No abstract available.
Staphylococcus aureus* ; Staphylococcus*

No abstract available.
Humans ; Uterine Cervical Neoplasms*

No abstract available.

We have studied the function of lymphokines on human tonsillar B cell prolifertion and differentiation. B cells were stimulated with Staphylococcus aureus Cowanl (SAC) or anti- bead. The followings showed the results of this study. 1) In B cell activation, SAC induced B cell DNA synthesis but anti-mubead did not. SAC could activate and proliferate B cells. Minimal number of B cells were required to proliferate effectively. 2) In B cell proliferation, SAC could proliferate B cell in the abscence of lymphokines. Exogenous IL-2 or IL-4 enhanced B cell proliferation. The roles of IL-2 were very important in B cell proliferation. The effect of IL-4 on the IL-2 induced B cell proliferation was inhibitory in SAC-B cells. IL-4 could enhance the proliferation of anti-mu bead activated B cells. 3) In B cell differentiation, IL-2 was a major factor to differentiate SAC activated B cells, but IL-4 did not. IL-6 had a synergistic effect on the differentiation. The results of this study showed that the different signal transduction mechanisms were involved in B cell proliferation and differentiation. The B cell resposes to lymphokine were different, and it is depend upon antigens or mitogens.
B-Lymphocytes ; Cell Differentiation ; Cell Proliferation* ; DNA ; Humans* ; Interleukin-2 ; Interleukin-4 ; Interleukin-6 ; Lymphokines ; Mitogens ; Signal Transduction ; Staphylococcus aureus

No abstract available.
Hysterectomy* ; Venous Thrombosis*

No abstract available.

A 63 Year-old-lady has had substernal chest pain on exertion for 8 years. The chest pain has been increased over the last 3 years. A continuous murmur was heard at the left second to third inercostal spaces along the left sternal border. The electrocardiogram showed the inverted T-waves in the precordial leads. The right heart catheterization revealed 5% oxygen step up between RV and PA. The right sided pressures were normal. The coronary arteriography revealed markedly tortuous vessels starting shortly after the left main stem coronary artery was normally originated. One of the large vessel was shown to be drained into the pulmonary artery. In the operation room, without using heart-lung machine this abnormally drained vessel was simply ligated at it's draining site into pulmonary artery. After the operation the patient is feeling well with little symptoms and the continuous murmur is no longer heard.
Angiography ; Arteriovenous Fistula* ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Coronary Vessels* ; Electrocardiography ; Heart-Lung Machine ; Humans ; Middle Aged* ; Oxygen ; Pulmonary Artery*

An induced hypotension is employed as a useful technique for operations on intracranial aneurysms, brain tumors and other intracranial lesions to diminish operative bleeding and to decrease brain tension. In aneurysm surgery under induced hypotension, the sac becomes softer and thus diminishes the risk of rupture when clips are applid. In 1946 Gardner used arteriotomy to lower blood pressure by decreasing the blood volume during brain tumor surgery, then gradually improved. Pharmacologically-induced hypotension soon became the cominant method of producing hypotension. Halothane and trimethaphan are the most popular drugs for this purpose. On the other hand, the risks of hypotension are obvious. These include decreased cardiac output, decreased cerebral blood flow, and low perfusion pressure exposing brain tissue to the risk of hypoxia thereby aggravating the effects of the circulatory disturbance present in the brain lesion. In this situation the blood oxygen tension in jugular-bulb and lactate content in brain tissue have been found to be reliable indices of degrees of cerebral oxygenation. Consequently, several investigators have studied the critical level of arterial blood pressure during hypotensive anesthesia and have accepted 60 mmHg of systolic pressure(40~50 mmHg of mean arterial pressure) as a clinically applicable level free from the danger of cerebral hypoxia. Furthermore, Griffiths and Gillies(1948) postulated that systolic pressure over 30 mmHg would provide adequate tissue oxygenation. However, there are only a few reports concerning the adequacy of cerebral oxygenation under such low levels of arterial blood pressure. The purpose of this study is to investigate cereral hemodynamics and metabolism during halothane-induced hypotensive anesthesia and to find any evidence of cerebral hypoxia at the levels of 60 mmHg and 30 mmHg, of systolic blood pressure. 15 adult mongrel dogs, weighing 10~13kg, were anesthetized with intravenous pentobarbital sodium. Endotracheal intubation was performed. One femoral artery was cannulated with a polyethylene tube for arterial blood sampling. The tube was connected to a Statham pressure transducer for continuous arterial blood pressure recording. The common carotid artery was exposed and a probe of square-wave electromagnetic flowmeter was placed on the vessel to record the carotid blood flow. An electrocardiogram and above two parameters were recorded simultaneously on a 4-channel polygraph. The internal jugular vein was cannulated and a catheter threaded up to the jugular-bulb for sampling of venous blood draining from the brain. The cisterna magna was punctured with an 18 gauge spinal needle to sample the cerebrospinal fluid. The experiments were divided into control phase, induction phase, hypotensive phase I, hypotensive phase II, and recovery phase. Each phase was maintained for 30 minutes. Cerebrospinal fluid, arterial venous blood were sampled at the end of each phase for analysis of gas tension and lactate content. 100% oxygen was inhaled during the induction phase. During the hypotensive phases, halothane/O2 was administered to lower the arterial blood pressure. In the hypotensive phase I and hypotensive phase II systolic pressure was maintained at 60 mmHg and 30 mmHg, respectively. In the recovery phase, halothane was discontinued and 100% oxygen only was inhaled. The results obtained are summarized as follows; 1. The carotid artery blood flow, which represents the cerebral blood flow, decreased linearly during the decline of the arterial blood pressure. At the end of each phase there was no difference in the carotid blood flow between hypotensive phase I and phase II. Cerebral vascular resistance was markedly reduced in the hypotensive phase II, which suggests cereral vasodilation. 2. Cerebral venous pO2 decreased significantly in the hypotensive phases, but the values till remained within normal limits. A marked reduction of arterial pCO2 was noted in the hypotensive phases. The values approach the lower limits of safety. 3. The most outstanding difference between hypotensive phase I and II is in the lactate content of cerebral venous blood and cerebrospinal fluid. There was a moderate increase of lactate content, and a slight reduction of cereral venous pH in hypotensive phase II, however, a significant degree of cerebral hypoxia and metabolic acidosis could be excluded. 4. Most of the changes in the cerebral metabolism and hemodynamics including arterial blood pressure, tent to return to return to normal at the end of the recovery phase. From the result of this study, it is concluded; Halothane-induced hypotensive anesthesia at 60 mmHg of systolic blood pressure(45 mmHg of possibility of mild metabolic acidosis 30 mmHg of systolic blood pressure(23 mmHg of mean arterial pressure), adequate cerebral oxygenation is maintained without difficulty.
Acidosis ; Adult ; Anesthesia* ; Aneurysm ; Animals ; Anoxia ; Arterial Pressure ; Blood Pressure ; Blood Volume ; Brain ; Brain Neoplasms ; Cardiac Output ; Carotid Arteries ; Carotid Artery, Common ; Catheters ; Cerebrospinal Fluid ; Cisterna Magna ; Dogs ; Electrocardiography ; Femoral Artery ; Flowmeters ; Halothane ; Hand ; Hemodynamics ; Hemorrhage ; Humans ; Hydrogen-Ion Concentration ; Hypotension ; Hypoxia, Brain ; Intracranial Aneurysm ; Intubation, Intratracheal ; Jugular Veins ; Lactic Acid ; Magnets ; Metabolism ; Needles ; Oxygen ; Pentobarbital ; Perfusion ; Polyethylene ; Research Personnel ; Rupture ; Transducers, Pressure ; Trimethaphan ; Vascular Resistance ; Vasodilation

