The goal of the present study was to evaluate the diagnostic value of a joint distractor in arthroscopy in small-breed dogs. Sixty stifle joints, which were collected from thirty cadavers, were used in this study. To simulate different injuries, no medial meniscal tear, a full-thickness vertical longitudinal tear, a partial-thickness vertical longitudinal tear, full- and partial-thickness vertical longitudinal tears, or a peripheral detachment were created on the caudal horn of the medial meniscus of each stifle joint along with rupture of the cranial cruciate ligament. Each stifle joint then underwent arthroscopy with and without a joint distractor. The sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), and correct classification rate (CCR) for the diagnosis of each type of medial meniscus pathology were calculated. For arthroscopy with and without a joint distractor, the Sn was 85% and 60%, the Sp was 96% and 92%, the PPV was 85% and 65%, the NPV was 96% and 90%, and the CCR was 94% and 86%, respectively. Arthroscopy is an effective diagnostic method for the assessment of medial meniscal pathologies in small-breed dogs, especially when performed with the aid of a joint distractor.
Animals ; Anterior Cruciate Ligament ; Arthroscopy ; Cadaver ; Classification ; Diagnosis ; Dogs* ; Horns ; Joints* ; Menisci, Tibial ; Methods ; Pathology ; Rupture ; Sensitivity and Specificity ; Stifle ; Tears

Dexamethasone is a widely used anti-inflammatory agent for a broad spectrum of diseases. The effectiveness of this agent is thought to be due to the capacity to modulate cytokine production in inflammatory cells. We examined the effects of dexamethasone on expressions of interferon gamma (IFN-gamma) and interleukin 4 (IL-4) by human peripheral blood mononuclear cells (PBMCs) in response to interleukin 12 (IL-12). Dexamethasone (10-5 M) inhibited IFN-gamma secretion, through direct suppression of IFN-gamma, IL-12 receptor (IL-12R) -beta1, and -beta2 expressions. Conversely dexamethasone increased IL-4 secretion as well as IL-4 expressions by PBMCs in response to IL-12. In addition, dexamethasone increased expression of suppressor of cytokine signalling (SOCS)-1, which inhibits JAK-STAT pathway of IL-12R signalling. The result of our study suggested that dexamethasone directly inhibited IFN-gamma expression, through suppression of IL-12 signalling and indirectly increases IL-4 expression, through suppression of IFN-gamma expression.
Dexamethasone* ; Humans ; Interferons ; Interleukin-12* ; Interleukin-4* ; Receptors, Interleukin-12

An English setter (case 1) and a Tibetan mastiff (case 2) presented with intermittent weight-bearing lameness on the right hind limb when trotting. The dogs had a history of femoral head and neck ostectomy (FHNO). Orthopedic examination revealed pain and crepitus on the right hip joint. The dogs underwent total hip replacement (THR). At the 2-year (case 1) and 1-year (case 2) follow-up, both dogs had resumed normal activity without lameness. The muscle mass and range of motion were significantly improved in the affected hind limb. In conclusion, FHNO with poor functional outcomes can be successfully ameliorated with THR.
Animals ; Arthroplasty, Replacement, Hip/methods/*veterinary ; Dog Diseases/*surgery ; Dogs ; Female ; Femur Head/*surgery

