BACKGROUND: Single or multiple episodes of brief period of ischemia and reperfusion(ischemic preconditioning, IP) have been shown to limit infarct size after a subsequent longer period of ischemia. A considerable number of possible mechanisms has been proposed, however, controversies still remain. Accordingly, we evaluated the effect of four cycles of 5 minutes ischemia and 5 minutes reperfusion(IP) followed by subsequent 30 minutes ischemia(ISCH) and 60 minutes reperfusion using isolated Langendorff-Perfused rabbit hearts. Methods and RESULTS: After a 50-minute recovery phase, parameters of the left ventricular function(LVF) including left ventricular developed pressure(LVDP), contractility and the heart rate were recorded, and ultrastructure was examined. Myosin ATPase activity was determined by measurement of inorganic phosphorus and isozymes of the myosin heavy chain were examined by polyacrylamide gel electrophoresis containing pyrophosphate buffer. The ISCH hearts showed severe to irreversible change of the cardiac myocytes homogenously in contrast to the IP hearts in which changes were not homogenous and irreversible injury was only focal. However, parameters of the LVF were not significantly different between the IP and the ISHC hearts during reperfusion. Myosin ATPase activities were also not significantly different(0.67+/-0.123 micromol/mg protein/h in the IP hearts, 0.56+/-0.172 micromol/mg protein/h in the ISCH hearts, and 0.76+/-0.239 micromol/mg protein/h in the control hearts). Band patterns of the myofibrillar proteins, separated by sodium ddodecyl sulfate-polyacrylamide gel electrophoresis, revealed no differences between the IP, ISCH and the control hearts. Myosin heavy chains in the IP and the ISCH hearts were separated into 3 isozymes, V1,V2and V3in pyrophosphate gel electrophoresis in contrast that the control hearts revealed two isozymes, V1and V2. However, there were no differences in the protein composition and electrophoretic motility between the IP and the ISCH hearts. CONCLUSION: These results indicate that IP could not attenuate the changes in LVF, myosin ATPase activity and myosin isozymes on reperfusion, however, it could attenuate the ultrastructural changes of the cardiac myocytes.
Adenosine Triphosphatases* ; Electrophoresis ; Electrophoresis, Polyacrylamide Gel ; Heart Rate ; Heart* ; Ischemia ; Ischemic Preconditioning* ; Isoenzymes ; Myocytes, Cardiac ; Myosin Heavy Chains ; Myosins* ; Phosphorus ; Reperfusion ; Sodium ; Ventricular Function, Left*

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy*

This study was undertaken to investigate the characterization and distribution patterns of MHC class II positive dendritic cells[DCs] and ED2 positive tissue macrophages throughout the estrous cycle and during pregnancy in the rat ovary. The immunohistochemical characterization of the cells was carried out using the monoclonal antibodies OX6 and ED2 in cryostat-cut sections. DCs were distributed in the theca cell layer of the growing and mature follicles,stroma and corpus luteum. Tissue macrophages were distributed in the theca externa of the growing and mature follicles, stroma and corpus luteum but they were smaller in number than DCs. None of DC and tissue macrophage was found in the ovum, granulosa layer and follicular cavity of the ovarian follicle. However, DCs and tissue macrophages were present in the granulosa layer and follicular cavity in the atretic follicles. Degenerating corpus luteum contained a vast number of OX6 positive cells. On the contrary, fewer tissue macrophages were founcl in the degenerating corpus luteum. More macrophages tended to be observed in the former follicular cavity and theca lutein cell layer than in the granulosa lutein cell layer of the corpus luteum. In stroma,DCs and tissue macrophages were more frequently found around the blood vessels than in the other region, however, DCs were relatively greater in number than tissue macrophages. There was no estrous cycle and pregnancy dependent variation in the numbers and distribution patterns of DCs and tissue macrophages. In conclusion, the rat ovary contains rich networks of MHC class II positive dendritic cells and ED2 positive tissue macrophages. These findings suggest the existence of a well-developed system of immunological surveillance in the rat ovary. The results of this study have potentially important implications for the understanding not only of the ovarian immune system and the pathogenesis of various ovarian diseases but also of various physiologic functions of the ovary.
Animals ; Antibodies, Monoclonal ; Blood Vessels ; Corpus Luteum ; Dendritic Cells* ; Estrous Cycle ; Female ; Immune System ; Immunologic Surveillance ; Luteal Cells ; Macrophages* ; Ovarian Diseases ; Ovarian Follicle ; Ovary* ; Ovum ; Pregnancy ; Rats* ; Theca Cells

