Pseudohyperkalemia after total splenectomy in a dog: a case report

A 16-year-old, 7.4 kg, castrated male Cocker Spaniel presenting anorexia and weight loss was referred due to a splenic mass, and total splenectomy was performed to resolve clinical signs. Following surgery, the dog developed mild hyperkalemia (6.27 mmol/L) without any clinical symptoms. Further investigations were conducted to determine the cause of hyperkalemia. The serum-plasma potassium difference was measured (1.05 mmol/L), and pseudohyperkalemia was diagnosed. The cause of pseudohyperkalemia was considered as thrombocytosis after splenectomy. The dog did not receive any specific treatment to lower blood potassium. To our knowledge, we report the first case of post-splenectomy pseudohyperkalemia in a dog.

Hypertrophic pyloric gastropathy with Helicobacter spp. in a dog

A 12-year-old, castrated male, mixed dog presented with a history of gradual abdominal distention for a year and anorexia recently, with abdominal radiographs showing a gastric pylorus distention. A solitary, pedunculated, heterogeneous mass arising from the mucosal layer in the pylorus with intact wall layers was identified during ultrasound and computed tomography. The gastric muscular layer was evenly thick. After surgical excision of the mass, histological examination confirmed hypertrophic pyloric gastropathy with polypoid growth and Helicobacter spp. infiltrating the gastric mucosal epithelium. This is the first reported diagnostic imaging case of hypertrophic pyloric gastropathy with Helicobacter spp. in a dog.

Hypertrophic pyloric gastropathy with Helicobacter spp. in a dog

A 12-year-old, castrated male, mixed dog presented with a history of gradual abdominal distention for a year and anorexia recently, with abdominal radiographs showing a gastric pylorus distention. A solitary, pedunculated, heterogeneous mass arising from the mucosal layer in the pylorus with intact wall layers was identified during ultrasound and computed tomography. The gastric muscular layer was evenly thick. After surgical excision of the mass, histological examination confirmed hypertrophic pyloric gastropathy with polypoid growth and Helicobacter spp. infiltrating the gastric mucosal epithelium. This is the first reported diagnostic imaging case of hypertrophic pyloric gastropathy with Helicobacter spp. in a dog.

Clinical Outcomes of Differentiated Thyroid Cancer Patients with Local Recurrence or Distant Metastasis Detected in Old Age

BACKGROUND: Differentiated thyroid carcinoma (DTC) shows a very good prognosis, but older patients have a higher recurrence rate and those show poor prognosis than younger patients. The aim of this study was to determine the clinical outcomes of thyroid cancer patients who experienced recurrence in old age according to the treatment strategy used. METHODS: This retrospective observational cohort study was conducted at Asan Medical Center, Seoul, Korea. Among DTC patients with no evidence of disease after initial treatment, we enrolled 86 patients who experienced recurrence at an age >65 years from 1994 to 2012. Sixty-nine patients had local recurrence and 17 patients showed distant metastasis. RESULTS: The mean age of patients at recurrence was 72 years. Patients were followed up for a median of 4.1 years after recurrence. Sixty-three of the 69 patients with local recurrence received additional treatment, while the other six received conservative care. The cancer-specific mortality rate was 15.5% in the local recurrence group. Airway problems were the main cause of death in patients who did not receive further treatment for local recurrence. Among the 17 patients with distant metastasis, 10 underwent specific treatment for metastasis and seven received only supportive management. Seven of those 17 patients died, and the cancer-specific mortality rate was 35% in the distant metastasis group. CONCLUSION: The overall cancer-specific mortality rate was 20% in DTC patients in whom recurrence was first detected at an age >65 years. Mortality due to uncontrolled local disease occurred frequently in patients who did not receive definitive management for recurrence.

Biodegradation and Biocompatibility of Poly L-lactic Acid Implantable Mesh / 대한배뇨장애요실금학회지

PURPOSE: The purpose of this study was to evaluate the biodegradation and biocompatibility of poly L-lactic acid (PLLA) implantable mesh under in vitro and in vivo conditions. METHODS: PLLA mesh was examined for changes in weight and tensile strength. The histology of the tissue around the PLLA implant was also evaluated. RESULTS: The weight and tensile strength of the PLLA prosthesis was stable for 180 days. In addition, the surface of the PLLA mesh was not digested under in vitro or in vivo conditions as determined by scanning electron microscope. Histologically, there were no significant changes in the diameters of implanted PLLA mesh and subtype fibers over the course of 180 days. Likewise, there were no significant changes in the number of inflammatory and mast cells after 180 days, nor was there an increase in the percentage of collagen surrounding the PLLA mesh. CONCLUSIONS: The results indicate that PLLA prostheses have good rigidity and biocompatibility in vivo and in vitro.

