No abstract available.
Health Promotion*

Takayasu,s arteritis is a systemic disease characterized by occlusion of aorta and its major branches because of a panaortitis with thickening of the adventitia. Coronary artery narrowing is due to extension of inflammations that occur in aorta. Angina pectoris may be the first symptom of the disease if the coronary arteries are the initial site of severe arterial narrowing. We present a case of bilateral coronary ostial stenosis where Takayasu,s arteritis was pathologically proved as an etiology. The patient was taken coronary ostial angioplasty with good result.
Adventitia ; Angina Pectoris ; Angioplasty ; Aorta ; Arteritis ; Constriction, Pathologic* ; Coronary Vessels ; Humans ; Inflammation ; Takayasu Arteritis*

The clinicopathologic features and the comparative analysis of diagnostic methods in 42 patients having intestinal tuberculosis were studied. In all the cases, clinical and colonoscopic diagnosis was confirmed by histological examination. Abdominal pain was the most common symptom (54%). Twenty nine patients had active pulmonary tuberculosis which was confirmed by a chest X-ray, or an AFB smear and a culture of sputum. A transverse ulcer with surrounding hypertrophic mucosa and multiple erosion was the usual colonoscopic findings. The granulomas were usually located in the just upper and lower portion of muscularis mucosa. The direct smear and culture of the fresh biopsy material showed AFB in 11 (32.4%) and 12 cases (36.4%) respectively. Ziehl-Neelsen staining in serially sectioned slides from formalin-fixed, paraffin- embedded tissue revealed AFB in 15 cases (35.7%). An immunohistochemical stain for Mycobacterium bovis was done in all cases and 13 cases were positive (31%). A polymerase chain reaction (PCR) was done and showed positivity in 4 out of 20 cases of fresh biospy material and 12 out of 40 cases in paraffin embedded tissue. For the conclusive diagnosis of intestinal tuberculosis, a Ziehl-Neelsen stain is the most sensitive, fast, and cost-effective method. The diagnostic accuracy will be increased when other diagnostic methods such as tissue culture and PCR are coupled with this simple staining method.
Abdominal Pain ; Biopsy ; Diagnosis* ; Granuloma ; Humans ; Intestines ; Mucous Membrane ; Mycobacterium bovis ; Paraffin ; Polymerase Chain Reaction ; Sputum ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer

PURPOSE: To assess the combined effectiveness of angioinfarction and immunotherapy for improving survival in patients with stage IV renal cell carcinoma. MATERIALS AND METHODS:During the past 3 years, 13 patients of stage IV renal cell carcinoma were treated with angioinfarction and immunotherapy. Angioinfarction was performed on these 13 patients using absolute ethanol and occlusive baloon catheter. After angioinfarction, Interferon alpha was used for immunotherapy. For our analysis, 12 control patients of stage IV renal cell carcinoma without treatment were included in the study. Survival has been calculated according to the Kaplan and Meier method. RESULTS: The 1 year survival rate and median survival time in patients treated with angioinfarction and immunotherapy, were 46% and 13 months and in patients without treatment, 16% and 4 months, respectively. CONCLUSION:The combined treatment of angioinfarction and immunotherapy is of considerable value for improving survival in patients with stage IV renal cell carcinoma
Carcinoma, Renal Cell* ; Catheters ; Ethanol ; Humans ; Immunotherapy* ; Interferon-alpha ; Survival Rate

