No abstract available.
Humans

BACKGROUND: Calcium plays a key role in vascular contraction and regulates receptor sensitivity to certain neurotransmitters. Calcium channel blockers are useful in the treatment of both clinical and experimental hypertension. The present study was designed to examine whether there is an alteration of the activity of calcium channels in association with the development of hypertension. METHODS: Deoxycorticosterone acetate(DOCA)-salt hypertension was made by subcutaneous implantation of DOCA(200mg/kg)strip plus saline drinking(1%) and 2-kidney, 1 clip(2KIC)hypertension by clipping the left renal artery with a silver clip(internal gap of 0.2mm). They were used 4 weeks later. Age-matched normal rats served as a control. Mean arterial pressure(MAP) and heart rate(HR) were continuously recorded from the right femoral artery. The drugs were administered intravenously. RESULTS: Vehicle alone was without effect on MAP or HR. In normotensive rats, nifedipine infusion(5 and 10ug/kg/min)caused a dose-dependent decrease in MAP without significant changes in HR, while Bay k 8644(Bay K, 5 and 10 ug/kg/min) increased MAP transiently. Both the depressor response to nifedipine and the pressor response to Bay k were more marked in DOCA-salt hypetensive rats than in normotensive rats. The maximal changes in MAP indced by nifedipine(5 and 50 ug/kg) or Bay K(5 and 50 ug/kg) were also enhanced in 2KIC hypertensive rats as compared with control rats. CONCLUSION: These results indicate that calcium channel inhibitors and activators can affect on the regulation of blood pressure in an opposite fashion. It is also suggested that the activity of calcium channels might be altered in the developement of experimental hypertension.
3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethyl-5-nitro-4-(2-(trifluoromethyl)phenyl)-, Methyl ester* ; Animals ; Bays* ; Blood Pressure ; Calcium ; Calcium Channel Blockers ; Calcium Channels ; Desoxycorticosterone ; Femoral Artery ; Heart ; Hypertension ; Neurotransmitter Agents ; Nifedipine* ; Rats* ; Renal Artery ; Silver

Epidural analgesia is frequently used for the management of labor pain in parturients. The neurologic complications of epidural analgesia are rare, but they are catastrophic when they occur. We report here on a case of bilateral femoral neuropathy in a vaginal delivery patient with epidural analgesia. The patient complained of weakness of both thighs and numbness around both knees. Neurologic examination and electromyographic study revealed that they occurred due to the delivery itself. The patient had not fully recovered at eight weeks after delivery. The declining incidence of postpartum femoral neuropathy may reflect a reduced duration of labor in accordance with modern obstetric practice, and particularly the more frequent use of Caesarean delivery. The exact etiology of postpartum femoral neuropathy is unknown, and the possible factors are direct compression of nerves that are proximal within the pelvis by either the fetal head or birthing instruments, or this malady is the result of pressure induced ischemia at the level of the inguinal ligament when the pregnant woman is in the lithotomy position.
Analgesia, Epidural ; Female ; Femoral Neuropathy ; Head ; Humans ; Hypesthesia ; Incidence ; Ischemia ; Knee ; Labor Pain ; Ligaments ; Neurologic Examination ; Parturition ; Pelvis ; Postpartum Period ; Pregnancy ; Pregnant Women ; Thigh

A crossed occlusion resulting from the presence of posterior teeth in one arch but no opposing teeth in the opposite arch results in collapse of the vertical dimension. In this case, the patient has a class III malocclusion with crossed occlusion and anterior crossbite. In order to evaluate the proper vertical dimension, provisional denture was used to stabilize the vertical occlusal dimension for 3 months. After, provisional fixed restoration was used for the stabilizing occlusal relationship and aesthetic improvement for lip support. Definitive prosthesis in implants in the mandible and abutments in the maxillary were using Porcelain-fused-to-metal crown (PFM) crown and the maxillary unilateral edentulous area was treated with removable partial dentures. Through this, proper support of the posterior region and normal anterior occlusal relationship were formed, and the patient was able to obtain aesthetically and functionally satisfactory treatment results.

