A number of drug administered during anesthesia can provoke pathologic response by immunologic or nonimmunologic mechanisms. Known drugs involved in hypersensitivity reactions are muscle relaxants, local anesthetics, narcotics, barbiturates, contrast media, protamine and antibiotics. Clinical manifestations of anaphylaxis are diverse, but during anesthesia, cardiovascular collapse is predominate. We experienced a case of anaphylactoid reaction with erythema on upper thoracic region, severe hypotension, tachycardia and ventricular fibrillation. After defibrillation, the patient was recovered. During follow-up, we knew that this patient was exposed aprotinin repeatedly, and suspect the possibility of anaphylactoid reaction due to aprotinin.
Anaphylaxis ; Anesthesia ; Anesthetics, Local ; Anti-Bacterial Agents ; Aprotinin ; Barbiturates ; Contrast Media ; Erythema ; Follow-Up Studies ; Heart Arrest* ; Humans ; Hypersensitivity ; Hypotension ; Narcotics ; Tachycardia ; Ventricular Fibrillation

Reexpansion pulmonary edema(RPE) is a complication of the treatment of lung collapse secondary to pneumothorax, pleural effusion or atelectasis, and generally believed to occur ipsilaterally when a chronically collapsed lung is rapidly reexpanded by evacuation of large amount of air or fluid. Clinical manifestations of RPE are dyspnea, tachypnea, cyanosis, frothy blood-tinged sputum, wet rale, and expiratory wheezing. Hypotension and decrease in organ perfusion can occur. We experienced intraoperative tension pneumothorax probably due to positive pressure ventilation or pleural injury during central venous catheterization through internal jugular vein. And bilateral RPE combined with acute renal failure occurs after spontaneous decompression of tension pneumothorax with chest tube insertion, even with brief duration of lung collapse.
Acute Kidney Injury ; Catheterization, Central Venous ; Central Venous Catheters ; Chest Tubes ; Cyanosis ; Decompression* ; Dyspnea ; Edema ; Hypotension ; Jugular Veins ; Lung ; Perfusion ; Pleural Effusion ; Pneumothorax* ; Positive-Pressure Respiration ; Pulmonary Atelectasis ; Pulmonary Edema* ; Respiratory Sounds ; Sputum ; Tachypnea

A review of 234 patients with cervical cancer during the last 5 years was undertaken to evaluate the efficacy of routine cystoscopic examination in staging cervical cancer. Cystoscopic abnormalities suggesting bladder invasion of the cervical cancer were found in none of the 127 patients with clinical stage 1 and 65 patients with clinical stage 2. In 7(22.6%) out of 31 patients with clinical stage 3 and in 4(80%) out of 5 patients with clinical stage 4. markedly bullous edema and hyperemia suggesting suspicious bladder invasion was identified on cystoscopy. Mucosal biopsy was done in 5 or them which revealed no pathologic invasion. Incidentally found transitional cell carcinoma was found in one patient. From these observations, it can be concluded that routine cystoscopy is not recommended in cervical cancer with clinical stage 1 and 2, and is indicated only in clinical stage 3 or greater.
Biopsy ; Carcinoma, Transitional Cell ; Cystoscopy* ; Edema ; Humans ; Hyperemia ; Urinary Bladder ; Uterine Cervical Neoplasms*

A case of renal amyloidosis with crescentic glomerulonephritis associated with rheumatoid arthritis is described. A 60-year-old female with 15 years' history of rheumatoid arthritis developed nephrotic syndrome followed by rapid deterioration of renal function. Glomerular amyloid deposition and sclerotic change was present in kidney biopsy specimen and crescentic change was found in 85% of the glomerulus. Electron microscopic finding of glomerulus showed randomly oriented, rigid-appearing, long nonbranching fibrils. The patient was treated with intravenous high-dose methylprednisolone pulses combined with intravenous cyclophosphamide followed by oral corticosteroids. Three months after the above treatment, renal function gradually improved, reaching serum creatinine level to 2.5 mg/dL. But the nephrotic range proteinuria persisted.
Adrenal Cortex Hormones ; Amyloidosis* ; Arthritis, Rheumatoid* ; Biopsy ; Creatinine ; Cyclophosphamide ; Female ; Glomerulonephritis* ; Humans ; Kidney ; Methylprednisolone ; Middle Aged ; Nephrotic Syndrome ; Plaque, Amyloid ; Proteinuria

Widespread use of amitriptyline in clinical practice has led to extensive knowledge of its therapeutic and toxic effects. In cases of amitriptyline overdose, delirium, arrhythmia, convulsion, and adult respiratory distress syndrome have been reported, but amitriptyline-associated rhabdomyolysis has been rarely reported in the literature. Several drugs are associated with myositis or myopathy, but amitriptyline-related myositis has not been reported. We describe a 40-year-old woman with rhabdomyolysis and localized myositis in left proximal thigh after she had taken 625mg of amitriptyline.
Adult ; Amitriptyline ; Arrhythmias, Cardiac ; Delirium ; Female ; Humans ; Muscular Diseases ; Myositis* ; Respiratory Distress Syndrome, Adult ; Rhabdomyolysis* ; Seizures ; Thigh

PURPOSE: To evaluate the radiologic and clinical outcomes of AO type C pelvic ring injury and identify the prognostic factors. MATERIALS AND METHODS: We studied 53 patients who were treated for AO type C pelvic ring injury from January 2002 to February 2010. Mean age and mean follow-up duration were 42.4 years and 14 months, respectively. We had 8 cases of AO type C1-1, 19 cases of C1-2, 11 cases of C1-3, 6 cases of C2 and 9 cases of C3 injury. We analyzed type of fracture, displacement, method of fixation and associated injuries. Radiologic outcome was evaluated with Matta and Saucedo criteria and clinical outcome was evaluated using Majeed score. RESULTS: The average Majeed score was 86.2 distributing as 36 excellent cases, 15 good cases and 2 fair cases. Using radiologic Matta and Saucedo criteria, patients were divided as 31 excellent cases, 17 good cases and 5 fair cases. There was no significant difference between the outcomes of anterior, posterior and antero-posterior fixation. Neurologic injury was the reason for an unsatisfactory functional outcome. We identified two cases with complication, one with postoperative infection and the other with nonunion following anterior-posterior fixation. CONCLUSION: Satisfactory radiologic and clinical outcomes were obtained with open reduction and internal fixation in the management of AO type C pelvic ring injuries. Neurologic injuries affected the clinical outcome.
Follow-Up Studies ; Humans ; Pelvis

No abstract available.
Erythromycin* ; Gastric Emptying* ; Gastroparesis*

It has been suggested that diseased and anomalous kidneys are more susceptible to injury. While horseshoe kidney is the most common congenital anomaly of renal fusion, occurring in about one in every 400-500 births, reports of the horseshoe kidneys associated with renal trauma are rare. Herewe now report our experiences with two cases of renal trauma on horseshoe kidney.
Kidney* ; Parturition

Acute fatty liver of pregnancy is a rare, clinically distinct cause of jaundice occuring during the third trimester of pregnancy, with maternal death as the usual outcome and first described in 1,940 by Sheehan, which may be characterized by nausea, vomiting, epigastric pain, jaundice and confirmed by liver biopsy. We have experienced a case of acute fatty liver at 38 weeks of gestation in 30 year-old primigravida woman and reproted with a brief review of related literatures.
Adult ; Biopsy ; Fatty Liver* ; Female ; Humans ; Jaundice ; Liver ; Maternal Death ; Nausea ; Pregnancy Trimester, Third ; Pregnancy* ; Vomiting

No abstract available.
Liver Cirrhosis* ; Liver*