Nowadays shoulder ultrasound is commonly used in the assessment of shoulder diseases and is as accurate as magnetic resonance imaging in the detection of several pathologies. Operator dependence is the main disadvantage of shoulder ultrasound. After adhering to a strict examination protocol, good knowledge of normal anatomy and pathologic processes and an awareness of common pitfalls, it can be used as a focused examination providing rapid, real-time diagnosis, and treatment by ultrasound-guided interventions in desired clinical situations. Also shoulder ultrasound can help the surgeon decide whether treatment will be surgical or nonsurgical. If arthroscopy is planned, sonographic findings help to counsel patients regarding surgical and functional outcomes. If a nonsurgical approach is indicated, ultrasound can be used to follow patients. This review article presents the examination techniques, the normal sonographic appearances and the main pathologic conditions found in shoulder ultrasound. And also addresses a simplified approach to scanning and ultrasound-guided intervention. Knowledge of optimal techniques, normal anatomy, dynamic maneuvers, and pathologic conditions is essential for optimal performance and interpretation of images.
Arthroscopy ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Pathologic Processes ; Pathology ; Shoulder* ; Ultrasonography*

PURPOSE: Variation in the morphology of gingival papilla may be determined by the shape and position of anatomic crown as well as contact area and embrasure form of individual teeth. However, periodontal biotype classification is regarded to be subjective because of the lack of definite criteria. In this study, we defined the objective parameters which constitute the periodontal biotype and measured their relationship. MATERIALS AND METHODS: 109 of dental casts were prepared using three dimensional scanner and specialized reconstruction software, then acquiredvirtual models were sent to the 20 professional dentists to define the specific periodontal biotypes. Several parameters around periodontal structures were measured from the virtual models; facial surface area of the anterior tooth (AT), anterior papillary area (AP), proportion of the dento-papillary complex, clinical papillary length (PL), and clinical papillary angle (PA). Statistical analysis was performed to confirm the relationship among parameters. RESULTS: Coincidence rate of periodontal biotype within observers was 63.77+/-16.05%. Coincidence rate between observers was 76.15+/-16.43%. Among the parameters measured, PL showed the most positive correlations and PA presented the most negative correlations. The parameter of the AP and PL of six maxillary anterior teeth showed significant correlation coefficient. CONCLUSION: Anterior papillary area and clinical papillary length would be objective parameters for determining the consistent periodontal biotypes.
Crowns ; Dentists ; Humans ; Tooth

No abstract available.
Tuberculosis, Laryngeal*

This study was carried out to elucidate the cytokine mRNAs expression and morphological features according to a microglial proliferation and apoptosis in a rat lumbar spinal cord, after a right sciatic nerve transection. The control group was composed of 5 rats (Spraque-Dawley) and the experimental group was composed of 70 rats. On post operation day (pod) 1, 2, 3, 5, and 7 eight rats were sacrificed on those days. On pod 10 five rats were sacrificed as well as five rats sacrificed on post operation weeks 2, 3, 4, 5, and 6. On light microscopy, activated microglia were often found in a perineuronal position around motoneurons in the ventral gray matter and more randomly distributed throughout the neuropil in the dorsal gray matter of lumbar spinal cord. GSA I-B4-positive microglia began to increase from 1 day after transection, and reached peak at 2~3 days and it persisted at 5~7 days and decreased thereafter. TUNEL-positive microglia was not observed in control group and began to increase from 5 days after transection and increased gradually until 3 weeks and decreased thereafter. On in situ RT-PCR, the positive signal for IL-1alpha and IL-6 mRNA was found mainly in the cytoplasm of the activated microglia and astrocytes at 1 day after transection and showed stronger signal at 3 days and decreased gradually until 10 days. TNF-alpha mRNA was detected 1 day after transection and remained for 7 days and localized to activated microglia as well as probably some astrocytes. The signal intensity of IL-1alpha and IL-6 mRNA was generally stronger than TNF-alpha mRNA. On transmission electron microscopy, there were chromatin condensation with margination toward nuclear membrane and condensation of cytoplasm at 3 days after transection. Apoptotic bodies were found after 5 days and increased gradually until 3 weeks. According to the above findings, it is concluded that apoptosis appears to be one mechanism by which activated microglia are gradually eliminated and cytokine expression seems to played an active role in the microglial turnover.
Animals ; Apoptosis* ; Astrocytes ; Chromatin ; Cytokines ; Cytoplasm ; Interleukin-6 ; Microglia ; Microscopy ; Microscopy, Electron, Transmission ; Neuropil ; Nuclear Envelope ; Rats* ; RNA, Messenger ; Sciatic Nerve* ; Spinal Cord* ; Tumor Necrosis Factor-alpha

