No abstract available.
Pregnancy*

Tuberculous pseudoaneurysm of the abdominal aorta (TBAA) is an exceedingly rare, but fatal complication of the tuberculosis, especially in the condition of the disseminated tuberculosis. We reported a case of TBAA treated successfully by surgical and medical therapy. A 65-year-old woman admitted to our hospital complaining of sudden abdominal pain, nausea and vomiting for 3 days. She underwent 4 times operation of orthopedic surgery for tuberculous spondylitis at the level of the L4-5, T5-7, tuberculous epidural abscess, both psoas abscess, and had been receiving antituberculous medications for disseminated miliary tuberculosis at the both lung fields. Soon after this, she developed aggravated abdominal pain and we examined contrast enhanced abdominal CT scan and revealed saccular, thrombosed aneurysmal dilatation on the level of the aortic bifurcation. We performed elective operation for direct closure of the small rent at the anterior wall of the abdominal aorta after confirming no active inflammatory reaction on the frozen biopsy. Currently, the patient is an antituberculous medications without any surgical complication for 12 months after operation.
Abdominal Pain ; Aged ; Aneurysm ; Aneurysm, False* ; Aorta ; Aorta, Abdominal* ; Biopsy ; Dilatation ; Epidural Abscess ; Female ; Humans ; Lung ; Nausea ; Orthopedics ; Psoas Abscess ; Spondylitis ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Miliary ; Vomiting

A 57-year-old woman scheduled for cochlear implant removal exhibited preoperative electrocardiographic findings of early repolarization (ER). Four episodes of transient ST segment elevations during surgery raised suspicion for vasospastic angina (VA). In the post-anesthetic care unit, the patient complained of chest discomfort and received sublingual nitroglycerin with uncertain effect. The patient refused to proceed with postoperative invasive coronary angiography, resulting in inconclusive diagnosis. Intraoperative circumstances limit the diagnosis of VA, which emphasizes the need for further testing to confirm the diagnosis. When VA is suspected in patients with underlying ER, it is reasonable to consider invasive examination to establish the diagnosis and prevent recurrence of VA. If ST changes are observed during surgery in patients with preoperative ER, careful monitoring is recommended. Due to general anesthesia, the absence of patient symptoms limits the definitive diagnosis of those with suspected VA. Therefore, additional postoperative surveillance is recommended.
Anesthesia, General ; Cochlear Implants ; Coronary Angiography ; Diagnosis ; Electrocardiography ; Female ; Head ; Humans ; Middle Aged ; Neck ; Nitroglycerin ; Recurrence ; Thorax

The totally implantable venous port device is used in patients undergoing chemotherapy. The complications associated with this device include venous thrombosis, infection, catheter fracture, extravasation, and intravascular dislodgement. The incidence of port catheter dislodgement is low. The treatment of choice for port dislocation involves immediate retrieval of the distal migrated part, and percutaneous transcatheter retrieval is regarded as the standard method. A 40-year-old female presented with intermittent palpitation. She was referred from the Department of General Surgery after detection of a fractured and dislocated implantable venous port system into the main pulmonary artery. We successfully retrieved the dislocated fractured device using a 5-Fr pigtail catheter and snare catheter. We herein report this case with a literature review.
Cardiac Complexes, Premature ; Catheterization, Central Venous ; Catheters ; Catheters, Indwelling ; Dislocations ; Female ; Humans ; Incidence ; Pulmonary Artery ; SNARE Proteins ; Vascular Access Devices ; Venous Thrombosis

BACKGROUND AND OBJECTIVES: Implantable cardioverter–defibrillators (ICDs) are indicated in patients with Brugada syndrome (BS), early repolarization syndrome (ERS), or idiopathic ventricular fibrillation (IVF) who are at high risk for sudden cardiac death. The optimal ICD programming for reducing inappropriate shocks in these patients remains to be determined. We investigated the difference in the mean cycle length of tachyarrhythmias that activated either appropriate or inappropriate ICD shocks in these three patient groups to determine the optimal ventricular fibrillation (VF) zone for minimizing inappropriate ICD shocks. SUBJECTS AND METHODS: We selected 41 patients (35 men) (mean age±standard deviation=42.6±13.0 year) who received ICD shocks between April 1996 and April 2014 to treat BS (n=24), ERS (n=9), or IVF (n=8). Clinical and ICD interrogation data were retrospectively collected and analyzed for all events with ICD shocks. RESULTS: Of the 244 episodes, 180 (73.8%) shocks were appropriate and 64 (26.2%) were inappropriate. The mean cycle lengths of the tachyarrhythmias that activated appropriate and inappropriate shocks were 178.9±28.7 ms and 284.8±24.4 ms, respectively (p<0.001). The cutoff value with the highest sensitivity and specificity for discriminating between appropriate and inappropriate shocks was 235 ms (sensitivity, 98.4%; specificity, 95.6%). When we programmed a single VF zone of ≤270 ms, inappropriate ICD shocks were reduced by 70.5% and appropriate shocks were missed in 1.7% of these patients. CONCLUSION: Programming of a single VF zone of ≤270 ms in patients with BS, ERS, or IVF could reduce inappropriate ICD shocks, with a low risk of missing appropriate shocks.
Brugada Syndrome* ; Death, Sudden, Cardiac ; Defibrillators* ; Humans ; Retrospective Studies ; Sensitivity and Specificity ; Shock* ; Tachycardia* ; Ventricular Fibrillation*