Changes in bispectral index score and cardiorespiratory function under constant rate infusion with alfaxalone in dogs

Changes in the cardiovascular and bispectral index score were evaluated in dogs subjected to constant rate infusion (CRI) with alfaxalone. Fifteen dogs were assigned to three groups of 5. Groups and doses of alfaxalone were as follows: group 1, 3 mg/kg for induction and 6 mg/kg/h for CRI; group 2, 3 mg/kg for induction and 8 mg/kg/h for CRI; and group 3, 3 mg/kg for induction and 10 mg/kg/h for CRI. CRI was maintained for 1 h. Respiratory rates and blood pressures showed minimal changes; however, mild tachycardia and mild hypoxemia occurred, especially in group 3. There were some disparities between bispectral index score, electromyography and pedal withdrawal reflex test when measuring anesthetic depth. Additional premedications and/or analgesic agents would be helpful to avoid adverse effects of alfaxalone and provide improved cardiopulmonary functions.

Effect of combined sodium hyaluronate and carboxymethyl cellulose on ocular surface in rat dry eye model

This study was conducted to evaluate three different mixed formulations of sodium hyaluronate (SH) and carboxymethyl cellulose (CMC) using a low-humidity air flow-induced rat dry eye model and determine the most suitable mixture. The total thickness of the cornea, corneal epithelial thickness, corneal stroma thickness, damaged corneal epithelium percentage region, thickness of the bulbar conjunctiva epithelium, number of goblet cells, goblet cell occupation percentage region, and damaged bulbar conjunctiva epithelium percentage region were measured by histomorphological evaluation. After 5 h exposure to drying airflow, the thickness of the cornea and conjunctiva was decreased with desquamation of the corneal and conjunctiva epithelium. However, these dry eye symptoms were markedly inhibited by treatment with the reference and test formulations. More favorable effects on decreased thickness were detected in response to the CMC than the SH. However, SH had a greater protective effect against corneal and conjunctiva epithelial damage. The application of a mixture of 0.1% SH and 0.2% CMC showed more favorable effects on the corneal and conjunctival damage and the stabilization of the ocular surface than SH or CMC alone.

The Pharmacological Effects of Benachio-F(R) on Rat Gastrointestinal Functions

Functional dyspepsia (FD) is a prevalent idiopathic upper gastrointestinal (GI) disorder characterized by diverse symptomatology including epigastric pain or discomfort, postprandial fullness, and early satiety. Although its pathophysiological mechanisms have not yet been fully established, the available studies suggest that the etiology of FD is invariably multifactorial. Benachio-F(R) (BF) is a proprietary liquid formulation of 7 herbal extracts that has been proposed to address this multifactorial etiology using multi-drug phytotherapy. The pharmacological effects of BF, in comparison with those of two other herbal products (Whalmyungsu(R); WM and Iberogast(R); IB) were evaluated in rats. In a laparotomy-induced rat model of delayed GI transit, BF significantly accelerated the delayed gastric emptying caused by morphine, apomorphine, and cisplatin, and also significantly increased mean gastric transit, as compared to the control animals. BF markedly increased gastric accommodation in rats and produced higher gastric volume values than did the control treatment. The effects of BF were generally comparable or superior to those of WM and IB in these models. Furthermore, BF significantly stimulated biliary flow, as compared to the control treatment. These results indicated that BF might have great potential as an effective phytotherapeutic agent capable of reducing GI symptoms and increasing quality of life in FD patients.

