The reconstruction of soft tissue defects with open fracture around the knee joint is limited by its unique location. Free tissue transfer is hindered by the selection of the recipient vessel and problems of microsurgery. The arc of rotation, defect size, and location must be taken into consideration in the use of regional muscle transfer such as gastrocnemius. According to Mathes et al, the flap survival can be enhanced by selective division of the dominant segmental pedicles, only a part of which can normally be transposed safely on its minor segmental pedicle. Neovascularization, vascular proliferation, and dilatation have also been produced by the delay procedure using silicone sheets. The authors have used the delay procedures with wrapping of the gracilis or sartorius muscle which enabled distally-based transposition of these muscles. The method showed satisfactory outcome in resurfacing the wound around the knee joint. The indictions for this procedure were defects of moderate size and those difficult to reach with conventional muscle flaps. The flap could reach the upper one-third of the lower leg. Other merits are relative simplicity and reliability without significant extension of hospital stay. The drawbacks are the two operative procedures necessary and the risk of infection due to silicone sheets.
Dilatation ; Fractures, Open ; Knee Joint* ; Knee* ; Leg ; Length of Stay ; Microsurgery ; Muscles ; Silicones ; Surgical Procedures, Operative ; Wounds and Injuries*

Hepatitis C virus (HCV) E2 protein is known to be one of putative envelope proteins. To develop a sensitive detection method for HCV infected tissues and cells, monoclonal antibodys (MAbs) to the E2 protein of HCV were prepared from mice immunized with recombinant baculovirus-expressing E2 protein (Bac-E2). Several hybridoma clones secreting various levels of MAb were isolated and isotypes of these MAb were determined. One clone (L.2.3.3) was used for ascites production and the E2-MAb was purified and characterized. The L.2.3.3 reacted well with both Bac-E2 and E. coli expressed glutathione-5-transferase-E2 (GST-E2) fusion proteins. Using HCV patient sera, E2 envelope protein was found to be localized in the cell membrane boundary both in CHO cells and insect cells which express HCV E2 protein. Similar result was obtained when same cells were treated with the MAb L.2.3.3. These results demonstrated that Bac-E2 protein is capable of eliciting high titer antibody production in mice.
Animals ; Antibody Formation ; Ascites ; Cell Membrane ; CHO Cells ; Clone Cells ; Cricetinae ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Hybridomas ; Insects ; Mice

Ethyl alcohol is believed to inhibit the secretion of antidiuretic hormone (ADH) from the neurohypohysis, and an increase in urinary volume and reduction in the extracellular fluid volume may follow. In the case of acute alcohol intoxication, the red cells may be exposed. to the increasing level of the blood alcohol, and are in danger of being oxidized and/or hemolysed, for which the blood glutathione may exert a protective action. The aim of this study is to elucidate the acute effect of alcohol on the hematocrit, assuming that the decreased secretion of ADH will result in an increased value of the hematocrit, and also the change of oxidized glutathione (GSSG) and reduced glutatbione (GSH) of the blood following by the adminstration of alcohol. Albino rats were used throughout the experiment, and a rat was given 50% ethyl alcohol in the dose of l. 5 ml per 100 gm of body weight by the oral intubation. In all the alcohol administered cases, the rat immediately following the intubation became comatose and no voluntary effort to intake food or water was observed for at least twenty hours. The rat was sacrificed first by a strong blow on the head and the thorax was immediately opened. The blood sample for both hematocrit and glutathione was drawn from the thoracic cavity with the heart puncture if necessary after cutting the pulmonary and carotid arteries. The experiment was performed at 1,3,6,12 and 24 hours after the alcohol administration, and hematocrit was determined by the conventional hematocrit centrifuge and reader. The blood GSH was measured by the method of Ellman, and GSSG was measured by the method described by Dohan and Woodward. Controls were set which received the same amount of distilled water in place of alcohol.
Animals ; Body Weight ; Carotid Arteries ; Coma ; Ethanol ; Extracellular Fluid ; Glutathione Disulfide ; Glutathione* ; Head ; Heart ; Hematocrit* ; Intubation ; Punctures ; Rats* ; Thoracic Cavity ; Thorax ; Water

Since 1971, (for 14 years) we have run the oxygen therapy unit in the Department of Anesthesiology. During this time, unauthorized personnel have carried out the duties in the unit under the supervision of anesthesiologist. We came to realize the necessity of having educated personnel to do the work in the oxygen therapy unit. 1) Our data on oxygen therapy increases yearly because the use of respiratory care is gradually increasing. 2) The postoperative use of a respirator increases due to the increase of critical surgical patients such as those who have had open heart and cerebral aneurysm surgery. 3) Hyperbaric oxygen treatment has decreased yearly. 4) Oxygen therapy was most frequently used in patients in the first 10 years of life. 5) The cases which had oxygen treatment were: pneumonia, atelectsis, pulmonary edema, CVA, head trauma, Gullian-Barre syndrome, sepsis, asthma and tetanus in that order. 6) Seasonally, the cases were more frequent in the spiring and fall.
Anesthesiology ; Asthma ; Craniocerebral Trauma ; Heart ; Humans ; Intracranial Aneurysm ; Organization and Administration ; Oxygen* ; Pneumonia ; Pulmonary Edema ; Seasons ; Systemic Inflammatory Response Syndrome ; Tetanus ; Ventilators, Mechanical

