The idiopathic hypereosinophilic syndrome (HES) represents a heterogenous group of disorder characterized by prolonged eosinophilia of undetectable cause and multiorgan system dysfunction. Bone marrow is the most frequentry involved organ, but the most severe clinicopathologic involvement is heart. The major cause of death in patients with the HES is cardiac dysfunction especially congestive heart failure resulted from endocardial fibrosis and restrictive cardiomyopathy. We have experienced a case of DES with both cardiac and pulmonary involvements. The patient was an 18-month-old infant with poorly controlled lung abscess who complained of fever and productive cough. On the microscopic examination of pleural effusion, eosinophilic infiltration was noted. M-mode echocardiogram showed diffuse thickening of interventricular septum and left ventricular posterior wall. On the peripheral blood smear, prolonged eosinophilia was observed. We confirmed this case with bone marrow aspiration which showed eosinophilic hyperplasia.
Bone Marrow ; Cardiomyopathy, Restrictive ; Cause of Death ; Cough ; Eosinophilia ; Eosinophils ; Fever ; Fibrosis ; Heart ; Heart Failure ; Humans ; Hypereosinophilic Syndrome* ; Hyperplasia ; Infant ; Lung Abscess ; Pleural Effusion

The purpose of present study is to compare the effect of treatment using Guidor(R) as a barrier membrane in conjunction with platelet-derived growth factor and insulin like growth factors on experimental dehiscence defects. Following the resection of premolar crowns, roots were submerged. After 12 weeks of healing period, experimental dehiscence defects of 4mm in height and 4mm in width were surgically created on the mid-facial aspect of the lower premolar roots in each of 4 adult dogs. After root planning and demineralization of the root surface with citric acid, the control groups received 4% methylcellulose gel only, the test group I received 4% methylcellulose gel and were covered by Guidor(R) and the test group II were treated with PDGF and IGF and 4% methylcellulose gel with Guidor(R) coverage. Histological and histomorphometric analysis following 8 weeks of healing revealed the following results. 1. The new bone formation showed no statistically significant difference in all groups with 0.59+/-0.82mm(14.03+/-19.60%) for control, 0.70+/-0.39mm(16.30+/-9.01%) for group I, 0.87+/-0.76mm(18.74+/-16.03%) for group II. 2. The new cementum formation showed no statistically significant difference in all groups with 0.54+/-0.48mm(16.38+/-14.57%) for control, 0.95+/-0.38mm(23.43+/-9.30%) for group I, 1.01+/-0.75mm(22.10+/-16.11%) for gorup II. 3. The root resorption showed statistically significant differences betweenthe control group and all test groups(p<0.05) with 2.11+/-0.53mm(52.93+/-12.32%) for control, 0.63+/-0.27mm(15.32+/-7.05%) for group I, 0.89+/-0.33mm (19.26+/-7.11%) for group II. On the bases of these results, there were no statistically difference between treatment using resorbable membrane and resorbable membrane in conjunction with PDGF and IGF in the dehiscence defects, where it was difficult to maintain space. The use of membrane seemed to be more effective in the inhibition of root resorption.
Adult ; Animals ; Bicuspid ; Citric Acid ; Crowns ; Dental Cementum ; Dogs* ; Humans ; Membranes* ; Methylcellulose ; Osteogenesis ; Platelet-Derived Growth Factor* ; Root Resorption ; Somatomedins*

Tuberous Sclrosis is a rare hereditary disease first described by Bourneville in 1880, and usually transmitted as autosomal dominant trait, and is characterized by mental retardation, seizares, and adenoma sebaceum. This 21 year old male patient visited for multiple pin head to pea siaed yelhwish red waxy papules on the face and gingival papillema af 10 years dunatio. Attacks of grandmal seisure eccr oacurred times in the past 8 yeara. Past hiatory and family history were noncountributory. There was a shagreen patch on left lower lumbo-sacral area. Hiatopathology disclosed an adenoma sebaceum showing dilatation of the capillaries, proliferation of collagen, mild cellular infiltration of papillary dermis and perivascular areas. EEG revealed asymmetrieal slow waves on right side of the brain, predommantly in anterior part, and intermittent sharp waves on right anterior frontotemporal area of the brain.
Brain ; Capillaries ; Collagen ; Dermis ; Dilatation ; Electroencephalography* ; Genetic Diseases, Inborn ; Head ; Humans ; Intellectual Disability ; Male ; Peas ; Tuberous Sclerosis* ; Young Adult

