Therapeutic plasma exchange is used in almost every condition in which there is a plasma factor thought possibly to the etiology or pathogenesis of a disease or one of its manifestations. In order to evaluate plasma exchange using fresh frozen plasma as replacement solution, eighty four therapeutic plasma exchanges were carried out in eighteen patients. In standardized procedures, 1.5 times the calculated plasma volume was replaced with a Hartman's solution and fresh frozen plasma. Anticoagulation was achieved using a whole venous blood to 2.5% trisodium citrate in the ratio of 10 to 1. Total calcium, phosphorus, glucose, urea nitrogen, creatinine, bilirubin, alkaline phosphatase, amylase, creatine kinase, IgG, C3, total white and red blood cell count, hemoglobin, and differential count were not significantly affected by the procedure. In contrast, serum cholesterol, total protein, albumin, aspartate aminotransferase, alanine aminotransferase, ionized calcium, IgM, C4 and platelet were significantly decreased by the plasma exchange. All these measurements had returned to the first pre-exchange level within 24 hours, while the C4 and platelet count took between 24 and 72 hours, and the IgM level, between 72 hours and 1 week. These data indicated that in an isovolemic plasma exchange there was a transient but rapidly reversible effect on all the components studied, with C4 and platelet count, returning more slowly to pre-exchange level than the others, and IgM levels responding the slowest. In summary, plasma exchanges using fresh frozen plasma as replacement solution were assumed to be not significantly affected the function of various organs.
Alanine Transaminase ; Alkaline Phosphatase ; Amylases ; Aspartate Aminotransferases ; Bilirubin ; Blood Platelets ; Calcium ; Cholesterol ; Citric Acid ; Creatine Kinase ; Creatinine ; Erythrocyte Count ; Glucose ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Nitrogen ; Phosphorus ; Plasma Exchange* ; Plasma Volume ; Plasma* ; Platelet Count ; Urea

No abstract available.
Chromosome Aberrations*

Ganglion cyst of the spinal facet joint is rare. It is believed that ganglion cysts on the dorsal aspect of the facet joints are asymptomatic and therefore are not clinically appreciated. But we have experienced a patient who had severe low-back and buttock pain and diagnosed as ganglion cyst located on the dorsal aspect of the right side facet joint between the fourth and fifth lumbar vertebrae. The treatment was surgical excision of the cyst and resulted in a satisfactory recovery. The differential diagnosis involving herniated lumbar intervertebral disc should not exclude ganglion cyst of the dorsal aspect of the lumbar facet joint.
Buttocks ; Diagnosis, Differential ; Ganglion Cysts* ; Humans ; Intervertebral Disc ; Lumbar Vertebrae ; Zygapophyseal Joint*

Calcium channel blockers (CCBs) are very popular drugs to lower blood pressure (BP) without significant side effects. A 72-year-old man admitted for uncontrolled hypertension. He had history of hypertension, atrial fibrillation with slow ventricular response, angina, abdominal aortic aneurysm, and stage 3 chronic kidney disease. He had taken several anti-hypertensives, such as amlodipine 5 mg, perindopril 8 mg, and indepamide 1.5 mg. To control BP, nifedipine 120 mg was added. Then pulmonary edema and pleural effusion was developed. Echocardiography showed preserved left ventricular ejection fraction and mild mitral regurgitation. Fluid restriction and high dose furosemide did not cease pleural fluid accumulation. Thus a total of 4 times of thoracentesis were done and all fluid analyses revealed transudate. We thought that pleural effusion and pulmonary edema was induced by CCBs and discontinued the drugs. He recovered quickly and finally discharged in a stable condition.
Aged ; Amlodipine ; Antihypertensive Agents ; Aortic Aneurysm, Abdominal ; Atrial Fibrillation ; Blood Pressure ; Calcium Channel Blockers* ; Calcium Channels* ; Calcium* ; Echocardiography ; Exudates and Transudates ; Furosemide ; Humans ; Hypertension* ; Mitral Valve Insufficiency ; Nifedipine ; Perindopril ; Pleural Effusion* ; Pulmonary Edema* ; Renal Insufficiency, Chronic ; Stroke Volume

He died after 2 months from diagnosis due to massive bleeding in esophageal lesion with complication. He died after 2 months from diagnosis due to massive bleeding in esophageal lesion with complication. We report one case of plasma cell leukemia associated with esophageal cancer. A 71-year-old man was admitted due to dysphagia and diagnosed as undifferentiated squamous cell cancer based on esophagogram and biopsy. In peripheral blood smear, large parcent of plasma cell like cells are found, so bone marrow examination was done and 52.5% of plasma cells are found with unusual morphology such as convoluted, multilobulated nuclei. Immunochemical stain and immunophenotypic features of these cells were suggestive of plasma cell origin with positivity for methylgreen pyronin positivity and CD38, CD56 positivity. Serum rotein electrophoresis and immunoelectrophoresis showed monoclonal gammopathy of Ig G ,k type. This patient had no history of previous multiple myeloma or other maligancy. He died after 2 months from diagnosis due to massive bleeding in esophageal lesion with complication.
Aged ; Biopsy ; Bone Marrow Examination ; Deglutition Disorders ; Diagnosis ; Electrophoresis ; Esophageal Neoplasms* ; Hemorrhage ; Humans ; Immunoelectrophoresis ; Leukemia, Plasma Cell* ; Multiple Myeloma ; Neoplasms, Squamous Cell ; Paraproteinemias ; Plasma Cells* ; Plasma*

