The influence of calcium phosphate (Ca-P) coating on the bone response of titanium implants was investigated two types of titanium implants, i.e. as -machined ,as -machined with Ca-P coating, were prepared. The Ca-P coating produced by OCT Inc technique. These implants were inserted into the left and right femur of beagle dog. After implantation periods of 3 days, 1weeks, weeks, 4weeks, 8weeks, 12weeks, 24weeks, the bone-implant interface was evaluated histologically, histomorphometrically, and removal torque. Histological evaluation revealed no new bone formation around different implant materials after 2weeks of implantation. After 4 weeks, Ca-P coated implants showed a higher amount of bone contact than either of the non coated implants. After 12weeks, bone healing was almost completed. And implant were removed by reverse torque rotation with torque-measuring device. Mean torque values for 4weeks control were 2.375Kgf.cm and experimental were 2.725Kgf.cm. And mean torque values for 8weeks control were 1.25Kgf.cm and experimental were 1.0Kgf.cm On the basis of these findings, we concluded that deposition of a Ca-P coating on an implant has a beneficial effect on the bone response to this implant during the healing phase. Besides implant surface conditions the bone response is also determined by local implant site condition.
Animals ; Calcium* ; Dogs* ; Femur ; Osseointegration* ; Osteogenesis ; Titanium ; Torque

We experienced a complication of brachial plexus palsy secondary to operative position during thoracoscopic thoracic sympathectomies. His general health was excellent and no previous histories vulnerable to peripheral nerve systems were observed. The thoracic sympathectomies were done under general anesthesia. The patient was placed left lateral position with his right arm abduced 150o on padded arm board. An operation was lasted 2 hours and 30 minutes at this position because of severe right apical lung adhesion. The controlateral side was performed same procedure and lasted 20 minutes. After the patient recovered from the anesthesia, the patient had a complete paralysis of right arm. There was also slightly diminished sensation to pinprick on the arm and hand. Neurologic examination and EMG study revealed brachial plexus palsy. Nerve blocks and physiotherapy were performed to treat brachial plexus injuries. His motor functions were improved day by day and he was discharged with a complete range of motion against gravity on 14th. postoperation day. However, there were loss of muscle powers against some resistances and tingling sensations of fingertips. Two months later, he was recovered completely and there was no residual disabilities.
Anesthesia ; Anesthesia, General ; Arm ; Brachial Plexus* ; Gravitation ; Hand ; Humans ; Lung ; Nerve Block ; Neurologic Examination ; Paralysis* ; Peripheral Nerves ; Range of Motion, Articular ; Sensation ; Sympathectomy*

We experienced one case of anesthesia for liver transplantation in 32-year-old male patient with liver cirrhosis. The liver donor was 27-year-old male patient who was diagnosed brain death due to car accident. The operation was finished successfuly for 12 hours with intensive monitoring and treatrnent with using TEG and RIS. Patient was transfered to ICU after operation with intubated state. Extubation was done 2 days after operation and patient discharged without complication about 2 months later.
Adult ; Anesthesia* ; Brain Death ; Humans ; Liver Cirrhosis ; Liver Transplantation* ; Liver* ; Male ; Tissue Donors

Orthotopic liver transplantation has been an established medical therapy for almost any end-stage liver disease. In spite of improved survival rates following transplantation, acute or chronic allograft failure requiring hepatic retransplantation still occurs with an incidence of 9% to 22%. We experienced one case of anesthesia for liver retransplantation in 30-year-old male patient with posttransplantation hepatic arterial thrombosis. He had taken primary liver transplantation due to hepatocelluar carcinoma 15days before retransplantation. The operation was finished successfully after 10hours of anesthesia with anhepatic time of 65 minutes. Careful attention was paid to eletrolyte balance, blood coagulation function as well as cardiovascular and respiratory function. Hemodynamic value was relatively stable throughout the operation and postoperative mechanical ventilatory support was required for about 15 hours.
Adult ; Allografts ; Anesthesia ; Blood Coagulation ; Hemodynamics ; Humans ; Incidence ; Liver ; Liver Diseases ; Liver Transplantation ; Male ; Survival Rate ; Thrombosis