No abstract available.
Cardiovascular Diseases* ; Echocardiography*

Epontol is well known as an ultra-short-acting intravenous anesthetic which can be used for minor surgery. This case report is to present the possibility of cardiac arrest while using Epontol in a patient with heart disease because its pharmacological action causes acute hypotension due to myocardial depression and histamine release. This 30 year old female who had a history of rheumatic fever with incomplete RBBB manifested by ECG, was admitted with vaginal bleeding and 500 mg of 5% Epontol was .administered for D % C. The patient appeared to have acute cyanosis immediately after Epontol administeration, followed by cardiac arrest. Despite cardiac resuscitation was performed adequately, the patient remained comatose for 1 year and 4 months and died of respiratory failure with sepsis.
Anesthesia, Intravenous* ; Coma ; Cyanosis ; Depression ; Electrocardiography ; Female ; Heart Arrest* ; Heart Diseases ; Histamine Release ; Humans ; Hypotension ; Minor Surgical Procedures ; Propanidid* ; Respiratory Insufficiency ; Resuscitation ; Rheumatic Fever ; Sepsis ; Uterine Hemorrhage

We evaluated median value and lower confidence limit of total serum IgE level in each age group of 1,493 pure atopic dermatitis patient without respiratory atopic diseases. The results were as follows . 1. The median value of total serum IgE level of each age group in patients with atopic dermatitis distributed from 56.5 IU/@Ll to 660It.J/C. The distributions of the median value of total serum IgE levels of total patients with atopic dermatitis, total male patients with atopic dermatitis, and total female patients with atopic dermatitis were 185 IU/C, 220 IUj'@C, and 165 IUj'C. There was no statistical significance of median value of total serum IgE level between mole patients and female patients. 2. The 95% and 99% lower confidence limit(one-sided) of total serum IgE level of ea.ch age group in patients with atopic dermatitis distributed from 32.6 IU /n4 to 287IU/v4 and from 31 IU/m0 to 202 IU4. The 95% lower confidence limit (one-sided) of total serum IgE level of total patients with atopic dermatitis, tatal male patients with atopic dermatitis, and. total female patients with atopic dermatitis were 170 II.J/m0, 185 IU,m/l, and 133 IUm/l. The 99% lower confidence limit.(one-sided) of total serum IgE level of total patient with atopic dermatitis, total male patient with atopic dermatitis, and total female patients with atopic dermatitis were 165 IU/ml, 180 IU/ml, and 125 IU/ml.
Dermatitis, Atopic* ; Female ; Humans ; Immunoglobulin E* ; Male

Conjunctival edema in surgical patients is known to be a complication resulting from various causative factors. We have observed 30 cases during genral anesthesia in the last 5 months. They were analyzed in terms of distribution of age, sex, blood loss, transfusion and appearence of edema during general anesthesia. 1) Ether is known as an anesthetic to cause it. 2) Position of patient (Trendelenburg position). 3) Mechanical disturbance of venous return such as open heart surgery and neck surgery. 4) Continuous positive pressure ventilation. 5) Reduction of plasma oncotic pressure. (l.V. fluid) 6) Circulatory overloading. 7) Miscellaneous local factors. Therefore, conjunctival edema can be avoided by prevention of the above factors.
Anesthesia ; Anesthesia, General* ; Edema* ; Ether ; Humans ; Neck ; Plasma ; Positive-Pressure Respiration ; Thoracic Surgery

In the present study, an effort was directed to assess the changes of hepatic ensymes according to the exposed in short and long surgical cases under halothane anesthesia. 60 surgical cases were studied in two different group. Halothane anesthesia was given for less than 2 hours in the first group of 30 cases and for more than 2 hours in the second group of 30 cases. The results were compared with the normal values and summarized as follows: In the first group, the changes after halothane exposure for less than 2 hours were negligible. In the second group, SGOT and SGPT were elevated significantly and the number of enzyme-elevated cases were 5~6 greater in group 1.
Alanine Transaminase* ; Anesthesia* ; Aspartate Aminotransferases* ; Halothane* ; Reference Values

Pseudolymphoma, the term clinically synonymous with pseudotumor, is one of the lymphoproliferative disease which frequently causes unilateral proptosis in adults. The clinical manifestations and the pathologic pictures may resemble that of a true neoplasm. Recently, immunologic methods such as immunofluorescent and immunohistochemical study were popularly used in the diagnosis and study of lymphoproliferative diseases. We have experienced three cases of pseudolymphoma of the orbit which were diagnosed with PAP(proxidase-antiperoxidase) stain of the immunohistochemical method.
Adult ; Diagnosis ; Exophthalmos ; Humans ; Orbit ; Pseudolymphoma*