Effect of beta-glucan from Aureobasidium on dermal wound healing in diabetic C57BL/KsJ-db/db mouse model / 동물의과학연구지

The objective of the present study was to examine the effects of beta-glucan originating from Aureobasidium on full-thickness skin wound healing in diabetic C57BL/KsJ-db/ db mouse models. In the diabetic C57BL/KsJ-db/db model, test articles were topically applied twice a day for 20 days starting from 1 day after wounding. The results were compared to that of MadecassolTM ointment (madecassol; 1% Centella asiatica extracts) topically applied at a concentration of 100 mg/kg. Treatment with beta-glucan resulted in significant (p<0.01 or p<0.05) and dose-dependent decreases in wound size compared with that of vehicle control showing increased wound size (WS, %). In addition, 50% contraction time (CT50) was dramatically and dose-dependently reduced, and inflammatory cells in granulation tissues of the wound area were significantly (p<0.01 or p<0.05) and dosedependently reduced compared with that of vehicle control showing increased numbers of micro-vessels and fibroblasts as well as re-epithelialization. In the madecassol group, similar changes in inflammatory cells and fibroblasts with re-epithelialization were also observed, but madecassol did not influence angiogenesis. No meaningful changes in body weight were detected in all tested groups compared with the vehicle control. Therefore, these data suggest that beta-glucan has a beneficial effect on diabetic delayed skin wound healing and may be useful to manage incurable skin wounds in diabetic animals.

DA-9701: A New Multi-Acting Drug for the Treatment of Functional Dyspepsia

Motilitone(R) (DA-9701) is a new herbal drug that was launched for the treatment of functional dyspepsia in December 2011 in Korea. The heterogeneous symptom pattern and multiple causes of functional dyspepsia have resulted in multiple drug target strategies for its treatment. DA-9701, a compound consisting of a combination of Corydalis Tuber and Pharbitidis Semen, has being developed for treatment of functional dyspepsia. It has multiple mechanisms of action such as fundus relaxation, visceral analgesia, and prokinetic effects. Furthermore, it was found to significantly enhance meal-induced gastric accommodation and increase gastric compliance in dogs. DA-9701 also showed an analgesic effect in rats with colorectal distension induced visceral hypersensitivity and an antinociceptive effect in beagle dogs with gastric distension-induced nociception. The pharmacological effects of DA-9701 also include conventional effects, such as enhanced gastric emptying and gastrointestinal transit. The safety profile of DA-9701 is also preferable to that of other treatments.

A Case of Parathyroid Adenoma Manifested by Acute Recurrent Pancreatitis / 대한내과학회지

Acute pancreatitis caused by primary hyperparathyroidism-induced hypercalcemia is a rare condition, as acute pancreatitis is typically associated with a decrease in serum calcium levels. If hypercalcemia is present in a patient with acute pancreatitis, the possibility of hyperparathyroidism should be considered, and parathyroid hormone levels should be evaluated and the parathyroid gland imaged. We present a case of a 48-year-old male with acute recurrent pancreatitis caused by hyperparathyroidism. Initially, the acute pancreatitis improved after conservative therapy. However, the patient relapsed 1 month later. The patient had hypercalcemia and was diagnosed with parathyroid adenoma. He underwent surgical resection of the parathyroid adenoma and recovered. After 24 months of the treatment, there was no recurrence of the hypercalcemia or pancreatitis.

A Case of Parathyroid Adenoma Manifested by Acute Recurrent Pancreatitis / 대한내과학회지

Acute pancreatitis caused by primary hyperparathyroidism-induced hypercalcemia is a rare condition, as acute pancreatitis is typically associated with a decrease in serum calcium levels. If hypercalcemia is present in a patient with acute pancreatitis, the possibility of hyperparathyroidism should be considered, and parathyroid hormone levels should be evaluated and the parathyroid gland imaged. We present a case of a 48-year-old male with acute recurrent pancreatitis caused by hyperparathyroidism. Initially, the acute pancreatitis improved after conservative therapy. However, the patient relapsed 1 month later. The patient had hypercalcemia and was diagnosed with parathyroid adenoma. He underwent surgical resection of the parathyroid adenoma and recovered. After 24 months of the treatment, there was no recurrence of the hypercalcemia or pancreatitis.

A Polymorphism (rs1801018, Thr7Thr) of BCL2 is Associated with Papillary Thyroid Cancer in Korean Population

OBJECTIVES: Among the apoptosis signals, B-cell CLL/lymphoma 2 (BCL2) is a well-known regulator of apoptosis with anti-apoptotic properties. We investigated here whether single nucleotide polymorphisms (SNPs) of the BCL2 were associated with host susceptibility of papillary thyroid cancer (PTC) occurrence and clinicopathologic parameters. METHODS: Ninety-two PTC patients and 222 control subjects were recruited. One promoter SNP (rs2279115, -938A/C) and one synonymous SNP (rs1801018, Thr7Thr) in the BCL2 gene were selected and genotyped using direct sequencing. Multiple logistic regression models were performed to evaluate odds ratios, 95% confidence intervals, and P-values. RESULTS: rs1801018 of the BCL2 gene was not associated with the development of PTC. In the clinicopathologic features, rs1801018 SNP was associated with the number and location. The G allele frequency of rs1801018 in PTC patients with multifocality (13.3%) was about four-fold higher than that in PTC patients with unifocality (3.4%). The G allele frequency of rs1801018 in PTC patients with both lobes (15.4%) was increased by about five-fold, compared to PTC patients with one lobe (3.2%). CONCLUSION: The results suggest that synonymous SNP rs1801018 and the G allele of the BCL2 gene may be associated with the multifocality and bilaterality of PTC in Korean population.

