Résumé
The purpose of this study is to validate the potential etiologic factors for temporomandibular disorder(TMD). TMJ arthroscopic examination was performed in upper joint compartment of 32 joints from 20 patients with mandibular fractures. Synovial fluid was collected from the upper joint space during pumping manipulation with normal saline. Cytologic smearing and histomorphologic exam of synovial fluid were performed in 15 joints. Prostaglandin E2(PGE2) concentration was measured in 11 joints. Leukotriene B4(LTB4) concentration was measured in 8 joints. There were several arthroscopic variables such as ecchymosis, fibrillation, and adhesion. Histomorphologic exam showed a variety of findings such as bloody smears, cellular cluster, degenerated cells and cartilage, undifferentiated crystal. Mean PGE2 concentrations were 316.5 pg/ml. Mean LTB4 concentrations were 45.9pg/ml. This study demonstrated a variety of findings on inflammatory and degenerative changes of TMJ. Because acute trauma such as mandibular fracture is a major etiologic factor in cartilage degradation and biochemical and intraarticular pathology, clinicians must identify and address TMJ signs and symptoms during follow-up periods in the long term.
Sujets)
Humains , Arthroscopie , Cartilage , Dinoprostone , Ecchymose , Études de suivi , Articulations , Leucotriène B4 , Fractures mandibulaires , Anatomopathologie , Synovie , Articulation temporomandibulaireRésumé
Sujets)
Femelle , Humains , Adulte d'âge moyen , Établissements de soins dentaires , Diagnostic , Ouïe , Mastication , Ostéochondrome , Squelette , Articulation temporomandibulaire , TrismusRésumé
BACKGROUND: The aim of this study was to characterize the nature and elucidate the pathogenesis of hemodialysis ascites(HA), especially with regard to the levels of Serum Ascites Albumin radient(SAAG) and the degrees of hemodialysis adequacy(Kt/Vurea). METHODS: In the study group, seven cases of HA which had developed in 6 patients from Feb. 1997 through July 1998 were included. In the control group, 24 cases which had not developed HA were included. The study design was a retrospective. Analysis of ascites on WBC, total protein and albumin, cytology, ADA(Adenosine deaminase), osmolality, SAAG and routine work-up were performed in HA group. Serum total protein and albumin, C-reactive protein(CRP), osmolality, and routine liver function test were also checked. Kt/Vurea and weekly Kt/Vurea were calculated in both group. In statistical analyses, t-test and chi-square test were used. RESULTS: Mean SAAG of HA was >1.1(1.49+/-0.40) gm/dL, and mean concentration of total protein of HA was >2.5(4.26+/-0.58) gm/dL. The mean of weekly Kt/Vurea of patients with HA(2.61+/-0.85) was significantly lower than that of patients without HA(3.48+/-0.90)(p<0.05). Positive ratio of CRP in patients with HA was higher than that of patients without HA(p<0.05). Mean concentration of serum total protein was significantly higher in patients with HA than that of patients without HA but with comparable weekly Kt/Vurea levels(p<0.05). CONCLUSION: It is regarded that the nature of HA is an exudate having high SAAG over 1.1 gm/dL. Low weekly Kt/Vurea is suggested as a cause of HA. Chronic inflammation was also regarded as an important factor causing HA.
Sujets)
Humains , Ascites , Exsudats et transsudats , Inflammation , Tests de la fonction hépatique , Concentration osmolaire , Dialyse rénale , Études rétrospectives , UréeRésumé
OBJECTIVES: This study evaluated the availability of mandibular symphysis corticocancellous block grafts in patients treated for reconstruction of intraoral jaw defects. MATERIALS AND METHODS: 8 patients with mandibular and maxillary bony defects were treated with corticocancellous block of symphysis. The types of defects included 4 pathologic jaw defects and 4 vertical and/or horizontal alveolar deficiencies. The age ranged from 13 to 45 years. Additional treatments such as plate fixation, alloplastic bony substitutes, and/or barrier membrane application were perfomred. They were evaluated for complications and healing of defects. Follow-up period ranged from 6 to 15 months. RESULTS: 2 patients experienced complications such as wound dehiscence and mild resorption of exposed bone. None of the patients needed secondary operation. Paresthesia of lip, chin, and teeth were recovered completely by 6 months postoperatively. Reconstructed wound showed favorable healing and bony consolidation. CONCLUSION: Corticocancellous block of mandibular symphysis can be used for the reconstruction of a variety of intraoral local jaw defects selectively. Advantages were easy fixation of graft, possibility of restoration of original alveolar contour, and decreased donor site morbidity.
