Primary central nervous system lymphoma (PCNSL) is an extranodal Non-Hodgkin's lymphoma that is confined to the brain, eyes, and/or leptomeninges without evidence of a systemic primary tumor. Although the tumor can affect all age groups, it is rare in childhood; thus, its incidence and prognosis in children have not been well defined and the best treatment strategy remains unclear. A nine-year old presented at our department with complaints of diplopia, dizziness, dysarthria, and right side hemiparesis. Magnetic resonance image suggested a diffuse brain stem glioma with infiltration into the right cerebellar peduncle. The patient was surgically treated by craniotomy and frameless stereotactic-guided biopsy, and unexpectedly, the histopathology of the mass was consistent with diffuse large B cell lymphoma, and immunohistochemical staining revealed positivity for CD20 and CD79a. Accordingly, we performed a staging work-up for systemic lymphoma, but no evidence of lymphoma elsewhere in the body was obtained. In addition, she had a negative serologic finding for human immunodeficient virus, which confirmed the histopathological diagnosis of PCNSL. She was treated by radiosurgery at 12 Gy and subsequent adjuvant combination chemotherapy based on high dose methotrexate. Unfortunately, 10 months after the tissue-based diagnosis, she succumbed due to an acute hydrocephalic crisis.
Biopsy ; Brain Stem* ; Brain* ; Central Nervous System* ; Child* ; Craniotomy ; Diagnosis ; Diplopia ; Dizziness ; Drug Therapy, Combination ; Dysarthria ; Glioma ; Humans ; Incidence ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Methotrexate ; Paresis ; Prognosis ; Radiosurgery

The marginal integrity of the crown can be broken during endodontic access cavity preparation due to the vibration of burs. Therefore, the purpose of this study was to evaluate the effect of endodontic access cavity preparation on the marginal leakage of full veneer gold crowns. 24 intact molars were mounted in acrylic resin blocks and prepared for crowns by a restorative dentist and crowns were cast with gold alloy. 20 Crowns were cemented with glass ionomer cement and 2 crowns were not cemented for positive control. 200 thermo-cycles from 5degrees C to 50degrees C with a travel time of 20s were completed. Then samples were randomly divided into 2 experimental groups of 9 each. Endodontic access preparation and zinc-oxide eugenol temporary fillings were done in Group 1. Teeth in Group 2 were not treated. Samples were coated with 2 layers of nail varnish and were immersed in 1% methylene blue dye for 20 hrs. Endodontic access was prepared in 2 samples, which were coated with nail varnish on all surfaces for negative control. After washing in running water, gold crowns were cut with a #330 bur. Four buccolingual sections, 2 mm apart, were cut from the central section of each tooth and were examined and scored under the microscope for dye leakage. Score 1: leakage to the cervical 1/3 of the axial wall, Score 2: leakage to the middle 1/3 of the axial wall, Score 3: leakage to the coronal 1/3 of the axial wall, Score 4: leakage to the occlusal surface. The median value for Group 1 is 4 and for Group 2 is 2. The result of this study showed that samples in Group 1 leaked more than those in Group 2. This finding was significant(P<0.001).
Acrylic Resins ; Alloys ; Crowns ; Dentists ; Eugenol ; Glass Ionomer Cements ; Humans ; Methylene Blue ; Molar ; Nails ; Paint ; Running ; Silicon Dioxide ; Tooth ; Vibration ; Water

