No abstract available.
Zygoma*

Dislocation involving tarsal navicular is a extremely rare injury compare to dislocation of other tarsal bone. One case of the tarsal navicular dislocation associated with subluxation of the midtarsal joint treated by open reduction and arthrodesis was reported.
Arthrodesis ; Dislocations ; Joints ; Tarsal Bones

OBJECTIVE: This study compared the bone thickness of the palate between lateral cephalogram and 3D model measurements. METHODS: The subjects consisted of 30 adults (15 men,15 women) with a normal skeletal pattern and occlusion. The CT images were transformed to a 3D model, and were compared with the cephalometric image. Descriptive statistics for each variable were calculated. RESULTS: In the 3D CT model, the mid-palatal area was the thickest part. It became thinner as the palate tapered laterally. In the male group, the thinnest portion was positioned 6 mm away from the mid-palate, while in the female group the thinnest portion was 8mm away from the mid-palate. Correlation analysis between the lateral cephalometric and 3D CT model revealed a significant correlation except in the mid palatal area and the area 2 mm lateral to the mid-palate in men, whereas there was a significant relationship in every area in the women. In both men and women, the highest correlation appeared in the area 8 mm lateral to the mid palate. CONCLUSIONS: Using regression analysis, an actual prediction of the bone thickness between the measured bone thickness of the lateral cephalometric radiograph and 3D model was made. This will provide useful information for mini-implant length selection when inserting into the palate.
Adult ; Female ; Humans ; Male ; Palate

A 65-year old Korean man, living in Mokpo-city, Jeollanam-do, Republic of Korea, visited a local clinic complaining of right upper quadrant pain and indigestion. At colonoscopy, he was diagnosed as having a carcinoma of the ascending colon, and thus, a palliative right hemicolectomy was performed. Subsequently, an adult fluke of Gymnophalloides seoi was incidentally found in a surgical pathology specimen of the lymph node around the colon. The worm was found to have invaded gut lymphoid tissue, with characteristic morphologies of a large oral sucker, a small ventral sucker, and a ventral pit surrounded by strong muscle fibers. This is the first reported case of mucosal tissue invasion by G. seoi in the human intestinal tract.
Trematode Infections/diagnosis/parasitology/*pathology ; Trematoda/*isolation & purification/ultrastructure ; Male ; Lymphoid Tissue/*parasitology ; Korea ; Intestinal Diseases, Parasitic/diagnosis/*parasitology/pathology ; Humans ; Colonic Diseases/*parasitology ; Colon/*parasitology/pathology/surgery ; Animals ; Aged

BACKGROUND AND OBJECTIVES: With recent advances in equipment and techniques, infrapopliteal angioplasty has shown results that are comparable to those of surgical bypass in patients with critical limb ischemia (CLI). In this study, we evaluated the efficacy and the feasibility of infrapopliteal angioplasty in patients with CLI. SUBJECTS AND METHODS: Between March 2002 and May 2008, infrapopliteal angioplasty was performed on 118 limbs of 101 patients (79 males; mean age 66 years) with CLI (Rutherford category 4, 5 or 6). Freedom from reintervention, limb salvage, and overall survival were analyzed. RESULTS: The median follow-up duration was 30 months. Initial technical and clinical success rates were 69.5% and 83.1%, respectively. No major complication requiring surgical intervention developed after angioplasty. Among 82 limbs with initial technical success, the rate of freedom from any reintervention at 2 years was 70.7% and that from limb salvage was 97.6%. Young age and Rutherford category 6 at initial presentation were independent predictors associated with poor 2 year primary patency in these patients with CLI. Overall survival at 1 year was 86.4% and that at 2 years 76.3%. A history of cerebrovascular accident was an independent predictor associated with poor 2 year survival in these patients. CONCLUSION: Infrapopliteal angioplasty as a primary choice of treatment in CLI patients showed favorable clinical outcomes and feasibility.
Angioplasty ; Extremities ; Follow-Up Studies ; Freedom ; Humans ; Ischemia ; Limb Salvage ; Stroke ; Tibial Arteries

