No Abstract Available.
Alopecia* ; Telemedicine*

No Abstract Available.
Sezary Syndrome*

No abstract available.
Kidney Transplantation* ; Kidney*

Minoxidil is a potent direct-acting peripheral vasodilator indicated in the management of severe or refractory hypertension. Well-known adverse effects include reflex tachycardia, fluid retention and hypertrichosis. This drug has also been reported to cause pericardial effusion in about three percent of nondialyzed patients with compromised renal function and to cause cardiac tamponade less frequently. Many studies have reported that the mean duration of therapy that caused pericardial effusion was about 8 months (range 1 month-53 months). We report a case of cardiac tamponade in nondialyzed patient with chronic renal failure receiving minoxidil for 10 years. A 58-year-old female was admitted to our hospital with dyspnea of NYHA III. She was a chronic renal failure patient without dialysis treatment and received kidney transplantation from cadaver donor and was dignosed chronic rejection in 1994. Minoxidil 10mg has been used for past 10 years. Lasix has been used for past 2 years, with dosage of 40mg to 240mg. On admission, blood pressure was 90/60mm Hg. Cardiomegaly was seen on chest radiograph. The two-dimensional echocardiogram showed a large amount of pericardial effusion. Emergency treatment with pericardiocentesis removed 2500ml of straw- colored pericardial fluid and resulted in marked improvement of dyspnea and stabilized blood pressure. The minoxidil was discontinued. The evidence of pericardial effusion was not seen for 12 months after minoxidil had been discontinued.
Blood Pressure ; Cadaver ; Cardiac Tamponade* ; Cardiomegaly ; Dialysis ; Dyspnea ; Emergency Treatment ; Female ; Furosemide ; Humans ; Hypertension ; Hypertrichosis ; Kidney Failure, Chronic* ; Kidney Transplantation ; Middle Aged ; Minoxidil* ; Pericardial Effusion ; Pericardiocentesis ; Radiography, Thoracic ; Reflex ; Tachycardia ; Tissue Donors

Interleukin-6 (IL-6) is introduced as a marker of disease. At present, a variety of method may be used to quantify expression of this protein. Antigen capture-ELISA is a sensitive and accurate quantification method previously used with ovine, rat, and human IL-6 proteins. However, it has never been reported to quantify porcine IL-6 protein using capture ELISA. In this study, we generated and characterized a set of IgY and mono-specific polyclonal antibodies to recombinant porcine IL-6 (rpIL-6), and combining these with a sensitive and specific capture-ELISA for a diagnostic purpose. cDNA encoding the mature protein coding region of porcine IL-6 was cloned and expressed with pQE-30UA expression vector. rpIL-6 was then expressed and purified by using Ni-NTA resin. Protein mass of 24 kDa was found with SDS-PAGE and the identity of the protein was confirmed by Western-blot. Production of polyclonal antibodies against rpIL-6 was performed using the purified rpIL-6 in mice and hens. An antigen capture-ELISA was developed with the antibodies after their extraction. To compare the IL-6 level in the different sanitary state of farms, pig sera were randomly collected and concentration of IL-6 in the sera was measured with the antigen capture-ELISA. The capture-ELISA with the optimal concentration of antibodies, in this study, was able to detect about 10 ng/ml of rpIL-6. IL-6 levels determined with the capture-ELISA in pig sera showed positive correlation with the sanitary states of the farms. These results suggested that the developed antigen capture-ELISA could be a good tool for the screening of microbial infection in pig farms.
Animals ; Biological Markers/blood ; Blotting, Western/veterinary ; Chickens ; Cloning, Molecular ; DNA, Complementary/genetics/isolation&purification ; Electrophoresis, Polyacrylamide Gel/veterinary ; Enzyme-Linked Immunosorbent Assay/methods/*veterinary ; Female ; Immunoglobulins/*blood ; Interleukin-6/*immunology ; Mice ; Mice, Inbred ICR ; Recombinant Proteins/immunology ; Swine/*immunology

We observed a 25-year-old male patient who had developed juvenile rheumatoid arthritis(RA) associated with alopecia areata at 14 years of age. When he received treatment for RA, his symptoms of RA and hair loss improved at approximately the same time. One year later, as the symptoms of RA aggravated, the hair loss had progressed eventually to alopecia universalis(AU). Thus we suggest that RA and AU may be associated with a common immunologic factor in etiology of the two diseases.
Adult ; Alopecia Areata ; Alopecia* ; Arthritis, Juvenile* ; Hair ; Humans ; Male

