No abstract available.
Humans ; Thrombocytosis

Intraosseous neurilemmoma(Schwannoma) is an extremely rare benign neoplasm. The site most commonly involved is the mandible. This occurrence is understandable because of the length of the inferior alveolar canal through the mandible. No other bone contains a canal that transmits a neurovascular bundle of such size and length. We report on a peripheral and central neurilemmoma along pathway of inferior alveolar nerve of the lower lip and mandible in a 28-year old man. A panoramic radiograph of the mandible showed a well-defined bilocular lesion with a thin uniform sclerotic margin located in the ramus and body of the mandible. The CT scan confirmed a well-defined lesion with thinning of the cortex of the body of the left side of the mandible. Histologically, the lesion was a cellular neoplasm with distinct palisading and numerous Verocay bodies. Complete excision was achieved by removing the tumor with the inferior alveolar nerve.
Adult ; Humans ; Jaw* ; Lip ; Mandible ; Mandibular Nerve ; Neurilemmoma* ; Tomography, X-Ray Computed

The therapeutic strategy of the left main disease is quite different frorn usual coronary artery disease. Therefore, the diagnostic evaluation should be done carefully. Eventhough coronary angiography has been considered as a gold standard for the diagnosis of left main disease, its diagnosis is not possible in all cases. In questionable situation, direct visualization of the left main coronary artery and Doppler measurements of coronary blood flow by transesophageal echocardiography may give some diagnostic aids. We report a case of suspected isolated ostial left main stenosis, which was helped diagnotically by perfoming transesophageal Doppler echocardiography.
Constriction, Pathologic* ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Diagnosis ; Echocardiography, Doppler* ; Echocardiography, Transesophageal

Actinomyces ; Actinomycosis ; Actinomycosis, Cervicofacial ; Anti-Bacterial Agents ; Bacteria ; Calculi ; Dental Caries ; Dental Plaque ; Humans ; Male ; Molar, Third ; Mucous Membrane ; Root Canal Therapy ; Tooth Fractures ; Young Adult

BACKGROUND: Epidural analgesia is the most effective way of providing pain relief during labor.However, its effect on the second stage of labor is controversial.This study examined the effect of epidural analgesia combined with caudal analgesia on the second stage of labor. METHODS: Forty three multiparous women were divided into three groups, non-epidural group, epidural group and epidural with caudal group.Epidural analgesia was maintained with patient-controlled epidural analgesia (0.09375% ropivacaine with 0.0002% fentanyl) in both the epidural and epidural with caudal groups.The epidural with caudal group was injected with 0.09375% ropivacaine into the caudal epidural space after inserting the lumbar epidural catheter.The assessments made throughout labor included the visual analogue score (VAS), patient's satisfaction, motor block and duration of the second stage. RESULTS: There were no significant differences in the patient's satisfaction, VAS and motor block between the epidural group and epidural with caudal group.There were no significant differences in the duration of the second stage between the non-epidural, epidural and epidural with caudal groups. No cesarean or instrumental deliveries were performed. CONCLUSIONS: Epidural with caudal analgesia offers no additional benefit during the second stage of labor.However, it carries no added risk on the maternal outcome.
Amides ; Analgesia ; Analgesia, Epidural ; Epidural Space ; Female ; Humans ; Labor Pain ; Pregnancy

BACKGROUND: Postoperative hypothermia and shivering is a frequent event in patients during cesarean section under spinal anesthesia. We assessed the effect of preoperative warming during cesarean delivery under spinal anesthesia for prevention of hypothermia and shivering. METHODS: Forty five patients undergoing elective cesarean section were randomly assigned to three groups. Group F received warmed intravenous fluid (40degrees C). Group A patients were actively warmed by forced air-warming. Group C was the control group. Forced air-warming and warmed fluid was maintained for the 15 min preceding spinal anesthesia. Core temperature (tympanic membrane) and the skin temperature of arm and thigh were measured and shivering was graded simultaneously. RESULTS: The core temperature at 45 min decreased less in Groups F and A than Group C (-0.5degrees C +/- 0.3degrees C vs -0.6degrees C +/- 0.4degrees C vs -0.9degrees C +/- 0.4degrees C, respectively; P = 0.004). The arm temperature at 15 min and 30 min exhibited a greater increase in Group A than Group F and Group C (P = 0.001 and P = 0.012, respectively). Leg temperature increased similarly among the three groups. The incidence of shivering was significantly less in Group A and Group F than Group C (20%, 13.3%, and 53.3%, respectively; P = 0.035). CONCLUSIONS: Preoperative forced air-warming and warmed fluid prevents hypothermia and shivering in patients undergoing elective cesarean delivery with spinal anesthesia.
Anesthesia, Spinal ; Arm ; Cesarean Section ; Female ; Humans ; Hypothermia ; Incidence ; Leg ; Pregnancy ; Shivering ; Skin Temperature ; Thigh

