Arytenoid cartilage dislocation is a very rare complication of endotracheal intubation. This change can occur as a result of compressing the cryco-arytenoid joint by inflated cuff of endotracheal tube. A 21-year old male, ASA physical status I with chronic otitis media underwent tympanoplasty with mastoidectomy. Anesthesia was induced with thiopental-succynylcholine and was maintained with nitrous oxide-oxygen-enflurane. On the first postoperative day, the patient complained of hoarseness, and on the second postoperative day, the right arytenoid was found dislocated under indirect laryngoscopy. Five days postoperatively, endoscopic reduction was performed under direct laryngoscopy, thereafter his symptom gradually disappeared.
Anesthesia ; Anesthesia, General* ; Arytenoid Cartilage ; Dislocations ; Hoarseness ; Humans ; Intubation, Intratracheal ; Joints ; Laryngoscopy ; Male ; Otitis Media ; Tympanoplasty ; Young Adult

No abstract available.
Leukemia

No abstract available.
Leukemia

No abstract available.
Neurofibromatoses* ; Neurofibromatosis 1* ; Neurofibromin 1 ; Vitiligo*

BACKGROUND: The toxicity of paraquat has been known to be caused by oxygen free radicals which leads to the lipid peroxidation and multiple organ failure. Although vitamin C has been known to be a potent antioxidant, recently there are numerous data which have shown that a low dose of vitamin C may act as a prooxidant due to the stimulation of the Fenton reaction with metal ions, which produces hydroxyl radicals. It has been reported that a deferoxamine in paraquat intoxication could reduce the production of the hydroxyl radicals by the inhibition of the Fenton reaction through the reduction of iron ion in tissue. The aim of this study was to evaluate the effect of the high and low dose of vitamin C and deferoxamine on lipid peroxidation and plasma TNF-alpha in paraquat intoxication. METHODS: Female Sprague-Dawley rats were divided into seven groups: control group which was not given paraquat(20mg/kg), P group which was given paraquat only, PVH group given paraquat and high dose of vitamin C(100mg/kg), PVL group given paraquat and low dose of vitamin C(10mg/kg), PVHD given paraquat, high dose of vitamine C and deferoxamine(100mg/kg), PVLD given paraquat, low dose of vitamin C and deferoxamine, and PD given paraquat and deferoxamine. Animals were killed at 6 and 24 hours after treatment. Malondialdehyde(MDA), superoxide dismutase(SOD) and glutathione(GSH) contents, catalase activity, plasma TNF-alpha, and histologic changes in the lung and liver tissue were measured. RESULTS: The lung histology in the PVH and PD or PVHD groups showed the significant decreases in the alveolar edema and interstitial thickness compared to the P group. The liver histology in the PVH and PVHD groups demonstrated marked differences in the central venous and sinusoidal dilatation compared to that of the P group. While the MDA levels of the lung and liver in the PVH and PD groups showed the significant reduction compared to that of the P group at 6 hours after treatment, all groups showed the significant changes compared to the P group at 24 hours. There was no significant change of the SOD levels of the lung and liver at 6 hours among all groups. At 24 hours, the SOD levels of the lung in PVH, PVL, and PVHD groups showed the significant increases compared to the P group. The increase of the SOD level in groups combined with deforoxamine, however, revealed a little reduction. The SOD level of the liver in PVH group only significantly increased compared to the P group at 24 hours. There was no significant change of the GSH level of the lung and liver among all groups at 6 hours. At 24 hours, the GSH level of the lung and liver were significantly increased in both PVH and PD group and PVH group, respectively, compared to the P group. Although the catalase activity of the lung was not significantly increased, that of liver was significantly increased in both PVHD and PD groups compared to the P group at 6 hours. The catalase activities of the lung and liver were significantly increased in PVH, PD, and PVHD at 24 hours. The concentrations of the Plasma TNF-alpha were slightly decreased at 6 hours and slightly increased at 24 hours compared to that of the P group, but they were not significant. CONCLUSION: This study showed that although the low dose of vitamin C had no effect, the high dose of vitamin C revealed a decrease of the MDA level and an increase of SOD, GSH, and catalase activity in the lung and lung and liver tissues, and the effect of the high dose of vitamin C increased with time. The administration of the deferoxamine with or without high dose of vitamin C, however, significantly showed the inhibition of the lipid peroxidation and antioxidant effect and low dose vitamin C decreased the effect of deferoxamine. The effects of the vitamin C and deferoxamine on plasma TNF-alpha were not clearly shown.
Animals ; Antioxidants ; Ascorbic Acid ; Catalase ; Deferoxamine ; Dilatation ; Edema ; Female ; Free Radicals ; Humans ; Ions ; Iron ; Lipid Peroxidation ; Liver ; Lung ; Multiple Organ Failure ; Oxygen ; Paraquat ; Plasma ; Rats ; Rats, Sprague-Dawley ; Superoxides ; Tumor Necrosis Factor-alpha ; Vitamins

