Acute pyogenic arthritis in renal transplant patient is one of the serious problem resulting in significant morbidity and mortality. The purpose of this paper is to analyze seven patients in whom acute pyogenic arthritis developed following renal transplantation. Pyogenic arthritis developed in seven (0.7%) out of 958 renal transplant patients whose transplanted kidney functioned well for more than two years. The age of the patients ranged from 37 to 65 years with a mean of 48 years. All patients were male. Pyogenic arthritis developed between the period of one and 12 years (mean: 4.5+/-4.2 years) following transplantation. Causative organisms were Staphylococcus aureus (three), E. coli (two), Salmonella (one) and Acinetobacter bananii (one). Involved joints were four knees, one hip, one elbow and one finger. Two patients improved on a conservative regimen of bed rest and antibiotics and five patients required open drainage. However, pyogenic arthritis recurred in three years, four years and seven years after renal transplant in one patient. Looking at the probable risk factors of age, sex, immunosuppresants, diabetics and acute graft rejection, diabetics and older age (over 40 years old) are highly associated with post renal transplant pyogenic arthritis.
Acinetobacter ; Anti-Bacterial Agents ; Arthritis* ; Bed Rest ; Drainage ; Elbow ; Fingers ; Graft Rejection ; Hip ; Humans ; Joints ; Kidney ; Kidney Transplantation ; Knee ; Male ; Mortality ; Risk Factors ; Salmonella ; Staphylococcus aureus ; Transplantation*

Tuberculosis of the thyroid gland is extremely rare with few cases reported in recent years. Tuberculosis may involve the thyroid gland in two main forms. The more common of theses is miliary spread to the thyroid as part of generalized dissemination and less commonly focal or caseous tuberculosis of the thyroid may occur, presenting as a nodule, as a thyroiditis, as a abscess, or as carcinoma like.We experienced two cases of tuberculosis of the thyroid gland presenting with palpable thyroid nodule in 26 year-old female and 65 year-old female patients. They have been clinically and biochemically euthyroid and their thyroid scans demonstrated a cold nodule at right thyroid gland. We found no evidence of tuberculosis elsewhere. The goiter was removed surgically and confirmed to be tuberculosis. They were medicated antituberculous agents after operation and followed up regulary out patient department.We report the cases of two patients with tuberculosis involving thyroid with reviews of literature.
Abscess ; Female ; Goiter ; Humans ; Thyroid Gland ; Thyroid Nodule ; Thyroiditis ; Tuberculosis

Isolated rabbit aortic ring with intact endothelial cell preparations precontracted with NE (10(-7) M) were relaxed by vanadate in a dose dependent manner (from 0.2 to 2 mM). Application of vanadate and ACh during the tonic phase of high K+(100 mM)-induced contraction showed a slight relaxation in contrast to that in NE-induced contraction, but sodium nitroprusside (10 microM) more effectively relaxed the aortic ring preparations in high K+ contraction than that of vanadate. Vanadate-induced relaxation in NE-contracted aortic rings was reversed by application of BaCl2 (50 microM) or glibenclamide (10 microM). Furthermore, Vanadate hyperpolarized membrane potential of smooth muscle cells in endothelium-intact aortic strips and this effect was abolished by application of glibenclamide. The above results suggest that vanadate release EDHF (Endothelium-Derived Hyperpolarizing Factor), in addition to EDRF (Endothelium-Derived Relaxing Factor) from endothelial cell. This EDHF hyperpolarize the smooth muscle cell membrane potential via opening of the ATP-sensitive K+ channel and close a voltage dependent Ca++ channel. So it is suggested that the vanadate-induced relaxation of rabbit thoracic aortic rings may be due to the combined effects of EDRF and EDHF.
Animal ; Aorta/drug effects/physiology ; In Vitro ; Membrane Potentials/drug effects ; Potassium/pharmacology ; Potassium Channels/physiology ; Rabbits ; Support, Non-U.S. Gov't ; Tetraethylammonium Compounds/pharmacology ; Vanadates/*pharmacology ; Vasodilation/*drug effects

A seven months old, tiger shovelnose catfish was referred to the veterinary medical teaching hospital of the college of veterinary medicine, Konkuk university because of suspecting a foreign body in the stomach. By physical and radiologic examinations, the catfish revealed abdominal enlargement, vomiting, inactivity and radiopaque foreign bodies in the stomach. Under general anesthesia with dilute isoflurane solution, celiotomy was performed. Stomach was atonic, and three foreign bodies were palpated in the stomach. In this process, three stones came out through mouth. Abdominal muscles were closed with a simple continuous suture pattern, and skin was closed with a simple mattress suture pattern. Sutured site was covered with glue and mucous taken from allogenic skin. On the second day after surgery, the patient recovered to normal condition, showing increased appetite and activity.
Animals ; Catfishes/*surgery ; Foreign Bodies/pathology/*surgery ; Gastroscopy/veterinary ; Stomach/*surgery

