BACKGROUND AND OBJECTIVES: Perfluorocarbon exposed sonicated dextrose albumin (PESDA) microbubbles has been suggested to facilitate thrombus disruption under the transcutaneous ultrasound (US). Thus, we investigated whether such a noninvasive approach could augment thrombolytic effect of fibrinolytic agent in an experimental thrombotic model. MATERIALS AND METHODS: Thrombus formation was induced with electrical injury in the rabbit iliofemoral arteries (n=20): Thrombus occlusion was documented by angiography in all arteries. In the control group, only tissue plasminogen activator (t-PA, 3 mg/kg) was administered intrav-enously in five rabbits. In the Group 1 (n=9), injured arteries were exposed to transcutaneous US (20 kHz, 30 W/cm2, continuous mode) with t-PA (3 mg/kg). In the Group 2 (n=6), the same treatment was given while administering PESDA continuously (10 ml/min, intravenous). Angiographic results were evaluated at 10 minute interval for 1 hour respectively. RESULTS: In the control group, two of five iliofemoral arteries (40.0%) were recanalized and one of nine iliofemoral arteries (11.1%) was recanalized in Group 1. In contrast, four of six iliofemoral arteries (66.7%) were recanalized angiographically in Group 2 (p=0.392 vs. control group: p=0.047 vs. Group 1). However, late reocclusion occurred in all iliofemoral arteries of Group 2. CONCLUSION: Although PESDA with transcutaneous US significantly enhanced initial angiographic patency rate of t-PA, it was associated with high rate of reocclusion. Further studies will be necessary for clinical application of this noninvasive method in acute arterial occlusion.
Angiography ; Arteries ; Glucose* ; Microbubbles ; Rabbits ; Thrombolytic Therapy* ; Thrombosis ; Tissue Plasminogen Activator ; Ultrasonography*

Little is known about the natural history and management of choroidal neovascularization (CNV) which developed as a complication of laser photocoagulation for central serous chorioretinopathy (CSC). We experienced two patients with CNV which developed after laser treatment for CSC. Submacular membranectomy was performed on both cases after the confirmation of subretinal CNV with optical coherence tomography. One patient received photodynamic therapy for recurrent CNV. The vision of both patients has been improved over 6 months of follow up. These cases suggest that active intervention, including submacular surgery, improves the visual prognosis of this condition.
Adult ; Choroid Diseases/*surgery ; Choroidal Neovascularization/etiology/*surgery ; Diagnostic Techniques, Ophthalmological ; Female ; Human ; Interferometry ; Laser Coagulation/*adverse effects ; Light ; Male ; Retinal Diseases/*surgery ; Tomography ; Treatment Outcome ; Visual Acuity

No abstract available.
Scoliosis* ; Syringomyelia*

Diencephalic syndrome of infancy which is characterized by progressive and profound emaciation often with normal or accelerated skeletal growth, hyperkinesias, hypotension, and hypoglycemia. The profound emaciation so characteristic this syndrome has yet to be explained. The diencephalic syndrome is caused by low grade astrocytoma, ependymoma in the third ventricle including the hypothalamus. Authers report a case of diencephalic syndrome which was confirmed in this patient with ependymoma in the region of anterior hypothalamus by transcallosal approach.
Astrocytoma ; Emaciation ; Ependymoma ; Humans ; Hyperkinesis ; Hypoglycemia ; Hypotension ; Hypothalamus ; Hypothalamus, Anterior ; Third Ventricle

Necrotizing sarcoid granulomatosis (NSG), now referred to as “sarcoidosis with NSG pattern,” is an uncommon variant of sarcoidosis. NSG is characterized by a trio of features: sarcoid granulomas, vasculitis, and extensive areas of necrosis. Symptoms can include cough, fever, chest pain, and dyspnea, typically presenting as either solitary or multiple lung nodules or masses. In this report, we describe a case of NSG accompanied by a persistent low-grade fever. Unlike the dominant presentation of NSG with single or multiple nodules, our case demonstrated diffuse micronodules with combined perilymphatic and random distribution on CT.Histological examination revealed widespread necrotizing granulomas surrounded by anthracotic pigmentation, alongside necrosis and vasculitis, diverging from the classic presentation of sarcoidosis. The diagnosis of NSG was established through a multidisciplinary discussion. The patient was administered oral prednisolone that led to noticeable clinical and radiological improvement within three months.

