Excitatory amino acids have been implicated as one of the important putative cellular toxins in ischemic brain. Ketamine antagonizes the excitotoxic action of excitatory amino acids in the central nervous system. The present study was undertaken to determine whether ketamine anesthesia protect the formation of brain edema in the model of focal cerebral ischemia in rats. Forty adult male Sprague-Dawley rats weighing between 300gm and 400gm were used in this study. The animals were anesthetized with either halothane or ketamine, and then right middle cerebral artery occlusion were performed. After 4 hours of ischemia, the brain water and ion contents(Na+ and K+) were determined in the central, intermediate, and outer zones of each cortical mantle. In both halothane and ketamine anesthetized groups, there were significant brain edema in the ischemic central and intermediate zones. Ionic shifts were also observed in the ischemic central and intermediate zones to approximately same extent as the brain water content in both groups. However, there were no significant differences of brain edema between the two groups in the corresponding ischemic zones. These results suggest that ketamine anesthesia does not have significant protective effect on the formation of brain edema during the early stages of permanent incomplete cerebral ischemia.
Adult ; Anesthesia* ; Animals ; Brain Edema* ; Brain Ischemia ; Brain* ; Central Nervous System ; Excitatory Amino Acids ; Halothane ; Humans ; Infarction, Middle Cerebral Artery ; Ischemia* ; Ketamine* ; Male ; Rats* ; Rats, Sprague-Dawley

There are many procedures for treatment of injuries of acromioclavicular separation but there are still con- roversies concerning the best management of these injuries. With this in mind, we treated surgically 22 cases of acromioclavicular separation of which 3 cases were old type 2 and 19 cases were type 3 in the department of orthopaedic surgery, Eul Ji General Hospital from March 1977 to darch 1982. The results were as follows: l. Of 22 cases, 21 cases (95.5%) were male with peak incidence in the 3rd and 5th decades (90.9%). 2. The most common causes of the injuries were traffic accidents (63.6%) and followed by falling from height (22.7%). 3. The diagnosis in type 2 and type 3 injuries is based on the clavicular displacement and instability at the acromioclavicular joint. 4. Operative treatment consists of Weaver and Dunn method (54.5%), modified Phemister method (18.2%), Neviaser method (13.0%), Stewart method (9.1%) and modified Henry method (4.5%). 5. The operative procedure in old type 2 and typc 3 injuries is good treatment of acromioclavicular separation.
Accidental Falls ; Accidents, Traffic ; Acromioclavicular Joint ; Diagnosis ; Hospitals, General ; Humans ; Incidence ; Male ; Methods ; Surgical Procedures, Operative

No abstract available.

From February 1987 to December 1990, 654 patients with renal stones completed the multiple ESWL monotherapies using the EDAP-LT01 piezoelectric lithotriptor. The location of stones was calyx in 452 patients. pelvis in 1O8. calyx and pelvis in 94 and the stone size ranged from 0.6 to 4.8cm (mean 1.9cm). The number of treatment sessions was 2 to 19 sessions (mean 4.7) with 72.2% of re-treatment rate. In accordance with increment of stone size, number of treatment increased but success rate decreased; 2.8 sessions. 96.2% for 0.6-<1 cm. 4.4, 93.2% for 1-<2 cm, 5.5. 87.7% for 2-<3 cm. 6.3, 65.5% for 3-<4 cm and 6.4, 58.8% for stones larger than 4 cm. Supposing 654 patients had been completed by 5 sessions only. 67.9% of success rate would have been expected. But. 88.4% (578,654) of success rate was obtained by multiple treatment up to 19 sessions, adding 20.5%. Auxiliary ureteral manipulations were required in 88 (13.5%) patients and there were no significant complications. Therefore. multiple ESWL monotherapy is considered to be a efficient. safe procedure as the first applicable method for treatment of larger renal stones and to extend the indications of ESWL for renal stone.
Humans ; Pelvis ; Ureter