Intracranial hypotension is characterized by a postural headache which is relieved in a supine position and worsened in a sitting or standing position. Although less commonly reported than postural headache, sixth nerve palsy has also been observed in intracranial hypotension. The epidural blood patch (EBP) has been performed for postdural puncture headache, but little is known about the proper timing of EBP in the treatment of sixth nerve palsy due to intracranial hypotension. This article reports a case of sixth nerve palsy due to spontaneous intracranial hypotension which was treated by EBP 10 days after the onset of palsy.
Abducens Nerve ; Abducens Nerve Diseases ; Blood Patch, Epidural ; Headache ; Intracranial Hypotension ; Paralysis ; Post-Dural Puncture Headache ; Supine Position

No abstract available.
Endometriosis* ; Female

For cervical cancer, the combination chemotherapy could increase the trial of radical hysterectomy due to reduction in tumor volume even in advanced stage and help to decrease corrected dose of radiotherapy. It also reduces postoperative radiotherapy to avoid the side effect and therefore make the quality of life better. Cisplatin chemotherapy alone was known to result in objective response rates of 20%. Todays animal experiment studies stated that Ifosfamide could accelerate the efficacy of Cisplatin. Thus in this study, neoadjuvant chemotherapy was applied to those cervical cancer patients in the use of the combination chemotherapy including Ifosfamide, PI(Cisplatin+ Ifosfamide) and PAIB(Cisplatin+ Ifosfamide+ Adriamycin+ Bleomycin). A total of 43 patients were entered in this trial, 23(53%) achieved at least a 50% reduction in tumor volume, 20(47%) showed no change. After completion of combination chemotherapy, 30(70%) of the 43 were done radical hysterectomy, 13(30%) given to radiotherapy. 9(30%) of the 30 patients were applied postoperative radiation therapy. Nausea and vomiting occurred in 35 of the 43 patients(81%) and alopecia 15(34%) for toxicity. Severe CNS toxicity(Grade 4) was detected in one patient. This study suggest that Ifosfamide combination chemotherapy is effective in tumor reduction and minimal toxity and can performed radical operation in cases of large tumor volume.
Alopecia ; Animal Experimentation ; Cisplatin ; Doxorubicin* ; Drug Therapy ; Drug Therapy, Combination ; Humans ; Hysterectomy ; Ifosfamide* ; Nausea ; Quality of Life ; Radiotherapy ; Tumor Burden ; Uterine Cervical Neoplasms* ; Vomiting

BACKGROUND: The blind sacroiliac joint (SIJ) block cannot always be performed accurately; it is commonly performed in the office based setting because intraarticular and periarticular injections are effective for SIJ pain. However, knowledge on the surface anatomy of the SIJ is lacking. The purpose of this study was to analyze the surface anatomical location of the posterior-inferior margin of the SIJ. METHODS: After informed consent was obtained, fifty patients undergoing SIJ block in the prone position were examined. The oblique angles where the anterior-inferior margin and the posterior-inferior margin of the SIJ overlap on X-ray were evaluated. In addition, the surface anatomical relationships between the posterior-inferior margin of the SIJ on X-ray and the posterior superior iliac spine (PSIS) and sacral hiatus by palpation were assessed. RESULTS: The oblique angle was 5.4 +/- 2.9degrees. The vertical and transverse distance between the posterior-inferior margin of the SIJ and PSIS were 3.8 +/- 0.8 cm and 0.9 +/- 0.6 cm, respectively. The vertical and transverse distance between the posterior-inferior margin of the SIJ and the midpoint of the sacral hiatus were 3.4 +/- 0.7 cm and 3.9 +/- 0.6 cm, respectively. Only the vertical distance between the posterior-inferior margin of the SIJ and PSIS showed significant difference between the male and the female groups (P = 0.0016). CONCLUSIONS: The measurements in this study can be used as a reference standards for the blind SIJ block.
Female ; Humans ; Informed Consent ; Male ; Palpation ; Prone Position ; Sacroiliac Joint ; Spine

