PURPOSE: In most cases of nasal bone fracture, closed reduction with internal or external splint fixation approach is selected. However, because of indiscriminate insertion of the internal splint without considering of anatomical difference or deformity, insufficient fixation happens frequently that need additional fixation. Therefore, we suggest a new method for providing adequate support in reduced nasal bone by carving Merocel(R) that is fixed for the anatomical structure. METHODS: Closed reduction and internal fixation with carved Merocel(R) was performed in 15 nasal bone fracture patients from March, 2010 to July, 2010. Each patient was evaluated by physical examination, facial photographic check, simple X-ray, and computerized tomography. On the first day post-operation, location of packing and amount of reduction were checked by follow up X-ray and computerized tomography. In addition, patients' symptoms were evaluated. During the 3-month post-op follow up at out-patient clinic, operator, 2 doctors in training and one assistant performed the objective evaluations by physical examination on nasal dorsal hump, nasal deviation, nasal depression, nasal breath difficulty, and nasal airway obstruction. A survey of subjective patients' satisfaction in 4-stages was also performed. RESULTS: The results of follow-up computerized tomography of the 15 patients revealed that 11 patients had good reduced state. Three patients with combined maxillary frontal process fracture had over reductions. A survey performed on the first day post-operation showed that 14 of 15 patients answered that their current symptoms were more than tolerable. At the 3-month follow-up physical exam, one case had a dorsal hump. However, there were no nasal deviations, nasal depressions, nasal breath difficulties, or nasal airway obstructions. Twelve of the 15 patients answered more than moderate on the 3-month survey. CONCLUSION: Intranasal packing after carving the Merocel(R) considering anatomical structure is a new effective method to promote proper-reduction, maintain stability, and minimize patients' symptoms by addition of a simple procedure.
Airway Obstruction ; Congenital Abnormalities ; Depression ; Follow-Up Studies ; Fractures, Closed ; Humans ; Nasal Bone ; Nasal Obstruction ; Outpatients ; Physical Examination ; Splints

OBJECTIVES: To evaluate preoperative anti-Mullerian hormone (AMH) levels in women with endometrioma or other benign ovarian cysts and differences of AMH changes according to various characteristics. METHODS: Ninety-seven patients aged 20 to 39 years who underwent surgery for benign ovarian cyst were enrolled retrospectively. Of these, 65 patients were diagnosed as endometriomas, and 32 had other benign cysts. Serum AMH, mean, maximum, and total diameter of ovarian cysts were measured. The AMH levels were compared according to pathology (endometrioma vs. other benign cyst), size of ovarian cyst, age-matched AMH quartile percentile and characteristics of endometrioma. RESULTS: Preoperative serum AMH level was significantly lower in endometrioma group than other benign cyst group (4.12 +/- 2.42 ng/mL vs. 6.02 +/- 2.29 ng/mL, P < 0.001). Serum AMH level was significantly lower in endometrioma group, especially in patients aged 30 to 39 years. Dividing to age-matched AMH quartile percentile, there were significantly fewer patients with AMH level > or = 75 percentile in endometrioma group (24.6% vs. 50.0%, P = 0.035). Among 4 subgroups of endometrioma, patients with AMH level > or = 75 percentile were significantly decreased in multiple bilateral endometrioma group. Mean and total diameter of cysts were negatively correlated with preoperative serum AMH level in other benign cyst group. CONCLUSION: We suggest that preoperative AMH level measurement might be considered in women with endometrioma, especially in 30 to 39 years old, multiple bilateral type, or big-sized other benign ovarian cyst to assess the diminished ovarian reserve.
Anti-Mullerian Hormone* ; Endometriosis* ; Female ; Humans ; Ovarian Cysts* ; Pathology ; Retrospective Studies

