No abstract available.
Echocardiography* ; Mass Screening*

PURPOSE: To present initial and follow-up HRCT findings of lymphangitic carcinomatosis of the lung. MATERIALS AND METHODS: Both initial and follow-up HRCT scans were obtained in 18 patients with lymphangitic carcinomatosis of the lung. After dividing the patients into two groups (with anticancer chemotherapy (n=12) and without chemotherapy (n=6), changes of pulmonary parenchymal abnormalities (percentile increase or decrease in the extent of each pattern) were assessed and compared on initial and follow-up HRCTs. RESULTS: Findings on initial CT were interlobular septal thickening (n=18) (smooth in 15 and mixed smooth and nodular in three), thickening of bronchovascular bundles (n=17), areas of ground-glass opacity (n=15), polygonal lines (n=15), and nodules (n=10). With chemotherapy, the finding of polygonal lines decreased by 20/3%, while findings of ground-glass opacity, bronchovascular bundle thickening, septal thickening, and nodules remained stable. Without chemotherapy, all CT patterns of abnormalities except nodules increased by 45-88%. In three patients who did not undergo chemotherapy, smooth interlobular septal thickening changed to nodular thickening. CONCLUSION: Lymphangitic carcinomatosis of the lung manifests initially as smooth thickening of the interlobular septae, bronchovascular bundle thickening,areas of ground-glass opacity, and polygonal lines, as seen on HRCT. Without chemotherapy, the extent of CT findings increases and there is a tendency for smooth septal thickening to change to nodular thickening. Chemotherapy induces improvement or cessation of the progression of CT findings.
Carcinoma* ; Drug Therapy ; Follow-Up Studies ; Humans ; Lung*

Alveolar Bone Loss ; Animals ; Bone Lengthening ; Cicatrix ; Congenital Abnormalities ; Electric Stimulation ; Electromagnetic Fields ; Hand ; Humans ; Magnets ; Mandible ; Mastication ; Osteogenesis ; Osteogenesis, Distraction ; Osteotomy ; Recurrence

BACKGROUND: The purpose of our study was to evaluate the usefulness of hip arthroscopy including extensive capsulectomy for synovial chondromatosis of the hip. METHODS: From 2008 to 2016, 13 patients with synovial chondromatosis of the hip were treated with arthroscopic removal of loose bodies and synovectomy using three arthroscopic portals. An extensive capsulectomy was performed to allow the remaining loose bodies to be out of the extracapsular space, and the excised capsule was not repaired. All patients were assessed by clinical scores and the radiographs were reviewed to determine whether the remaining loose bodies disappeared at the last follow-up. RESULTS: Eight men and two women were followed up for a minimum of 1 year (mean, 3.8 years; range, 1 to 6.8 years) after hip arthroscopy. Clinical outcomes such as modified Harris hip score, University of California Los Angeles score, and Western Ontario and McMaster Universities Osteoarthritis Index score improved at the last follow-up. Although seven hips had remaining loose bodies after arthroscopic surgery, the remaining loose bodies disappeared in five hips (71.4%) at the last follow-up. CONCLUSIONS: Arthroscopic surgery was useful to treat synovial chondromatosis of the hip. In spite of limited removal of loose bodies, arthroscopic procedures including extensive capsulectomy could be effective for the treatment of synovial chondromatosis of the hip.
Arthroscopy* ; California ; Chondromatosis, Synovial* ; Female ; Follow-Up Studies ; Hip* ; Humans ; Male ; Ontario ; Osteoarthritis

Multiple coronary arteries to communicating with the left ventricular fistulae is a very rare congenital anomaly in adults. This anomaly involves three major coronary arteries that have a direct communication between these arteries and the left ventricle. Hemodynamically, it induces myocardial ischemia due to coronary steal syndrome and diastolic volume overload from a left-to-left shunt. A 70-year-old woman with essential hypertension was admitted to our clinic to evaluate complaints of exertional dyspnea. Clinical examination revealed a diastolic murmur at the apex. A coronary angiogram showed a common fistular channel connecting the right coronary artery, the left circumflex coronary artery, and the first large diagonal branch of the left anterior descending coronary artery with the left ventricular chamber. The patient's symptoms were relieved by the administration of calcium channel blocker and angiotensin II receptor blocker. We report a very rare case of three major coronary arteries communicating to the left ventricular fistulae via a common channel.
Adult ; Aged ; Arteries ; Calcium Channels ; Coronary Vessel Anomalies ; Coronary Vessels* ; Dyspnea ; Female ; Fistula* ; Heart Murmurs ; Heart Ventricles ; Humans ; Hypertension ; Myocardial Ischemia ; Receptors, Angiotensin

It is now well established that acute subarachnoid hemorrhage secondary to rupture of a cerebral aneurysm can precipitate life-threatening cardiac arrhythmia. We experienced a 60 year old patient with a subarachnoid hemorrhage (neurologic grade III) due to rupture of anterior communicating artery aneurysm who presented with such intraoperative electrocardiographic changes as ST segment elevation and T wave inversion which are hallmark of acute myocardial infarction. The operation was uneventfully ended. On the postoperative laboratory examination about suspected acute myocardial infarction, the patient was found to have normal triple enzyme study and echocardiographic finding. The electrocardiogram three days after subarachnoid hemorrhage due to cerebral aneurysm returned to normal sinus rhythm. This case suggests that this patient's electrocardiographic change simulating acute myocardial infarction is transient change due to subarachnoid hemorrhage.
Arrhythmias, Cardiac ; Echocardiography ; Electrocardiography* ; Humans ; Intracranial Aneurysm ; Middle Aged ; Myocardial Infarction* ; Rupture ; Subarachnoid Hemorrhage*

