In this study, the glycogen depletion and repletion of 4 hind limb skeletal muscles which are composed of different type of muscle fibers were investigated in the streptozotocin induced diabetic rats. At sixth day after intraperitoneal injection of streptozotocin (65mg/kg, BW), the plasma insulin level was decreased to 28.2 ±4.16u U/ml comparing with the level of 49.3 ±9.41 in control rats, And it showed approximatly 300% increment of the level of blood glucose concentration in the sedentary diabetic rats. The soleus (slow oxidative), rad gastrocnemius (fast oxydtive glycolytic), extensor digitorum longus (fast oxidative glycolytic and fast glycolytic mixed), and white gastrocnemius (fast gltycolytic) were subjected in this study. The decreased amount of glycogen in the muscles by 3 minutes treadmill running in disbetic rats was larger than that of control rats. The largest amount of depletion was observed in the soleus in diabetic rats. The repleted amount of muscle glycogen was measured at 2 hours after glucose ingestion (25% glucose sol., 2ml/10gm BW). In the control rats, the highest amount of glycogen was repleted in the soleus, but lowest in white gastrocnemius. The repleted amount of glycogen in soleus, red gastrocnemius, and extensor digitorum longus was lower in the muscles of diabetic rats than in control rats, but no difference was observed in white gastroenemius muscles. These data suggest that glycogen synthetic activities of all of muscles except the muscles which are composed of fast glycolytic fiber, were stimulated by insulin.
Animals ; Blood Glucose ; Eating ; Extremities ; Glucose ; Glycogen ; Injections, Intraperitoneal ; Insulin ; Muscle Fibers, Skeletal ; Muscle, Skeletal ; Muscles ; Plasma ; Rats ; Running ; Streptozocin

Lidocaline if frequently administered as a component of an anesthetic : for local or regional nerve blocks, to mitigate the autonomic response to laryngoscopy and tracheal intubation, to suppress the cough reflex, and for antiarrythmic therapy. Diazepam dectease the potential central nervous system (CNS) toxicity of local anesthetic agents but -may modify the sitmulant action of lidocaine in addition to their own cardiovascular depressant. The potential cardiovascular toxicity of local anesthetics may be enhanced by the concomitant administration of diazepam. This study was designed to investigate the effects of lidocaine dose and pretreated diazepam to cardiovascular system and plasma concentration of lidocaine. Lidocaine in 100 mcg/kg/min, 200 mcg/kg/min, and 300 mcg/kg/min was given by sequential infusion to dogs anesthetized with halothane-nitrous oxide (Group I). And in group II, after diazepam pretreatment, lidocaine was infused by same way when lidocaine was administered in 100 mcg/kg/min, the low plasma levels (3.97+/-0.22-4.48+/-0.36 mcg/ml) caused a little reduction in cardiovascular hemodynamics. As administered in 200 mcg/kg/min, 300 mcg/kg/min, the higher plasma levels (7.50+/-0.66-11.83+/-0.59 mcg/ml) reduced mean arterial pressure (MAP), cardiac index (CI), stroke index (SI), left ventricular stroke work index (LVSWI), and right ventricular stroke work index (PVSWI) and incresed pulmonary artery wedge pressure (PAWP), central venous pressure (CVP), systemic vascular resistance index (SVRI), but was assciated with little changes of heart rate (HR), mean pulmonary artery pressure (MPAP), and pulmonary vascular resistance index (PVM). When lidocaine with pretreated diazepam was administered in 100 mcg/kg/min, the low plasma level, the lower level than when only lidocaine administered. reduced MAP, but was not changed other cardiovascular hemodynamics. While lidocaine was infused in 200 mcg/kg/min, 300 mcg/kg/min in dogs pretreated diazepam, the higher plasma level (7.64+/-0.79-13.79+/-0.82 mcg/ml) was maintained and was associated with reduced CI, SI, LVSWI and incresed PAWP, CVP, SVRI but was a little changes of HR, MPAP, PVRI. After CaCl2 administeration, CI, SI, SVRI, LVSWI was recovered but PAWP, UP was rather incresed than recovered. The foregoing results demonstrate that pretreated diazepam imposes no additional burden on cardiovascular system when a infusion of large dose of lidocaine is given to dogs anesthetized with halothanenitrous oxide. But caution may be advised if the addition of lidocaine is indicated in subjects who have impared autonomic nervous system and who are in hypercarbic, hypoxic, or acidotic states.
Anesthetics ; Anesthetics, Local ; Animals ; Arterial Pressure ; Autonomic Nervous System ; Cardiovascular System* ; Central Nervous System ; Central Venous Pressure ; Cough ; Diazepam* ; Dogs* ; Heart Rate ; Hemodynamics ; Intubation ; Laryngoscopy ; Lidocaine* ; Nerve Block ; Plasma* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Reflex ; Stroke ; Vascular Resistance