This study was performed to compare the effect of intratesticular (IT) injection of xylazine/ketamine combination for canine castration with those of intramuscular (IM) or intravenous (IV) injection. Xylazine and ketamine was administered simultaneously via intratesticularly (IT group), intramuscularly (IM group) or intravenously (IV group) at doses of 2 and 10 mg/kg, respectively. Pain response at the time of injection, mean induction time, mean arousal time, mean walking time and cardiopulmonary function during anesthesia were monitored after the xylazine and ketamine administration. In IV and IM groups, heart rates were significantly decreased 30 and 45 min after xylazine and ketamine administration, respectively (p < 0.05). Respiratory rates were significantly decreased in the IV group (p < 0.05). In the IT group, there was no significant changes in heart and respiratory rates. The occurrence of cardiac arrhythmias was less severe in IT group compared with those in IM and IV groups. The route of administration did not affect rectal temperature. Mean induction time was significantly (p < 0.05) longer in IT group than in IM and IV groups. On the contrary, mean arousal time and mean walking time were shortened in IT group. Clinical signs related to pain response at the time of injection and vomiting were less observed in IT group than in IM group, and head shaking was less shown in IT group than in IM and IV groups during recovery period. These results indicated that intratesticular injection of xylazine/ketamine for castration has several advantages such as less inhibition of cardiopulmonary function and fast recovery from anesthesia without severe complications, and would be an effective anesthetic method for castration in small animal practice.
Anesthesia, Intravenous/veterinary ; Anesthetics, Combined/adverse effects/*therapeutic use ; Anesthetics, Dissociative/adverse effects/*therapeutic use ; Animals ; Body Temperature/drug effects ; Castration/*veterinary ; Dogs ; Drug Administration Routes/veterinary ; Electrocardiography/drug effects/veterinary ; Heart Rate/drug effects ; Injections/veterinary ; Injections, Intramuscular/veterinary ; Ketamine/adverse effects/*therapeutic use ; Male ; Pain, Postoperative/prevention&control/veterinary ; Pulmonary Ventilation/drug effects ; Testis/*drug effects ; Vomiting/chemically induced/veterinary ; Xylazine/adverse effects/*therapeutic use

Cyanoacrylate is well recognized for its effect in the treatment of the gastric variceal bleeding rather than the esopahgeal variceal bleeding. We used endoscopic injection sclerotherapy (EIS) with cyanoacrylate for the control of esophageal variceal bleeding in which endoscopic variceal ligation (EVL) was difficult due to severe post-EVL scar changes of the esophageal mucosa. The hemostasis by EIS with cyanoacrylate was successfully achieved despite the massive bleeding. However, esophageal obstruction occurred after the EIS treatment. Later, the obstruction resolved spontaneously as the polymer was expelled into the esophageal lumen. We report this case with a brief review of the literatures.
Cicatrix ; Cyanoacrylates* ; Deglutition Disorders ; Esophageal and Gastric Varices ; Hemorrhage ; Hemostasis ; Ligation ; Mucous Membrane ; Polymers ; Sclerotherapy*

We present a case of suprarenal & infrarenal absence of inferior vena cava combined with hyperhomocysteinemia in a 39-year-old woman who presented with symptoms of deep venous thrombosis. The patient has also C677T methylenetetrahydrofolate reductase homozygous mutation. Deep vein thrombosis has multifactorial etiology involving both genetic and acquired factors. Absence of inferior vena cava is a rare congenital anomaly, but recently it was confirmed as important risk factor for the development of deep vein thrombosis especially young person. Hypercoagulability by the hyperhomocysteinemia with suggested tendency to venous stasis mediated by agenesis of inferior vena cava must have caused the deep vein thrombosis in our patient. To our knowledge, such an association has not been reported. Clinical features and prognosis of this entity are discussed.
Adult ; Female ; Humans ; Hyperhomocysteinemia* ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Prognosis ; Risk Factors ; Thrombophilia ; Vena Cava, Inferior* ; Venous Thrombosis*

