PURPOSE: For periodontal tissue engineering, it is a primary requisite and a challenge to select the optimum types of cells, properties of scaffold, and growth factor combination to reconstruct a specific tissue in its natural form and with the appropriate function. Owing to fundamental disadvantages associated with using a two-dimensional substrate, several methods of seeding cells into three-dimensional scaffolds have been reported and the authors have asserted its usefulness and effectiveness. In this study, we explore the cell attachment of periodontal ligament fibroblasts on nanohydroxyapatite (n-HA) scaffold using avidin biotin binding system (ABBS). METHODS: Human periodontal ligament fibroblasts were isolated from the health tooth extracted for the purpose of orthodontic procedure. HA nanoparticles were prepared and Ca(NO3)2-4H2O and (OC2H5)3P were selected as precursors of HA sol. The final scaffold was 8 mm in diameter and 3 mm in height disk with porosity value of 81.55%. 1x10(5) periodontal ligament fibroblasts were applied to each scaffold. The cells were seeded into scaffolds by static, agitating and ABBS seeding method. RESULTS: The number of periodontal ligament fibroblasts attached was greater for ABBS seeding method than for static or agitating method (P<0.05). No meaningful difference has been observed among seeding methods with scanning electron microscopy images. However, increased strength of cell attachment of ABBS could be deduced from the high affinity between avidin and biotin (Kd=10(-15) M). CONCLUSIONS: The high-affinity ABBS enhances the ability of periodontal ligament fibroblasts to attach to three-dimensionally constructed n-HA scaffolds.
Avidin ; Biotin ; Cell Adhesion ; Dihydroergotamine ; Fibroblasts ; Humans ; Microscopy, Electron, Scanning ; Nanoparticles ; Periodontal Ligament ; Polymethyl Methacrylate ; Porosity ; Seeds ; Tissue Engineering ; Tooth

Malignant fibrous histiocytoma (MFH) is an uncommon soft-tissue sarcoma that occurs primarily in the extremities and rarely involves the retroperitoneum and abdomen. A 63-year-old man was admitted to the emergency room because of epigastric pain. Computed tomography revealed a large heterogeneous enhanced mass originating from the omentum with hemoperitoneum. The patient underwent laparoscopic omental mass excision and hematoma evacuation. Histological examination of the resected tumor revealed MFH. This case was therefore omental MFH presenting with hemoperitoneum.
Abdomen ; Emergencies ; Extremities ; Hematoma ; Hemoperitoneum ; Histiocytoma, Malignant Fibrous ; Humans ; Middle Aged ; Omentum ; Sarcoma

Esophageal bezoars are rare, but are recognized as a distinct clinical entity. They are known to occur in patients with esophageal structural and functional abnormalities, but only a few cases of the development of esophageal bezoars in patients with esophageal motility disorders have only been described. We report a rare case of an esophageal bezoar that developed in a patient with achalasia, and review the literature concerning esophageal bezoars associated with esophageal motility disorders.
Bezoars ; Esophageal Achalasia ; Esophageal Motility Disorders ; Esophagus ; Humans

Fibrosing mediastinitis is a rare disease that is characterized by the proliferation of dense fibrous tissue of the mediastinum. The pathogenesis of fibrosing mediastinitis is unknown in most cases. However, histoplasmosis, tuberculosis, autoimmune disease, radiation therapy, and other idiopathic fibroinflammatory diseases have been implicated in some cases. Most clinical features are related to an obstruction or compression of the mediastinal structure. Fibrosing mediastinitis is often progressive and occurs diffusely throughout the mediastinum. We encountered a case of fibrosing mediastinitis of a very focal lesion without evidence of mediastinal involvement. The condition was confirmed by biopsy and graft bypass surgery was performed because of SVC syndrome.
Autoimmune Diseases ; Biopsy ; Histoplasmosis ; Mediastinitis* ; Mediastinum ; Rare Diseases ; Transplants ; Tuberculosis

