BACKGROUND: The action of the volatile anesthetics on various organs in the body is not well known. Since Furchgott (1980) discovered endothelium derived relaxing factor (EDRF) from endothelium, many studies have been tried. Many investigators were studied about the relationship between the EDRF and the effect of the volatile anesthetics on blood vessels too. But the effect of volatile anesthetics and the site of action on the blood vessel were still controversial. In this study, we evaluated that the effect and the action site of halothane and isoflurane on isolated aortic rings of the rabbit. METHODS: Each of obtained thoracic aorta from rabbits (1.5~2.5 Kg) was divided into 3~5 mm sized rings, and a half of that were denuded. All of the aortic rings were preconstricted with phenylephrine 1.5 10-7 Mole in warm organ bath filled with modified Krebs' solution, and then LNAME (inhibitor of nitric oxide synthase, 3 10-4Mole) was administered to one group of aortic rings. MB (inhibitor of soluble guanylate cyclase, 2 10-5Mole) was administered to another one group and neither of LNAME nor MB was administered to the other group. And then isoflurane or halothane was administered (1~4%) to all of aortic rings. The polygraph recorded the changes of tension of aortic ring which was transmitted through the force transducer. RESULTS: It was proved that basal EDRF was released from endothelium by the fact that intact aortic rings were more constricted after LNAME or MB administration. The intact aortic rings were constricted in all concentration of isoflurane and both intact and denuded rings were relaxed in 4% concentration of halothane. CONCLUSION: It is concluded that isoflurane in all concentrations has an endothelium -mediated vasoconstriction and 4% halothane produced vascular relaxation directly independent of existence of the endothelium of vessel.
Anesthetics ; Aorta, Thoracic ; Arginine* ; Baths ; Blood Vessels ; Endothelium ; Endothelium-Dependent Relaxing Factors ; Guanylate Cyclase ; Halothane* ; Humans ; Isoflurane* ; Methylene Blue ; Nitric Oxide Synthase ; Phenylephrine ; Rabbits ; Relaxation ; Research Personnel ; Transducers ; Vasoconstriction

BACKGROUND: Desflurane is a new inhaled anesthetic with the lowest blood/gas partition coefficient and enflurane is one of the major anesthetics in these days. But the effect of volatile anesthetics and the site of action on the blood vessel are still controversial. Since Furchgott (1980) discovered endothelium derived relaxing factor (EDRF) from endothelium, many investigators have studied about the relationship between the EDRF and the effect of the volatile anesthetics on blood vessels. In this study, we evaluated that the effect and the action site of enflurane and desflurane on isolated aortic rings of the rabbit. METHODS: Each of obtained thoracic aorta from rabbits (1.5~2.5 kg) was divided into 4~6 mm rings, and a half of that were denuded. All of the aortic rings were preconstricted with phenylephrine 1.5 10-7 Mole in warm organ bath filled with modified Krebs' solution, and then LNAME (inhibitor of nitric oxide synthase, 3 10-4Mole) was administered to one group of aortic rings. MB (inhibitor of soluble guanylyl cyclase, 2 10-5Mole) was administered to another one group and neither of LNAME nor MB was administered to the other group. And then enflurane (1%, 2%, 3%, 4%) or desflurane (6%, 9%, 12%) was administered to all of aortic rings. The polygraph recorded the changes of tension of aortic ring which was transmitted through the force transducer. RESULTS: It was proved that basal EDRF was released from endothelium by the fact that intact aortic rings were more constricted after LNAME or MB administration. The intact aortic rings were constricted in all concentration of enflurane and both intact and denuded rings were maintained from control tension in all concentrations of desflurane. CONCLUSION: It is concluded that enflurane in all concentrations has an endothelium-mediated vasoconstriction effect and desflurane in all concentrations has no effect on isolated aortic rings of rabbit.
Anesthetics ; Aorta, Thoracic ; Arginine* ; Baths ; Blood Vessels ; Endothelium ; Endothelium-Dependent Relaxing Factors ; Enflurane* ; Guanylate Cyclase ; Humans ; Nitric Oxide Synthase ; Phenylephrine ; Rabbits ; Research Personnel ; Transducers ; Vasoconstriction

Histologic reactions of bone and soft tissue to CFRE were explored, and biomechanical properties of both CFRE plate and stainless steel plate were tested and compared. Six achilles tendons of albino rabbits were replaced with CFRE implant after artificial rupture and serial histologic examination of neotendon and histologic response in vivo were done during 8 weeks. Proximal tibia of twelve albino rabbit was selected, subjected the tibia a single osteotomy and internal fixation with CFRE plate in six cases, and stainless steel plate in the others. And then, consequent radiographic and histologic change was observed during 8 weeks. Objectives in this paper is to provide basic data of CFRE in its biomechanical and biologic response in vivo. The results were as follows :1. Foreign body reaction and fibroblast were decreased at 7-8 weeks after operation. Early formation of collagen, which is similar to that found in the normal side, was shown. So, CFRE seems to be ideal material in the aspect of tissue tolerance among biocomaptibility factors. 2. In biomechanical test, CFRE plate is lower than stainless steel plate in flexural strength and flexural modulus. This means that CFRE plate is semirigid in nature. 3. While external callus formation is marked after fixation of CFRE, internal callus for mation is marked after fixation of stainless steel plate. In CFRE plated tibia, the resorption-cavity is much smaller than stainless steel plated, and there is some formation of woven bone beneath the plate. In conclusion, CFRE is ideal material in the aspect of its biomechanical compatibility and tissue tolerance. Further efforts on production and varying design of CFRE make it to use widely in clinical application, Such as internal fixator of fracture and temporary replacement of tendon or ligament.
Achilles Tendon ; Bony Callus ; Carbon ; Collagen ; Fibroblasts ; Foreign-Body Reaction ; Internal Fixators ; Ligaments ; Osteotomy ; Rabbits ; Rupture ; Stainless Steel ; Tendons ; Tibia

