BACKGROUND: Intraoperative hypothermia is common in patients undergoing general anesthesia during arthroscopic hip surgery. In the present study, we assessed the effect of heating and humidifying the airway with a heated wire humidification circuit (HHC) to attenuate the decrease of core temperature and prevent hypothermia in patients undergoing arthroscopic hip surgery under general anesthesia. METHODS: Fifty-six patients scheduled for arthroscopic hip surgery were randomly assigned to either a control group using a breathing circuit connected with a heat and moisture exchanger (HME) (n = 28) or an HHC group using a heated wire humidification circuit (n = 28). The decrease in core temperature was measured from anesthetic induction and every 15 minutes thereafter using an esophageal stethoscope. RESULTS: Decrease in core temperature from anesthetic induction to 120 minutes after induction was lower in the HHC group (–0.60 ± 0.27℃) compared to the control group (–0.86 ± 0.29℃) (P = 0.001). However, there was no statistically significant difference in the incidence of intraoperative hypothermia or the incidence of shivering in the postanesthetic care unit. CONCLUSIONS: The use of HHC may be considered as a method to attenuate intraoperative decrease in core temperature during arthroscopic hip surgery performed under general anesthesia and exceeding 2 hours in duration.
Anesthesia, General* ; Arthroscopy ; Body Temperature ; Heating ; Hip* ; Hot Temperature* ; Humans ; Hypothermia ; Incidence ; Methods ; Respiration ; Shivering ; Stethoscopes

In acute myocardial infarction, mural thrombi occur in approximately 20 per cent of patients who do not receive anticoagulant therapy and about 10 percent of thrombi result in systemic embolization. Threrfore, in acute phase of myocardial infarction, heparinization is considered as essential therapeutic regimen which afterwards acute phase, might have no clinical significance. We experienced a patient with recurrent LV apical thrombi inspite of an sufficient anticoagulation. This patient was treated with primary balloon PTCA and optimal duration of anticoa-gulation with IV heparin was maintained. At predischarge follow-up, TTE revealed huge LV apical thrombi and warfarinization was started. Three episodes of appearance and disappearance of thrombi have been noted and we report this patient as thrombophilia associated with acute myocardial infarction.
Follow-Up Studies ; Heparin ; Humans ; Myocardial Infarction* ; Thrombophilia* ; Warfarin

Pheochromocytoma may cause anatomic and functional cardiac abnormalities. Various echocardiographic abnormalities have been observed, including systolic anterior movement, global hypokinesis as well as hypokinesis of the base and the apex of LV. There are no previous reports of serial echocardiographic finding in patients with pheochromocytoma. We experienced a 38-year-old woman with pheochromocytoma who suffered from acute myocardial injury. Echocardiography revealed that the acute myocardial injury started in the base in the early phase and subsequently extended to the mid-portion of left ventricule. The injury persisted longer in the base than the mid-portion. than 1.5 times the adjacent normal coronary artery.
Adult ; Coronary Vessels ; Echocardiography ; Female ; Humans ; Pheochromocytoma

The brain grows with age in non-human primates (NHPs). Therefore, atlas-based stereotactic coordinates cannot be used directly to target subcortical structures if the size of the animal's brain differs from that used in the stereotactic atlas. Furthermore, growth is non-uniform across different cortical regions, making it difficult to simply apply a single brain-expansion ratio. We determined the skull reference lines that best reflect changes in brain size along the X, Y, and Z axes and plotted the changes in reference-line length against the changes in body weight. The skull reference lines had a linear relationship with body weight. However, comparison of skull reference lines with body weight confirmed the non-uniform skull growth during postnatal development, with skull growth more prominent in the X and Y axes than the Z axis. Comparing the differences between the atlas-based lengths and those calculated empirically from plot-based linear fits, we created craniometric indices that can be used to modify stereotactic coordinates along all axes. We verified the accuracy of the corrected stereotactic targeting by infusing dye into internal capsule in euthanized and preserved NHP brains. Our axis-specific, craniometric-index-adjusted stereotactic targeting enabled us to correct for targeting errors arising from differences in brain size. Histological verification showed that the method was accurate to within 1 mm. Craniometric index-adjusted targeting is a simple and relatively accurate method that can be used for NHP stereotactic surgery in the general laboratory, without the need for high-resolution imaging.
Body Weight ; Brain ; Internal Capsule ; Methods ; Primates ; Skull

The coexistence of carcinoma of the endometrium and ovary of female genital tract are an uncommon event, and it occurred in 5% of the patients with endometrial cancer and 10% of the patients with ovarian cancer. However, most of them are metastatic lesion from one organ and synchronous primary cancers from both organs are rare. In the present case, we experienced a case with simultaneous primary cancers from endometrium and ovary, occurring in 37-year-old woman presented with abnormal vaginal bleeding. Preoperative endometrial biopsy revealed endometrial carcinoma, and magnetic resonance imaging showed both ovarian lesion, which is suspicious of malignancy. Intraoperative and histological finding showed stage Ib endometrioid endometrial carcinoma and stage IIIc mucinous adenocarcinoma of both ovary, and we present this case with a brief review of reference.
Adenocarcinoma, Mucinous ; Adult ; Biopsy ; Endometrial Neoplasms ; Endometrium ; Female ; Humans ; Magnetic Resonance Imaging ; Neoplasms, Multiple Primary ; Ovarian Neoplasms ; Ovary ; Uterine Hemorrhage

Cardiac amyloidosis describes a clinical disorder caused by infiltration of abnormal insoluble fibrils in the heart, characterized by progressive heart failure and a grave prognosis. Pleural effusion in cardiac amyloidosis may represent a sign of heart failure, but it can also result from pleural infiltration of amyloid, manifested by recurrent large fluid accumulations. Recently, the role of vascular endothelial growth factor (VEGF) has been implicated in the pathogenesis of refractory pleural effusion. We report a case of a 53 year-old female patient with cardiac amyloidosis who presented with recurrent accumulation of large pleural effusions. She was initially treated with high dose loop diuretics, but the pleural effusion persisted, with the daily amount of drainage averaging 1 L/day. Accumulation of pleural fluid did not subside after 3 cycles of melphalan/prednisolone therapy. After the introduction of bevacizumab, an anti-VEGF antibody, the amount of pleural effusion decreased significantly. Efficacy of anti-VEGF therapy for refractory pleural effusions needs to be defined through further studies.
Amyloid ; Amyloidosis ; Antibodies, Monoclonal, Humanized ; Drainage ; Female ; Heart ; Heart Diseases ; Heart Failure ; Humans ; Pleural Effusion ; Prognosis ; Sodium Potassium Chloride Symporter Inhibitors ; Vascular Endothelial Growth Factor A ; Bevacizumab