No abstract available.
Apoptosis* ; Placenta Previa* ; Placenta*

No abstract available.
Anemia, Aplastic* ; Penicillamine*

BACKGROUND: Mycobacterium tuberculosis (Mtb) heparin binding hemagglutinin (HBHA) is an Ag known to evoke effective host immune responses during tuberculosis infection. However, the molecular basis of the host immune response to HBHA has not been fully characterized. In this study, we examined the molecular mechanisms by which HBHA can induce the expression of proinflammatory cytokines in macrophages. METHODS: HBHA-induced mRNA and protein levels of proinflammatory cytokines were determined in bone marrow-derived macrophages (BMDMs) using RT-PCR and ELISA analysis. The roles of intracellular signaling pathways for NF-kappaB, PI3-K/Akt, and MAPKs were investigated in macrophage proinflammatory responses after stimulation with HBHA. RESULTS: HBHA robustly activated the expression of mRNA and protein of both TNF-alpha and IL-6, and induced phosphorylation of NF-kappaB, Akt, and MAPKs in BMDMs. Both TNF-alpha and IL-6 production by HBHA was regulated by the NF-kappaB, PI3-K, and MAPK pathways. Furthermore, PI3-K activity was required for the HBHA-induced activation of ERK1/2 and p38 MAPK, but not JNK, pathways. CONCLUSION: These data suggest that mycobacterial HBHA significantly induces proinflammatory responses through crosstalk between the PI3-K and MAPK pathways in macrophages.
Cytokines ; Enzyme-Linked Immunosorbent Assay ; Hemagglutinins ; Heparin ; Interleukin-6 ; Lectins ; Macrophages ; Mycobacterium tuberculosis ; NF-kappa B ; p38 Mitogen-Activated Protein Kinases ; Phosphorylation ; RNA, Messenger ; Tuberculosis ; Tumor Necrosis Factor-alpha

A 15-year-old adolescent with unilateral multiple adrenal pheochromocytoma had an episode of subcortical intracerebral hemorrhage and seizure 6 weeks before the surgery. He was pretreated with terazosin, losartan, atenolol and levetiracetam for 2 weeks. Dexmedetomidine was started in the preoperative waiting area, and a combination of dexmedetomidine and remifentanil was continuously infused for most of anesthetic time. To control blood pressure, bolus injection of remifentanil and low-dose infusion of sodium nitroprusside, nicardipine, and esmolol were administered during three adrenergic crises. There was minimal post-resection hypotension, and his trachea was extubated safely 20 min after the surgery. He was discharged without noticeable complication. His catecholamine levels showed the steadily decreasing pattern during the operation in this case. Though a combination of dexmedetomidine and remifentanil may not prevent the hemodynamic instability impeccably during the tumor manipulation, this combination seems to be the way of interrupting release of catecholamines and minimizing hemodynamic fluctuations.
Adolescent ; Atenolol ; Blood Pressure ; Catecholamines ; Cerebral Hemorrhage ; Dexmedetomidine ; Hemodynamics ; Humans ; Hypotension ; Losartan ; Nicardipine ; Nitroprusside ; Pheochromocytoma ; Piperidines ; Piracetam ; Prazosin ; Propanolamines ; Seizures ; Trachea

