BACKGROUND AND OBJECTIVES: Ischemic preconditioning (IP) has been shown to reduce the infarct size and severity of arrhythmia in a post-ischemic reperfused heart. Angina before myocardial infarction reflects brief episodes of myocardial ischemia and may be a marker of ischemic preconditioning. We studied the effect of a history of previous angina on early outcomes (infarct size, left ventricular (LV) function and residual myocardial ischemia) for patients with acute myocardial infarction (AMI) after thrombolytic therapy. MATERIALS AND METHOD: We examined prospectively 58 consecutive patients who had AMI and arrived hospital within 6 hours after chest pain developed. IP was defined as prodromal angina within 24 hours before myocardial infarction. Patients were divided 2 groups:Group I (Gr I, 30 cases) without IP, Group II (Gr II, 28 cases) with IP. Thrombolytic therapy was done 23 cases (77%) and 21 cases (75%) respectively in each groups. Thereafter, electrocardiographic findings, infarct size on the basis of peak creatine kinase, LV function on the 2-D echocardiographic findings, recurrent myocardial ischemia were examined between 2 groups. RESULTS: In predischarge 2-D echocardio-graphic findings, LV dilatation and normal regional wall motion did not differ between two groups. But, there were significantly smaller creatine kinase (CK)-determined infarct size in Gr II than that in Gr I (peak CK level, Gr I:1566.3+/-960.0 IU/L vs Gr II:1066.9+/-773.2; p<0.05). The time interval between the onset of infarction and peak CK level was shorter in Gr II than that in Gr I (Gr I:18.3+/-8.3 vs Gr II:10.7+/-3.4 hours; p<0.001). There were significantly more common incidences of residual myocardial ischemia in Gr II (Gr I:26.7% vs Gr II:60.7%; p<0.01). CONCLUSION: Patients with a history of prodromal angina preceding myocardial infarction had small infarct size and earlier reperfusion of infarct related artery. However, there were significantly more common residual myocardial ischemia in these patients and a trend toward re-infarction on same previous infarction sites.
Angina Pectoris* ; Arrhythmias, Cardiac ; Arteries ; Chest Pain ; Creatine Kinase ; Dilatation ; Echocardiography ; Electrocardiography ; Heart ; Humans ; Incidence ; Infarction ; Ischemic Preconditioning* ; Myocardial Infarction* ; Myocardial Ischemia ; Prospective Studies ; Reperfusion ; Thrombolytic Therapy

Fracture of the femur during total hip arthroplasty presents the simultaneous problems of prosthetic stability and fracture treatment. The treatment of such fractures can be complex and is one of the major challenges and this complication is associated with a high morbidity and a significant delay in convalescence. Among the 237 cases, who were treated by cementless total hip arthroplasty from Jan. 1986 to Dec. 1992, 13 cases of femoral fracture were experienced. They usually occured during insertion of prosthesis and preparation of the medullary canal. There were 6 cases of type II fracture, 1 case of type III fracture, 5 cases of type IV fracture and 1 case of type V fracture according to AAOS classification. All of the fracture healed, but the prognosis of these cases must be determined by follow up. We recommend that femoral fractures can be prevented by accurate preoperative evaluation of the size of the femoral canal, identification and management of the predisposing factors for intraoperative fractures.
Arthroplasty, Replacement, Hip ; Causality ; Classification ; Convalescence ; Femoral Fractures ; Femur ; Follow-Up Studies ; Prognosis ; Prostheses and Implants

PURPOSE: To explore the effect of bilateral oophorectomy on the several proteins of female rat bladder via a proteomic approach. MATERIALS AND METHODS: A total of 20 female Sprague-Dawley rats were obtained at 8 weeks of age and were divided randomly into 3 groups: a control groups underwent sham operation and bladders were excised 4 weeks and 8 weeks after operation each. Other two groups underwent bilateral oophorectomy and bladders were excised 4 weeks (group 1) and 8 weeks (group 2) after operation each, too. Each group has 5 rats. Conventional proteomics was conducted via high resolution 2-D gel electrophoresis, followed by image analysis and protein identification through mass spectrometry. RESULTS: Bladder weights were reduced significantly in group 2 as compared with the 8-week control group. A comparison of the bladders of the oophorectomy group subjects with those of the control group subjects demonstrated that the expressions of 11 proteins were altered Eukaryotic translation initiation factor 5A (elF-5A), chaperone grp 75 precursor, actin-depolymerizing factor, contrapsin-like inhibitor 1 precursor, guanine deaminase, actin, peroxiredoxin 2, phosphatidylethanolamine, putative protein kinase, Keratin complex 2 and Enol protein. CONCLUSION: The roles of 11 proteins are variable. A part of these proteins have a role of cellular apoptosis, acute inflammation, and muscle contraction. It seems that these changes of proteins have an influence on bladder functions and LUTS.
Actins ; Animals ; Apoptosis ; Electrophoresis, Gel, Two-Dimensional ; Female ; Guanine Deaminase ; Humans ; Inflammation ; Mass Spectrometry ; Muscle Contraction ; Ovariectomy* ; Peptide Initiation Factors ; Peroxiredoxins ; Protein Kinases ; Proteomics ; Rats* ; Rats, Sprague-Dawley ; Urinary Bladder* ; Weights and Measures

