The normal vascularization of peripheral nervesand the vascular factor in peripheral nerve les ons have regained increasing interest among surgeons. So, several attempts have been made to assess the relative importance of the vasa nervorum and intrinsic longitudinal vascular plexuses of nerve in maintaining the blood supply.of a segment of nerve trunk. The purpose of our experiment was to determine in laboratory animals the maximum extent to which a nerve can be mobilized without impairing its vascular supply so much that nerve function is jeopardized. All our studies were carried out on both sides of the sciatic-tibial nerve of thirty-two rabbit which were anesthetized intraperitoneally with urethane. The experimental procedure differed in three groups, Group I in which the sciatic nerve was mobilized 3 cm in length, Group II was mob lized 7 cm length and Group III was mobilized 10cm long. The tibialis post. muscles of each group were analyzed at intervals ot 1,2,4,6 and 8 weeks after neurolysis. Each muscles were examined grossly and histologically after hematoxylin and eosin staining. Experimental studies showed that a peripheral nerve is a well vascularized structure with a considerable reserve capacity in its microirculation. The intrinsic collateral system is well developeed and experimental deta supported the view that peripheral nerves may be mobilized over a cons derable length with or the only minium interference with their microvascular flow. The results were as follows: 1. The first evidence of histologic change in the muscle fibers was in the sarcolemmal neclei. 2. Localized atrophy of muscle fibers were observed at the six weeks after neurolysis. 3. With increasing length of neurolysis, abnormal finding were developed in early stage. 4. Massive atrophy of muscle fibers were noted in the muscle fibers which neurolysed more 7cm.
Animals, Laboratory ; Atrophy ; DEET ; Eosine Yellowish-(YS) ; Hematoxylin ; Muscles ; Peripheral Nerves ; Sciatic Nerve ; Surgeons ; Urethane ; Vasa Nervorum

No abstract available.

Incarceration of the gravid uterus is a rare but serious complication of pregnancy. Reported is the case of a gravid 2, para 0, abortus 1 with known uterine subserosal myoma(5.3 x5.5cm sized) 26-year-old woman presented with acute dysuria and urinary retention. The patient was 14 weeks and 3 days pregnant and presented several week history of urinary frequency and sensation of incomplete bladder emptying. Examination revealed a retroflexed uterus with cervical opening pointing toward the anterior abdominal wall. An ultrasound revealed a thin, elongated maternal bladder and a uterus incarcerated between the sacral promontary and the pubis. The incarceration was successfully reduced by tenaculum traction of the cervical posterior lip without surgical intervention and had a normal infant of appropriate weight at term.
Abdominal Wall ; Adult ; Dysuria ; Female ; Humans ; Infant ; Leiomyoma ; Lip ; Myoma* ; Pregnancy ; Sensation ; Traction ; Ultrasonography ; Urinary Bladder ; Urinary Retention ; Uterine Retroversion ; Uterus*

: In order to observe the antigenic fractions in saline extract of adult Paragonimus westermani, proteins in the crude extract were separated by sodium dodecyl sulfate-polyacylamide gel electrophoresis (SDS-PAGE) in reducing conditions. The separated protein fractions were transferred to nitrocellulose paper on which 20 sera from human paragonimiasis were reacted and immunoblotted. Out of 15 stained protein bands in SDS-PAGE, 7 reacted with the sera. Of 14 reacted bands, 30 kilodalton(kDa) band was the most frequently reacted (95%) and was a strong antigen. Protein bands of 23 and 46 kDa were also strong antigens. Bands of over 150 kDa, 120 kDa, 92 kDa, 86 kDa, 74 kDa, 62 kDa, 51 kDa, 32 kDa, 28 kDa, 16.5 kDa and 15.5 kDa were also reactive but their frequencies of the reaction were variable.
parasitology-helminth-trematoda ; Paragonimus westermani ; immunology ; antigen ; electrophoresis