Sujets)
Humains , Menton , Études de suivi , Mâchoire , Lèvre , Membranes , Paresthésie , Donneurs de tissus , Dent , Transplants , Plaies et blessuresRésumé
BACKGROUND: The expression of mutant p53 seems to induce malignant transformation by blocking the progression of cell differentiation or apoptotic process. The purpose of this study was to investigate the role of apoptosis and, possibly, a mutant p53 in ineffective hematopoiesis in myelodysplastic syndrome(MDS). The role of the mutant p53 in the leukemic transformation was also studied. METHODS: The bone marrow sections were prepared from 41 patients with MDS, 20 patients with acute myelogenous leukemia(AML) and 10 normal controls. The degree of apoptosis and the overexpression of p53 were evaluated using in situ end-labelling (ISEL) and immunohistochemical staining, respectively. RESULTS: Apoptosis was significantly increased in MDS(P<0.01 vs controls), while AML showed decreased apoptosis (P<0.01 vs controls). Overexpression of p53 protein was observed in 7 (17.1%) of 41 MDS and 3 (15.0%) of 20 AML patients, while it was not increased in normal controls. There were no p53 overexpression in all patients with normal karyotype. However, p53 overexpression was found in 5 out of 10 patients with abnormal karyotype. Three of 5 patients with p53 overexpression showed weak positive staining, and 2 with strong positive staining had complete or partial loss of 17p. CONCLUSION: These findings suggest that apoptosis has a role in ineffective hematopoiesis in MDS. The apoptosis is remarkably decreased in patients with AML. Mutation of p53 may contribute to transformation. Further systemic studies using more cases would be needed to obtain objective assessment data that immunohistochemical examination for p53 overexpression is considered to be useful in predicting the evolution to overt leukemia from MDS in the future.
Sujets)
Humains , Caryotype anormal , Apoptose , Moelle osseuse , Différenciation cellulaire , Hématopoïèse , Caryotype , Leucémies , Leucémie aigüe myéloïde , Syndromes myélodysplasiquesRésumé
Sujets)
Femelle , Humains , Mâle , Parodontite chronique , Mucocèle , Chirurgie stomatologique (spécialité) , Troubles de l'articulation temporomandibulaireRésumé
Changes of human pulse rates are influenced by psychological factor as well as systemic disease. Pulse rates tend to increase in the state of fear, pain, anxiety, and excitement. We performed this study for the evaluation of psychological state during the surgical extraction of mandibular impacted 3rd molar. Total 42 patients without systemic compromised condition were selected and pulse rates were checked with pulse oximeter(Nellcor, N-180) during the initial sitting state at dental unit chair, local anesthesia, draping and operation(5-minute interval). Male patients were 22, female 20. Age ranged from 13 to 57, with a mean of 26.9. Operative time(from incision to end of suture) ranged from 4 minutes to 32 minutes, with a mean of 11.1 minutes. The most significant elevation of pulse rates were observed during draping, the next at 10 minutes after incision(P 0.05).
Sujets)
Femelle , Humains , Mâle , Anesthésie , Anesthésie locale , Anxiété , Rythme cardiaque , Molaire , PsychologieRésumé
While oral and maxillofacial surgery such as orthognathic surgery, TMJ surgery is in progress, there always exists a risk of bleeding from maxillary artery, and this perplexes the surgeon in operation. In case of massive bleeding, it is mostly very difficult or even impossible to take an immediate action in order to stop bleeding. Even when hemostasis is possible by applying such methods as the use of local hemostatics, pressing, electrocoagulation or direct ligation, there is a high risk of secondary bleeding. Therefore, in case there is bleeding from maxillary artery, it is the best to restrain bleeding completely either by the ligation of the artery in bleeding in operation fields or by the ligation of the external carotid artery.
Sujets)
Artères , Artère carotide externe , Électrocoagulation , Hémorragie , Hémostase , Hémostatiques , Ligature , Artère maxillaire , Chirurgie orthognathique , Chirurgie stomatologique (spécialité) , Articulation temporomandibulaireRésumé
Trichinosis is a worldwide parasitic infection developed after the ingestion of uncooked meat containing viable larvae of the nematode Trichinella spiralis. Fever, myalgia, periorbital edema and eosinophilia are characteristic features and most infections are mild and asymptomatic, but a few cases have a severe clinical course due to cardiac or cerebral complications. This parasitic infection is spread in nature among a large number of carnivorous animals, human being an incidental host. While the highest prevalence is in North America and Europe, some outbreaks of trichinosis have been reported in the areas of Southeast Asia, China and Japan recently, but it has not been reported in Korea yet. We experienced a case of trichinosis with typical clinical features and laboratory findings of trichinosis after eating a raw liver and blood of wild badger which was poached in Chi-ri mountain.