Phenylepherine HCI widely used as a mydriatic and vasoconstrictor, have been generally considered safe and innocuous. But hypertension caused by instillation of phenylepherine HCI is frequently reported, and even severe systemic adverse reactions, such as myocardial in farction, sudden death etc. are reported, recently. For the purpose of studying alteration of B.P. and systemic adverse reactions that are caused by instillation of phenylephrine HCI. we divided 42 patients into 2 groups; group 1 includes 20 patients who are instilled once a drop of 10% phenylephrine HCI viscous solution into the conjunctival cul-de-sac of bOth eyes, group 2 includes 22 patients who are instilled twice a drop at 2 minute intervals. We observed alteration of B.P. and systemic adverse reactions in both groups, next made a comparative study, and mydriatic effect too. The results was generally there was no severe reaction, but marked increase of B.P. that statistically significant was observed in 3 patients. There was no significant difference between the 2 groups. In mydriatic effect, the significant difference was not observed between the 2 groups or according to the age. When a clinician does its instillation, he should keep possible adverse reactions in mind. and especially in cardiac disease, hypertensjon, aneurysms, advanced arteriosclerosis, infants and the elderly etc., who have much chance of accompanying severe adverse reactions, he should use phenylepherine HCI cautiously. (this time it is desirable that he use low percentage of phenylepherine HCI).
Aged ; Aneurysm ; Arteriosclerosis ; Death, Sudden ; Heart Diseases ; Humans ; Hypertension ; Infant ; Mydriatics ; Phenylephrine*

The purpose of this study was to evaluate the adjunctive combined effect of demineralized freeze-dried bone allograft(DFDB) in guided bone regeneration on supra-alveolar peri-implant defect. Supra-alveolar perio-implant defects, 3mm in height, each including 4 IMZ titanium plasma-sprayed implants were surgically created in two mongrel dogs. Subsequently, the defects were treated with 1 of the following 3 modalities: Control) no membrane or graft application, Group1) DFDB application, Group2) guided bone regeneration using an expanded polytetrafluoroethylene membrane, Group3) guided bone regeneration using membrane and DFDB. After a healing period of 12-week, the animals were sacrificed, tissue blocks were harvested and prepared for histological analysis. Histologic examination were as follows; 1. New bone formation was minimal in Control and Group 1, but considerable new bone formation was observed in Group 2 and Group 3. 2. There was no osteointegration at the implant-bone interface in the high-polished area of Group2 and Group 3. 3. In fluorescent microscopic examination, remodeling of new bone was most active during week 4 and week 8. There was no significant difference in remodeling rate between group 2 and group 3. 4. DFDB particles were observed, invested in a connective tissue matrix. Osteoblast activity in the area was minimal. The results suggest that guided bone regeneration shows promising results in supra-alveolar peri-implant defects during the 12 week healing period although it has a limited potential in promoting alveolar bone regeneration in the high-polished area. There seems to be no significant adjunctive effect when DFDB is combined with GBR.
Allografts* ; Animals ; Bone Regeneration* ; Connective Tissue ; Dogs* ; Membranes ; Osteoblasts ; Osteogenesis ; Polytetrafluoroethylene ; Titanium ; Transplants

PURPOSE: Implant survival rates using a bone-added osteotome sinus floor elevation (BAOSFE) procedure with simultaneous placement of a non-submerged sand blasted with large grit and acid etched (SLA) implant are well documented at sites where native bone height is less than 5 mm. This study evaluated the clinical results of non-submerged SLA Straumann implants placed at the time of the BAOSFE procedure at sites where native bone height was less than 4 mm. Changes in graft height after the BAOSFE procedure were also assessed using radiographs for 5 years after the implant procedure. METHODS: The BAOSFE procedure was performed on 4 patients with atrophic posterior maxillas with simultaneous placement of 7 non-submerged SLA implants. At least 7 standardized radiographs were obtained from each patient as follows: before surgery, immediately after implant placement, 6 months after surgery, every year for the next 3 years, and after more than 5 years had passed. Clinical and radiographic examinations were performed at every visit. Radiographic changes in graft height were calculated with respect to the implant's known length and the original sinus height. RESULTS: All implants were stable functionally, as well as clinically and radiographically, during the follow-up. Most of the radiographic reduction in the grafted bone height occurred in the first 2 years; reduction after 2 years was slight. CONCLUSIONS: The simultaneous placement of non-submerged SLA implants using the BAOSFE procedure is a feasible treatment option for patients with severe atrophic posterior maxillas. However, the grafted bone height is reduced during the healing period, and patients must be selected with care.
Dental Implantation ; Floors and Floorcoverings ; Follow-Up Studies ; Humans ; Maxilla ; Maxillary Sinus ; Silicon Dioxide ; Survival Rate ; Transplants

The aim of this retrospective study was to compare the amount of marginal bone loss between upper anterior area and upper posterior area with 71 upper single-tooth restorations on 2 stage machined Branemark implants since Jan 1995. The second aim was to compare the bone defect group which had dehiscence and fenetration and the others in the upper anterior region. The results were as follows. 1. The most frequent reason of missing tooth in the upper anterior region was trauma by 61%. While upper posterior region showed various reasons such as congenital missing, advanced periodontitis, trauma. 2. Peri-implantitis with fistula occurred 1 of 41 implants in the upper anterior group in 1 year after loading and 2 of 32 implants in the upper posterior group failed before loading. The 1 year success rate of upper anterior group was 97.56 %, and 93.75 % for upper posterior group. 3. The mean marginal bone loss in the upper anterior group was 0.44 +/- 0.25 mm, while 0.57+/- 0.32 mm in the upper posterior group. There was stastically significant difference in the amount of mean marginal bone loss (P<0.05). 4. The mean marginal bone loss of bone defect group was 0.40+/- 0.10 mm at one year, and 0.48+/- 0.26 mm for the control group. No statistically significant difference of mean marginal bone loss was showen between bone defect group and the others at implantation. According to the results, the upper anterior region showed less marginal bone loss than the upper posterior region. In case of missing single upper tooth, careful consideration on recipient residual ridge to determine proper implant diameter and length, sufficient healing time, proper loading would lead to implant success. Single tooth implants in the maxilla seemed to be an alternative to fixed partial dentures without damage to adjacent teeth.