Radiotherapy in the treatment of head and neck cancers is often used either alone or in addition to surgery. Radiation disrupts the proliferative capacity of the cancer while doing as little damage as possible to the normal tissue. Nevertheless, conventional radiotherapy of advanced head and neck tumors is frequently associated with severe oropharyngeal mucositis. The fungiform papillae are found on the dorsal surface of the anterior 2/3 of the tongue and have one taste bud which always located on the superior side. In recent years, many study have demonstrated the location of neuropeptides in the intragemmal cells of the taste buds. We used neural cell adhesion molecule (NCAM) in this study. NCAM is a membrane surface glycoprotein found in neural tissue that functions in cell -cell interactions such as adhesion and recognition and may contribute to neuronal and receptoneural synaptogenesis. However, to the best of our knowledge, there is no study about NCAM in relation to dysgeusia, especially after radiotherapy. Therefore, we studied the change of the expression of NCAM in the fungiform papilla of the young rat tongue following single dose radiation. Twenty days old 18 Sprague -Dawley rats were used. Twelve rats were irradiated with a single dose of 17 Gy gamma radiation. We sacrificed rats 1, 7, 20 days after radiation. The anterior part of tongues were removed and cut into at 30 micro gram on a cryocut. Using the free floating method, we immunostained sections. In control group, NCAM is expressed on some intragemmal cells which were located in the center of the bud and intragemmal nerve fibers. NCAM -immunoreactive (ir) perigemmal nerve fibers were rare, however basal plexus fibers and subpapillary nerve bundle showed strong immunoreactivity. One day after radiation, taste buds had no detectable changes of the expression of NCAM. However, seven days after radiation, the number of NCAM -ir intragemmal cells was reduced and the shape of ir cells was deformed. Immunoreactivity of basal plexus fibers and subpapillary nerve bundle was also decreased. The surface of the papilla was transformed into dome shape. Twenty days after radiation, overall forms of buds were recovered except a few deformed NCAM -ir intragemmal cells. NCAM was expressed in the intragemmal cells which are thought to be related with taste sensation, and we speculate that NCAM participate synaptogenesis. However, more studies using immunoelectron microscopic method are required.
Animals ; Dysgeusia ; Gamma Rays ; Head ; Immunohistochemistry ; Membrane Glycoproteins ; Membranes ; Mucositis ; Neck ; Nerve Fibers ; Neural Cell Adhesion Molecules* ; Neurons ; Neuropeptides ; Radiotherapy ; Rats* ; Sensation ; Taste Buds ; Tongue*

No abstract available.
Female* ; Humans ; Neck* ; Urinary Bladder* ; Urinary Incontinence*

Herein, we report on an unusual case of craniopharyngioma arising in the temporal lobe with no prior history of surgery and with no connection to the craniopharyngeal duct. MR images showed a cystic tumor with a small solid portion. To the best of our knowledge, this is the first case of a craniopharyngioma occurring in the temporal lobe.
Adult ; Brain Neoplasms/diagnosis/*pathology/surgery ; Craniopharyngioma/diagnosis/*pathology/surgery ; Human ; Magnetic Resonance Imaging ; Male ; Temporal Lobe/*pathology/surgery

