No abstract available.
Lymphomatoid Papulosis* ; Mycobacterium* ; Tuberculosis*

No abstract available.
Lymphomatoid Papulosis* ; Mycobacterium* ; Tuberculosis*

Recruitment maneuvers have been increasingly used to reverse the alveolar derecruitment associated with low tidal volume ventilation in patients with acute lung injury and acute respiratory distress syndrome. We report a case of improved oxygenation without hypotension or lung rupture, due to an early application of recruitment maneuvers (40 cmH2O of continuous positive airway pressure for 40 s, three times [at 4.5 h, 5 h, 7 h], guided by pulse oximetry) followed by a mechanical pressure controlled ventilation with 20 cmH2O of positive end-expiratory pressure in acute lung injury after femoral intramedullary nailing.
Acute Lung Injury* ; Continuous Positive Airway Pressure ; Fracture Fixation, Intramedullary ; Humans ; Hypotension ; Lung ; Oxygen ; Positive-Pressure Respiration ; Respiratory Distress Syndrome, Adult ; Rupture ; Tidal Volume ; Ventilation

Viridicatol (1) has previously been isolated from the extract of the marine-derived fungus Penicillium sp. SF-5295. In the course of further biological evaluation of this quinolone alkaloid, anti-inflammatory effect of 1 in RAW264.7 and BV2 cells stimulated with lipopolysaccharide (LPS) was observed. In this study, our data indicated that 1 suppressed the expression of well-known pro-inflammatory mediators such as inducible nitric oxide synthase (iNOS) and cyclooxygenase (COX)-2, and consequently inhibited the production of iNOS-derived nitric oxide (NO) and COX-2-derived prostaglandin E2 (PGE2) in LPS stimulated RAW264.7 and BV2 cells. Compound 1 also reduced mRNA expression of pro-inflammatory cytokines such as interleukin-1beta (IL-1beta), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha). In the further evaluation of the mechanisms of these anti-inflammatory effects, 1 was shown to inhibit nuclear factor-kappa B (NF-kappaB) pathway in LPS-stimulated RAW264.7 and BV2 cells. Compound 1 blocked the phosphorylation and degradation of inhibitor kappa B (IkappaB)-alpha in the cytoplasm, and suppressed the translocation of NF-kappaB p65 and p50 heterodimer in nucleus. In addition, viridicatol (1) attenuated the DNA-binding activity of NF-kappaB in LPS-stimulated RAW264.7 and BV2 cells.
Cytokines ; Cytoplasm ; Dinoprostone ; Fungi ; Interleukin-1beta ; Interleukin-6 ; NF-kappa B* ; Nitric Oxide ; Nitric Oxide Synthase Type II ; Penicillium* ; Phosphorylation ; Prostaglandin-Endoperoxide Synthases ; RNA, Messenger ; Tumor Necrosis Factor-alpha

Thoracic empyema can result from the pleural accumulation of infected fluid or the infection of accumulated pleural fluid. The causes of empyema are pneumonia, surgery of lung, mediastinum, diaphragm, trauma, and so on. The impact of anesthetic technique (regional versus general versus combination of both) on the respiratory complication rate has not been established. A 86-yr-old male patient, who had COPD about 15 years and chronic empyema for several months, scheduled to operation for a femur neck fracture. We report a case that this patient with COPD and empyema operated under combined spinal-epidural anesthesia and converted to general anesthesia because of the rupture of the chronic empyema.
Anesthesia* ; Anesthesia, General ; Diaphragm ; Empyema ; Empyema, Pleural* ; Femoral Neck Fractures* ; Femur Neck* ; Femur* ; Humans ; Lung ; Male ; Mediastinum ; Pneumonia ; Pulmonary Disease, Chronic Obstructive ; Rupture*

BACKGROUND: Use of pneumatic tourniquet is commonly accepted in total knee arthroplasty (TKA) to reduce perioperative blood loss. However, hemodynamic changes and cardiovascular collapse, which is caused by tourniquet, might be fatal to elderly patient. It is important to maintain the hemodynamic stability. We evaluated the effect of general anesthesia using propofol-remifentanil or sevoflurane on hemodynamic changes by using tourniquet during TKA. METHODS: Thirty patients underwent TKA were randomly divided into two groups; propofol-remifentanil (n = 15) and sevoflurane (n = 15). Mean arterial blood pressure (MBP), heart rate (HR), central venous pressure (CVP), stroke volume (SV), cardiac index (CI) and systemic vascular resistance (SVR) were recorded throughout the operation. Statistical analysis was done using nonparametric test and repeated measures of ANOVA. RESULTS: There are no differences in MBP, HR, CVP and SV between both groups during the tourniquet inflation but there are differences of CI at the 6, 9, 12 minute after the tourniquet inflation. During the tourniquet deflation, there are differences of MBP, HR between the two groups at just after, 3, 30, 45 minutes after the tourniquet deflation. But the changes of both groups are within 20% of baseline. There are no differences of CVP, SVR between the two groups during the tourniquet deflation. CONCLUSIONS: Propofol-remifentanil based anesthesia provided more stable hemodynamic conditions than sevoflurane based anesthesia, although both may be useful techniques for maintaining the hemodynamic changes within 20% of the baseline values, according to the tourniquet application in TKA.
Aged ; Anesthesia ; Anesthesia, General ; Arterial Pressure ; Arthroplasty ; Central Venous Pressure ; Heart Rate ; Hemodynamics ; Humans ; Inflation, Economic ; Knee ; Methyl Ethers ; Propofol ; Stroke Volume ; Tourniquets ; Vascular Resistance

