ABSTRACT
Rapid crestal bone resorption following maxillary tooth loss is further accentuated in the posterior regions because of pneumatization and enlargement of the maxillary sinuses. A treatment rationale that allows preservation and augmentation of vertical available bone at the time of posterior maxillary tooth extraction may offer numerous therapeutic benefits which are more short courses of therapy and no needs of additional surgical augmentation. The present study comprised 3 patients who had 4 posterior maxillary teeth with no evident bone between the tooth apex and sinus floor, as estimated through preoperative radiographic analysis. Sinus floor augmentation at the time of tooth extraction was chosen for the ltreatment of these patients. After the tooth was carefully extracted, the empty alveolus was thoroughly debrided and a trephine approach was performed. Particulated autogenous bone was gently pushed beyond the empty alveolus to elevate the sinus membrane using an osteotome. The distance between bone crest and sinus floor was radiographically estimated 4 months after the first procedure. Another procedure was then carried out to place the implants of 11 mm length without another augmentation procedure. All implant were clinically stable, with no sign of infection. The presented surgical procedure performed at the time of extraction of posterior maxillary teeth in close proximity to the sinus floor allowed placement of implants of proper length.
Subject(s)
Humans , Bone Resorption , Maxillary Sinus , Membranes , Sinus Floor Augmentation , Tooth Apex , Tooth Extraction , Tooth Loss , ToothABSTRACT
Twin pregnancy is at increased risk for congenital anomalies. Although twins were relatively infrequent, they accaunted for a disproportionately large portion of adverse pregnancy outcome, primarily as a consequence of preterm delivery, gestational diabetes, and pregnancy induced hypertension. In case of twin pregnancy with a single anomalous fetus, the clinicians are faced with difficult decision-making processes regarding the route of delivery, when to deliver, how aggressively to attempt to prevent delivery. Twin pregnancy discordant for a fetal abnormality can be managed expectantly or by selective fetocide of abnormal twin. Recently we experienced two cases of twin pregnancy with a single anornalous fetus. We reported cases with concerned literatures.
Subject(s)
Female , Humans , Pregnancy , Diabetes, Gestational , Fetus , Hypertension, Pregnancy-Induced , Pregnancy Outcome , Pregnancy, TwinABSTRACT
The uterus with rudimentary horn occurs as a result of a lack of development during fetal life of the middle and lower parts of one of the Miillerian ducts, in which there is a failure of fusion of the two ducts, The incidence of this uterine anomaly is rare. Many cases of rudimentary uterine horn are not discovered since they do not become involved in a pregnancy, and thus remain symptomless and uncomplicated, and the diagnosis usually being made only with pregnancy with rupture. In this presentation, we describe a case of diagnosis and management of unruptured non-communicating rudimentary uterine horn pregnancy at the third trimester. The patient diagnosed by ultrasonography and MRI, was hospitalized for further evaluation and delivery under the impression of unruptured non-communicating rudimentary horn pregnancy. A living male infant weighing 1,930 gm was delivered by cesarean section at 33+l weeks due to impending preterm labor. Some articles concerned this subject were reviewed briefly to discuss relevant method of diagnosis, treatment, and clinical characteristics.
Subject(s)
Animals , Female , Humans , Infant , Male , Pregnancy , Cesarean Section , Diagnosis , Horns , Incidence , Magnetic Resonance Imaging , Obstetric Labor, Premature , Pregnancy Trimester, Third , Rupture , Ultrasonography , UterusABSTRACT
OBJECTIVE: The purpose of this study was to determine whether cyclooxygenase [COX]-1 and COX-2 are expressed in the pregnant human uterine cervix and if they are expressed differentially between preterm and term pregnancies. METHODS: Fourteen patients delivered between 29 and 41 weeks of gestation were matched for obstetrical history and maternal age were divided into a preterm group who delivered between 29 and 36 weeks [n=7], and a term group who delivered between 37 and 41 weeks of gestation [n=7]. Immediately after vaginal delivery cervical biopsy samples were obtained and immunohistochemicaly stained for COX-1 and COX-2 and the degree of staining was evaluated by H-scoring system. RESULTS: Expression of COX-1 and COX-2 was found in all epithelial and stromal cells of uterine cervical tissues of pregnancy. The expression of COX-1 and COX-2 was significantly stronger in the term group compared to the preterm group in epithelial cells [HSCORE : 2.14+/-0.69 vs. 1.14+/-0.38 ; 3.71+/-0.76 vs. 1.86+/-0.90, p0.05]. CONCLUSION: In the pregnant human uterine cervix, COX-1 and COX-2 are found to be expressed, and both are strongly expressed in the cervical epithelial cells of term pregnancies compared to preterm pregnancies. It is suggested that the uterine cervix, under the control of prostaglandins, is actively involved in the process of labor, and that the role of COX-2 in epithelium is particularly significant in term pregnancies compared to preterm pregnancies.
