Extraordinary radiation super-sensitivity accompanying with sorafenib combination therapy: what lies beneath?

Primary liver tumor, especially hepatocellular carcinoma (HCC), is a common cause of cancer death worldwide. The incidence is generally higher in Asian countries than in western countries. Carcinogenesis of HCC is often associated with hepatitis viral infections. Current standard treatment of HCC is surgical resection or transplantation in patients with early stage disease. However, the patient with advanced stage disease, surgical resection is often limited. Sorafenib or other treatment modalities are not so effective as well. We report a case of unusual radiation super-sensitivity in advanced stage HCC, and review the literature.

Primary Hyperparathyroidism with Ectopic Parathyroid Adenoma Detected by Both 99mTc-MIBI SPECT and Contrast-Enhanced Neck CT / 대한내과학회지

An ectopic parathyroid gland is a major cause of persistent and recurrent hyperparathyroidism. Surgical success depends on accurate preoperative localization of the parathyroid adenoma. We herein report the case of a 52-year-old male patient who suffered from primary hyperparathyroidism for several years. He initially presented with urinary frequency, hypercalcemia, and a ureter stone. Ultrasonography and a 99mTc-sestamibi scan were performed, but failed to localize the parathyroid lesion. Four years later, the patient revisited our hospital, complaining of general weakness, headache, dyspepsia, and recurrent urinary symptoms secondary to persistent primary hyperparathyroidism. In addition, renal function was decreased and severe osteoporosis was found. We performed a 99mTc-sestamibi scan with single photon emission computed tomography (99mTc-MIBI SPECT) and contrast-enhanced neck CT, and detected an ectopic parathyroid adenoma in the upper anterior mediastinum. In conclusion, the combination of both 99mTc-MIBI SPECT and neck CT could permit better preoperative parathyroid localization, especially for mediastinal adenomas.

Effect of surface treatment methods on the shear bond strength of resin cement to zirconia ceramic / 대한치과보철학회지

STATEMENT OF PROBLEM: The aims of the study were to evaluate the effect of current surface conditioning methods on the bond strength of a resin composite luting cement bonded to ceramic surfaces and to identify the optimum cement type. MATERIAL AND METHODS: The sixty zirconia ceramic specimens(10 per group) with EVEREST milling machine and 60 tooth block were made. The zirconia ceramic surface was divided into two groups according to surface treatment: (1) airborne abrasion with 110micrometeraluminum oxide particles; (2) Rocatec system, tribochemical silica coating. The zirconia ceramic specimens were cemented to tooth block using resin cements. The tested resin cements were Rely X ARC, Panavia F and Superbond C and B. Each specimen was mounted in a jig of the universal testing machine for shear strength. The results were subjected to 2-way ANOVA and Post hoc tests was performed using Tukey, Scheffe, and Bonferroni test. RESULTS: The mean value of shear bond strength(MPa) were as follows: RelyXARC(+Al2O3),5.35+/-1.69; RelyXARC(+Rocatec),8.50+/-2.13; PanaviaF(+Al2O3),9.58+/-1.13; PanaviaF(+Rocatec),12.98+/-1.71; Superbond C and B(+Al2O3),8.27+/-2.04; Superbond C and B(+Rocatec),14.46+/-2.39. There was a significant increase in the shear bond strength when the ceramic surface was subjected to the tribochemical treatment(Rocatec 3M) in all cement groups(P<0.05). Bonding strengths of cements applied to samples treated with Al2O3 were compared; Rely X ARC showed the lowest values, whereas Panavia F cement showed higher value than that of Superbond C and B group with no statistical significance. When the bond strength of cements with Rocatec treatment was compared, Rely X ARC showed lowest values. Overall, it was apparent that tribochemical treated Super-Bond possessed higher mean bond strength.(14.46MPa; P<0.05) than that of Panavia F cement group with no significance. CONCLUSIONS: Silica coating followed silanization(Rocatec treatment) increase the bond strength between resin cement and zirconia ceramic. Panavia F containing phosphate monomer and Superbond C and B comprised of 4-META tend to bond chemically with zirconia ceramic, thus demonstrating higher bond strength compared to BisGMA resin cement. Superbond C and B has shown to have highest value of bonding strength to zirconia ceramic after Rocatec treatment compared to other cement.

A Case of Choledochal Cyst Complicated by Liver Cirrhosis on Pathology in a 20-Month-Old-Girl / 소아과

Choledochal cyst is considered to be congenital anomalies of the biliary tract, characterized by varying degrees of cystic dilatation at various segments of the biliary tract. A 20-month-old girl was admitted to Eul-Ji general hospital because of abdominal distension. Physical examination revealed marked splenomegaly and hepatomegaly with nodular surface and hard consistency. Laboratory examination showed elevated transaminase level, alkaline phosphatase level and gamma glutamyltranspeptidase level without evidence of cholestasis. Diagnostic imaging study revealed choledochal cyst with Todani classification type 1. Cholecystectomy and Roux-en-Y choledochojejunostomy was performed, and wedge liver biopsy showed diffuse periportal fibrosis with cirrhotic change and ductular proliferation in the portal area. After operation, hepatosplenomegaly and abnormal laboratory examinations improved rapidly, and in 9 months, the liver and spleen became not palpable. We experienced a case of choledochal cyst complicated by liver cirrhosis on pathology in a 20 month-old girl, and removal of choledochal cyst improved clinical manifestations rapidly.

Local application of NK1 receptor antagonists and pulpal blood flow in cat / 대한치과보존학회지

The purpose of this study was to investigate the influence of NK1 receptor antagonists on the pulpal blood flow (PBF) when applied iontophoretically through the dentinal cavity of the teeth in order to understand whether iontophoretically applied NK1 receptor antagonists can control the pulpal inflammation. Eleven cats were anesthetized with alpha-chloralose and urethane, and substance P (SP) was administered to the dental pulp through the catheterized lingual artery in doses that caused PBF change without the influence of systemic blood pressure. NK1 receptor antagonists were applied iontophoretically to the prepared dentinal cavity of ipsilateral canine teeth of the drug administration, and PBF was monitored. Data were analyzed statistically with paired t-test. PBF increase after iontophoretic application of the NK1 receptor antagonists followed by the intra-arterial administration of SP was significantly less than PBF increase after iontophoretic application of the 0.9% saline followed by the intra-arterial administration of SP as a control (p < 0.05). Iontophoretic application of the NK1 receptor antagonists (0.2~3.4 mM) following the intra-arterial administration of SP resulted in less increase of PBF than the iontophoretic application of the 0.9% saline following the intra-arterial administration of SP as a control (p < 0.05). Therefore, the results of the present study provide evidences that the iontophoretic application is an effective method to deliver drugs to the dental pulp, and that iontophoretically applied NK1 receptor antagonists block SP-induced vasodilation effectively. The above results show the possibility that the iontophoretical application of NK1 receptor antagonists can control the neurogenic inflammation in the dental pulp.