Nerve palsy as a complication of hematoma following total hip arthroplasty (THA) is a rare development. Although rare, this complication can cause permanent nerve palsy. The authors experienced a case of recovery from sciatic nerve palsy after emergency evacuation of a hematoma. The expanding thigh hematoma was due to anticoagulation treatment for prevention of venous thromboembolism after total hip arthroplasty. After 10 months from the operation, the patient regained complete motor power and leads an ordinary life. The authors would like to emphasize the danger of hematoma following anticoagulation therapy for prevention of venous thromboembolism after total hip arthroplasty.
Arthroplasty ; Emergencies ; Hematoma ; Hip ; Humans ; Paralysis ; Sciatic Nerve ; Sciatic Neuropathy ; Thigh ; Venous Thromboembolism

Gastric neurofibroma is rare and its exact incidence is unknown. We experienced a case of solitary gastric neurofibroma. A 49-year-old woman was admitted because of hematemesis and melena. Neither cafe-au-lait spots in skin nor superficial tumor were found. Gastrofibroscopic examination and UGI series showed a 3 * 4 cm sized luminal protruding mass with adjacent bridging mucosal fold and cental ulceration on the anterior wall of lower body. Mass excision was performed. Grossly, the mass was 4.5 * 3.0 * 2.0 cm sized, well circumscribed submucosal tumor with homogenous cut surface, Microscopically, each of the tumor cells had oval shaped nucleus and spindle shaped cytoplasm. Nuclear atypism and frequent mitosis were not observed. We report a rare case of solitary gastric neurofibroma with review of the literatures.
Cafe-au-Lait Spots ; Cytoplasm ; Female ; Hematemesis* ; Humans ; Incidence ; Melena* ; Middle Aged ; Mitosis ; Neurofibroma* ; Phenobarbital ; Skin ; Stomach ; Ulcer

BACKGROUND/AIMS: Anisakiasis is a well known parasitosis resulted from eating raw seafoods and there were many reports of cases. However, its endoscopic and clinical characteristics have not been reviewed well. The aim of this study was to clarify the gastric mucosal changes and influencing factors of upper gastrointestinal (UGI) anisakiasis. METHODS: We analyzed retrospectively the endoscopic and clinical characteristics of 141 cases with UGI anisakiasis diagnosed during UGI endoscopy, based on the review of medical records. The patients' data were collected consecutively from October 1999 through September 2006. RESULTS: In the 141 patients with UGI anisakiasis, the peak age was the 40s (44.7%). The female to male ratio was 1.82:1. The most prevailed season was winter (41.1%). The most frequent symptom was acute epigastric pain and 76.6% of the patients developed symptoms within 12 hours after the ingestion of raw seafoods. The greater curvature of body was the most preferred site of anisakid larvae. The median time from meal to symptom onset was shortest in esophageal location and longest in fundus location (3 vs. 18.7 hours). The various mucosal changes were observed and the most frequent mucosal change was edema (90.8%). Submucosal tumor was also found in 31.9% of the patients. The severity of mucosal change was related inversely with the time interval from meal to endoscopy (p=0.048). CONCLUSIONS: Anisakiasis presented various mucosal changes depending on the time interval from ingestion of raw seafood to endoscopy. Delayed endoscopy may lead chronic mucosal change and cause difficulty in the detection of anisakiasis. Therefore, the prompt endoscopic examination is required for the patients presenting acute gastrointestinal symptoms after taking raw fish.
Adult ; Aged ; Animals ; Anisakiasis/*diagnosis/parasitology ; Edema/etiology ; Esophageal Diseases/*parasitology/pathology ; Female ; Gastric Mucosa/parasitology/*pathology ; Gastroscopy ; Humans ; Male ; Medical Records ; Middle Aged ; Retrospective Studies ; Seafood ; Stomach Diseases/*parasitology/pathology ; Time Factors ; Upper Gastrointestinal Tract/parasitology/*pathology

