BACKGROUND: The purpose of this study is to examine the effect of intravenous ketorolac administration before surgical stimulation for postoperative pain control. METHODS: Forty four patients scheduled for total hip replacement were randomly assigned to one of three groups of prospectively designed study. Group 1 (n=14) received intravenous saline (placebo) and Group 2 (n=15) received intravenous ketorolac (30 mg) at one hour after skin incision and Group 3 (n=15) received intravenous ketorolac (30 mg) before induction. Postoperative pain relief was provided with intravenous morphine from PCA system. Postoperative visual analogue pain score (VAS), analgesic requirement and side effects were evaluated and compared between groups for postoperative two days. RESULTS: VAS at rest were significantly less in Group 2,3 than in Group 1 at 3 hours after surgery (p<0.05) and significantly less in group 3 than in group 1 at 6 and 9 hours after surgery (p<0.05). VAS on movement were significantly less in group 3 than group 1 at 1 hour and significantly less in group 2,3 than group 1 at 3 and 6 hours after surgery (p<0.05). Patient controlled morphine consumption in group 1 was significantly higher than in group 2,3 for 12 hours after surgery. After administration of intravenous ketorolac any side effect did not occur. CONCLUSIONS: Administration of intravenous ketorolac before skin incision as a pre-emptive analgesia has better analgesia than those of 1 hour after skin incision and no administration of ketorolac.
Analgesia ; Arthroplasty, Replacement, Hip* ; Humans ; Ketorolac* ; Morphine ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Prospective Studies ; Skin

No abstract available.
Coxiella burnetii* ; Coxiella* ; Korea* ; Milk*

Hurthle cell carcinoma, an oncocytic variant of follicular thyroid carcinoma, has a higher malignancy potential than well differentiated thyroid carcinomas. It has a tendency to metastasize easily to the lungs and bones, although isolated sacral bone metastasis has been rarely reported. Hurthle cell carcinoma has been characterized by increased mitotic activity and abundant abnormal mitochondria, which have profound mitochondrial DNA (mtDNA) alterations. In general, a well-known hypothesis is that genomic alteration, especially microsatellite instability of the mtDNA D-loop, might result in whole mtDNA instability as seen in Hurthle cell carcinoma. Recently, we experienced a case of Hurthle cell carcinoma that presented with extensive sacral bone metastasis. To investigate the relationship between mtDNA genomic instability and metastatic potential in this case, we performed direct sequencing of the mtDNA D-loop in samples extracted from normal thyroid tissue, thyroid carcinoma tissue, and sacral bone metastasis tissue. Here, we describe the results of mtDNA D-loop sequencing and present a literature review.
Adenocarcinoma, Follicular ; DNA ; DNA, Mitochondrial ; Genomic Instability ; Humans ; Lung ; Microsatellite Instability ; Mitochondria ; Neoplasm Metastasis ; Oxyphil Cells ; Sacrum ; Thyroid Gland ; Thyroid Neoplasms

Members of the inhibitors of differentiation (Id) family of helix-loop-helix (HLH) proteins are known to play important roles in the proliferation and differentiation of many cell types. Thyroid-stimulating hormone (TSH) regulates proliferation and differentiation by activating TSH receptor (TSHR) in thyrocytes. In this study, we found that Id2, one of the Id family proteins, is a major target for regulation by TSH in FRTL-5 thyroid cells. TSH rapidly increases the Id2 mRNA level in FRTL-5 thyroid cells but the Id2 protein showed biphasic regulatory patterns, being transiently reduced and subsequently induced by TSH treatment. Transient reduction of Id2 protein was noted within 2 hr of TSH treatment and was mediated by proteasomal degradation. Moreover, reduced Id2 expression correlated with the activity of the phosphatidylinositol 3 kinase pathway, which is activated by TSH. Although TSH increases the activity of the Id2 promoter, TSH-induced activation of this promoter was independent of c-Myc. Id2 did not alter TTF-1- and Pax-8-mediated effects on the regulation of the Tg promoter. Thus, in summary, we found that TSH regulates Id2 expression, but that Id2 does not alter the expression of thyroid-specific genes, such as Tg, in FRTL-5 thyroid cells.
1-Phosphatidylinositol 3-Kinase/metabolism ; Animals ; Cattle ; Cell Differentiation ; Cell Proliferation ; *Gene Expression Regulation ; Inhibitor of Differentiation Protein 2/metabolism ; Insulin/metabolism ; Paired Box Transcription Factors/metabolism ; Promoter Regions, Genetic ; Proto-Oncogene Proteins c-myc/metabolism ; Rats ; Thyroglobulin/metabolism ; Thyroid Gland/*cytology ; Thyrotropin/*metabolism

PURPOSE: This study was conducted to investigate the efficacy of black cohosh (Cimicifuga racemosa) and St. John's wort (Hypericum perforatum) in women with climacteric symptoms, and to assess their effects on vaginal atrophy, hormone levels, and lipid profiles. MATERIALS AND METHODS: In this double-blind randomized, placebo-controlled, multicenter study, 89 peri- or postmenopausal women experiencing climacteric symptoms were treated with St. John's wort and black cohosh extract (Gynoplus
Plant Extracts/*therapeutic use ; Placebos ; *Phytotherapy ; *Perimenopause ; Middle Aged ; *Hypericum ; Humans ; Hot Flashes/*prevention & control ; Female ; Estrogens/blood ; Double-Blind Method ; *Cimicifuga

The bronchopulmonary sequestration is a region of lung parenchyma that has an incomplete or no connection with the airways and is supplied by an aberrant artery arising from the aorta or one of its branches. The anatomy of supplied artery is very important during operation. We present a case of pulmonary sequestration supplied with left gastric artery. The patient was 61 years old male and had hemoptysis. The left lower lung was cystic bronchiectasis and a few air-fluid level on chest CT. Also, in aortogram, arterial supply was from left gastric artery of abdominal aorta branches. Left lower lobectomy and abnormal arterial ligation was done.
Aorta ; Aorta, Abdominal ; Arteries* ; Bronchiectasis ; Bronchopulmonary Sequestration* ; Hemoptysis ; Humans ; Ligation ; Lung ; Male ; Middle Aged ; Tomography, X-Ray Computed

The incidence of deep neck infection has been reduced by modern antibiotic therapy. Life-threatening deep neck infection of odontogenic or upper airway origin may extend to the thorax. Early diagnosis, administration of the potent antibiotics, and complete debridement and drainage are essential to improve the chances for survival in these very ill patients. We report two cases of deep neck infection which were complicated by thoracic infection such as mediastinitis, pericarditis, and empyema as a result of descending infection.
Anti-Bacterial Agents ; Debridement ; Drainage ; Early Diagnosis ; Empyema ; Humans ; Incidence ; Mediastinitis ; Neck* ; Pericarditis ; Thorax