Although heterotopia of pancreatic tissue is a developmental anomaly found in approximately 2% of all autopsies, pancreatic tissue within the thorax and mediastinum is uncommon. In most of these instances, the pancreatic tissue is a component of gastroenteric duplication cysts, intralobar pulmonary sequestrations or teratomas. We describe an anterior mediastinal cyst consisting entirely of pancreatic tissue. A previously healthy 27-year-old woman was admitted due to chest pain during deep inspiration. The computed tomographic scan of the thorax showed a large cyst occupying the right anterior mediastinum. The excised multilocular cystic lesion measured 12 cm in maximum diameter and contained a brown, turbid fluid. The wall was fibrotic and showed a haphazard mixture of ducts and exocrine acini without islets. The histogenesis of this lesion is unclear.
Adult ; Autopsy ; Bronchopulmonary Sequestration ; Chest Pain ; Female ; Humans ; Mediastinal Cyst ; Mediastinum* ; Pancreatic Cyst* ; Teratoma ; Thorax

Anaphylaxis during anesthesia is rare, but often fatal. Rocuronium is a neuromuscular relaxant used for induction of anesthesia. We experienced a case of anaphylaxis after rocuronium administration during induction of anesthesia. A 64-year-old female patient was scheduled for bilateral radius fracture fixation. The history of patient showed no specific findings other than hypersensitivity to mackerel. She had no previous experience of anesthesia. Anesthesia was induced by intravenous injection of propofol 100 mg and continuous infusion was begun with remifentanil 0.25 µg/kg/min, followed by rocuronium 40 mg. Immediately after intravenous administration of rocuronium, the manual ventilation became difficult, and the patient developed erythema and severe hypotension. The patient was diagnosed with anaphylaxis based on clinical features and started treatment. First, we performed endotracheal intubation promptly. Then, immediate intravenous administration of epinephrine and fluid followed. Despite adequate treatment, hypotension was not corrected and intravenous epinephrine was administered. However, ventricular tachycardia occurred which was successfully treated with a defibrillator. Later, the patient uneventfully recovered in the intensive care unit. The patient was not tested for skin prick test, but rocuronium was the most likely cause of anaphylaxis at that time. The authors unexpectedly experienced drug-induced anaphylaxis, which is life-threatening to the patient. Clinicians should be aware of the diagnosis, treatment, and prevention as anaphylaxis can be hazardous to the patient.
Administration, Intravenous ; Anaphylaxis* ; Anesthesia* ; Defibrillators ; Diagnosis ; Epinephrine ; Erythema ; Female ; Humans ; Hypersensitivity ; Hypotension ; Injections, Intravenous ; Intensive Care Units ; Intubation, Intratracheal ; Middle Aged ; Perciformes ; Propofol ; Radius Fractures ; Skin ; Tachycardia, Ventricular ; Ventilation

PURPOSE: The aim of this study was to evaluate the periodontal and prosthodontic complications of multiple freestanding implants in the posterior jaws for up to 1 year of function. MATERIAL AND METHODS: Eight patients received 20 implants posterior to canines. Two or more implants were consecutively inserted to each patient. Single crowns were delivered onto the implants. Marginal bone loss, implant mobility, probing depth, and screw loosening were examined to evaluate the clinical success of such restorations for maximum 1 year of functional loading. RESULTS: All the implants performed well during the observation period. Neither periodontal nor prosthodontic complications were found except a slight porcelain chipping. While the marginal bone level was on average 0.09 mm lower around the implant after 6 months of loading, it was 0.15 mm higher after 1 year. CONCLUSION: Within the limits of this investigation, separate single-tooth implant restorations to replace consecutive missing teeth may clinically function well in the posterior jaw.
Cohort Studies ; Crowns ; Dental Implants, Single-Tooth ; Dental Porcelain ; Humans ; Jaw ; Prospective Studies ; Prosthodontics ; Tooth

