This study was performed to evaluate the effect of deproteinized bovine bone mineral soaked in inorganic polyphosphate on bone regeneration in the calvaria of rabbit in the procedure of guided bone regeneration with titanium reinforced expanded polytetrafluoroethylene(TR-ePTFE) membrane. The rabbits were divided into four groups. Control group used TR-ePTFE membrane filled with deproteinized bovine bone mineral, experimental group I used TR-ePTFE membrane and deproteinized bovine bone mineral soaked in 4% inorganic polyphosphate, experimental group II and III used TR-ePTFE membrane and deproteinized bovine bone mineral soaked in 8% or 16% inorganic polyphosphate respectively. After decortication in the calvaria, GBR procedure was performed on 8 rabbits with only TR-ePTFE membrane or titanium reinforced ePTFE membrane filled with deproteinized bovine bone mineral soaked in inorganic polyphosphate. The animals were sacrificed at 4 weeks, and 8 weeks after the surgery. Non-decalcified specimens were processed for histologic analysis, and new bone formation was assessed by histomorphometric as well as statical analysis. 1. Both control group and experimental group demonstrated increasing of new bone formation until 8weeks. 2. At 8 weeks, experimental group I and group II showed the significant difference compared to control group in new bone formation. Especially experimental group II showed the most increasing of new bone formation. 3. The higher concentration of inorganic polyphosphate filled, the more volume of bone formation promoted, but experimental group III did not reveal significant difference compared to contol group. 4. Deproteinized bovine bone mineral did not resorbed at all until 8 weeks. These results suggest that inorganic polyphosphate has a promoting effect on bone regeneration, possibly by enhancing osteoconductivity of the carrier and by increasing osteoinductivity of the defected alveolar bone tissue, but not as we respect.
Animals ; Bone and Bones ; Bone Regeneration* ; Membranes ; Osteogenesis ; Rabbits ; Skull ; Titanium

Communication between coronary arteries and cardiac chambers or large vessels is unusual type of congenital malformation. Aneurysmal formation of a coronary arteriovenous fistula is even rare. We report a case of 83-year-old women with giant aneurysm of the coronary arteriovenous fistula from the left anterior descending coronary artery treated by percutaneous deployment of embolization coil.
Aged, 80 and over ; Aneurysm* ; Arteriovenous Fistula* ; Coronary Vessels ; Embolization, Therapeutic ; Female ; Humans

The purpose of this study was to investigate variations in the communicating branch between the musculocutaneous and the median nerves and to discuss their clinical significance. Seventy two arms from 36 Korean adults were used. Twenty four cases (33.4%) among 72 arms had communications between the musculocutaneous and the median nerves. In 19.5%, a communicating branch ran from the musculocutaneous to the median nerves and in 4.2% of these a communicating branch formed a loop. A branch running from the median to the musculocutaneous nerves was observed in 6.9%. There were more than two communicating branches between two nerves in 5.6%. The average angle between the musculocutaneous nerve proximal and distal to the coracobrachialis was 159+/-9degrees at adduction of the arm. The musculocutaneous nerve did not pierce the coracobrachialis muscle in 2.8%. One case (1.4%) showed partial fusion of the trunks of the musculocutaneous and median nerves. The musculocutaneous nerve ran next to the median nerve after the coracobrachialis muscle and coursed laterally in 5.6% with or without a communicating branch. In these cases, the angle of the musculocutaneous nerve was more acute. The musculocutaneous nerve entrapment is discussed with this angle.
Adult ; Arm ; Humans ; Median Nerve* ; Musculocutaneous Nerve ; Running

Provisional restoration plays an important role in the process of restoration with fixed partial denture by providing protection and restoring function and esthetics of abutment tooth. This is especially true in patients requiring use of provisional prosthesis for a long term. However, such situations may lead to higher possibility of provisional prosthesis fracture, and if expected so, reinforcement of provisional prosthesis should be considered. In this article, a patient requiring prosthetic treatment with increase of vertical dimension of occlusion was introduced. Due to increased vertical dimension of occlusion, the provisional restoration was expected to withstand relatively larger amount of load during a relatively long observation period. In order to minimize possible occurrence of fracture, reinforcement of the provisional restoration was sought by insertion of cast-metal framework and by using bis-acryl resin. The reinforced provisional restoration showed satisfactory results during the observation period of 4 months.
Acrylic Resins ; Dental Casting Technique ; Denture, Partial, Fixed ; Esthetics ; Humans ; Prostheses and Implants ; Tooth ; Vertical Dimension