PURPOSE: Accurate evaluation of side branch (SB) ostium could be critical to the treatment of bifurcation lesions. We compared measured and calculated values of side branch ostial length (SBOL) in coronary bifurcation lesions with intravascular ultrasound (IVUS). MATERIALS AND METHODS: Pre-intervention and post-intervention IVUS was performed in 113 patients who underwent stent implantation of bifurcation lesions. For the IVUS longitudinal reconstruction of the bifurcation lesions, SBOL, SB diameter, and the angle between the distal portion of the main vessel (MV) and SB were directly measured. In addition, SBOL was calculated as: SB diameter/sin (angle between distal MV and SB). The relationship between measured and calculated SBOL was then evaluated. RESULTS: The angled between the distal MV and SB were 57.3+/-12.4degrees at pre-intervention and 59.4+/-12.6degrees at post-intervention. The mean measured and calculated SBOL values were 2.91+/-0.86 mm and 3.06+/-0.77 mm at pre-intervention and 2.79+/-0.82 mm and 2.92+/-0.69 mm at post-intervention, respectively. Differences between measured and calculated SBOL were 0.15+/-0.44 mm at pre-intervention and 0.13+/-0.41 mm at post-intervention. We found that calculated SBOL was correlated with measured SBOL (pre-intervention r=0.863, p<0.001; post-intervention r=0.868, p<0.001). CONCLUSION: There was a good correlation between measured and calculated SBOLs of the bifurcation lesions in IVUS longitudinal reconstruction. SBOL in the bifurcation lesions can therefore be estimated using the SB diameter and the angle between distal MV and SB.
Aged ; Angioplasty, Balloon, Coronary ; Coronary Angiography ; Coronary Artery Disease/surgery/*ultrasonography ; Coronary Vessels/*ultrasonography ; Female ; Humans ; Male ; Middle Aged ; Ultrasonography, Interventional

PURPOSE: The aim of this study was to determine whether retinol-binding protein 4 (RBP4), adiponectin and high molecular weight (HMW) adiponectin are associated with insulin resistance (IR) and metabolic parameters in non-diabetic hypertensive patients. Also, we sought to compare the predictive values of these adipocytokines for IR in non-diabetic hypertensive patients. MATERIALS AND METHODS: Analyses of RBP4, adiponectin, and HMW adiponectin were performed on 308 non-diabetic hypertensives (148 males, age 58 +/- 10 years, 189 non-metabolic syndrome and 119 metabolic syndrome). The homeostasis model assessment (HOMA) index for IR, lipid profiles, and anthropometric measure-ments were assessed. RESULTS: There was no significant difference in RBP4 levels according to the presence of metabolic syndrome, although adiponectin and HMW adiponectin were significantly lower in metabolic syndrome. Correlation analysis of log RBP4 with IR and metabolic indices revealed that there was no significant correlation of RBP4 with waist circumference (r = 0.056, p = 0.324), HDL cholesterol (r = 0.005, p = 0.934), ApoB/ApoAI ratio (r = 0.066, p = 0.270), and the HOMA index (r = 0.017, p = 0.756). However, adiponectin and HMW adiponectin showed significant correlations with the HOMA index (r = - 0.247, p < 0.001; r = - 0.296, p < 0.001) and metabolic parameters. With IR defined as HOMA index > or = 2.5, HMW adiponectin did not demonstrate a superior predictive value for IR compared to adiponectin (AUC = 0.680 vs. 0.648, p = 0.083). The predictive value of RBP4 for IR was minimal (AUC = 0.534). CONCLUSION: RBP4 was not associated with IR or metabolic indices and the predictive value for IR was minimal in hypertensives. HMW adiponectin didn't have a superior predictive value for IR compared to adiponectin. Therefore, we can suggest that RBP4 and HMW adiponectin don't have more additive information than adiponectin in non-diabetic hypertensives.
Adiponectin/*blood ; Aged ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Hypertension/*blood/*physiopathology ; Insulin Resistance/*physiology ; Male ; Middle Aged ; Radioimmunoassay ; Retinol-Binding Proteins, Plasma/*metabolism ; Risk Factors ; Waist Circumference/physiology

