No abstract available.
Appointments and Schedules*

Chronic bronchiolitis is a condition associated with cigarette smoking, and later associated with pulmonary parenchymal alteration and progressive deterioration of lung function. Early respiratory bronchiolitis was produced in Sprague-Dawley rats by indirect inhalation of cigarette smoke daily in a smoke exposure chamber designed by authors for 1 month. Experimental group A (n=5) was sacrificed after having smoked 30 cigarettes, group B (n=5) after 80 cigarette, and group C (n=7) after 140 cigarettes, respectively. Examination of morphologic changes in the lungs was done on light microscope, transmission and scanning electron microscopes. Light microscopically, increase in number of goblet cells in the bronchial mucosa, brown-pigmented macrophages in the alveoli, multifocal alveolar collapse adjacent to the bronchioles, dilatation of alveolar ducts and alveolar spaces were observed. Transmission electron microscopically, irregularly shaped Clara cells, alveolar wall collapse, and focally type I epithelial cell injury were seen. Scanning electron microscopically, scattered alveolar collapse, irregular dilatation of alveolar ducts, alveolar spaces and interalveolar pores (pores of Kohn) were seen. The terminal and respiratory bronchioles showed morphological alteration of Clara cells, but no evidence of cellular bronchiolitis or bronchiolar obstruction. We conclude that sidestream smoke induces an early respiratory bronchiolitis including aggregates of brown pigmented macrophages and varying degrees of structural alteration of adjacent pulmonary parenchyma.
Bronchioles ; Bronchiolitis ; Dilatation ; Epithelial Cells ; Goblet Cells ; Inhalation ; Lung ; Macrophages ; Mucous Membrane ; Rats, Sprague-Dawley ; Smoke* ; Smoking ; Tobacco Products*

No abstract available.

PURPOSE: We report clinical and radiologic outcomes after metacarpal extension osteotomy for mild osteoarthritis of the thumb carpometacarpal joint. MATERIALS AND METHODS: From 1999 to 2008, 11 patients were diagnosed with mild thumb carpometacarpal arthritis (Eaton stage I, II), and extension osteotomies were performed. Of these, seven patients with at least 6 years follow-up were analyzed retrospectively. Male to female ratio was 2:5, and mean age at time of surgery was 38.9 years old. Symptom onset period was a mean of 11.2 months. Two patients were I, and five patients were II in Eaton stage. Preoperative visual analogue scale (VAS) and disabilities of the arm, shoulder and hand scale (DASH) scores were 3.7 points (3-4 points), and 40.1 points (32-51 points). Radial abduction was 38.5degrees (30degrees-45degrees), and volar abduction was 42.1degrees (40degrees-45degrees). Grip strengths and pinch powers, compared with the normal contralateral side were 82% (64%-90%) and 72% (40%-100%), respectively. RESULTS: The mean follow-up period was 8.5 years, and all patients except one maintained their occupational activity during the follow-up period. Final VAS and DASH scores were 0.7 points (0-2 points) and 11.7 points (8-16 points), respectively, and were statistically significant. Volar abduction, grip strengths, and pinch power were improved to 45degrees (40degrees-50degrees), 92.3% (73%-117%), and 94.4% (75%-117%) with statistical significances. In five patients, Eaton stages did not change, and two patients advanced to the next stage (stage I to II in one patient, stage II to III in one patient). CONCLUSION: Among the various treatment options for mild thumb carpometacarpal arthritis, metacarpal extension osteotomy may be considered as an effective treatment.
Arm ; Arthritis* ; Carpometacarpal Joints ; Female ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Male ; Osteoarthritis ; Osteotomy* ; Retrospective Studies* ; Shoulder ; Thumb*