Moyamoya is a chronic cerebrovascular disease characterized by progressive stenosis or occlusion of the terminal parts of both intermal carotid arteries with telangiectatic vascular network of collateral circulation at the base of the brain and leptomeningeal arteries. The etiology and pathophysiology of this disease are still unknown. Although the idiopathic presentattion is the commonest, moyamoya disease has also been reported in several hereditary or acquired clinical conditions including neurofibromatosis, sickle cell anemia, tuberculous meningitis, atherosclerosis, and following radiation therapy to the head. The term moyamoya disease should be reserved for those cases in which the characteristic angiogrphic pattern is idiopathic; moyamoya syndrome is used when the underlying condition is known. We have experienced a case of coexistence of moyamoya syndrome and hereditary spherocytosis in a 6-year-8-month-old girl who presented with right-sided hemiparesis and pallor. A cerebral angiogram revealed occlusion of proximal portion of left middle cerebral artery and abnormal collateral network. The peripheral blood smear and osmotic fragility test disclosed hereditary spherocytosis. To our knowledge, the coexistence of moyamoya syndrome and hereditary spherocytosis has not been documented. We report here the case and the brief review of related literatures. Further studies are needed to clarify the intimate relationship between the two diseases.
Anemia, Sickle Cell ; Arteries ; Atherosclerosis ; Brain ; Carotid Arteries ; Collateral Circulation ; Constriction, Pathologic ; Female ; Head ; Humans ; Middle Cerebral Artery ; Moyamoya Disease* ; Neurofibromatoses ; Osmotic Fragility ; Pallor ; Paresis ; Tuberculosis, Meningeal

No abstract available.
Hyperaldosteronism* ; Nephrocalcinosis*

BACKGROUND: Upper gastrointestinal endoscopy is a very important and highly sensitive method to detect gastroduodenal lesions. But the investigation and diagnosis of gastrointestinal diseases might be delayed by discomfort, pain and anxiety in patients during endoscopy. This study was performed to evaluate the effect of family member's attendance on relief of discomfort in patients and to identify the predictors for pain and discomfort during upper gastrointestinal endoscopy. METHODS: From July to August 2005, 147 clients who underwent gastrointestinal endoscopy were enrolled in this study. The subjects were randomly grouped into family-attended (n=70) group and non-family-attended group (n=77). The patients recorded their pain and discomfort during endoscopy by Visual-Analogue Scale (VAS) score. And also the client's demographic characteristics and endoscopy related factors (procedure duration, previous endoscopy experience, biopsy, endoscopist etc.) were evaluated. We studied the relationship between the various characteristics and discomfort during endoscopy. RESULTS: There were no significant differences of clients' demographic characteristics and endoscopy related factors between the two groups. There was a significant difference of VAS scores between the family-attended group (3.51+/-1.90) and non-family-attended group (4.35+/-2.10) (P= 0.012). Oxygen saturation and pulse rate during the procedure were lower in the family-attended group than in the non-attended group. Recipients' demographic characteristics and various factors related with the procedure (waiting time, biopsy, and previous experience, etc) were not associated with the degree of discomfort. CONCLUSION: Family member's attendance decreased pain and discomfort during endoscopy. The recipients' demographic characteristics and factors related to the procedure had no influence on the degree of discomfort during endoscopy. In conclusion, attendance of a family member should be considered during endoscopy in order to decrease pain and discomfort during the procedure.
Anxiety ; Biopsy ; Endoscopy ; Endoscopy, Gastrointestinal ; Gastrointestinal Diseases ; Heart Rate ; Humans ; Oxygen ; Pain Measurement

