This study was conducted to determine the effect of treatment with intravenous human immunoglobulin G (hIVIgG) on outcome in dogs with idiopathic immune-mediated hemolytic anemia (IMHA), and to identify prognostic variables that determine outcome in affected dogs. Thirty-seven dogs that met the inclusion criteria were enrolled in a retrospective study. The dogs were categorized into two groups based on their having received hIVIgG. There was no significant difference in survival between the hIVIgG group and the non-hIVIgG group. Mortality during hospitalization and at 1 month, 1 year, or 2 years after discharge was not significantly different between the hIVIgG and the non-hIVIgG groups. Hemoglobinuria was significantly less prevalent in dogs that lived more than 1 year than in those who lived less than 1 year, and was less prevalent in dogs that lived more than 2 years than in those who lived less than 2 years. However, there was no difference in the presence of hemoglobinuria between dogs that lived less than 1 month and those that lived more than 1 month. Overall, there was no evidence of a beneficial effect of hIVIgG in dogs with idiopathic IMHA.
Anemia, Hemolytic* ; Anemia, Hemolytic, Autoimmune ; Animals ; Dogs* ; Hemoglobinuria ; Hospitalization ; Humans* ; Immunoglobulin G* ; Immunoglobulins* ; Mortality ; Retrospective Studies*

This study was conducted to determine whether serum adipokine concentrations differed between healthy dogs and dogs with diabetes mellitus (DM). To accomplish this, 19 dogs with newly diagnosed DM were compared to 20 otherwise healthy dogs. The serum concentrations of visfatin, leptin, IL-1beta, IL-6, IL-18, and TNF-alpha were significantly higher in diabetic dogs than in healthy dogs, whereas the serum adiponectin concentrations were lower in diabetic dogs. However, there were no significant differences in the IL-10 and resistin levels between groups. The serum leptin concentrations in diabetic dogs with and without concurrent disorders differed significantly. Treatment with insulin induced a significant decrease in IL-6 in diabetic dogs without concurrent disorders. These results show that the clinical diabetic state of dogs could modulate the circulating visfatin and adiponectin concentrations directly, while upregulation of leptin was probably a result of concurrent disorders rather than an effect of persistent hyperglycemia as a result of DM.
Adipokines/*blood ; Animals ; Case-Control Studies ; Diabetes Mellitus, Type 2/*blood/etiology ; Dogs ; Female ; Male ; Pilot Projects ; Prospective Studies

BACKGROUND: In this prospective, randomized, double-blind, placebo-controlled trial, we tried to find out appropriate amounts of single-dose dexmedetomidine to prolong the duration of spinal anesthesia in a clinical setting. METHODS: Sixty patients who were scheduled for unilateral lower limb surgery under spinal anesthesia were randomized into three groups receiving normal saline (control group, n = 20) or 0.5 or 1.0 ug/kg dexmedetomidine (D-0.5 group, n = 20; D-1, n = 20) intravenously prior to spinal anesthesia with 12 mg of bupivacaine. The two-dermatome pinprick sensory regression time, duration of the motor block, Ramsay sedation score (RSS), and side effects of dexmedetomidine were assessed. RESULTS: The two-dermatome pinprick sensory regression time (57.6 +/- 23.2 vs 86.5 +/- 24.3 vs 92.5 +/- 30.7, P = 0.0002) and duration of the motor block (98.8 +/- 34.1 vs 132.9 +/- 43.4 vs 130.4 +/- 50.4, P = 0.0261) were significantly increased in the D-0.5 and D-1 groups than in the control group. The RSS were significantly higher in the D-0.5 and D-1 groups than in the control group. However, there were no patients with oxygen desaturation in dexmedetomidine groups. The incidences of hypotension and bradycardia showed no differences among the three groups. CONCLUSIONS: Both 0.5 and 1.0 ug/kg of dexmedetomidine administered as isolated boluses in the absence of maintenance infusions prolonged the duration of spinal anesthesia.
Anesthesia, Spinal* ; Bradycardia ; Bupivacaine ; Dexmedetomidine* ; Humans ; Hypotension ; Incidence ; Lower Extremity ; Oxygen ; Prospective Studies

