Computed tomography revealed variable sized small areas of extremely low attenuation in the right orbit of a45-year-old woman who had fallen face down. The appearance and attenuation of the areas suggested air, but on widewindow-width images attenuation was seen to be higher than that of sinus air. We report a case involvingintraorbital wood foreign bodies which on CT mimicked the appearance of air and which were surgically removed.
Female ; Foreign Bodies* ; Humans ; Orbit ; Wood*

No abstract available.
Brain Injuries* ; Child* ; Glasgow Coma Scale ; Humans

The purpose of this study is to identify a group of mild head injury patients having lesions on computerized tomography(CT) and to investigate the risk factors affecting the abnormal findings on CT scan. The study was limited to patients 16 years of age and older with a initial Glasgow Coma Scale(GCS) scores of at least 13 at the time of admission. Of a total of 243 patients studied, 156(64.2%) had abnormal CT findings. 49 patients(20.2%) required neurosurgical intervention(craniotomies for hematoma in 33, hematoma in 1 and subdural hygroma in 3). Four patients(2.4%) died of their cranial injury and three died of extracranial causes. The incidence of CT abnormalities for each GCS score was 86.7% in GCS of 13, 68.6% in GCS of 14, and 58.6% in GCS of 5. The factors affecting GCS scores at the time of admission were the presence of loss of consciousness and posttraumatic amnesia. The factors affecting abnormal CT scans were the presence of posttraumatic amnesia and skull fracture. A new lesion of extension of the initial finding on follow-up CT scans was found in 9.3% of 75 patients who underwent follow-up CT scans. Even though routine CT scans for mild head injury patients are not always necessary, these result suggest that all patients admitted to hospital after mild head injury should undergo CT scanning to enable early detection of an intracranial lesion.
Amnesia ; Coma ; Craniocerebral Trauma* ; Follow-Up Studies ; Glasgow Coma Scale ; Head* ; Hematoma ; Humans ; Incidence ; Risk Factors ; Skull Fractures ; Subdural Effusion ; Tomography, X-Ray Computed* ; Unconsciousness

For a missing teeth, orthodontic treatment may be a better choice of treatment in comparison to a conventional prosthetic replacement such as FPD, resin bonded prosthesis in view of aesthetics, periodontal health and function. Occasionally after an orthodontic treatment, an insufficient space may occur. The mini-implant could be an alternative in situations of narrow ridge dimension, where conventional root form implant could be compromised. The aim of this clinical report is to describe how a space that could not be restored with a traditional root form endosteal implant was managed and to present a technique to achieve optimal anterior esthetics in single implant restoration.
Esthetics ; Prostheses and Implants ; Tooth*

No abstract available.
Pulmonary Artery*

No abstract available.
Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Pregnancy*

PURPOSE: To evaluate the characteristic CT and cerebral angiographic findings in patients with acutespontaneous subdural hematomas and correlate these imaging findings with causes of bleeding and clinical outcome. MATERIALS AND METHODS: Twenty-one patients with nontraumatic acute spontaneous subdural hematoma presentingduring the last five years underwent CT scanning and cerebral angiography was performed in twelve. To determinethe cause of bleeding, CT and angiographic findings were retrospectively analysed. Clinical history, laboratoryand operative findings, and final clinical outcome were reviewed. RESULTS: The 21 cases of acute spontaneoussubdural hematomas were caused by cerebral vascular abnormalities(n=10), infantile hemorrhagic disease(n=5), orwere of unknown origin(n=6). All ten cases of cerebral vascular abnormality were confirmed angiographically; sixwere aneurysms, three were arteriovenous malformations, and one was moyamoya disease. On CT, subarachnoidhemorrhage was seen to be associated with aneurysms, intracerebral hemorrhage with arteriovenous malformations,and intraventricular hemorrhage with moyamoya disease. All five patients with hemorrhagic disease were infantsaged 1-17 months ; characteristic diffuse distribution of subdural hematoma in both temporoparietal-occipitalregions is typical. The average overall mortality rate was 52.4%(11/21). In patients with cerebral vascularabnormalities, mortality was as low as 20%(2/10), but in hemorrhagic disease was high (60%). In cases of unknownorigin it was 100%. CONCLUSION: Acute spontaneous subdural hematoma is a rare condition, and the mortality rateis high. In patients with acute spontaneous subdural hematoma, as seen on CT, associated subarachnoid orintracerebral hemorrhage is strongly indicative of intracerebral vascular abnormalities such as aneurysm andarteriovenous malformation, and cerebral angiography is necessary. To ensure proper treatment and thus morkedlyreduce mortality, the causes of bleeding should be prompty determined by means of cerebral angiography.
Aneurysm ; Arteriovenous Malformations ; Cerebral Angiography ; Cerebral Hemorrhage ; Hematoma ; Hematoma, Subdural* ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Mortality ; Moyamoya Disease ; Retrospective Studies ; Tomography, X-Ray Computed

