This case involved a pulmonary thromboembolism, which originated from the lower extremity. A 68-year-old female, with a femur neck fracture, underwent spinal anesthesia with 0.5% heavy bupivacaine 11 mg for total hip arthroplasty. Ten minutes after the induction of spinal anesthesia, dyspnea, tachycardia and hypotension appeared. Under the impression of a pulmonary embolism, intubation was done and dopamine and epinephrine were infused. The operation stopped and she was sent to the intensive care unit. On the spiral CT chest angiogram, a pulmonary embolism was found. Deep venous thrombosis was detected in the left lower extremity on the venogram. Heparin therapy was started at a rate of 800 U/hour with a bolus of 5000 U. A consultative operation for the removal of deep vein thrombosis was performed by a chest surgeon, and total hip arthroplasty was performed successfully under spinal anesthesia.
Aged ; Anesthesia, Spinal* ; Arthroplasty, Replacement, Hip ; Bupivacaine ; Dopamine ; Dyspnea ; Epinephrine ; Female ; Femoral Neck Fractures* ; Femur Neck* ; Femur* ; Heparin ; Humans ; Hypotension ; Intensive Care Units ; Intubation ; Lower Extremity ; Pulmonary Embolism* ; Tachycardia ; Thorax ; Tomography, Spiral Computed ; Venous Thrombosis

BACKGROUND: Recently, the commercial kits for measurement of the absolute number of CD34+ cells have been introduced as a standard method. The aims of this study was to investigated optimal timing of peripheral blood progenitor cell(PBPC) collection and optimal CD34+ cells dose transplanted by measurement of the absolute CD34+ cells. METHODS: We measured total leukocyte count, mononuclear cell count and the absolute number of CD34+ cells using ProCOUNT(Becton Dickinson, USA) in peripheral blood from 54 patients and 7 normal donors who underwent 101 leukapheresis for PBPC collection. We studied correlations among the absolute number of circulating CD34+ cells, other predictors and harvesting yields. We investigated relationships between the posttransplant hematopoietic recovery and CD34+ cells dose in 30 patients. RESULTS: The total number of CD34+ cells in harvesting products could be mostly predicted from the absolute number of circulating CD34+ cells. From 4 to 6 day after G-CSF mobilization, the absolute number of circulating CD34+ cells was peaked. A number of circulating CD34+ cells more than 20/microliter ensured 2.5x106 CD34+ cells/Kg in harvesting products. The patients received CD34+ cells dose >3.5x106/Kg led to a significantly faster recovery of platelets, compared with the patients receiving <3.5x106 CD34+ cells/Kg(P<0.05). CONCLUSIONS: These results suggest that PBPC collection should be started at day of circulating CD34+ cells more than 20/microliter or 4-6 days after G-CSF mobilization for successful leukapheresis and the CD34+ cell dose more than 3.5x106/Kg for PBPC transplantation could predicted rapid hematopoietic recovery.
Cell Count ; Granulocyte Colony-Stimulating Factor ; Humans ; Leukapheresis ; Leukocyte Count ; Stem Cells* ; Tissue Donors

Behcet's Disease (BD) is a chronic inflammatory disorder characterized by vasculitis of unknown cause, involving multiple organs. In the past years, renal involvement has not been regarded as a feature of BD. However, renal lesions in BD, although uncommon, have increasingly been recognized in recent years. Five categories of renal lesions associated with BD have been identified, including glomerulonephritis, amyloidosis, renal vascular involvement, interstitial nephritis, and other problems, such as complications of drug therapy or abnormalities of the genitourinary tract. On the other hand, regional differences in the disease expression of BD are well appreciated. Renal lesions accompanied by BD have rarely been reported in Korea, although it have been described occasionally in the Middle Eastern countries. Hereby, we described a 46-year-old female patient who had BD with persistent hematuria and proteinuria, whose renal biopsy specimens were consistent with thin glomerular basement membrane disease. Interestingly, some portions of her glomerular capillary walls were filled with fuchsinophilic fibrin-like materials.
Amyloidosis ; Basement Membrane ; Biopsy ; Capillaries ; Drug Therapy ; Female ; Glomerular Basement Membrane* ; Glomerulonephritis ; Hand ; Hematuria ; Humans ; Korea ; Middle Aged ; Nephritis, Interstitial ; Proteinuria ; Vasculitis