Background: Desflurane, a fluorinated methyl-ethyl ether, has some advantageous properties including low blood solubility, stability in soda lime, and resistance to biodegradation. Desflurane in vivo has demonstrated myocardial depressant property. The purpose of this study was to test the direct effects of desflurane on myocardial contractile function and coronary flow in the isolated heart. Methods: Twelve isolated rat hearts were continuously perfused with modified Krebs solution containing 6, 9 and 12 vol% of desflurane for 10 min at each concentration. Systolic left ventricular pressure and rate of change of ventricular pressure (dp/dt) were measured. Heart rate and coronary flow were also measured. To differentiate direct vasodilatory effect of desflurane from an indirect metabolic effect due to autoregulation of coronary flow, oxygen delivery, myocardial oxygen consumption and percent oxygen extraction were calculated. Results: Heart rate (control 266+/-22 beats/min) decreased to 250+/-23 beats/min at 6 vol%, 236+/-26 beats/min at 9 vol% and 223+/-22 beats/min at 12 vol% of desflurane. Systolic left ventricular pressure and dp/dt decreased in a concentration-dependent manner. In spite of decrement of myocardial oxygen consumption, coronary flow (control 12.0+/-1.2 ml/min) increased to 12.8+/-1.6 ml/min at 6 vol%, 12.9+/-1.6 ml/min at 9 vol% and 13.7+/-1.4 ml/min at 12 vol% of desflurane. Oxygen delivery increased proportionally with coronary flow. Percent oxygen extraction decreased in a concentration-dependent manner. Conclusion: These results suggest that desflurane has a direct myocardial depressing and coronary vasodilating effect in a concentration-dependent manner.
Animals ; Ether ; Heart Rate ; Heart* ; Homeostasis ; Oxygen ; Oxygen Consumption ; Rats* ; Solubility ; Ventricular Pressure

Clinodactyly, as rare congenital malformation, refers to a curvature of a digit in a radial or ulnar direction in the coronal plane. The abnormality is inherited as an autosomal dominant trait. And its frequency was low, however, it was higher by accompanying other congenital anomaly. In present study, the frequency and genetic characteristics of clinodactyly were investigated. In 100 family (382 peoples), clinodactyly was found in 4.7% (n=18). All clinodactyly were bilateral and it was more frequent in female (6.8%) than male (2.6%), without statistical difference (p=0.056). Its inheritance was autosomal dominant trait in 80% (4/5) families, however, one family did not have any inheritance pattern. We described the frequency and clinical implication of clinodactyly, and this description will be lead to an improved understanding of its spectrum and inheritance.
Female ; Hand Deformities ; Humans ; Inheritance Patterns ; Male ; Prevalence* ; Wills

BACKGROUND: Desflurane has some cardiovascular effects similar to isofl-urane. Desflurane has decreased systemic vascular resistance and demonstrated a myocardial depressant property in vivo animal stulies. The purpose of this study was to compare the myocardial and coronary effects of desflurane and isoflurane. METHODS: Cardiac effects were examinated in 24 rat hearts perfused with modified Krebs solution containing 1 MAC and 2 MAC desflurane or isoflurane for 10 min. at each concentration in a retrograde manner. Left ventricle pressure, heart rate and rate of change of ventricular pressure (dp/dt) were mea-sured, as were coronary flow and partial oxygen pressure. Oxygen delivery, myocardial oxygen consumption and percent oxygen extraction were calculated by each measurement. RESULTS: Heart rate, left ventricle pressure and dp/dt decreased each anesthetic similarly in a concentration-dependent manner. Heart rate decreased by 243.86 15.7 beats/min at 1 MAC and 219.14 15.8 beats/min at 2 MAC with isoflurane (control: 262.99 2.35 beats/min.) and by 250 23 beats/min at 1 MAC and 223.89 23 beats/min at 2MAC with desflurane (control 266.94 22.30 beats/min). Coronary flow increased by 13.72 0.99 ml/g/min at 1 MAC and 14.30 1.05 ml/g/min at 2 MAC with isoflurane (control :12.04 0.84 ml/g/min) and by 12.80 1.63 ml/g/min at 1 MAC and 13.71 1.46 ml/g/min at 2 MAC with desflurane (control 14.04 1.22 ml/g/min). Oxygen delivery increased proportionally with coronary flow. The increase in MVO2 was accompanied by a decrease in heart rate and pressure but there were no significant differences. Percent oxygen extraction decreased in a concentration dependent manner. CONCLUSIONS: This study shows that desflurane and isoflurane decreased heart rate, myocardial depression and coronary vasodilating effects, resulting in improved oxygen perfusion effects.
Animals ; Depression ; Heart Rate ; Heart Ventricles ; Heart* ; Isoflurane* ; Oxygen ; Oxygen Consumption ; Perfusion ; Rats ; Rats, Sprague-Dawley* ; Vascular Resistance ; Ventricular Pressure

