Multiple myeloma is a blood dyscrasias that accounts of almost 10% of all hematological malignancy. The presentation of myeloma kidney is highly variable and it often presents as renal insufficiency, renal tubular dysfunction and proteinuria of various types. In Malaysia the true incidence of myeloma kidney is unknown. Often the diagnosis of myeloma kidney was missed out despite the patient has sought medical treatment early. A high index of suspicion is required when the middle to elderly age patients present with unexplained renal impairment and enlarged kidneys. We present here the presentation of a rare subtype of myeloma in a relatively young patient whereby the patient presented with nephrotic syndrome and azotemia.

Acrylic resin is commonly used to fabricate removable prostheses due to its adequate physical, mechanical properties and cost effectiveness. There has been continuous development of the materials to improve their properties and to widen its application in different clinical setting. To study the history development of the acrylic resin and elaborate on the properties of different types and the processing methods of acrylic resins used to fabricate denture base which are commercially available in the market. This would help the dental clinician in choosing the best material of choice. The authors have summarized the history, development and classification of different types of acrylic resins used in fabricating denture and processing methods based on all the published research available on this topic using published materials available in the Dental Library, University of Malaya and the database (Science Direct, PubMed). Every type of acrylic denture base material has its pros and cons. Therefore, careful selection of material and the processing method is crucial to ensure the best outcome for prosthodontic treatment. Hence, upholding the patients’ best interest and improving their quality of life.

BACKGROUND: Determination of left ventricular(LV) myocardial mass with echocardioraphy is feasible and validated. American society of echocardiography(ASE) issued recommendations for the quantitation of the left ventricle by M-mode and 2-dimensional echocardiography in 1978 and 1989, respectively. Although some controversies exist regarding the relative accuracy of M-mode and 2-dimensional techniques, many workers now agree that 2-dimensional methods are more accurate and can be applied to a higher percentage of patients. But sometimes the validated methods are not optimal when parasternal short axis view is difficult to obtain, when the ventricle is distorted, or when scar tissue constitutes a portion of the myocardial volume. METHODS: We measured left ventricular mass in 72 normal subjects using three different methods-ASE cube method with correction in M-mode(method A), area-length method from parasternal short axis view and apical four chamber view(method B), and the method using Simpson's rule from apical four chamber view(method C). RESULTS: 1) LV mass(index) was 161.8+/-30.3g(98.7+/-15.6g/m2) by method A, 166.2+/-32.8g(101.2+/-16.5g/m2) by method B, and 161.2+/-31.8g(98.2+/-15.5g/m2) by method C. 2) LV mass or index by method B was significantly different from that by method A(p<0.001) and from that by method C(p<0.001). However there was no significant difference in LV mass or index between by method A and C(p>0.05). 3) There was a strong correlation between LV mass or index by the method A and B(r=0.873, p<0.001), by the method B and C(r=0.923, p<0.001), and by the A and C(r=0.945, p<0.001). CONCLUSIONS: It is suggested that the method using Simpson's rule can reliably assess LV mass, although it results in smaller value that that by area-length method.
Axis, Cervical Vertebra ; Cicatrix ; Echocardiography* ; Heart Ventricles ; Humans

No abstract available.
Crowns* ; Dental Porcelain*

We examined cerebrospinal fluids of 338 patients with syphilis who underwent the routine physical examinations or visited out-patient skin clinic at Kyunghee University hospital from January, 1978 to December, 1979. They were diagnosed as syphilis only with serological tests such as VDRL and TPHA tests. The patients did not have any neurologic symptoms associated with syphilis or any other clinical syphilitic syrnptoms. They did not have any history of receiving antisyphilitic treatment. The VDRL test, cell count, protein value, sugar and chloride levels in cerebr-ospinal fluid were tested in these patients. The results were as follows. 1) CSF VDRL reactive rate was 2. 1% among 388 patients with syphilis. 2) CSF celI count was not less than 5/mm in 2 patients (28. 6%) among the 7 patients with syphilis, who showed the positive reactivity of CSF VDRL, and in 13 patients (3. 9%) among the 331 patients with syphilis who did not show the positive reactivity of CSF VDRL. 3) CSF protein level was more thnn 45ml/dl in 3 patients (42. 9%) among the 7 patients with syphilis who showed the positive reactivity of CSF VDRL anct ig, 65 patients (19. 6%) among the 331 patients with syphilis who did not show the positive reactivity of CSF VDRL. 4) Both CSF sugar and chloride levels were within norrnal limits in all of the 7 patients who showed the positive reactivity of CSF VDRL.
Cell Count ; Cerebrospinal Fluid* ; Humans ; Neurologic Manifestations ; Outpatients ; Physical Examination ; Serologic Tests ; Skin ; Syphilis*