OBJECTIVES: Glide path preparation is recommended to reduce torsional failure of nickel-titanium (NiTi) rotary instruments and to prevent root canal transportation. This study evaluated whether the repetitive insertions of G-files to the working length maintain the apical size as well as provide sufficient lumen as a glide path for subsequent instrumentation. MATERIALS AND METHODS: The G-file system (Micro-Mega) composed of G1 and G2 files for glide path preparation was used with the J-shaped, simulated resin canals. After inserting a G1 file twice, a G2 file was inserted to the working length 1, 4, 7, or 10 times for four each experimental group, respectively (n = 10). Then the canals were cleaned by copious irrigation, and lubricated with a separating gel medium. Canal replicas were made using silicone impression material, and the diameter of the replicas was measured at working length (D0) and 1 mm level (D1) under a scanning electron microscope. Data was analysed by one-way ANOVA and post-hoc tests (p = 0.05). RESULTS: The diameter at D0 level did not show any significant difference between the 1, 2, 4, and 10 times of repetitive pecking insertions of G2 files at working length. However, 10 times of pecking motion with G2 file resulted in significantly larger canal diameter at D1 (p < 0.05). CONCLUSIONS: Under the limitations of this study, the repetitive insertion of a G2 file up to 10 times at working length created an adequate lumen for subsequent apical shaping with other rotary files bigger than International Organization for Standardization (ISO) size 20, without apical transportation at D0 level.
Dental Pulp Cavity ; Silicones ; Transportation

OBJECTIVES: Glide path preparation is recommended to reduce torsional failure of nickel-titanium (NiTi) rotary instruments and to prevent root canal transportation. This study evaluated whether the repetitive insertions of G-files to the working length maintain the apical size as well as provide sufficient lumen as a glide path for subsequent instrumentation. MATERIALS AND METHODS: The G-file system (Micro-Mega) composed of G1 and G2 files for glide path preparation was used with the J-shaped, simulated resin canals. After inserting a G1 file twice, a G2 file was inserted to the working length 1, 4, 7, or 10 times for four each experimental group, respectively (n = 10). Then the canals were cleaned by copious irrigation, and lubricated with a separating gel medium. Canal replicas were made using silicone impression material, and the diameter of the replicas was measured at working length (D0) and 1 mm level (D1) under a scanning electron microscope. Data was analysed by one-way ANOVA and post-hoc tests (p = 0.05). RESULTS: The diameter at D0 level did not show any significant difference between the 1, 2, 4, and 10 times of repetitive pecking insertions of G2 files at working length. However, 10 times of pecking motion with G2 file resulted in significantly larger canal diameter at D1 (p < 0.05). CONCLUSIONS: Under the limitations of this study, the repetitive insertion of a G2 file up to 10 times at working length created an adequate lumen for subsequent apical shaping with other rotary files bigger than International Organization for Standardization (ISO) size 20, without apical transportation at D0 level.
Dental Pulp Cavity ; Silicones ; Transportation

We report 3 cases of multiple myeloma showing ABO discrepancy with missed reaction in serum typing. They showed markedly decreased immunogolobulin level except for monoclonally increased abnormal immunoglobulin. Their blood group was confirmed by saliva test and addition of anti-globulin reagent. As serum immunoglobulin level is raised, the reactivity in serum typing showed improving tendency and ABO discrepancy appeared when immunoglobulin was markedly decreased.
Immunoglobulins ; Multiple Myeloma* ; Saliva

No abstract available.
Survival Rate* ; Uterine Cervical Neoplasms*

A 74-year-old woman who had paroxysmal atrial fibrillation without mitral stenosis was hospitalized for syncope and right-sided weakness. Echocardiography revealed a large free-floating thrombus in the left atrium, sometimes prolapsing partially into the left ventricle in diastole. Because of her poor neurological status, she was managed with anticoagulation. On the 12th day, the thrombus had disappeared on the follow-up echocardiography, and aortoiliac embolization was later detected on computed tomography. Unfortunately, she developed various complications of stroke and limb infarction, and died after 4 months of hospital care. In addition to this case report, we reviewed a total 70 cases of left atrial free-floating thrombus. Atrial fibrillation and mitral pathology were two major causative factors. All the cases, except 1, were confirmed on echocardiography. The most common presentation that led to echocardiography was systemic embolization, followed by heart failure. Others were acute hemodynamic decompensation from mitral obstruction, chest pain, palpitation, and bacteremia. Cardiac thrombectomy was the preferred treatment modality with favorable outcomes.
Aged ; Atrial Fibrillation ; Bacteremia ; Chest Pain ; Diastole ; Echocardiography ; Extremities ; Female ; Follow-Up Studies ; Heart Atria ; Heart Failure ; Heart Ventricles ; Hemodynamics ; Humans ; Infarction ; Mitral Valve Stenosis ; Pathology ; Stroke ; Syncope ; Thrombectomy ; Thrombosis*