No abstract available.
Foreign Bodies*

The purpose of this study is to determine whether magnetic resonance imaging(MRI) can assist in deci- sion-making in the treatment of acute posterolateral complex injuries. We reviewed retrospectively seven patients with acute posterolateral complex injury, among the 79 cases that had taken cruciate ligament recon- struction. MRI findings were then correlated with the results of examination under anesthesia or operi lateral reconstruction. Based on surgical and clinical findings, there were six complete and four partial posterolateral complex injuries. MRI was able to accurately describe the extent of injury in each case. All ten patients had concomitant anterior cruciate ligament tears, and seven were three posterior cruciate ligament injuries. The iliotibial band was avulsed from Gerdys tubercle in seven patients. In knees with complete tears, separation of the coronary ligament of the lateral meniscus was noted on MRI. A characteristic bone contusion on the anteromedial femoral condyle was present in nine patients. Popliteal tendon tearing was observed in eight cases, and biceps femoris was torn in six patients. In knee with complete tears, tears of the lateral collateral ligament complex was noted both on MRI and intraoperatively. A high-quality MRI in patients sustaining these injuries will assist the surgeon in directly applying surgical techniques in a timely fashion.
Anesthesia ; Anterior Cruciate Ligament ; Contusions ; Humans ; Knee* ; Lateral Ligament, Ankle ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Posterior Cruciate Ligament ; Retrospective Studies ; Tendons

One hundred and ninety-four consecutive patients with two hundred and one diaphyseal femur fractures were retrospectively reviewed to evaluate the frequencies, types and the results of treatments for the associated ipsilateral knee ligaments and menisci injuries from Oct. 1990 to Feb. 1997 at Eulji Medical Center. Fifteen patients had associated ipsilateral knee ligament injuries. There were eleven(73.3%) males and four(26.7%) females with an average age of 35.7(17-68) years. Thirteen(86.7%) patients were injured by traffic accident. Ten patients were followed for average of 38 months(12-73 months). There were five(33.4%) partial and two(13.3%) complete tears of anterior cruciate ligaments, three(20.0%) partial and four(26.7%) complete tears of posterior cruciate ligaments, one(6.7%) partial and four(26.7%) complete tears of medial collateral ligaments, one(6.7%) complete and three(20.0%) partial tears of lateral collateral ligaments, five(33.3%) tears of medial menisci and four(26.7%) tears of lateral menisci. There was no relationship between specific ligament damage and the cause of the injury or level of fracture. Better range of knee motion and HSS knee score was obtained when both the femur and ligament injuries were surgically managed. The invention of the MRI and the development of arthroscopic techniques have made it easy to diagnose and take care for ligament injuries. Early diagnosis and proper treatment on ruptured ligaments and tom meniscus combined with diaphyseal femur fractures seem to be important for good prognosis.
Accidents, Traffic ; Anterior Cruciate Ligament ; Collateral Ligaments ; Early Diagnosis ; Female ; Femoral Fractures* ; Femur ; Humans ; Inventions ; Knee* ; Lateral Ligament, Ankle ; Ligaments* ; Magnetic Resonance Imaging ; Male ; Menisci, Tibial ; Posterior Cruciate Ligament ; Prognosis ; Retrospective Studies