A case is presented of an amnionic rupture sequence which led to massive fetal ventral herniation and lordoscoliosis. Characteristic ultrasonographic findings of an omphalocele, fetal attachment to the placenta, and the absence of free-floating umbilical cord were observed.
Abnormalities, Multiple/*etiology/ultrasonography ; Adult ; Amnion ; Female ; Fetal Membranes, Premature Rupture/*complications ; Gestational Age ; Hernia, Umbilical/etiology ; Humans ; Infant, Newborn ; Male ; Pregnancy ; Umbilical Cord/abnormalities

BACKGROUND: Intravenous alfentanil is one of the effective methods to minimize the hemodynamic responses to laryngoscopy and endotracheal intubation. The purpose of this study is to get effective dose (ED50, ED95) of alfentanil to minimize the hemodynamic responses to laryngoscopy and endotracheal intubation. METHODS: Sixty patients were divided into four groups. Each group received intravenous normal saline 5 ml (Control group), alfentanil 10microgram/kg (Al10), alfentanil 20microgram/kg (Al20) and alfentanil 30microgram/kg (Al30), respectively. Mean arterial pressure (MAP) and heart rate (HR) were measured before and after intubation. We considered the doses of alfentanil effective when the increase in MAP and HR after intubation did not exceed 10% of those before intubation. RESULTS: The ED50 of alfentanil was 12.7 (8.6-16.4)microgram/kg for MAP, 20.1 (15.7-25.6)microgram/kg for HR, respectively. The ED95 of alfentanil was 26.4 (21.7-36.2)microgram/kg for MAP, 38.6 (31.2-56.7)microgram/kg for HR, respectively. CONCLUSIONS: Alfentanil was effective to minimize the hemodynamic responses to laryngoscopy and endotracheal intubation with its ED50 and ED95 as mentioned earlier.
Alfentanil* ; Arterial Pressure ; Heart Rate ; Hemodynamics* ; Humans ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy*

Prostatic adenocarcinoma cells can be detected in urine cytology specimens when the tumor extends to the bladder mucosa. We report a case of prostatic adenocarcinoma diagnosed by urine cytology. A 70-year-old man presented with urinary frequency and low back pain. On rectal examination, a nodular mass was palpated in the left side of prostate. Bone scan revealed multifocal hot lesions suggesting metastasis. Urine cytology revealed hypocellular smear on clean or bloody background. Tumor cells were mainly arranged in syncytial or papillary clusters which occasionally contained foci of luminal formation. The cytoplasm of tumor cells was finely granular. The nuclei of tumor cells revealed evenly distributed fine chromatin and large prominent nucleoli without nuclear pleomorphism. In needle biopsy specimen of prostate, tumor cells were detected in entire prostatic tissue with extension to pericapsular soft tissue. The tumor cells infiltrated individually or in a cord-like fashion with foci of cribriform pattern. Inconspicuous nuclear pleomorphism and prominent nucleoli were also noted.
Adenocarcinoma* ; Aged ; Biopsy, Needle ; Chromatin ; Cytoplasm ; Humans ; Low Back Pain ; Mucous Membrane ; Neoplasm Metastasis ; Phenobarbital ; Prostate ; Urinary Bladder

