We report a cace of 69-year-old man who developed massive pulmonary hemorrhage and subsuquent adult respiratory distress syndrome following intravenous urokinase for acute myocardial infarction. Pulmonary hemorrhage is a rare but a potentially life-threatening complication after thrombolytic therapy and should be considered in the differential diagnosis of pulmonary infiltrates of falling hemoglobin after thrombolytic therapy for acute myocardial infarction with no obvious site of bleeding.
Adult* ; Aged ; Diagnosis, Differential ; Hemorrhage* ; Humans ; Myocardial Infarction* ; Respiratory Distress Syndrome, Adult* ; Thrombolytic Therapy* ; Urokinase-Type Plasminogen Activator

No abstract available.
Aged ; Diagnosis, Differential ; Female ; Fluorescein Angiography ; Fundus Oculi ; Humans ; *Intraocular Pressure ; Regional Blood Flow/*physiology ; Retina/*diagnostic imaging ; Retinal Hemorrhage/*diagnosis/physiopathology ; Retinal Vein Occlusion/*diagnosis

When clinicians faced with an insufficient volume of supporting bone on ideally esthetic and biomechanical position for dental implantation, guided bone regeneration(GBR) was indicated. Although GBR has wide application at clinic, proper time of membrane removal remains qustionable in using non-resorbable membrane, such as non-expanded polytetrafluoroethylene(PTFE). The aim of this study was to compare the effect of maintenance period of PTFE membrane on bone regeneration in rabbit calvarial defects. Eight adult New Zealand white female rabbits were used in this study. Four defects were surgically made in their calvaria. Using a trephine bur, 4 'through and through' defects were created and classified into 3 groups, which were consisted of control group(no graft), experimental group 1(autogenous bone)and experimental group 2(deproteinized bovine bone; OCS-B(R)). The defects were covered with PTFE membrane(Cytoplast(R)). Membranes were removed after 1, 2, 4 and 8 weeks post-GBR procedure in 2 rabbits repectively. All rabbits were sacrificed after 8 week post-GBR procedure. Specimens were harvested and observed histologically. The results were as follow; 1) The use of graft material and membrane was necessary in GBR procedure. 2) When PTFE membranes were removed early, the most favorable bone regeneration was revealed in experimental group I, followed by experimental group II and control group. 3) On GBR, it is recommended that membrane should maintain for 4 weeks with autogenous graft. As well, the use of xenograft need longer maintenance period than autogenous bone. Further evaluations will be needed, such as histomorphologic research, more species and different kinds of graft materials. And on the basis of these studies, clinical researches would be required.
Adult ; Bone Regeneration* ; Dental Implantation ; Dental Implants ; Female ; Heterografts ; Humans ; Membranes* ; New Zealand ; Polytetrafluoroethylene ; Rabbits ; Skull ; Transplants

Objective: Vascular calcification requires the differentiation of vascular smooth muscle cells (VSMCs) into osteoblast-like cells. This phenomenon can be enhanced by inflammation and oxidative stress. Zingerone is one of the active ingredients present in the ginger plant that has anti-inflammatory and antioxidant effects. Other functions include anti-obesity, antinausea effects. However, the functions of zingerone on vascular calcification has not yet been elucidated. This study investigated the effect of zingerone on vascular calcification and its molecular mechanism. Methods: Reverse transcription-polymerase chain reaction (PCR), real-time PCR and Western blot analysis was used to measure expression levels of osteogenic marker genes and to investigate whether calcification was regulated by the expression of AMP-activated protein kinase (AMPK) and tissue inhibitor of metalloproteinase 4 (TIMP4). Alizarin red S staining was used to measure calcium deposition. Studies were carried out in VSMCs. Results: Zingerone induced the expression of 2 markers of VSMCs differentiation (α-smooth muscle actin (α-SMA) and smooth muscle 22α (SM22α)) and decreased the expression of corebinding factor α-1 (CBFA1). Additionally, zingerone decreased inorganic phosphate (Pi)-induced expression of distal-less homeobox 5 and CBFA1. AMPK phosphorylation and TIMP4 expression were increased by zingerone. Importantly, zingerone protected VSMCs from calcification, and this protective effect was confirmed by increased TIMP4 via overexpression of AMPK, and inhibition of TIMP4 by Compound C. Zingerone upregulated AMPK/TIMP4 expression and recovered Pi-induced inhibition of TIMP4. Conclusions Taken together, our results show that zingerone inhibits Pi-induced vascular calcification by regulating the AMPK/TIMP4 signaling cascade in VSMCs. These results suggest that the natural product zingerone could be useful for treating vascular and metabolic diseases.

