In 1938, Jarcho and Levin initially described shortening of the trunk, prominent occiput, broad forehead, multiple vertebral defects and ribs anomaly, short neck, increased anteroposterior chest diameter, lordosis, kyphoscoliosis. After that, Jarcho-Levin syndrome is an eponym that has been used to describe a variety of clinical phenotypes. We examined a girl who was suspected as suffering from Jarcho-Levin syndrome because she had shortening of the trunk, multiple vertebral defects and ribs anomaly, short neck, increased anteroposterior chest diameter, lordosis, kyphoscoliosis. We report a case of Jarcho-Levin syndrome with intrathoracic kidney, and review related literature.
Animals ; Eponyms ; Female ; Forehead ; Humans ; Kidney* ; Lordosis ; Neck ; Phenotype ; Ribs ; Thorax

BACKGROUND: To test whether propofol with fentanyl pretreatment produces better sedative efficacy than that of propofol alone in patients under spinal anesthesia. METHODS: Fifty-four patients undergoing lower leg orthopedic surgery were sedated randomly with propofol-normal saline (PN, n = 27) or propofol-fentanyl (PF, n = 27). In both groups, sedation was maintained with an initial loading dose of propofol 0.4 mg/kg, and subsequent infusion at a rate of 50 microg/kg/min. Prior to propofol administration, normal saline 0.02 ml/kg or fentanyl 1 microg/kg was given intravenously to Group PN and Group PF, respectively. We measured bispectral index (BIS) and the Observer's Assessment of Alertness/ Sedation (OAA/S) scale scores to investigate sedative efficacy, prior to and at 5 minute intervals for 1 hour after propofol infusion. RESULTS: BIS and OAA/S scores were decreased in both groups over time after starting propofol infusion (P < 0.0001). Comparison between the PF group and the PN group at each time point did not demonstrate statistically significant differences, and group effect was also not found to be statistically significant for BIS and OAA/S [BIS, P = 0.4644 (group effect), P = 0.7817 (time*group interaction)], [OAA/S scale, P = 0.4373 (group effect), P = 0.125 (time*group interaction)]. CONCLUSIONS: Judging from the BIS and OAA/S scores, propofol with fentanyl pretreatment did not produce an additional sedative effect compared to propofol alone in spinal anesthesia.
Anesthesia, Spinal* ; Fentanyl* ; Humans ; Hypnotics and Sedatives ; Leg ; Orthopedics ; Propofol*

BACKGROUND: To test whether propofol with fentanyl pretreatment produces better sedative efficacy than that of propofol alone in patients under spinal anesthesia. METHODS: Fifty-four patients undergoing lower leg orthopedic surgery were sedated randomly with propofol-normal saline (PN, n = 27) or propofol-fentanyl (PF, n = 27). In both groups, sedation was maintained with an initial loading dose of propofol 0.4 mg/kg, and subsequent infusion at a rate of 50 microg/kg/min. Prior to propofol administration, normal saline 0.02 ml/kg or fentanyl 1 microg/kg was given intravenously to Group PN and Group PF, respectively. We measured bispectral index (BIS) and the Observer's Assessment of Alertness/ Sedation (OAA/S) scale scores to investigate sedative efficacy, prior to and at 5 minute intervals for 1 hour after propofol infusion. RESULTS: BIS and OAA/S scores were decreased in both groups over time after starting propofol infusion (P < 0.0001). Comparison between the PF group and the PN group at each time point did not demonstrate statistically significant differences, and group effect was also not found to be statistically significant for BIS and OAA/S [BIS, P = 0.4644 (group effect), P = 0.7817 (time*group interaction)], [OAA/S scale, P = 0.4373 (group effect), P = 0.125 (time*group interaction)]. CONCLUSIONS: Judging from the BIS and OAA/S scores, propofol with fentanyl pretreatment did not produce an additional sedative effect compared to propofol alone in spinal anesthesia.
Anesthesia, Spinal* ; Fentanyl* ; Humans ; Hypnotics and Sedatives ; Leg ; Orthopedics ; Propofol*

Drug-induced acute interstitial nephritis is characterized by renal interstitial inflammatory cell infiltration and commonly presents as acute renal failure. This is caused mainly by methicillin, non-steroidal antiinflammatory drugs, sulfonamide diuretics such as thiazide, but cases induced by furosemide are rare. We report a patient with acute interstitial nephritis causing reversible acute renal failure and dermatitis while she was taking furosemide. A 37-year old woman was referred to our hospital because of generalized skin rash and non-oliguric acute renal failure. She had peripheral eosinophilia (1,577/mm3) and serum creatinine level of 6.8mg/dL. Skin biopsy showed leukoclastic vasculitis and percutaneous renal biopsy showed severe interstitial infiltration of lymph ocyte and mild interstitial fibrosis with focal tubular atrophy. After withdrawal of furosemide, renal function and skin lesions were completely recovered.
Acute Kidney Injury ; Adult ; Atrophy ; Biopsy ; Creatinine ; Dermatitis ; Diuretics ; Eosinophilia ; Exanthema ; Female ; Fibrosis ; Furosemide* ; Humans ; Methicillin ; Nephritis, Interstitial* ; Skin ; Vasculitis