No abstract available.
Hemolytic-Uremic Syndrome*

Carbamazepine is a derivative of iminostilbene with carbamoyl group and related chemically to the tricyclic antidepressants. Carbamazepine has been introduced for treatment of trigeminal neuralgia. Recently it is used as an antiepileptic agent such as diphenylhydantoin. Antiepileptic drugs are known to affect experimentally induced cardiac arrhythmia and are now widely used clinically for treatment of ventricular tachyarrhythmias, particularly those produced by digitalis intoxication. Steiner et al. (1970) reported that carbamazepine was found to be very effective in converting ventricular tachycardia due to digitalis toxicity to normal sinus rhythm. Clinically bradycardia, complete heart block, ventricular standstill and Adams-stokes attack were reported in the course of carbamazepine treatment. The purpose of this study was to investigate the effects of carbamazepine on the ouabain-induced arrhythmia in vivo. The rabbits of either sex, weighing from 1.6 to 3.2 kg were anesthetized by urethane. After the trachea was cannulated, the rabbits were ventilated with room air using a respirator. Drugs were given into polyethylene cannula in the femoral vein. Blood pressure were recorded by physiograph via pressure tranducer connected with the cannula in the femoral artery. EKG were recorded by physiograph via electrode implanted in both fore leg and left hind leg. The results are summarized as follows 1. Arrhythmia was induced by continuous infusion of ouabain (65±8.8 µg/kg). 2. Single administration of ouabain (64 µg/kg) induced arrhythmia which was persisted for 7-8 min. 3. Ouabain induced arrhythmia was restored to normal sinus rhythm by administration of carbamazepine (the more dosage, the less frequent and the longer duration). 4. Severe bradycardia, A-V block, atrial fibrillation were seen on the EKG after injection of carbamzepine alone. By the above results, it may be concluded that carbamzepine inhibits the ouabain-induced arrhythmia by dose-dependent.
Anticonvulsants ; Antidepressive Agents, Tricyclic ; Arrhythmias, Cardiac* ; Atrial Fibrillation ; Blood Pressure ; Bradycardia ; Carbamazepine* ; Catheters ; Digitalis ; Electrocardiography ; Electrodes ; Femoral Artery ; Femoral Vein ; Heart Block ; Leg ; Ouabain ; Phenytoin ; Polyethylene ; Rabbits* ; Tachycardia ; Tachycardia, Ventricular ; Trachea ; Trigeminal Neuralgia ; Urethane ; Ventilators, Mechanical

Lithium salts are being used increasingly to treat patient with affective disorders, especially acute mania, or bipolar manic-depressive illness. For therapeutic effect the lithium content must be maintained at or above a particular level. Lithium poisoning due to overdosage may be seen occasionally, and its course is determined primarily by the rate of renal lithium elimination. A search is therefore indicated for procedures that could raise the lithium clearance. In a number of reports renal lithium excretion has been studied in relation to the excretion of water, sodium, potassium and hydrogen, but effects of sodium or water on the lithium excretion has not yet been clarified. Hence the present study was undertaken to investigate the effects of corticosteroid on the excretion of lithium ion. The female rat (Sprague-Dowley), weighing from 200 to 300g, was injected with 50mg/kg of lithium chloride intraperitoneally, and then injected with graded dosage of fludrocortisones and dexamethasone in each group. During the injected rats were incubated in metabolic cage, 24 hour urine of rats were collected. At 24 hours after injection, the rats were sacrificed with guillotine, the blood were collected. And then the concentrations of Na⁺, K⁺, Li⁺ of collected urine and serum were checked by Flame photometer. The results are summarized as follows 1. Fludrocortisone decreased the serum concentration of lithium and increased the urinary excretion of lithium. 2. In the group treated with low dose of dexamethasone (0.1 mg/kg), the serum concentration of lithium was decreased and high dose of dexamethasone (1 mg/kg) increased the urinary excretion of lithium. 3. Fludrocortisone increased the urinary [Na⁺]/[K⁺] in serum and decreased [Na⁺]/[K⁺] inurine, but opposite effects were occurred in dexamethasone. By above results, it may be concluded that corticosteroid increased the urinary excretion of lithium and decreased the serum concentration of lithium, but it seems to be there in no relationship between these effects of corticosteroid and of the renal Na⁺ or K⁺ transport.
Adrenal Cortex Hormones* ; Animals ; Bipolar Disorder ; Dexamethasone ; Female ; Fludrocortisone ; Humans ; Hydrogen ; Lithium Chloride ; Lithium* ; Mood Disorders ; Poisoning ; Potassium ; Rats ; Renal Elimination* ; Salts ; Sodium ; Water