Intramuscular lipomas are benign adipose tumors of the soft tissues that may resemble liposarcomas because of their size, deep location, and occasionally infiltrative growth. An awareness of their existence is fundamental to treating them correctly, and their differential diagnosis from liposarcoma is essential. Magnetic resonance imaging (MRI) is a useful diagnostic tool to differentiate benign adipose tumors from liposarcoma. Marginal excision and biopsy are required for the definite diagnosis and the treatment of symptomatic intramuscular lipomas. To the best of the authors’ knowledge, this is the first report in South Korea regarding the treatment of an intramuscular giant lipoma of the ankle.

PURPOSE: This study was performed to investigate the cellular characteristics of the secondary pupillary membrane. METHODS: The secondary pupillary membrane was removed from the anterior lens surface during cataract extraction from 2 patients with cataract associated with uveitis. Specimen from one patient was stained with hematoxylin-eosin with flat preparation method. Specimen from the other patient cultured for 1 and 2 weeks was observed with transmission electron microscopy. RESULTS: The flat preparation showed the neovascular membrane with pigment-laden cells. The cultured cells consisted of the well preserved vascular components which had the vascular endothelial cells and pericyte and pigment-laden cells lined by basement membrane on first week of culture. The iris pigment epithelial cell which contained the pigment granules within cytoplasm and lined by basement membrane were observed on second week of culture. CONCLUSIONS: These results suggest that the secondary pupillary membrane consists of vascular membrane and pigment epithelial cell of iris which is a major component of secondary pupillary membrane and secrets extracellular matrix.
Basement Membrane ; Cataract ; Cataract Extraction ; Cells, Cultured ; Cytoplasm ; Endothelial Cells ; Epithelial Cells ; Extracellular Matrix ; Humans ; Iris ; Membranes* ; Microscopy, Electron, Transmission ; Pericytes ; Uveitis

STUDY DESIGN: Case report. OBJECTIVES: To report a rare case of a spinal extradural meningioma in a patient with longstanding nonspecific thoracic nocturnal pain. SUMMARY OF LITERATURE REVIEW: Meningioma is a frequent intradural extramedullary tumor that is associated with pain, sensory/motor deficits, and sphincter weakness. Spinal meningiomas most commonly occur in the thoracic spine, although they can also be found at other locations. MATERIALS AND METHODS: A 65-year-old woman first visited the cardiac and gastrointestinal departments of our institution due to chest pain 2 years previously. No explanation for the complaint could be found in the heart or other organs. On a computed tomography scan of the thorax, a spinal mass was found a few months before the diagnosis. On magnetic resonance imaging, an extramedullary and extradural mass was observed at T7/8. RESULTS: We performed surgery and found an extradural spinal meningioma upon the histological diagnosis. Postoperatively, the patient could adequately move both legs and feet and the nocturnal chest pain disappeared after surgery without any complications. CONCLUSIONS: Awareness of the rarity and nonspecific symptoms of extradural spinal meningiomas will be beneficial for their accurate diagnosis and proper treatment.
Aged ; Chest Pain ; Diagnosis ; Female ; Foot ; Heart ; Humans ; Leg ; Magnetic Resonance Imaging ; Meningioma ; Spine ; Thorax