Gastric emptying in patients after several upper gastrointestinal surgeries was studied using the acetaminophen method. The subjects consisted of 23 gastric cancer patients, 2 duodenal ulcer patients, 5 periampullary cancer patients and 4 normal subjects. As an indicator of the gastric emptying rate, the serum acetaminophen concentration was measured by fluorescence polarization immunoassay, in units of g/ml, at 0, 30, 60, 120, and 180 minutes after ingestion of a liquid meal with 1.5 g of acetaminophen. In the normal subjects, the acetaminophen concentrations were 0, 16.35+/-5.06, 18.71+/-5.58, 16.38+/-4.82, and 11.09+/-3.62 g/ml at time 0, 30, 60, 120, and 180 min, respectively. The concentration peaked at 60 min after ingestion of the test meal in the normal subjects. We observed significant delayed gastric emptying after pancreas preserving pancreaticoduodenectomy (PPPD) and a standard Whipple's operation in the early postoperative period. In all patients with a subtotal gastrectomy, a truncal vagotomy was done. However, in patients with a pancreaticoduodenectomy, the vagus nerves were preserved. The gastric emptying pattern was different between the patients with a subtotal gastrectomy and the patients with a pancreaticoduodenectomy, despite similar reconstructions of the gastroenterostomy (Billroth I or Billroth II type reconstruction). There was more rapid gastric emptying in patients with a truncal vagotomy and pyloroplasty than in the normal subjects. Hence, we speculate that the truncal vagotomy was the main cause of the different gastric emptying between the patients with a pancreaticoduodenectomy and the patients with a subtotal gastrectomy.
Acetaminophen* ; Duodenal Ulcer ; Eating ; Fluorescence Polarization Immunoassay ; Gastrectomy ; Gastric Emptying* ; Gastroenterostomy ; Humans ; Meals ; Pancreas ; Pancreaticoduodenectomy ; Postoperative Period ; Stomach Neoplasms ; Vagotomy, Truncal ; Vagus Nerve

In complication of infective endocaditis splenomegaly and splenic infarction are not uncommon but splenic rupture is very rare. We report a case of splenic rupture complicated by infective endocarditis in 1 71-yr-old man who had been suffered from rheumatic heart disease (aortic regurgitation and stenosis and mitral regurgitation). The patient was admitted to mild fever and generalized weakness for 20 days. Diagnosis of infective endocarditis due to Staphylococcus epidermidis was made by clinical manifestaions and blood culture study.On 34th day of admissionthe patient suddenly displayed the symptoms and signs of massive intraperitoneal hemorrhage. Splenic rupture was revealed by paracentesis and radiologic studies. Rupture of spleen is an uncommon and usually fatal complication of infective endocarditis. Therefore early diagnosis and prompt treatment must be performed.
Constriction, Pathologic ; Diagnosis ; Early Diagnosis ; Endocarditis* ; Fever ; Hemorrhage ; Humans ; Paracentesis ; Rheumatic Heart Disease ; Rupture ; Spleen ; Splenic Infarction ; Splenic Rupture* ; Splenomegaly ; Staphylococcus epidermidis

PURPOSE: This study was intended to evaluate the positional relationship between the hyoid bone and the mandible in patients with mandibular protrusion after mandibular set-back surgery by means of 3D-CT. MATERIALS AND METHODS: Preoperative(3 weeks before) and postoperative (6 weeks after) 3D-CT and cephalogram were taken on 32 patients(12 male, 20 female, mean age of 23.2) treated by bilateral sagittal split osteotomy with rigid fixation. The angular measurement on 3D-CT basilar view were deviation of Me and H, long axis angle of left and right cornu majus. The lineal measurement on 3D-CT basilar view were composed of intercondylar line and coordinates(x,y) of Me and H. The angular and lineal measurement of lateral cephalogram were composed of mandibular plane angle, SNA, SNB, ANB, FH-NA and FH-NB, and coordinates(x,y) of B, Pog, Me and H, PAS, Lpw, MPH and IAS. On the frontal cephalogram, deviation of Me were evaluated. RESULTS: The mean mandibular set-back was 8.0mm horizontally and mandibular plane angle was slightly increased. The hyoid bone was displaced postero-inferiorly, the distance between MP(mandibular plane) and H(hyoid bone) was increased and the posterior airway space values (PAS, Lpw, IAS) were decreased. The coordinates Me(x,y), H(x,y) and deviation angle Me' and H'were revealed the strong positive correlation. CONCLUSION: The results revealed that the horizontal, vertical and transverse relationship of the mandibular and the hyoid bone movements were significantly correlated in patients performed mandibular set-back surgery.
Axis, Cervical Vertebra ; Female ; Humans ; Hyoid Bone* ; Male ; Mandible* ; Orthognathic Surgery* ; Osteotomy

Broncho-gastric fistula caused by benign gastric ulcer perforation after esophagectomy is very rare. In general anesthesia of a patient with broncho-gastric fistula, in spite of hyperventilation, leakage of the anesthetic gases through fistula may make the patient hypercapneic, and positive pressure ventilation may increase the risk of the pulmanary aspiration by the regurgitation of gastric fluid by stomach distension. For that reason, in this patient, denitrogenation was performed during patient's voluntary respiration with 100% oxygen for 5 minutes, and induction was performed without positive pressure ventilation, and one lung ventilation was carried out. Hypoxemia was followed by one lung ventilation because his pulmonary function was moderate obstructive type and his lung was damaged by aspiration of gastric fluid via broncho-gastric fistula. A low level of continuous positive airway pressure (CPAP) has no significant hemodynamic effect and can maintain the patency of nonventilated lung, so hypoxemia induced by one lung ventilation may be reduced. Thus we carried out one lung ventilation with CPAP (10 cmH2O) in nonventilated lung and blocked broncho-gastric fistula with a bronchial blocker for prevention of both regurgitation of gastric fluid and leakage of anesthetic gases. One lung anesthesia was performed without any problem in this case.
Anesthesia ; Anesthesia, General* ; Anesthetics, Inhalation ; Anoxia ; Continuous Positive Airway Pressure ; Esophagectomy ; Fistula* ; Hemodynamics ; Humans ; Hyperventilation ; Lung ; One-Lung Ventilation ; Oxygen ; Positive-Pressure Respiration ; Respiration ; Stomach ; Stomach Ulcer