A 78-year-old woman presented to our hospital with progressive dyspnea (NYHA class I-II) and epigastric discomfort that had developed after a traffic accident. She had a history of hypertension and cerebral infarction, but no history of cardiovascular disease. Her blood pressure was 130/70 mmHg and her heart rate was 66 beats/min and regular. The electrocardiogram showed normal sinus rhythm. The chest X-ray revealed bilateral pleural effusions. Transthoracic echocardiography (TTE) demonstrated an aneurysm of the descending thoracic aorta compressing the left atrium (LA). Left and right ventricular systolic function was preserved. Whole-body computed tomography (CT) angiography revealed that a focal 40-mm-diameter saccular aneurysm in the descending aorta at the level of T7-8, with an intramural hematoma, was compressing the LA and left pulmonary vein. After surgical management, follow-up TTE and CT showed decompression of the LA and left pulmonary vein.
Accidents, Traffic ; Aged ; Aneurysm* ; Angiography ; Aorta, Thoracic* ; Aortic Aneurysm ; Blood Pressure ; Cardiovascular Diseases ; Cerebral Infarction ; Decompression ; Dyspnea ; Echocardiography ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Atria* ; Heart Rate ; Hematoma ; Humans ; Hypertension ; Pleural Effusion ; Pulmonary Veins ; Thorax

The objective of this study was to fabricate Zr-xCu and Zr-xSi alloys with low elastic modulus for preventing bone resorption in dental biomaterials. Metallic materials are widely used for orthopedic and dental applications due to their superior characteristics of mechanical properties and biocompatibility. Many metals and alloys, such as stainless steel, Co-Cr alloys, and Ti-based alloys are commonly used. Among these dental metallic materials, pure Ti and Ti-6Al-4V alloy have become the most popular metals used for the endosseous parts of the implant, bone plates, and artificial joints due to their excellent specific corrosion resistance and high biocompatibility with natural bone. Stress shield effect results in the reduction in bone density as a result of the removal of typical stress from the bone by an implant. In general, the bone in a healthy person will remodel in response to the loads it is placed under. Therefore, if the loading on a bone decreases, the bone will become less dense and weaker because there is no stimulus for continued remodeling that is required to maintain bone mass. Although Ti-based alloys have been widely used as implant components and devices, its elastic modulus (110 GPa) is much higher than that of natural human bone (10–30 GPa). Serious damage may be easily caused in the human body when the modulus of implant materials does not match the natural bone due to the stress shield effects. Therefore, in recent, persistent efforts have been done to obtain biological hard tissue materials with low elastic modulus to transfer stress to the surrounding bones effectively. The Zr-xCu binary alloy exhibited moderate compressive strength (1291-1411 MPa), yield stress (517-552 MPa), favorable elongation (16.4–49.2%), elastic energy (6.76–7.43 MJ/m3 ) and low elastic modulus (18.5–23.1 GPa). The Zr-xSi binary alloy exhibited high compressive strength (1105-1623 MPa), yield stress (673-1514 MPa), favorable elongation (6.0–27.2%), high elastic energy (10.2–34.6 MJ/m3 ) and low elastic modulus (22.3–33.1 GPa). Consequently, Zr-xCu and Zr-xSi binary alloys have the potential to be used as biomaterials with nullifying stress shield effects for biological hard tissue materials.

The objective of this study was to fabricate Zr-xCu and Zr-xSi alloys with low elastic modulus for preventing bone resorption in dental biomaterials. Metallic materials are widely used for orthopedic and dental applications due to their superior characteristics of mechanical properties and biocompatibility. Many metals and alloys, such as stainless steel, Co-Cr alloys, and Ti-based alloys are commonly used. Among these dental metallic materials, pure Ti and Ti-6Al-4V alloy have become the most popular metals used for the endosseous parts of the implant, bone plates, and artificial joints due to their excellent specific corrosion resistance and high biocompatibility with natural bone. Stress shield effect results in the reduction in bone density as a result of the removal of typical stress from the bone by an implant. In general, the bone in a healthy person will remodel in response to the loads it is placed under. Therefore, if the loading on a bone decreases, the bone will become less dense and weaker because there is no stimulus for continued remodeling that is required to maintain bone mass. Although Ti-based alloys have been widely used as implant components and devices, its elastic modulus (110 GPa) is much higher than that of natural human bone (10–30 GPa). Serious damage may be easily caused in the human body when the modulus of implant materials does not match the natural bone due to the stress shield effects. Therefore, in recent, persistent efforts have been done to obtain biological hard tissue materials with low elastic modulus to transfer stress to the surrounding bones effectively. The Zr-xCu binary alloy exhibited moderate compressive strength (1291-1411 MPa), yield stress (517-552 MPa), favorable elongation (16.4–49.2%), elastic energy (6.76–7.43 MJ/m3 ) and low elastic modulus (18.5–23.1 GPa). The Zr-xSi binary alloy exhibited high compressive strength (1105-1623 MPa), yield stress (673-1514 MPa), favorable elongation (6.0–27.2%), high elastic energy (10.2–34.6 MJ/m3 ) and low elastic modulus (22.3–33.1 GPa). Consequently, Zr-xCu and Zr-xSi binary alloys have the potential to be used as biomaterials with nullifying stress shield effects for biological hard tissue materials.

