No abstract available.
Diaphragmatic Eventration*

No abstract available.
Diabetes Mellitus, Type 1* ; Hypothyroidism*

No abstract available.
Prune Belly Syndrome*

No abstract available.
Ectromelia*

We report a case of ciliated hepatic foregut cyst which was incidentally found in a 64 year-old man. The cyst, 6 cm in diameter, was unilocular, solitary and was located in the medial segment of left lobe, just below the Glisson's capsule. Microscopically, the cyst wall consisted of 4 layers; pseudostratified ciliated columnar epithelium, subepithelial loose connective tissue, smooth muscle bundles and an outermost fibrous capsule. Although cartilage or subepithelial sero-mucous glands were absent, the morphologic features of the cyst correspond with those of an incomplete form of brochogenic cyst.
Cysts

PURPOSE: To illustrate frequently encountered anatomic variations on PNS computed tomography(CT) and to assess their clinical significance. MATERIALS AND METHODS: CT findings of 1523 patients, who underwent PNS CT with no history of sinus surgery, were reviewed, and prevalence of each anatomic variation and its relationship with mucociliary clearance pathway was evaluated. RESULTS: Two categories of anatomic variations were encountered. The first group included variations of the turbinates, such as concha bullosa(28.6% ), paradoxical middle turbinate(31.5%), of the uncinate process, such as medially bent or folded(36.3%), laterally bent(3.7%) or uncinate bulla(0.5%), of the ethmoidal sinus, such as Haller's ce11(28.2%), large agger nasi ce11(9.6%) or large ethmoidal bulla(23.5%) and nasal septal deviation(24. 1%), which might cause obstruction of mucociliary clearance pathway and thus give rise to secondary obstructive sinusitis. The second group included Onodi ce11(1.4%) and medial depression of the lamina papyracea (3.5%), which were not related with obstructive sinusitis. 87 cases of large agger nasi cell were associated with obstruction of nasofrontal recess. Large ethmoidal bulla(452 cases), Haller's ce11(245 cases) and true concha bullosa (25 cases) contributed to narrowing of the infundibulum. Medially bent uncinate process(220 cases), concha bullosa(157 cases), paradoxical middle turbinate(126 cases) and nasal septal deviation(93 cases) were observed in middle meatal obstruction and supreme concha (3 cases) accompanied sphenoethmoidal recess obstruction. CONCLUSION: Recognition of anatomic variations on PNS CT is important to build a treatment plan in patients with obstructive sinusitis as they may represent causes of the disease, and to avoid critical complications during functional endoscopic sinus surgery.
Anatomic Variation ; Depression ; Humans ; Mucociliary Clearance ; Prevalence ; Sinusitis ; Turbinates

No abstract available.
Adult* ; Diaphragm* ; Humans

PURPOSE: In order to classify the involving patterns of maxillary sinus aspergillosis on CT that will be an important guidance for functional endoscopic sinus surgery(FESS) and to evaluate CT findings of each pattern. MATERIALS AND METHODS: We reviewed CT findings of 37 cases of maxillary sinus aspergillosis which were confirmed pathologically. These were classified into three patterns according to the location:the maxillary pattern(I), the infundibular pattern(11), and combined pattern(Ill). All cases were correlated with FESS findings. We also evaluated CT density, presence of contrast enahncement and calcifications, and surrounding bony changes of each pattern. RESULT: The combined pattern was most commonly seen in 24 of 37 cases(64.9%). The maxillary pattern was identified in 8(21.6%), with 5(13.5%)cases demonstrating the infundibular patttern. These patterns were consistent with FESS findings. Calcifications were seen in 28 cases(75.7%). 31 cases(83.8%) revealed hypodensity and 16cases among them showed peripheral enhancement. Central high density with peripheral low density rim was shown in 25%(2/8) of the maxillary pattern and 12.5%(3/24) of combined patttern. Surrounding bony changes were noted mainly in infundibular pattern and combined pattern. Erosion of uncinate process showed all cases of both patterns. Erosion or elevation of ethmomaxillary plate was seen in 3 of 5 cases of infundibular pattern and all cases of the combined pattern. CONCLUSION: CT fidnings of maxillary sinus aspergillosis can be classified into 3 patterns according to their distribution. These classification could be helpful for planning FESS approach. Calcifications are the most characteristic findings of maxillary sinus aspergllosis whereas CT density or enhancement pattern do not contribute to diagnosis.
Aspergillosis* ; Classification ; Diagnosis ; Maxillary Sinus*

The purposes of this study were to investigate the initial tissue changes on the teeth and surrounding tissues under contraction and intrusive force by contraction UTA. A control and experimental dogs, 10-months in age, were studied. Contraction and intrusive force(60gm) were applied at upper four incisors by contraction UTA. Experimental dogs were sacrificed at 2 weeks and 4weeks after force application, respectively. In this study, 2 experimental groups were designed by the duration of force applied(E1, E2). The specimens were taken around the upper first and second incisor in each groups and were prepared for the H-E and MT stain for light microscopic observation. From the results of the study, the following conclusions may be drown. : 1. In control group, the periodontal ligament width was constant from apical third to cervical third of the root and periodontal fiber arrangement was horizontal or oblique in cervical third, oblique in middle third and apical third. In alveolar bond, smooth appearance was shown with osteoblast. 2. In experimental group 1, in proportion to force was concentrated at labial middle third and apical third of root of the upper first and second incisors, root of these tooth tipped labially and intruded at a time. 3. In experimental group 2, periodontal ligament width and arrangement was similar to control and observed strong calcified response at the labial middle third of root. But, alveolar bond resorption and cementum resorption were as before seen at labial middle third and apical third of root force was concentrated.
Animals ; Dental Cementum ; Dogs* ; Incisor* ; Osteoblasts ; Periodontal Ligament ; Tooth*

Efforts to improve end-of-life (EOL) care have generally been focused on cancer patients, but high-quality EOL care is also important for patients with other serious medical illnesses including heart failure (HF). Recent HF guidelines offer more clinical considerations for palliative care including EOL care than ever before. Because HF patients can experience rapid, unexpected clinical deterioration or sudden death throughout the disease trajectory, choosing an appropriate time to discuss issues such as advance directives or hospice can be challenging in real clinical situations. Therefore, EOL issues should be discussed early. Conversations are important for understanding patient and family expectations and developing mutually agreed goals of care. In particular, high-quality communication with patient and family through a multidisciplinary team is necessary to define patient-centered goals of care and establish treatment based on goals. Control of symptoms such as dyspnea, pain, anxiety/ depression, fatigue, nausea, anorexia, and altered mental status throughout the dying process is an important issue that is often overlooked. When quality-of-life outweighs expanding quantity-of-life, the transition to EOL care should be considered. Advanced care planning including resuscitation (i.e., do-not resuscitate order), device deactivation, site for last days and bereavement support for the family should focus on ensuring a good death and be reviewed regularly. It is essential to ensure that treatment for all HF patients incorporates discussions about the overall goals of care and individual patient preferences at both the EOL and sudden changes in health status. In this review, we focus on EOL care for end-stage HF patients.