No abstract available.
Wegener Granulomatosis*

BACKGROUND: Generalized immune aetivation occurs early in the course of many infectious diseases. Clinical investigations have known that immune activation can be qiantified by the measurement of soluble immune activation products, neopterin and elastase-a-antitypsm in serum. OBJECTIVE: The purpose of this study was to assess macrophage and neutrophil activation in patient with leprosy by measurement of neopterin and elhstase-a-antitrypin. METHODS: The study population consisted of 31 patients with subculoid leprosy and 71 patients with lepromatous leprosy (39 cases of M. leprae positive patients and 32 cases of M. leprce negative patients). Serum samples and clinical and laboratory data were collected form each patient and control. The levels of serum neopterin and elastase-a-antitrypsin were masured by a sandwich enzyme immunoassay. RESULTS: The serum neopterin levels were significantly raised in patients with leprosy and significantly higher in lepromatous leprosy than tuberculoid leprosy. The sejum elastase-a-antitrypsin levels were significantly increased in pat,ients with leprosy, but did not vary significantly between tuberculoid and lepramatous leprosy. There was also no significant correlation between the neopterin and elastase-a-antitrypsin levels and bacterial index in patients with lepromatous prosy. CONCLUSION: These data suggest that non-specific activation of macrophages and neutrophiles occurs in leprosy and high titers of ineopterin and elastase-a-antitrypsin alore, in the absenee of a functioning T cell response, do not appee,r to confer resistance against Mycobacterium leprae.
Communicable Diseases ; Humans ; Immunoenzyme Techniques ; Leprosy ; Leprosy, Lepromatous ; Leprosy, Tuberculoid ; Macrophages ; Mycobacterium leprae ; Neopterin* ; Neutrophil Activation ; Neutrophils ; Pancreatic Elastase* ; Syphilis ; Treponema pallidum

BACKGROUND: Generalized immune aetivation occurs early in the course of many infectious diseases. Clinical investigations have known that immune activation can be qiantified by the measurement of soluble immune activation products, neopterin and elastase-a-antitypsm in serum. OBJECTIVE: The purpose of this study was to assess macrophage and neutrophil activation in patient with leprosy by measurement of neopterin and elhstase-a-antitrypin. METHODS: The study population consisted of 31 patients with subculoid leprosy and 71 patients with lepromatous leprosy (39 cases of M. leprae positive patients and 32 cases of M. leprce negative patients). Serum samples and clinical and laboratory data were collected form each patient and control. The levels of serum neopterin and elastase-a-antitrypsin were masured by a sandwich enzyme immunoassay. RESULTS: The serum neopterin levels were significantly raised in patients with leprosy and significantly higher in lepromatous leprosy than tuberculoid leprosy. The sejum elastase-a-antitrypsin levels were significantly increased in pat,ients with leprosy, but did not vary significantly between tuberculoid and lepramatous leprosy. There was also no significant correlation between the neopterin and elastase-a-antitrypsin levels and bacterial index in patients with lepromatous prosy. CONCLUSION: These data suggest that non-specific activation of macrophages and neutrophiles occurs in leprosy and high titers of ineopterin and elastase-a-antitrypsin alore, in the absenee of a functioning T cell response, do not appee,r to confer resistance against Mycobacterium leprae.
Communicable Diseases ; Humans ; Immunoenzyme Techniques ; Leprosy ; Leprosy, Lepromatous ; Leprosy, Tuberculoid ; Macrophages ; Mycobacterium leprae ; Neopterin* ; Neutrophil Activation ; Neutrophils ; Pancreatic Elastase* ; Syphilis ; Treponema pallidum

