No abstract available.
Liver*

BACKGROUND: The goal of successful resuscitation is not only to stop the process of ischemia as soon as possible but also to overcome the secondary injury process after resuscitation, which involves a complex interplay of mechanisms. Brain damage accompanying cardiac arrest and resuscitation is frequent and devastating. Cells die by one of two mechanisms: necrosis or delayed neuronal death. Delayed neuronal death may require protein synthesis. Neurons in the CA1 subfield of the hippocampus are selectively vulnerable to death after injury by ischemia and reperfusion. Death of these neurons occurs after an interval of 1 or 2 days. We assessed the effects of a protein synthesis inhibitor, cycloheximide(CHX), on hippocampal neuronal death of rats by using the ventricular fibrillation cardiac arrest(VFCA) model. METHODS: The effect of CHX(3mg/kg, s.c.) on hippocampal neuronal death was studied in two groups of 18 rats each, one group being subjected to a 2-min VFCA and the other to a 3-min VFCA. Each group was divided into three subgroups: control(group I,II) without subcutaneous injection of CHX, 'exp-12' of group I/II treated with CHX 12 hours after return of spontaneous circulation (ROSC), and 'exp-24' of group I/II treated with CHX 24 hours after ROSC. The coronal sections of the hippocampus levels were stained with hematoxylin-eosin after 72 hours of survival. The histologic damage score(HDS) was used to assign a score to the total number of damaged neurons counted in each of the hippocampal CA1 subfields. RESULTS: 1. There were not significan differences in heart rates, blood pressures, blood sugar, and blood gas in group I & II during the pre-arrest steady state or at 5 min and 30 min after ROSC. 2. In group I & II, the HDS, were significantly reduced in rats(I exp-12, 1.1+/-0.6; I exp-24, 1.3+/-0.5; II exp-12, 1.4+/-0.7; and II exp-24, 1.8+/-0.8) treated with CHX 12 hours or 24 hours after ROSC than control rats(I, 2.5+/-0.9, II, 2.9+/-0.8)(p<0.05). CONCLUSION: These results suggest that delayed hippocampal neuronal death from ischemic insult after ventricular fibrillation cardiac arrest followed by resuscitation can be prevented by a protein synthesis inhibitor, CHX. Further experimental studies of the action mechanism of protein synthesis inhibitors to delayed neuronal death and clinical applications are required.
Animals ; Blood Glucose ; Brain ; Heart Arrest* ; Heart Rate ; Hippocampus ; Injections, Subcutaneous ; Ischemia ; Necrosis ; Neurons* ; Protein Synthesis Inhibitors ; Rats* ; Reperfusion ; Resuscitation ; Ventricular Fibrillation*

Objectives: There was no previous report about the electrical cardioversion for the patients with atrial fibrillation after successful percutaneous ballon mitral valvuloplasty (PBMV). We performed electrical cardioversion after PBMV to evaluate the effectiveness of this procedure in the view of conversion to and maintenance of the sinus rhythm. METHODS: 28 patients who had persistent atrial fibrillation after successful PBMV were included in this study. All patients were anticoagulated with warfarin. Amiodarone was loaded and maintained before cardioversion. The PBMV procedures were guided by transesophageal echocardiography in all patients. Transthoracic echocardiography was done before and after PBMV and cardioversion, and was followed. RESULTS: The number of patients were 28 (male 9 and female 19) within the mean age of 50.3+/-12.0 years (24-66). Initially 24 patients (86%) succeeded in electrical cardioversion. The energy required for successful conversion was 230+/-75J, on average. There were no complications except for the transient sinus bradycardia in 2 cases. The mean follow-up duration was 357+/-144 days and when followed-up, the sinus rhythm was maintained in 15 patients out of 24 with initial success (63%). No factor was significantly related to the success of cardioversion, but left atrial dimension after 1 month of PBMV was significantly related to the maintenance of the sinus rhythm. CONCLUSIONS: This study suggests that electrical cardioversion of atrial fibrillation after successful PBMV is favorable and recommendable treatment modality of chronic valvular atrial fibrillation with high conversion rate (88%) and good maintenance rate (63%).
Amiodarone ; Atrial Fibrillation* ; Bradycardia ; Echocardiography ; Echocardiography, Transesophageal ; Electric Countershock* ; Female ; Follow-Up Studies ; Humans ; Warfarin

