Quantitative Ultrastructural Analysis of Endings Presynaptic to the Tooth Pulp Afferent Terminals in the Trigeminal Oral Nucleus

The ultrastructural parameters related to synaptic release of endings which are presynaptic to tooth pulp afferent terminals (p-endings) were analyzed to understand the underlying mechanism for presynaptic modulation of tooth pulp afferents. Tooth pulp afferents were labelled by applying wheat-germ agglutinin conjugated horseradish peroxidase to the rat right lower incisor, whereafter electron microscopic morphometric analysis with serial section and reconstruction of p-endings in the trigeminal oral nucleus was performed. The results obtained from 15 p-endings presynaptic to 11 labeled tooth pulp afferent terminals were as follows. P-endings contained pleomorphic vesicles and made symmetrical synaptic contacts with labeled terminals. The p-endings showed small synaptic release-related ultrastructural parameters: volume, 0.82 ± 0.45 µm³ (mean ± SD); surface area, 4.50 ± 1.76 µm²; mitochondrial volume, 0.15 ± 0.07 µm³; total apposed surface area, 0.69 ± 0.24 µm²; active zone area, 0.10 ± 0.04 µm²; total vesicle number, 1045 ± 668.86; and vesicle density, 1677 ± 684/µm². The volume of the p-endings showed strong positive correlation with the following parameters: surface area (r=0.97, P<0.01), mitochondrial volume (r=0.56, P<0.05), and total vesicle number (r=0.73, P<0.05). However, the volume of p-endings did not positively correlate or was very weakly correlated with the apposed surface area (r=-0.12, P=0.675) and active zone area (r=0.46, P=0.084). These results show that some synaptic release-related ultrastructural parameters of p-endings on the tooth pulp afferent terminals follow the "size principle" of Pierce and Mendell (1993) in the trigeminal nucleus oralis, but other parameters do not. Our findings may demonstrate a characteristic feature of synaptic release associated with p-endings.

A Case Report of Effective Use of an Intra-aortic Balloon Pump in Calcium Channel Blocker Intoxication

When used appropriately, calcium channel blockers are safe and efficacious. When overdose, however, these agents have the potential for serious morbidity which can lead to profound bradycardia and hypotension. The initial management of a calcium channel blocker overdose is supportive care, including stabilization and decontamination, followed by pharmacotherapy, including calcium agents, glucagon, insulin, catecholamines, and phosphodiesterase inhibitors (amrinone and milirone). Intra-aortic balloon pumps (IABP), extracorporeal membrane oxygenation, and even cardiopulmonary bypass, followed by conventional therapy have been used for patients with hypotension and bradycardia. We report a case of successful treatment with an IABP followed by pharmacotherapy.

Hemothorax Due to Diaphragm Laceration Induced Osteochondroma of Rib: A case report / 대한흉부외과학회지

Spontaneous hemothorax vary in cause and are rare for hemothorax induced osteochondroma. Sometimes hemothroax is reported due to osteochondroma induced injury of diaphragm, lung, pericardium, heart, or pleura. We report a patient with diaphragm laceration due to osteochondroma.

The Value of Grading of Pulmonary Contusion by the Chest CT Scanning

PURPOSE: Pulmonary contusion is the most common injury in patients with blunt chest trauma, and reported as 15~20% of multiple traumatic patients. In this study, we would like to predict a prognosis for pulmonary contusion easily at ED through the chest CT scanning. METHODS: We reviewed medical records and chest CT findings of 190 pulmonary contusion patients retrospectively. Both lung were devided into 4 areas, RUL +RML, RLL, LUL, and LLL (RUL: right upper lobe, RML:right middle lobe, LUL:left upper lobe, LLL: left lower lobe). 3 point were given to each area, maximally. In each area, a ratio was measured as the longest pulmonary contusion length per the transverse axis length of lung on the largest pulmonary contusion image of chest CT scan. The score can be obtained by multiplying 3 to the ratio and raising fractions not lower than 0.5 to a unit. We classified to three groups as mild (PCS 0-2), moderate (3-5), and severe (6-12) PCS groups. RESULTS: 179 patients with pulmonary contusion were classified as 94 mild, 52 moderate, 33 severe pulmonary contusion groups by PCS. As PCS was high, PRF (Pao2/ FiO2) was decreasing, number of patients treated with mechanical ventilation was increasing, ICU stay was long, and a complication rate was increasing. CONCLUSION: For patients with blunt chest trauma at ED which classified as severe PCS group (6-12), the patients need ICU admission and active treatment for a long time to reduce the mortality and complication rate.