PURPOSE: To evaluate the effect of the lateral tarsal strip for the correction of the paralytic and involutional ectropion in Sorokdo leprosy patients. METHODS: Lateral tarsal strip operations were performed in 23 Sorokdo leprosy patients with recurrent corneal erosion and exposure keratopathy due to ectropion. Preoperative and postoperative sclera show and lagophthalmos were measured with a slit lamp, and anterior segment findings were taken at 1 week, 2 weeks and last follow up after the surgery. Postoperative subjective functional improvements were assessed at the last follow up. RESULTS: There was significant reductions between preoperative and postoperative measurements for scleral show (from 2.19 +/- 0.22 mm to 0.37 +/- 0.11 mm) and lagophthalmos (from 4.51 +/- 0.38 mm to 2.07 +/- 0.24 mm) (p<0.05). Ocular irritation symptoms including pain and tearing, and cosmetic satisfaction significantly improved after the surgery. CONCLUSIONS: Lateral tarsal strip operation is an effective surgical option in the treatment of paralytic and involutional ectropion in leprosy patients.
Cosmetics ; Ectropion ; Follow-Up Studies ; Humans ; Leprosy ; Sclera

PURPOSE: To evaluate the visual outcomes and operative complications following cataract surgery in Sorokdo leprosy patients. METHODS: Forty three eyes of 35 leprosy patients with cataract underwent phacoemulsification and posterior chamber intraocular lens implantation surgeries. Eyes with small pupil and insufficient pupildilatation were treated with iris retractor and iris sphincterotmy. RESULTS: The mean age of patients was 71.0 +/- 8.2 years and the mean follow up was 4.5 +/- 2.0 months. The mean visual acuity significantly increased from 0.34 +/- 0.23 to 0.73 +/- 0.21 (p<0.05). Sixteen eyes (38%) gain 5 or more lines and 35 eyes (83%) gain 2 or more lines in corrected visual acuity. Common intraoperative events were 8 (19%) iris retractor use and 6 (14%) posterior capsular tear. CONCLUSIONS: Phacoemulsification and posterior chamber intraocular lens implantation surgeries in aged Sorokdo Hansen patients were safe and efficient to improve visual quality and life expectations.
Aged ; Cataract ; Eye ; Follow-Up Studies ; Humans ; Iris ; Lens Implantation, Intraocular ; Leprosy ; Miosis ; Phacoemulsification ; Visual Acuity

The epidural space is located along the entire spinal column hetween the dural mater and the external dural (periosteal) layer. It contains fat, connective tissue and numerous vessels, primarily veins. It is known that epidural pressure is negative. Negative intrathoracic pressure is thus transfered via the paravertebral spaces to the thoracic epidural spaces and to a diminishing extent to the cervical and lumbar regions. The spread of the anesthetic solution within the epidural spacea is variable according to the patient's physical characteristics such as age, arteriosclerosis according to the patients physical character-sitics such as age, arteriosclerosis, pregnancy, venous circulation and extradural fat. Other factors are under the direct control of the anesthesiologist such as positioning the patient, choosing the site of epidural puncture, orientation of the needle bevel and determining the speed of injection, volume and concentration of anesthetic solution. The epidural pressure (initial negative pr flexion pr., pr. after 10ml lidocaine injection) was measured at the lumbar 3-4 interspace by the hanging drop method. The results were summarized as follows: 1) The negative pressure was meassured in 70 cases and was observed in 95.7 percent. The lowest value was -21 cm. of water in one case and no negative pressures were observed in 2 cases. 2) The pressures after 10 ml injection exhibited three successive components: the peak, the descent and the residual values which were scattered from the injection and were observed more frequently in patients under the age of 50. A slower rate of descent and higher residual pressures were found in older patients. 3) The relationship between height, weight and epidural pressure was not observed. 4) In older patients it was observed that epidural pressures were pulsated along with the heart beats and were moved up and down with the respiratory movement.
Arteriosclerosis ; Connective Tissue ; Epidural Space ; Heart ; Humans ; Lidocaine ; Lumbosacral Region ; Needles ; Pregnancy ; Punctures ; Spine ; Veins ; Water

PURPOSE: To report a case of retrocorneal membrane effectively treated with focal argon laser photocoagulation combined with subconjunctival and intravitreal bevacizumab injections. CASE SUMMARY: A 69-year-old female presented with persistent ocular pain and decreased visual acuity of the right eye following a complicated extracapsular cataract extraction performed nine months earliet. On examination, there was a neovascular retrocorneal membrane covering the superior one-third of the cornea with a sutured wound along the limbus. Following unresponsive conservative treatment, we performed focal argon laser photocoagulation followed by subconjunctival and intravitreal bevacizumab injections (1.25 mg). Two weeks later, markedly regressed neovascularization was noted. Additional argon laser photocoagulation, subconjunctival and intravitreal bavacizumab were performed six weeks later. Four months after the last treatment, the neovascular component substantially decreased and fibrous scar tissue replaced the neovascularization. The retrocorneal membrane showed no progression.
Aged ; Antibodies, Monoclonal, Humanized ; Argon ; Cataract Extraction ; Cicatrix ; Cornea ; Eye ; Female ; Humans ; Light Coagulation ; Membranes ; Visual Acuity ; Bevacizumab