No abstract available.
Diabetes Insipidus* ; Pregnancy*

BACKGROUND: A conventional treadmill provides manually controlled constant speed during exercise. A fast interactive automatic speed control treadmill (FAST), which is highly sensitive to the position of the user on the belt and spontaneously adjusts its speed accordingly, was evaluated in terms of energy expenditure (EE) during exercise. METHODS: A total of 43 subjects were recruited and assigned to one of three exercise intensity groups-low (LIG; 40-50% of VO2max), moderate (MIG; 55-65% of VO2max), and high (HIG; 70-80% of VO2max). During the first test (Test-1), each subject performed an exercise bout on the FAST while spontaneously changing their locomotion speed within their assigned range of intensity. The average speed in Test-1 was calculated and applied to the second test (Test-2), in which the subjects exercised at a constant belt speed and matched the total travel distance of Test-1. During the tests, the oxygen uptake (VO2), heart rate (HR), respiratory quotient (RQ), oxygen pulse (OP), and EE of each subject were measured. RESULTS: The average VO2 in Test-1 was higher than that in Test-2 for both the LIG (22.95+/-2.55 vs. 21.72+/-2.90 ml/kg/min) and MIG (31.17+/-3.75 vs. 29.73+/-4.86 mL/kg/min) (P<.05) subjects. The EE in Test-1 was higher than that in Test-2 for both the LIG (7.09+/-1.67 vs. 6.71+/-1.73 kcal/min) and MIG (9.79+/-2.62 vs. 9.32+/-2.71 kcal/min) (P<.05) subjects. The HR, RQ, and OP in the LIG and the MIG were similar. There was no difference between Test-1 and Test-2 in any of the metabolic parameters for the HIG subjects. CONCLUSIONS: The results indicated that, low- to moderate-intensity treadmill exercise at varying speeds required higher energy expenditure than that at a constant speed. Thus, a treadmill with a spontaneous speed variation function may be an effective exercise modality that increases energy expenditure.
Energy Metabolism* ; Heart Rate ; Locomotion ; Oxygen ; Running ; Walking

OBJECTIVE: To evaluate and compare the effects and outcomes of extracorporeal shock wave therapy (ESWT) and intra-articular injections of hyaluronic acid (HA) in patients with knee osteoarthritis (OA). METHODS: Of the 78 patients recruited for the study, 61 patients met the inclusion criteria. The enrolled patients were randomly divided into two groups: the ESWT group and the HA group. The ESWT group underwent 3 sessions of 1,000 shockwave pulses performed on the affected knee with the dosage adjusted to 0.05 mJ/mm² energy. The HA group was administered intra-articular HA once a week for 3 weeks with a 1-week interval between each treatment. The results were measured with the visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequesne index, 40-m fast-paced walk test, and stair-climb test (SCT). A baseline for each test was measured before treatment and then the effects of the treatments were measured by each test at 1 and 3 months after treatment. RESULTS: In both groups, the scores of the VAS, WOMAC, Lequesne index, 40-m fast-paced walk test, and SCT were significantly improved in a time-dependent manner (p<0.01). There were no statistically significant differences measured at 1 and 3 months after treatment between the two groups (p>0.05). CONCLUSION: The ESWT can be an alternative treatment to reduce pain and improve physical functions in patients with knee OA.
High-Energy Shock Waves ; Humans ; Hyaluronic Acid* ; Injections, Intra-Articular* ; Knee* ; Ontario ; Osteoarthritis ; Osteoarthritis, Knee* ; Shock