BACKGROUND: The aim of this study was to investigate the prevalence, clinical and laboratory findings of hereditary hemolytic anemia (HHA) in Korea from 1997 to 2006 and to develop the appropriate diagnostic approach for HHA. METHODS: By the use of questionnaires, information on the clinical and laboratory findings ofHHA diagnosed from 1997 to 2006 in Korea was collected and analyzed retrospectively. A total of 431 cases were enrolled in this study from 46 departments of 35 hospitals. RESULTS: The overall frequency of HHA did not change through the 10-year period for pediatrics but did show an increasing tendency for internal medicine. The overall male to female sex ratio did not show sex predominance (1.17:1), but a significant male predominance with a ratio of 1.49:1 was seen for pediatrics while a significant female predominance with a ratio of 1:1.97 was seen forinternal medicine. Of the total cases, 74.2% (282/431) were diagnosed before the age of 15 years. The etiologies of HHA were classified as red cell membrane defects, hemoglobinopathies, red cell enzyme deficiencies and unknown causes. There were 382 cases (88.6%) of red cell membrane defects with 376 cases (87.2%) of hereditary spherocytosis and 6 cases (1.4%) of hereditary elliptocytosis, 20 cases (4.6%) of hemoglobinopathies with 18 cases (4.2%) of beta-thalassemia, a case (0.2%) of alpha-thalassemia and a case (0.2%) of Hemoglobin Madrid, 7 cases (1.6%) of red cell enzyme deficiencies with 5 cases (1.2%) of glucose-6- phosphate dehydrogenase (G-6-PD) deficiency, a case (0.2%) of pyruvate kinase (PK) deficiency and a case (0.2%) of enolase deficiency, and 22 cases (5.1%) of unknown causes. The most common chief complaint in pediatric patients was pallor and that in adult patients was jaundice. In the red cell membrane defect group of patients, the level of hemoglobin was significantly higher than in adult patients. The mean corpuscular volume, mean corpuscular hemoglobin, corrected reticulocyte count, total and indirect bilirubin level and lactate dehydrogenase levels in the hemoglobinopathy group of patients were significantly lower than the values in the red cell membrane defect group of patients. The mean concentration of G-6-PD was 0.8+/-0.7U/1012RBC in the G-6-PD deficient patients, PK was 1.7U/1010 RBC in the PK deficient patient, and the level of enolase was 0.04U/g of Hb in the enolase deficient patient. CONCLUSION: The most prevalent cause of HHA in Korea during 1997 to 2006 was hereditary spherocytosis, but HHA by other causes such as hemoglobinopathy and red cell enzyme deficiency gradually increased with the development of molecular diagnostic methods and increasing general interest. However, the etiologies of HHA need to be pursued further in 5.1% of the patients. An systematic standard diagnostic approach is needed in a nationwide prospective study for correct diagnoses and appropriate management of HHA.
Adult ; alpha-Thalassemia ; Anemia, Hemolytic, Congenital* ; beta-Thalassemia ; Bilirubin ; Cell Membrane ; Diagnosis ; Elliptocytosis, Hereditary ; Erythrocyte Indices ; Female ; Hemoglobinopathies ; Humans ; Internal Medicine ; Jaundice ; Korea* ; L-Lactate Dehydrogenase ; Male ; Oxidoreductases ; Pallor ; Pathology, Molecular ; Pediatrics ; Phosphopyruvate Hydratase ; Prevalence ; Pyruvate Kinase ; Reticulocyte Count ; Retrospective Studies* ; Sex Ratio ; Surveys and Questionnaires