BACKGROUND: Intraperitoneal hyperthermic perfusion (IPHP) has been introduced in clinical practice to improve the survival of cancer patients. But despite of this advantage, postoperative hepatic dysfunction may occur more severely after IPHP than general anesthesia. The protective mechanism of liver is destroyed by hyperthermia as the result. The purpose of this study is to evaluate the effect of intraperitoneal hyperthermic perfusion on the postoperative liver function in cancer patients. METHODS: Sixty patients with ovarian cancer were divided into two groups; 30 patients undergone only radical hysterectomy (control group), and 30 patients undergone radical hysterectomy combined with IPHP (IPHP group). Anesthesia was performed with enflurane-N2O-O2 in both groups. Serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT) and albumin levels were evaluated before anesthesia, 1, 3, 5, 7, 10 and 14th days after surgery on both groups. RESULTS: Postoperative SGOT levels were increased on 1, 3, 5, 7, 10 and 14th days in both groups, and on 1, 3 and 5 days postoperatively were increased more significantly in IPHP group than control group, but there were no significant difference between both groups after post-operative 7 days. SGPT levels were increased more significantly on 1, 3 and 5 days postoperatively in IPHP group than control group. Albumin levels were decreased more significantly on 1 and 3 days postoperatively in IPHP group than control group. CONCLUSION: We consider that postoperative liver function in cancer patients is influenced by the intraperitoneal hyperthermic perfusion.
Alanine Transaminase ; Anesthesia ; Anesthesia, General ; Aspartate Aminotransferases ; Fever ; Humans ; Hysterectomy ; Liver* ; Ovarian Neoplasms ; Perfusion*

PURPOSE: For patients with Dukes' stage B and C rectal cancer, surgery followed by adjuvant chemoradiotherapy is considered to be the standard treatment. However, the drugs used in combination with 5-fluorouracil (5-FU), the method of administration, duration of adjuvant therapy and the frequencies of administration presently remain controversial topics. We investigated (1) the efficacy and safety of adjuvant radiotherapy and 5-FU/leucovorin (LV) chemotherapy for patients who had undergone curative resection and (2) the effect of dose related factors of 5-FU on survival. MATERIALS AND METHODS: 130 rectal cancer patients with Dukes' B or C stage disease who were treated with curative resection were evaluated. The adjuvant therapy consisted of two cycles of 5-FU/LV chemotherapy followed by pelvic radiotherapy with chemotherapy, and then 4~10 more cycles of the same chemotherapy regimen were delivered based on the disease stage. The cumulative dose of 5-FU per body square meter (BSA), actual dose intensity and relative dose intensity were obtained. The patients were divided into two groups according to the median value of each factor, and the patients' survival rates were compared. RESULTS: With a median follow-up duration of 52 months, the 5-year disease-free survival and overall survival rates of 130 patients were 57% and 73%, respectively. Loco- regional failure occurred in 17 (13%) of the 130 patients, and the distant failure rate was 27% (35/130). The chemotherapy related morbidity was minimal, and there was no mortality for these patients. The cumulative dose of 5-FU/ BSA had a significant effect on the 5-year overall survival for Dukes' C rectal cancer patients (p=0.03). Multivariate analysis demonstrated that only the performance status affected the 5-year overall survival (p=0.003). CONCLUSION: An adjuvant therapy of radiotherapy and 5-FU/LV chemotherapy is effective and tolerable for Dukes' B and C rectal cancer patients. A rospective, multicenter, randomized study to evaluate the effects of the cumulative dose of 5-FU/BSA on survival is required.
Chemoradiotherapy, Adjuvant ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Drug Therapy ; Fluorouracil ; Follow-Up Studies ; Humans ; Mortality ; Multivariate Analysis ; Radiotherapy ; Radiotherapy, Adjuvant ; Rectal Neoplasms* ; Survival Rate

BACKGROUND: Hemodilution after focal cerebral ischemia increases cerebral blood flow to ischemic brain tissue and reduces neurologic injury. With rare exceptions, most studies have reduced hematocrit (Hct) to no less than 30%. We studied the effect of moderate hemodilution (hematocrit 27%) on cerebral infarct volume after focal cerebral ischemia in rabbits. METHODS: Twenty rabbits were divided into a control group (n = 10) and a hemodilution group (n = 10). In the control group, cerebral infarction was induced by embolization of the middle cerebral artery using an autologous blood clot without hemodilution. In the hemodilution group (n = 10), hemodilution of around hematocrit 27% was achieved by exchanging arterial blood with 10% hydroxyethyl starch 1 hour before embolization of the middle cerebral artery in the hemodilution group. Seven hours after embolization, coronal brain slices were made with 2 mm thickness at 1 cm from the frontal pole and stained with 2% 2,3,5-triphenyltetrazolium chloride. The infarct volume was quantitated by image analysis of photography of the infarcted area. RESULTS: The infarct volume of the cerebral hemisphere (25.9 +/- 8.9%), subcortex (16.3 +/- 3.1%) in the hemodilution group was significantly smaller than in the control group (34.9 +/- 8.9%, 19.3 +/- 5.1%) (P<0.05), but, in the cortex, the difference of infarct volume is not statistically significant between the control group (23.5 +/- 11.9%) and the hemodilution group (15.6 +/- 2.7%). CONCLUSIONS: These results indicate that moderate hemodilution (hematocrit 27%) reduces neurologic injury after focal cerebral ischemia.
Brain Ischemia* ; Brain* ; Cerebral Infarction ; Cerebrum ; Hematocrit ; Hemodilution* ; Middle Cerebral Artery ; Photography ; Rabbits* ; Starch