OBJECTIVE: This study was performed to evaluate the effect of body mass index (BMI) on the outcome of in vitro fertilization and embryo transfer (IVF-ET) in patients with polycystic ovary syndrome (PCOS). METHODS: Ninety-six patients with PCOS who completed their first cycle of IVF-ET were included in this retrospective study. All patients were stimulated by GnRH antagonist multi-dose protocol. The patients were divided into one of two groups on the basis of BMI > or =23 kg/m2 vs. BMI <23 kg/m2, and their outcome of IVF-ET was compared. Additionally the patients with BMI > or =23kg/m2 were divided into patient group with 23 < or =BMI <25 kg/m2 and patient group with BMI > or =25 kg/m2, and these three groups were also compared in regard to the outcome of IVF-ET. RESULTS: The total amount and duration of rhFSH administration were significantly higher in PCOS women with BMI > or =23 kg/m2 than in those with BMI <23 kg/m2 (P<0.001 in both). The implantation rate was significantly lower in women with BMI > or =23 kg/m2 (17.4% vs 7.8%, P=0.024). When compared three group divided on the basis of BMI <23 kg/m2 vs BMI 23~25 kg/m2 vs BMI > or =25 kg/m2, similar results were showed in women with BMI > or =25 kg/m2, although implantation rate in women with BMI > or =25 kg/m2 was lower with borderline significance (P=0.069). CONCLUSION: Obesity (BMI > or =23 kg/m2) has a detrimental effect on implantation rate and is associated with the increased total amount and duration of rhFSH administration for ovarian stimulation in IVF-ET cycle. Consequently BMI may be a predictor for IVF outcomes in patients with PCOS.
Body Mass Index ; Embryo Transfer ; Embryonic Structures ; Female ; Fertilization in Vitro ; Gonadotropin-Releasing Hormone ; Humans ; Obesity ; Ovulation Induction ; Polycystic Ovary Syndrome ; Retrospective Studies

BACKGROUND: Genetic abnormalities in adult AML are caused most frequently by somatic mutations in exon 12 of the NPM1 gene, which is observed in approximately 35% of AML patients and up to 60% of patients with cytogenetically normal AML (CN-AML). METHODS: We performed mutational analysis, including fragment analysis and direct sequencing of exon 12 of the NPM1 gene, on 83 AML patients to characterize the NPM1 mutations completely. RESULTS: In this study, NPM1 mutations were identified in 19 (22.9%) of the 83 AML patients and in 12 (42.9%) of the 28 CN-AML patients. Among the 19 patients with NPM1 mutations, type A NPM1 mutations were identified in 16 (84.2%) patients, whereas non-A type NPM1 mutations were observed in 3 (15.8%) patients. Two of the 3 non-A type NPM1 mutations were novel: c.867_868insAAAC and c.869_873indelCTTTAGCCC. These 2 novel mutant proteins display a nuclear export signal motif (L-xxx-L-xx-V-x-L) less frequently and exhibit a mutation at tryptophan 290 that disrupts the nucleolar localization signal. CONCLUSIONS: This study suggests that novel NPM1 mutations may be non-rare and that supplementary sequence analysis is needed along with conventional targeted mutational analysis to detect non-A types of NPM1 mutations.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Amino Acid Motifs ; Base Sequence ; DNA Mutational Analysis ; Exons ; Female ; Humans ; Leukemia, Myeloid, Acute/*genetics/pathology ; Male ; Middle Aged ; Mutation ; Nuclear Proteins/*genetics ; Young Adult

The purpose of this study was to measure and evaluate radiation dose for MDCT parameters. Patient dose for various combination of MDCT parameters were experimentally measured, using MDCT (GE light speed plus 4 slice, USA), model 2026C electrometer (RADICAL 2026C, USA), standard Polymethylmethacrylate (PMMA) head and body CT dosimetry phantoms. In clinical situations, for a typical abdominal scan performed with MDCT at 120 kVp, 180 mAs, 20 mm collimation, and a pitch of 0.75, CTDIw, CTDIvol were measured as 20.2 mGy, 26.9 mGy, respectively. When scan length is assumed as 271.3 mm, DLP and measured effective dose of the abdominal would be calculated as 729.1 mGy cm, 10.9 mSv, respectively.
Head ; Humans ; Polymethyl Methacrylate

Endometriosis is a long term, disabling condition and a relatively common disease, affecting 5~15% of the adult female population. Endometriosis of the urinary tract, which occurs mostly bladder or ureter, is rare and accounts for 1 or 2% of cases. However, they may cause hydronephrosis and other serious complications on the involved site. We experienced one case of vesical endometriosis and two cases of ureteral endometriosis, and report these cases with a brief review of the concerned literatures.
Adult ; Endometriosis ; Female ; Humans ; Hydronephrosis ; Ureter ; Urinary Bladder ; Urinary Tract