No abstract available.
Microsporum ; Tinea Capitis

The aim of this study is to review the protective effect of a bicycle helmet on each facial location systematically. PubMed was searched for articles published before December 12, 2014. The data were summarized, and the odds ratio (OR) between the locations of facial injury was calculated. A statistical analysis was performed with Review Manager (The Nordic Cochrane Centre). Bicycle helmets protect the upper and middle face from serious facial injury but do not protect the lower face. Non-wearers had significantly increased risks of upper facial injury (OR, 2.07; P<0.001) and of middle facial injury (OR, 1.97; P<0.001) as compared to helmet users. In the case of lower facial injury, however, only a slightly increased risk (OR, 1.42; 95% confidence interval (CI), 0.67-3.00, P=0.36) was observed. The abovementioned results can be attributed to the fact that a helmet covers the head and forehead but cannot cover the lower face. However, helmets having a chin cap might decrease the risk of lower facial injury.
Bicycling ; Chin ; Facial Injuries* ; Forehead ; Head ; Head Protective Devices* ; Odds Ratio

BACKGROUND: To evaluate the effects of severe hypoglycemia without hypokalemia on the electrocardiogram in patients with type 2 diabetes in real-life conditions. METHODS: Electrocardiograms of adult type 2 diabetic patients during the episodes of severe hypoglycemia and the recovered stage were obtained and analysed between October 1, 2011 and May 31, 2012. Patients who maintained the normal serum sodium and potassium levels during the episodes of severe hypoglycemia were only selected as the subjects of this study. Severe hypoglycemia was defined, in this study, as the condition requiring active medical assistance such as administering carbohydrate when serum glucose level was less than 60 mg/dL. RESULTS: Nine type 2 diabetes patients (seven men, two women) were included in the study. The mean subject age was 73.2+/-7.7 years. The mean hemoglobin A1c level was 6.07%+/-1.19%. The median duration of diabetes was 10 years (range, 3.5 to 30 years). Corrected QT (QTc) intervals were significantly increased during the episodes of severe hypoglycemia compared to the recovered stage (447.6+/-18.2 ms vs. 417.2+/-30.6 ms; P<0.05). However, the morphology and the amplitude of the T waves were not changed and ST-segment elevation and/or depression were not found during the episodes of severe hypoglycemia. CONCLUSION: In this study, QTc interval prolongation during the episodes of severe hypoglycemia was observed without hypokalemia. Therefore, the distinct alterations in cardiac repolarization during the episodes of severe hypoglycemia may not be associated with hypokalemia.
Adult ; Depression ; Diabetes Mellitus, Type 2 ; Electrocardiography ; Glucose ; Hemoglobins ; Humans ; Hypoglycemia ; Hypokalemia ; Male ; Medical Assistance ; Potassium ; Sodium

OBJECTIVE: To set up the methodology for PCR analysis of XbaI/intron 22 polymorphism of the factor VIII gene, and to identify the usefulness of XbaI/intron 22 polymorphism analysis for carrier detection and prenatal diagnosis of hemophilia A in the Korean population. DESIGN: A laboratory analysis. MATERIALS AND METHODS: A XbaI/intron 22 polymorphism of the factor VIII gene was analyzed in 56 unrelated Korean mothers of patients with severe hemophilia A, using polymerase chain reaction. RESULTS: Analysis of XbaI/intron 22 polymorphisms of the factor VIII gene were feasible by PCR method. The expected heterozygosity rates of XbaI/intron 22 polymorphism of the factor VIII gene were 44.8%. Analysis of XbaI/intron 22 polymorphism revealed heterozygous patterns in 22 (39.3%) of 56 mothers studied. Using linkage analysis with XbaI/intron 22 polymorphism, we have attempted one case of carrier detection and two cases of prenatal diagnosis in two families of patients with severe hemophilia A. CONCLUSION: These results suggest that PCR analysis of the XbaI/intron 22 polymorphism within the factor VIII gene is very useful in the carrier detection and prenatal diagnosis of hemophilia A in the Korean population.
Diagnosis* ; DNA* ; Factor VIII ; Hemophilia A* ; Humans ; Molecular Biology* ; Mothers ; Polymerase Chain Reaction* ; Prenatal Diagnosis

