Five cases of tennis elbow seen during the time period from Jaunary 1983 to January 1985 had operative treatment. Of the five clinical cases, four elbows in three patients were treated with Nirschl and Pettrone operation. This operative technique included exposure of the extensor carpi radialis brevis, excision of the identified lesion, and repair. The following results were obtained. 1. Correct analysis of the patient's emotional stability was essential prior to undertaking surgical procedure for tennis elbow. 2. The results of Nirschl and Pettrone operation were graded as excellent in three elbows and fair in one.
Elbow ; Humans ; Mortuary Practice ; Tennis Elbow ; Tennis

Recently, several reports of extrahepatic hepatocellular carcinoma metastasis demonstrated by technetium-99mTc-IDAs scan have shown that 99mTc-IDAs can be used to detect extrahepatic metastasis in hepatocellular carcinoma. We report here a case of hepatocellular carcinoma with pulmonary nodules that were demonstrated as metastasis in nature by the use of the 99mTc-DISIDA. The findings in this case and several reports reviewed here suggest that the 99mTc-DISIDA scan may be a useful diagnostic agent that can detect the extrahepatic metastasis of hepatocellular carcinoma and stage the disease. But more clinical study in needed to establish the position of 99mTc-DISIDA in the field of diagnosis of extrahepatic hepatocellular carcinoma.
Carcinoma, Hepatocellular* ; Clinical Study ; Diagnosis ; Lung* ; Neoplasm Metastasis ; Technetium Tc 99m Disofenin

A study was performed to investigate a relationship between the status of T lymphocyte subsets in the peripheral blood and the pathogenesis of erythema nodosum leprosum (ENL) reactions. T lymphocyte subsets, B lymphocytes and serum immnnoglobulin levels were explored in 40 leprosy patients (10 tuberculoid (TT), 17 lepromatous (LL), and 13 lepromatous with ENL). In patients with LL, suppressor cells increased and helper cell diminished, resulting in a decrease in the helper/suppressor (Th/Ts) ratio to 0.86 + 0.20, as compared with controls (1. 77 + 0.41). But in ENL patients, there was a significant diminution of suppressor cells and an increase of helper cells, resulting in an increase in Th/Ts ratio to 2.08 + 0.30. Four weeks after treatment of ENL, Th/Ts ratio decreased to l.18+ 0.31 again. The mean percentages of B cells and serum immunoglobulin levels in with LL. and ENL increased significantly compared with controls. Only IgG increased in patients with ENL compared with patients with LL. The results in patiients with TT did not differ significantly from those of controls. The findings suggest that cell-mediated immune responses, imbalance in T lymphocyte subsets, may play a role in the pathogenesis of ENL, either directly or by inducing an antibody critical to the formation of the immune complex
Antigen-Antibody Complex ; B-Lymphocytes ; Erythema Nodosum* ; Erythema* ; Humans ; Immunoglobulin G ; Immunoglobulins ; Leprosy ; T-Lymphocyte Subsets* ; T-Lymphocytes, Helper-Inducer

No Abstract Available.
Allografts* ; Posterior Cruciate Ligament*

Eotaxin is an important inflammatory chemokine in eosinophil chemotaxis and activation and, thus, is implicated in asthma. Recently, obesity was associated with an increased prevalence of asthma, but the relationship between obesity and eotaxin expression has only been partially understood in obese mice and human studies. Therefore, we studied the expression patterns of eotaxin in 3T3-L1 preadipocytes/adipocytes to determine whether eotaxin levels are influenced by body weight gain and/or reduction in diet-induced obese mice. First, we investigated eotaxin expression during differentiation in 3T3-L1 adipocytes. Then, we treated 3T3-L1 preadipocytes/adipocytes with tumor necrosis factor-alpha (TNF-alpha), eotaxin, interleukin (IL)-4, IL-5, or leptin. To examine the effects of weight loss in high-fat diet induced obese mice, we fed C57BL/6 mice a high-fat diet or a normal diet for 26 weeks. Then, half of the high-fat diet group were fed a normal diet until 30 weeks to reduce weight. Epididymal adipose tissue, visceral adipose tissue, serum, and bronchoalveolar fluid of mice were examined for eotaxin expression. The results showed that eotaxin expression levels increased with adipocyte differentiation and that more eotaxin was expressed when the cells were stimulated with TNF-alpha, eotaxin, IL-4, IL-5, or leptin. An in vivo study showed that eotaxin levels were reduced in visceral adipose tissues when high-fat diet fed mice underwent weight loss. Taken together, these results indicate a close relationship between eotaxin expression and obesity as well as weight loss, thus, they indirectly show a relation to asthma.
Adipocytes ; Adipose Tissue ; Animals ; Asthma ; Body Weight ; Chemotaxis ; Diet ; Diet, High-Fat ; Eosinophils ; Humans ; Interleukin-4 ; Interleukin-5 ; Interleukins ; Intra-Abdominal Fat ; Leptin ; Mice ; Mice, Obese ; Obesity ; Prevalence ; Tumor Necrosis Factor-alpha ; Weight Loss