BACKGROUND: The therapeutic effect of morphine on neuropathic pain states was controversial, but there are some reports that systemic morphine reduced pain. Recently, many investigators have reported that locally administered morphine alleviated pain in local inflammatory pain model. Therefore, we designed this study to evaluate the peripheral effect of morphine and its antagonism by naloxone in rats experiencing neuropathic pain. METHODS: Neuropathic pain was produced by tightly ligating the left 5 th and 6 th lumbar spinal nerves of male Spraw-Dawley rats. To evaluate the systemic effect, morphine 200 microgram was injected into the unaffected right paw. Morphine 50, 100 and, 200 microgram were injected into the affected left paw. Naloxone 5, 10 and 20 microgram were injected into the affected left paw ten minutes before morphine 200 microgram was injected into the affected left paw. Before and after drug injection, mechanical allodynia was quantified by the foot withdrawal frequency to von Frey filaments of 5.50 g or 1.48 g, applied to the affected left paw. RESULTS: Morphine 200 g injected into the unaffected right paw did not affect the foot withdrawal frequency on the affected left paw. Morphine 100 and 200 microgram decreased the foot withdrawal frequency. In rats with morphine 200 microgram injected into the left paw, naloxone 5, 10, and 20 microgram increased foot withdrawal frequency. Conclusion: These data represented that morphine injected into the affected paw dose-relatedly reduced mechanical allodynia via peripheral effect and pretreatment of naloxone significantly antagonized the morphine effect.
Animals ; Foot ; Humans ; Hyperalgesia* ; Male ; Models, Animal* ; Morphine* ; Naloxone ; Neuralgia* ; Rats* ; Research Personnel ; Spinal Nerves

PURPOSE: To determine the optimal radiation dose in a localized non-Hodgkin's lymphoma of the head and neck in the treatment setting for combined chemoradiotherapy. MATERIALS AND METHODS: Fifty-three patients with stage I and II diffuse large cell non-Hodgkin's lymphoma of the head and neck, who were treated with combined chemoradiotherapy between 1985 and 1998 were retrospectively reviewed. The median age was 49 years, and the male-to-female ratio was approximately 1.6. Twenty-seven patients had stage I disease and 26 had stage II. Twenty-three patients had bulky tumors (> or =5 cm) and 30 had non-bulky tumors (<5 cm). The primary tumors arose mainly from an extranodal organ (70%), most cases involving Waldeyer's ring (90%). All patients except one were initially treated with 3~6 cycles of chemotherapy, which was followed by radiotherapy. Radiation was delivered either to the primary tumor area alone (9%) or to the primary tumor area plus the bilateral neck nodes (91%) with a minimum dose of 30 Gy (range 30~60 Gy). The failure patterns according to the radiation field were analyzed, and the relationship between the dose and the in-field recurrence was evaluated. RESULTS: The 10-year overall survival and the 10-year disease free survival rates were similar at 75% and 76%, respectively. A complete response (CR) after chemotherapy was achieved in 44 patients (83%). Subsequent radiotherapy showed a CR in all patients. Twelve patients (23%) had a relapse of the lymphoma after the initial treatment. Two of these patients had a recurrence inside the radiation field. No clear dose response relationship was observed and no significant prognostic factors for the in-field recurrences were identified because of the small number of in-field recurrences. However, for patients with tumors <5 cm in diameter, there were no in-field recurrences after a radiation dose 30 Gy. The 2 in-field recurrences encountered occurred in patients with a tumor > or =5 cm. CONCLUSION: A dose of 30 Gy is sufficient for local control in patients with a non-bulky (<5 cm), localized, diffuse large cell non-Hodgkin's lymphoma when combined with chemotherapy. An additional boost dose in the primary site is recommended for patients with bulky tumors (> or =5 cm).
Chemoradiotherapy ; Disease-Free Survival ; Drug Therapy ; Head* ; Humans ; Lymphoma ; Lymphoma, Large B-Cell, Diffuse* ; Lymphoma, Non-Hodgkin ; Neck* ; Radiotherapy ; Recurrence ; Retrospective Studies