PURPOSE: We prospectively conducted this study to evaluate the effect of laser in-situ keratomileusis (LASIK) on axial length because axial length is an important varible for IOL power calculation. METHODS: One hundred three eyes of fifty two myopic patients had measurements of axial length, ultrasonic central pachymetric readings and otherwise preoperatively and 3 months after LASIK. RESULTS: The axial length and central corneal thickness were reduced statistically significant 3 months after LASIK by 66+/-0.28 micrometer and 57+/-23 micrometer respectively (P<0.05). IOL power is about 15.8+/-3.25 diopter preoperatively and 15.9+/-3.21 diopter postoperatively. The mean difference is -0.13 diopter.(p value>0.05) CONCLUSIONS: But the reduction of axial length after LASIK is so small that very small influence is expected on IOL power calculation for the patient who had previous LASIK. So when preoperative IOL power calculation is done using historical method, post-LASIK axial length can be replaced for pre-LASIK axial length to calculate proper IOL power for cataract surgery.
Cataract ; Humans ; Keratomileusis, Laser In Situ ; Prospective Studies ; Reading ; Ultrasonics

Hydroxyethyl starch (HES) solutions are synthetic non-protein colloid solutions used to treat hypovolemia. However, their use is not free from the risk of allergic reactions. A 42-year-old male was scheduled to undergo aortic-iliac-femoral bypass surgery for the treatment of arteriosclerosis obliterans. He had no history of allergy. Two hours after the start of surgery, and within minutes after HES administration, facial erythema, hypotension and bronchospasm developed. HES infusion was discontinued under the estimation of anaphylaxis. The patient received phenylephrine, ephedrine, diphenhydramine and hydrocortisone with hydration. After restoration of vital signs, surgery was performed without complications.
Adult ; Anaphylaxis ; Arteriosclerosis Obliterans ; Bronchial Spasm ; Colloids ; Diphenhydramine ; Ephedrine ; Erythema ; Hetastarch ; Humans ; Hydrocortisone ; Hypersensitivity ; Hypotension ; Hypovolemia ; Male ; Phenylephrine ; Vital Signs

BACKGROUND: Propofol is the most commonly using intravenous hypnotic for the induction and maintenance of general anesthesia. However, pain on propofol injection is a well known adverse event. Currently, acute and chronic pain can be controlled by utilizing the "gate control" theory. METHODS: Patients were randomized to receive lidocaine (0.5 mg/kg; Group L), touch on IV injection site (Group T), combination lidocaine (0.5 mg/kg) and touch on IV injection site (Group B), or normal saline (Group S) with venous occlusion for 1 minute, followed by administration of propofol (0.5 mg/kg) into the largest dorsal vein of the hand. Immediately after administering propofol, an investigator blinded to the group assignments asked the patient about pain at the injection site and assessed pain intensity using a 4-point verbal rating scale (0 = none, 1 = mild, 2 = moderate, 3 = severe). RESULTS: A significant decrease in the incidence of pain on propofol injection was achieved in group L (37%) and group B (23%) compared to either group T (80%) and group S (83%) (P < 0.001). But, the incidence of moderate and severe pain was significantly lower in group L (7%), group T (20%) and group B (0%) when compared to group S (53%) (P < 0.05). CONCLUSIONS: Light touch and rubbing reduced pain, although while, they did not reduce the incidence of pain, they reduced the intensity of pain. This method might be considered as an alternative to other treatments but may be contraindicated for use with other drugs.
Anesthesia, General ; Chronic Pain ; Hand ; Humans ; Incidence ; Lidocaine ; Light ; Propofol ; Research Personnel ; Veins

A rotator cuff tear causes shoulder pain and limits movement of the shoulder joint. A chronic degenerative change or impingement is the reason for a rotator cuff tear. Diagnosis is made based on medical history and, physical and radiological examinations. Other causes of shoulder pain include calcific tendinitis, degenerative arthropathy, joint dislocation, fracture, and primary or metastatic neoplasm. However, metastatic cancer in the shoulder joint is difficult to diagnosis. We experienced a case in which a 46-year-old female patient complained of left shoulder pain and limited joint mobility, and these symptoms were due to metastatic breast cancer in the shoulder.
Breast ; Breast Neoplasms ; Dislocations ; Female ; Humans ; Joints ; Middle Aged ; Neoplasm Metastasis ; Rotator Cuff ; Shoulder ; Shoulder Joint ; Shoulder Pain ; Tendinopathy