No abstract available.

No abstract available.
Emergencies* ; Emergency Service, Hospital*

Ischemia causes tissue necrosis in a wide variety of pathologic conditions. Permanent deprivation of blood flow is lethal to any tissue and the prudent therapy for ischemia unquestionably is reperfusion. While reperfusion is necessary to reverse the progression towards ischemic death, reperfusion is also thought to be accompanied by its own component of injury. Oxygen free radicals, formed during ischemia/reperfusion, have been proposed as one of the main causes of reperfusion injury. Free radical attacks on biological membrane, such as mitochondria and endoplasmic reticulum, and can lead to the oxidative destruction of the polyunsaturated fatty acids of the membranes through lipid peroxidation. However, direct association between microsomal lipid peroxidation in vivo after ischemia/reperfusion and changes in secretory function and drug metabolism on the liver have not been established. Therefore, present study was performed to evaluate the hepatic secretory function and the hepatic microsomal drug metabolizing enzyme activity after ischemia/reperfusion preparation in rat liver. Further, the effect of oxygen free radical scavengers was investigated. The animals were divided into sham operation group and ischemia/reperfusion group. The ischemia/reperfusion group was subdivided into non-treated control and treated (with superoxide dismutase, allopurinol, alpha-tocopherol, deferoxamine) groups. Hepatic ischemia was produced by clamping the left branches of portal vein and hepatic artery, resulting in complete ischemia to the median and left lobes while the right lobes remained per Fused to prevent intestinal congestion. Reperfusion was permitted by declamping after 1 hour. After 1 or 5 hours of reperfusion, bile was collected, blood was obtained from abdominal aorta, and liver microsomes were isolated. The results are as follows. Serum aminotransferase was increased 15~20 times by ischemia/reperfusion. However, this increase was attenuated by free radical scavengers, especially 5 hours of reperfusion. The wet weight-to-dry weight ratio of the liver was significantly increased by ischemia/reperfusion. alpha-tocopherol pretreatment minimized the increase of ratio. Malondialdehyde level in the liver microsomal fraction was significantly increased after ischemia/reperfusion, but this increase was attenuated by scavenger pretreatment, especially alpha-tocopherol. Bile flow and cholate output but not the bilirubin output, were decreased after ischemia/reperfusion. The free radical scavenger pretreahnent restored the secretion significantly. Cytochrome P-450 content was significantly decreased after ischemia/reperfusion and ameliorated by free radical scavenger pretreatment. NADPH cytochrome P-450 reductase activity and aminopyrine N-demethylase activity were also decreased and improved by free radical scavengers pretreatment. These results indicate that ischemia/reperfusion deteriorates the hepatic secretory function as well as hepatic microsomal drug metabolizing enzyme activity, and the oxygen free radical scavengers attenuate the functional changes of the liver induced by ischemia/reperfusion.
Allopurinol ; alpha-Tocopherol ; Aminopyrine N-Demethylase ; Animals ; Aorta, Abdominal ; Bile ; Bilirubin ; Cholates ; Constriction ; Cytochrome P-450 Enzyme System ; Endoplasmic Reticulum ; Estrogens, Conjugated (USP) ; Fatty Acids, Unsaturated ; Free Radical Scavengers ; Free Radicals ; Hepatic Artery ; Ischemia ; Lipid Peroxidation ; Liver ; Malondialdehyde ; Membranes ; Metabolism* ; Microsomes, Liver ; Mitochondria ; NADPH-Ferrihemoprotein Reductase ; Necrosis ; Oxygen ; Portal Vein ; Rats* ; Reperfusion ; Reperfusion Injury ; Superoxide Dismutase

