The idiopathic hypereosinophilic syndrome (HES) represents a heterogenous group of disorder characterized by prolonged eosinophilia of undetectable cause and multiorgan system dysfunction. Bone marrow is the most frequentry involved organ, but the most severe clinicopathologic involvement is heart. The major cause of death in patients with the HES is cardiac dysfunction especially congestive heart failure resulted from endocardial fibrosis and restrictive cardiomyopathy. We have experienced a case of DES with both cardiac and pulmonary involvements. The patient was an 18-month-old infant with poorly controlled lung abscess who complained of fever and productive cough. On the microscopic examination of pleural effusion, eosinophilic infiltration was noted. M-mode echocardiogram showed diffuse thickening of interventricular septum and left ventricular posterior wall. On the peripheral blood smear, prolonged eosinophilia was observed. We confirmed this case with bone marrow aspiration which showed eosinophilic hyperplasia.
Bone Marrow ; Cardiomyopathy, Restrictive ; Cause of Death ; Cough ; Eosinophilia ; Eosinophils ; Fever ; Fibrosis ; Heart ; Heart Failure ; Humans ; Hypereosinophilic Syndrome* ; Hyperplasia ; Infant ; Lung Abscess ; Pleural Effusion

Gaucher disease is caused by a deficiency of glucocerebrosidase. Patients with Gaucher disease are divided into three major phenotypes: chronic nonneuronopathic, acute neuronopathic, and chronic neuronopathic, based on symptoms of the nervous system, the severity of symptoms, and the age of disease onset. The characteristics of patients with acute neuronopathic- and chronic neuronopathic-type Gaucher disease include oculomotor abnormalities, bulbar signs, limb rigidity, seizures and occasional choreoathetoid movements, and neuronal loss. However, the mechanisms leading to the neurodegeneration of this disorder remain unknown. To investigate brain dysfunction in Gaucher disease, we studied the possible role of inflammation in neurodegeneration during development of Gaucher disease in a mouse model. Elevated levels of the proinflammatory cytokines, IL-1alpha, IL-1beta, IL-6, and TNF-alpha, were detected in the fetal brains of Gaucher mice. Moreover, the levels of secreted nitric oxide and reactive oxygen species in the brains of Gaucher mice were higher than in wild-type mice. Thus, accumulated glucocerebroside or glucosylsphingosine, caused by glucocerebrosidase deficiency, may mediate brain inflammation in the Gaucher mouse via the elevation of proinflammatory cytokines, nitric oxide, and reactive oxygen species.
Up-Regulation/genetics ; Tumor Necrosis Factor-alpha/genetics/secretion ; Reverse Transcriptase Polymerase Chain Reaction ; Reactive Oxygen Species/metabolism ; RNA, Messenger/genetics/metabolism ; Nitric Oxide/metabolism ; Microglia/cytology/metabolism ; Mice, Knockout ; Mice, Inbred ICR ; Mice, Inbred C57BL ; Mice ; Interleukin-6/genetics/secretion ; Interleukin-1/genetics/secretion ; Inflammation/immunology ; Glucosylceramidase/genetics ; Gaucher Disease/*genetics/metabolism/pathology ; Cytokines/*genetics/immunology/secretion ; Cells, Cultured ; Brain/embryology/*metabolism/pathology ; Animals

A 41-year-old female complaining of easy fatigue, headache, thickened extremities and deepened facial folds was admitted to the hospital. As early as 6 years ago, she had been told by family members that her voice was changed and both hands was thickened. Cranial plain radiography indicated ballooning of sella turcica. Sella MRI disclosed 2.2cm sized pituitary tumor with suprasellar extension. The pituitary tumor with hypothalamic extension was removed via a transsphenoidal approach. The postoperative course was uneventful until hyponatremia with sudden headache and respiratory arrest was developed. The case was due to hyponatremic encephalopathy on the basis of the clinical course and symptoms, and 3% hypertonic saline was infused for 12 hours until the hyponatremia was corrected. We have experienced a mortality case of hyponatremic encephalopathy in which surgieal removal of a pituitary tumor from a female acromegalic patient in menstruant period was followed by the sudden occurrence of hyponatremia, which in turn was later associated with marked brain edema.
Adult ; Brain Edema ; Extremities ; Fatigue ; Female ; Hand ; Headache ; Humans ; Hyponatremia ; Magnetic Resonance Imaging ; Mortality ; Pituitary Neoplasms ; Radiography ; Sella Turcica ; Voice

