Dexmedetomidine Sedation in an Old Patient for Revision Total Hip Arthroplasty

A revision total hip arthroplasty (THA) that anticipated massive bleeding and the need for blood transfusion was scheduled. The patient was a 73-year-old man who had well controlled hypertension. A combined spinal and epidural anesthesia was performed. Dexmedetomidine was administered from the beginning of the arterial and central line catheterization, until the end of the operation. During the 10 hours and 30 minutes surgery, the estimated blood loss was about 7,000 mL, with a total infused red blood cell amount of 14 units, total fresh frozen plasma of 6 units, a total crystalloid of 6,850 mL and of colloid 1,500 mL. The Ramsay sedation score was maintained within 3 and the hemodynamic condition was stable. We found that dexmedetomidine can be safely used for sedation, even during an operation requiring massive transfusions and a prolonged operation time.

Extensive skin color change caused by extravasation of indigo carmine / 대한마취과학회지

No abstract available.

Ultrasonographic Appearances of the Plantar Fasciitis / 대한족부족관절학회지

PURPOSE: This retrospective study was designed to evaluate the appearances of plantar fasciitis by ultrasonography. MATERIALS AND METHODS: 48 cases of unilateral plantar fasciitis were enrolled in this study. Plain radiograph and real- time sonography of both feet were perfomred and the results were compared between the affected feet and controlateral symptomless feet. Calcaneal spur were observed on plain radiograph and thickness of plantar fascia, hypoechogenecity, blurring of border of plantar fascia, perifascial effusion, wavy plantar fascia were observed on sonography. RESULTS: Women (35 cases) and left feet (30 cases) were more frequent than men and right feet. Thickness of plantar fascia in affected site was thicker than normal site (p<0.01). Hypoechogenecity was observed only in 39 cases (81%) affected site, blurring of border of plantar fascia in affected site was 30 cases (62%) and 7 cases (15%) in normal site, perifascial effusion was observed only in 38 cases (79%) affected site, wavy plantar fascia in affected site was 43 cases (90%) and 2 cases (4%) in normal site. Calcaneal spur in affected site was 36 cases (75%) and 33 cases (69%) in normal site. CONCLUSION: Sonography is a useful diagnostic procedure for the plantar fasciitis especially in the unilateral plantar fasciitis.

Slipped Capital Femoral Epiphysis after Curettage of Juxtaphyseal Chondromyxoid Fibroma of the Femoral Neck / 대한정형외과학회잡지

Chondromyxoid fibroma is a relatively rare benign but potentially aggressive tumor of cartilagenous origin. It usually occurs in the metaphysis of the long bones and the most common site of involvement is near the growth plate of the proximal tibia. We experienced a case of chondromyxoid fibroma, which occurred in the juxtaphyseal portion of the femoral neck. It was treated by curettage and allogenic bone graft initially. Twenty-seven months after this first operation, the capital femoral epiphysis slipped, which was treated by screw fixation. Here, report a case of SCFE after curettage and bone graft for juxtaphyseal chondromyxoid fibroma at the femoral neck and include a brief review of literature.

Intracellular trafficking and metabolic turnover of yeast prepro-alpha-factor-SRIF precursors in GH3 cells

Chimeric genes coding for prepro region of yeast alpha-factor and anglerfish SRIF were expressed in rat GH3 cells to determine whether yeast signals could regulate hormone processing in mammalian cells. We report that nascent hybrid polypeptides were efficiently targeted to ER, where cleavage of signal peptides and core glycosylation occurred, and were localized mainly in Golgi. These data indicate that prepro region of yeast alpha-factor functions in sorting molecules to secretory pathway in mammalian cells. A hybrid construct with a mutated signal peptide underwent similar ER translocation, whereas such a mutation resulted in defective translocation in yeast (Cheong et al., 1997). This difference may be due to the differences in ER translocation between yeast and mammalian cells, i.e., posttranslational versus cotranslational translocation. Processing and secretion of metabolically labeled hybrid propeptides to mature SRIF peptides were assessed by HPLC. When pulse-labeled cells were chased for up to 2 h, intracellular propeptides disappeared with a half-life of approximately 25 min, showing that -68% of initially synthesized propeptides were secreted constitutively. About 22% of SRIF-related products were proteolytically processed to mature SRIF, of which 38.7% were stored intracellularly with a half-life of - 2 h. In addition, immunocytochemical localization showed that a small proportion of SRIF molecules accumulated in secretory vesicles. All these results suggest that yeast prepropeptide could direct hybrid precursors to translocate into ER lumen and transit through secretory pathway to the distal elements of Golgi compartment, but could process and target it less efficiently to downstream in rat endocrine cells.

Intracellular trafficking and metabolic turnover of yeast prepro-alpha-factor-SRIF precursors in GH3 cells

Chimeric genes coding for prepro region of yeast alpha-factor and anglerfish SRIF were expressed in rat GH3 cells to determine whether yeast signals could regulate hormone processing in mammalian cells. We report that nascent hybrid polypeptides were efficiently targeted to ER, where cleavage of signal peptides and core glycosylation occurred, and were localized mainly in Golgi. These data indicate that prepro region of yeast alpha-factor functions in sorting molecules to secretory pathway in mammalian cells. A hybrid construct with a mutated signal peptide underwent similar ER translocation, whereas such a mutation resulted in defective translocation in yeast (Cheong et al., 1997). This difference may be due to the differences in ER translocation between yeast and mammalian cells, i.e., posttranslational versus cotranslational translocation. Processing and secretion of metabolically labeled hybrid propeptides to mature SRIF peptides were assessed by HPLC. When pulse-labeled cells were chased for up to 2 h, intracellular propeptides disappeared with a half-life of approximately 25 min, showing that -68% of initially synthesized propeptides were secreted constitutively. About 22% of SRIF-related products were proteolytically processed to mature SRIF, of which 38.7% were stored intracellularly with a half-life of - 2 h. In addition, immunocytochemical localization showed that a small proportion of SRIF molecules accumulated in secretory vesicles. All these results suggest that yeast prepropeptide could direct hybrid precursors to translocate into ER lumen and transit through secretory pathway to the distal elements of Golgi compartment, but could process and target it less efficiently to downstream in rat endocrine cells.