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*

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 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

Tooth mobility may be the decisive factor that determines whether dental treatment of any kind is undertaken. Although tooth mobility in isolation says little in itself, the finding of increased tooth mobility is of both diagnostic and prognostic importance. Only the detection of an increase or decrease in mobility makes an evaluation possible. Thus prior to treatment, we must understand the pathologic process causing the observed the tooth mobility and decide whether the pattern and degree of observed tooth mobility is reversible or irreversible. And then it must be decided whether retention and treatment or extraction and replacement. The purpose of this study was to compare tooth mobility at different time period during root planing and flap operation and to relate changes in mobility to each treatment method. Twenty-one patients (287 teeth) with chronic adult periodontitis were treated with root planing(control group) and flap operation(experimental group), and each group was divided 3 subgroups based upon initial probing pocket depth (1-3mm, 4-6mm, 7mm and more). Tooth mobility was measured with Periotest (R) at the day of operation, 4 days, 1 week, 2 weeks, 3 weeks, 4 weeks, 8 weeks, 12 weeks after each treatment. Tooth mobility, attachment loss, radiographic bone loss, and bleeding on probing were measured at the day of operation, 4 weeks, 8 weeks and 12 weeks after treatment. 1.In group initial probing depth was 1-3mm, tooth mobility had no significant difference after root planing and flap operation. 2.In group initial probing depth was 4-6mm, 7mm and more, tooth mobility had decreased in 12 weeks after root planing(p<0.01). And the mobility had increased after flap operation(p<0.01) and was at peak in 1 week, and decreased at initial level in 4 weeks, below the initial level in 12 weeks(p<0.01). 3.In 1 week, significant difference in tooth mobility between control and experimental group was found(p<0.01) but, in 12 weeks no difference between two groups was found. 4.Change of immediate tooth mobility after treatment was more larger in deep pocket than in shallow one. In group with the same probing pocket depth, the change of tooth mobility in molar group was greater than that of premolar group. 5.Tooth mobility before treatment was more strongly correlated with radiographic bone loss(r=0.5325) than probing depth, attachment loss and bleeding on probing, in 12 weeks after treatment, was more strongly correlated with attachment loss(r2=0.4761) than probing depth and bleeding on probing. Evaluation of the treatment effect and the prognosis after root planing and flap operation were meaningful on tooth initial probing depth 4mm and more. After flap operation, evaluation of the prognosis should be performed at least in 4 weeks and in 12 weeks after treatment, no difference in tooth mobility between two groups was observed. Radiographic bone loss and attachment loss were good clinical indicators to evaluate tooth mobility.
Adult ; Male ; Female ; Humans

The purpose of this study was to investigate the width of attached gingiva of 414 subjects with healthy gingiva, or early stage of gingivitis. We compared the differences according to the tooth location, age (Yonger group : 14~30, Older group : 31~67) and gender. In addition, we compared the width of attached gingiva in the subjects with less than 2 sites of gingival recession(Re< or =2) and the subjects with more than 3 sites of gingival recession(Re> or =3) to study the relationship between the gingival recession and the width of attached gingiva. The results were as follows : 1. The width of keratinized gingiva was widest in maxillary incisors(5.3+/-1.4mm) and narrowest in mandibular right 1st bicuspid and mandibular right and left 2nd molars(3.5+/-1.1mm). 2. The width of attached gingiva was widest in maxillary right central incisor(3.8+/-1.5mm) and narrowest in mandibular right 2nd molar(1.2+/-1.0mm). 3. In the comparison between the age groups, the width of keratinized in older group was significantly(p<0.05) wider than that in younger group in maxillary right and left 1st bicuspids, mandibular right and left 1st and 2nd molars, maxillary right and left cuspids and mandibular right 1st bicuspid. There was no significant difference in the width of attached gingiva between the two groups except for maxillary right and left 1st molars and maxillary left 2nd molar. 4. In the comparison between male group and female group, in maxillary right and and left lateral incisors and cuspids, mandibular right and left cuspids and 1st bicuspids, the width of attached gingiva in female was significantly(p<0.05) wider than that in male group. 5. In the comparison between the Re 3 group and Re 2 group, there was no significant difference except for maxillary right and left 2nd molars and maxillary left 1st molar. 6. The frequency of gingival recession was in the order of mandibular right 1st bicuspid(16.6%), maxillary right 1st bicuspid(13.7%), maxillary and mandibular left 1st bicuspids(13.4%), mandibular left cuspid(10.5%), maxillary left and mandibular right cuspids(10.1%) and maxillary right cuspid(7.9%).
Bicuspid ; Cuspid ; Female ; Gingiva* ; Gingival Recession ; Gingivitis* ; Humans ; Incisor ; Male ; Molar ; Tooth

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

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