Fractionation of DNases Specific to Haemonchus contortus Intestine by Phenyl Sepharose Column / 한국실험동물학회지

Multiple DNases were identified from Haemonchus contortus intestine based on previous studies. The DNases detected at 34, 36 and 38.5 kDa had diverse characteristics. Some of them had characteristics similar to those of mammalians and others had unusual characteristics. This study was carried out to fractionate worm intestinal DNases from other proteins using phenyl Sepharose chromatographic methods. All DNases detected from Haemonchus contortus intestine were fractionated in the flowthrough of phenyl Sepharose, indicating the worm DNases are hydrophilic. The DNases were enriched five-fold in the flowthrough fraction while additional steps are required for isolation of the worm DNases. Thus, fractionation with phenyl Sepharose could be used as a good initial step to enrich and separate DNases from other proteins.

Fractionation of DNases Specific to Haemonchus contortus Intestine by Phenyl Sepharose Column / 한국실험동물학회지

Multiple DNases were identified from Haemonchus contortus intestine based on previous studies. The DNases detected at 34, 36 and 38.5 kDa had diverse characteristics. Some of them had characteristics similar to those of mammalians and others had unusual characteristics. This study was carried out to fractionate worm intestinal DNases from other proteins using phenyl Sepharose chromatographic methods. All DNases detected from Haemonchus contortus intestine were fractionated in the flowthrough of phenyl Sepharose, indicating the worm DNases are hydrophilic. The DNases were enriched five-fold in the flowthrough fraction while additional steps are required for isolation of the worm DNases. Thus, fractionation with phenyl Sepharose could be used as a good initial step to enrich and separate DNases from other proteins.

Operations about Hip in Human Immunodeficiency Virus-Positive Patients

BACKGROUND: The number of human immunodeficiency virus (HIV)-infected patients is increasing constantly, and it is well known that there is a significantly high prevalence of osteonecrosis of the femoral head in HIV-infected patients. Therefore, it is important to develop methods that can ensure the safety of both the patients and medical personnel who participate in surgery on HIV-infected patients. Recently, the authors performed 8 procedures on 5 HIV-infected patients. This paper reports our experience. METHODS: This study examined the medical records and radiological studies of 5 HIV-infected patients who had undergone surgery around the hip joint from January, 2005 to September, 2007. During the procedures, their mean age was 38.6 years (range, 23 to 53 years) and all were male. Four of them were under an anti-retroviral therapy program. The reasons for the operations were nonunion of the femoral shaft after trauma in two patients and osteonecrosis of both femoral heads in three. One autologous bone grafting, one screw fixation with autologous bone grafting, five total hip replacement arthroplasties, and one multiple drilling were performed. All procedures were carried out according to the guidelines of HIV infection control made by the Korea Centers for Disease Control and Prevention. The mean follow-up period was 16.6 months (range, 4 to 37 months). RESULTS: The preoperative CD4 count was 130 in one patient, and 200 to 499 in the other 4. The viral loads were 15100 and 420 in two patients, and negative in the other 3. Bony union was achieved in those who had undergone autologous bone grafting. There were significant improvements in both the Harris Hip Score and functional state in those who had total hip replacement arthroplasty. There were no immediate postoperative complications, such as infection. During the follow-up period, one patient died from esophageal variceal bleeding. However, no surgery-related complications were observed in the other 4 patients. CONCLUSIONS: There were no significant complications in HIV-infected patients after the operations around the hip joint when their preoperative immunity was optimal. In addition, the safety of medical personnel can be assured when the operation is performed in line with the guidelines of HIV infection control.