STATEMENT OF PROBLEM: Use of custom tray and tray adhesive is clinically recommended for elastomeric impression material. However there is not clear mention of drying time of tray adhesive in achieving appropriate bonding strength of tray material and impression material. PURPOSE: This study is to investigate an appropriate drying time of tray adhesives by evaluating tensile bonding strength between two types of polyvinylsiloxane impression materials and resin tray, according to various drying time intervals of tray adhesives, and with different manufacturing company combination of impression material and tray adhesive. MATERIAL AND METHODS: Adhesives used in this study were Silfix (Dentsply Caulk, Milford, Del, USA) and VPS Tray Adhesive (3M ESPE, Seefeld, Germany) and impression materials were Aquasil Ultra (monophase regular set, Dentsply Caulk, Milford, Del, USA) and Imprint II Garant (regular body, 3M ESPE, Seefeld, Germany). They were used combinations from the same manufacture and exchanged combinations of the two. The drying time was designed to air dry, 5 minutes, 10 minutes, 15 minutes, 20 minutes, and 25 minutes. Total 240 of test specimens were prepared by auto-polymerizing tray material (Instant Tray Mix, Lang, Wheeling, Il, USA) with 10 specimens in each group. The specimens were placed in the Universal Testing machine (Instron, model 3366, Instron Corp, University avenue, Nowood, MA, USA) to perform the tensile test (cross head speed 5 mm/min). The statistically efficient drying time was evaluated through ANOVA and Scheffe test. All the tests were performed at 95% confidence level. RESULTS: The results revealed that at least 10 minutes is needed for Silfix-Aquasil, and 15 minutes for VPS Tray Adhesive-Imprint II, to attain an appropriate tensile bonding strength. VPS Tray Adhesive-Imprint II had a superior tensile bonding strength when compared to Silfix-Aquasil over 15 minutes. Silfix-Aquasil had a superior bonding strength to VPS Tray Adhesive-Aquasil, and VPS Tray Adhesive-Imprint II had a superior tensile bonding strength to Silfix-Imprint II at all drying periods. CONCLUSION: Significant increase in tensile bonding strength with Silfix-Aquasil and VPS Tray adhesive-Imprint II combination until 10 and 15 minutes respectively. Tray adhesive-impression material combination from the same company presented higher tensile bonding strength at all drying time intervals than when using tray adhesive-impression material of different manufactures.
Adhesives ; Collodion ; Dental Impression Materials ; Elastomers ; Head ; Polymers ; Polymethyl Methacrylate ; Polyvinyls ; Siloxanes

Moyamoya disease is a rare, progressive, occlusive cerebrovascular disorder characterized by bilateral stenosis of the intracranial portion of the internal carotid artery. Symptoms including transient ischemic attacks, seizures, intracranial hemorrhage and cerebral infarction, are variable. There are few case reports of moyamoya disease in pregnancy. Since hyperventilation-induced cerebral ischemia and hypertension are provoked by active labor, cesarean section has been recommended to avoid neurologic complications for pregnant women with moyamoya disease. The optimal anesthetic management for cesarean section in these patients has not been discussed. We report a case of moyamoya disease in a patient presenting for cesarean section at 40 weeks' gestation. Epidural anesthesia was administered using 0.5% bupivacaine and fentanyl. Intraoperative hemodynamic state was stable. The patient has no significant postoperative complications.
Anesthesia* ; Anesthesia, Epidural ; Brain Ischemia ; Bupivacaine ; Carotid Artery, Internal ; Cerebral Infarction ; Cerebrovascular Disorders ; Cesarean Section* ; Constriction, Pathologic ; Emergencies* ; Female ; Fentanyl ; Hemodynamics ; Humans ; Hypertension ; Intracranial Hemorrhages ; Ischemic Attack, Transient ; Moyamoya Disease* ; Postoperative Complications ; Pregnancy ; Pregnant Women ; Seizures

There have long been a lot of controversies on the treatment of unstable thoracolumbar spine fracture, and the role of decompression is also controversial. Compression of the neural elements by retropulsed bone fragments can be relieved indirectly by the reduction with posterior instrumentation or directly by the exploration of the spinal canal through a posterolateral or anterior approach. There is no universal agreement about the indications for each of these method. Authors analyzed the result of 24 cases of thoracolumbar spine fracture which had been operated by anterior decompression and Kaneda instrumentation from the February 1990 to May 1993 at Inha general hospital. The results were as follows: 1. The most common cause of injury was falling from a height, 20 cases (83.3%). And the 12 cases were in the 4th decade, with an average age of 37.7 years. 2. According to McAfee classification, there were 7 stable(29.2%) and 15 unstable bursting fractures(62.5%). And the most common level of injury was L1(11 cases, 45.8%). 3. Neurologic status was improved one or more grade(Frankel grade) in 21 cases except one case of complete paraplegia. 4. The average correctional angle of kyphotic deformity was 13.1° immediate postoperatively, and the loss of correction(average, 6.7°) was observed during the follow-up period. 5. The segmental instability was found at the level below the fusion in three cases during the follow-up period. 6. There was neither failure of instrument, dislodgement of graft bone nor lateral wedging during the follow-up period.
Accidental Falls ; Classification ; Congenital Abnormalities ; Decompression ; Follow-Up Studies ; Hospitals, General ; Methods ; Paraplegia ; Spinal Canal ; Spine ; Transplants