Serologic tests for syphilis, including the qualitative and quantitative VDRL test and TPHA test, were carried out on 18, 151 healthy young men, who took a medical check-up for the overseas employment at Kyunghee University Hospital from April, 1978 to February, 1979. The syphilitics who revealed TPHA reactive, were given a questionare that dealt with three items. The results are summarized as follows. 1) The reactive rate of VDRL test was 3. 1% among 18, 151 healthy young men, 2) The biologic false positive rate of VDRL test was 7. 7% among the 520 men in whom TPHA test was carried out, using TPHA as standard. 3) The reactive rate of TPHA test was 2. 7% among 18, 109 men. On 42 men the TPHA test was not carried out. 4) With regard to the VDRL quantitative test, the reactive rate of the group with a titration of 1: 4 or lower was 85,2% out of 480 syphilitics. 5) In 480 syphilitics, 45. 8% (220) had a history of venereal 72.3%(347) had no general knowledge of syphilis, and 86. 2% (414) was unaware of his syphilitic infection.
Employment* ; Humans ; Male ; Prevalence* ; Serologic Tests ; Syphilis*

Although the reported number of malignant lymphoma of the thyroid has been increased, primary malignant lymphoma of the thyroid associated with chronic lymphocytic thyroiditis has been sporadically reported since its first description by Graham in 1931. The apparent coexistence of these two conditions has undoubtedly been noted by other observers. And they suggested that malignant lymphoma of the thyroid might arise from the lymphoid tissue ina wide variety of preexisting thyroidal disease. This report was made to record a case of primary thyroid lymphoma recently seen in this department with special emphasis on the associated thyroiditic changes in the uninvolved portion of the gland, which suggest the antecedent presence of chronic lymphocytic thyroiditis.

No abstract available.
Antioxidants* ; Glutathione* ; Humans

Enterobacter gergoviae is a gram negative rod-shaped opportunistic organism reported to cause urinary and respiratory tract infections, but peritonitis caused by this organism is unknown. We report a case of 50-year-old patient on peritoneal dialysis (PD) presented with Enterobacter gergoviae peritonitis with septic shock. Despite Intraperitoneal (IP) cloxacillin 250mg qid and IP ceftazidime 1gram q24h and subsequent escalation with IP amikacin 2mg/kg q24h and IP vancomycin 15mg/kg q24h within the next 48 hours, his peritonitis remained refractory and required catheter removal. Although Enterobacter gergoviae is naturally sensitive to aminoglycosides, carbapenems and quinolones, it reacts differently to the beta lactam antibiotics. Their resistance to third-generation cephalosporins is fast emerging and treatment with third-generation cephalosporins may cause AmpC-overproducing mutants. The majority of Enterobacteriaceae, including Extended-spectrum beta-lactamases producers, remain susceptible to carbapenems. Our report provides an unfavourable course of E. gergoviae peritonitis likely due to acquired secondary drug resistance during the therapy period.

Angiogenesis is an essential process in tumor growth and metastasis. VEGF has been considered a leading candidate inducing tumor angiogenesis. VEGF expression was significantly correlated with clinical stage, lymph node matastasis, and prognosis of cancers of various parts of body. However, little has been known about the correlation between VEGF expression and clinicopathologic parameters in oral squamous cell carcinoma. The aim of this study was to correlate VEGF expression with the clinicopathological parameters and microvessel density. Forty six oral squamous cell carcinomas were analyzed using immunohistochemical method with primary antibodies to VEGF and CD31. VEGF expression was detected in 33 (71.7%) of the 46 cases. The microvessel density was significantly correlated with VEGF expression (P=0.002). There was no correlation between microvessel density and tumour size, clinical stage, and lymph node metastasis, respectively. VEGF expression did not correlate with the histological grade of tumour differentiation, tumour size, and clinical stages. The VEGF-positive rate seemed to be higher in patients with cervical lymph nodal metastasis than in those without it, but it was not statistically significant. In conclusion, the overexpression of VEGF in the oral squamous cell carcinoma seemed to be associated with a more aggressive course of the disease. Further study is necessary to define the role of VEGF in oral squamous cell carcinoma.
Antibodies ; Carcinoma, Squamous Cell* ; Humans ; Lymph Nodes ; Microvessels* ; Neoplasm Metastasis ; Prognosis ; Vascular Endothelial Growth Factor A*