PURPOSE: To investigate the short-term efficacy of topical immunosuppressive agents on the survival of cultivated allo-conjunctival equivalents. METHODS: Twenty-five eyes of New Zealand white rabbits were included. Temporal conjunctivae were trephined to a diameter of 7.5 mm, and then cultured allo-conjunctival epithelial cells on amniotic membrane were transplanted onto them. Various immunosuppressants including steroid, cyclosporine, and rapamycin were applied topically four times a day for a week. Epithelial defects and graft edema were graded daily. Numbers of inflammatory cells were measured in H&E. PKH26 and cytokeratin 4 and 7 were immunostained. RESULTS: Earlier epithelialization was observed in 1% steroid-treated eyes and defects persisted significantly in 0.5% CsA applied eyes. In histology, PKH26 positive cells considered as donor cells were only found in 1% steroid or 0.01% rapamycin applied eyes. 1% steroid- or 0.01% rapamycin-applied eyes both showed positive staining for keratin-4 and -7. Inflammatory cells were less found in 1% steroid or 0.01% rapamycin treated eyes. CONCLUSIONS: Topical steroid or rapamycin can help to suppress acute inflammation and enhance the acute survival of transplanted conjunctival cells.
Administration, Topical ; Animals ; Cell Count ; *Cell Transplantation ; Cells, Cultured ; Conjunctiva/*cytology ; Cyclosporine/pharmacology ; Epithelial Cells/metabolism/*transplantation ; Female ; Fluorescent Antibody Technique, Indirect ; Graft Survival/*drug effects ; Immunosuppressive Agents/*pharmacology ; Keratin-4/metabolism ; Keratin-7/metabolism ; Male ; Organic Chemicals/metabolism ; Prednisone/pharmacology ; Rabbits ; Sirolimus/pharmacology ; Transplantation, Homologous

BACKGROUND: The goals of this study were to compare maximal metacarpophalangeal joint (MCPJ) flexion angles after application of a volar short arm splint at 3 different locations and verify the relations between the three different physical and radiological locations. METHODS: Forty dominant hands of healthy subjects were analyzed in the study. We defined a transverse skin folding line as a line drawn from the radial aspect of the thenar crease to the ulnar aspect of the distal transverse palmar crease. The distal end of the volar short arm splint was applied on 3 parallel locations to this line. Location A was on this transverse skin folding line; location B was 1 cm proximal to location A; and location C was 1 cm distal to location A. Two orthopedic surgeons measured the maximal MCPJ flexion angles of each finger except the thumb with the application of a volar short arm splint at 3 different locations as well as without a splint as a control. Radiological locations of the 3 different distal ends of the volar short arm splint were also assessed by anteroposterior radiographs of the wrist. RESULTS: When the splint was applied at location A and C, the maximal MCPJ flexion angle decreased to a mean of 83° (91% of control value) and 56° (62% of control value), respectively (compared to the control, p < 0.001). At location B, the maximal MCPJ flexion angle was a mean of 90° (99% of control value); no significant difference was observed compared to the control or without the splint (p = 0.103). On radiography, the average length from the metacarpal head to the distal end of the splint at all fingers decreased in the order of location B, A, and C (29 mm, 19 mm, and 10 mm, respectively; p < 0.001). CONCLUSIONS: We recommend applying the distal end of a volar short arm splint at proximal 1 cm to the transverse skin folding line to preserve MCPJ motion perfectly, which is located at distal 44% of the whole metacarpal bone length radiologically.
Arm* ; Fingers ; Hand ; Head ; Metacarpophalangeal Joint* ; Orthopedics ; Radiography ; Range of Motion, Articular ; Skin ; Splints* ; Thumb ; Wrist

BACKGROUND: The goals of this study were to compare maximal metacarpophalangeal joint (MCPJ) flexion angles after application of a volar short arm splint at 3 different locations and verify the relations between the three different physical and radiological locations. METHODS: Forty dominant hands of healthy subjects were analyzed in the study. We defined a transverse skin folding line as a line drawn from the radial aspect of the thenar crease to the ulnar aspect of the distal transverse palmar crease. The distal end of the volar short arm splint was applied on 3 parallel locations to this line. Location A was on this transverse skin folding line; location B was 1 cm proximal to location A; and location C was 1 cm distal to location A. Two orthopedic surgeons measured the maximal MCPJ flexion angles of each finger except the thumb with the application of a volar short arm splint at 3 different locations as well as without a splint as a control. Radiological locations of the 3 different distal ends of the volar short arm splint were also assessed by anteroposterior radiographs of the wrist. RESULTS: When the splint was applied at location A and C, the maximal MCPJ flexion angle decreased to a mean of 83° (91% of control value) and 56° (62% of control value), respectively (compared to the control, p < 0.001). At location B, the maximal MCPJ flexion angle was a mean of 90° (99% of control value); no significant difference was observed compared to the control or without the splint (p = 0.103). On radiography, the average length from the metacarpal head to the distal end of the splint at all fingers decreased in the order of location B, A, and C (29 mm, 19 mm, and 10 mm, respectively; p < 0.001). CONCLUSIONS: We recommend applying the distal end of a volar short arm splint at proximal 1 cm to the transverse skin folding line to preserve MCPJ motion perfectly, which is located at distal 44% of the whole metacarpal bone length radiologically.
Arm* ; Fingers ; Hand ; Head ; Metacarpophalangeal Joint* ; Orthopedics ; Radiography ; Range of Motion, Articular ; Skin ; Splints* ; Thumb ; Wrist