BACKGROUND: Etomidate is short-acting non-barbiturate intravenous anesthetic with minimal cardiovascular depression. As a small change in venous capacitance significantly alters venous return and thus cardiac output, it is important to know the effects of intravenous anesthetics on venous capacitance. The purpose of this study was to examine the effect of etomidate or pentobarbital (control agent) on venous capacitance. METHOD: All twenty rats (etomidate group: 10, pentobarbital group: 10), weighing 350-450 gram, were anesthetized with pentobarbital 50 mg/kg given intraperitoneally for surgical preparation. Mean arterial pressure (MAP), heart rate (HR), and mean circulatory filling pressure (MCFP) were measured in the awake state(recovered from pentobarbital anesthesia for surgical preparation) as well as during anesthesia with etomidate or pentobarbital. Venous capacitance was assessed before and during anesthesia with etomidate or pentobarbital by measuring MCFP. MCFP was measured during a brief period of circulatory arrest produced by inflating a balloon inserted in right atrium. RESULTS: As compared with MCFP in the corresponding awake state, MCFP was not significantly altered by etomidate but significantly decreased by pentobarbital. As compared with MAP in the corresponding awake state, MAP was not significantly altered by etomidate but significantly decreased by pentobarbital. CONCLUSION: The results suggest that unaltered venous capacitance by etomidate may contribute to a maintained MAP but increased venous capacitance by pentobarbital decrease in MAP of the normovolemic rat.
Anesthesia ; Anesthetics, Intravenous ; Animals ; Arterial Pressure ; Cardiac Output ; Depression ; Etomidate* ; Heart Atria ; Heart Rate ; Pentobarbital ; Rats*

Iliacus muscle is the strongest hip flexor of gluteal region that acts with psoas muscle, whereas gluteus maximus muscle is the largest muscle engaged in extension and external rotation of the hip. Mountaineering requires strong contractile force of both flexor and extensor around the hip. A 57-year-old man presented to our hospital with severe pain in left groin after mountaineering for 5 hours without a break. Magnetic resonance imaging revealed incomplete rupture of iliacus muscle and strain of gluteus maximus muscle. Conservative treatment was done. At 3 months of follow-up, he returned to normal life. If we are going to climb mountain, it is important to start warming up with some stretches, take a break while climbing, and use climbing sticks. There have been no report about athletic injury of both iliacus and gluteus maximus after mountaineering. So we report this case with a review of the literature.
Athletic Injuries ; Buttocks ; Follow-Up Studies ; Groin ; Hip ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Mountaineering ; Psoas Muscles ; Rupture

The fat embolism syndrome is a serious and potentially life threatening complication of long bone trauma, blunt trauma and intramedullary manipulation. A 26-year-old woman underwent an intramedullary nailing of the femur under general anesthesia 45 hours after a traffic accident. The operation ended uneventfully and the patient was extubated in the operatirg room. About one hour after the patient arrived at the recovery room, she progressively developed tachycardia, tachypnea, cyanosis and drowsiness. The fat embolism syndrome was suspected because of the above clinical signs, and because pulmonary edema appeared on a simple chest A-P. During six days of intensive treatment in response to the fat embolism syndrome, the patient,s vital signs and ventilatory status progressively improved. The patient was uneventfully discharged from the hospital 19 days after her operation.
Accidents, Traffic ; Adult ; Anesthesia, General ; Cyanosis ; Embolism, Fat* ; Female ; Femur* ; Fracture Fixation, Intramedullary* ; Humans ; Pulmonary Edema ; Recovery Room* ; Sleep Stages ; Tachycardia ; Tachypnea ; Thorax ; Vital Signs

A heterogenic group of staphylococcal exotoxins, including staphylococcal superantigenic toxins, enterotoxin (SE), toxic shock syndrome toxin-1 (TSST-1), and coagulase are the most important virulence factors of Staphylococcus aureus. We analyzed the prevalence of genes encoding five enterotoxins and TSST-1 in S. aureus isolated from clinical ear discharges. The genes were identified by multiplex PCR and we compared the results to references of coagulase serotypes. In 102 isolates of S. aureus, 44 of them were methicillin-resistant S. aureus (MRSA) and the others were methicillin-susceptible S. aureus (MSSA). Among both types of S. aureus, 33 strains were positive for sea, 2 for seb, 23 for sec, 26 for see, and 26 for tst. Overall, 59 (57.8%) isolates were positive for one or more superantigenic toxin genes. From these, 71.2% (42/59) strains harbored more than one toxin gene in different combinations. The major combinations of genes were sea and see, and sec and tst. The degree of possession of superantigenic toxic genes was similar in both MRSA and MSSA isolates (56.8% vs 58.6%, respectively), yet significant differences in toxin gene profiles and coagulase serotypes between two isolates were detected. All of 13 positive strains for sec and tst were MRSA and belonged to coagulase serotype II. On the other hand, 80.0% of 20 positive strains for sea and see were MSSA with coagulase serotype IV and VII, whereas 20.0% of them were MRSA with coagulase serotype IV. This data indicates that the profile of superantigenic toxin genes correlates to coagulase serotype and methicillin resistance in S. aureus isolates.
Bacterial Toxins ; Coagulase ; Ear ; Enterotoxins ; Exotoxins ; Hand ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Multiplex Polymerase Chain Reaction ; Prevalence ; Shock, Septic ; Staphylococcus ; Staphylococcus aureus ; Superantigens ; Virulence Factors