PURPOSE: The aim of this study was to investigate a comparison of implant bone bed preparation with Er,Cr:YSGG laser and conventional drills on the relationship between implant stability quotient (ISQ) values and implant insertion variables. MATERIALS AND METHODS: Forty implants were inserted into two different types of pig rib bone. One group was prepared with conventional drills and a total of 20 implants were inserted into type I and type II bone. The other group was prepared with a Er,Cr:YSGG laser and a total of 20 implants were inserted into type I and type II bone. ISQ, maximum insertion torque, angular momentum, and insertion torque energy values were measured. RESULTS: The mean values for variables were significantly higher in type I bone than in type II bone (P < .01). In type I bone, the ISQ values in the drill group were significantly higher than in the laser group (P < .05). In type II bone, the ISQ values in the laser group were significantly higher than in the drill group (P < .01). In both type I and type II bone, the maximum insertion torque, total energy, and total angular momentum values between the drill and laser groups did not differ significantly (P > or = .05). The ISQ values were correlated with maximum insertion torque (P < .01, r = .731), total energy (P < .01, r = .696), and angular momentum (P < .01, r = .696). CONCLUSION: Within the limitations of this study, the effects of bone bed preparation with Er,Cr:YSGG laser on the relationship between implant stability quotient (ISQ) values and implant insertion variables were comparable to those of drilling.
Mandrillus ; Ribs ; Salicylates ; Torque

Percutaneous transluminal coronary angioplasty of chronic total coronary artery occlusions are at a high risk of failure and complication. We report a case of arteriovenous fistula with drainage into the coronary sinus during the percutaneous transluminal coronary angioplasty of the chronic total occlusion of circumflex coronary artery. We think that the arteriovenous fistula of this case was occurred by the guide wire- induced trauma. But after 20-30 minutes later, the injection of contrast no longer detectd arteriovenous fistula. Later we recommended coronary artery bypass graft surgery to the patient, but he refused. Thereafter he received conservative treatment and dyspnea, chest pain were improved.
Angioplasty* ; Angioplasty, Balloon, Coronary ; Arteriovenous Fistula* ; Chest Pain ; Coronary Artery Bypass ; Coronary Sinus* ; Coronary Vessels* ; Drainage* ; Dyspnea ; Humans ; Transplants

Local anesthetics systemic toxicity (LAST) is a grave complication of regional anesthesia that usually occurs immediately after local anesthetics injection. Here, we report on rare late-onset toxicity cases after supraclavicular brachial plexus blocks. Case: Two patients underwent surgery for radius fractures. We used lidocaine 100 mg and ropivacaine 150 mg for blocking and infused dexmedetomidine for intraoperative sedation. The 63-year-old male patient’s blood pressure dropped to 87/60 mmHg after 3 h 15 min after blocking. Ventricular fibrillation occurred 10 min later. After five defibrillations, electrocardiography showed ventricular tachycardia that was normalized through one cardioversion. The 54-year-old female patient’s heart rate decreased to 35 beats/min 2 h 30 min after blocking. Her vital signs returned to normal after administering atropine, ephedrine, epinephrine, and lipid emulsion. Conclusions: Physicians should remember that LAST may occur long after local anesthetic injection and be aware of factors that may adversely affect the course of LAST.

A 47-year-old female was admitted for an evaluation of a left mediastinal mass. The chest X-ray performed 16 months ago was normal, but the chest X-ray upon admission showed a large mass adjacent to the anterior aspect of the left hemidiaphragm. The CT scan demonstrated a large mass with a fat density in the left lower hemithorax. A focal diaphragmatic defect behind the xiphoid process was suspected. A thoracoscopic examination revealed omental herniation through the diaphragmatic defect. Therefore, a left thoracotomy was performed and the defect was repaired. We believe that a differential diagnosis should be needed to include a diaphragmatic omental hernia when a fat density mass is observed in the mediastinum.
Diagnosis, Differential ; Female ; Hernia ; Humans ; Mediastinum* ; Middle Aged ; Thoracotomy ; Thorax ; Tomography, X-Ray Computed

Coronary pseudo-lesion is an artificial lesion that occurs during percutaneous transluminal coronary angioplasty by an angioplasty guide wire and/or a balloon as a result of a straightening of the vessel curvature. A specific treatment is not required and the condition is completely resolved after removing the angioplasty wire. There are few reports about a pseudo-lesion, particularly in the left circumflex artery. We report two cases of a coronary pseudo-lesion induced by an angioplasty guide wire; one case affecting the left circumflex artery and the other affecting the right coronary artery.
Angioplasty* ; Angioplasty, Balloon, Coronary ; Arteries* ; Coronary Vessels*