BACKGROUND: Laparoscopic gynecologic surgery is a standard procedure today for its small skin incision and short hospital admission stay. However pneumoperitoneum (PP) and Trendelenberg position induce adverse effects in hemodynamics and pulmonary gas exchange. The purpose of this study is to evaluate the effects of propofol compared with enflurane for pulmonary gas exchange in the Trendelenberg position and pneumoperitoneum. METHODS: Twenty women were randomly allocated to either the enflurane (n = 10) or propofol (n = 10) with fentanyl-N2O/O2 anesthesia. PaCO2, PaO2, PETCO2 were checked at pre-PP, 10 min after PP, 30 min after PP, and 10 min after CO2 deflation. In addition the Vd/Vt ratio was calculated according to the Bohr equation. Vital sign and peak airway pressure were checked at each stage. RESULTS: PaCO2 and PETCO2 increased and PaO2 decreased significantly during PP in both groups. Vd/Vt increased significantly in the enflurane group at 30 min after PP. Peak airway pressure increased significantly in both groups. Blood preassure and heart rate were not changed significantly. All of the parameters were not significantly different between groups. CONCLSIONS: Propofol compared with enflurane did not show any advantage in gas exchange during gynecologic laparoscopic surgery under Trendelenberg position and PP.
Anesthesia* ; Enflurane* ; Female ; Gynecologic Surgical Procedures ; Heart Rate ; Hemodynamics ; Humans ; Laparoscopy* ; Pneumoperitoneum ; Propofol* ; Pulmonary Gas Exchange ; Skin ; Vital Signs

We report a case of neuroblastoma with multiple skin metastases as a chief complaint in a 2-month-old girl. the skin lesions were rnultiple, pea-sized, bluish, nontender, moable subcutaneous nodules on abdomen, back and scalp. Histopathology showed small round or poly gonal tumor cells which have deeply stained, basophilic, hyperchromatic nuclei with some mitoses. Th.se tumor cells showed clumping tendency which is one of early menifestations of rosette formation. Immunohistochemically positive reaction was demonstrated by anti-NSE(neuron specific enolase) antilody but negative reaction by anti-NFP (neurofilament proteiin ) antibody. She has been succesfully treated with combined chemotherapy for 10 months without relapse.
Abdomen ; Basophils ; Drug Therapy ; Female ; Humans ; Infant ; Mitosis ; Neoplasm Metastasis* ; Neuroblastoma* ; Phosphopyruvate Hydratase ; Recurrence ; Rosette Formation ; Scalp ; Skin*

Potassium (K) balance is regulated not only by ion channels and ion transporters, but also by various genes including NF-E2-related factor 2 (Nrf2). Although mRNA distribution and role of Nrf2 has been studied in hypokalemic kidney, the distribution of Nrf2 and phosphorylated-Nrf2 (p-Nrf2) proteins are not known. The present study was planned to examine the alteration of expression and distribution of Nrf2 and p-Nrf2 protein in the kidney of normal and K-depleted rats using immunohistochemistry. In normal rat kidneys, Nrf2 was highly expressed in the proximal convoluted tubule and proximal straight tubule, moderately in cortical thick ascending limb, and weakly in cortical collecting duct, outer medullary thick ascending limb, and outer medullary collecting duct. In K-depleted groups, the pattern of cellular labeling of Nrf2 protein was identical to that of normal group, but the signal intensity was prominently increased in proximal convoluted tubule and proximal straight tubule especially in rats at K-free diet 3 weeks. In normal rat kidneys, p-Nrf2 was highly expressed in nucleus of cortical thick ascending limb, cortical collecting duct, and glomerular endothelial cell, moderately in distal convoluted tubule and outer medullary collecting duct, and weakly in proximal convoluted tubules and outer medullary thick ascending limb. In K-depleted groups, the pattern of cellular labeling of p-Nrf2 protein was similar to that of normal group, but signal intensity was significantly increased in the nucleus of outer medullary collecting duct from of K-free diet 2 and 3 weeks groups. These results suggest that Nrf2 and p-Nrf2 expression was gradually increased in K-depleted groups of kidney, but Nrf2 and p-Nrf2 expression patterns were not exactly matched. In addition, it is suggested that enhanced expression of Nrf2 and p-Nrf2 in hypokalemic condition may affect the regulation of ion channels and ion transporters and subsequent intracellular signal transduction.
Animals ; Diet ; Endothelial Cells ; Extremities ; Hypokalemia ; Immunohistochemistry ; Ion Channels ; Ion Transport ; Kidney* ; NF-E2-Related Factor 2 ; Potassium ; Rats* ; RNA, Messenger ; Signal Transduction