BACKGROUND: In this prospective, randomized, double-blind, placebo-controlled trial, we tried to find out appropriate amounts of single-dose dexmedetomidine to prolong the duration of spinal anesthesia in a clinical setting. METHODS: Sixty patients who were scheduled for unilateral lower limb surgery under spinal anesthesia were randomized into three groups receiving normal saline (control group, n = 20) or 0.5 or 1.0 ug/kg dexmedetomidine (D-0.5 group, n = 20; D-1, n = 20) intravenously prior to spinal anesthesia with 12 mg of bupivacaine. The two-dermatome pinprick sensory regression time, duration of the motor block, Ramsay sedation score (RSS), and side effects of dexmedetomidine were assessed. RESULTS: The two-dermatome pinprick sensory regression time (57.6 +/- 23.2 vs 86.5 +/- 24.3 vs 92.5 +/- 30.7, P = 0.0002) and duration of the motor block (98.8 +/- 34.1 vs 132.9 +/- 43.4 vs 130.4 +/- 50.4, P = 0.0261) were significantly increased in the D-0.5 and D-1 groups than in the control group. The RSS were significantly higher in the D-0.5 and D-1 groups than in the control group. However, there were no patients with oxygen desaturation in dexmedetomidine groups. The incidences of hypotension and bradycardia showed no differences among the three groups. CONCLUSIONS: Both 0.5 and 1.0 ug/kg of dexmedetomidine administered as isolated boluses in the absence of maintenance infusions prolonged the duration of spinal anesthesia.
Anesthesia, Spinal* ; Bradycardia ; Bupivacaine ; Dexmedetomidine* ; Humans ; Hypotension ; Incidence ; Lower Extremity ; Oxygen ; Prospective Studies

BACKGROUND: From our clinical experiences, there are some problems with a paratracheal stellate ganglion block at the 6th cervical level e.g. small changes in blood flow to the upper extremities and more difficulty in differentiating sympathetically-maintained pain from neuropathic pain. This study compared the effectiveness of the classic injection technique and the modified injection technique in paratracheal stellate ganglion block at the 6th cervical level. METHODS: Forty patients were randomly divided into 2 groups. In Group I, the patients underwent a paratracheal stellate ganglion block at the 6th cervical level with 1% mepivacaine 6 ml using the classic injection technique. In Group II, the patients underwent a paratracheal stellate ganglion block at the 6th cervical level with 1% mepivacaine 6 ml using the modified injection technique by applying strong pressure to the cephalad portion of the needle entry point. The skin temperature of the first finger was measured before and after the stellate ganglion block, and the warm sensation on the face and upper extremities, hoarseness and upper extremity paralysis were examined. RESULTS: The increase in skin temperature of the first finger after the procedure was 0.26 +/- 0.22 degrees C in Group I and 0.84 +/- 0.63 degrees C in Group II, which was statistically significant (P < 0.05). There were no significant differences in the warm sensation on the face and upper extremities, hoarseness and upper extremity paralysis between the two groups. CONCLUSIONS: The modified injection technique is more effective in the sympathetic block on the upper extremities than the classic injection technique.
Fingers ; Hoarseness ; Humans ; Mepivacaine ; Needles ; Neuralgia ; Paralysis ; Sensation ; Skin Temperature ; Stellate Ganglion* ; Upper Extremity*

Duodenal varices can result from portal hypertension regardless of the etiologies of liver cirrhosis. Bleeding from duodenal varices is rare but often severe and life threatening. Treatment modalities of duodenal varices include endoscopic sclerotherapy, transjugular intrahepatic portosystemic shunt, and surgery. As an initial treatment, endoscopic sclerotherapy is recommended due to easy accessibility but has limited success in controlling active duodenal variceal bleeding. In this case, we report a spurting duodenal varix treated with Histoacryl(R) injection in a 48-year-old woman with secondary biliary cirrhosis. Endoscopic sclerotherapy with Histoacryl(R) is a useful therapeutic measure in the treatment of bleeding duodenal varix.
Esophageal and Gastric Varices* ; Female ; Hemorrhage ; Humans ; Hypertension, Portal ; Liver Cirrhosis ; Liver Cirrhosis, Biliary* ; Middle Aged ; Portasystemic Shunt, Surgical ; Sclerotherapy* ; Varicose Veins