BACKGROUND: Volatile anesthetics are potent bronchodilators of airway smooth muscle. Bronchodilation is occured by depressing reflex neural pathways innervating airway smooth muscle and by acting directly on the smooth muscle cell. We studied the direct relaxation effect and their potency of halothane, isoflurane and desflurane on isolated rat distal bronchial segment of fourth order precontracted with acetylcholine. METHODS: Isolated Sprague-Dawley rat bronchial rings were suspended in tissue bath with modified- Krebs's solution. Based on the dose-response curve, the ED50 of acetylcholine (ACh) was calculated for fourth bronchial segment and administered to each tissue bath, after which the stabilized response was recorded. After then each bronchial segment with intact epithelium was exposed to increasing concentration of halothane, isoflurane and desflurane (1.0, 1.5 and 2.0 MAC)and the relaxant responses were recorded by polygraph. RESULTS: Halothane, isoflurane and desflurane produced concentration-dependent bronchodilation (P<0.05 for either anesthetics; 22 4%, 18 6%, 24 5% for halothane, isoflurane and desflurane at 1.5 MAC, 32 6%, 27 7%, 38 5% for halothane, isoflurane and desflurane at 2.0 MAC). Overall, desflurane had a significantly greater relaxing effect as compared with halothane, isoflurane at 1.5 MAC and 2.0 MAC during ACh-mediated contraction. CONCLUSION: The mechanism of halothane, isoflurane and desflurane-mediated bronchodilation is not known, but may be due to an epithelium dependent effect. The potency of relaxing the ACh precontracted isolated rat bronchial smooth muscle is desflurane, halothane, isoflurane in ordered.
Acetylcholine ; Anesthetics ; Animals ; Baths ; Bronchi* ; Bronchodilator Agents ; Epithelium ; Halothane* ; Isoflurane* ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Neural Pathways ; Rats* ; Rats, Sprague-Dawley ; Reflex ; Relaxation

BACKGROUND: Volatile anesthetics are potent bronchodilators of airway smooth muscle. Bronchodilation is occured by depressing reflex neural pathways innervating airway smooth muscle and by acting directly on the smooth muscle cell. We studied the direct relaxation effect and their potency of halothane, isoflurane and desflurane on isolated rat distal bronchial segment of fourth order precontracted with acetylcholine. METHODS: Isolated Sprague-Dawley rat bronchial rings were suspended in tissue bath with modified- Krebs's solution. Based on the dose-response curve, the ED50 of acetylcholine (ACh) was calculated for fourth bronchial segment and administered to each tissue bath, after which the stabilized response was recorded. After then each bronchial segment with intact epithelium was exposed to increasing concentration of halothane, isoflurane and desflurane (1.0, 1.5 and 2.0 MAC)and the relaxant responses were recorded by polygraph. RESULTS: Halothane, isoflurane and desflurane produced concentration-dependent bronchodilation (P<0.05 for either anesthetics; 22 4%, 18 6%, 24 5% for halothane, isoflurane and desflurane at 1.5 MAC, 32 6%, 27 7%, 38 5% for halothane, isoflurane and desflurane at 2.0 MAC). Overall, desflurane had a significantly greater relaxing effect as compared with halothane, isoflurane at 1.5 MAC and 2.0 MAC during ACh-mediated contraction. CONCLUSION: The mechanism of halothane, isoflurane and desflurane-mediated bronchodilation is not known, but may be due to an epithelium dependent effect. The potency of relaxing the ACh precontracted isolated rat bronchial smooth muscle is desflurane, halothane, isoflurane in ordered.
Acetylcholine ; Anesthetics ; Animals ; Baths ; Bronchi* ; Bronchodilator Agents ; Epithelium ; Halothane* ; Isoflurane* ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Neural Pathways ; Rats* ; Rats, Sprague-Dawley ; Reflex ; Relaxation