PURPOSE: The cortical bone thickness on the anterior region is important for achieving implant stability. The purpose of this study was to examine the thickness of the cortical and cancellous bones on the anterior region of the maxilla and mandible. MATERIALS AND METHODS: Twenty-five cadaver heads were used (16 male and 9 female; mean death age, 56.7 years). After the long axis of alveolar process was set up, it was measured in 5 levels starting from 2 mm below the cementoenamel junction (L1) at intervals of 3 mm. All data was analysed statistically by one-way ANOVA at the .05 significance level. RESULTS: The cortical bone thickness according to measurement levels in both the labial and lingual sides increased from L1 to L5, and the lingual side below L3 was significantly thicker than the labial side on the maxilla and mandible. In particular, the labial cortical bone thickness in the maxilla was the thinnest compared to the other regions. The cancellous bone thickness according to measurement levels increased from L1 to L5 on the maxilla, and on the mandible it was the thinnest at the middle level of the root. CONCLUSION: For implant placement on the anterior region, a careful evaluation and full knowledge on the thickness of the cortical and cancellous bone are necessary, therefore, these results may provide an anatomic guideline to clinicians.
Alveolar Process ; Axis, Cervical Vertebra ; Cadaver ; Head ; Humans ; Male ; Mandible ; Maxilla ; Tooth Cervix

Tamoxifen is an selective estrogen receptor antagonist widely used in the management of patients with breast cancer for more than 30 years. It was thought to act primarily through occupying the estrogen receptor sites in ER positive breast cancer cells and directly on cancer cell proper. These inhibitory effects, which have been shown to be independent of the ER, highlight new mechanism of therapeutic action of tamoxifen. The purposes of this study were to identify ER in oral carcinoma cell lines and to evaluate ER independent cytotoxic effect of tamoxifen. KB(SCC), HSC-3(SCC) and A253(ACC) cell line were used and capacity of cell proliferation, apoptosis, in vitro invasion and gelatin zymography were tested. ER expression of each cell line were detected by RT-PCR and immunocytochemistry. Dose dependent inhibition of cell proliferation and inhibition of gelatinolytic activity were observed in all oral carcinoma cell lines and significant difference of apoptotic index were observed in A253 and KB. Tamoxifen inhibited in vitro invasion in all experimental groups. ER expression was detected in KB and A253. These data suggest that tamoxifen may play a role in management of oral carcinoma by independent cytotoxic effect and more advanced research must processed confirming ER-dependent cytotoxicity.
Apoptosis ; Breast Neoplasms ; Cell Line ; Cell Proliferation ; Estrogens ; Gelatin ; Humans ; Immunohistochemistry ; Mouth Neoplasms* ; Tamoxifen*

Enterobacter cloacae, a gram negative bacillus is an increasingly frequent cause of nosocomial pediatric infection. It can cause infection of postsurgical wounds, meningitis, and infection of the gastrointestinal, urinary, and respiratory tracts. Newborn infants often are colonized by Enterobacter species in the gastrointestina tract or respiratory tract soon after birth, and a acquisition of hospital strains in immunocompromised newborn infants is common. Neonatal pneumonia has been associated with many infectious agents. Pneumatocele, a cyst-like lesion that develops within the lung parenchyma, is an unusual complication of pneumonia in the neonate, especially in the preterm neonate. Pneumatocele has been reported to occur with Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Streptococcus pneumoniae, and Pseudomonas aeruginosa infections. We describe 2 cases of premature neonates with pneumonia and subsequent pneumatocele formation caused by Enterobacter cloacae.
Bacillus ; Colon ; Enterobacter cloacae* ; Enterobacter* ; Escherichia coli ; Humans ; Infant, Newborn* ; Klebsiella pneumoniae ; Lung ; Meningitis ; Parturition ; Pneumonia ; Pseudomonas aeruginosa ; Respiratory System ; Staphylococcus aureus ; Streptococcus pneumoniae ; Wounds and Injuries

No abstract available.
Thrombocytopenia, Neonatal Alloimmune*

No abstract available.
Thrombocytopenia, Neonatal Alloimmune*

OBJECTIVE: To document our experience of the vascular anomalies or variants in paraaortic region and intend to increase vigilance among the gynecological surgeons for presence of variable vascular anomalies or variants. METHODS: We conducted a retrospective chart review of 280 patients with various gynecologic malignancies who had undergone systemic laparotomic or laparoscopic paraaortic lymphadenectomy between November 2003 and July 2011. RESULTS: We discovered total nine patients of vascular anomalies during the surgery. Seven patients had an accessory polar renal artery. One patient had a duplicated inferior vena cava and the other had a right paravertebral vein. There were no vascular complications such as tearing, ligation or transection. CONCLUSION: It is not uncommon to encounter vascular anomalies in paraaortic region during the lymphadenectomy. Hence, the gynecological surgeons must be cognizant of various vascular anomalies occurring within this area to reduce the vascular accidents.
Humans ; Ligation ; Lymph Node Excision ; Renal Artery ; Retrospective Studies ; Veins ; Vena Cava, Inferior