Although it is known that hypothyroidism can cause cardiac dysfunction, it is very hard to find a case report on sudden death due to hypothyroidism. There are only two reported cases on medline; one is about a 15-year-old girl who died suddenly of Hashimoto's thyroiditis and the other is about a 31-year-old man who also died suddenly of hypothyroidism associated with chronic lymphocytic thyroiditis. Recently we found a young woman who unexpectedly died while she was sleeping. She was diagnosed as hypothyroidism when she went to hospital about a month before she died. At autopsy there were roughly four abnormal findings; Hashimoto's thyroiditis, mild chronic active hepatitis, diverticulosis and accessory spleen. Trace of chlorpheniramine was detected in gastric remains and blood alcohol level was 0.37 percent. To our knowledge, this is the first case reporting sudden and unexpected natural death associated with hypothyroidism in Korea.
Adolescent ; Adult ; Autopsy ; Chlorpheniramine ; Death, Sudden* ; Diverticulum ; Female ; Hashimoto Disease ; Hepatitis, Chronic ; Humans ; Hypothyroidism* ; Korea ; Spleen ; Thyroid Gland ; Thyroiditis

Although it is known that hypothyroidism can cause cardiac dysfunction, it is very hard to find a case report on sudden death due to hypothyroidism. There are only two reported cases on medline; one is about a 15-year-old girl who died suddenly of Hashimoto's thyroiditis and the other is about a 31-year-old man who also died suddenly of hypothyroidism associated with chronic lymphocytic thyroiditis. Recently we found a young woman who unexpectedly died while she was sleeping. She was diagnosed as hypothyroidism when she went to hospital about a month before she died. At autopsy there were roughly four abnormal findings; Hashimoto's thyroiditis, mild chronic active hepatitis, diverticulosis and accessory spleen. Trace of chlorpheniramine was detected in gastric remains and blood alcohol level was 0.37 percent. To our knowledge, this is the first case reporting sudden and unexpected natural death associated with hypothyroidism in Korea.
Adolescent ; Adult ; Autopsy ; Chlorpheniramine ; Death, Sudden* ; Diverticulum ; Female ; Hashimoto Disease ; Hepatitis, Chronic ; Humans ; Hypothyroidism* ; Korea ; Spleen ; Thyroid Gland ; Thyroiditis

No abstract available.
Lasers, Dye* ; Melanosis*

BACKGROUND: Laparoscopy with peritoneal carbon dioxide insufflation is a standard procedure in many gynecological departments. And more prolonged gynecological laparoscopic operations are being performed in recent years, and a steeper head-down position is required. Despite laparoscopic operations have many advantages, peritoneal insufflation of CO2 to create the pneumoperitoneum necessary for laparoscopy induces intraoperative hemodynamic changes that complicate anesthetic management of laparoscopy.The purpose of this study is to evaluate the effect of general anesthesia on hemodynamics during loparoscopic hysterectomy. METHODS: Twenty six women undergoing laparoscopic hysterectomy were randomly allocated to either a propofol (Group 1, n=13) intravenous anesthesia or a enflurane (Group 2, n=13) anesthesia with fentanyl-N2O/O2-vecuronium. Hemodynamic parameters were measured before induction (T1), 5 min after induction (T2), 5 min after head-down (T3), 5, 10, 15, 20 min after pneumoperitoneum (T4, T5, T6, T7), 5, 10 min after deflation (T8, T9). The MAP, HR, CI, SVRI, SI were measured by transthoracic electrical bioimpedence method and automated blood pressure device. RESULTS: The mean arterial pressure were increased during pneumoperitonem in both groups and heart rate were increased in Group 2. The cardic index were decreased in both groups after induction by 27.4 % in Group 1 and 25.7% in Group 2. The systemic vascular resistanace index were increased in both groups from head-down to after deflation by 68.3% in Group 1, 73.1% in Group 2 maximally. No significant changes of stroke index were observed during surgery in Group 1. CONCLUSIONS: Laproscopy with CO2 insufflation induces significant hemodynamic changes includig increases of MAP, SVR and a reduction of CI. And usual intraoperative hemodynamic monitoring; the blood pressure and heart rate give no information on the reduction in cardic output.
Anesthesia ; Anesthesia, General* ; Anesthesia, Intravenous ; Arterial Pressure ; Blood Pressure ; Carbon Dioxide ; Enflurane ; Female ; Heart Rate ; Hemodynamics* ; Humans ; Hysterectomy* ; Insufflation ; Laparoscopy ; Pneumoperitoneum ; Propofol ; Stroke

No abstract available.
Acute Kidney Injury* ; Edema* ; Hemofiltration*

No abstract available.
Acute Kidney Injury* ; Edema* ; Hemofiltration*