The purpose of this study was to evaluate the clinical efficacy of guided tissue regeneration(GTR) technique using chitosan nanofiber membrane and to compare it to the clinical efficacy following GTR using PLA/PLGA(copolymer of polylactic acid and polylacticglycolic acid) membrane in mandibular class II furcation defects in human. The chitosan nanofiber membranes were applied to the mandibular class II furcation defects of 13 patients(test group) and PLA/PLGA membranes were applied to those of 11 patients(control group). Probing pocket depth, clinical attachment level, gingival recession, plaque index and gingival index were measured at baseline and 3 months postoperatively. Vertical and horizontal furcation defect depth were measured at surgery. Both groups were statistically analyzed by Wilcoxon signed Ranks Test and Mann-Whitney Test using SPSS program. The results were as follows: 1. Probing pocket depth, clinical attachment loss and gingival index were significantly reduced at 3 months postoperatively compared to values of baseline in both groups(p<0.05). 2. Gingival recession and plaque index were not significantly decreased at 3 months postoperatively compared to values of baseline in both groups. 3. No significant difference between two groups could be detected with regard to changes of probing pocket depth, gingival recession, clinical attachment level, plaque index and gingival index at 3 months postoperatively. In conclusion, chitosan nanofiber membrane is effective in the treatment of human mandibular class II furcation defects and a longer period study is needed to fully evaluate the outcomes.
Humans

The purpose of this study was to evaluate the clinical efficacy of guided tissue regeneration(GTR) technique using chitosan nanofiber membrane and to compare it to the clinical efficacy following GTR using PLA/PLGA(copolymer of polylactic acid and polylacticglycolic acid) membrane in mandibular class II furcation defects in human. The chitosan nanofiber membranes were applied to the mandibular class II furcation defects of 13 patients(test group) and PLA/PLGA membranes were applied to those of 11 patients(control group). Probing pocket depth, clinical attachment level, gingival recession, plaque index and gingival index were measured at baseline and 3 months postoperatively. Vertical and horizontal furcation defect depth were measured at surgery. Both groups were statistically analyzed by Wilcoxon signed Ranks Test and Mann-Whitney Test using SPSS program. The results were as follows: 1. Probing pocket depth, clinical attachment loss and gingival index were significantly reduced at 3 months postoperatively compared to values of baseline in both groups(p<0.05). 2. Gingival recession and plaque index were not significantly decreased at 3 months postoperatively compared to values of baseline in both groups. 3. No significant difference between two groups could be detected with regard to changes of probing pocket depth, gingival recession, clinical attachment level, plaque index and gingival index at 3 months postoperatively. In conclusion, chitosan nanofiber membrane is effective in the treatment of human mandibular class II furcation defects and a longer period study is needed to fully evaluate the outcomes.
Humans

The pathogenesis of cerebral aneurysm until now is a subject of continuing debate. Some authors stress the important role of hemodynamics in the pathogenesis of cerebral aneurysm by confirming it with experimental work, pathological study, autopsy study and review of angiograms. With the findings of cerebral angiograms and operations, the authors had studied the difference in size and shape between ruptured and unruptured aneurysms, the relationship between afferent arteries from afferent arteries. 103 patients were admitted to the Keimyung University Dong San Hospital during the period from September 1982 to August 1985. According to studies on individual sizes of aneurysms, 52% of unruptured aneurysms were smaller than 5mm, but 68% of ruptured aneurysms were over 5mm but below 10mm. Moreover, the mean size of unruptured aneurysms was 4.87mm and ruptured aneurysms was 9.38mm. 53% of unruptured aneurysms were spherical in shape and combined daughter aneurysms in unruptured were 13%. However, in case of ruptured aneurysms, 34% were spherical and combined daughter aneurysms were 35%. The origin of daughter aneurysms in the dome was 59%, waist 29% and neck 12% in order. The direction of aneurysms was variable, but most of them pointed in the direction of blood flow in afferent arteries. We infer with this study that the hemodynamics of blood flow plays an important role in the pathogenesis of cerebral aneurysms.
Aneurysm ; Aneurysm, Ruptured ; Arteries ; Autopsy ; Hemodynamics ; Humans ; Intracranial Aneurysm* ; Neck ; Nuclear Family