In the early stage of the development of ischemic brain injury, oxygen free radical-mediated lipid peroxidation is suspected to play an important role. U74389G is considered as one of the effective scavengers of free radicals and inhibitors of lipid peroxidation. However, the cytoprotective effect of U74389G in rodent models of neocortical infarction still remains controversial. Forty-four adult Sprague-Dawley rats weighing 250-300gm were subjected to permanent or transient middle cerebral artery occlusion(MCAO) using modified Longa's method while anesthetized with ketamine and xylazine. In the permanent MCAO groups, the animals were subjected to 4-hours of occlusion and were treated with vehicle(control, n=9), 3mg/kg U74389G(low-dose treatment, n=9) or 7mg/kg U74389G(high-dose treatment, n=10) intravenously at the time of occlusion and then half of the initial dose was administered 30 minuites after occlusion respectively. In the transient MCAO groups, the animals were subjected to 0.5 hours of occlusion and 3.5-hours of reperfusion and were treated with vehicle(control, n=8) or 3mg/kg U74389G(treatment, n=8) intravenously at the time of occlusion and then half of the initial dose was administered at the time of reperfusion respectively. Four hours after occlusion neurological evaluation was performed and then the animals were sacrificed immediately to determine brain water content. In the rats of permanent MCAO, treatment with both low and high-dose U74389G did not protect them against neurological deficit;however, treatment with high-dose U74389G was found to reduce brain edema in the ischemic core(19%, p<0.05) and intermediate regions(23%, p<0.05). In the rats of transient MCAO, treatment with U74389G was found to protect them against neurological deficit(p<0.05) and reduce brain edema in the ischemic core region(58%, p<0.05). These results suggest that free radical-mediated lipid peroxidation plays a significant role in focal ischemic reperfusion brain injury and that 21-aminosteroids might have the potential to be a useful supplementary drug as a cerebral protective agent for the thrombolytic therapy of acute cerebral infarction.
Adult ; Animals ; Brain Edema* ; Brain Injuries ; Brain Ischemia ; Brain* ; Cerebral Infarction ; Free Radicals ; Humans ; Infarction ; Ischemia* ; Ketamine ; Lipid Peroxidation ; Middle Cerebral Artery ; Oxygen ; Rats* ; Rats, Sprague-Dawley ; Reperfusion ; Rodentia ; Thrombolytic Therapy ; Water ; Xylazine

With 80 cases of impotent patients (30 psychogenic, 50 organic : 39 vasculogenic, 2 neurogenic, 5 vasculogenic + neurogenic, 4 undetermined). we compared the penile rigidity and the change of penile circumference between the visual stimulated erection (VSE) and nocturnal penile erection (NPE) by RigiScan. The results were obtained as follows. 1. In psychogenic impotent patients, the maximal degree of penile rigidity of the basal and tip portions were similar in 21 NPE (70.0%) and 22 VSE (73.3%), and 6 VSE of above showed the rigidity below 10%. All 9 NPE (100%) and 5 VSE (62.5%), out of 9 NPE and 8 VSE dissociated cases, were more higher degree of rigidity in base than that of tip. 2. In organic impotent patients, the maximal degree of penile rigidity of the basal and tip portions were similar in 29 NPE (58.0%) and 39 VSE (78.0%), and 10 NPE (34.5%) and 22 VSE (56.4 %) of above showed the rigidity below 40%. Among the remainders 21 NPE and 11 VSE, the cases who represented dissociation, 18 NPE (85.7%) and 9 VSE (81.8%), the majority, were more higher degree of rigidity in base than that in tip. 3. There were 29 psychogenic (96.7%) and 30 organic (60.0%) impotent patients in NPE, and 7 psychogenic (23.3%) and 5 organic (10.0%) in VSE, who represented over 40% of rigidity more than 5 minutes both in tip and base of penis. 4. Among the all 80 cases, the changes in penile circumferences of the basal and tip portions were similar in 41 NPE (51.3%) and 39 VSE (48.8%), and in remainders, 26 NPE (66.7%) and 34 VSE (82.9%) showed more changes in base than tip. Therefore, we concluded that NPE is more significant than VSE for the diagnosis and evaluating the degree of organic impotence because the rigidity of NPE were more higher than VSE both in psychogenic and organic impotent patients. In the other hand, however, if VSE represents sufficient rigidity, enough rigidity will be expected in NPE, so VSE is useful screening test before NPE.
Diagnosis ; Erectile Dysfunction ; Hand ; Humans ; Male ; Mass Screening ; Penile Erection* ; Penis

Xanthoma tendinosum is a hereditary lipid storage disease marked by formation of papules or nodules in the tendon, especially the extensor tendon of the hand and feet and the Achilles tendon. Xanthoma of the Achilles tendon is a rather rare, interesting orthopaedic condition that has important ramification in internal medicine and dermatology because the lesion is associated with a specific disturbance of lipid metabolism with elevated blood cholesterol level. Author present a case of bilaterally involved Achilles tendon Xanthoma. We performed subtotal resection with gastrocnemius fascial transfer on one side and total resection with peroneus brevis tendon transfer on the other side.
Achilles Tendon ; Cholesterol ; Dermatology ; Foot ; Hand ; Internal Medicine ; Lipid Metabolism ; Tendon Transfer ; Tendons ; Xanthomatosis

No abstract available.

