No abstract available.
Aortic Valve*

Epidural hematoma associated with epidural anesthesia is rare. We describe a case of a epidural hematoma after continuous epidural anesthesia and analgesia for arthroscopic patella shaving. Anesthesia was indudced with 8 ml lidocaine, 2.0% with epinephrine, 1:200,000 and surgery proceeded. When additional boluses of bupivacaine were administered later, aspiration of the epidural catheter still yielded no blood. At the end of the operation, an epidural infusion of 0.125% bupivacaine was done 2 ml/hr by two-day infusor. In the third postoperative day, the patient suffered from acute myocardial infarction and then heparin was infused. In the fourth postoperative day, she complained lumbar back pain and developed depressed dorsiflexion (Grade II) of great toe in left foot during the infusion of heparin. Sagittal MRI showed posterior thickened epidural hematoma along the segments of T12-L4. Despite the delayed laminectomy and decompression, which was performed six days after her initial operation, she had a good postoperative response, followed by a complete neurological recovery.
Analgesia ; Anesthesia ; Anesthesia, Epidural* ; Back Pain ; Bupivacaine ; Catheters ; Decompression ; Epinephrine ; Foot ; Hematoma* ; Heparin ; Humans ; Infusion Pumps ; Laminectomy ; Lidocaine ; Magnetic Resonance Imaging ; Myocardial Infarction ; Patella ; Toes

No abstract available.
Malacoplakia* ; Urinary Bladder*

No abstract available.
Diagnosis* ; Leptospirosis* ; Scrub Typhus*

The molecular mechanisms that regulate glossal muscle cell cycle and terminal differentiation remain largely unknown. To determine which cyclins, cyclin dependent kinases (CDKs), cyclin dependent kinase inhibitors (CKIs) are important for glossal cell proliferation, we have examined expression of cyclins CDKs, CKIs during normal glossal muscle development in the rat. All cyclins, CDKs, and KIP/CIP family of CKIs were highly expressed during fetal glossal muscle development, then they decreased at different rates after birth. While the mRNAs of cyclin Dl, D3, E , A, and B decreased gradually in glossal muscle during all stages of development, the protein levels of these cyclins decreased differently in tongue during pre- and postnatal development. While the functionally active formed of cyclin Dl, cyclin D3 and E proteins were observed until 7 days after birth, cyclin A and B proteins were decreased more slowly. While the CDK4, CDK6, CDK2, cdc2, and proliferating cell nuclear antigen (PCNA) proteins were higllly present during fetal glossal muscle development and gradually decreased during postnatal development. Particularly, cdc2 levels decreased markedly after birth. Immunohistochemical data for PCNA was consistent with Western blotting data for PCNA temporally and spatially. The mRNA and protein levels of p21, p27, and p57 were high, then their levels changed differently during glossal development. While the mRNA levels of p21 and p57 decreased gradually, the mRNA level of p27 did not change during glossal development. While the protein levels of p21 and p57 in tongue decreased markedly after birth, the protein levels of p27 increased slightly after birth, then decreased at adulthood. These findings suggest that the all cyclins and CDKs observed are involved in glossal muscle cell cycle, and reduction of cyclins and CDKs and induction of p21 are associated with the withdrawal of glossal muscle cell cycle after birth.
Animals ; Blotting, Western ; Cell Proliferation ; Cyclin A ; Cyclin D3 ; Cyclin-Dependent Kinases* ; Cyclins* ; Humans ; Muscle Cells ; Muscle Development ; Parturition ; Phosphotransferases* ; Proliferating Cell Nuclear Antigen ; Rats* ; RNA, Messenger ; Tongue

No abstract available.
Thyroid Gland* ; Thyroid Neoplasms*

A case of congenital dislocation of the both knees in a newborn infant which is a very rare condition and difficult to treat, is reported together with the reviews of the literature and the discussion of the future therapeutic programme of the condition.
Dislocations ; Humans ; Infant, Newborn ; Knee

No abstract available.
Cystadenoma*

No abstract available.
Amyloidosis*

PURPOSE: Newborn infants with diarrhea, metabolic acidosis and dehydration may develop methemoglobinemia without exposure to oxidizing agents. This study was undertaken to investigate clinical features in the development of methemoglobinemia in newborn infants with diarrhea. METHOD: This study involved 16 newborn infants with diarrhea who were admitted to NICU at Dong San Medical Center between January 1995 and June 1996. We investigated the age of onset of methemoglobinemia, sex ratio, level of methemoglobin in the blood, feeding methods, clinical manifestations, arterial blood gas findings, the results of culture findings and the response to therapy. RESULT: 1) The age of onset was beyond the second week of life in most cases, no sex predilection was noted and formula feeding was used in all cases. 2) Methemoglobin level in the blood was 10.1-20.0% in 7 cases, 20.1-30.0% in 6 cases, 30.1-40.0% in 2 cases and above 40.1% in one case. 3) Clinical rnanifestations on admission: moderate to severe dehydration developed in all patients with diarrhea along with respiratory distress in 13 cases, cyanosis in 6 cases, fever was noted in 5 cases, vomiting in 5 cases, while 2 cases presented with abdominal distention. Combined diseases included metabolic acidosis in most cases (93.8%), hypokalemia in 6, failure to thrive in 3, chronic diarrhea in 2, hyponatremia in 2, necrotizing enterocolitis in 1 and hepatitis was found in one case. 4) In all cases, there were no pathogenic organisms found in either blood or urine cultures along with similar negative findings in stool cultures, and Rotazyme test results using ELISA method were negative. 5) Rehydration and correction of acidosis with sodium bicarbonate was accomplished in all patients and 11 cases with greater than 15% methemoglobin were treated with methylene blue, 2mg/kg as a 1% solution in normal saline. Response to methylene blue was indicated in 1 to 2 hours in all cases although there was a reoccurrence of methemoglobinemia after an initial response in 2 cases, they both responded favorably with retreatment with methylene blue. CONCLUSION: In all newborn infant with diarrhea, dehydration and metabolic acidosis, screening tests for early diagnosis of methemoglobinemia should be considered with prompt fluid replacement therapy.
Acidosis ; Age of Onset ; Cyanosis ; Dehydration ; Diarrhea* ; Early Diagnosis ; Enterocolitis, Necrotizing ; Enzyme-Linked Immunosorbent Assay ; Failure to Thrive ; Feeding Methods ; Fever ; Fluid Therapy ; Hepatitis ; Humans ; Hypokalemia ; Hyponatremia ; Infant* ; Infant, Newborn* ; Mass Screening ; Methemoglobin ; Methemoglobinemia* ; Methylene Blue ; Oxidants ; Retreatment ; Sex Ratio ; Sodium Bicarbonate ; Vomiting