BACKGROUND: Although congenital anomalies of the coronary arteries are rare, which may cause serious clinical problems in diagnostic or surgical procedures, the accurate knowlegde and understanding of these are essential. We are to assess the clinical and angiographic characteristics of congenital anomalies of the coronary arteries detected in adulthhood. METHODS: We retrospectively analyzed a total of 67 cases of primary congenital anomalies of the coronary arteries with particular emphasis in angiographic findings in corelation with the clinical and surgical findings, reviewing 16,099 coronary angiography performed during last 6 years in three institutes. RESULTS: The incidence of congenital anomalies of the coronary arteries detected in coronary angiography was 0.4% and all were primary anomalies, among which major anomalies were 53 cases(79%) and minor anomalies were 14 cases(21%). Twenty-nine cases had associated cardiac defects. Among them congenital heart disease were 10 cases(34%), valvular heart disease were 10 cases(34%), coronary atherosclerotic disease were 8 cases(28%) and hypertrophic obstructive cardiomyopathy was 1 cases(4%). The coronary artery fistula were 40 cases, which was the most common anomaly among major group and the communication between coronary artery and bronchial artery were 6 cases, which was the most common one among minor group. Myocardial ischemia was observed in 49% of major and in 29% of minor anomalies. CONCLUSION: We are reporting 67 cases of the congenital anomalies of the coronary arteries detected in adulthood with the clinical and the angiographic characteristics. We suggest that new modified classification of the congenital coronary anomalies is necessary, because symptoms and signs of myocardial ischemia were observed in a significant number of patients among minoranomaly group.
Academies and Institutes ; Bronchial Arteries ; Cardiomyopathy, Hypertrophic ; Classification ; Coronary Angiography ; Coronary Vessels* ; Fistula ; Heart Defects, Congenital ; Heart Valve Diseases ; Humans ; Incidence ; Myocardial Ischemia ; Retrospective Studies

Background: Evaluation of bony union after bone grafting is very important in orthopedic surgery. The aim of this study was to verify inter- and intraobserver reliability of the Goldberg scoring system for radiographic evaluation of bony union after bone grafting in various situations of animal models. Methods: Twenty-seven male C57/BL6 mice, which lack the ability to synthesize galactose-alpha-1,3-galactose (GalT KO mice), and 9 C57/BL6 mice carrying a wild-type gene were used as animal models. We divided the mice into four groups. In group 1, syngenic bone grafting and intramedullary fixation were performed (9 wild type C57BL/6 mice). In group 2, allogenic bone grafting was performed (9 GalT KO mice). In group 3, an alpha-galactosidase-treated porcine xenograft was transplanted into the femur to reduce the antigenicity (9 GalT KO mice). In group 4, a non-treated porcine xenobone grafting was performed (9 GalT KO mice). The level of radiographic bony union (Goldberg method) was assessed by three orthopedic surgeons. Intra- and interobserver reliability for radiographic evaluation was assessed. Results: In the Goldberg scoring system, most of the radiographic measurements showed substantial to almost perfect intraobserver reliability. The total score showed substantial intraobserver reliability. The kappa coefficient (κ) of the first examiner was 0.603, the κ of the second examiner was 0.790, and the κ of the third examiner was 0.758. The scoring system showed substantial interobserver reliability. The κ of the first session was 0.641 and the κ of the second session was 0.649. Conclusions The Goldberg scoring system is a reliable tool for radiographic evaluation of bony union after bone grafting.

No abstract available.
Lymphangioma*

Cauda equina syndrome is a rare neurologic complication in patient with long-standing ankylosing spondylitis. Authors report a case of cauda equina syndrome. in ankylosing spondylitis. On plain radiographs, typical "bamboo spine" and fusion of sacroiliac joints were noted. MRI of the lumbar spine revealed arachnoid diverticulae which were isointense to cerebrospinal fluid on all spin echo sequences, and showed bony erosion and scalloping of posterior arches.
Arachnoid Cysts ; Cauda Equina* ; Cerebrospinal Fluid ; Humans ; Magnetic Resonance Imaging* ; Pectinidae ; Polyradiculopathy* ; Sacroiliac Joint ; Spine ; Spondylitis, Ankylosing*

No abstract available.
Arteritis* ; Lupus Erythematosus, Systemic* ; Nephritis*

PURPOSE: The purpose of this study was to determine the changing patterns of nausea, vomiting, anorexia and calorie intake. To examine the influence of those variables on the nutritional status of the cancer patients receiving chemotherapy. METHOD: To assess nutritional status, anthropometry and blood test were performed on 94 stomach cancer patients receiving postoperational chemotherapy on the daily basis. NVA and calorie intake were measured during chemotherapy. RESULT: 93% of subjects had low level of hemoglobin and 45.7% was below the lymphocyte count. 57% of subjects lost 10% of usual weight. The value of anthropometry was reduced but the difference between pre- and post-chemotherapy did not reach any statistical significance. 27% of subjects was grouped into the malnutritional state. During chemotherapy, the higher the degree of NVA, the less calorie intake. The significant predictors for nutritional status were nausea and calorie intake. CONCLUSION: The chemotherapy affected the food intake of cancer patients through NVA. Though the influence of chemotherapy on anthropopmetry was not significant in this research, nausea and food intake were the most affecting factors for nutrition of cancer patients. Therefore we need to assess nutritional status and support for cancer patients receiving chemotherapy and to develop an intervention for improvement of symptoms and food intake.
Anorexia ; Anthropometry ; Drug Therapy* ; Eating ; Hematologic Tests ; Humans ; Lymphocyte Count ; Nausea ; Nutritional Status* ; Stomach Neoplasms ; Vomiting

No abstract available.