No abstract available.
Mitral Valve Insufficiency*

As the use computed tomographic (CT) scanning spread, the diagnosis of blowout fractures of the medial orbital wall increased. Now, the diagnosis of blowout fracture in the medial wall are not uncommon. Conventionally, the surgery of blowout fractures in medial orbital wall was performed by the various approach with external incision. The conventional method had seveal possible disadvantages, including an external scar, incomplete reduction, increased mobidity rate and general anesthesia. Recently, endoscopic reconstruction of the medial orbital wall has provided good functional and cosmetic results. We performed endoscopic transnasal reduction surgery without external incision in 12 cases of medial blowout fracture under local anesthesia. The fractured bony fragments were removed after the intranasal ethmoidectomy and the entrapped medial rectus was released. And then a sheet of silicone late or uncinate process were placed on the fracture site. For the maintain of the position of fractured wall, Merocel packing or urinary ballon catheter were used in orbital fracture site for 1-3 weeks. There were no specific complications related to this procedure. Result of the surgery in all cases were satisfactory. In this article, we discussed the surgical procedure, the benifit of the transnasal endoscopic approach, the indications for surgery, and possible comlications.
Anesthesia, General ; Anesthesia, Local ; Catheters ; Cicatrix ; Diagnosis ; Orbit* ; Orbital Fractures ; Silicones

Sweat gland carcinoma is the uncommon neoplasm, with few cases reported in the literatures. In a review of literatures, the most commonly used term is malignant nodular hidradenoma; however, similar cases also have been known as a malignant clear cell hidradenoma, malignant clear cell myoepithelioma, clear cell eccrine carcinoma and malignant clear cell acrospiroma. It is difficult to differentiate clinically between sweat gland carcinomas and other skin lesion, such as keloids, sebaceous cyst, dermatofibroma, lymphoma, and squamous cell carcinoma. Thus, a preoperative diagnosis of sweat gland carcinoma is rarely made and histologic examination is the only means of diagnosis. Most sweat gland carcinomas are found on the scalp, face, upper extremities, and axilla. The lesions are typically small, very slow growing, painless nodules. However, it is aggressive, infiltrative, and has highly recurrent rate. Lymph node metastases are frequent and overall survival is poor. So, that must be treated with wide local excision of the lesion and primary regional node dissection is recommended.We have experienced of a case of malignant nodular hidradenoma in cheek area. It was widely excised by total parotidectomy and covered by scapula fasciocutaneous free flap. We report this case with the review of the literature.
Acrospiroma* ; Axilla ; Carcinoma, Squamous Cell ; Cheek ; Diagnosis ; Epidermal Cyst ; Free Tissue Flaps ; Histiocytoma, Benign Fibrous ; Keloid ; Lymph Nodes ; Lymphoma ; Myoepithelioma ; Neoplasm Metastasis ; Scalp ; Scapula ; Skin ; Sweat Glands ; Upper Extremity

Sweat gland carcinoma is the uncommon neoplasm, with few cases reported in the literatures. In a review of literatures, the most commonly used term is malignant nodular hidradenoma; however, similar cases also have been known as a malignant clear cell hidradenoma, malignant clear cell myoepithelioma, clear cell eccrine carcinoma and malignant clear cell acrospiroma. It is difficult to differentiate clinically between sweat gland carcinomas and other skin lesion, such as keloids, sebaceous cyst, dermatofibroma, lymphoma, and squamous cell carcinoma. Thus, a preoperative diagnosis of sweat gland carcinoma is rarely made and histologic examination is the only means of diagnosis. Most sweat gland carcinomas are found on the scalp, face, upper extremities, and axilla. The lesions are typically small, very slow growing, painless nodules. However, it is aggressive, infiltrative, and has highly recurrent rate. Lymph node metastases are frequent and overall survival is poor. So, that must be treated with wide local excision of the lesion and primary regional node dissection is recommended.We have experienced of a case of malignant nodular hidradenoma in cheek area. It was widely excised by total parotidectomy and covered by scapula fasciocutaneous free flap. We report this case with the review of the literature.
Acrospiroma* ; Axilla ; Carcinoma, Squamous Cell ; Cheek ; Diagnosis ; Epidermal Cyst ; Free Tissue Flaps ; Histiocytoma, Benign Fibrous ; Keloid ; Lymph Nodes ; Lymphoma ; Myoepithelioma ; Neoplasm Metastasis ; Scalp ; Scapula ; Skin ; Sweat Glands ; Upper Extremity

