No abstract available.
Posterior Cruciate Ligament*

BACKGROUND: This study aimed to investigate bradycardia as an adverse effect after administration of dexmedetomidine during 33degrees C target temperature management. METHODS: A retrospective study was conducted on patients who underwent 33degrees C target temperature management in the emergency department during a 49-month study period. We collected data including age, sex, weight, diagnosis, bradycardia occurrence, target temperature management duration, sedative drug, and several clinical and laboratory results. We conducted logistic regression for an analysis of factors associated with bradycardia. RESULTS: A total of 68 patients were selected. Among them, 39 (57.4%) showed bradycardia, and 56 (82.4%) were treated with dexmedetomidine. The odds ratio for bradycardia in the carbon monoxide poisoning group compared to the cardiac arrest group and in patients with higher body weight were 7.448 (95% confidence interval [CI] 1.834-30.244, p = 0.005) and 1.058 (95% CI 1.002-1.123, p = 0.044), respectively. In the bradycardia with dexmedetomidine group, the infusion rate of dexmedetomidine was 0.41 +/- 0.15 microg/kg/h. Decisions of charged doctor's were 1) slowing infusion rate and 2) stopping infusion or administering atropine for bradycardia. No cases required cardiac pacing or worsened to asystole. CONCLUSIONS: Despite the frequent occurrence of bradycardia after administration of dexmedetomidine during 33degrees C target temperature management, bradycardia was completely recovered after reducing infusion rate or stopping infusion. However, reducing the infusion rate of dexmedetomidine lower than the standard maintenance dose could be necessary to prevent bradycardia from developing in patients with higher body weight or carbon monoxide poisoning during 33degrees C targeted temperature management.
Atropine ; Body Weight ; Bradycardia* ; Carbon Monoxide Poisoning ; Dexmedetomidine* ; Diagnosis ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Hypothermia, Induced ; Logistic Models ; Odds Ratio ; Retrospective Studies

Crescentic glomerulonephritis in rheumatoid arthritis is described recently with increasing frequency. It can occur directly as a manifestation of rheumatoid arthritis or may be a reaction to drugs such as D-penicillamine and bucillamine. We report a case of crescentic glomerulonephritis in a 46-year-old woman with rheumatoid arthritis for 20 years who had been treated intermittently with herb medicine or nonsteroidal anti-inflammatory drugs (NSAIDS). Light microscopic examination showed severe focal segmental and global necrotizing glomerulonephritis with crescent formation in 50% of the glomeruli. Immunofluorescent study revealed scanty amount of mesangial granular deposits of IgA, IgM, C3 and fibrinogen in a diffuse pattern.
Female ; Humans

BACKGROUND: For most patients, recovery from anesthesia is a smooth uneventful. But for some, recovery can be life threatening. To prevent this, adequate and prompt evaluation of patients on recovery state is essential. Activity, respiration, circulation, awareness, and color are comprehensively assessed by PAR score. So we performed this clinical study to compare ongoing changes in PAR score and the effects of age, physical status, operation site and operation time on PAR score were evaluated. METHODS: Two hundred and fifty-four patients (ASA 1, 2) undergoing elective surgery under general anesthesia were evaluated in our recovery room. They were anesthetized with enflurane or isoflurane, and nitrous oxide, and were transferred to the recovery room when SpO2 was more than 97% and there was no supplemental oxygen during transport. Once there, O2 5 l/min was administered via a face mask to all the patients. Assessment of each patient's PAR score was made at ten-minute intervals by the same anesthesiologist. RESULTS: Emergence from anesthesia was significantly dependent on patient's age, preoperative physical status but not on operation site and time. PAR score was significantly increased according to PAR-stay time regardless of age, physical status, operation site or time. CONCLUSION: In evaluating the postanesthetic recovery state, it seems to be important to consider patient's age and physical status.
Anesthesia* ; Anesthesia, General ; Enflurane ; Humans ; Isoflurane ; Masks ; Nitrous Oxide ; Oxygen ; Recovery Room ; Respiration

Symptoms of deep cerebral vein thrombosis (DCVT) are variable and nonspecific. Radiologic findings are essential for the diagnoses. In the majority of cases of deep internal cerebral venous thrombosis, the thalamus is affected bilaterally, and venous hypertension by thrombosis causes parenchymal edema or venous infarction and may sometimes cause venous hemorrhage. Intravenous injections of mannitol can be administered or decompressive craniectomy can be performed for reduction of intracranial pressure. The objectives of antithrombotic treatment in DCVT include recanalization of the sinus or vein, and prevention of propagation of the thrombus. Herein, the authors report DCVT which was successfully treated by low molecular weight heparin.
Brain Edema ; Cerebral Infarction ; Cerebral Veins ; Decompressive Craniectomy ; Edema ; Hemorrhage ; Heparin, Low-Molecular-Weight ; Hypertension ; Infarction ; Injections, Intravenous ; Intracranial Pressure ; Intracranial Thrombosis ; Mannitol ; Thalamus ; Thrombosis ; Veins ; Venous Thrombosis

The need for organ and tissue regeneration in patients continues to increase because of a scarcity of donors, as well as biocompatibility issues in transplant immune rejection. To address this, scientists have investigated artificial tissues as an alternative to transplantation. Three-dimensional (3D) bioprinting technology is an additive manufacturing method that can be used for the fabrication of 3D functional tissues or organs. This technology promises to replicate the complex architecture of structures in natural tissue. To date, 3D bioprinting strategies have confirmed their potential practice in regenerative medicine to fabricate the transplantable hard tissues, including cartilage and bone. However, 3D bioprinting approaches still have unsolved challenges to realize 3D hard tissues. In this manuscript, the current technical development, challenges, and future prospects of 3D bioprinting for engineering hard tissues are reviewed.
Bioprinting* ; Cartilage ; Humans ; Methods ; Regeneration ; Regenerative Medicine ; Tissue Donors ; Tissue Engineering*