BACKGROUND: In recent years in Korea, human brucellosis (HB) and human leptospirosis (HL) have become the major zoonoses with a dramatic increased cases of incidence in man; we analyzed the current state and epidemiological aspects of related risk factors from 2001 to 2008. METHODS: Based on the surveillance data of HB and HL, most are confirmed cases in Korea from the Annual Reports of HB and HL in the Disease Web Statistics System, Korea Center for Disease Control and Prevention (KCDCP). RESULTS: The incidence of HB in Korea from 2001 to 2008 was 596 cases, and that of HL was 1,025 cases. When both prevalence rates were compared during the same period, the HB was lower than that of HL. The seasonal distribution of HB cases showed that the incidence from spring to summer were higher than that of HL (P<0.01), while the outbreaks of HL in autumn was much more than that of HB (P<0.01). Geographical distribution HB cases were western and central regions of the rural (60.4% of total) in the Korean peninsula, showing higher outbreaks than other areas, while HL occurred in easterly regions (72.7%). Significantly more males were infected in both HB (84.2%) and HL (58.9%) than those of females in both HB (13.1%) and HL (41.1%), respectively (P<0.01). The distribution by age groups were different between HB and HL, while the outbreaks over 62.8% of the cases of HB occurred in 40 to 59 year-old age group, and that of HL was clearly showing a high incidence in the elderly age over-60-year-old (60.8%) (P<0.01). In both diseases, elderly people especially in farmers showed a very high prevalence rate (62.8% of HB and 60.8% of HL), which is possibly due to increased outdoor activities and a decreased number of young people in those areas. The occupational distribution of HB cases were farmers, veterinarians, dairyman and others, and those of HL cases were broad. CONCLUSION: The difference in HB and HL risk factors reflects the different influences of hosts/vector, climate, and geographical and environmental characteristics in the epidemiological patterns.
Aged ; Brucellosis ; Centers for Disease Control and Prevention (U.S.) ; Climate ; Disease Outbreaks ; Female ; Humans ; Incidence ; Korea ; Leptospirosis ; Male ; Prevalence ; Public Health ; Risk Factors ; Seasons ; Veterinarians ; Zoonoses

A 55-year-old woman was referred to our hospital with a 6-month history of dyspnea (NYHA II-III). The physical examination revealed a grade 2/6 "tumor plop," i.e., a low-pitched sound heard during early or mid-diastole. The chest X-ray showed mild cardiomegaly with lung congestion in both lower lung fields. Two-dimensional echocardiogram showed a large myocardial mass, prolapsing into the left ventricle during diastole. Chest computed tomography showed a multi-lobulated mass (6.8x4.1 cm) attached to the interatrial septum during systole and prolapsing into the left ventricle during diastole. Coronary angiography demonstrated large tumor vessels arising from and surrounding the posterior lateral branch of the right coronary artery. The mass was excised and the patient recovered uneventfully.
Cardiomegaly ; Coronary Angiography ; Coronary Vessels ; Diastole ; Dyspnea ; Estrogens, Conjugated (USP) ; Female ; Glycosaminoglycans ; Heart Atria ; Heart Ventricles ; Humans ; Lung ; Middle Aged ; Myxoma ; Physical Examination ; Systole ; Thorax

The purpose of these studies was an establishment of human auricular chondrocyte cell line using retrovirus mediated v-myc transfer, characterizing the human auricular chondrocyte cell line by type II collagen mRNA expression and transplantation of human auricular cell line into immunological incompetent nude mice to establish neocartilage formation. Also, I evaluated the growth rate of chondrocyte cell line to measure the cellular proliferative potency. I have established the human auricular chondrocyte cell line integrated v-myc and confirmed by v-myc transduced Myc protein expression by immunohistochemistry and immunoblotting study. And, growth rate of established human auricular chondrocyte cell line increased 4 folds times faster than primarily cultured human auricular chondrocyte. The established human auricular chondrocyte had type II collagen mRNA upto 8 months in monolayer culture. And we observed formation of neocartilage on the back of nude mice using chondrocyte cell line/fibrin glue polymer at 12 weeks transplantation.
Adhesives ; Adult* ; Animals ; Cell Line* ; Chondrocytes ; Collagen Type II ; Humans* ; Immunoblotting ; Immunohistochemistry ; Mice ; Mice, Nude ; Polymers ; Retroviridae ; RNA, Messenger