A free-floating ball thrombus in the left atrium is a rare complication of the mitral valvular disease. A 53-year-old man was admitted for pain and paresthesia on both legs. On admission he had auscultatory sign of mitral stenosis and mitral regurgitation, and the roentgenogram of his chest revealed a slight pulmonary ve..ous congestion, enlargement of the pulmonary conus and cardiomegaly. Laboratory findings including complete blood counts, coagulation studies and blood chemistry were normal. An echocardiographic examination revealed a mitral stenosis and a free-floating ball thrombus in the left atrium. We performed the emergent open heart surgery for removal of the ball thrombus and mitral replacement successfuly with Duromedics 29 mm valve. The size of thrombus was 39 X 32 X 30 mm.
Blood Cell Count ; Cardiomegaly ; Chemistry ; Conus Snail ; Echocardiography ; Estrogens, Conjugated (USP) ; Heart Atria ; Humans ; Leg ; Middle Aged ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Paresthesia ; Thoracic Surgery ; Thorax ; Thrombosis*

BACKGROUND: Antihypertensive agents such as verapamil and esmolol are well known for their effects of hemodynamic stabilization on tracheal intubation. However, our previous study, Verapamil and esmolol did not attenuate heart rate and blood pressure. The aim of the present study was to evaluate the efficacy of combined administration of these drugs for controlling hemodynamic responses to tracheal intubation. METHODS: Forty-eight patients, ASA physical status I or II, were randomly assigned to one of four groups (n = 12 each):normal saline (control), verapamil 0.1 mg/kg, esmolol 1 mg/kg, and verapamil 0.05 mg/kg mixed with esmolol 0.5 mg/kg. Anesthesia was induced with thiopental 5 mg/kg intravenously, and then saline, verapamil, esmolol or the mixed drugs were administered as an intravenous bolus, and immediately followed by succinylcholine 1.5 mg/kg. Tracheal intubation was performed 90 s after intravenous injection of experimental drugs. Systolic and diastolic blood pressure and heart rate were measured before induction and every minute for 5 minutes after tracheal intubation. RESULTS: There was a significant attenuation in systolic blood pressure after tracheal intubation in the verapamil and mixed groups compared to the control and esmolol groups. Heart rates were significantly lower in the esmolol and mixed groups than in the verapamil groups after tracheal intubation. CONCLUSIONS: Combined administration of Verapamil 0.05 mg/kg with esmolol 0.5 mg/kg attenuated increases in blood pressure and heart rate after tracheal intubation.
Anesthesia ; Antihypertensive Agents ; Blood Pressure* ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Injections, Intravenous ; Intubation* ; Succinylcholine ; Thiopental ; Verapamil*

Nowadays shoulder ultrasound is commonly used in the assessment of shoulder diseases and is as accurate as magnetic resonance imaging in the detection of several pathologies. Operator dependence is the main disadvantage of shoulder ultrasound. After adhering to a strict examination protocol, good knowledge of normal anatomy and pathologic processes and an awareness of common pitfalls, it can be used as a focused examination providing rapid, real-time diagnosis, and treatment by ultrasound-guided interventions in desired clinical situations. Also shoulder ultrasound can help the surgeon decide whether treatment will be surgical or nonsurgical. If arthroscopy is planned, sonographic findings help to counsel patients regarding surgical and functional outcomes. If a nonsurgical approach is indicated, ultrasound can be used to follow patients. This review article presents the examination techniques, the normal sonographic appearances and the main pathologic conditions found in shoulder ultrasound. And also addresses a simplified approach to scanning and ultrasound-guided intervention. Knowledge of optimal techniques, normal anatomy, dynamic maneuvers, and pathologic conditions is essential for optimal performance and interpretation of images.
Arthroscopy ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Pathologic Processes ; Pathology ; Shoulder ; Ultrasonography