Renal involvement in systemic lupus erythematosus (SLE) is a typical manifestation of the disease. The occurrence of non-lupus nephritis, especially IgA nephropathy (IgAN), in patients with SLE has rarely been reported. We describe the case of a 21-year-old woman who was diagnosed with IgAN and subacute necrotizing lymphadenitis, and her renal lesion biopsy was typical of lupus nephritis (ISN/RPS Class III). Although IgAN and lupus nephritis share some common physiopathological characteristics, their laboratory, histopathologic findings, and the extra-renal clinical manifestations are different and support a different pathogenesis. Our case highlights the importance of a renal biopsy in patients with lupus and urinary alterations despite underlying IgAN. A correct diagnosis would permit the most appropriate immunosuppressive treatments to be considered.
Biopsy ; Female ; Glomerulonephritis, IGA ; Humans ; Immunoglobulin A ; Kidney ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Lymphadenitis ; Nephritis ; Young Adult

BACKGROUND AND OBJECTIVES: Coronary flow reserve (CFR) decreases in the presence of significant coronary stenosis. Hence, CFR can be used for the detection of restenosis after percutaneous coronary intervention (PCI). However, because CFR can also be affected by other conditions such as endothelial dysfunction, microvascular damage, and left ventricular hypertrophy, the absolute value of CFR is not routinely used for detection of coronary restenosis. We hypothesized that changes in the value of CFR, rather than the absolute CFR value, are better correlated with restenosis in various clinical settings. SUBJECTS AND METHODS: We studied 99 patients (71 males/28 females, mean age 58+/-11 years) who underwent successful PCI of the left anterior descending artery. Pre-PCI diagnoses were as follows: 37 unstable angina, 35 stable angina, 27 acute myocardial infarction. CFR using transthoracic Doppler was measured at 48 hours after PCI and at the time of follow-up angiography (6.0+/-1.5 months later). Coronary flow velocity was measured in the distal left anterior descending artery with a 7 MHz transducer (HDI 5,000, Philips, The Netherlands) at baseline and during intravenous infusion of adenosine (140 microgram.kg(-1).min(-1)). Mean diastolic coronary flow velocities from at least three cardiac cycles were averaged. RESULTS: CFRs in 69 patients without restenosis were 2.55+/-0.99 at 48 hours after PCI and 2.93+/-1.00 at follow-up (p<0.005). CFRs in 30 patients with restenosis (>50% in diameter stenosis) decreased significantly from 2.70+/-1.01 at 48 hours after PCI to 1.98+/-0.91 at follow-up (p<0.001). There was a significant difference in CFR change (ratio of CFR(followup)/CFR(initial)) between the two groups. CFR change had a better receiver operating characteristics (ROC) curve than absolute CFR for prediction of restenosis [area under the curve (AUC) for absolute CFR=0.76, AUC for CFR change=0.82]. CONCLUSION: Restenosis after PCI leads to a significant decrease in CFR, even in the presence of variable baseline CFR values. Serial measurements of CFR can be used to detect restenosis after PCI.
Adenosine ; Angina, Stable ; Angina, Unstable ; Angiography ; Area Under Curve ; Arteries ; Coronary Restenosis ; Coronary Stenosis ; Echocardiography ; Echocardiography, Doppler ; Female ; Follow-Up Studies ; Humans ; Hypertrophy, Left Ventricular ; Infusions, Intravenous ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Polyenes ; ROC Curve ; Transducers

Henoch-Schonlein purpura (HSP) is a vasculitis of the small vessels in skin, joints, gastrointestinal (GI) tract and kidney. GI symptoms occur in up to 85% of patients and may lead to severe problems such as intussusception, obstruction, and perforation. GI symptoms may not be easily controlled, showing refractoriness to the conventional corticosteroid therapy. Although GI involvements of HSP are acute, and self-limited in most instances, they may cause fatal results in some unusual cases. In such conditions all the possible therapeutic modalities should be considered. We report two cases of severe small bowel involvement of HSP. One case presented with severe abdominal pain showing refractoriness to corticosteroid, but improved with IV immunoglobulin therapy. In the second case, HSP with transmural infarction in the small bowel could be cured with surgical intervention.
Abdominal Pain ; Humans ; Immunization, Passive ; Immunoglobulins ; Infarction ; Intussusception ; Joints ; Kidney ; Purpura, Schoenlein-Henoch* ; Skin ; Vasculitis