OBJECTIVE: The cordocentesis is regarded as an useful procedure for the prenatal evaluation of fetal disease, but it's complications are fetal loss, umbilical cord bleeding, umbilical cord hematoma, fetal bradycardia, fetomaternal hemorrhage, abruptio placentae, and chorioamnionitis due to it's invasiveness. The fetal bradycardia following cordocentesis is transient and self-limited in most cases, and the prevalence rate of fetal bradycardia following cordocentesis was reported to be between 1.5 and 13 per cent. The purpose of this study was to evaluate the association of fetal heart rate pattern following cordocentesis with adverse pregnancy outcome. METHODS: We investigated retrospectively the fetal heart rate following cordocentesis, the Apgar score of neonate, the birth weight of neonate, gestational age at delivery, preterm delivery, intrauterine growth retardation, stillbirth, and chromosome analysis in 64 codocenteses between 1 February 2000 and 28 February 2001. Normal fetal heart rate was defined as 100 up to 170 bpm, fetal bradycardia as less than 100 bpm lasting one more minute, and fetal tachycardia as more than 170 bpm lasting one more minute. RESULTS: 1. Fetal heart rate pattern following the cordocentesis was normal in 53 cases (82.8%), bradycardia in 6 cases (9.4%) and tachycardia in 5 cases (7.8%). 2. The pregnancy outcome was well-being fetus at birth in 51 cases, terminated pregnancy in 5 cases, intrauterine growth restricted fetus in 5 cases, preterm birth in 1 case and intrauterine death in 2 cases. 3. Mean Apgar-1minute/-5minute scores in neonates were 8.4 +/- 0.2/9.3 +/- 0.2 in the normal fetal heart rate group, 6.8 +/- 1.7/7.6 +/- 1.9 in fetal bradycardia group and 8.4 +/- 0.2/9.4 +/- 0.2 in fetal tachycardia group, that showed no statistically significant difference between groups. 4. The gestational weeks at birth/birth weight were 38.9 +/- 0.4 weeks/3193 +/- 90 g in normal fetal heart rate group, 36.8 +/- 3.2 weeks/2733 +/- 340 g in bradycardia group and 40.0 +/- 0.2/3465 +/- 21 g in tachycardia group, that showed no statistically significant difference between groups. 5. The number of puncture at the same time of cordocentesis was one in 45 cases, two in 15 cases and three in 4 cases. 6. There was no difference in fetal heart rate pattern following cordocentesis between 60 cases of normal and 4 cases of abnormal cardiovascular findings sonographycally. 7. The karyotyping was normal in 60 cases and abnormal in 4 cases, each of which was 46,XY,inv(9),46,X,i(Xq)/45,X,47,XY,+mar, and 46,XX,t(7;15)(q10;q10) respectively. CONCLUSION: Fetal bradycardia or tachycardia following cordocentesis was not associated with adverse pregnancy outcomes.
Abruptio Placentae ; Apgar Score ; Birth Weight ; Bradycardia ; Chorioamnionitis ; Cordocentesis* ; Female ; Fetal Diseases ; Fetal Growth Retardation ; Fetal Heart* ; Fetomaternal Transfusion ; Fetus ; Gestational Age ; Heart Rate, Fetal* ; Hematoma ; Hemorrhage ; Humans ; Infant, Newborn ; Karyotyping ; Parturition ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Premature Birth ; Prevalence ; Punctures ; Retrospective Studies ; Stillbirth ; Tachycardia ; Umbilical Cord

Endomyocardial biopsy (EMB) is a valuable diagnostic procedure for the surveillance of cardiac allograft rejection. Interpretation of individual cases is still problematic due to variations of findings for grading of rejection and other associated lesions. We reevaluated an experience on endomyocardial biopsies to develop better diagnostic criteria for rejection and other complications. Immunohistochemical studies against cytokines were performed to assess the usefulness of the method for the diagnosis or researches. A total of 249 EMBs taken from 33 cardiac allograft recipients were reviewed. There were 25 males and 8 females. Dilated cardiomyopathy was present (24 cases) and valvular heart disease (4 cases), restrictive cardiomyopathy (3 cases) were also common conditions. We applied the grading system of the International Society for Heart Transplantation (ISHT) for the assessment of acute cellular rejection. Grades of 0, 1A, 1B, 2, 3A and 3B were 39.0%, 28.1%, 11.2%, 11.5%, 12.4% and 1.6% respectively, but 3.2% were inadequate. Thirty five episodes of grade 3A or 3B were present in 17 patients. The response to therapy was assessed using a next follow up biopsy, which revealed resolving or resolved rejection in 85% of patients. The intensity of immunohistochemical stains for IL-6 and TNF-alpha was increased in proportion to the histologic grade but Quilty lesion and cardiomyopathy also showed a positive reaction. The other pathologic findings were ischemic change, previous biopsy site, interstitial edema and fibrosis, and Quilty lesion. These findings showed usefulness of endomyocardial biopsy not only for the evaluation of cardiac allograft rejection but also for the diagnosis of associated cardiac lesions. Immunohistochemical study of the cytokines was related to the degree of inflammation rather than degree of rejection.
Allografts ; Biopsy* ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Cardiomyopathy, Restrictive ; Coloring Agents ; Cytokines ; Diagnosis ; Edema ; Female ; Fibrosis ; Follow-Up Studies ; Heart Transplantation* ; Heart Valve Diseases ; Heart* ; Humans ; Inflammation ; Interleukin-6 ; Male ; Tumor Necrosis Factor-alpha