BACKGROUND AND OBJECTIVES: There are many audiological tests to distinguish between the hearing loss patients of cochlear lesion and the retrocochlear lesion. We started this research to compare the efficacy of the audiological tests and to make helpful selections of the auditory hearing tests in diagnosis of the sensorineural hearing loss patients. MATERIALS AND METHOD: Our study was conducted on 198 patients with hearing loss. They received otologic physical examination, neurological examination, and MRI. We evaluated SISI, STAT, ARDT, DPOAE, and ABR data values and analysed their sensitivity and specificity. RESULTS: Sensitivity of SISI was 55% and specificity was 74%. Sensitivity of STAT was 58% and specificity was 67%. Sensitivity of ARDT was 44% and specificity was 71%. Sensitivity of DPOAE was 50% and specificity was 64%. Sensitivity of ABR was 90% and specificity was 74%. CONCLUSION: Among the tests performed above, ABR showed the highest sensitivity and specificity value, which implies it to be the most meaningful screening test in the sensorineural hearing loss patients. But for the patients with severe hearing loss, such that the auditory hearing test results are suspicious in its accuracy, or for the patients who are suspicious of retrocochlear lesions based upon multiple tests, MRI should be performed to make the final diagnosis.
Diagnosis ; Diagnosis, Differential* ; Evoked Potentials, Auditory, Brain Stem ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing Tests ; Humans ; Magnetic Resonance Imaging ; Mass Screening ; Neurologic Examination ; Physical Examination ; Retrocochlear Diseases* ; Sensitivity and Specificity

Background: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a type of autoimmune encephalitis that causes characteristic symptoms through the formation of antibodies against NMDA receptors. If ovarian teratomas are detected, surgical removal under general anesthesia is often considered. Many general anesthetic agents inhibit NMDA receptors. As such, anesthetic agents may have unexpected effects on disease progression. For anesthesiologists, providing general anesthesia for these patients is challenging and there are few studies on which anesthetic is most appropriate Case: Two female patients were diagnosed with anti-NMDA receptor encephalitis and ovarian teratomas. Successful teratoma resection was performed under general anesthesia using remimazolam and remifentanil. After the surgery, one patient showed some improvement but died a month later. The other patient progressively improved over time. Conclusions Remimazolam and remifentanil are useful general anesthetic agents for patients with anti-NMDA receptor encephalitis. Further studies are warranted.

Recent molecular studies indicate two different genetic pathways leading to the development of glioblastoma; final progression of astrocytoma and de novo formation. To define the mutual relationships of cytogenetic changes in the pathogenesis of glioblastoma, molecular histopathologic alterations of p53 and epidermal growth factor receptor (EGFR) were evaluated by single stranded conformational polymorphion, reverse transcriptase-polymerase chain reaction and immunohistochemical stains in 15 primary and 21 secondary glioblastomas. Mutations in p53 gene and positive immunoreactivity to p53 protein (DO1) were more prevalent in secondary glioblastomas than in primary glioblastomas. A correlation between p53 mutations and p53 immunopositivities in glioblastomas was observed in 83.3% of the cases. All cases with positive p53 immunoreactivities showed p53 mutations; however, 13.9% of glioblastomas with p53 immuno-positivities lacked the relevant mutations. EGFR amplifications were detected in 73.3% of primary glioblastomas and 9.5% of secondary glioblastomas (p<0.001). The concurrence of p53 mutation and EGFR amplification was revealed in only 2 out of 15 primary glioblastomas and none among the secondary glioblastomas. Immunoreactivities for EGFR were noted in 66.7% of primary glioblastomas and in 9.5% of secondary glioblastomas (p<0.001). A correlation between EGFR amplification and EGFR immunopositivity in glioblastomas was observed in 91.7% of the cases. These data indicate that EGFR amplification and p53 mutations are two independent genetic events in the development of glioblastomas.
Adolescence ; Adult ; Brain Neoplasms/*genetics/metabolism ; Female ; *Genes, p53 ; Glioblastoma/*genetics/metabolism ; Human ; Immunohistochemistry ; Loss of Heterozygosity ; Male ; Middle Age ; *Mutation ; Protein p53/analysis ; Receptor, Epidermal Growth Factor/analysis/*genetics ; Reverse Transcriptase Polymerase Chain Reaction