The relationship between the intestinal histopathology and number and position of intraepithelial lymphocytes (IEL) was observed chronologically in the small intestine of rats experimentally infected with Metagonimus yokogawai. Fifteen Sprague-Dawley rats were orally infected each with 3,000 metacecariae, and 3 were kept uninfected for controls. Three rats each were sacrificed on the day 5, 10, 15, 24 and 70 post-infection (PI) and samples of the small intestine, 5 cm, 10 cm, 20 cm and 70 cm posterior to the pylorus were taken. The samples were processed routinely and stained with Giemsa. The intestinal histopathology was severe during the day 5-15 PI and characterized by villous atrophy, crypt hyperplasia, and decrease of villus/crypt height ratio. After the day 24 PI, the intestinal lesions showed some tendency of recovery. The number of IEL increased at the early stage of infection, but decreased thereafter to a lower level than that of controls, with progression of the pathological changes. Then, the IEL number began to increase again after the day 24 PI. In control rats, the great majority of the IEL were located at the basal region of the epithelium. During the early stage of infection, however, a considerable proportion of IEL was found to have moved to the intermediate or apical region of the epithelium. From the above results, it is suggested that the change of IEL number and position during the course of M. yokogawai infection should be closely related to the progression and recovery of the intestinal histopathology.
English-Abstract ; Epithelium-pathology ; Rats- ; Rats,-Sprague-Dawley ; Time-Factors ; *Heterophyidae- ; *Intestinal-Diseases,-Parasitic-pathology ; *Intestines-pathology ; *Lymphocytes-pathology ; *Trematode-Infections-pathology

Although vascular injuries associated with femoral intertrochanteric fractures have been reported infrequently, bleeding due to vascular injury can lead to severe complications that can be potentially life and limb-threatening. The authors report a case of an injury of the ascending branch of the lateral femoral convolutional artery in a patient who underwent surgical treatment for a femoral intertrochanteric fracture. Vascular injury occurred due to the sharp margin of displaced lesser trochanter five weeks after surgery. Percutaneous transcatheter embolization was done and improved without additional complications. Therefore, the surgeons need to be aware of possible associated vascular injuries caused by displaced lesser trochanter fragments in femoral intertrochanteric fractures.

Although vascular injuries associated with femoral intertrochanteric fractures have been reported infrequently, bleeding due to vascular injury can lead to severe complications that can be potentially life and limb-threatening. The authors report a case of an injury of the ascending branch of the lateral femoral convolutional artery in a patient who underwent surgical treatment for a femoral intertrochanteric fracture. Vascular injury occurred due to the sharp margin of displaced lesser trochanter five weeks after surgery. Percutaneous transcatheter embolization was done and improved without additional complications. Therefore, the surgeons need to be aware of possible associated vascular injuries caused by displaced lesser trochanter fragments in femoral intertrochanteric fractures.

Delayed rupture of the extensor pollicis longus tendon mostly occur after plate fixation of distal radius fracture. However, delayed rupture of the extensor pollcis longus tendon following intramedullary nailing of radial shaft fracture is very rare. We report one case of delayed rupture of the extensor pollicis longus tendon following intramedullary nailing, presenting abnormal signs from adhesion of the extensor pollicis longus with extensor indicis at the nail insertion site.
Fracture Fixation, Intramedullary* ; Radius Fractures ; Rupture* ; Tendon Injuries ; Tendon Transfer ; Tendons*

Purpose: The clinical outcomes were investigated to determine if arthroscopic management is a useful method for 19 hips with iliopsoas tendon impingement (IPI) after total hip arthroplasty (THA). Materials and Methods: Eighteen patients (19 hips), who complained of groin pain and flexion pain that persisted after THA from September 2013 to December 2019, were the subjects of this investigation. The mean time to manifestation after THA was four months (range, 1–9 months) in patients of an average age of 60 years (range, 50–69 years). Thirteen out of 18 patients underwent THA using the direct anterior approach and five by the lateral approach. IPI was diagnosed by the medical history, physical examination, blood test, radiographic examination using X-ray and computed tomography, and topical injection therapy. All patients underwent arthroscopic treatment and a dynamic arthroscopic physical examination after exposure to the iliopsoas tendon revealed impingement. Tenotomy was then performed on the muscle portion through the total tendon portion. Symptoms and pain levels of preoperative, postoperative and follow-up period were investigated and compared. Results: The Western Ontario and McMaster Universities Osteoarthritis Index score decreased from an average of 58.4 (range, 40–88) before surgery to an average of 35.0 (range, 15–76) after surgery. Similarly, the visual analogue scale decreased from an average of 4.0 (range, 2–6) before surgery to an average of 1.4 (range, 0–4) after surgery. Sixteen patients (88.9%) showed pain relief and improvement in the straight leg raise test, and two patients showed postoperative muscle weakness and sustained pain. In the follow-up period, muscle weakness improved. One patient underwent arthroscopic iliopsoas tenotomy at the lesser trochanteric level but the symptoms persisted.The clinical symptoms were improved after one more tenotomy at the joint level. Conclusion Arthroscopic iliopsoas tenotomy performed in patients with IPI after THA showed good clinical results.

