PURPOSE: Postoperative serial serum thyroglobulin (Tg) measurements on levothyroxine (L-T4) therapy in patients with differentiated thyroid carcinoma (DTC) is known to be useful in monitoring tumor progression or regression. The objective of this study was to evaluate the significance of serum Tg levels on L-T4 therapy after surgery. METHODS: To determine the basal serum Tg levels on L-T4 therapy after surgery in patients with DTC, Tg levels during the initial 2 year-period after surgery were analyzed retrospectively in 37 patients who had undergone a total thyroidectomy for papillary thyroid carcinoma with (Group 2) or without (Group 1) palpable cervical lymph node metastasis. The Tg levels had been measured 1 to 4 times for each patient with total of 53 and 35 times in Group 1 and Group 2 respectively. RESULTS: The basal Tg levels in Group 1 were all less than 4 ng/mL with 79.3% less than 2 ng/mL, and those in Group 2 were all less than 9 ng/mL with 71.4% less than 2 ng/mL. CONCLUSION: The data suggests that the postoperative serum Tg level of 10 ng/mL can be a useful reference value in long-term follow-up after total thyroidectomy for patients with DTC.
Follow-Up Studies ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Reference Values ; Retrospective Studies ; Thyroglobulin* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Thyroxine

The purpose of this study was to examine the effect of smoking on the clinical, radiographic outcome of surgical peridontal therapy. The outcome of periodontal surgery was evaluated in 51 systemically healthy subjects that had received maintenance care. The study subjects consisted of 26 smokers and 25 non-smokers. The average age of smoking patients was 51 years old and non-smoking patients was 48 years old. Changes of probing pocket depth(PPD) and radiographic bone height, and number of missing teeth compared between smokers and non-smokers during maintenance period after surgical therapy. The clinical parameters were less favorable in the smoking group compared with non-smoking group. The number and percentage of missing teeth were greater in smokers(21.6%) than non- smokers(12.4%), especially in molars. The mean presurgery PPD was similar in smokers and non-smokers, molars and premolars, but significantly decreased at least 2 years after surgery. The mean PPD reduction was significantly greater in nonsmokers than smokers. Both in the smoking and non-smoking group, the mean PPD reduction was significantly greater in premolars than molars. The radiographical evaluation was also less favorable in the smoking group than non-smoking group. The radiographic evaluation of bone height in smokers showed bone loss. On the contrary, bone height of nonsmokers showed bone gain during the period of maintenance. But there was no significant difference between molars and premolars. The clinical and radiographic outcomes of the smoking group was less favorable than those of the nonsmoking group. Therefore, smoking seems to influence on the clinical and radiographic outcomes of surgical periodontal therapy.

In order to examine the neurotoxic mechanism of oxygen radicals on cultured bovine oligodendrocytes, cytoxic effect of oxygen radicals was examined when cultures were treated with various concentrations of xanthine oxidase (XO) and hypoxanthine (HX) in culture medium. In addition, the neuroprotective effect of iron-chelators against the neurotoxicity induced by oxygen radicals was evaluated by MTT assay. Cell viability was remarkably decreased in a time-dependent manner after exposure of cultured bovine oligodendrocytes to 20mU/ml XO and 0.1mM HX for 4 hours. In the neuroprotective effect of iron-chelators on oxidant-induced neurotoxicity, tetrakis (2-pyridylmethyl)ethylenediamine (TPEN) blocked the neurotoxicity induced by oxygen radicals, while DFX was not effective in blocking oxidant-induced neurotoxicity in these cultures. These results suggest that oxygen radicals are toxic in cultured bovine oligodendrocytes, and also selective iron-chelators such as TPEN are effective in blocking the neurotoxicity induced by oxygen radicals.
Allopurinol* ; Cell Survival ; Hypoxanthine ; Neuroprotective Agents ; Oligodendroglia ; Reactive Oxygen Species ; Xanthine Oxidase