BACKGROUND: The focus of this study is the effects of thiopental sodium, etomidate and propofol on systemic vascular resistance and venous capacitance during cardiopulmonary bypass with constant pump flow. METHODS: Thirty patients (ASA III) scheduled for open heart surgery were randomly divided into three groups. Anesthesia was induced with thiopental sodium 5 mg/kg, fentanyl 5 microgram/kg and vecuronium 1 mg/kg. CPB was conduced with a membrane oxygenator using non-pulsatile flow and moderate hypothermia. When rectal temperature and pump flow had been stable for 5 min, patients randomly received thiopental sodium 4 mg/kg, etomidate 0.3 mg/kg and propofol 2 mg/kg. Perfusion pressure and pump flow were measured 0, 1, 3, 5, 10, 15, 20 and 30 min after administration. RESULTS: The systemic vascular resistance index (SVRI) decreased to 84.3% of the control values after thiopental sodium 4 mg/kg, to 74.7% of the control after etomidate 0.3 mg/kg and to 79.8% of the control after propofol 2 mg/kg. SVRI returned to control value levels 3 min after the administration of thiopental sodium, 20 min after etomidate, and 5 min after propofol. Thiopental sodium, etomidate and propofol reduced venous reservoir volume 1 min after injection and the reduction was sustained throughout the all period of the cardiopulmonary bypass. CONCLUSIONS: The results indicate that thiopental sodium, etomidate and propofol dilate both resistance and capacitance vessels, but there was no correlation between the two vessels.
Anesthesia ; Cardiopulmonary Bypass* ; Etomidate* ; Fentanyl ; Humans ; Hypothermia ; Oxygenators, Membrane ; Perfusion ; Propofol* ; Thiopental* ; Thoracic Surgery ; Vascular Access Devices ; Vascular Resistance* ; Vecuronium Bromide

BACKGROUND: Laparoscopy with peritoneal carbon dioxide insufflation is a standard procedure in many gynecological departments. And more prolonged gynecological laparoscopic operations are being performed in recent years, and a steeper head-down position is required. Despite laparoscopic operations have many advantages, peritoneal insufflation of CO2 to create the pneumoperitoneum necessary for laparoscopy induces intraoperative hemodynamic changes that complicate anesthetic management of laparoscopy.The purpose of this study is to evaluate the effect of general anesthesia on hemodynamics during loparoscopic hysterectomy. METHODS: Twenty six women undergoing laparoscopic hysterectomy were randomly allocated to either a propofol (Group 1, n=13) intravenous anesthesia or a enflurane (Group 2, n=13) anesthesia with fentanyl-N2O/O2-vecuronium. Hemodynamic parameters were measured before induction (T1), 5 min after induction (T2), 5 min after head-down (T3), 5, 10, 15, 20 min after pneumoperitoneum (T4, T5, T6, T7), 5, 10 min after deflation (T8, T9). The MAP, HR, CI, SVRI, SI were measured by transthoracic electrical bioimpedence method and automated blood pressure device. RESULTS: The mean arterial pressure were increased during pneumoperitonem in both groups and heart rate were increased in Group 2. The cardic index were decreased in both groups after induction by 27.4 % in Group 1 and 25.7% in Group 2. The systemic vascular resistanace index were increased in both groups from head-down to after deflation by 68.3% in Group 1, 73.1% in Group 2 maximally. No significant changes of stroke index were observed during surgery in Group 1. CONCLUSIONS: Laproscopy with CO2 insufflation induces significant hemodynamic changes includig increases of MAP, SVR and a reduction of CI. And usual intraoperative hemodynamic monitoring; the blood pressure and heart rate give no information on the reduction in cardic output.
Anesthesia ; Anesthesia, General* ; Anesthesia, Intravenous ; Arterial Pressure ; Blood Pressure ; Carbon Dioxide ; Enflurane ; Female ; Heart Rate ; Hemodynamics* ; Humans ; Hysterectomy* ; Insufflation ; Laparoscopy ; Pneumoperitoneum ; Propofol ; Stroke

No abstract available.
Humans

Morton's neuroma has been treated with resection of the enlarged interdigital nerve by most of surgeons, but the numbness after resection could bother the patients. We reported the experiences of the good results after treatment of Morton's neuroma with the decompression of the interdigital nerve. Three patients, 4 feet were diagnosed to Morton's neuroma and taken the surgery, decompression of the interdigital nerve after the conservative treatments. The decompression can be considered first as another choice of treatment for interdigital neuroma before resection of the nerve.
Decompression ; Foot ; Humans ; Hypesthesia ; Neuroma

Epidural block is one of the most effective methods of intrapartum pain relief in current practice. This is a case of a scalding burn resulting from a sitz bath long enough after epidural block for vaginal delivery. The patient received 7 ml of 0.25% bupivacaine mixed with 1 : 300,000 epinephrine and fentanyl 50 microgram for epidural block. Following delivery, the patient started complaining of voiding difficulty without any motor weakness 6 hours after the epidural block occured. At that time, the patient did not feel any hot or pain sensations during the 15 minutes of unintentional hot water application for sitz bath. Consequently, an approximately 5~10% superficial second degree burn developed on her perineal and inner thigh region.
Baths* ; Bupivacaine ; Burns* ; Epinephrine ; Fentanyl ; Humans ; Sensation ; Thigh ; Water