Purpose: Dislocation is the second most common cause of failure, after implant loosening, in revisional THA (Total hip arthroplasty), and its evaluation and treatment still remain controversial issue. This study was undertaken to evaluate the risk factors after THA using the posterolateral approach and posterior soft tissue repair. Materials and Methods: Between January 1998 and May 2003, 211 consecutive primary total hip replacement arthroplasties using the posterolateral approach and posterior soft tissue repair were performed by the same surgeon. To compare the dislocation groups (6 cases) with the non-dislocation groups (205 cases), we randomized 120 of the non-dislocation cases. The risk factors for hip dislocation were categorized into patient factors and surgical factors. Patient factors included gender, age, preoperative diagnosis, underlying systemic disease, and alcoholic history. Surgical factors included position of the component (acetabular version and inclination, femoral anteversion), leg length discrepancy, and sum of anteversions of the cup and stem. Their parameters were measured on postoperative radiographs. Statistics were performed with Fishe`s Exact test and T test. Results: Dislocations occurred at an overall incidence rate of 2.8% (6/211cases). There were 4 (1.9%) cases of anterior dislocations and 2 (0.9%) cases of posterior dislocations. Dislocations occurred on average at postoperative day 6.1 and all dislocated hips were reduced with the closed method, except for one case that was treated surgically. There was no statistical significance in patient factors between the two groups, except for neurologic disease and alcoholic history. However, the sum of the acetabular and femoral anteversions in the anterior dislocation group was larger than that of the non-dislocation group by approximately 19 degrees. Conclusion: Our results demonstrated that by using the posterior approach and repair of soft tissue, the posterior dislocation rate after total hip replacement arthroplasty can be reduced and the sum of the acetabular and femoral anteversions had more influence on dislocations after THAs than did either anteversion alone.
Acetabulum ; Alcoholics ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Diagnosis ; Dislocations ; Hip Dislocation* ; Hip* ; Humans ; Incidence ; Leg ; Risk Factors*

No abstract available.
Female ; Fetal Heart* ; Hearing* ; Heart Rate, Fetal* ; Pregnancy

No abstract available.
Female ; Fetal Heart* ; Heart Rate, Fetal* ; Pregnancy ; Pregnancy*

Schizencephaly is an infrequent congenital disorder of neuronal migration characterized by gray matter-lined clefts that extent through the entire cerebral hemisphere, from the ependymal lining of the lateral ventricle to the pial covering of the cortex. We have studied seven patients with schizencephaly retrospectively to correlate clinical outcome with the type, Size, and location of the clefts and to find associated brain anomalies. Three patients had bilateral clefts(one with two open lip clefts and the other two with a left open lip cleft and a right closed lip cleft), another two patients had left unilateral open lip clefts, and the rest two patients had right closed lip clefts. Clinically, these patients presented motor dysfunction such as hemiparesis, seizures, and variable developmental delay. Patients with bilateral clefts, particularly open lip type, had worse motor and developmental impairment than those with unilateral clefts. Patient with unilateral medium open lip cleft had worse motor and inte llectual impairment than those with unilateral closed lip clefts or small open lip cleft. All patients with frontal lobe involvement had motor dysfunction. Absence of septum pellucidum, gray matter heterotopia, polymicrogyria, and hypoplasia of optic nerves were also frequently found to be associated with schizencephaly. Three patients with skull canges such as enlargement of the hemicranium or erosion of the inner table of the skull were shunted but only one patient improved in the imaging study. We conclude that the severity of patient's symptoms is related to the amount, type, and location of the involved brain.
Brain ; Cerebrum ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Frontal Lobe ; Humans ; Lateral Ventricles ; Lip ; Malformations of Cortical Development ; Neurons ; Optic Nerve ; Paresis ; Retrospective Studies ; Seizures ; Septum Pellucidum ; Skull