Subject(s)
Female , Humans , Pregnancy , Biopsy , Cervix Uteri , Cyclooxygenase 1 , Cyclooxygenase 2 , Epithelial Cells , Epithelium , Maternal Age , Prostaglandin-Endoperoxide Synthases , Prostaglandins , Stromal CellsABSTRACT
BACKGROUND: Nonimmune hydrops fetalis has become an important perinatal problem since it was first described in 1943. Although recent advances in antenatal ultrasound have made it possible to detect and manage nonimmune hydrops fetalis in early pregnancy, the perinatal mortality is still high. OBJECTIVE: To obtain clinically useful data regarding antenatal diagnosis, management, and perinatal outcomes of nonimmune hydrops fetalis, and to assist clinicians offer proper antepartum counseling and obstetric management which may be able to improve prognosis. Study design: We retrospectively reviewed 33 cases of nonimmune hydrops fetalis delivered in our hospital over a 4-year period. RESULTS: The antenatal diagnosis was possible by ultrasonography in all cases. Accumulation of fluid in fetal serous cavity and generalized skin edema were observed in all cases. A probable etiology was found in 23 (69.7%) cases through ultrasonography, various laboratory studies including fetal karyotyping, and autopsies. These were cardiovascular (4), respiratory (6), chromosomal (4), skeletal (1), and others (8). Despite extensive diagnostic studies, no definite etiology was found in 10 (30.3%) cases. Excluding the ten fetuses delivered after induced abortion, eight infants were born alive and six died in the neonatal period. The mortality rate was 91.3% (21/23). CONCLUSION: Nonimmune hydrops fetalis represents a very poor perinatal outcome. It is suggested that to improve the prognosis, various antenatal and postnatal approaches to find associated etiologic factors should be performed, and intensive perinatal cares are needed.
Subject(s)
Female , Humans , Infant , Pregnancy , Abortion, Induced , Autopsy , Counseling , Edema , Fetus , Hydrops Fetalis , Karyotyping , Mortality , Perinatal Mortality , Prenatal Diagnosis , Prognosis , Retrospective Studies , Skin , UltrasonographyABSTRACT
OBJECTIVE: The goal of this study is to determine the efficacy of rapid karyotyping from fetal ascitic fluid. METHODS: In three cases of isolated fetal ascites diagnosed by prenatal ultrasonography, ultrasound guided fetal paracentesis and amniocentesis were performed and successfully obtained. Fetal karyotyping in each case at 29, 30 and 32 weeks gestation using modified lymphocyte culture method was conducted. RESULTS: The chromosomal analysis was successful within 72 hours and abnormalities were detected in two cases and revealed trisomy 21 in each case. Our study demonstrated that the majority distribution of white blood cells was lymphocytes which ranged from 2.1 * 10(6) cells/ml to 3.7 * 10(6) cells/ml and the cell density for culture was at least than 0.35 * 10(6) cells/ml. CONCLUSION: The use of ascitic fluid as a cell source to achieve rapid fetal karyotyping can be valuable when cordocenteis or amniocentesis would be technically more difficult, or when rapid result is required for planning of perinatal management at late second or third trimester gestational age.
Subject(s)
Female , Humans , Pregnancy , Amniocentesis , Ascites , Ascitic Fluid , Cell Count , Cytogenetics , Diagnosis , Down Syndrome , Gestational Age , Karyotyping , Leukocytes , Lymphocytes , Paracentesis , Pregnancy Trimester, Third , Ultrasonography , Ultrasonography, PrenatalABSTRACT
Primary renal lymphoma is a rare tumor of the kidney that typically presents with bilateral nodular enlargement in the absence of extrarenal masses. We describe MR findings of a case of primary renal lymphoma along with ultrasound and CT findings. MR imaging demonstrated globular enlargement of both kidneys with multilobulated contour and multiple masses which had isosignal intensity on T1WI and low signal intensity on T2WI. The masses enhanced slightly on dynamic contrast enhanced scan.