Purulent pericarditis is a rare condition with a high mortality rate. We report a case of purulent pericarditis subsequently caused by Candida parapsilosis, Peptostreptococcus asaccharolyticus, Streptococcus anginosus, Staphylococcus aureus, Prevotella oralis, and Mycobacterium tuberculosis in a previously healthy 17-year-old boy with mediastinal tuberculous lymphadenitis. The probable route of infection was a bronchomediastinal lymph node-pericardial fistula. The patient improved with antibiotic, antifungal, and antituberculous medication in addition to pericardiectomy.
Adolescent ; Bronchial Fistula ; Candida ; Coinfection ; Fistula* ; Humans ; Male ; Mortality ; Mycobacterium tuberculosis ; Peptostreptococcus ; Pericardiectomy ; Pericarditis* ; Pericarditis, Tuberculous ; Prevotella ; Staphylococcus aureus ; Streptococcus anginosus ; Tuberculosis, Lymph Node*

INTRODUCTION: Mandibular third molar extraction is one of the most common procedures performed in oral and maxillofacial surgery units. Although the overall complication rate is low with most complications being minor, mandibular third molar removal is so common that the population morbidity of complications might be significant. Therefore, efforts to limit intraoperative or postoperative complications might have a significant impact in terms of enhancing the patient outcome. The aims of this study were to identify the position and angulation associated complications after mandibular third molar extractions. MATERIALS AND METHODS: This study surveyed 568 patients who had a mandibular third molar extracted, showed clinical complications and underwent a radiographic measurement of the available space, depth and spatial relationship. RESULTS: The results obtained were as follows: 1. The complications were a dry socket, nerve injury, root rest, infection, bleeding, hamatoma, and adjacent teeth injury. 2. There were no significant differences between the complication and ramus relationship (available space) of the mandibular third molar. 3. There were no significant differences between the complications and depth of the mandibular third molar. 4. There were no significant differences between the complications and spatial relationship of the mandibular third molar. CONCLUSION: There were no significant differences in the complication rate, ramus relationship, depth and spatial relationship of the mandibular third molar. This suggests that the position and angulation of the mandibular third molar may not have an impact on the complications. The relationship between the position and angulation of the mandibular third molar, and complications deserves a further study using longitudinal data.
Dry Socket ; Hemorrhage ; Humans ; Molar, Third ; Postoperative Complications ; Surgery, Oral ; Tooth

Brain and skin metastasis from urothelial carcinoma of the bladder is rare. There have been few case reports of the clinical course of patients with metastatic urothelial carcinoma of the brain and skin. In the present case, a 60-year-old man had undergone radical cystectomy with an ileal conduit owing to urothelial carcinoma (T1N0M0). The patient developed dizziness 9 years later and a solitary brain tumor was discovered in his left cerebellar hemisphere. The tumor was totally resected and the mass was verified to be metastatic urothelial carcinoma. One year after the metastasectomy of the brain lesion, multiple erythematous nodular lesions developed on his abdominal skin. The skin lesions were excised and verified to be metastatic urothelial carcinoma. This report describes this case of urothelial carcinoma of the bladder that metastasized to the brain and abdominal skin.
Brain ; Brain Neoplasms ; Cystectomy ; Dizziness ; Humans ; Metastasectomy ; Neoplasm Metastasis ; Skin ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Diversion

