[A case of extensive pulmonary atelectasis after intubation in a patient undergoing elective tympanoplasty].

A 33-year-old male, without significant medical history, underwent elective tympanoplasty. It was difficult to manage his airway because of overbites, small jaw, and short neck. After intubation, his left chest revealed obvious abnormality in sound and movement, and showed free air in the mediastinum on X ray. CT revealed extensive atelectasis. Although he is a current smoker, the length of preoperative smoking cessation necessary to decrease postoperative pulmonary complications is not clear. This case demonstrates the importance of preoperative preparation including education in smoking damage.

Augmentation of DHCR24 expression by hepatitis C virus infection facilitates viral replication in hepatocytes.

BACKGROUND & AIMS: We characterized the role of 24-dehydrocholesterol reductase (DHCR24) in hepatitis C virus infection (HCV). DHCR24 is a cholesterol biosynthetic enzyme and cholesterol is a major component of lipid rafts, which is reported to play an important role in HCV replication. Therefore, we examined the potential of DHCR24 as a target for novel HCV therapeutic agents. METHODS: We examined DHCR24 expression in human hepatocytes in both the livers of HCV-infected patients and those of chimeric mice with human hepatocytes. We targeted DHCR24 with siRNA and U18666A which is an inhibitor of both DHCR24 and cholesterol synthesis. We measured the level of HCV replication in these HCV replicon cell lines and HCV infected cells. U18666A was administrated into chimeric mice with humanized liver, and anti-viral effects were assessed. RESULTS: Expression of DHCR24 was induced by HCV infection in human hepatocytes in vitro, and in human hepatocytes of chimeric mouse liver. Silencing of DHCR24 by siRNA decreased HCV replication in replicon cell lines and HCV JFH-1 strain-infected cells. Treatment with U18666A suppressed HCV replication in the replicon cell lines. Moreover, to evaluate the anti-viral effect of U18666A in vivo, we administrated U18666A with or without pegylated interferon to chimeric mice and observed an inhibitory effect of U18666A on HCV infection and a synergistic effect with interferon. CONCLUSIONS: DHCR24 is an essential host factor which augmented its expression by HCV infection, and plays a significant role in HCV replication. DHCR24 may serve as a novel anti-HCV drug target.

Three cases of diffuse large B-cell lymphoma of the mandible treated with radiotherapy and chemotherapy.

CASE REPORT: We report three cases of diffuse large B-cell lymphoma of the mandible and a review of the literature. All 3 of our patients had stage I AE disease and had complete remission for more than 2 years after 42-46 Gy of irradiation to the primary tumor with regional lymph nodes and 3 courses of chemotherapy consisting of cyclophosphamide, adriamycin, vincristine, and predonisolone (CHOP). Literature analysis, although biased toward published data, indicated that the 3-year disease-specific survival rates for non-Hodgkin's lymphoma (NHL) of the mandible were 90.5% and 47.6% for stages I and II, respectively. The treatment results for NHL of the mandible may be similar to general primary bone NHL and to other extranodal NHL's. CONCLUSION: Radiotherapy alone is not sufficient for tumor control for stage I+II, disease, and combination chemotherapy may be needed.

Optical surgical navigation system causes pulse oximeter malfunction.

An optical surgical navigation system is used as a navigator to facilitate surgical approaches, and pulse oximeters provide valuable information for anesthetic management. However, saw-tooth waves on the monitor of a pulse oximeter and the inability of the pulse oximeter to accurately record the saturation of a percutaneous artery were observed when a surgeon started an optical navigation system. The current case is thought to be the first report of this navigation system interfering with pulse oximetry. The causes of pulse jamming and how to manage an optical navigation system are discussed.