The kidney and balances of fluid and volume are the basic components of bloocl pressure control, and the kidney is the primary site that initiates the hypertensive process and is affected by hypertensive vascular disease. In the kidney, the dopamine is a potent natriuretic and vasodilating agent, participat- ing in renal sodium excretion and maintenance of cardiovascular homeostasis. And the dopamine receptors in central nervous system and peripheral organs were identified by physiological, biochernical and radioligand binding techniques. Rut previous morphological and biochemical studies have been unable to characterize or determine the tissue distribution of the dopamine receptor subtypes because no selective ligands are available yet. Furthermore, the cellular distribution of the dopamine receptor subtypes in the rat kidney is not demonstrated well. In the SHR, the ability of exogenous and endogenous renal dopamine to engender a natriuresis is impaired. Since renal dopamine levels in genetic models of hypertension are not lower than their normotensive controls, the impaired intrarenal paracrine effect of dopamine in these animal models of hypertension appears to be receptor or postreceptor mediated. And renal dopamine derives mainly from renal tubular dopamine production and to a lesser extent from dopaminergic nerves. The present study utilizes imrnunohistochemistry with specific antibodies to characterize the renal distribution of dopamine receptor subtypes and recognize the role of dopamine receptor defect in the pathogenesis of hypertension in 14-week-old WKY (mean HP 108+/-5mmHg) and SHR (mean RP 174+/-7 mmHg) kidneys. Also it utilizes antibody of tyrosine hyclroxylase (TH) to recognize the site of the dopamine production mediated by TH using light microscopic immunohistochemistry. In the immunohistochemistry of the WKY kidney, dopamine D1 receptor protein is localized to glomerulus, proximal tubule, distal tubule, renal vessels, cortical and medullary collecting duct. And in the SHR kidney, dopamine D1 receptor protein is localized to glomerulus, distal tubule, renal vessels, cortical and medullary collecting duct, and juxtaglomerular apparatus (JGA). But there is no demonstrable positive reaction in the proximal tubule and weakly positive reactions in the renal arterioles of SHR compared with WKY kidney. In the immunohisto-chemistry of the WKY kidney, dopamine D1 receptor protein is localized to glomerulus, proxirnal tubule, distal tubule, renal vessels, cortical and rnedullary collecting duct. And in the SHR kidney, dopamine D2 receptor protein is localized to glomerulus, distal tubule, renal vessels, cortical and medullary collecting duct, and JGA. So, there is no demonstrable positive reaction in the proximal tubule of SHR compared with WKY. In the glomerulus of the WKY and SHR kidneys, both dopamine D1 and D2 receptors are localized. In the in situ hybridization of the WKY and SHR kidneys, dopamine D and D receptors are only demonstrated at the renal vessels. The positive reaction to TH immunohistochemistry of the WKY and SHR kidneys is only observed in the renal medulla compared with negative reaction on the renal cortex. Considering the excretion of sodium up to 65-70% with volume expansion may be mediated by dopamine D1-like receptors in the proximal tubule, our immunohistochemistry findings for the dopamine receptors may support the failure of natriuretic response in the SHR due to an abnormal dopamine receptor. Also our results rnay mean that the glornerular filtration rate is mediated by both dopamine D1 and Dz receptors comparing with the previous studies that the glomerular filtration rate was mediated by dopamine D2 receptor. I'here are some differences in the receptors expressing sites on the previous radioligand binding and pharmacologic studies, but our results suggest that at least some of the renal dopamine DA and DAz receptors correspond structurally to the central dopamine D1 and D2 receptors. Finally the result of TH immunohisto-chemistry suggests that the production of dopamine in the proximal tubule is not mediated by TH.
Animals ; Antibodies ; Arterioles ; Central Nervous System ; Dopamine* ; Filtration ; Glomerular Filtration Rate ; Homeostasis ; Hypertension ; Immunohistochemistry* ; In Situ Hybridization ; Juxtaglomerular Apparatus ; Kidney* ; Ligands ; Models, Animal ; Models, Genetic ; Natriuresis ; Rats* ; Rats, Inbred SHR* ; Receptors, Dopamine ; Receptors, Dopamine D1 ; Receptors, Dopamine D2 ; Sodium ; Tissue Distribution ; Tyrosine ; Vascular Diseases

No abstract available.
Lung*