BACKGROUND: Ischemic-reperfusion injury (IRI) is a clinically important mechanism of cellular damage, which is suspected to be caused by the attack of oxygen radicals generated in a reoxygenation phase. Nitric oxide (NO), which is essential to the endothelial function, has been thought to be a key material in IRI. In hepatic transplantation, IRI is inevitable, but the effect of NO on hepatic IRI has not yet been elucidated exactly. This experiment was designed to evaluate the effects of antioxidants and a NO supplement on hepatic IRI. METHODS: Male Sprague-Dawley rats were divided into five groups: a sham operation group, a group with ischemic-reperfusion (IR), and a group with vitamin C and vitamin E (VC&VE) administered after IR, a group with L-arginine injected after IR, and a group with NG-nitro-L-arginine (NNLA) injected after IR. IRI was induced by clamping the hepatic portal area for 30 minutes, followed by declamping. To prevent blood congestion in the mesenteric vessel, we had performed a porto-systemic shunt operation 4 weeks before the portal clamping. Biochemical assays (tumor necrosis factor-alpha (TNF-alpha) in serum and malondialdehyde (MDA), catalase activity, superoxide dismutase (SOD) activity, and NO synthase (NOS) activity in liver tissue) were performed after sacrificing five rats of each group, respectively, at one and six hours after reperfusion. RESULTS: IRI increased the MDA level dramatically and exhausted the catalase and the SOD activities remarkably at 1 hour and 6 hours. The group receiving VC&VE had much lower MDA levels and higher catalase and SOD activities than the IR group did. VC&VE had no significant effect on the NOS activities of the liver tissue. L-arginine administration had a definite antioxidant effect, but the effect was muchlower than that of VC&VE. The antioxidant effect of L-arginine seemed related to a reduction in the catalase exhaustion rather than to SOD exhaustion. Strangely, NNLA had a slight antioxidant effect, but had no effect on either the catalase or the SOD activity. CONCLUSIONS: Antioxidants and a supplement of NO partially prevented IRI of the liver. This effect is thought to be related to suppression of catalase exhaustion. Blocking NO biosynthesis also had a mild antioxidant effect.
Animals ; Antioxidants* ; Arginine ; Ascorbic Acid ; Catalase ; Constriction ; Estrogens, Conjugated (USP) ; Humans ; Liver ; Liver Transplantation ; Male ; Malondialdehyde ; Necrosis ; Nitric Oxide Synthase ; Nitric Oxide* ; Nitroarginine ; Rats* ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; Reperfusion ; Superoxide Dismutase ; Tumor Necrosis Factor-alpha ; Vitamin E ; Vitamins

OBJECTIVE: This study compared the area of the regurgitant orifice, as measured by the use of multidetector-row CT (MDCT), with the severity of aortic regurgitation (AR) as determined by the use of echocardiography for AR. MATERIALS AND METHODS: In this study, 45 AR patients underwent electrocardiography-gated 40-slice or 64-slice MDCT and transthoracic or transesophageal echocardiography. We reconstructed CT data sets during mid-systolic to enddiastolic phases in 10% steps (20% and 35-95% of the R-R interval), planimetrically measuring the abnormally opened aortic valve area during diastole on CT reformatted images and comparing the area of the aortic regurgitant orifice (ARO) so measured with the severity of AR, as determined by echocardiography. RESULTS: In the 14 patients found to have mild AR, the ARO area was 0.18+/-0.13 cm2 (range, 0.04-0.54 cm2). In the 15 moderate AR patients, the ARO area was 0.36 +/- 0.23 cm2 (range, 0.09-0.81 cm2). In the 16 severe AR patients, the ARO area was 1.00 +/- 0.51 cm2 (range, 0.23-1.84 cm2). Receiver-operator characteristic curve analysis determined a sensitivity of 85% and a specificity of 82%, for a cutoff of 0.47 cm2, to distinguish severe AR from less than severe AR with the use of CT (area under the curve = 0.91; 95% confidence interval, 0.84-1.00; p < 0.001). CONCLUSION: Planimetric measurement of the ARO area using MDCT is useful for the quantitative evaluation of the severity of aortic regurgitation.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Aortic Valve/physiopathology/radiography/ultrasonography ; Aortic Valve Insufficiency/*radiography/*ultrasonography ; Area Under Curve ; Body Weights and Measures/methods ; Echocardiography/methods ; Echocardiography, Doppler, Color/methods ; Echocardiography, Transesophageal/methods ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity ; Severity of Illness Index ; Tomography, X-Ray Computed/*methods ; Young Adult

Short stature and gonadal dysgenesis are two characteristic clinical features of Turners syndrome. Very rarely, patients with Turners syndrome may menstruate and even be fertile. We experienced a case of Turners syndrome with spontaneous sexual development and menstruation. A 16-year-old girl was referred for severe anemia and menometrorrahgia. She had nearly normal features, with the exception of a short stature and a single right kidney. Also, she had spontaneous development of secondary sexual characteristics. We performed and anemia study and evaluated her short stature. In chromosomal study of her bone marrow and peripheral blood lymphocytes, she was revealed to have monosomy 45,X. Herein, this case is reported, with a brief review of literature
Adolescent ; Anemia ; Anemia, Iron-Deficiency* ; Bone Marrow ; Female ; Gonadal Dysgenesis ; Humans ; Iron* ; Kidney ; Lymphocytes ; Menstruation ; Monosomy ; Sexual Development* ; Turner Syndrome*