No abstract available.
Depression, Postpartum* ; Female ; Postpartum Period*

BACKGROUND/AIMS: There is considerable variance in individual susceptibility to hepato-toxic effects of ethanol as evidenced by the finding that only about 10-20% of alcoholics develop alcoholic liver cirrhosis. The aims of this study were, 1) to get the data on the genetic polymorphisms of three major ethanol-metabolizing enzymes (ADH, CYP2E1, ALDH) in normal Korean adults, and to search for the specific genotypes influencing alcohol drinking behavior by the comparison of allele frequencies between healthy control group and heavy drinker group with or without liver disease, 2) to investigate the influence of the genetic polymorphisms of these enzymes on the susceptibility to alcoholic liver disease by the comparison of allele frequencies between heavy drinker group without liver disease and alcoholic liver cirrhosis group. METHODS: Healthy control group included 53 healthy males in military service without evidence of liver disease or alcoholism. Heavy drinker group without liver cirrhosis included 29 males who had been drinking 80g or more of alcohol daily for more than ten years but did not have any clinical evidence of liver disease. Alcoholic cirrhosis group included 43 male patients who had drunk 80g or more of alcohol daily for more than ten years and had clinical evidences of overt cirrhosis. Subjects with hepatitis B surface antigen or anti-hepatitis C antibody were excluded. Genotypes of the three enzymes were determined by PCR (polymerase chain reaction) and restriction fragment length polymorphism (RFLP) with genomic DNAs extracted from peripheral leukocytes. RESULTS: 1) In healthy Korean males, allele frequency of ADH22, ADH31, CYP2E1 c2 and ALDH22 was 81%, 94%, 30% and 14%, respectively. 2) The absence of ALDH22 or CYP2E1 c2 allele were significant risk factors for being a heavy drinker (odds ratio,' 0.09, 0.42, respectively). 3) Although it was not associated with the polymorphism of each ethanol-metabolizing enzymes, the susceptibility to alcoholic liver cirrhosis was significantly associated with combined genotypes of ADH2(22) & ADH3(1+1)& CYP2E1 B or C. COMCLUSION: Genetic polymorphisms of ethanol-metabolizing enzyrnes are significantly associated with the suseptability to alcoholic liver disease as well as alcohol drinking behavior.
Adult ; Alcohol Drinking ; Alcoholics* ; Alcoholism ; Alleles ; Cytochrome P-450 CYP2E1 ; DNA ; Drinking ; Ethanol ; Fibrosis ; Gene Frequency ; Genotype ; Hepatitis B Surface Antigens ; Humans ; Leukocytes ; Liver Cirrhosis ; Liver Cirrhosis, Alcoholic* ; Liver Diseases ; Liver Diseases, Alcoholic ; Male ; Military Personnel ; Polymerase Chain Reaction ; Polymorphism, Genetic* ; Polymorphism, Restriction Fragment Length ; Risk Factors

BACKGROUND/AIMS: Imrnortalized human fetal liver cell lines established by transfecting simian virus 40 T gene wae found to lose differentiated liver cell functions in successive long-term culture. Butyrate, known as a differentiation-promoting agent for a variety of cancer cell lines, is produced in the colon by bacterial flora and selectively transported into the liver though the portal blood flow. Therefe, butyrate might play a role in the maintenance of differentiation in hepatocytes in vivo. In thepresent study, the effects of butyrate on cell growth and differentiation in human fetal liver cell lines was investigated. METHODS: Human fetal liver cell lines imrnortalized by SV 40 T antigen were treated with sodium butyrate (1mM), and cell growth rate after butyrate treatment were nmsured by the number of viable cells, determined by trypan blue dye exclusice method. The effects of sodium butyrate on the hepatocyte-specific differentiatian were assessed by albumin and alfa-fetoprotein (AFP) mRNA expression, analyzed using reverse-transcription polymerase chain reaction, and were also by the increment of albumin secretion into culture media, determined by a competitive inhibition ELISA. RESULTS: Treatment with sodium butyrate resulted in a cessation of cellular proliferation and alterations in cellular morphology (increased cell size and polygonal change in shape). The level of albumin mRNA after sodium butyrate treatment was elevated by about two times as compared to that of control. In contrast, AFP mRNA expression were dennstrated neither before nor after sodium butyrate treatment. The average amount of albumin released in the medium was less than 6pghnl/10'cells/2days in the absence of sodium butyrate, and increased to 17 p g/ml/10'cells/2days at day 2, 21ugfml 10'cells/2days at day 4 in the presence of sodium butyrate, and these levels thereafter were over 10 times higher than that in the absence of sodium butyrate until day 10. CONCLUSION: These mults indicate that treatment of immcetalized fetal liver cell lines with butyrate leads to inhibition of cellular proliferation and promotion of adult hepatocyte-specific differentiation.
Adult ; Antigens, Viral, Tumor ; Butyrates ; Butyric Acid* ; Cell Line* ; Cell Proliferation ; Cell Size ; Colon ; Culture Media ; Enzyme-Linked Immunosorbent Assay ; Hepatocytes ; Humans* ; Liver* ; Polymerase Chain Reaction ; RNA, Messenger ; Simian virus 40 ; Sodium* ; Trypan Blue