OBJECTIVE: To evaluate the clinical effectiveness of minilaparotomy total hysterectomy compared with other methods of hysterectomy ever used. METHODS: Data of 300 women who had been done hysterectomy due to benign gynecologic disease were used for this thesis. Minilaparotomy hysterectomy was done for 40 women, classical transabdominal hysterectomy for 186 women, laparoscopic assisted vaginal total hysterectomy for 28 women and vaginal total hysterectomy for 46 women. Women's clinical data and clinical outcome were compared using Excel and SPSS. RESULTS: Minilaparotomy hysterectomy has no limitation in choosing patient and adnexal surgery like classical transabdominal hysterectomy, and postoperative clinical course is so rapid similar with laparosocopic assisted vaginal total hysterectomy. CONCLUSION: Minilaparotomy hysterecomy is good choice for treatment of benign gynecologic disease.
Female ; Genital Diseases, Female* ; Humans ; Hysterectomy* ; Laparotomy

No abstract available.

PURPOSE: Wilson's disease is an autosomal recessive disorder characterized by copper accumulation in the liver, brain, and other organs due to defected copper metabolism. The incidence of Wilson's disease is approximately one in 30,000 population in the world, more common than phenylketonuria in Korea. The early diagnosis or presymptomatic diagnosis of Wilson's disease is critical in order for them to live a normal life. However, unfortunately, there are no commercial kits available for Wilson's disease screening in the world yet. METHODS: We developed a mass-screening kit for the purpose of early diagnosis and prevention of Wilson's disease using sandwich ELISA method. This kit can handle a large number of samples at the same time by using filter paper as in newborn screening. Using the polyclonal or monoclonal anti-ceruloplasmin antibodies, this kit determines the plasma ceruloplasmin levels-one of the main markers for Wilson's disease. RESULTS: The plasma levels of the ceruloplasmin were considerably lower in the Wilson's disease (4.5+/-1.6 mg/dL) group compared to normal controls(22.1+/-1.4 mg/dL), sufficient to be used for mass screening. In addition, the results using this screening kit showed 100% positive and negative concordance rates with the test results obtained from immuno-turbidimetry analysis which is the currently used in most test centers for ceruloplasmin measurement in the serum or plasma after centrifugation. CONCLUSION: Taken together, we successfully developed a screening kit which is very effective for the early diagnosis and prevention of Wilson's disease. By using simple filter paper method for sample collection, this kit provides suitable mass screening. We suggest the screening for Wilson's disease at the age of 3-5 years.
Antibodies ; Brain ; Centrifugation ; Ceruloplasmin ; Copper ; Diagnosis ; Early Diagnosis* ; Enzyme-Linked Immunosorbent Assay ; Hepatolenticular Degeneration* ; Humans ; Incidence ; Infant, Newborn ; Korea ; Liver ; Mass Screening* ; Metabolism ; Phenylketonurias ; Plasma

Kinky hair disease is X-linked recessive neurodegenerative disorder produced by defects in a gene(ATP7A) that encodes an intracellular copper-transporting ATPase. About 90-95% of the patients have a severe clinical course leading to death in early childhood. ATP7A mutations associated with Menkes disease show great variety from cytogenetic abnormalities to partial gene deletions to single base-pair changes. We experienced a 15 month-old boy with loss of developmental milestones, hypotonia, seizures and failure to thrive. On laboratory findings, the levels of serum copper and ceruloplasmin were low. Electron microscopy of hair illustrated pathognomic pili torti and other abnormalities such as trichorrhexis nodosa and trichoptilosis(longitudinal splitting of the shaft). Brain magnetic resonance image showed diffuse cerebral and cerebellar atrophy with tortousity of cerebral blood vessels. Genetic defect was evaluated. Our sequencing data on the amplified exon 19 of ATP7ase genomic DNA confirmed point mutation, G1255A, resulting in a glycine-to-arginine conversion. So, we report a brief view with the related literatures.
Adenosine Triphosphatases ; Atrophy ; Blood Vessels ; Brain ; Ceruloplasmin ; Chromosome Aberrations ; Copper ; DNA ; Exons ; Failure to Thrive ; Gene Deletion ; Hair ; Humans ; Infant ; Male ; Menkes Kinky Hair Syndrome* ; Microscopy, Electron ; Muscle Hypotonia ; Neurodegenerative Diseases ; Point Mutation ; Seizures