BACKGROUND/AIMS: Although many individual cases of toxic hepatitis have been reported in Korea, there are few comprehensive systematic studies on acute toxic hepatitis. The first aim of this study is to investigate the frequency and clinical characteristics of acute toxic hepatitis patients. The second aim of this study is to investigate the efficacy of steroid therapy for immunoallergic idiosyncrasy. METHODS: Between March 1998 and March 2004 forty eight patients were included in this study. The medical records were reviewed retrospectively. Acute toxic hepatitis was diagnosed by score of more than 3 in RUCAM criteria. All the patients were tested for hepatitis A, B and C. Other tests included antibodies to CMV and EBV, ANA, AMA and SMA. RESULTS: Seventy-three percent of the patients were female and the mean age of the patients was 47. Twenty cases of acute toxic hepatitis (42%) were related to prescribed medications. The other causes were herbs (35%) and traditional therapeutic preparations (23%). Common symptoms were jaundice (35%), fatigue (10%), fever (9%) and abdominal pain (9%). The biochemical pattern of hepatotoxicity was divided into three groups: hepatocellular (81%), mixed (13%), and cholestatic types (6%). Three patients who have prolonged and severe jaundice were classified into immunoallergic idiosyncrasy based upon clinical and histologic findings. Prednisolone was prescribed in all three cases whose bilirubin levels had been higher than 15 mg/dL for at least 7 days. Jaundice and the laboratory findings rapidly improved within 8 days since the treatment began. CONCLUSIONS: In a demographic point of view, most patients of acute toxic hepatitis were middle aged women. Jaundice was the most commonly observed symptom. Prescribed drugs were the most common cause of acute toxic hepatitis. Although most cases of toxic hepatitis will recover with supportive care after cessation of the causative agent, steroid treatment may be helpful for the patients with severe jaundice patients who have immunoallergic idiosyncrasy.
Prednisolone/therapeutic use ; Middle Aged ; Male ; Jaundice/drug therapy/etiology ; Humans ; *Hepatitis, Toxic/diagnosis/drug therapy/etiology ; Glucocorticoids/therapeutic use ; Female ; Adult ; Acute Disease

High systemic complication rates and severe tissue injuries are associated with more successful revascularization and reperfusion of ischemia rather than ischemia itself. It is regarded as a "ischemia- reperfusion (I/R) injury". It is well recognized that the microvasculature is highly sensitive to I/R and that the initial damage of endothelial cells contributes to I/R-induced tissue injury. The endothelial cells serve as an important modulator of vascular homeostases by secreting vasoactive materials. One of the important product of endothelial cells, nitric oxide helps to maintain hemostasis through its involvement in coagulation, platelet activation, vascular tone regulation. But The exact role of nitric oxide and time dependent change of its synthesis during the reperfusion injury are not clear. In this study, endothelial cells were isolated from human fetal umbilical vein and cultured in M-199 medium. We observed morphological change of the endothelial cells and time dependent change of nitric oxide synthesis following anoxia and reperfusion injuries. The results were as follows: 1) More significantly, the endothelial cells of anoxia group were flattened and detached than contol group. More severe detachment of endothelial cells was founded in R-O group than anoxia group. There is no significant differences in morphological changes between allopurinol group and anoxia group. 2) The concentration of NO in the anoxia group (2511.62 428.60nM/1 105 cells/ml) was lower than that of the control group (3505.14 192.95nM/1 105 cells/ml) (P<0.005). The NO concentration of the reoxygenation group reached its highest level of 2953.14 90.98 nM/1 105 cells/ml at 180 minutes (P<0.05) and decreased thereafter. There was no significant differences in NO concentration between allopurinol group and anoxia group. In conclusion, morphologic damage of endothelial cells in reoxygenation group was significantly increased compared with anoxia group. Nitric oxide syntheses in reoxygenation group and anoxia group were decreased compared with control group. More advanced study will be needed to elucidate the detailed mechanism of time-dependent change of nitric oxide synthesis during the reperfusion injury.
Allopurinol ; Anoxia* ; Endothelial Cells* ; Hemostasis ; Humans ; Ischemia ; Microvessels ; Nitric Oxide* ; Platelet Activation ; Reperfusion ; Reperfusion Injury ; Umbilical Veins*

This study evaluated the surgical outcome and complications of phacoemulsification and the implantation of an acryl foldable intraocular lens (IOL) with a squared edge in dogs with cataracts. Thirty-two eyes from 26 dogs were examined. The mean follow up period was 75.9 days ranging from 23 to 226 days. The complications after phacoemulsification were posterior capsular opacity (PCO) around the IOL (n = 11), ocular hypertension (n = 4), focal posterior synechia (n = 4), hyphema (n = 3) and corneal ulcer (n = 2). The complications associated with the IOL were decenteration of the optic (n = 2) and ventral haptic displacement (n = 1). Most cases of PCO were found only around the margin of the IOL, and all eyes had vision during the observation period. In conclusion, the implantation of an acryl-foldable lens with a squared edge at the time of phacoemulsification is an effective method for preserving the central visual field of dogs with cataract.
Animals ; Cataract/*veterinary ; Dog Diseases/*surgery ; Dogs/*surgery ; Female ; Lens Implantation, Intraocular/adverse effects/*veterinary ; Male ; Phacoemulsification/adverse effects/*veterinary ; Retrospective Studies