PURPOSE: T1G3 bladder tumor has an incidence ranging from 6 to 23% of all superficial bladder tumors, a recurrence rate of 50 to 74%, and a rate of up to 50% for progression to invasive cancer after transurethral resection (TUR) followed by intravesical BCG instillation. We evaluated the recurrence and progression rates after TUR followed by BCG intravesical instillation. MATERIALS AND METHODS: We retrospectively reviewed the records of 30 patients with T1G3 transitional cell carcinoma (TCCa); a group consisting of 14 papillary, 14 non-papillary and 2 mixed TCCa. We evaluated the tumor recurrence and progression rates in relation with the patients' age, tumor multiplicity and configuration. Mean patients' age was 63.2 years and mean follow-up duration was 32.2 months. All patients received TUR and BCG intravesical instillation. RESULTS: Eleven cases (36.7%) had recurrence after a mean interval of 8.3 months, and 6 cases (20%) had progression after a mean interval of 10.2 months. The mean age appears to be a predictive factor of tumor recurrence, but not progression. All cases of non-papillary TCCa progressed to invasive bladder cancer. Two-year cumulative recurrence-free survival was 66.7% and progression-free survival was 83.3%. CONCLUSIONS: Our study demonstrated the high recurrence rate and progression potential of T1G3 bladder tumor. In cases of tumor recurrence during the follow-up period in elderly patients and in cases of reported non-papillary TCCa, close observation is recommended and early cystectomy should be considered.
Administration, Intravesical* ; Aged ; Carcinoma, Transitional Cell ; Cystectomy ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Mycobacterium bovis* ; Recurrence* ; Retrospective Studies ; Urinary Bladder Neoplasms* ; Urinary Bladder*

OBJECTIVE: To systematically review previous studies and to assess, via a subgroup meta-analysis, the combined odds ratio (OR) of prognostic factors affecting the success of miniscrew implants (MIs) inserted into the buccal posterior region. METHODS: Three electronic searches that were limited to articles on clinical human studies using MIs that were published in English prior to March 2015 were conducted. The outcome measure was the success of MIs. Patient factors included age, sex, and jaw of insertion (maxilla vs. mandible), while the MI factors included length and diameter. A meta-analysis was performed on 17 individual studies. The quality of each study was assessed for non-randomized studies and quantified using the Newcastle-Ottawa Scale. The meta-analysis outcome was a combined OR. Subgroup and sensitivity analyses based on the study design, study quality, and sample size of miniscrews implanted were performed. RESULTS: Significantly higher success rates were revealed for MIs inserted in the maxilla, for patients ≥ 20 years of age, and for long MIs (≥ 8 mm) and MIs with a large diameter (> 1.4 mm). All subgroups acquired homogeneity, and the combined OR of the prospective studies (OR, 3.67; 95% confidence interval [CI], 2.10-6.44) was significantly higher in the maxilla than that in the retrospective studies (OR, 2.10; 95% CI, 1.60-2.74). CONCLUSIONS: When a treatment plan is made, these risk factors, i.e. jaw of insertion, age, MI length, and MI diameter, should be taken into account, while sex is not critical to the success of MIs.
Humans ; Jaw ; Maxilla ; Odds Ratio ; Outcome Assessment (Health Care) ; Prospective Studies ; Retrospective Studies ; Risk Factors ; Sample Size