PURPOSE: A case of frosted branch angiitis in Kikuchi-Fujimoto disease is reported. CASE SUMMARY: A 33-year-old male complained of a sudden decrease in visual acuity that developed in both eyes 5 days prior. He suffered from a headache, chills, myalgia, and flank pain 1 week before. The initial best-corrected visual acuity (BCVA) was 0.1 in the right eye and 0.2 in the left eye. On slit lamp examination, no inflammatory finding was observed in the anterior chamber and vitreous body of both eyes. On fundus examination, a diffuse vascular sheathing-like frosted branch was found in the retinal vessels, and retinal hemorrhage was observed. Fluorescein angiography showed staining and leakage of dye along the vascular sheathing. Serological findings were negative, showing no evidence of an autoimmune disease or viral infection. Neck ultrasonography revealed non-tender left cervical lymph node enlargement >1 cm in diameter. Ultrasound-guided fine needle aspiration cytology showed findings compatible with Kikuchi-Fujimoto disease, including necrotic changes and pronounced karyorrhexis, plus histiocyte and lymphocyte infiltration without neutrophils. We started systemic steroid therapy. One month after treatment, the BCVA of both eyes improved to 1.0. CONCLUSIONS: In patients with frosted branch angiitis, systemic disease such as Kikuchi-Fujimoto disease should be considered.
Adult ; Anterior Chamber ; Autoimmune Diseases ; Biopsy, Fine-Needle ; Chills ; Flank Pain ; Fluorescein Angiography ; Headache ; Histiocytes ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Lymph Nodes ; Lymphocytes ; Male ; Myalgia ; Neck ; Neutrophils ; Retinal Hemorrhage ; Retinal Vessels ; Slit Lamp ; Ultrasonography ; Vasculitis ; Visual Acuity ; Vitreous Body

Thrombosis at the left ventricular outflow tract occurs without any detectable heart disease or predisposing factors only extremely rarely. A 48-year-old male visited Konkuk University Medical Center with loss of consciousness one month prior to presentation. Before he visited our hospital, he had been diagnosed with a cardiac tumor, which was located between the left atrium and posterior aortic root, and which was adjacent to both the aortic and mitral valves. Cardiac transplantation was recommended at the other hospital because of the high risk of cardiac dysfunction induced by both aortic and mitral valvular dysfunction after surgical resection. Based on preoperative transthoracic echocardiography, cardiac computed tomography, cardiac magnetic resonance imaging, and intra-operative transesophageal echocardiography, we considered it to be a benign tumor. Complete resection was achieved and the pathology confirmed organizing thrombus. We report a case of organizing thrombus mimicking a cardiac tumor, which was located at the mitral-aortic intervalvular fibrosa of the left ventricular outflow tract without any heart disease.
Academic Medical Centers ; Aneurysm, False ; Causality ; Echocardiography ; Echocardiography, Transesophageal ; Heart Atria ; Heart Diseases ; Heart Neoplasms* ; Heart Transplantation ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Mitral Valve ; Pathology ; Thrombosis* ; Unconsciousness

The aim of this study was to evaluate the accuracy of 3 different automatic landmark identification programs on lateral cephalgrams and the clinical acceptability in pediatric dentistry.
Sixty digital cephalometric radiographs of 7 to 12 years old healthy children were randomly selected. Fourteen landmarks were chosen for assessment and the mean of 3 measurements of each landmark by a single examiner was defined as the baseline landmarks. The mean difference between an automatically identified landmark and the baseline landmark was measured for each landmark on each image.
The total mean difference of 3 automatic programs compared to the baseline landmarks were 2.53 ± 1.63 mm. Errors among 3 programs were not significantly different for 12 of 14 landmarks except Orbitale and Gonion. The automatic landmark identification programs showed significant higher mean detection errors than the manual method. The programs couldn’t be used as the 1st tool to replace human examiners. But considering short consuming time, these results indicate that all 3 programs have sufficient validity to be used in pediatric dental clinic.