A helical blade type of hip screw is used widely for the operative management of femoral trochanteric fractures. A 73-year-old female patient was admitted for femoral trochanteric fracture AO/OTA type 31A2.2. A helical blade locking sleeve dissembled 18 weeks after surgery did not achieve accurate reduction. The patient underwent bipolar hip hemiarthroplasty because the fracture reduction was lost, and it was impossible to remove the remaining helical blade without bone loss. The authors report this case of a rare complication of helical blade.

A helical blade type of hip screw is used widely for the operative management of femoral trochanteric fractures. A 73-year-old female patient was admitted for femoral trochanteric fracture AO/OTA type 31A2.2. A helical blade locking sleeve dissembled 18 weeks after surgery did not achieve accurate reduction. The patient underwent bipolar hip hemiarthroplasty because the fracture reduction was lost, and it was impossible to remove the remaining helical blade without bone loss. The authors report this case of a rare complication of helical blade.

A retained surgical drain in the operation site is a rare complication that may cause clinical problems and result in medical disputes.The discovery of a retained drain is most often reported after abdominal and pelvis surgery but drain migration in the prevertebral space after anterior cervical spine surgery has not been reported. This paper reports a case of drain retained and migrated into the thorax level following anterior cervical spine surgery with a review of the relevant literature.

Syndrome of inappropriate antidiutetic hormone(SIADH) secretion is the most common cause of hyponatremia in clinical medicine. Before diagnosis of the SIADH is made, other causes for a decreased diluting capacity and nonosmotic stimuli for AVP release need to be rule out. Disorders associated with SIADH can be divided into 4 major etiologic groups: malignancies, pulmonary diseases, central nervous disorders, and drugs. A 45-year-old woman was admitted due to maculopapular skin eruption and fever after taking medications for fever and myalgia. Generalized tonic clonic seizure was developed nine days later, and laboratory results showed marked hyponatremia. During the evaluation, treatment, and subsequent follow-up, the diagnosis of SIADH was confirmed, but the definitive cause was obscure. With fluid restriction, sodium replacement and demeclocycline therapy, she recovered completely 6 months later. We suggest that the SIADH might be related to drug-induced generalized maculopapular rash via menmgitis-like reaction in CSF as one of systemic adverse side effects to drugs rather than direct effect of related drugs.
Clinical Medicine ; Demeclocycline ; Diagnosis ; Exanthema* ; Female ; Fever ; Follow-Up Studies ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome* ; Lung Diseases ; Middle Aged ; Myalgia ; Seizures ; Skin ; Sodium

BACKGROUND: Liver transplantation (LT) has become the treatment of choice for advanced liver disease. However, renal dysfunction often complicates the course of liver transplant recipients. The preoperative serum creatinine level have been shown to be an important predictor of a short-term graft and patient survival rates and the need for perioperative dialysis. This study examined the impact of the pretransplant renal function on the anesthetic characteristics and renal function after LT. METHODS: Patients undergoing LT were divided two groups according to the creatinine (Cr) level at time of LT. The following information was collected for each patient: age, etiology, weight and height, serum Cr, Cr clearance, patient survival, and cause of death. The laboratory data was collected at preoperative day, operation day and postoperative 1, 7, 30 days and 6 months. The hemodynamic profile was collected during LT. RESULTS: There were 27 patients in the renal dysfunction (RD) group. Ascites, total blood transfusion and fluid administration was significantly higher in the RD group. The hemodynamic parameters were similar in both groups. The BUN and Cr levels were significantly higher in the RD group in the perioperative period. At the preoperative period, the AST, ALT, bilirubin and prothrombin time was significantly higher in the RD group. The postoperative ICU stay and mortality rate was higher in the RD group. CONCLUSIONS: A pretransplant renal dysfunction is the result of deterioration in the liver function in the preoperative period, and indicates a greater requirement of blood and fluid during surgery.
Ascites ; Bilirubin ; Blood Transfusion ; Cause of Death ; Creatinine ; Dialysis ; Hemodynamics ; Humans ; Liver Diseases ; Liver Transplantation ; Liver* ; Mortality ; Perioperative Period ; Preoperative Period ; Prothrombin Time ; Survival Rate ; Transplantation ; Transplants