No abstract available.
Depression* ; Humans

No abstract available.
Hypokalemic Periodic Paralysis*

Xanthogranulomatous inflammation (XGI) is an uncommon type of chronic inflammation and is histologically characterized by foamy histiocytes and giant cells. The most common sites of occurrence are kidneys and gallbladder. The etiology remains controversial. Involvement of the lower jaw bone is rare. In this study, we report a case of XGI presenting in the lower jaw.

OBJECTIVE: Cerebral endothelial cells have unique biological features and are fascinating candidate cells for stroke therapy. METHODS: In order to understand the molecular mechanisms of human cerebral endothelial cell (hCMEC/D3) transplantation in a rat stroke model, we performed proteomic analysis using 2-dimensional electrophoresis and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Protein expression was confirmed by quantitative real-time PCR and Western blot. RESULTS: Several protein spots were identified by gel electrophoresis in the sham, cerebral ischemia (CI), and CI with hCMEC/D3 treatment cerebral ischemia with cell transplantation (CT) groups, and we identified 14 differentially expressed proteins in the CT group. Proteins involved in mitochondrial dysfunction (paraplegin matrix AAA peptidase subunit, SPG7), neuroinflammation (peroxiredoxin 6, PRDX6), and neuronal death (zinc finger protein 90, ZFP90) were markedly reduced in the CT group compared with the CI group. The expression of chloride intracellular channel 4 proteins involved in post-ischemic vasculogenesis was significantly decreased in the CI group but comparable to sham in the CT group. CONCLUSION: These results contribute to our understanding of the early phase processes that follow cerebral endothelial cell treatment in CI. Moreover, some of the identified proteins may present promising new targets for stroke therapy.
Animals ; Blotting, Western ; Brain ; Brain Ischemia ; Cell Transplantation ; Cell- and Tissue-Based Therapy ; Electrophoresis ; Endothelial Cells* ; Fingers ; Humans* ; Ischemia ; Mass Spectrometry ; Neurons ; Proteomics ; Rats* ; Real-Time Polymerase Chain Reaction ; Stroke ; Transplants

Apoptosis after global or focal cerebral ischemia plays a crucial role in mediating cell death. In this study, we observed the time point expression of physiologic events involving apoptosis regulatory proteins after photochemically-induced focal cerebral ischemia in Sprague-Dawley rats. Protein expression was evaluated at days 1, 3, and 7 by Western blot. Bcl-2, Bax, caspase-3, and phosphorylated Akt (pAkt) activity markedly increased in the ischemic hemisphere in a time-dependent manner, not affected. The expression of Bcl-2, Bax, and caspase-3 was dramatically changed around day 3, whereas changes in pAkt expression occurred at day 1. Differential elevation of these apoptosis regulatory proteins at various time points indicates that different modes of cell death occur in photochemically-induced focal cerebral ischemia in a rat brain.
Animals ; Apoptosis ; Apoptosis Regulatory Proteins ; Blotting, Western ; Brain ; Brain Ischemia ; Caspase 3 ; Cell Death ; Negotiating ; Rats ; Rats, Sprague-Dawley ; Rose Bengal

BACKGROUND: Soluble adhesion molecules including soluble vascular cell adhesion molecule-1 (sVCAM-1) are released during an infalmmatory process such as artherosclerosis. Elevated sVCAM-1 also has been reported in diabetic nephropathy. But, the clinical significance of elevated of sVCAM-1 is not certain. We measured serum sVCAM-1 for the purpose to validate the clinical usefulness in diabetic nephropathy. METHODS: In this study, we measured serum sVCAM-1 in 12 normal subjects and 64 type 2 diabetic patients with proteinuria over 300 mg/day [median 24-h urine protein (range): 2.2 (0.3-18.7) g/day]. We evaluated the relationship of serum sVCAM-1 with lipoproteins including total cholesterol, LDL, oxidized LDL (oxLDL), HDL, and lipoprotein(a) (Lp(a)), with markers of inflammation including high-sensitivity CRP (hs-CRP), serum albumin and fibrinogen, and with renal parameters including 24-h urine protein, serum creatinine and homocysteine. RESULTS: In patients with diabetic nephropathy, median sVCAM-1 was 561 ng/mL (range 183-1304), which was significantly higher than that of normal subjects (324 ng/mL; 213-760, p< 0.05). In the diabetic nephropathy patients, sVCAM-1 was positively correlated with serum creatinine (r=0.34, p< 0.01), serum Lp(a) (r=0.27, p< 0.05) and 24-h urine protein (r=0.26, p< 0.05). In a multiple linear regression analysis, 24-h urine protein and serum Lp(a) were associated with an increased level of sVCAM-1 (r2=0.22, p=0.003). CONCLUSION: In summary, a positive correlation of sVCAM-1 with 24-h urine protein suggests that high sVCAM-1 may reflect increased production of sVCAM-1 due to more advanced renal injury. A positive association of sVCAM-1 and serum Lp(a) also suggests increased release of sVCAM-1 from associated atherosclerotic lesions in these patients. These results suggest that sVCAM-1 may be closely related with the renal function in patients with overt diabetic nephropathy.
Cholesterol, LDL ; Creatinine ; Diabetes Mellitus, Type 2* ; Diabetic Nephropathies ; Fibrinogen ; Homocysteine ; Humans ; Inflammation ; Linear Models ; Lipoprotein(a) ; Lipoproteins ; Proteinuria ; Serum Albumin ; Vascular Cell Adhesion Molecule-1*