No abstract available.
Cholangitis, Sclerosing*

No abstract available.
Hemorrhoids*

No abstract available.
Hemorrhoids*

BACKGROUND: The purpose of this study is to compare the radiological and clinical outcomes after open reduction and plate fixation of midshaft clavicle fractures between patients who achieved successful anatomical reduction and those who had a remaining fracture gap even after open reduction and plate fixation, and were thus treated with additional demineralized bone matrix (DBM). METHODS: This retrospective analysis was conducted on 56 consecutive patients who underwent open reduction and internal fixation using a locking compression plate for acute displaced midshaft clavicle fractures, and who underwent radiographic and clinical outcome evaluations at least 6 months postoperatively. The outcomes between those who achieved perfect anatomical reduction without remnant gap (n=32) and those who had a remaining fracture gap even after open reduction and plate fixation treated with additional DBM (n=24) were evaluated. RESULTS: There were no differences in the use of lag screws or wiring and operation time (all p>0.05) between those with and without remnant gap. No difference in the average radiological union time and clinical outcomes (satisfaction and Constant score) was observed between the two groups (all p>0.05). However, significantly faster union time was observed for AO type A fracture compared with other types (p=0.012), and traffic accident showed association with worse clinical outcomes compared with other causes of injury. CONCLUSIONS: Surgical outcome of midshaft clavicle fracture was more affected by initial fracture type and event, and re-reduction and re-fixation of the fracture to obtain a perfect anatomical reduction spending time appears to be unnecessary if rigid fixation is achieved.
Accidents, Traffic ; Bone Matrix ; Clavicle* ; Fracture Fixation ; Fracture Healing ; Humans ; Retrospective Studies

A case of 14 year-old female with linear porokeratosis is reported with review of articles. She has been suffering from dark brownish, typical porokeratotic patches on the face, neck, right axilla, left hand and left lower extremity. Each lesions are distributed in linear arrangement. Family and past history are not contributory. On histologic examination of skin specimen shows typical cornoid lamella which is hallmark of this disease. Treament was carried with 5go salicylic acid ointment and 0. 025% halcinonide ointment alternatively without successful response.
Adolescent ; Axilla ; Female ; Halcinonide ; Hand ; Humans ; Lower Extremity ; Neck ; Porokeratosis* ; Salicylic Acid ; Skin

Benign symmetric lipomatosis is characterized by massive symmetric fat deposition, predominantly in the neck and shoulder girdle ares. We present a case of benign symmetric lipomatosis with alcoholic liver cirrhosis in a 54-year-old man. About two years ago, solitary skin-colored, non-tender swelling on the right upper arm was developed. The lesion had been aggravsted abruptly and rapidly in size and distribution since about one month ago. Histopathologic findings showed completely replaced reticular dermis and invaded subcutaneous tissue by mature fat cells.
Adipocytes ; Arm ; Dermis ; Humans ; Lipomatosis* ; Liver Cirrhosis, Alcoholic ; Middle Aged ; Neck ; Shoulder ; Subcutaneous Tissue

Typhlitis or neutropenic enterocolitis is a life-threatening, necrotizing process of the cecum whose incidence is increasing. Typhlitis presents as fever, abdominal pain, and diarrhea in neutropenic patients. As the incidence of typhlitis increases, emergency physicians must be aware of this rapidly progressive and potentially fatal disease. The definitive management of typhlitis is controversial. The most prudent course for the emergency physician is to initiate aggressive medical management early in the ED. We describe a 25-year-old man with severe neutropenia presented to the emergency department with fever, abdominal pain, diarrhea that began 2days earlier. Abdominal computerized tomography(CT) demonstrated diffuse concentric thickening of the cecal wall, intramural edema, inflammatory bowel changes but no free air and abscess formation. He was recovered by early diagnosis and aggressive medical therapy. We report a case of typhlitis with literature reviews.
Abdominal Pain ; Abscess ; Adult ; Cecum ; Diarrhea ; Early Diagnosis ; Edema ; Emergencies* ; Emergency Service, Hospital ; Enterocolitis, Neutropenic ; Fever ; Humans ; Incidence ; Neutropenia ; Typhlitis*