PURPOSE: Appendicitis represents one of the most common surgical disorders. Typically, the diagnosis can be made from well established clinical criteria, with an acceptable negative appendectomy rate from 7~25%. However, when surgical intervention is performed in the patients suspected of having appendicitis but with equivocal clinical findings, the negative appendectomy rate approaches 50%. Routine contrast-enhanced computed tomography (CECT) has described as an accurate diagnostic imaging modality in patients with suspected appendicitis. We evaluated the role of intravenous CECT (iCECT) in patients suspected of having appendicitis but with equivocal clinical exams. METHODS: Eighty seven consecutive patients who were thought to have appendicitis but with equivocal clinical findings and/or physical exams were imaged by iCECT over 18 months period. Intravenous contrast-enhanced, spiral abdominal and pelvic images were obtained using 7.5 mm cuts. iCECT images were interpreted by a board-certified radiologist. Main outcome measures included iCECT sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accurary and negative appendectomy rate in the diagnosis of acute appendicitis, and determining the impact iCECT on the clinical management of the patient population. RESULTS: A group of 87 patients consisting of 36 males (41.4 %) and 51 females (58.6%) with median age of 32 years (range 12 to 75 years) were imaged with iCECT to evaluate suspected appendicitis. Of the 87 iCECTs performed, 8 false-positive and 2 false-negative readings were identified, resulting in a sensitivity of 93.5%, specificity of 85.7%, PPV of 78.4%, NPV of 96%, and an overall accuracy of 88.5%. With regard to clinical management, 100% (31/31) of patients with appendicitis, and 4% (2/50) of patients without appendicitis underwent appendectomy. Therefore, the overall negative appendectomy rate was 6.1% (2/33). CONCLUSION: iCECT is a useful diagnostic imaging modality for patients suspected of having acute appendicitis but with equivocal clinical findings and/or physical exams. iCECT is particularly useful in excluding the diagnosis of appendicitis in those without disease.
Appendectomy ; Appendicitis* ; Diagnosis* ; Diagnostic Imaging ; Female ; Humans ; Male ; Outcome Assessment (Health Care) ; Reading ; Sensitivity and Specificity

We report a rare case of a patient with Moyamoya syndrome who presented with intracerebral hemorrhage resulting from rupture of a middle meningeal artery pseudoaneurysm. This 38-year-old woman was unconscious and hemiplegic when she was admitted to our hospital. The patient had mental retardation as a result of tuberculous meningitis infection at the age of one year. On radiologic examination, she had intracerebral hemorrhage in the right temporo-parietal lobe and an aneurysm in the middle meningeal artery with right internal carotid artery occlusion. The patient underwent surgical treatment for the hemorrhage and aneurysm. The radiologic data, intraoperative findings, and pathology were consistent with a diagnosis of pseudoaneurysm. In the current report, we describe a rare case of a patient with a history of tuberculous meningitis who developed Moyamoya syndrome and pseudoaneurysm, which resulted in a ruptured middle meningeal artery pseudoaneurysm and brain hemorrhage.
Adult ; Aneurysm ; Aneurysm, False* ; Carotid Artery, Internal ; Cerebral Hemorrhage ; Diagnosis ; Female ; Hemorrhage ; Humans ; Intellectual Disability ; Intracranial Hemorrhages ; Meningeal Arteries* ; Moyamoya Disease* ; Pathology ; Rupture* ; Tuberculosis, Meningeal*

Ectopic pregnancy and appendicitis in pregnancy are two most common causes of acute abdomen in young women and differenciation of these diseases is very difficult. Heterotopic pregnancy is a rare event, occuring less than 1:30,000 pregnancies in natural conception cycles. However, with assisted reproduction techniques, this incidence has increased. We experienced a case of spontaneous heterotopic pregnancy after missed abortion and acute appendicitis treated by laparoscopy. So we report this case with brief review of literature.
Abdomen, Acute ; Abortion, Missed ; Appendicitis ; Female ; Fertilization ; Humans ; Incidence ; Laparoscopy ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic ; Reproductive Techniques