Necrotizing sarcoid granulomatosis (NSG), now referred to as “sarcoidosis with NSG pattern,” is an uncommon variant of sarcoidosis. NSG is characterized by a trio of features: sarcoid granulomas, vasculitis, and extensive areas of necrosis. Symptoms can include cough, fever, chest pain, and dyspnea, typically presenting as either solitary or multiple lung nodules or masses. In this report, we describe a case of NSG accompanied by a persistent low-grade fever. Unlike the dominant presentation of NSG with single or multiple nodules, our case demonstrated diffuse micronodules with combined perilymphatic and random distribution on CT.Histological examination revealed widespread necrotizing granulomas surrounded by anthracotic pigmentation, alongside necrosis and vasculitis, diverging from the classic presentation of sarcoidosis. The diagnosis of NSG was established through a multidisciplinary discussion. The patient was administered oral prednisolone that led to noticeable clinical and radiological improvement within three months.

Necrotizing sarcoid granulomatosis (NSG), now referred to as “sarcoidosis with NSG pattern,” is an uncommon variant of sarcoidosis. NSG is characterized by a trio of features: sarcoid granulomas, vasculitis, and extensive areas of necrosis. Symptoms can include cough, fever, chest pain, and dyspnea, typically presenting as either solitary or multiple lung nodules or masses. In this report, we describe a case of NSG accompanied by a persistent low-grade fever. Unlike the dominant presentation of NSG with single or multiple nodules, our case demonstrated diffuse micronodules with combined perilymphatic and random distribution on CT.Histological examination revealed widespread necrotizing granulomas surrounded by anthracotic pigmentation, alongside necrosis and vasculitis, diverging from the classic presentation of sarcoidosis. The diagnosis of NSG was established through a multidisciplinary discussion. The patient was administered oral prednisolone that led to noticeable clinical and radiological improvement within three months.

A majority of patients who sustain injuries to the peripheral sensory nerves of the face and jaws experience a slow but gradual return of sensation that is functional and tolerable, if not the same as before the injuries. However, long-term effects of such injuries are aggravating for many patients, and a few patients experience significant suffering. In some of these patients, posttraumatic symptoms become pathological and are painful. The predominant painful components are (1) numbing anesthesia dolorosa pain, (2) triggered neuralgiaform pain, (3) burning and aching causalgiaform pain, and (4) phantom pain. This is a case report of conservative management of traumatic neuralgia and neuritis as part of posttraumatic pain syndromes in geriatric patients who have undergone the teeth extraction and alveoloplasty.
Alveoloplasty* ; Anesthesia ; Burns ; Humans ; Jaw ; Neuralgia* ; Neuritis ; Phantom Limb ; Sensation ; Tooth Extraction ; Tooth*

No abstract available.
Bicuspid*

We analyzed Doppler echocardiographic data in 120 subjects with normal sinus rhythm; normals (NL, n=60, ages 54.1 15.1) and essential hypertensive patients (HT, n=60, ages 57.3 10.2). The IMP was calculated as follows: IMP=(ICT+IRT)/ET, ICT; isovolumic contraction time, IRT; isovolumic relaxation time, ET; ejection time. There were no significant differences in ejection fraction (EF), stroke volume index (SVI), cardiac index (CI), ET and ICT between NL and HT. There were, however, significant differences in deceleration time (DT), E/A ratio, IRT and the IMP between the two groups (199.5 45.6 msec vs 222.3 54.3 msec, p<0.01; 1.4 0.7 vs 0.9 0.2, p<0.01; 113.6 30.2 msec vs 134.2 29.6 msec, p<0.01; 0.6 0.1 vs 0.8 0.3, p<0.05). In HT, there were no differences in EF, SVI, CI, E/A ratio and DT between the NYHA I (Gp I, n=36) and II (Gp II, n=24) groups. However, ET of Gp II was significantly shorter than that of Gp I (259.4 43.5 msec vs 297.8 33.6 msec, p<0.01). ICT, IRT and the IMP were significantly increased in Gp II, compared to those of Gp I (64.4 23.9 msec vs 89.4 46.2 msec, p<0.05; 120.3 21.0 msec vs 155.2 28.5 msec, p<0.001; 0.6 0.2 vs 1.0 0.4, p<0.001). There were no differences in heart rate and mean blood pressure between Gp I and Gp II (70.9 11.4/min vs 66.3 11.4/min, p>0.05; 138.4 21.2 mmHg vs 131.3 19.9 mmHg, p>0.05). These data suggest that the IMP may be a useful parameter and an early indicator of left ventricular dysfunction in essential hypertensive patients with normal systolic function.
Adult ; Aged ; Diastole/physiology ; Echocardiography, Doppler* ; Female ; Human ; Hypertension/ultrasonography* ; Hypertension/physiopathology* ; Male ; Middle Age ; Systole/physiology ; Ventricular Function, Left/physiology*