Angiography has been playing important roles in diagnosis and treatment in the field of orthopaedic surgery. Conventional angiography is the most reliable and widely used method in diagnosis of peripheral arterial disease. But the clinical use of the conventional angiography has been limited by the risk of possible complications and time-consuming procedures. Radionuclide sngiography is rapidly performed, rapidly interpretable and time-saving procedure for the visualization of arterial tree prior to vascular intervention in the critically ill patient. We have analyzed and compared the 22 cases who had taken radionuclide angiography and conventional angiography simultaneously from November, 1986 to August, 1987 in Department of Orthopaedic Surgery, Hanysng University Hospital. The results were as follow 1. Radionuclide angiography is simple, non-invasive, accurste, reproducible method. It eliminstes the discomfort and morbidity of conventional angiography and can be done on an outpatient basis at a much lower cost. It is useful in the patients who may be allergic to the contrast medium. 2. In cases of arterial occlusion, radionuclide angiogrpahy is also useful in the evsluation of obstruction of major artery and can be substituted for conventionsl angiography. 3. For the purpose of evaluation of success in the cases of vascular reconstruction, radionuclide angiogrphy also demonstrate the vasculsr blood flow without any risk. 4. Although rsdionuclide angiography has limitstion in snatomic detsil, it could be psrtially substituted for conventionsl angiography in the diagnosis of vascular anomalies or tumors.
Angiography ; Arteries ; Critical Illness ; Diagnosis ; Humans ; Methods ; Outpatients ; Peripheral Arterial Disease ; Radionuclide Angiography ; Trees

BACKGROUND: Blepharospasm and apraxia of lid opening (ALO) are nonparalytic causes of involuntary eyelid closure (IEC). Recently Aramideh (1994) divided the IEC into 5 groups by electromyography (EMG) study, and reported that each group had different responses to Botulinum A toxin treatment. Objective : We looked whether clinical observation can match the EMG, and possibly predict the response to Botulinum A toxiu treatment. Method : Based on EMG study of Aramideh (1994), clinically observable characteristics of each group were defined. One of the authors reviewed the videotapes of IEC and applied the above criteria to make the clinical diagnosis. Other author blinded to the clinical information performed 2 channel EMG of levator palpebrae superioris (LP) and orbicularis oculi (00) muscles, and made the EMG diagnosis. Clinical and EMG diagnoses were matched. Results : Twenty five patients (5 men and 20 women) were included in the study. Clinically, 16 were diagnosed as group I (blepharospasm), 1 as group 111(combined blepharospasm and LP motor impersistence), 7 as group tV(combined blepharospasm and involuntary LP inhibition), and 1 as group V(involuntary LP inhibition). There were no patient in group ll (combined dystonic activities of LP and 00). On EMG study, 14 were diagnosed as group 1, 2 as group ll, 1 as group 111, 7 as group IV, and 1 as group V The mismatch between the two diagnoseis occurred between group I and tV in 4 patients, group I and ll in 2, and group I and 111 in 2. Conclusions : Clinical observations are generally correct in predicting EMG diagnosis. Holvever groups with mixed features(ll, 111, and Iv) are difficult to diagnose by clinical observation only. Usefulness of clinical and EMG diagnosis on predicting Botulinum A toxin response will need to be evaluated. Key Words : Involuntary eyelid closure, Blepharospasm, Apraxia of lid opening, Electromyography.
Apraxias ; Blepharospasm ; Botulinum Toxins, Type A ; Diagnosis* ; Electromyography ; Eyelids* ; Humans ; Male ; Muscles ; Videotape Recording