BACKGROUND: The aim of this study was to compare the efficacy of ketorolac, paracetamol, and paracetamol plus morphine on pain relief after thyroidectomy. METHODS: Eighty patients were randomly allocated to one of the 4 groups: normal saline (group C), ketorolac 30 mg (group K), paracetamol 1 g (group P), and paracetamol 700 mg plus morphine 3 mg (group PM). Each regimen was administered intravenously (IV) 30 min. before the end of surgery. If pain was not relieved, patients received an IV bolus of pethidine hydrochloride 25 mg. Pain intensity using a visual analogue scale (VAS) was recorded at 0.5, 1, 2, 4, and 6 hr after the end of surgery. RESULTS: VAS at 0.5 and 1 hr after the end of surgery were significantly lower in group K, group P, and group PM than in group C (P < 0.05). The number of patients receiving pethidine hydrochloride at 0.5 and 1 hr after the end of surgery was significantly lower in group K, group P, and group PM than in group C (P < 0.05). There was no significant difference among the groups in the incidences of adverse events associated with study medications and patient satisfaction (P > 0.05). CONCLUSIONS: Paracetamol 1 g IV possesses a similar analgesic efficacy to ketorolac 30 mg IV after thyroidectomy. Paracetamol may represent an alternative to ketorolac for pain prevention after mildly to moderately painful surgery in situations where the use of NSAIDs is unsuitable.
Acetaminophen ; Analgesics ; Anti-Inflammatory Agents, Non-Steroidal ; Humans ; Incidence ; Ketorolac ; Meperidine ; Morphine ; Patient Satisfaction ; Thyroidectomy

PURPOSE: To evaluate the early clinical results of lumbar microdiscectomy using minimally invasive tubular retractor (METRx-MD system, Medtronic Sofamor Danek, Memphis, TN), and to validate the merits of minimally invasive spinal surgery. MATERIALS AND METHODS: From April, 2003 to April 2004 we retrospectively studied a consecutive series of 45 patients who underwent lumbar microdiscectomy using minimally invasive tubular retractor. In all cases, minimally invasive approach using the tubular retractor were performed with a 2 cm sized paramedian incision. The following data were collected: clinical outcomes, operative time, intraoperative blood loss, need for blood replacement, time needed before ambulation, length of hospital stay, and complications. The clinical outcomes were assessed by the modified MacNab criteria. RESULTS: Minimally invasive tubular microdiscectomy was performed in 45 patients over a 12-month period with an average follow-up of approximately 8 months. The clinical outcomes assessed by MacNab criteria were excellent in 33 patients (73%), good in 10 patients (22%). The average operative time was 63 minutes (range, 35 to 95 minutes). The average blood loss was 62 mL (range, 50 to 110 mL). None of the patients needed blood replacement. With the exception of 2 patients, all patients could walk at the day of surgery. The average hospital stay was 2.3 days. None of the patients had dural tear, wound problem, or other complications. CONCLUSION: Lumbar microdiscectomy using tubular retractor can offer a useful modality for the treatment of lumbar herniated disc with the merits of minimally invasive spinal surgery. Further long-term, randomized, prospective investigations are needed to fully evaluate the impact of this technique.
Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; Length of Stay ; Operative Time ; Wounds and Injuries

PURPOSE: To evaluate the clinical efficacy of balloon catheter dilatation in the treatment of esophageal achalasia. MATERIALS AND METHODS: Seven patients(three males and four females) with esopha-geal achalasia were treated with balloon catheter dilatation. Balloon catheters of variable sizes were used depending on patient's conditions. The patients were followed up over a period of 12-39months. RESULTS: Balloon catheter dilatation in esophageal achalasia was successful in all patients without esophageal perforation. All patients were relieved from dysphagia. Recurrence was not found in 5 patients on long term follow-up study, but was seen in 2 patients after 18 and 21 months, respectively. CONCLUSION: Balloon catheter dilatation was a safe and effective method in the treatment of esophageal achalasia with low recurrence rate of 29% on follow-up study.
Catheters* ; Deglutition Disorders ; Dilatation* ; Esophageal Achalasia* ; Esophageal Perforation ; Follow-Up Studies* ; Humans ; Male ; Recurrence

No abstract available.
Hematuria* ; Humans ; Mass Screening* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Hemophilia, a genetically determined disorder, can be divided into hemophilia A and hemophilia B. Hemophilia A, defined as a sex-linked recessive trait hemorrhagic disease of males characterized by a deficiency of factor VIII occurs about seven times more frequently than hemophilia B which is characterized by a deficiency of factor IX. The complications resulting from hemophilia occurs in virtually every system. This paper is concerned with a rare complication of hemophilia, iliacus hematoma with femoral neuropathy. On case of spontaneous hemorrhage of iliacus muscle with femoral neuropathy in hemophilia was decompressed through a small incision with sump drainage under cover of AHF(Anti-hemophilic factor) concentrated plasma cryoperecipitate followed AHF replacement therapy.
Drainage ; Factor IX ; Factor VIII ; Femoral Neuropathy ; Hematoma ; Hemophilia A ; Hemophilia B ; Hemorrhage ; Humans ; Male ; Plasma

Invasive carcinoma of the cervix during the pregnancy is relatively uncommon , It must be considered fetal viability, tumor control as well. If the carcinoma is diagnosed in the first or second trimester, treatment should be undertaken immediately. At the third trimester, treatment should be undertaken until the fetus is viable.
Cervix Uteri ; Female ; Fetal Viability ; Fetus ; Humans ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnancy* ; Uterine Cervical Neoplasms

Massive ovarian deema is a tate conditian. It is a benign enlargement of the ovary caused by accumulation of fluid, which is thought to result from intermittent partial toraion of the ovarian pedicle. Histologically, the ovaries were characterized by diffuse edema of medulla and inner cortex. Two cases of massive ovanan edema are reported with brief review of the literatures.
Edema* ; Female ; Ovary