This study was performed to investigate the effect of octreotide on the contractility of rat vas deferens. The -smooth muscle strips isolated from the prostatic portion were myographied in isolated organ bath. Electric -field stimulation (monophasic square wave, duration : 1. mSec, voltage : 50 V, frequency : 5 Hz or 30 Hz, train : 10 Sec) produced reproducible contraction. The contraction was composed of two component, first phasic component (FPC) and second tonicc component (STC).. These contractions were abolished by -tetrodotoxin (1 microM). Octreotide inhibited the field stimulation induced contractions both FPC and STC concentration- dependently. The FPC was decreased by a desentization of purinergic receptor by pretreatment of mATP, and the STC was decreased by pr,,creatment of reserpine (3 mg/kg, EP) 24 hours before experiments. Octreotide reduced the field stimulation induced contraction in the presence of mATP and of reserpinized muscle strips. The inhibitory effect of octreotide was more potent at 5 Hz than at 30 Hz. Octreotide did not affect basal ton and exogenous norepinephrine- or ATP-induced contraction. These results suggest that octreotide inhibit the contractility of the isolated rat vas deferens by inhibition of the release of neurotransmitters, both ATP and norepinephrine from adrenergic nerve terminal.
Adenosine Triphosphate ; Animals ; Baths ; Neurotransmitter Agents ; Norepinephrine ; Octreotide* ; Rats* ; Reserpine ; Vas Deferens*

GABA is an inhibitory neurotransmitter in central nervous system and produce sedative, antianxiety and muscle relaxing effects via GABA(A) receptor or GABA(B) receptor. Recently it is known that GABA is widely distributed throughout peripheral organs and may play a physiological role in certain organ. The vas deferens is innervated by species-difference. These study, therefore, was performed to investigate the mode and the mechanism of action of GABA on the norepinephrine-, ATP- and electric stimulation-induced contraction of vas deferens of rat. Sprague-Dawley rats were sacrificed by cervical dislocation. The smooth muscle strips were isolated from the prostatic portion and were mounted in the isolated muscle bath. PSS in the bath was aerated with 95/5%-O₂/CO₂ at 33℃. Muscle tensions were measured by isometric tension transducer and were recorded by biological recording system. 1. GABA, muscimol, a GABA(A) agonist, and baclofen, a GABA(B) agonist inhibited the electric field stimulation (EFS, 0.2Hz, 1mSec, 80V, monophasic square wave)-induced contraction with a rank order of potency of GABA greater than baclofen greater than muscimol. 2. The inhibitory effect of GABA was antagonized by delta aminovaleric acid (DAVA), a GABA(B) antagonist, but not by bicuculline, a GABA(A) intagonist. 3. The inhibitory effect of baclofen was antagonized by DAVA, but the effect of muscimol was not antagonized by bicuculline. 4. Exogenous norepinephrine (NE) and ATP contracted muscle strip concentration dependently, but the effect of acetylcholine was negligible and GABA did not affect the NE-and ATP-induced contractions. 5. GABA, baclofen and muscimol did not affect basal tone, and GABA did not affect the NE-and ATP-induced contractions. 6. EFS-induced contraction was inclucling 2 distinctable components. The first phasic component was inhibited by beta gamma-methylene ATP (mATP), a desensitizing agent of APT receptor and the second tonic component was reduced by pretreatment of reserpine (3 mg/Kg, IP). 7. GABA inhibited the EFS-induced contraction of reserpinized strips, but not the mATP-treated strips. These results suggest that in the prostatic portion of the rat vas deferens, adrenergic and purinergic neurotransmissions are exist, and GABA inhibits the release of ATP via presynaptic GABA(B) receptor on the excitatory neurons.
Acetylcholine ; Adenosine Triphosphate ; Animals ; Baclofen ; Baths ; Bicuculline ; Central Nervous System ; Dislocations ; gamma-Aminobutyric Acid ; Muscimol ; Muscle, Smooth ; Neurons ; Neurotransmitter Agents ; Norepinephrine ; Rats* ; Rats, Sprague-Dawley ; Receptors, GABA-A ; Reserpine ; Transducers ; Vas Deferens*