OBJECTIVE: The purposes of this study are to compare imaging features with operative findings and to determine significance of imaging studies for early detection of craniosynostosis(CS). METHODS: Plain radiograph of skull and three-dimensional(3D) CT reconstruction were analyzed in 10 consecutive patients with CS to assess the presence and the extent of synostosis. The radiological findings were investigated and compared with operative findings. RESULTS: The locations of lesion were coronal suture in 6, sagittal suture in 3 and multiple sutures in one patient, and the age ranged 1 to 53 months(mean age: 17.4 months). Reconstructive procedures with or without advancement of supraorbital rim were performed in coronal CS patients and PI-procedures or synostectomy were done in sagittal CS patients. Radi-ological abnormalities such as sutural indistinctness or sclerosis, bony ridge, bossing and other bony deformities were nearly consistent with surgical findings. CONCLUSION: The interpretation of imaging study are very important for early detection of craniosynostosis, especially, the plain radiographs of skull. Also 3D CT imaging is helpful in diagnosis and surgical planing of craniosynostosis. There are no significant differences between imaging features and operative findings in CS patients.
Congenital Abnormalities ; Craniosynostoses* ; Diagnosis ; Humans ; Sclerosis ; Skull ; Sutures ; Synostosis

A total 400 patients underwent 676 treatments with E.D.A.P.-LTOI extracorporeal shock wave lithotripsy for urinary tract stones between February 25 and August 18, 1987. The results were obtained as follows; 1. sex ratio was about 3: 1, 292(73.0 %) in male and 108(27.0 %) in female patients. The average patient age was 43.9 years, with a range of 2 to 85 years. The fifth decade(30.5 %) was most followed by the forth decade (26.0 %) and sixth decade (20.7 %). 2. Treated stone locations were kidney in 286 (71.5 %);calyx in 187 (46.8%) and renal pelvis in 98 (24.5 %) and ureter in 144 (28.5 %); upper ureter in 71 (17.8%) and lower ureter 43(10.7 %). There were multiple renal stone in 83 (20.7 %), bilateral renal stone in 22(5.5 %), bilateral renal stone in 22 (5.5 %), bilateral ureteral stone in 3 (0.7 %) and unilateral renal and ureteral stones in 23 (5.8 %). The average stone size was 1.6 cm, with a range of 0.6 to 4.8 cm. 3. The average numbers of treatment were 1.4 sessions and the average treatment time was 13.7 minutes, with a range of 12 to 78 minutes. Of the patients, 81 (20.2 %) were complained severe pain but treatment interruption or anesthesia were not required. 4. The success rate of treatment-ended patients were 97.8 % in 0.6~1.0cm(137 cases), 89.2% in 1.0~2.0 cm (93 cases) and 89.2 % in 2.0~3.0 cm (37 cases). Therefore, the total average success rate was 93.6 %. 5. The method of pre-ESWL additional manipulation was used a ureteral stone `push up` in 12 (3.0 %). The post-ESWL additional measures were made in 10 (2.5%); ureteral manipulation in 8 cases and lithotomy in 2 cases. The causes of failed ESWL (21 cases) were stone components in 8, impacted stone in 8, incomplete stone localization in 4 and infundibular stricture in 1. 6. ESWL-complications were required admission and medical management in 18(4.5 %); colic in 12 (3.0 %), acute urinary retention in 2 (0.5 %) and subscapular hematoma in 1(0.3% ), Therefore, we confirmed that E.D.A.P.-LTOI ESWL is a safe and effective method for the treatment of urinary tract stones.
Anesthesia ; Colic ; Constriction, Pathologic ; Female ; Hematoma ; Humans ; Kidney ; Kidney Pelvis ; Lithotripsy ; Male ; Sex Ratio ; Shock* ; Ureter ; Urinary Calculi ; Urinary Retention