BACKGROUND/AIMS: Limited information is available regarding patient survival after sorafenib discontinuation in patients with hepatocellular carcinoma (HCC). Thus, we developed and validated a novel survival prediction model. METHODS: Clinical data from 409 patients with HCC who stopped taking sorafenib between September 2008 and February 2015 were reviewed. RESULTS: In the training cohort, four factors were independent negative predictors of survival (p<0.05). Based on the β regression coefficient of each factor, we established the NEXT score (Survival after Stopping Nexavar Treatment), allocating 1 point each for an Eastern Cooperative Oncology Group score ≥2, Child-Pugh class B or C, serum sodium ≤135 mEq/L, and α-fetoprotein >400 ng/mL. Area under the receiver operating characteristic curve values to predict 1-, 3-, and 6-month survival rates were 0.805, 0.809, and 0.774, respectively, in the training cohort and 0.783, 0.728, and 0.673, respectively, in the validation cohort (n=137). When the training and validation cohorts were stratified into three risk groups (NEXT score 0 [low-risk] vs 1 to 2 [intermediate-risk] vs 3 to 4 [high-risk]), survival differed significantly between the groups (p<0.05, log-rank test). CONCLUSIONS: In patients with HCC, survival after stopping sorafenib is poor. However, risk estimates based on a new “NEXT score” may help predict survival and prognosis even in patients who discontinue sorafenib treatment.
Carcinoma, Hepatocellular* ; Cohort Studies ; Humans ; Prognosis ; ROC Curve ; Sodium ; Survival Rate

BACKGROUND: Since highly active antiretroviral therapy has lengthened the life span of individuals infected with human immunodeficiency virus (HIV), the importance of malignancy associated with HIV has been increased. The relative frequencies of malignancies in HIV infected patients may vary in different race and region. The aim of this study is to determine the prevalence and characteristics of malignancies in patients with HIV infection in South Korea. MATERIALS AND METHODS: To identify HIV patients with malignancy, we reviewed the electronic database of pathological reports for all HIV-infected patients seen from January 1986 to December 2005 at the Seoul National University Hospital. We retrospectively reviewed the medical records of them. RESULTS: Among 850 patients infected with HIV, 33 episodes of malignant diseases were diagnosed in 32 patients (3.76%). Thirty were males, and median age was 46 years (range 29-70). At the time of the diagnosis of malignancy, median CD4+ lymphocytes count was 100/uL (range 5-620) and in 27 (82%) patients, CD4+ lymphocytes count were less than 200/uL. For 13 patients (40%), malignancy was initial presentation of HIV infection. Excluding patients initially diagnosed as malignancy, median follow-up duration from the first visit to diagnosis of malignancy was 36 months (range 3-96). Non-Hodgkin's lymphoma was the most frequent malignancy (13 patients), followed by Kaposi's sarcoma (7), Hodgkin's disease (3), acute myeloid leukemia (1), and other solid cancer (9) including one case of anal cancer associated with human papillomavirus. Among 13 patients with non-Hodgkin's lymphoma, 4(31%) achieved the complete remission after chemotherapy and/or radiation therapy, and had been followed without evidence of recurrence. CONCLUSION: Malignancy was diagnosed in 3.76% of patients infected with HIV. Non-Hodgkin's lymphoma is the most prevalent malignancy in HIV patients in South Korea.
Antiretroviral Therapy, Highly Active ; Anus Neoplasms ; Continental Population Groups ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; HIV Infections ; HIV* ; Hodgkin Disease ; Humans ; Humans* ; Korea* ; Leukemia, Myeloid, Acute ; Lymphocytes ; Lymphoma ; Lymphoma, Non-Hodgkin ; Male ; Medical Records ; Prevalence ; Recurrence ; Retrospective Studies ; Sarcoma, Kaposi ; Seoul