Left-Sided Cisterna Chyli: a Case Report on a Rare Normal Anatomic Structure

The cisterna chyli, a dilated lymphatic sac in the retrocrural space, is usually located to the right of the aorta. We report a case of a left-sided cisterna chyli, which was incidentally detected on the radiologic examinations of a preoperative workup for cholangiocarcinoma. Computed tomography (CT) and magnetic resonance (MR) images revealed a cisterna chyli measuring 2.5 cm in length in the left retrocrural space. The dilated lumbar lymphatics joined with the cisterna chyli, which was continuous with the left-sided thoracic duct. To the best of our knowledge, this is the second antemortem case of a left-sided cisterna chyli in literature. The cisterna chyli can mimic retrocrural lymphadenopathy, solid tumor with cystic degeneration, abscess or hematoma. The left-sided cisterna chyli should be referred to as a structure so as to be cautious in surgical approach.

Clinical outcome of immediately and early loaded implants with laser treated surface: a 3-year retrospective study

PURPOSE: The marginal bone loss of implants with laser treated surface was investigated after six weeks of loading after implant installation to the mandible molar area. MATERIALS AND METHODS: A total of 23 implants were placed in the edentulous molar area of the mandible: 13 implants were immediately loaded and 10 implants were early loaded. The implants used were made of titanium grade 23, screw shaped, 4.2 mm in diameter, and 10 mm in length. Patients were evaluated with resonance frequency analysis at implant fixture installation and 1, 2 (final prosthesis installation), 3, 5, 8, and 14 months later. X-rays were taken at 2 months after fixture installation and 1, 2, 3 years after to measure the marginal bone loss. RESULTS: The mean ISQ value measured at the implant installation was over 70 at all-time points. The average of marginal bone loss was average 0.33 mm. CONCLUSION: Immediate implant loading for laser treated implants would be possible.

Cutaneous Anaplastic Large T-Cell Lymphoma with Invasion of the Central Nervous System: A Case Report

Anaplastic large T-cell lymphoma (ALCL) encompasses different clinical entities that can be aggressive or localized. Scalp anaplastic lymphoma kinase (ALK)-negative ALCL is considered a localized lymphoma, and usually extends to the regional lymph nodes; intracranial invasion is rare. A 74-year-old woman was diagnosed with scalp ALK-negative ALCL, but did not exhibit invasion of the lymph nodes. Computed tomography and magnetic resonance imaging revealed intracranial masses with bony erosions. We treated the patient using CHOP chemotherapy and achieved short-term regression of the scalp and intracranial lesions. However, the patients ultimately died of pneumonia during the pancytopenic period. Therefore, caution must be exercised when treating scalp ALK-negative ALCL with intracranial invasion.

Effect of titanium surface microgrooves and thermal oxidation on in vitro osteoblast responses / 대한치과보철학회지

PURPOSE: We aimed to investigate the effect of combined various microgrooves and thermal oxidation on the titanium (Ti) and to evaluate various in vitro responses of human periodontal ligament cells (PLCs). MATERIALS AND METHODS: Grade II titanium disks were fabricated. Microgrooves were applied on titanium discs to have 0/0 microm, 15/3.5 microm, 30/10 microm, and 60/10 microm of respective width/depth by photolithography. Thermal oxidation was performed on the microgrooves of Ti substrata for 3 h at 700degrees C in air. The experiments were divided into 3 groups: control group (ST), thermal oxidation group (ST/TO), and combined microgrooves and thermal oxidation group (Gr15-TO, Gr30-TO, Gr60-TO). Surface characterization was performed by field-emission scanning microscopy. Cell adhesion, osteoblastic differentiation, and mineralization were analyzed using the bromodeoxyurdine (BrdU), Alkaline phosphatase (ALP) activity, and extracellular calcium deposition assays, respectively. Statistical analysis was performed using the oneway analysis of variance and Pearson's bivariate correlation analysis (SPSS Version 17.0). RESULTS: In general, the combined microgrooves and thermal oxidation group (Gr15-TO, Gr30-TO, Gr60-TO) showed significantly higher levels compared with the control (ST) or thermal oxidation (ST-TO) groups in the BrdU expression, ALP activity, and extracellular calcium deposition. Gr60-TO group induced highest levels of cell adhesion and osteoblastic differentiation. CONCLUSION: Within the limitation of this study, we conclude that the Ti surface treatment using combined microgrooves and thermal oxidation is highly effective in inducing the cell adhesion andosteoblastic differentiation. The propose surface is also expected to be effective in inducing rapid and strong osseointegration of Ti oral implants.