BACKGROUND: Cases of patients presenting side effects after illegal therapeutic attempts by non-medical personnel have been increasing and the patterns of attempts and related side effects become complicated. OBJECTIVE: To analyze the causes and characteristics of illegal therapeutic attempts and its' side effects performed by non-medical personnel. METHODS: Between April 1, 2008 and April 30, 2008, a total of 120 case reports of patients who developed side effects after illegal therapeutic attempts by non-medical personnel were collected from the members of the Korean dermatological association and analyzed. RESULTS: Clinical diagnoses, suggested to have before receiving illegal therapeutic attempts, revealed that 44 (36.6%) patients presented various pigmentary disorders, such as acquired melanocytic nevi and melasma, 22 (18.3%) wanted to have tattooing for permanent make up, skin aging in 16 (13.3%) cases, and acne in 10 (8.3%). Illegal therapeutic attempts performed included tattooing for permanent make up in 22 (18.3%) cases, peelings 19 (15.8%), laser therapies 18 (15.0%), and filler injection 12 (10.0%). The various clinical diagnoses of the patients with side effects were suggested, such as contact dermatitis in 34 (25.6%) cases, scarring in 33 (24.8%), post-inflammatory hyperpigmentation 20 (15.0%), secondary infection 19 (14.3%), and acne or acneiform eruption 9 (6.8%). CONCLUSION: In this report, we demonstrated patterns of illegal therapeutic attempts by non-medical personnel and its' side effects. We suggest that more effort should be followed by dermatologists to inform patients the risks of the illegal therapeutic attempts by non-medical personnel and to increase public health awareness.
Acne Vulgaris ; Acneiform Eruptions ; Cicatrix ; Coinfection ; Cosmetics ; Dermatitis, Contact ; Humans ; Hyperpigmentation ; Laser Therapy ; Melanosis ; Nevus, Pigmented ; Public Health ; Skin Aging ; Tattooing

The current interest in periodontal tissue regeneration has lead to research in bone graft, root surface treatments, guided-tissue regeneration, and the administration of growth factors as possible means of regenerating lost periodontal tissue. Several studies have shown that a strong correlation between platelet-rich plasma and the stimulation of remodeling and remineralization of grafted bone exists, resulting in a possible increase of 15-30% in the density of bone trabeculae. The purpose of this study was to study the histopathological correlation between the use of platelet-rich plasma and a bone xenograft used in conjunction with a non-resorbable guided-tissue membrane, e-PTFE, compared to a control group with regards to bone regeneration at the implant fixture site. Implant fixtures were inserted and graft materials placed into the left femur of in the experimental group, while the control group received only implant fixtures. In the first experimental group, platelet-rich plasma and BBP xenograft were placed at the implant fixture site, and the second experimental group had platelet-rich plasma, BBP xenograft, and the e-PTFE membrane placed at the fixture site. The degree of bone regeneration adjacent to the implant fixture was observed and compared histopathologically at 2, 4, and 8 weeks after implant fixture insertion. The results of the experiment are as follows: 1. The rate of osseointegration to the fixture threads was found to be greater in the first experimental group compared to the control group. 2. The histopathological findings of the second experimental group showed rapid resorption of BBP with subsequent new bone formation replacing the resorbed BBP. 3. The second experimental group showed new bone formation in the area adjacent to the fixture threads beginning two weeks after fixture implantation, with continued bone remodeling in the areas mesial and distal to the fixture. 4. Significant new bone formation and bone remodeling was observed in both experimental groups near the implant fixture sites. 5. The rate of osseointegration at the fixture threads was greater in the second experimental group compared to the first group, and the formation of new bone and trabeculae around the fixture site occurred after the fourth week in the second experimental group. The results of the experiment suggest that a greater degree of new bone formation and osseointegration can occur at the implant fixture site by utilizing platelet-rich plasma and bone xenografts, and that these effects can be accelerated and enhanced by concurrent use of a non-resorbable guided tissue membrane.
Bone Regeneration ; Bone Remodeling ; Dental Implants* ; Femur ; Heterografts ; Intercellular Signaling Peptides and Proteins ; Membranes ; Osseointegration ; Osteogenesis ; Platelet-Rich Plasma* ; Regeneration* ; Transplants