After hemiglossectomy due to tongue cancer, such factors as mobility, sensation, volume and the shape of the tongue are critical elements for successful rehabilitation. As long as there is a residual segment of mobile tongue with an intact motor nerve supply, the mobility of native tongue can be preserved by using tissue with thin, pliable and sensory potential. The residual tongue motion can be maximized by separating the reconstruction of mobile tongue from the reconstruction of the floor of mouth. Six patients who underwent significant glossectomy for squamous cell cancer were reconstructed with a bilobed design of sensate radial forearm flap. One lobe of the flap is used to restore the shape and volume of the tongue, while the other lobe is used to resurface the floor of the mouth. There were no flap failure and fistula formation. In all patients, the tongue mobility was preserved and the earliest recovery of sensation was noted 5 weeks following the surgery. The articulation was good enough for them to perform daily activities. With the bilobed design, we can maximize the mobility of the residual tongue by preventing tethering of the root of tongue to the inner table of the mandible. In this article e present our successful experiences with this method, especially in view of mobility and sensation.
Fistula ; Forearm* ; Free Tissue Flaps* ; Glossectomy ; Humans ; Mandible ; Mouth ; Mouth Floor ; Neoplasms, Squamous Cell ; Rehabilitation ; Sensation ; Tongue ; Tongue Neoplasms

BACKGROUND: Spontaneous echo contrast (SEC) of the left atrium (LA) is associated with increased risk of thromboembolism in patients with mitral stenosis(MS). The determination of the presence and severity of LA spontaneous echo contrast(SEC) is of prognostic importance in these patients. Harmonic imaging(HI), a novel echocardiographic technique that differs from conventional fundamental imaging(FI) by transmitting ultrasound at one frequency and receiving at twice the transmitted frequency, produces better endocardial border definition and myocardial opacification. However, there are no data about its value on the detection of LA SEC. The purpose of this study was to investigate the utility of transthoracic noncontrast HI in the detection of LA SEC in patients with. METHODS: Seventy-four consecutive patients with MS (49 female, mean age 51) underwent standard transthoracic echocardiograms (TTE) in both HI and FI and transesophageal echocardiography (TEE) to determine the presence and severity of LA SEC. LA SEC was graded by TEE; mild if only seen at high gain, severe if visible in the entire LA at normal gain control of the equipment. Control subjects comprised of 30 patients randomly selected from patients who did not have LA SEC at TEE examination. RESULTS: Atrial fibrillation was found in 46 patients (62.2%). The mean mitral valve area and mean mitral gradient were 1.0+/-0.3cm2 and 8.2+/-4.1mmHg, respectively. Nine patients (12.2%) had episodes of systemic embolism; stroke in 8 and peripheral embolism in 1. LA thrombus was found in 11 patients (14.9%) by TEE. LA SEC was present in all but one patient by TEE (mild in 35, severe in 38 patients). FI of TTE, however, revealed LA SEC in only 5 (6.8%) of the 73 patients. In contrast, in HI, LA SEC could be detected in 63 (86.3%) of the 73 patients. In the detection of severe LA SEC, the sensitivity of FI and HI were 13.2% (5/38) and 100% (38/38), respectively. LA SEC was not observed in control subjects either by FI or HI. CONCLUSION: Transthoracic HI significantly enhances the detection of LA SEC in patients with MS.
Atrial Fibrillation ; Echocardiography ; Echocardiography, Transesophageal ; Embolism ; Female ; Heart Atria ; Humans ; Mitral Valve ; Mitral Valve Stenosis* ; Stroke ; Thromboembolism ; Thrombosis ; Ultrasonography

Chronic mucocutaneous candidiasis (CMC) consists of several clinical syndrome characterized by chronic, treatment-resistant, superficial candidal infections of skin, nails and oropharynx. The patients with CMC usually have other manifestations including non-candidal infections, endocrinopathies and autoimmune diseases. These findings suggest that patients with CMC have multiple or complex abnormalities in their immune systems, especially of cell mediated immunity. The scrofuloderma or scrofuloderma-like BCGitis is used to describe the skin reaction and enlargement of regional lymph node with suppuration. In contrast to chronic mucocutaneous candidiasis, BCGitis does not suggest underlying host immune defect in most cases. In our knowledge, there is no report about scrofuloderma-like BCGitis and chronic mucocutaneous candidiasis occurring in the same patient. Herein, we report a case of chronic mucocutaneous candidiasis associated with scrofuloderma-like BCGitis.
Autoimmune Diseases ; Candidiasis, Chronic Mucocutaneous ; Humans ; Immune System ; Immunity, Cellular ; Lymph Nodes ; Nails ; Oropharynx ; Skin ; Suppuration ; Tuberculosis, Cutaneous

Acute generalized exanthematous pustulosis (AGEP) is an uncommon aseptic pustular eruption that usually follows recent administration of oral or parenteral drugs. Characteristic AGEP features include the sudden onset of fever with widespread erythematous eruption, rapidly progressing to a fine, non-follicular, micropustular rash. The illness usually resolves spontaneously with fever and pustulation clearing within 15 days, sometimes followed by desquamation. Histopathology shows non-follicular spongiotic pustules in the epidermis filled with neutrophils, a mixed perivascular infiltrate of neutrophils and occasional eosinophils with papillary dermal edema. We describe a 10-month-old boy with AGEP secondary to exposure to amoxicillin. This is an uncommon condition in children.
Acute Generalized Exanthematous Pustulosis ; Amoxicillin ; Child ; Drug Eruptions ; Edema ; Eosinophils ; Epidermis ; Exanthema ; Fever ; Humans ; Infant ; Neutrophils