The diagnosis of dilated cardiomyopathy associated with pheochromocytoma was made in a 24 year old male on the basis of symptoms and signs, measurements of metabolites of catecholamine,echocardiography and radionuclide ventriculography were preformed and demonstrated. The presence of a tumor on both adrenal glands without definite distant metastasis was demonstrated by abdominal ultrasonography, CT scanning and 131I-MIBC scintigraphy. Surgical removal was performed after proper preoperative preparation with a-adrenergic blocker. During the surgery, neither significant arrhythmia nor severe change of blood pressure was observed. After surgery, cardiac function of the patient improved slowly and progressively.
Adrenal Glands ; Arrhythmias, Cardiac ; Blood Pressure ; Cardiomyopathy, Dilated* ; Diagnosis ; Humans ; Male ; Neoplasm Metastasis ; Pheochromocytoma* ; Radionuclide Imaging ; Radionuclide Ventriculography ; Thoracic Surgery ; Tomography, X-Ray Computed ; Ultrasonography ; Young Adult

No abstract available.
Stroke*

Frictional force between the orthodontic bracket and arch wire during sliding tooth movement is related to many factors, such as the size, shape and material of both the bracket and wire, ligation method and the angle formed between the bracket and wire. There have been clear conclusions drawn in regard to most of these factors, but as to the effect of bracket width on frictional force there are only conflicting studies. This study was designed to investigate the effect of bracket width on the amount of frictional forces generated during clinically simulated tooth movement. Three different widths of brackets (0.018x0.025"standard), narrow (2.40mm), medium (3.00mm) and wide (4.25mm) were used in tandem with 0.016x0.022" stainless steel wire. Three bracket-arch wire combinations were drawn on for 4 minutes on a testing apparatus with a head speed of 0.5mm/min and tested 7 times each. To reproduce biological conditions, dentoalveolar models were designed with indirect technique using a material with similar elastic properties as periodontal ligament (PDL). In addition, to minimize the effect of ligation force, elastomer was used with added resin, which was attached to the bracket to make up for the discrepancies of bracket width. The results were as follows: 1. Maximum frictional force for each bracket-arch wire combination was: Narrow (2.40mm) : 68.09+/-4.69 gmf Medium (3.00mm) : 72.75+/-4.98 gmf Wide (4.25mm) : 72.59+/-4.54 gmf 2. Frictional force was increased with more displacement of wire through the bracket slot. 3. The ANOVA post-hoc test showed that the bracket width had no significant effect on frictional force when tested under clinically simulated conditions (P>0.05)
Elastomers ; Friction* ; Glia Maturation Factor ; Head ; Ligation ; Orthodontic Brackets ; Periodontal Ligament ; Stainless Steel ; Tooth Movement* ; Tooth*

Background: The purpose of the present study was to assess the daily protein uptake and its relationship with sarcopenia, as defined by the Asian Working Group for Sarcopenia (AWGS), among elderly patients with hip fractures. Methods: Forty-seven elderly patients with hip fractures were enrolled in this retrospective observational study. The main outcome measures included protein uptake, muscle mass, and grip strength for sarcopenia in elderly patients. Sarcopenia was diagnosed according to AWGS. Wholebody densitometry was used to measure skeletal muscle mass, and muscle strength was evaluated using handgrip testing. Results: Of 47 patients with hip fractures (12 men and 35 women), 37 (79%) patients exhibited insufficient protein intake (range, 0.01-0.588 g/kg/day), and 10 (21%) patients exhibited excessive protein intake (range, 1.215-2.121 g/kg/day). The mean daily protein intake was 56.5 g (range, 7.2–136.0 g). Prevalence of low muscle strength (handgrip strength <18 kg in women and <26 kg in men) was detected in 13 (37%) women and 8 (67%) men (P=0.076). Sarcopenia (lower muscle mass and lower muscle strength) was detected in 9 (26%) women and 6 (50%) men (P=0.119). Although lower protein intake was marginally associated with sarcopenia (P=0.189), it was significantly associated with lower grip strength (P=0.042). Conclusions The present study demonstrated that insufficient protein intake in elderly patients with hip fractures was common, and lower protein intake was significantly associated with lower muscle strength.