The aim of the present study was to investigate the mRNA expression of several cytokines which were not reported previously from interface tissues around loose cemented acetabulum to obtain better understanding of the biological mechanisms connected with aseptic loosening and osteolysis of THA. We investigated mRNA expression for several cytokines (interleukin-1 alpha [IL-l~a], IL-lp, IL-2, IL-2 receptor[2R], IL-4, IL-5, IL-8, IL-10, transforming growth factor-beta [TGF-p], and interferon- gamma [IFN-y]) by reverse transcription-polymerase chain reaction (RT-PCR) and release of metalloproteinase (MMP)-2 and MMP-9 from the cement-bone interface tissues around five loose polyethylene acetabular components. We did not include TNF-a and IL-6 because the biologic effect of the former is so similar to that of IL-1, and the latter fails to stimulate prostaglandin E, or collagenase production by fibroblsts or synovial cells. Expression of mRNA for IL-1p was detected in four, IL-2R and IL-8 in three, IL-10 and TGF-p in two of five interface tissues .No expression of mRNA for IL-la, IL-2, IL-4, IL-5, and IFN-p was detected. Zymographic analysis for gelatinase/type IV collagenase revealed gelatinolytic bands corresponding to metalloproteinase(MMP)-2 and MMP-9 in cemenl-bone interface tissues. Activated cells phagocytose particles in cement-bone interface tissues expressed more cytokines mRNA than previously known to be related to periprosthetic bone resorption, and secreted metalloproteinases associated with extracellular matrix degradation and fibrosis.
Acetabulum ; Arthroplasty, Replacement, Hip* ; Bone Resorption ; Collagenases ; Cytokines* ; Extracellular Matrix ; Fibrosis ; Interleukin-1 ; Interleukin-10 ; Interleukin-2 ; Interleukin-4 ; Interleukin-5 ; Interleukin-6 ; Interleukin-8 ; Metalloproteases* ; Osteolysis ; Polyethylene ; RNA, Messenger*

The pregnancy causes the marked change in maternal renal hemodynamic and volume homeostasis. During pregnancy, renal sodium and water retention result in an expansion of extracellular fluid and plamsma volume. Although many studies suggested that water balance or water balance disorder was associated with regulation of Aquaporin (AQP) expression, the studies were only limited to AQP-2 expression during the pregnancy. The present study was to examine altered expression and distribution of AQP-1, 2, and 3 proteins in the kidneys of non-pregnant (NP) and pregnant rats using Westhern blot analysis and immunohistochemistry. Pregnant Sprague-Dawley rats were evaluated on various time sets: days 10.5 (P10.5), 12.5 (P12.5), 17.5 (P17.5), and 19.5 (P19.5). In Westhern blot analysis, expression of AQP-1, 2 was peaked at P17.5 and AQP-3 at 19.5. Immunoreactivity of AQP-1 of NP rat was detected in the apical membranes of proximal tubules and thin limb of Henle loop. In pregnant rats, the pattern of cellular labeling of AQP-1 protein was identical to NP rat, but signal intensity was continuously increased from P10.5 and peaked at P17.5. In NP rat, immunoreactivity of AQP-2 was the most prominent in apical region and moderate in cytoplasm of the principal cells of entire collecting duct. In pregnant rats, the pattern of cellular labeling of AQP-2 protein was identical to NP rat, but signal intensity was moderately expressed in P10.5 and P12.5 and most prominent signal was observed in P19.5. In NP rat, immunoreactivity of AQP-3 was most prominent in the bosolateral plasma membrane of principal cells of entire collecting duct. In pregnant rats, the pattern of cellular labeling of AQP-3 protein was identical to NP rat, but signal intensity was continuously increased from P10.5 to P17.5 and peaked at P19.5. These results suggest that the expansion of extracellular fluid volume and water retention are regulated by AQP-1, 2, and 3 during the pregnancy, especially at late stage.
Animals ; Cell Membrane ; Cytoplasm ; Extracellular Fluid ; Extremities ; Hemodynamics ; Homeostasis ; Immunohistochemistry ; Kidney ; Loop of Henle ; Membranes ; Pregnancy ; Proteins ; Rats ; Rats, Sprague-Dawley ; Retention (Psychology) ; Sodium