BACKGROUND/AIMS: Lens culinaris agglutinin-A reactive alpha-fetoprotein (AFP L3) has been reported to be highly specific for the diagnosis of hepatocellular carcinoma (HCC). The present study was to evaluate the clinical usefulness of AFP-L3 for the diagnosis of HCC in the patients either with chronic liver disease or with HCC in complete remission who showed significant increment of serum AFP level and no mass lesion in the liver on ultrasonography. METHODS: A total numer of 34 patients (24 with chronic liver disease, 10 with HCC in complete remission) were enrolled, who showed significant increment of serum AFP level and no mass lesion in the liver on ultrasonography. Serum AFP L3 levels were analysed by AFP differentiation kit L. Abdominal spiral CT or ultrasonogram was performed at 1-3 month intervals and all of the patients were followed up for more than 6 months. RESULTS: Among 24 patients with chronic liver disease, two were positive (higher than 15%) for AFP L3; however, HCC was not detected in these patients, while HCCs were detected in two of 22 patients negative for AFP L3 during followe-up. Eight of the 10 patients with HCC in complete remission were positive for AFP L3; recurrent HCCs were detected in 7 of those 8 patients as well as in the rest 2 patients negative for AFP L3 during follow-up. The overall sensitivity and specificity of AFP L3 measurement for the detection of HCC within 6 months of follow-up were 63.6% and 87.0%, respectively. The positive and negative predictive value for HCC in patients with chronic liver disease were O% and 90.9% and for recurrent HCC in HCC patients in remission were 87.5% and ON, respectively. CONCLUSION: The measurement of AFP L3 is suggested to be useful for the diagnostic strategy in patients either with chronic liver disease or hepatocellular carcinoma in complete remission, who showed progressive increment of serum AFP level and no mass lesion in liver on ultrasonogram.
alpha-Fetoproteins* ; Carcinoma, Hepatocellular ; Diagnosis* ; Follow-Up Studies ; Humans ; Lens Plant* ; Liver Diseases* ; Liver* ; Recurrence ; Sensitivity and Specificity ; Tomography, Spiral Computed ; Ultrasonography*

STUDY DESIGN: A retrospective study was performed in obese and nonobese patients undergoing lumbar spine surgery. OBJECTIVES: To report perioperative complications and surgical outcomes in obese patients who underwent lumbar surgery compared with a similar consecutive control group to determine whether obesity is a predictor of poor outcome as well as a factor associated with perioperative complications in lumbar spine surgery. SUMMARY OF LITERATURE REVIEW: Perioperatiye challenges in managing the obese patient include anesthesia considerations related to impaired preoperative cardiac and respiratory function, technical difficulties associated with incubation, positioning, and gaining venous and arterial access for monitoring and administering medications. Obesity has also been implicated in delayed wound healing and thrombophlebitis. MATERIALS AND METHODS: One hundred twenty seven patients with spondylolisthesis treated with decompression and fusion were retrospectively evaluated. Forty four patients were obese and remaing eighty three patients were nonobese. The operation time, amount of transfusion, duration of hospital stay and clinical outcomes were studied. RESULTS: There were no significant differences between the obese and control groups in terms of duration of surgery (224 versus 200 min), amount of transfusion (2.6 versus 2.2 pint), duration of hospital stay (21.3 versus 19.7 days), and symptom improvement (74fo versus 73fo). CONCLUSIONS: Obesity is not a predictor of poor outcome as well as a factor associated with high perioperative complication rate in lumbar spine surgery.
Anesthesia ; Decompression ; Humans ; Length of Stay ; Obesity* ; Retrospective Studies ; Spine* ; Spondylolisthesis ; Thrombophlebitis ; Wound Healing

Neuroleptic malignant syndrome is a rare, but potentially life-threatening adverse event associated with the use of neuroleptic agents. We describe the case of a 47-year-old schizophrenic woman who was treated with clozapine for years. The patient developed acute renal failure with pulmonary edema, and underwent mechanical ventilation and hemodialysis.
Acute Kidney Injury ; Antipsychotic Agents ; Clozapine* ; Female ; Humans ; Middle Aged ; Neuroleptic Malignant Syndrome* ; Pulmonary Edema ; Renal Dialysis ; Respiration, Artificial ; Rhabdomyolysis