Sujets)
Animaux , Humains , Asie du Sud-Est , Chine , Épidémies de maladies , Consommation alimentaire , Oedème , Éosinophilie , Europe , Fièvre , Japon , Corée , Larve , Foie , Viande , Mustelidae , Myalgie , Amérique du Nord , Prévalence , Trichinella spiralis , TrichinelloseRésumé
BACKGROUND: Recent worldwide increase of tuberculosis has been mainly caused by opportunistic infections in the patients with AIDS. Emergence of multidrug- resistant Mycobacterium tuberculosis has been also posing serious problems on the treatment of tuberculosis. The purpose of this study was to evaluate the usefulness of the PCR-reverse hybridization method (line probe assay, INNO-LIPA; Innogenetics, Belgium) for the identification of M. tuberculosis and detection of rifampicin- resistant M. tuberculosis. METHOD: Identification of 37 isolates was performed by both conventional method and line probe assay. Detection of rifampin resistance by line probe assay was based on the reaction of amplified gene products of isolates with either wild type probes (S1, S2, S3, S4, and S5) specific for rpoB gene or mutant type probes (R2, R4a, R4b, and R5) specific for the mutation sequence in the rpoB region, and the results were compared with those by the absolute concentration method. RESULTS: All of the 37 isolates were identified as M. tuberculosis by both line probe assay and conventional method. Eight isolates susceptible to rifampin by absolute concentration method showed no mutation by line probe assay. Twenty seven of 29 isolates resistant to rifampin by absolute concentration method showed the following mutations in rpoB gene: 11, S5-R5+(loss of S5 with R5); 7, S4-R4a; 1, S4-R4b+; 4, S2-R2+; 1, S1-S2+: 1; S2-S4-; 1, S4-; and 1, R5+. The sensitivity of rifampin resistance by line probe assay was 95%. CONCLUSION: Line probe assay is a useful tool for the early identification of M. tuberculosis as well as determination of its rifampin resistance, especially in cases of emergent need for rapid treatment for tuberculosis before getting the final of conventional antituberculous drug susceptibility test.
Sujets)
Humains , Mycobacterium tuberculosis , Mycobacterium , Infections opportunistes , Réaction de polymérisation en chaîne , Rifampicine , TuberculoseRésumé
BACKGROUND: Troponin T(TnT), a 37 kDa polypeptide subunit of contractile protein, is part of the troponin complect in striated muscle, where it binds to tropomyosin. TnT is not usually found in circulating blood, but increase in serum by cytoplasmic damage. Because the amino acid sequence is unique to cardiac muscle, one can immunologically differentiate skeletal muscle and cardiac protein isoforms. METHODS: We evaluated serum cardiac TnT (ELISA, Troponin-T, Boehringer Mannheim, Germany) versos CK-MB mass (IMX CK-MB, Abbott Laboratories, USA) in 46 cases (173 samples) of acute myocardial infarction, 28 cases (94 samples) of ansi na pectoris, 23 cases (62 samples) of other cardiac disease, and 32 cases of non-cardiac disease from September 1994-June 1996. RESULTS: TnT was detected in serum(cutoff value 0.20 ng/ml) within 6 hours after onset of chest pain, slightly earlier than CK-MB mass (cutoff value 5.0 ng/ml). Sensitivity of TnT (81%) is not statistically different from CK-MB mass (84%) within 24 hour of cutest pain but more sensitive after 24-72 hours of symptom, Specificity (79.5%) and positive predictive value (70.7%) of TnT were superior to that of CK-MB mass within 24 fours of cutest pain, and persistent to 6 days, which was longer than that of Cl4-MB mass. More patients show increment of TnT in unstable angina pectoris(40.0%) than stable angina pectoris(15.4%), No difference in detection rate of TnT between angina pectoris(28.6%) and other cardiac disease patients(34.8%). Only 3.1 % of non-cardiac disease patients show TnT increment. CONCLUSIONS: We concluded that TnT Is not detected In most of non-cardiac disease patients, and is an early and later marker with very wide diagnostic time win-dow. Also, TnT can be used as a valuable masker for ischemic myocardial damage in any underlying causes.
Sujets)
Humains , Séquence d'acides aminés , Angor stable , Angor instable , Douleur thoracique , Cytoplasme , Cardiopathies , Muscles squelettiques , Muscle strié , Infarctus du myocarde , Ischémie myocardique , Myocarde , Isoformes de protéines , Sensibilité et spécificité , 2,4,6-Trinitro-toluène , Tropomyosine , Troponine T , TroponineRésumé
No abstract available.
Résumé
No abstract available.