A Case Report of Tuberculous Brain Abscess and Tuberculous Peritonitis Developing Due to Paradoxical Reactions / 결핵및호흡기질환

While receiving appropriate treatment, patients with tuberculosis occasionally have unusual, paradoxical reactions, with transient worsening of lesions or the development of new lesions. This report is a case of tuberculosis brain abscess and tuberculosis peritonitis with intra-abdominal abscess that developed during appropriate anti-tuberculosis chemotherapy. A 45-year-old male patient had been diagnosed as with all-drug susceptible pulmonary tuberculosis with pleurisy. Subsequently, the patient underwent standard treatment with anti-tuberculosis therapy; the pulmonary lesions improved. Three months after initial treatment, the patient developed brain abscesses and peritonitis. With the addition of corticosteroid treatment, the patient's neurologic symptoms were relieved. Exploratory laparotomy with surgical drainage was performed and a diagnosis of tuberculosis peritonitis was confirmed on biopsy. Anti-tuberculosis therapy was continued for 19 months, the patient improved eventually without further complications, although the therapeutic regimen had not been altered. In this case, the paradoxical response to treatment may have been involved in the pathogenesis of disease.

Incomplete Intertrochanteric Fractures Based on Multiplanar Reconstruction Computerized Tomography : A Report of Three Cases

We experienced 3 cases of incomplete intertrochanteric fracture that were detected by multiplanar reconstruction computerized tomography (MPR CT). On the plain radiographs, two cases had only greater trochanteric fracture and the other case had a localized intertrochanteric fracture. There were linear hot uptakes in the intertrochanteric area in all cases on the bone scintigrams. On MPR CT, cortical breakage was found only in the anterior cortex, and the medial, lateral and posterior cortices were intact in all cases. Two cases were treated surgically with using compression hip screws and the other case was managed conservatively because of the patient's poor general condition. The findings of MPR CT were definitely different from those MRI findings of the previously reported incomplete intertrochanteric fractures.

Inhibition of corneal neovascularization by rapamycin

The purpose of this study was to determine whether rapamycin could inhibit corneal angiogenesis induced by basic fibroblast growth factor (bFGF). Using human dermal microvascular endothelial cells (HDMECs), we examined the effect of rapamycin on cell proliferation and migration, and the expression of vascular endothelial growth factor (VEGF). The rabbit's eye was implanted intrastromally into the superior cornea with pellet containing bFGF for the control group and pellet containing bFGF and rapamycin for the rapamycin group. Biomicrographically, corneal angiogenesis was evaluated for 10 days after pellet implantation. The neovascularized cornea also was examined histologically. bFGF induced corneal neovascularization was significantly reduced by treatment with rapamycin. Using in vitro model, rapamycin strongly inhibited bFGF induced proliferation, migration, and VEGF secretion of HDMECs. We could observe that the bFGF induced corneal angiogenesis was inhibited by rapamycin in a micropocket rabbit model. The score of neovascularization was significantly decreased in the rapamycin group than in the control group at 10 days after pellet implantation. Histologically, the cornea of rapamycin group also showed much less new vessels than that of control group. Collectively, rapamycin appears to inhibit bFGF induced angiogenesis in a rabbit corneal micropocket assay and may have therapeutic potential as an antiangiogenic agent.

A Minimal-Incision Technique in Total Hip Arthroplasty : Early Postoperative Results and Learning Curve

Purpose: We hereby would like to compare on the basis of the initial 12 hips and latter 18 hips by analyzing the initial results of the minimal incision total hip arthroplasty of 30 hips we experienced. Materials and Methods: For the period of December 2004 through June 2005, we performed the total hip arthroplasty with minimal incision in 10cm or shorter using the posterolateral approach on 25 patients (30 hips) whose BMI(body mass index) is 30 or lower. We compared by analyzing results of the initial 12 cases and 18 latter cases. Results: The average BMI was 23.7. There weren`t statistically meaningful differences the change in the hemoglobin value of pre-op and post-op, necessity of blood transfusion, position of component, and the Harris hip score 6 weeks after operation. But, the average initial operation time of 124 minutes was remarkably reduced to 65 minutes in average in the latter operation and the length of a skin incision was reduced from the average 9.2 cm in the initial operation to an average of 8.1cm in the latter operation. There wasn't the malposition of acetabular cup and femoral stem. Conclusion: Although we need more statistical data through more cases and the analysis of long-term results, we think that, to surgeons with much experience in the conventional total hip arthroplasty, the total hip anthroplasty using minimal incision for patients with BMI of 30 or below would be a useful approach having the advantage in a cosmetic aspect.