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.
Diagnosis* ; Leptospirosis* ; Scrub Typhus*

No abstract available.
Malacoplakia* ; Urinary Bladder*

No abstract available.
Thyroid Gland* ; Thyroid Neoplasms*

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

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*

BACKGROUND: Tuberculosis itself causes not only lung parenchymal destruction but also pulmonary vascular damage. Secondary emphysema also causes pulmonary vascular damage, which can develop as a late sequela of pulmonary tuberculosis. Therefore, pulmonary circulatory impairment tends to be more severe in post-tuberculosis emphysema than in primary emphysema. In post-tuberculosis emphysema, the right ventricular function may play an important role. However, little information regarding the right ventricular function is available. The purpose of this study was to evaluate and compare the right ventricular function between post-tuberculosis emphysema and primary emphysema. METHOD: Post-tuberculosis emphysema(PTE) or primary emphysema(PE) was diagnosed by history, HRCT finding and pulmonary function. Twenty patients with post-tuberculosis emphysema were matched with 20 patients with primary emphysema according to both FEV1 and FVC. Arterial blood gas analysis and echocardiography were done at rest and immediately after symptom-limited exercise. The right ventricular function was evaluated with the right ventricular ejection fraction using a modification of Simpson's method. RESULTS: There was no significant difference inthe demographics and pulmonary function between the two groups. In post-tuberculosis emphysema, the PaCO2 was higher (42.9±4.7 vs 38.8±3.1 mmHg at rest ; 47.9±7.0 vs 41.1±5.9 mmHg after exercise ; p<0.01) and the right ventricular ejection fraction was lower (57.6±6.5 vs 61.4±4.7 % at rest ; 51.1±10.8 vs 59.8±6.6 % after exercise ; p<0.01) both at rest and after exercise. The PaO2 after exercise was also lower (65.7±12.6 vs 80.2%±14.4 mmHg, p<0.01), while the PaO2 at rest tended to be lower(82.9±12.0 vs 87.8±7.5, p>0.05). In both groups, right ventricular ejection fraction correlated with the PaO2 after exercise(PTE r=0.536, PE r=0.557), and the PaCO2 at rest(PTE r=-0.576, PE r=-0.588) and after exercise(PTE r=-0.764, PE r=-0.619). CONCLUSION: Impairment of the right heart function and gas exchange were more serious in post-tuberculosis emphysema than in primary emphysema, and gas exchange may be influenced by the right ventricular function in post-tuberculosis emphysema.
Blood Gas Analysis ; Demography ; Echocardiography ; Emphysema* ; Heart ; Humans ; Lung ; Stroke Volume ; Tuberculosis ; Tuberculosis, Pulmonary ; Ventricular Function, Right*

Disibling pansclerotic morphea, a severe form of generalized morphea, has a relentless clisabling course, producing marked contract,ion and joint deformity due to sclerosis of the skin and the deeper structures. We report herein an unusual case of morphea in a 25 year old male who had suffered from chronic recurrent ulceration with scar like sclerotic changes overlying limb folds, ankles, nape and abdomen since 4 years of age. The indurated lesions on the chest and abdomen were ivory colored, sclerotic guttae and plaques having a, violac ous border. At l4 years of age, the skin lesions were diagnostically ambiguous, wherea.s the immunologic results revealed a selective IgA deficiency with partial T lymphacyte inactivation. About 10 years later, the follow up visit showed this severe form of morphea over generalized area and disabling contractures of knees, elbows and alkles, but IgA value returned nearly to the nomal level.
Abdomen ; Adult ; Ankle ; Cicatrix ; Congenital Abnormalities ; Contracture ; Elbow ; Extremities ; Follow-Up Studies ; Humans ; IgA Deficiency ; Immunoglobulin A ; Joints ; Knee ; Male ; Scleroderma, Localized* ; Sclerosis ; Skin ; Thorax ; Ulcer