About one tenth of all CNS neoplasms involves the brain. Due to their location in the ventricles they often present similar nonspecific clinical manifestation. Localization and differential diagnosis are dependent on radiological investigation. For the identification of specific CT characteristics of the intraventricular tumors and the differental diagnosis, we retrospectively analyzed 22 pathologically proved cases seen on CT. Important differential features included age and sex of the patient, the location within the ventricle, and the morpholgic appearance of the mass and density on CT before and after intravenous administration of contrast material. Meningiomas (4 cases) and a germinoma showed increased density on the precontrast CT scans, and demonstrated dense uniform enhancement of the postenhanced scan. Choroid plexus papillomas (3 cases) showed dense uniform contrast enhancement. Intraventricular neurocytomas (3 cases) demonstrated characteristic attachment to the septum pellucidum, confinement of the lateral and third ventricle, and calcification within the mass Colloid cysts (2 cases) showed characteristic location of anterosuperior aspect of the third ventricle. In conclusion, CT findings of intraventricular tumors are usually nonspecific. The location of the mass and the patient's age are the most helpful information in the differential diagnosis.
Administration, Intravenous ; Brain ; Colloid Cysts ; Diagnosis ; Diagnosis, Differential ; Germinoma ; Humans ; Meningioma ; Neurocytoma ; Papilloma, Choroid Plexus ; Retrospective Studies ; Septum Pellucidum ; Third Ventricle ; Tomography, X-Ray Computed

PURPOSE: Mesenteric and omental cysts are uncommon lesions found all age groups. They elicit interest because of their unclear pathogenesis and confusing terminology. MATERIALS AND METHODS: CT findings of 12 case with mesenteric and omental cysts were described and compared with surgical and pathologic findings. RESULTS: In mesenteric and omental cyst, the histologic diagnoses were lymphangioma(7 cases), nonpancreatic pseudocyst(3 cases), mesothelial cyst(2 cases). Lymphangiomas were usually multiloculated with enhancing wall, located in the small bowel mesentery. And these cystic lesions were frequently attached to bowel and required resection of a bowel segment. In three cases of pseudocyst, thick and enhancing wall was shown in unilocular cyst. Two cases of mesothlial cyst were located in greater omenturn, showed very thin wall in unilocuation. CONCLUSION: The CT features of the mesenteric and omental cysts are fairly characteristic. Identification of lymphangioma, which shows a multilocuation and enhancing wall, is important due to frequent bowel resection in operative field.
Diagnosis ; Humans ; Lymphangioma ; Mesentery

The present study evaluates the effects of calcium sulfate and DFDB on alveolar bone regeneration and cementum formation and connective tissue adhesion in intrabony angulated 1 wall defects of dogs. Four millimeter-deep angulated one-wall intrabony defects were surgically created in the mesial & distal aspects of premolars and with flap operaion alone(control group), with calcium sulfate(experimental group 1), with composit graft of 50% calcium sulfate and 50% DFDB(experimental group 2), with DFDB alone(experimental group 3). Histologic analysis following 8 weeks of healing revealed the following results: 1. The lengths of connective tissue adhesion was 1.05+/-0.48mm in the control, 1.30+/-0.67mm in the test group I, 0.97+/-0.22mm in the test group II and 0.93+/-0.15mm in the test group III. There was no statistical significance between control and all experimental groups. 2. Changes in alveolar bone level was 0.97+/-0.27mm in the control group, 1.45+/-0.42mm in the test group I, 2.00+/-0.33mm in the test group II , 1.88+/-0.34mm in the test group III. There was no statistically significant difference between control and experimental group I. There was a statistically significant difference between the control and experimental group II,III.(p<0.05). There was no statistically significant difference between all experimental group. 3. Cementum formation was 1.13+/-0.17mm in the control, 1.78+/-0.31mm in the test group I, 2.17+/-0.38mm in the test group II, 2.15+/-0.47mm in the test group III with statistically significant differences between control group and all experimental group(P<0.05). There was no statistically significant differences between all experimental group. These results suggest that the use of composit graft of 50% calcium sulfate and 50% DFDB and DFDB alone in angulated 1 wall intrabony defects has little effects on connective tissue adhesion, but has significant effects on new bone and new cementum formations.
Animals ; Bicuspid ; Bone Regeneration ; Calcium Sulfate* ; Calcium* ; Connective Tissue ; Dental Cementum ; Dogs* ; Transplants*