BACKGROUND AND OBJECTIVES: Perfluorocarbon exposed sonicated dextrose albumin (PESDA) microbubbles has been suggested to facilitate thrombus disruption under the transcutaneous ultrasound (US). Thus, we investigated whether such a noninvasive approach could augment thrombolytic effect of fibrinolytic agent in an experimental thrombotic model. MATERIALS AND METHODS: Thrombus formation was induced with electrical injury in the rabbit iliofemoral arteries (n=20): Thrombus occlusion was documented by angiography in all arteries. In the control group, only tissue plasminogen activator (t-PA, 3 mg/kg) was administered intrav-enously in five rabbits. In the Group 1 (n=9), injured arteries were exposed to transcutaneous US (20 kHz, 30 W/cm2, continuous mode) with t-PA (3 mg/kg). In the Group 2 (n=6), the same treatment was given while administering PESDA continuously (10 ml/min, intravenous). Angiographic results were evaluated at 10 minute interval for 1 hour respectively. RESULTS: In the control group, two of five iliofemoral arteries (40.0%) were recanalized and one of nine iliofemoral arteries (11.1%) was recanalized in Group 1. In contrast, four of six iliofemoral arteries (66.7%) were recanalized angiographically in Group 2 (p=0.392 vs. control group: p=0.047 vs. Group 1). However, late reocclusion occurred in all iliofemoral arteries of Group 2. CONCLUSION: Although PESDA with transcutaneous US significantly enhanced initial angiographic patency rate of t-PA, it was associated with high rate of reocclusion. Further studies will be necessary for clinical application of this noninvasive method in acute arterial occlusion.
Angiography ; Arteries ; Glucose* ; Microbubbles ; Rabbits ; Thrombolytic Therapy* ; Thrombosis ; Tissue Plasminogen Activator ; Ultrasonography*

This study was aimed at investigation of the stimulatory innervations on the rat urinary bladder. Detrusor muscle strips of 15 mm long were suspended in isolated muscle chambers containing 1 ml of PSS maintained at 37℃ and aerated with 95% O²/5% Co². Isometric myography was performed, and the results were as followings: Muscle strips showed “on-contraction” by electric field stimulation (EFS) frequency-dependently. The EFS-induced contraction was not affected by hexamethonium, a ganglion blocker, but abolished by tetrodotoxin, a nerve conduction blocker. Physostigmine, a cholinesterase inhibitor enhanced the EFS-induced contraction which was inhibited by hemicholinium, an inhibitor of choline uptake at the cholinergic nerve ending. Such an EFS-induced contraction was antagonized by atropine only partially, and the atropine-resistant portion was completely abolished by the desensitization of purinergic receptors by prolonged incubating of the strips in the presence of high concentration of ATP. Bethanechol, a cholinergic agonist, elicited concentration-dependent contraction. Adenosine triphosphate (ATP), a purinergic agonist, induced a weak but concentration-dependent contraction of short duration. Bethanechol-induced contraction was not affected by ATP-desensitization, and ATP-induced contraction was not affected by tetrodotoxin. These results suggest that there are at least two main stimulatory components of innervations in the detrusor muscle, cholinergic muscarinic and purinergic; and those receptors are independent each other.
Adenosine Triphosphate ; Animals ; Atropine ; Bethanechol ; Choline ; Cholinergic Agonists ; Cholinesterases ; Ganglion Cysts ; Hemicholinium 3 ; Hexamethonium ; Myography ; Nerve Endings ; Neural Conduction ; Physostigmine ; Rats* ; Receptors, Purinergic ; Tetrodotoxin ; Urinary Bladder*