ; Outcome Assessment (Health Care) ; Resuscitation