Cystic lesion of the jaw are frequently encountered clinically. Although they rarely lead to development of tumors, they can result in resorption of the jaw bone or asymmetry of the face may occur. The purpose of this study is to find the clinical and histopathological pattern of cysts and to help better understanding for the diagnosis and treatment of jaw cysts. The hospital chart, out-patient chart, panorama X-ray, histopathological report and operation report of 246 patients were reviewed who had been diagnosed as cyst. Sex distribution, age distribution, classification, anatomic distribution, clinical sign & symptoms, treatment, post-operation complications, recurrence rate were studied. Then significant difference between the diameter of cyst with bone graft and none-bone graft was calculated with SAS program. The results were as follows. 1. Among the total patient of 246 cases, male were 163 case(67.0%), and female were 83 case(37.0%), male predominated by the ratio of 1.98. 2. By age group, the 20's accounted for the largest proportion of the cases(27.2%) and the 30' accounted for the 2nd largest proportion of the case(19.5%). 3. Radicular cyst and dentigerous cyst were most common cysts, irrespective of 166 case(67.5%) and 62 case(25.2%). 4. Clinical sign & symptoms were swelling(167case), pain(85case), pus discharge(53case), teeth discoloration(28case), indicating that most complaints were related to inflammation and facial asymmetry. 4.9% of the total cases were discovered accidentally. 5. The primary site of cysts were maxillary anterior area(43.9%), the others were, in descending order, mandibular posterior area(25.6%), maxillary posterior area(14.6%). 6. Enucleation with endodontic treatment was a main treatment method(133 case, 54.1%) and 38 cases(15.4%) were enucleation with extraction, and 37 cases(15.0%) were only enucleation, and 21 cases(8.5%) were enucleation with bone graft. 7. The average diameter of cysts with bone graft was significally greater than with non-bone graft(p<0.05). 8. Post-operation complications occurred in 10 case(4.1%), all of this were due to secondary infection.
Age Distribution ; Classification ; Coinfection ; Dentigerous Cyst ; Diagnosis ; Facial Asymmetry ; Female ; Hospital Distribution Systems ; Humans ; Inflammation ; Jaw Cysts ; Jaw* ; Male ; Outpatients ; Radicular Cyst ; Recurrence ; Sex Distribution ; Suppuration ; Tooth ; Transplants

No abstract available.
Acute Kidney Injury* ; Hemoglobinuria, Paroxysmal*

BACKGROUND: Phenol has effects like surgical neurectomy, but may evoke pain after local infiltration in nerves. Transection of peripheral nerves may induce neuropathic pain through increased spontaneous discharge and other mechanisms. Proto-oncogene, c-fos, is an indicator of neuronal activity, and its expression in the spinal cord may be related to pain development, because inhibition of c-fos expression has corresponding effects like analgesia. We evaluated the effects of local infiltration of phenol and transection injury at the sciatic nerve on c-fos expression in the spinal cords of rats. METHODS: Sixteen male Sprague-Dawley rats were divided into 2 groups; transection of the sciatic nerve was performed for group 1; phenol was infiltrated into the sciatic nerve in group 2. Three hours, 1 week, 2 weeks, and 3 weeks after the experiment, the corresponding spinal cord was stained immunohistochemically for c-fos. RESULTS: c-fos was expressed from 3 hours to 2 weeks over the laminae of the dorsal horn in each group. Phenol increased the expression of c-fos initially, but decreased 1 week later. Transection injury did not increase it initially, but showed the peak expression at 1 week, and maintained it for 2 weeks. Therefore, it seems that phenol, rather than the transection injury, stimulates c-fos expression early, but decreases later. CONCLUSIONS: Phenol treatment, caused by chemical block due to protein denaturation and nonspecific inflammation, may induce less neuropathic pain than the transection of a nerve.
Analgesia ; Animals ; Horns ; Humans ; Inflammation ; Male ; Neuralgia ; Neurons ; Peripheral Nerves ; Phenol* ; Protein Denaturation ; Proto-Oncogenes ; Rats* ; Rats, Sprague-Dawley ; Sciatic Nerve* ; Spinal Cord*

BACKGROUND: The technique to evaluate left internal mammary artery (LIMA) is not well established during right transradial coronary angiography. MATERIALS AND METHODS: Following coronary angiography via right radial artery, LIMA angiography was performed using 5 French (F) Judkins JL-3.5 catheter in 110 patients (56+/-9 years [range: 46-81], 77 males). Eleven (10%) patients had grafted LIMAs. Subclavian and innominate arteries were moderately tortuous in 14 (13%) patients and aortic arches elongated and more vertically oriented in 16 (15%). The catheter, standing in the ascending aorta with its natural curve, was withdrawn slowly while being rotated clockwise to engage its tip in the proximal left subclavian artery. After the tip portion was adjusted, contrast material was injected while sphyngomanometer cuff inflation applied to the left upper arm. RESULTS: Nonselective LIMA angiography was successfully performed in 108 (98%) patients. The catheter was engaged in the subclavian artery in a mean of 11+/-8 seconds (range: 3-136) from the time when the catheter was withdrawn from the ascending aorta. The image quality of LIMA was satisfactory in 103 (95%) patients and not satisfactory in 5 (5%) in whom the catheter tip was not placed near the origin of LIMA. In ten (91%) of the 11 patients with grafted LIMA, the anastomosis site and distal coronary vessels were well visualized. There were no complications, including arterial dissection and thromboembolism. CONCLUSION: Nonselective technique using 5 F Judkins JL-3.5 catheter is easy, fast, safe and reliable for evaluating LIMA during right transradial coronary angiography.
Angiography ; Aorta ; Aorta, Thoracic ; Arm ; Brachiocephalic Trunk ; Catheters ; Coronary Angiography* ; Coronary Vessels ; Humans ; Inflation, Economic ; Mammary Arteries* ; Radial Artery ; Subclavian Artery ; Thromboembolism ; Transplants