No abstract available.
Embolism, Air*

BACKGROUND: The goal of therapeutic interventions for Parkinson's Disease (PD) is to improve the symptoms and mitigate the effect on the Quality of Life (QOL) in the individual patient. The purpose of this study was to investigate QOL and related factors in PD patients in Korea. METHODS: Between January 1, 2004 and July 15, 2004, eighty-one PD patients were included. The patients were assessed using Parkinson's Disease Quality of Life (PDQL), Modified Beck Depression Inventory (BDI), and K-MMSE. RESULTS: Twenty-five male and 56 female patients were included in the study. The mean age was 60.7 years and the mean disease duration was 7 years. The male patients (p=0.07) and young age at onset (p=0.07) showed borderline correlation with PDQL score. Medical cost for PD showed significant correlation with PDQL score (p<0.001). The patients working in the daytime or spending the daytime with their spouse showed significantly higher PDQL score than those who did not (p=0.01). Among the disease characteristics, the disease duration, levodopa dosage, UPDRS score, ADL, Hoehn and Yahr stage, the presence of motor fluctuation and dyskinesia, showed that depression had a strong correlation with the PDQL score (p<0.001). On the stepwise regression analysis, the most important factor was presence of depression, disease duration and the UPDRS total score in order of strength. CONCLUSIONS: The QOL in PD patients was strongly associated with depression, disease duration, and the severity of PD. We suggest that the assessment and proper management of depression as well as other PD symptoms is necessary to improve QOL of the PD patients.
Activities of Daily Living ; Depression ; Dyskinesias ; Female ; Humans ; Korea ; Levodopa ; Male ; Parkinson Disease* ; Quality of Life* ; Regression Analysis ; Spouses

BACKGROUND: Caring for patients with Parkinson's disease (PD) is a burden to caregivers since currently available treatment modalities for PD depend on symptomatic treatments. However, there have only been a few studies regarding the caregivers of PD patients. The authors investigated the burden, depression, and anxiety of the caregivers of PD patients. METHODS: Fifty-three main caregivers of PD patients were included. The burden, anxiety, and depression of the caregivers were evaluated using the Zarit Burden Inventory (ZBI), the Spielberger State-trait Anxiety Inventory, and the Beck Depression Inventory. RESULTS: Twenty-one male and 32 female patients had a mean age 61.4 years and a mean disease duration of 7.5 years. The caregivers included 29 men and 24 women with a mean age of 55.8 years. The sex of the patients (male) and caregivers (female), the relation to the patient (daughter-in-law), and frequency of hospital visits were all significantly associated with the caregiver's burden. Among the disease characteristics, the duration, severity of PD, presence of motor fluctuation, and levodopa-associated confusion/hallucination affected the caregivers' burden significantly. The level of depression and anxiety was positively correlated with the level of burden. On a stepwise regression analysis, the significant predictors of the caregivers' burden were ADL, UPDRS IV, and state anxiety in order of strength. CONCLUSIONS: The caregivers' burden in PD was affected by various demographic and disease characteristics, which also correlated with the level of depression and anxiety. We suggest that comprehensive treatment strategies for PD should be developed for the caregivers as well as the patients.
Activities of Daily Living ; Anxiety ; Caregivers ; Depression ; Female ; Humans ; Male ; Parkinson Disease* ; Regression Analysis

Chorea is an uncommon clinical manifestation of Sytemic lupus erythematosus (SLE). Its pathogenic mechanism has not been clearly clarified. We report a 54-year-old woman with SLE who presented with generalized chorea as an initial manifestation. Fluorine-18-fluorodeoxyglucose (FDG) PET revealed increased metabolism in the bilateral putamen. Intravenous and oral administration of steroid markedly improved chorea. Hypermetabolism of the bilateral putamen diminished on follow-up FDG-PET after the disappearance of chorea. This study suggests that chorea in SLE is associated with striatal hypermetabolism.
Administration, Oral ; Chorea* ; Female ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Humans ; Lupus Erythematosus, Systemic* ; Metabolism ; Middle Aged ; Putamen

Cystic lesions of adrenal gland are rare and those are most often identified incidentally during radiological investigation, surgery for unrelated process or at the time of autopsy. Most of cystic lesions are usually asymptomatic and less than 10 cm in diameter. Clinical management of an adrenal cyst can be aided by the imaging findings. Surgery is indicated for large and complicated cysts, parasitic cysts, uncertain cyst, and functioning or malignant cysts. We present a case of a 36-year-old female with the benign and non-functioning cyst that was detected by clinical assay and imaging study. The 4 X 2 cm right adrenal cyst contained linear calcification and septation. Laparoscopic resection and histologic findings were compatible with epithelial cyst of lymphangiomatous type of adrenal gland. With this case, diagnostic features of adrenal cysts are discussed.
Adrenal Glands ; Adult ; Autopsy ; Female ; Humans ; Lymphangioma, Cystic*