PURPOSE: The purpose of this study was to compare the marginal fitness and fracture load of the zirconia copings according to the design with different thickness and coloration. MATERIAL AND METHODS: The evaluation was based on 80 zirconia copings. Zirconia copings were fabricated in design with different thicknesses using CAD/CAM system (Everset, KAVO dental GmbH, Biberach, Germany). The designs of copings were divided into four groups. The first group consisted of copings with uniform thickness of 0.3 mm. The thickness in the second group was 0.3 mm on the buccal surface and 0.6 mm on the lingual surface. The third group consisted of coping with uniform thickness of 0.6 mm. The thickness in the fourth group was 0.6 mm on the buccal surface and 1mm on the lingual surface. Each group consisted of 10 colored and 10 uncolored copings. Half of the copings (40) processed with a milling system according to the specific design were sent to be given a color (A3) through saturation in special dye by a manufacturing company. Just after sintering, the marginal discrepancies of copings were measured on the buccal, lingual, mesial and distal surfaces of metal die, under a Video Microscope System (sv-35, Sometech, Seoul, Korea) at a magnification of x100. It was remeasured after the adjusting of the inner surface. Next, all copings were luted to the metal dies using reinforced cement {GC FujiCEM (GC Corp. Tokyo, Japan)} and mounted on the testing jig in a Universal Testing Machine (Instron 4467, Norwood, MA, USA). The results were analyzed statistically using the one-way ANOVA test. RESULTS: The obtained results were as follow: 1. The measured value of marginal discrepancy right after sintering was the greatest in the contraction of the buccal area in all groups, except for group I2. 2. There was no significant difference of marginal fitness among the groups in the colored zirconia group (P<.05). 3. When the marginal fitness among the groups in the uncolored zirconia group was considered, group II2 had the smallest marginal discrepancy. 4. When the colored and uncolored groups with the same design were compared, there was a significant difference between I1 and II1 groups. In group 2, 3, and 4, the uncolored zirconia had the greatest marginal fitness (P<.05). 5. After adjustment of inner surface, there was no significant difference in the marginal fitness in all groups when color and design of the zirconia coping were compared. 6. The fracture load of CAD/CAM zirconia copings showed significant difference in group 1, 2, 3, and 4. I4 and II4 had the strongest fracture load. 7. When groups with different color and same design were compared, all colored groups showed greater fracture load (P>.05), with no significance. CONCLUSION: There was difference in the marginal fitness according to the design and coloration of zirconia copings right after sintering, but it was decided that the copings may well be used clinically if the inner surface are adjusted. The copings should be thick enough for the reinforcement of fracture strength. But considering the esthetics of the visible surfaces (labial and buccal surface), the thickness of copings may be a little thin, without giving any significant effect on the fracture strength. This type of design may be considered when giving priority to preservation of tooth or esthetics.
Ceramics ; Collodion ; Contracts ; Esthetics ; Glass Ionomer Cements ; Reinforcement (Psychology) ; Tokyo ; Tooth ; Zirconium

No abstract available.
Canada* ; Gastrointestinal Tract*

Tethered cord syndrome is a type of spinal dysraphism with a low-lying conus, which is frequently associated with an intraspinal lipoma, diastematomyelia, or fibrous band. The clinical manifestations include spine abnormalities such as the spina bifida or various neurological symptoms involving lower extremities and sphincters. However, the spinal roots are often injured during the detethering procedures which clinically results in a neurological deficit. The continuity of spinal roots should be monitored during detethering surgery for the tethered spinal cord because neural elements are embedded in lipoma or anomalous tissues. Evoked muscle action potentials indicate only motor function, therefore, it is more appropriate to record somatosensory evoked potentials across the operative field at the same time. We used a combined technique of tibial nerve somatosensory evoked potential and compound muscle action potentials stimulated in the spinal roots directly for an intraoperative monitoring during the untethering procedure. We reported good results from three patients with tethered cord syndrome who had taken the intraoperative monitoring during the untethering surgery. We suggest that intraoperative monitoring can prevent the unwanted injury to the neural tissue in the level of the tethering during the detethering surgery.
Action Potentials ; Conus Snail ; Evoked Potentials, Motor* ; Evoked Potentials, Somatosensory* ; Humans ; Lipoma ; Lower Extremity ; Monitoring, Intraoperative* ; Neural Tube Defects* ; Spinal Cord ; Spinal Dysraphism ; Spinal Nerve Roots ; Spine ; Tibial Nerve

Measurements of local shoulder muscle function during shoulder abduction are of a great interest in biomechanics research and in ergonomic applications. There have been so many opinions that the supraspinatus muscle acts in synergy with the deltoid muscle as a single unit throughout the shoulder abduction. However the specific actions of deltoid and supraspinatus muscles have been subjects of controversy. Electromyography is an established evaluation method of biomechanical study. It reflects the electrical activity at the muscle membrane level and indirectly the mechanical output of the muscle. The purpose of this study was to evaluate the role of deltoid and supraspinatus muscles during shoulder abduction by the comparison of motor unit action potentials using a quantitative electromyographic analysis method, to provide a good insight into the biomechanics of shoulder abduction. Motor unit action potentials of deltoid muscle were seen earlier than those of supraspinatus muscle at the time of initiation of shoulder abduction. The Root Mean Square (RMS) voltage of deltoid muscle was increased gradually from 0o to 90o of shoulder abduction, and then decreased gradually above 90o to 180o of shoulder abduction. The RMS voltages of deltoid muscle were significantly higher than those of supraspinatus muscle at each degree of shoulder abduction wholly. There was no differences in the RMS voltages of deltoid muscle, during shoulder abduction between the loading of 1 kg and without loading. However, the RMS voltages of supraspinatus muscle were significantly higher in the loading state than without loading. The Mean Rectified Voltages (MRV) were similar to the RMS voltages of deltoid and supraspinatus muscles during shoulder abduction. Based on these results, we concluded that the deltoid muscle was not only an initiator but also a major contributor in shoulder abduction, where as the supraspinatus muscle acts as a secondary muscle for the initiation of shoulder abduction and a supporting muscle when there is a resistance against shoulder abduction.
Action Potentials ; Deltoid Muscle ; Electromyography ; Membranes ; Muscles* ; Shoulder*