Purpose: The primary aim of this study was to examine the effects of 8-week lower trapezius strengthening exercise (LTSE) on shoulder pain, function and archery performance. The secondary aim was to identify main factors that have something to do with injury prevention and performance enhancement for elite archers. Methods: Thirty-one elite archers were recruited and evenly assigned into the LTSE group (n=16) and into the control group (n=15) based on gender and athletes’ career. Shoulder pain was evaluated using Numeric pain rating scale (NPRS). Shoulder function was assessed using the Western Ontario Shoulder Instability Index (WOSI), upper quarter Y balance test (UQYBT), Trapezius and Deltoid muscle activity ratios by surface electromyography and the angle of scapula elevation/abduction by 3-dimentional motion analyses. Archery performance was estimated using draw force line (DFL) angle at full bowstring draw position and the scores acquired from real archery shooting. After the baseline measurements, the 8-week LTSEs were implemented and the post-exercise measurements were conducted. Results: In the LTSE group, NPRS score and WOSI score significantly decreased after exercise program. The activity ratio of upper to lower trapezius muscle, scapula elevation angle and the DFL angle were also significantly reduced. The UQYBT scores significantly increased on both shoulders. Conclusion Eight weeks of LTSE has reduced shoulder pain in archers and improved shoulder function and performance factors.

The evaluation of peripheral nerve disorders has traditionally relied on clinical history, physical examination and electrodiagnostic studies. The electrodiagnostic study is currently the most popular procedure to analyse the nerve lesion, but it is painful and its result is operator dependent. The purpose of this study is to evaluate the significance of MRI signal change of denervated muscle in peripheral nerve as an adjuvant study of electrodiagnostic study. After the compression of sciatic nerves in 20 rabbits and severance of scitic nerve in 10 rabbits, the signal change of both T1WI(TR; 450 msec, TE; 15 msec) and T2WI(TR; 3,000 msec TE; 90 msec) of calf muscles were compared with EMG findings of the same muscles. Signal intensity ratio(SIR) of calf muscles was measured and compaired with the grade of abnormal spontaneous activity in the same muscles in needle EMG study. Serial studies were done on 4th day, 1 week, 2 weeks, 3 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks after sciatic nerve injury. Among 25 rabbits showing abnormal spontaneous activity in needle EMG, the signal intensity of both T1WI and T2WI was increased in 13 rabbits. The signal intensity began to increase at 1 week in 10 rabbits and 2 weeks in 3 rabbits following nerve injury which was about 1 week later than appearance of abnormal spontaneous activity in needle EMG study. There were no signal intensity increase in rabbits which showed no abnormal spontaneous activity in needle EMG study. The signal intensity ratio and grade of abnormal spontaneous activity had a good correlation(Spearman's correlation coefficiency : 0.635). The signal intensity of 3 rabbits which showed regeneration evidence in needle EMG study returned to normal. These findings suggest that MRI study of denervated muscle can be used as an evaluation method for severe peripheral nerve injury, howeverits value is doubtful in mild peripheral nerve injury.
Magnetic Resonance Imaging* ; Muscles ; Needles ; Peripheral Nerve Injuries ; Peripheral Nerves ; Physical Examination ; Rabbits ; Regeneration ; Sciatic Nerve*

Background: Both allogenous fibular bone graft and minimally invasive plate osteosynthesis have been developed to reduce issues such as fixation failure, displacement, angulation, and nonunion after plate fixation of proximal humeral fractures. However, there have been no studies investigating the differences in clinical results between these methods. The purpose of this study was to investigate the clinical differences between open reduction and plate fixation via a deltopectoral approach with allogenous fibular bone graft and a minimally invasive approach, in Neer's classification two-, three-part proximal humeral fractures. Methods: In this retrospective study, 77 patients with Neer classification two-, three-part proximal humeral fractures were treated at two different institutions. Clinical and radiological evaluations were performed in 39 patients who underwent minimally invasive plate osteosynthesis at one institution (group A) and 38 patients who underwent the deltopectoral approach with allogenous fibular bone graft at another institution (group B). The results between the groups were compared. Results: The minimally invasive plate osteosynthesis procedure (group A) was significantly less time- consuming and caused less bleeding than allogenous fibular bone graft through a deltopectoral approach (group B) (P<0.05). The duration of the fracture union was significantly reduced in group A (14.5±3.4 weeks; range, 10–22 weeks) compared to group B (16.4±4.3 weeks; range, 12–28 weeks) (P<0.05). There were no statistically significant differences between the two groups when evaluating the visual analog scale and Constant scores 1 year postoperatively. Radiological evaluation including neck-shaft angle and plate height were measured on the final follow-up X-ray image. There was no difference in radiological outcomes between the two groups. There were no statistically significant differences in malunion between the two groups; there were three malunion cases (7.7%) in group A and four (10.5%) in group B. Conclusions The minimally invasive plate osteosynthesis procedure and deltopectoral approach with allogenous fibula bone graft for Neer's classification two-, three-part proximal humeral fractures demonstrated similar clinical and radiological results. However, allogenous fibula grafts require longer surgery, cause more bleeding, and result in longer fracture healing time than the minimally invasive plate osteosynthesis procedure.