PURPOSE: Nocternal enuresis is a common disorder. Tricyclic antidepressant and desmopressin have been accepted pharmacological treatment for this disorder. We conducted a cooperative study to investigate the efficacy and adverse reactions of imipramine, desmopressin and combination treatment in children with primary monosymptomatic nocturnal enuresis(PMNE). METHODS: Data from a large multicenter study were analysed. In the period of 8 months in 2002, the study comprised of 168 children(78 boys and 90 girls, 5 to 15 years old) with PMNE for imipramine, desmopressin or combination treatment. Before treatment a history, physical examination and laboratory tests were performed and the children were observed for 2 weeks. Response rate, adverse reactions and enuresis episodes after stopping drug administration were evaluated after 12-weeks of imipramine, desmopressin or combination of both. RESULTS: After 4 weeks, the frequency of bed wetting in all treated patients decreased during treatment significantly. Even though a 30-50% reduction in the number of wet nights were 68.6%, 74.4% and 86.1% during 12 weeks treatment by imipramine, desmopressin and both of them respectively, there was no significant difference between them. The most common adverse reaction was decreased appetite from imipramine administration. But no serious drug-related adverse events were reported. CONCLUSION: Efficacy of the combination therapy of imipramine and desmopressin in PMNE appears not to be better than either drug alone. It is necessary to pay attention on account of adverse reactions during imipramine treatment even though imipramine and desmopressin were generally well tolerated.
Appetite ; Child ; Deamino Arginine Vasopressin* ; Enuresis ; Female ; Humans ; Imipramine* ; Nocturnal Enuresis* ; Physical Examination

PURPOSE: The effect of different peritoneal dialysis (PD) modalities on the decline in residual renal function (RRF) is unclear due to inconsistencies among studies. In particular, the effect of automated peritoneal dialysis (APD) modalities [continuous cyclic peritoneal dialysis (CCPD) and nightly intermittent peritoneal dialysis (NIPD)] on RRF has not been examined in a large cohort. MATERIALS AND METHODS: We conducted a single-center retrospective study to investigate the association between PD modalities and decline in RRF in 142 incident PD patients [34 on CCPD, 36 on NIPD, and 72 on continuous ambulatory peritoneal dialysis (CAPD)]. RRF was measured within 2 months from PD start and at 1 year after PD initiation. RESULTS: The RRF at 1 year after PD initiation was 1.98+/-2.20 mL/min/1.73 m2 in CCPD patients and 3.63+/-3.67 mL/min/1.73 m2 in NIPD patients, which were moderately lower than 4.23+/-3.51 mL/min/1.73 m2 in CAPD patients (p=0.064). Moreover, there was no significant difference in the 1-year rate of decline of RRF between CCPD and NIPD patients, although APD patients had a faster 1-year RRF decline rate than CAPD patients (CCPD and NIPD vs. CAPD: -45.68 and -36.69 vs. 1.17%/year, p=0.045). APD was associated with a more rapid decline in RRF in patients with end-stage renal disease undergoing PD, although multivariate analysis attenuated the significance of this finding (beta=-31.50; 95% CI, -63.61 to 0.62; p=0.052). CONCLUSION: Our results suggest that CAPD might be more helpful than APD for preserving RRF during the first year of dialysis therapy, although there was no significant difference in the 1-year rate of decline of RRF between the two APD modalities.
Adult ; Female ; Glomerular Filtration Rate/physiology ; Humans ; Kidney/pathology/physiopathology ; Kidney Failure, Chronic/*therapy ; Male ; Middle Aged ; Peritoneal Dialysis/*adverse effects ; Retrospective Studies

Chronic sclerosing mediastinitis is a rare disease of unknown etiology, pathologically characterized by chronic inflammation and fibrosis of mediastinal soft tissue. The process is often progressive and can occur either focally or diffusely throughout the mediastinum. This can result in compression of adjacent mediastinal structures, most commonly the low-pressure superior vena cava but also the pulmonary artery and vein, trachea and bronchi, esophagus and can result in a variety of functional and roentgenographic manifestation and occasionally death. We experienced a case of chronic sclerosing mediastinitis of unknown cause, which was confirmed by biopsy with thoracotomy, so reported it with a review of literature.
Biopsy ; Bronchi ; Esophagus ; Fibrosis ; Inflammation ; Mediastinitis* ; Mediastinum ; Pulmonary Artery ; Rare Diseases ; Thoracotomy ; Trachea ; Veins ; Vena Cava, Superior