The aim of this study is to evaluate the development of the left mandibular third-molar development with modified Demirjian method and its relation to chronological age.
A total of 1653 digital panoramic radiographs of healthy individuals aged between 7 and 23 years who visited Yonsei University Dental hospital were selected. The developmental status of the left mandibular third molars was assessed using dental maturity scoring proposed by Demirjian et al. The mean age of the first appearance of mineralization, complete crown formation, and complete root formation were around 9, 14, 21 years respectively. Statistically significant differences between males and females in the development stage of D and G were revealed that crown formation and root length completion were attained earlier in males than in females. There was significant positive relationship between age and third molar development in both sexes, and new formula was presented to estimate age of children and adolescents based on their developmental stages of third molars.
In this study, the use of left mandibular third molar as a developmental marker is appropriate, and age estimation can be attained with dental maturity stage.

The X-ray synchrotron is quite different from conventional radiation sources. This technique may expand the capabilities of conventional radiology and be applied in novel manners for special cases. To evaluate the usefulness of X-ray synchrotron radiation systems for real time observations, mouse fetal skeleton development was monitored with a high resolution X-ray synchrotron. A non-monochromatized X-ray synchrotron (white beam, 5C1 beamline) was employed to observe the skeleton of mice under anesthesia at embryonic day (E)12, E14, E15, and E18. At the same time, conventional radiography and mammography were used to compare with X-ray synchrotron. After synchrotron radiation, each mouse was sacrificed and stained with Alizarin red S and Alcian blue to observe bony structures. Synchrotron radiation enabled us to view the mouse fetal skeleton beginning at gestation. Synchrotron radiation systems facilitate real time observations of the fetal skeleton with greater accuracy and magnification compared to mammography and conventional radiography. Our results show that X-ray synchrotron systems can be used to observe the fine structures of internal organs at high magnification.
Animals ; Bone and Bones/*anatomy & histology/radiography ; Female ; Fetus/*anatomy & histology/radiography ; Histocytochemistry ; Mice ; Mice, Inbred ICR ; Pregnancy ; Synchrotrons ; X-Rays

Erlotinib (Tarceva(R)) is a new anti-cancer agent which acts by inhibiting epidermal growth factor receptor (EGFR) signal transduction. It is currently used in the treatment of advanced stage non-small cell lung cancer and pancreatic cancer. We report a case of acneiform eruption and paronychia induced by erlotinib in a 69-year-old man. The patient visited our clinic with multiple erythematous papules and pustules on the face, periungual erythema and pus discharge, xerosis, fissures on the sole. He had taken erlotinib for the treatment of recurred lung cancer for 4 weeks. The skin lesions were partially improved with oral pyridoxine, corticosteroid and topical antibiotics.
Acneiform Eruptions* ; Aged ; Anti-Bacterial Agents ; Carcinoma, Non-Small-Cell Lung ; Erythema ; Humans ; Lung Neoplasms ; Pancreatic Neoplasms ; Paronychia* ; Pyridoxine ; Receptor, Epidermal Growth Factor ; Signal Transduction ; Skin ; Suppuration ; Erlotinib Hydrochloride

PURPOSE: To evaluate the parameters of optic nerve head (ONH) and retinal nerve fiber layer (RNFL) in patients with large cup/disc ratio (CDR) and normal neuroretinal rim configuration who have normal perimetry (physiologic large cups, LC) and to compare these parameters with those of the normal and early glaucoma patients. METHODS: Using Heidelberg retinal tomography (HRT) and optical coherence tomography (OCT), 30 patients with LC, 29 normal subjects, and 31 early glaucoma patients were examined. One eye from each subject was randomly selected. RESULTS: Significant differences between LC and glaucomatous eyes (GE) were found in parameters indicating loss of nerve fibers, such as rim area, rim volume, and mean RNFL thickness. However, there was no difference between LC and normal eyes (NE) in RNFL thickness, rim area, and rim volume. LC was able to be defined as a normal central excavation with a large disc and large CDR with a normal rim area. CONCLUSIONS: HRT ONH parameters and RNFL thickness obtained with OCT may be useful for differentiating between glaucoma and LC eyes.
Retina/*pathology ; Optic Disk/*pathology ; Nerve Fibers/*pathology ; Middle Aged ; Humans ; Glaucoma/*pathology ; Adult ; Adolescent