Subclinical atherosclerosis in patients with recurrent aphthous stomatitis.

OBJECTIVE: Recurrent aphtous stomatitis (RAS) is an inflammatory oral mucosal disease. It has been known that inflammatory cascade plays important role in the atherosclerotic process. The aim of the study was to investigate the relationship between subclinical atherosclerotic findings and a systemic inflammatory disease, RAS. METHODS: In total, 32 patients with RAS were matched with 30 control subjects on the basis of age, sex, and major cardiovascular risk factors. Laboratory parameters including lipid profiles were determined for patients and controls. B-mode ultrasonography was used to assess carotid extra-medial thickness (cEMT) and carotid intima-media thickness (cIMT). RESULTS: Both cEMT and cIMT in the RAS group were significantly higher than in the control group (P = 0.002 and 0.013, respectively). There was a significant positive correlation between cIMT and cEMT (r = 0.381, P = 0.034). cIMT was positively correlated with age, triglyceride levels, and systolic blood pressure, while cEMT was positively correlated with age in patients with RAS. CONCLUSIONS: To our knowledge, this is the first reported study to evaluate cEMT and cIMT in patients with RAS. This study presents morphological evidence of subclinical atherosclerosis in patients with RAS. Further studies investigating the relationship between atherosclerosis and RAS are needed.

The level of termination of the dural sac by MRI and its clinical relevance in caudal epidural block in adults.

BACKGROUND: Caudal epidural block (CEB) is a reliable and effective technique commonly used in pain practice. Having accurate knowledge of sacral anatomy and its anatomical variations is very important for avoiding complications, especially as may occur during dural puncture. This study was undertaken to delineate the anatomical features of the sacrococcygeal region relevant to dural sac (DS) puncture. METHODS: We reviewed magnetic resonance (MRI) images of 1,000 adult patients to determine of the level of termination of the DS, the distance between the upper margin of the sacrococcygeal membrane and the DS, and the presence of incidental dural cystic lesions. Each sacral vertebra was divided into three equal portions (upper, middle, and lower thirds), was defined as a separate region. RESULTS: The level (26.7% of all patients) of termination of the DS was most commonly the upper one-third of S2. The DS terminated below the 3rd sacral vertebra in 0.1% of all patients. No posterior sacral meningocele was seen, but 13 (1.3% of all patients) had a sacral Tarlov cyst. In three of 13 patients (23%), the Tarlov cysts terminated below 3rd sacral vertebra level (0.3% of all patients). CONCLUSION: Knowledge of the level of termination of the DS, the distance between the upper margin of the sacrococcygeal membrane and the DS, and the presence of Tarlov cysts on MRI images of before CEB is very important and might decrease the risk of dural puncture.