Glucocorticoid-induced TNF receptor (GITR) was a new member of the TNF/nerve growth factor receptor (TNFR/ NGFR) family and induced in murine T cells by dexamathasone. Recombinant soluble GITR (sGITR) induced an inflammation in peritoneal membrane and changes in spleen after i.p. injection of 3 mg/kg in C57BL/6 mice. Spleen was enlarged and percentage of neutrophils and monocytes were increased. The area of red pulp in spleen was increased, while that of white pulp was decreased after GITR injection. The thickening of membrane and neutrophil infiltration was observed in peritoneal membrane with increased myeloperoxidase activity. At later time, neutrophil infiltration moved to inside the tissue with tissue damage. GITR ligand and GITR were expressed constitutively on the surface of spleen cells and cells from peritoneal fluid. In contrast, no significant change in the spleen and in peritoneal membrane was observed in mice treated with LPS. GITR may play a role in body's inflammatory processes.
Animals ; Carrier Proteins/metabolism ; Flow Cytometry ; Inflammation/*chemically induced/pathology ; Injections ; Male ; Mice ; Mice, Inbred C57BL ; Receptors, Nerve Growth Factor/*metabolism ; Receptors, Tumor Necrosis Factor/*metabolism ; Solubility ; Spleen/metabolism/pathology ; Support, Non-U.S. Gov't

The cDNA nucleotide sequence of genome segment B encoding the VP1 protein was determined for the aquatic birnavirus GC1 isolated from the rockfish Sebastes schlegeli in Korea. The VP1 protein of GC1 contains a 2,538 bp open reading frame, which encodes a protein comprising 846 amino acid residues that has a predicted MW of 94 kDa. The sequence contains 6 potential Asn-X-Ser/Thr motifs. Eight potential Ser phosphorylation sites and 1 potential Tyr phophorylation site were also identified. GC1 contains the Leu-Lys-Asn (LKN) motif instead of the typical Gly-Asp- Asp (GDD) motif found in other aquatic birnaviruses. We also identified the GLPYIGKT motif, the putative GTPbinding site at amino acid position 248. In total, the VP1 regions of 22 birnavirus strains were compared for analyzing the genetic relationship among the family Birnaviridae. Based on the deduced amino acid sequences, GC1 was observed to be more closely related to the infectious pancreatic necrosis virus (IPNV) from the USA, Japan, and Korea than the IPNV from Europe. Further, aquatic birnaviruses containing GC1 and IPNV have genogroups that are distinct from those in the genus Avibirnaviruses and Entomo-birnaviruses. The birnavirusstrains were clustered into 5 genogroups based on their amino acid sequences. The marine aquatic birnaviruses (MABVs) containing GC1 were included in the MABV genogroup; the IPNV strains isolated from Korea, Japan, and the USA were included in genogroup 1 and the IPNV strains isolated primarily from Europe were included in genogroup 2. Avibirnaviruses and entomobirnaviruses were included in genogroup 3 and 4, respectively.
Amino Acid Sequence ; Animals ; Base Sequence ; Birnaviridae/classification/*genetics ; Capsid Proteins/chemistry/*genetics ; Cell Line ; Fishes/*virology ; Korea ; Molecular Sequence Data ; Phylogeny

A pseudoaneurysm occurs as a late complication of an arterial wall injury after a surgical procedure or injuries such as a fracture, stab injury and penetrating trauma. Acute compartment syndrome as an elevation of the pressure in a closed compartment results in vascular compromise and a dysfunction. However, its occurrence in the thigh is quite rare. We report a case of a patient treated with an excision of a pseusoaneurysm and an artificial vessel graft who had compartment syndrome of the thigh caused by a pseudoaneurysm of the femoral artery that had developed after a blunt injury.
Aneurysm, False* ; Compartment Syndromes* ; Femoral Artery* ; Humans ; Thigh* ; Transplants ; Wounds, Nonpenetrating

PURPOSE: We evaluated the usefulness of two-stage revision knee arthroplasty for treatment of infected total knee arthroplasty(TKA). MATERIALS AND METHODS: We retrospectively reviewed 13 cases treated by two-stage reimplantation among the 18 infected TKA cases from February 1993 to March 2003, which had been followed up for more than two years. We analyzed the results of treatment, knee society score before and after the two stage reimplantation, recurrence of infection, and other complications. RESULTS: The mean period between the time of primary TKA and that of diagnosis of deep infection was 1.7 years. The mean period from removal of infected primary prosthesis to the second stage reimplantation was 7.2 weeks. The mean range of motion increased from 60.3 degrees to 95.7 degrees after operation. The mean Knee Society Score increased from 50.2 points to 83.4 points. Infection recurred in two cases but immediately subsided by intravenous antibiotics therapy. One case with patella fracture was treated by total patellectomy. CONCLUSION: This procedure using antibiotics-impregnated cement spacer and complete debridement of necrotic tissues can control infection and improve functional results. The result of two-stage revision for deep infected total knee arthroplasty was satisfactory in view of eradication of infection and functional restoration of the knee.
Anti-Bacterial Agents ; Arthroplasty* ; Debridement ; Diagnosis ; Knee Joint ; Knee* ; Patella ; Prostheses and Implants ; Range of Motion, Articular ; Recurrence ; Replantation* ; Retrospective Studies

Skin and soft tissue defect developed after total knee arthroplasty have important influence on prosthesis survival. Thus an adequate treatment have to be performed according to the size and depth of defect. We report a case of dorsalis pedis flap for treatment of skin and soft tissue defect combined with infection after conversion total knee arthroplasty and its good result with a review of the literature.
Arthroplasty ; Knee ; Prosthesis Failure ; Skin