Cutaneous angiosarcomas are uncommon malignancies which account about 1% of sarcomas. They are found most commonly in the head and neck regions, frequently on the scalp. Although preferred treatment has been combined surgery and postoperative radiation therapy, the extensiveness and multiplicity of the lesions set limits to such an approach and the patient is often referred for radiotherapy without surgery. As the entire scalp usually needs to be treated, radiation therapy is a challenging problem to radiation oncology staffs. We report a case of angiosarcoma of the scalp, which was treated successfully by radiation therapy with a simple and repeatable method using mixed photon and electron beam technique. Using a bolus to increase the surface dose of the scalp and to minimize dose to the normal tissues of the brain desirable but difficult technically to be well conformed o the three dimensional curved surface such as vertex of the head. A helmet made of thermoplastics filled with paraffin was elaborated and used for the treatment, resulting of the relatively uniform surface doses along the several points measured on the scalp, the difference among the points not exceeding 7% of the prescribed dose by TLD readings.
Brain ; Head ; Head Protective Devices ; Hemangiosarcoma* ; Humans ; Neck ; Paraffin ; Radiation Oncology ; Radiotherapy* ; Reading ; Sarcoma ; Scalp*

BACKGROUND: Unexpected and uncontrolled bleeding remains the principal fear of the surgeon performing transurethral resection of prostate (TURP). Many surgeons and anesthesiologists believe the spinal anesthesia reduces blood loss during TURP. This study evaluate the effects of spinal versus general anesthetic technique on the development of postoperative coagulopathies. METHODS: 20 patients undergoing TURP were randomly allocated into 2 groups. Group I (n=10) received general anesthesia and group II (n=10), spinal anesthesia. PT (prothrombin time), PTT (partial thromboplstin time), Hb (hemoglobin), FDP (fibrin degradation product), platelet and fibrinogen were measured before induction and 24 hours postoperatively. RESULTS: There was no significant difference in measured coagulation variables between the two groups, but there was significant decrease in postoperative Hb compared to preoperative values in both groups and the effect was more pronounced in the general anesthesia than in the spinal anethesia group. CONCLUSION: It is concluded that coagulopathies after TURP is not affected by the anesthetic technique.
Anesthesia, General* ; Anesthesia, Spinal ; Blood Platelets ; Fibrinogen ; Hemorrhage ; Humans ; Transurethral Resection of Prostate*

No abstract available.
Blastocyst* ; Female ; Humans ; Oocytes* ; Parturition* ; Polycystic Ovary Syndrome*

No abstract available.
Alzheimer Disease* ; Animals ; Cerebral Amyloid Angiopathy* ; Mice*

A 68-year-old male patient with a history of femoro-femoral bypass following unsuccessful intervention for chronic total iliac occlusion was found to have a saccular pseudoaneurysm of the right common iliac artery (CIA) due to interventional device-related injuries associated with the past endovascular intervention. An iatrogenic pseudoaneurysm in the CIA is generally asymptomatic, but it has a high risk of rupture, regardless of its size or symptoms. Endovascular therapy may be the best treatment option; however, ineffective sealing with a stent graft may lead to a type I endoleak. Under such conditions, use of the liquid embolic agent, Onyx, as a bailout solution for the type 1 endoleak is promising.
Aged ; Aneurysm ; Aneurysm, False ; Blood Vessel Prosthesis ; Endoleak ; Humans ; Iliac Artery ; Male ; Rupture ; Stents