Polyatreritis nodosa is a rare autoimmune disease (the immune system attacking its own body) characterized by spontaneous inflammation of the arteries (arteritis) of the body. Because arteries are involved, the disease can affect any organ of the body. The most common areas of involvement include the muscles, joints, intestines (bowels), nerves, kidneys, and skin. Gastrointestinal involvement is reported in about 50% of the cases, but bleeding complications are rare and result in a poor prognosis. Polyarteritis nodosa is most common in middle-age persons. Recently, we experienced polyarteritis nodosa which presented as small bowel bleeding and which was diagnosed by angiography, a small-bowel series, and patholgic examination of the surgically removed ileum specimen. We report this case with a brief review of the literature.
Angiography ; Arteries ; Autoimmune Diseases ; Hemorrhage ; Humans ; Ileum ; Immune System ; Inflammation ; Intestines ; Joints ; Kidney ; Muscles ; Polyarteritis Nodosa* ; Prognosis ; Skin

We report the treatment experience of a patient who developed pain in the right anterior thigh and buttock 3 months later after lumbar disc surgery. He was treated as failed back surgery syndrome and had no symptom improvement. On physical examination, groin pain was elicited by Patrick's test and internal rotation of the hip. Plain radiographs of the pelvis showed calcification or osteophytes near the superior lip of the acetabulum. On magnetic resonance imaging, the lesion was identified as osteophytes and joint effusion was also noted. Under C-arm guidance, we injected corticosteroids and local anesthetics, and the patient obtained dramatic pain relief and no recurrence of symptoms.
Acetabulum ; Adrenal Cortex Hormones ; Anesthetics, Local ; Buttocks ; Failed Back Surgery Syndrome ; Groin ; Hip ; Humans ; Joints ; Lip ; Magnetic Resonance Imaging ; Osteoarthritis ; Osteophyte ; Pelvis ; Physical Examination ; Recurrence ; Thigh

Atypical medullary carcinomas and carcinosarcoma have unique histopathological features. Here we present a case with a breast malignancy that had pathological characteristics of both. A 54-year old patient with a malignant breast mass received 6 cycles of adriamycin-based chemotherapy, followed by 3 cycles of paclitaxel monotherapy, and had a poor clinical response to treatment. A modified radical mastectomy was performed. The pathological diagnosis was complicated by an inability to distinguish between atypical medullary carcinoma and carcinosarcoma. The findings included a tumor that was well-circumscribed, high grade and a syncytial growth pattern as well as biphasic sarcomatous and carcinomatous characteristics. In conclusion, atypical medullary carcinoma and carcinosarcoma of the breast have entirely different prognoses and should be managed differently. Both should be treated by surgical resection, and additional therapy should be considered based on the cancer with the poorer prognosis.
Breast Neoplasms* ; Breast* ; Carcinoma, Medullary* ; Carcinosarcoma* ; Diagnosis ; Diagnosis, Differential* ; Drug Therapy* ; Humans ; Mastectomy, Modified Radical ; Middle Aged ; Paclitaxel ; Prognosis

PURPOSE: To evaluate the efficacy of a modified small bowel follow-through (SBFT) and to optimize this technique. MATERIALS AND METHODS: Ninety-nine subjects without small bowel pathology underwent modified SBFT using oral administration of methylcellulose after taking 100ml of 120% or 100, 150, or 200ml of 70% barium. Thirty-three and 39 normal subjects undergoing enteroclysis or conventional SBFT, respectively, were also evaluated for comparison of image qualities and transit time. RESULTS: Enteroclysis was the most successful ofthree types of small bowel examination for obtaining the best quality of bowel transradiency and distension. Modified SBFT was, however much superior to the conventional series for obtaining good bowel transradiency and rapid transity time (mean, 37-49 minutes). The use of 150ml of 70% barium was better than the other three modified techniques in achieving good bowel transradiency, rapid transit time, and less flocculation. CONCLUSION: Our modified SBFT is a simple and safe method for easily improving bowel transradiency and transit time.
Administration, Oral ; Barium ; Flocculation ; Methylcellulose* ; Pathology

Cirsium japonicum belongs to the Asteraceae or Compositae family and is a medicinal plant in Asia that has a variety of effects, including tumour inhibition, improved immunity with flavones, and antidiabetic and hepatoprotective effects. Silymarin is synthesized by 4-coumaroyl-CoA via both the flavonoid and phenylpropanoid pathways to produce the immediate precursors taxifolin and coniferyl alcohol. Then, the oxidative radicalization of taxifolin and coniferyl alcohol produces silymarin. We identified the expression of genes related to the synthesis of silymarin in C. japonicum in three different tissues, namely, flowers, leaves, and roots, through RNA sequencing. We obtained 51,133 unigenes from transcriptome sequencing by de novo assembly using Trinity v2.1.1, TransDecoder v2.0.1, and CD-HIT v4.6 software. The differentially expressed gene analysis revealed that the expression of genes related to the flavonoid pathway was higher in the flowers, whereas the phenylpropanoid pathway was more highly expressed in the roots. In this study, we established a global transcriptome dataset for C. japonicum. The data shall not only be useful to focus more deeply on the genes related to product medicinal metabolite including flavolignan but also to study the functional genomics for genetic engineering of C. japonicum.
Asia ; Asteraceae ; Cirsium ; Dataset ; Estrone ; Flavones ; Flowers ; Gene Expression Profiling ; Genetic Engineering ; Genomics ; Humans ; Plants, Medicinal ; Sequence Analysis, RNA ; Silymarin ; Transcriptome