PURPOSE: The aim of this study is to determine whether certain biomaterials have the potential to support cell attachment. After seeding bone marrow stromal cells onto the biomaterials, we investigated their responses to each material in vitro. METHODS: Rat bone marrow derived stromal cells were used. The biomaterials were deproteinized bovine bone mineral (DBBM), DBBM coated with fibronectin (FN), synthetic hydroxyapatite (HA), HA coated with FN, HA coated with beta-tricalcium phosphate (TCP), and pure beta-TCP. With confocal laser scanning microscopy, actin filaments and vinculin were observed after 6, 12, and 24 hours of cell seeding. The morphological features of cells on each biomaterial were observed using scanning electron microscopy at day 1 and 7. RESULTS: The cells on HA/FN and HA spread widely and showed better defined actin cytoskeletons than those on the other biomaterials. At the initial phase, FN seemed to have a favorable effect on cell adhesion. In DBBM, very few cells adhered to the surface. CONCLUSIONS: Within the limitations of this study, we can conclude that in contrast with DBBM not supporting cell attachment, HA provided a more favorable environment with respect to cell attachment.
Actin Cytoskeleton ; Animals ; Biocompatible Materials ; Bone Marrow ; Bone Substitutes ; Calcium Phosphates ; Cell Adhesion ; Durapatite ; Fibronectins ; Mesenchymal Stromal Cells ; Microscopy, Confocal ; Microscopy, Electron, Scanning ; Rats ; Seeds ; Stem Cells ; Stromal Cells ; Transplants ; Vinculin

BACKGROUND: Elevated homocysteine (hcy) levels are associated with dementia, which is a frequent non-motor symptom of Parkinson's disease (PD). High levels of hcy in PD patients treated with levodopa are thought to result from increased synthesis during the metabolism of levodopa by COMT, and that use of a COMT-inhibitor may reduce hcy levels. In this study, we sought to clarify the effects of COMT-inhibitors on dementia in PD patients. METHODS: Thirty-eight PD patients without dementia (PDwoD), 35 PD patients with dementia (PDD), and 48 controls were enrolled in this study. All subjects underwent neuropsychological testing and a neurological examination. The hcy levels were measured in all subjects, and the relationship between hcy levels and dementia was evaluated in two PD groups (those that underwent treatment with levodopa-alone versus treatment with levodopa plus a COMT-inhibitor). RESULTS: Patients in the PDD group showed higher hcy levels than patients in the PDwoD group, though there was no significant difference in the hcy level between PDwoD patients and healthy controls. Regarding the effects of a COMT-inhibitor, there was no correlation between hcy levels in the 2 PD subgroups, indicating that there were no significant effects of the COMT-inhibitor on PDD. In addition, the odds ratio for PDD with the use of a COMT-inhibitor was 0.864 (95% CI=0.342-2.180). CONCLUSIONS: These results are in agreement with previous studies in that levodopa treatment in PD patients leads to elevated hcy concentrations. COMT-inhibitors, on the other hand, had no preventive effect on cognitive impairment in PD patients.
Dementia ; Hand ; Homocysteine ; Humans ; Levodopa ; Neurologic Examination ; Neuropsychological Tests ; Odds Ratio ; Parkinson Disease

Pleomorphic xanthoastrocytoma(PXA) is a rare neoplasm with favorable prognosis despite of its aggressive histological features. The authors report three cases of pleomorphic xanthoastrocytomas. The masses were in the temporal or parietal lobe of children or adolscence and presented as complex partial seizures. Total removal of mass was performed in all three cases and the seizure was abscent postoperatively. It is important to differentiate of pleomorphic xanthoastrocytoma from other malignant brain tumors and identify this type of glioma as a distinct entity.
Brain Neoplasms ; Child ; Glioma ; Humans ; Parietal Lobe ; Prognosis ; Seizures