Purpose: Septic arthritis of the knee is an orthopedic emergency that requires early diagnosis and surgical treatment. This study examined the effectiveness of drain insertion and irrigation in the treatment of septic arthritis of the knee under local anesthesia. Materials and Methods: A retrospective study was conducted on nine cases (eight patients) diagnosed with septic arthritis of the knee from September 2017 to February 2020 and treated with drain insertion and irrigation under local anesthesia. After penetrating through the superolateral portal to the superomedial portal and inserting the drain, daily irrigation of approximately 3 L of normal saline was done. The following were investigated: age, sex, underlying disease, cause, degree of osteoarthritis, time from diagnosis to surgery, duration of hospitalization, duration of normalization of C-reactive protein, and smear and culture. Results: The initial white blood cell count of joint fluid was 71,472±51,667/mm3 (32,400–203,904/mm3 ), and polymorphic leukocytes were 91.1%±2.6% (86%–95%). The average time from diagnosis to surgery was 8.3±1.3 hours (6–10 hours), and the irrigation period was 8.2±3.2 days (4–15 days). The average length of hospitalization was 20.8±8.7 days (9–37 days). There was no reoperation or recurrence. Smear and culture tests were not identified. Conclusion In the treatment of septic arthritis of the knee, the insertion of a drain tube and irrigation under local anesthesia is a relatively fast and simple method to reduce pain by repetitive draining of purulent joint fluid and can be used as an alternative treatment for patients with a risk of general or spinal anesthesia.

OBJECTIVES: To report a rare case of a spinal extradural meningioma in a patient with longstanding nonspecific thoracic nocturnal pain.SUMMARY OF LITERATURE REVIEW: Meningioma is a frequent intradural extramedullary tumor that is associated with pain, sensory/motor deficits, and sphincter weakness. Spinal meningiomas most commonly occur in the thoracic spine, although they can also be found at other locations. MATERIALS AND METHODS: A 65-year-old woman first visited the cardiac and gastrointestinal departments of our institution due to chest pain 2 years previously. No explanation for the complaint could be found in the heart or other organs. On a computed tomography scan of the thorax, a spinal mass was found a few months before the diagnosis. On magnetic resonance imaging, an extramedullary and extradural mass was observed at T7/8. RESULTS: We performed surgery and found an extradural spinal meningioma upon the histological diagnosis. Postoperatively, the patient could adequately move both legs and feet and the nocturnal chest pain disappeared after surgery without any complications. CONCLUSIONS Awareness of the rarity and nonspecific symptoms of extradural spinal meningiomas will be beneficial for their accurate diagnosis and proper treatment.

Background: Although the scallop sign is considered the most important risk factor for extensor tendon ruptures (ETRs) in patients with osteoarthritis of the distal radioulnar joint (DRUJ), previous reports provide a limited understanding of the changes at DRUJ, as risk factors were examined in plain radiographs of the wrist. The aim of this study was to assess the changes of DRUJ using axial images of computed tomography (CT) in patients with DRUJ osteoarthritis and associated ETRs and to evaluate the relationship between the changes of DRUJ and ETRs. Methods: Twelve patients with ETRs due to osteoarthritis of the DRUJ were enrolled. The changes of DRUJ were examined on axial images of CT and the following 8 parameters were measured: width of radius, anteroposterior (AP) length of radius, width of sigmoid notch (SN), AP length of SN, AP length of ulnar head, subluxation length of ulnar head, dorsal inclination of SN, and distance from Lister’s tubercle to SN. Radiological parameters of the DRUJ were measured in 60 control wrists without trauma or osteoarthritis, and the patient and control groups were statistically compared. Results: Statistically significant differences were observed between the patient and control groups in all the radiological parameters except for the AP length of SN and AP length of ulnar head. The width of radius, AP length of radius, width of SN, subluxation length of ulnar head, and dorsal inclination of SN were greater and the distance from Lister’s tubercle to SN was smaller in the patient group than in the control group. The width of SN, dorsal inclination of SN, and distance from Lister’s tubercle to SN were statistically significant risk factors among the 8 parameters. Conclusions ETRs due to osteoarthritis of the DRUJ was related to the changes of DRUJ, especially the changes around SN of the distal radius. In addition to the existing risk factors, a decreased distance from Lister’s tubercle to SN and increased dorsal inclination of SN were identified as new risk factors. Axial images of CT were effective to evaluate degenerative changes at the DRUJ.