Early gastric cancer (EGC) is defined as a carcinoma confined to the mucosa or submucosa of the stomach, with or without lymph-node metastasis. Synchronous liver metastasis is 5~12.8% in advanced gastric cancer, but is very low in EGC. A 64-year-old woman was admitted to St. Vincent's Hospital with a complaint of epigastric pain. Gastrofiberscopic examination showed a polypoid mass on the gastric antrum. Abdominal computed tomography demonstrated an intraluminal polypoid mass in the gastric antrum, but no tumor mass in the liver. A laparotomy revealed a solitary liver metastasis, we performed a distal partial gastrectomy with a group-2 lymph-node dissection and resection of metastatic liver tumor. Histologic examination showed a tubular adenoma with a focal carcinomatous change, which was confined to the gastric mucosa and to the metastatic adenocarcinoma in the liver. We present a case of early gastric mucosal cancer associated with synchronous liver metastasis, along with a review of the literature.
Adenocarcinoma ; Adenoma ; Female ; Gastrectomy ; Gastric Mucosa ; Humans ; Laparotomy ; Liver* ; Middle Aged ; Mucous Membrane ; Neoplasm Metastasis* ; Pyloric Antrum ; Stomach ; Stomach Neoplasms

Hypertension is a frequent complication after organ transplantation and remains risk factor for the development of cardiovascular disease and graft dysfunction after renal transplantation. The prevalence of hypertension after renal transplantation varies from 50% to 93%. There are multiple mechanisms for development of post-transplant hypertension. To examine the effects of hypertension on renal allograft survival, we studied the clinical course of 319 kidney transplant recipients(male:female=231:88, mean age=32.9+/-10.4 yrs) who had functioning graft at least 6 months. The patients were divided into three groups : normotensive groups(n=90), controlled hypertensive groups(n=176) and uncontrolled hypertensive groups(n=53). Among 319 patients, 229(72%) were hypertensive at the time of renal transplantation. The incidence of hypertension decreased progressively to 68%, 65% and 61% at 1, 3 and 5 years after transplantation (p<0.05). The numbers of antihypertensive medication at the time of operation was 1.35+/-1.09, which decreased significantly to 0.98+/-0.76 at 12 months after renal transplantation(p<0.05). Cumulative graft survival at 5 years for normotensive and controlled hypertensive patients were 44% and 50% respectively, 20% for uncontrolled hypertensive patients. The difference of 5 years graft survival between controlled hypertensive and uncontrolled hypertensive patietns was significant (p<0.01), whereas the difference between the normotensive and controlled hypertensive group was not significant. We conclude that hypertension per se may not be an important risk factor for renal graft survival. However, the control of hypertension appear to be a more important risk factor for renal allograft survivial.
Allografts* ; Cardiovascular Diseases ; Graft Survival ; Humans ; Hypertension* ; Incidence ; Kidney Transplantation* ; Kidney* ; Organ Transplantation ; Prevalence ; Risk Factors ; Transplants

Thrombospondin-1 (TSP-1), a multifunctional protein that is able to function as a negative regulator of solid tumor progression and angiogenesis, is normally present at a very low level but rapidly elevated in pathological tissues. To understand the cellular regulation of TSP-1 expression, the mode of it's expression in Hep3B, SK-HEP-1, and porcine aortic endothelial (PAE) cells was examined in the presence of all-trans retinoic acid (ATRA), interleukin-6 (IL-6), interferon-gamma (IFN-gamma), or phorbol 12-myristate 13-acetate (PMA). ATRA or IL-6 induced a dose-dependent increase of TSP-1 protein and mRNA levels in PAE cells, while they negatively regulated TSP-1 expression in the Hep3B and SK-HEP-1 cells. In contrast, PMA showed just the opposite effects on the TSP-1 expression in the same cells. IFN-gamma had little effect on TSP-1 level in Hep3B and PAE cells. The TSP-1 expression in SK-HEP-1 cells by these agents showed a close resemblance to that of liver cells rather than that of the endothelial cell line. Possible TSP-1 promoter-mediated responses by ATRA, IL-6, IFN-gamma, or PMA in Hep3B and PAE cells examined with luciferase activity of TSP-LUC reporter plasmid showed that levels of TSP-1 promoter activity were lower than that of the expressed TSP-1 protein and mRNA levels. Transfection of c-Jun and/or RARalpha expression vectors into Hep3B and PAE cells resulted in the enhanced TSP-1 promoter activity as well as the increments of of its protein and mRNA level. These results suggest that regulatory agents-induced TSP-1 expression may be attributed to mRNA stability and/or translational activation in concert with transcriptional activation and TSP-1 expression may be independently controlled via each signal pathway stimulated by PMA or ATRA.
Animal ; Cell Line ; Endothelium, Vascular/cytology/drug effects/metabolism ; *Gene Expression Regulation/drug effects ; Genes, Reporter ; Genes, jun ; Human ; Immunoblotting ; Interferon Type II/pharmacology ; Interleukin-6/pharmacology ; *Promoter Regions (Genetics) ; Proto-Oncogene Proteins c-jun/genetics/metabolism ; Receptors, Retinoic Acid/genetics/metabolism ; Recombinant Fusion Proteins/metabolism ; Tetradecanoylphorbol Acetate/pharmacology ; Thrombospondin 1/*genetics/metabolism ; Transcription, Genetic ; Tretinoin/pharmacology