Results of Staged 360-Degree Spinal Fusion for Unstable Thoracolumbar Burst Fracture

OBJECTIVE: The purpose of this study was to evaluate the results obtained in patients who underwent staged 360-degree fusion with posterior fusion following anterolateral fusion for unstable thoracolumbar burst fractures. METHODS: The authors performed 360-degree fusion for thoracolumbar burst fractures in 21 patients between 2006 and 2010. We reviewed the medical records and follow-up data including pre- and postoperative neurological status, spinal canal compromise, segmental kyphotic angulations, complications, visual analogue scale (VAS) pain scores, and revision surgery rates. RESULTS: The mean computed tomography-measured preoperative spinal canal compromise was 55.9+/-20.7%. The segmental kyphotic deformity measured 20.2+/-4.4degrees preoperatively and had been corrected to 4.5+/-2.8degrees postoperatively. The mean vertebral body height loss of 57.4+/-6.9% improved significantly to 1.2+/-0.7% at the final follow-up examination. The mean preoperative VAS pain score of 8.2+/-0.8 improved to 1.5+/-0.6 at discharge. There were no cases of vascular complication, neurological deterioration, or revision surgery. CONCLUSION: Unstable burst fracture of thoracolumbar spine managed by staged posterior fusion and anterolateral interbody fusionis effective for kyphosis correction, significant canal decompression, pain reduction, maintaining stabilization and neurological improvement.

A Clinical Comparison of AcrySof(r) with Hyd rophilic Acrylic IOLs

To evaluate and compare the clinical results of implantation of the AcrySof(r) with Hydrophilic Acrylic IOLs in early postoperative period(to 2 months), we retrospectively analyzed 34patients who had taken clear cornea incision and had been implanted with AcrySof(r)IOL in one eye and Hydrophilic Acrylic IOL in the other eye. There were no stastically significant difference in postoperative best corrected visual acuity, preoperative and postopearative astigmatic changes between AcrySof(r) and Hydrophilic Acrylic IOLs. But, the rates of postoperative capsular fibrosis and contracture of Hydrophilic Acrylic IOL was higher than those of AcrySof(r) IOL as well as postoperative complications. In conclusion, in the degree and rate of after-cataract, AcrySof(r)IOLs are more useful than Hydrophilic Acrylic IOLs. ;therefore, more excellent in long term visual prognosis. Further studies will be needed for the evaluation of clinical safety and efficacy.

Acquired Unilateral Night Blindness

Night blindness is not an uncommon symptom and may occur in a wide variety of disease.However, the occurrence of acquired unilateral night blindness that has no specific clinical symptoms and signs including retinal pigment degeneration is very rare. We studied patient's family history, ocular examinations, perimetry, fluorescein angiography, electroretinogram, visual evoked potential and electrooculogram. No ocular abnormality could be found on clinical examination including fundus examnination in both eyes.Two patients had hyperfluo-rescence of optic disc in late phase of fluorescein angiography, and signifi-cantly reduced b wave and intact a wave were registered in the scotopic electroretinogram. We report 2 cases of acquired unilateral night blindness that have similar clinical findings with congenital stationary night blindness[CSNB]and melanoma-associated retinopathy[MAR].

Association of HLA Type with Stevens-Johnson Syndrome Induced by Methazolamide Treatment

There have been reports between Stevens-Johnson syndrome (SJS)induced by methazolamide treatment and genetic background especially in Japanese and Korean descent.We report 6 cases of SJS and the results of HLA (human leukocyte antigen)typing that suggest a relationship between genetic background and SJS induced by methazolamide treatment. We observed 6 patients as the subjects of this research, who had been suffering from SJS induced by methazolamide treatment at the Department of Ophthalmology, Catholic University.SJS appeared about 2 weeks after the patient started taking methazolamide (100 or 200 mg/d).After 15~30 days of treatment, they recovered with no serious complication.The results of HLA typing carried out 6 patients that all of the patients had HLA-A2, 5 patients were HLA-Cw1 and HLA-B59. Methazolamide should be carefully prescribed in patients of Japanese or Koreans descent and should not prescribe sulfonamide in SJS patients. A further systematic research on more cases is required to explaining ethnic peculiarity of the syndrome.