Reconstruction of Dislocated Septal Cartilage through Columellar Flap Approach / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Sepatal deviation with caudal septal dislocation is difficult to correct using the classic septoplasty technique. Using the columellar flap approach, we remodeled the dislocated septal cartilage and fixed it at the anterior nasal spine. We report the techniques and results. MATERIALS AND METHOD: Eighteen men with the caudal septal dislocation from anterior nasal spine were operated using the columella flap approach. The study was conducted in a retrospective fashion focusing on preoperative status, operative results and complications. RESULTS: The operation time was in the average of 30 minutes. All patients except one showed improvement in nasal obstruction. Dislocation and deviation was corrected in all patients. The scar at nasolabial angle was not remarkable and no patient complained about the scar. CONCLUSION: Columellar flap approach in septoplasty can be used in patients with caudal septal dislocation.

Clonical Experience on Non-Scrotal Testosterone Transdermal Patch in the Middle Aged Male / 대한내분비학회지

BACKGROUND: To evaluate metabolic effects of testosterone on whole bodily systems, non-scrotal testosterone transdermal patch was given to middle aged men. METHODS: Sixteen impotent patients with serum testosterone levels between 300 and 500 ng/dL, were recruited for 6 month of treatment with non-scrotal testosterone transdermal delivery system, and six patients dropped during the study. All patients have a non-organic impotence (mean age:48 +/- 7). After 1 month placebo patch running period, patients were given 1 or 2 patches. The parameters were evaluated at each stage; before treatment, after placebo patch, and after testosterone patch for 3 months and 6 months. The evaluation parameters included body weight, blood pressure, heart rate, body mass index (BMI), body fat, haemoglobin, haematocrit, RBC, lipid profiles, Prostatic Specific Antigen (PSA), Transrectal Ultrasonography (TRUS), International Prostatic Symptom Score (IPSS), bone markers such as osteocalcin and Deoxypyridinoline (dPyr), Bone Mineral Density (BMD), psychological evaluation with Questionnaire and hormones such as cortisol, Dehydroepiandrosterone sulfate (DHEA-S), Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), prolactin, testosterone and Sex Hormone Binding Globulin (SHBG). Sexual functions were evaluated by means of sexual Questionnaire which has grade systems (high grade means good response) on each domain. RESULTS: Hormonal, hematopoietic, lipid and prostatic parametem were not changed with statistical insignificance. There were no significant changes in BMD. But mean osteocalcin values increased about 31.5% (p<0.05). Bone resorption marker, D-Pyr values were also decreased significantly about 18.6% after 4 montbs treatment, but such changes were not shown after 6 months. Tendencies of improvement in all domains of Sexual Questionnaire were noticed, even though they were not statistically significant except in frequency of coitus and satisfaction with ejaculation (p<0.05), CONCLUSION: Decreased bone resorption was noticed while persistent increased bone formation occurred after 4 months treatment of testosterone. Testosterone supplementation has a beneficial effects on mood and sexual function in the impotent patients with lower borderline testosterone level. And it can be concluded that 6 months testosterone treatment dose not produce any adverse reactions on bodily system.

CLASSIFICATION OF THE GUNSHOT WOUNDS OF THE FACE BY ENTRANCE AND EXIT WOUNDS OF THE BULLET

No abstract available.

EXPLOSIVE INJURY OF THE HAND

No abstract available.