The synovium is lined by a layer of intimal cells which have been classified on ultrastructural criteria into type A and B synoviocytes. The functionally important lining cells of the synovium(type A and B synoviocytes) are the subjects of many study but have presented problems with their characterization and microscopical identification. Synovial sarcoma is a distinct and generally recognized soft tissue tumor that its origin still raises controversy. In this study, 12 cases of nonspecifically proliferative and resting human synoviocytes have been obtained from the synovium of knee and hip joints, and 3 cases of synovial sarcoma which have arisen in the left thigh, left buttock and right inguinal region were examined with light microscopy, immunohistochemical observation, and electron microscopy. In light microscopic level, it was difficult to differentiate the type A synoviocytes from type B synoviocytes morphologically. The reactive type B synoviocytes were positive for the protein of cytoskeleton such as pancytokeratin, CK1, CK8, CEA, and vimentin. The resting type B synoviocytes showed positive reactions for pancytokeratin, CK1, and CK8. The markers for the monocytes/histiocytes(CD15, CD68, lysozyme, Al-AT, Al-ACT) were reactive in resting and reactive type A synoviocytes. Also, MHC class II antigen was reactive in type A synoviocytes. Three cases of primary synovial sarcoma were 2 fibrous monophasic and 1 biphasic. Spindle-shaped cell in fibrous monophasic synovial sarcoma showed reactivity for CK7 and pancytokeratin, and epithelial cells (lining the glands) in biphasic synovial sarcoma were reactive for CK 7, pancytokeratin, EMA, and focally CEA, but only spindle cells reactive for vimentin, By electron microscopy, fibrous monophasic synovial sarcoma showed pseudogland formation with intercellular junctions of paired subplasmalemmal density and discontinuous basal lamina. These results suggest that the reactive type B synoviocytes and synovial sarcoma show an aberrant expression of the vimentin and CEA. The expression of CK on the resting and reactive type B synoviocytes and fibrous monophasic and biphasic synovial sarcomas are different. Type A synoviocytes expressing the MHC class II molecule and monocyte/histiocyte markers suggest a member of the mononuclear phagocytic system. The reasons of the aberrant expression of the intermediate filament, vimentin and oncofetal antigen, and CEA in reactively proliferative type B synoviocytes and synovial sarcoma and the different expression of cytokeratin on the resting, reactive type B synoviocyte and synovial sarcoma should be further evaluated.
Basement Membrane ; Buttocks ; Cytoskeleton ; Epithelial Cells ; Hip Joint ; Histocompatibility Antigens Class II ; Humans* ; Immunohistochemistry ; Intercellular Junctions ; Intermediate Filaments ; Keratins ; Knee ; Microscopy ; Microscopy, Electron ; Muramidase ; Sarcoma, Synovial* ; Synovial Membrane ; Thigh ; Vimentin

A fifty-five year old male was admitted because of fever and chill for one month. He complained of upper abdominal pain, malaise, anorexia and weight loss. So diagnostic procedures were performed: stool exam., bload chemistry testing, ultrasonography, radionuclide scintigraphy. ERCP, abdominal CT, and sonoguided liver aspiration, which revealed intrahepatic cholangiocarcinoma associated with clonorchiasis.
Abdominal Pain ; Anorexia ; Chemistry ; Cholangiocarcinoma* ; Cholangiopancreatography, Endoscopic Retrograde ; Clonorchiasis* ; Fever ; Humans ; Liver ; Male ; Radionuclide Imaging ; Tomography, X-Ray Computed ; Ultrasonography ; Weight Loss ; Cholangiocarcinoma

The surgical and anesthetic management for giant cerebral aneurysm is difficult because of their great size or lack of an anatomic neck. Recently, total circulatory arrest, profound hypothermia using cardiopulmonary bypass and the cerebral protection of barbiturate are able to manage the difficult cerebral aneurysm operation due to the ease of the surgical approach and the decreased post operative neurological injury. These techniques were successfully utilized in the patient of the diamerer-3 cm sized giant cerebral aneurysm located at the bifurcation between the right internal carotid artery and the anterior cerebral artery, and the surgical and anesthetic considerations are reviewed.
Anterior Cerebral Artery ; Cardiopulmonary Bypass ; Carotid Artery, Internal ; Humans ; Hypothermia* ; Intracranial Aneurysm* ; Neck

PURPOSE: The aim of this study was to investigate the usefulness of mortise angle and fibular length measured in radiologic findings in predicting the ankle stability. MATERIALS AND METHODS: One hundred cases fifty cases were randomly selected volunteers with normal ankle function and the other fifty cases were randomly selected patients whose ankle were treated in our hospital and who were followed for over 1 years with good results. A specific experimental fixture were made to get the even AP and lateral view and objective stress view. RESULTS: The mortise angle and fibular length was not statistically significant to the degree of talar tilt angle under valgus or varus stress and that of displacement under anterior or posterior stress. CONCLUSION: The mortise angle and fibular length was not the objective predicting factors on the ankle stability. Maintenance of constrained talus in dynamic status is most important factors in determining the ankle stability.
Ankle* ; Humans ; Talus ; Volunteers