Cesarean scar pregnancy is one of the rarest forms of ectopic pregnancy. Little is known about its incidence and natural history. With increasing incidence of caesarean section worldwide, more and more cases are diagnosed and reported. Transvaginal ultrasound and colour flow Doppler provides a high diagnostic accuracy with very few false positives. A delay in diagnosis and/or treatment can lead to uterine rupture, major haemorrhage, hysterectomy and serious maternal morbidity. Surgical management can be safe and effective and medical treatment can be selected as appropriate selection criteria. Patients with history of a pregnancy in a cesarean delivery scar should be advised of the risk for future uterine rupture and placenta accreta. We experienced a case of ectopic pregnancy with treatment of surgical excision and report with a brief review of literatures.
Cesarean Section ; Cicatrix* ; Diagnosis ; Female ; Humans ; Hysterectomy ; Incidence ; Natural History ; Patient Selection ; Placenta Accreta ; Pregnancy ; Pregnancy, Ectopic* ; Ultrasonography ; Uterine Rupture

The unique clinical syndrome of the uterus didelphys, a unilateral partially or completely obstructed vagina, and ipsilateral renal agenesis is quite rare, and observed on the right side in greater frequency than on the left. The case of fifteen year old girl with uterus didelphys, unilateral partially obstructed vagina and acute renal failure associated with ureteral stone in unilateral kidney is described. Extracorporealshock wave lithotripsy (ESWL) and evacuation of the hematocolpos and excision of the vaginal septum were done. Aware of this relatively rare condition is mainstay of prompt diagnosis which will prevent permanent renal failure and unnecessary and destructive surgery.
Acute Kidney Injury ; Congenital Abnormalities ; Female ; Hematocolpos ; Kidney ; Kidney Diseases ; Lithotripsy ; Renal Insufficiency ; Ureter ; Uterus ; Vagina

Premature ovarian failure (POF) is defined as the complete cessation of menses less than 40 years of age. The criteria are more than four months of amenorrhea, with serum follicle stimulating hormone value of >40 mIU/mL and the frequency of POF is about 1% of all women. Although the etiologies of POF remain unknown, suggested factors are genetic, autoimmune, chemotherapy, radiotherapy and environmental toxins. The cytogenetic abnormalities predominantly concern the X chromosome, including Turner syndrome, Fragile X syndrome and deletion, translocation, or duplication of X chromosome. We report a very rare case of premature ovarian failure with the following karyotype: 46,X,dup(Xq), and report it with a brief review of literature.
Amenorrhea ; Chromosome Aberrations ; Female ; Follicle Stimulating Hormone ; Fragile X Syndrome ; Humans ; Primary Ovarian Insufficiency ; Turner Syndrome ; X Chromosome

While epidural abscesses are rare in hemodialysis patients, they can cause severe neurological complications that can be fatal because only nonspecific symptoms appear in the early stages of the infection. Their incidence increased recently due to intravenous drug abuse, invasive spinal surgery, percutaneous vertebral procedures, and the development of diagnostic modalities. The increased number of cases is related to the use of dialysis catheters in hemodialysis patients. If a patient has fever and back pain, doctors should eliminate the possibility of other common diseases and consider spinal epidural infection. Early diagnosis and proper treatment are important to prevent neurological complications. In this paper, the symptoms, blood work, magnetic resonanceimaging (MRI) findings, and clinical course of two hemodialysis patients who developed spinal epidural abscesses are described.
Back Pain ; Catheters ; Dialysis ; Early Diagnosis ; Epidural Abscess ; Fever ; Humans ; Incidence ; Low Back Pain ; Magnetics ; Magnets ; Renal Dialysis ; Substance Abuse, Intravenous