The visualization of coronary arteries by transthoracic two-dimensional echocardiography has been used for over 10 years. In many cases, the imaging quality is too poor to allow an anatomic evaluation. During the last few years, transesophageal echocardiography has been shown to provide optimal imaging quality in virtually all patients and of all cardiac structures including the coronary arteries. The purpose of this study was to test the ability of transesophageal echocardiography in the visualiation of the coronary arteries and assessment of coronary blood flow by transesophageal two-dimensional pulsed Doppler echocardiography. We Studied 285 patients, 91 men and 194 women, aged 16 to 81 year(mean 50.6 year men, mean 54.2 year women). We have been used a 5-MHz phased array transducer with incorporated color-coded Doppler. The left main coronary artery was visualized 95.1%, left circumflex artery 27.4, left anterior descending artery 21.4% and the main stem of the proximal right coronary artery 45.1%. The time-sequential left anterior descending artery flow pattern generally consisted of a small late systolic component and a large diastolic component. The peak flow velocity in the proximal left anterior descending artery during diastole was 40.8+/-8.0cm/sec(integrity 7.6+/-0.9) and during late systole was 18.5+/-5.5cm/sec(integrity 2.9+/-0.9). There were no complications during and after examination. This study suggests that transesophageal color-coded Doppler two-dimensional echocardiography appers to be a feasible noninvasive technique for imaging the proximal left coronary artery and the left anterior descending artery flow is detectable from the transesophageal approach.
Arteries ; Coronary Vessels* ; Diastole ; Echocardiography ; Echocardiography, Doppler* ; Echocardiography, Doppler, Pulsed ; Echocardiography, Transesophageal ; Female ; Humans ; Male ; Systole ; Transducers

Transesophageal echocardiography(TEE) is a new acoustic window to the cardiac structures and great vessels via retrocardiac esophagus. Because of the close relation between the esophagus and the heart, higher transducer frequencies can be applied, therefore leading to improved resolution and more accurate images than transthoracic echocardiography. We describe our experience with the first 353 awake patients. The procedure was well tolerated by the patients and associated with no major complications, within examination 10 to 20 minutes. Clinical diseases which appear to be suited for TEE includes 1) evaluation of native valve diseases, particulary mitral valve, pathologic valvular abnormalities and color Doppler regurgitant flows ; 2) assesment of prosthetic heart valves to better define malfunction and important pathologic associations ; 3) congenital heart disease, particularly atrial septal defect ; 4) endocarditis and detection of vegetations and complications ; 5) detection of thrombus and tumors, size, location, morphology, stalk ; and 6) aortic pathology including atherosclerosis, aneurysm and dissection. We conclude that transesophageal echocardiography is a new imaging technique that is rapidly evolving into a major tool for general cardiac imaging in a variety pathologic conditions and is a safe and useful tool in patients. Future advances in probe technology will continue to expand its applications.
Acoustics ; Aneurysm ; Atherosclerosis ; Echocardiography ; Echocardiography, Transesophageal* ; Endocarditis ; Equidae ; Esophagus ; Heart ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Heart Valves ; Humans ; Mitral Valve ; Pathology ; Thrombosis ; Transducers

PURPOSE: Connective tissue reattachment to periodontally damaged root surfaces is one of the most important goals of periodontal therapy. The aim of this study was to develop a root conditioning agent that can demineralize and detoxify the infected root surface. METHODS: Dentin slices obtained from human teeth were treated with a novel root planing agent for 2 minutes and then washed with phosphate-buffered saline. Smear layer removal and type I collagen exposure were observed by scanning electron microscopy (SEM) and type I collagen immunostaining, respectively. Cell attachment and lipopolysaccharides (LPS) removal demonstrated the efficiency of the root conditioning agent. RESULTS: SEM revealed that the smear layer was entirely removed and the dentinal tubules were opened by the experimental gel. Type I collagen was exposed on the surfaces of the dentin slices treated by the experimental gel, which were compared with dentin treated with other root planing agents. Dentin slices treated with the experimental gel showed the highest number of attached fibroblasts and flattened cell morphology. The agar diffusion assay demonstrated that the experimental gel also has effective antimicrobial activity. Escherichia coli LPS were effectively removed from well plates by the experimental gel. CONCLUSIONS: These results demonstrated that this experimental gel is a useful tool for root conditioning of infected root surfaces and can also be applied for detoxification of ailing implant surface threads.
Agar ; Collagen ; Collagen Type I ; Connective Tissue ; Dentin ; Diffusion ; Drugs, Chinese Herbal ; Escherichia coli ; Fibroblasts ; Humans ; Lipopolysaccharides ; Microscopy, Electron, Scanning ; Root Planing ; Smear Layer ; Tooth