OBJECTIVE: To investigate the effectiveness and safety of the laparoscopic L5-S1 fusion, its perioperative parameters and long-term outcome are compared with those of open anterior surgical approach. METHODS: Data of 54 consecutive patients who underwent anterior approach for L5-S1 fusion either by laparoscopic or open mini-anterior lumbar interbody fusion(ALIF) from 1997 to 1999 were analyzed. Among them, 47 cases were available with more than 2-years follow-up data. In all cases, carbon cage and autologous bone graft were used. RESULTS: Twenty five patients underwent a laparoscopic procedure and twenty two a open mini-ALIF. Three laparoscopic procedures were converted to open ones. For perioperative parameter, only the operative time was statistically different(p=0.001) while length of postoperative hospital stay and blood loss were not. The incidence of operative complication was three in laparoscopic group and two in open mini-ALIF group. After the follow-up of at least two years, the two groups showed no statistical difference in visual analog scale for pain, Oswestry disability index, and patient satisfaction index. The fusion rate was 91% in each group. CONCLUSION: The findings of this study suggest that laparoscopic ALIF has similar effectiveness and safety with open mini-ALIF. However, the advantage of laparoscopic approach as a minimally invasive surgery should be reconsidered because no objective additional benefit was found.
Carbon ; Follow-Up Studies ; Humans ; Incidence ; Length of Stay ; Operative Time ; Patient Satisfaction ; Surgical Procedures, Minimally Invasive ; Transplants ; Visual Analog Scale

This experiment was aimed to investigate the contractile responses of the fermoral artery to the electrical stimulation and the inhibitory effects of verapamil and papaverine on the electrical stimulation of the fermoral artery in the control (n=46) and the diabetic rabbits(n=40). Diabetic rabbits were made by and administration of alloxan (100 mg/kg) intravenously and sacrified 8 weeks later. Femoral arterial rings 3 mm in length were taken and mounted on the force-displacement transducer for the measurements of isometric tension. All experiments were done in the aerated (95% O2 with 5% CO2)biological chamber filled with Kreb's solution and the initial tension of 1.5g was applied to the rings. After 1 hour of equilibrium of the rings, the contractile responses of the electrical stimulation on the femoral arterial rings were taken without vasoactive drugs and then, under verapamil and papaverine solution. And we compared the morphologic findings of the vessels in the two groups in relation to the functional changes by transmission electron miroscopy. The results are as follows: 1. The contractile responses in the presence of verapamil or papaverine solutions to the electrical stimulation were lowed significantly in the fermoral arterial rings of the diabetic rabbits compared with that of the control rabbits (verapamil; 10M~10M: p<0.01, papaverine; 10M & 10M: p<0.01). 2. Transmission electron microphotographs showed many morphological differences of the femoral arteries between the control and the diabetic rabbits. These were irregularities of the internal elastic lamina and the hypertrophy of the cytoplasms of the smooth muscle cells. And also, there were many vacuoles in the cytoplasm of the endothelial cells, lateral to the internal elastic laminaes, and between the smooth muscle cells in the diabetic rabbit femoral artery. By this study, we found that the contractile responses of the femoral arterial rings to the electrical stimulation were decreased in the diabetic rabbits, and the vasodiatory effects of verapamil and papaverine on the electrically stimulated femoral arterial rings were also lowered in the diabetic rabbits compared with the control rabbits. These changes of the vasular responses of the diabetic vessel may be associated with morphological changes manifested by transmission electron microscopy or any other functional derangement of the vessels.
Alloxan ; Arteries ; Cytoplasm ; Electric Stimulation* ; Endothelial Cells ; Femoral Artery ; Hypertrophy ; Microscopy, Electron, Transmission ; Myocytes, Smooth Muscle ; Papaverine ; Rabbits ; Transducers ; Vacuoles ; Vasodilator Agents* ; Verapamil

No abstract available.
Diskectomy*

No abstract available.
Diskectomy*

No abstract available.
Empyema* ; Typhoid Fever* ; Urinary Bladder*

INTRODUCTION: Anterior lumbar interbody fusion with video-assistance has become an increasing popular technique to stabilize the anterior vertebral column disease. A minimally invasive technique with reduced soft tissue dissection allows low morbidity and has cosmetic and functional advantages. METHOD: Fifty patients with chronic degenerative lumbar instability [degenerative disc disease(14), degenerative spondylolisthesis(14), Grade I lytic spondylolisthesis(9) and failed back syndrome(13)] who did not respond to conservative treatment for 6 months underwent minimal invasive retroperitoneal ALIF with video-assistance from Oct. 1996 to Sep. 1997. Access to lumbar disc was achieved through retroperitoneal space with a small vertical 4 to 5 cm incision on the midline after retroperitoneal endoscopic ballooning. After performing complete discectomy under guidance of endoscopic viewing and restoring the narrowed disc height, we stabilized the spine with carbon interbody fusion cages filled with allograft bone. RESULTS: Postoperatively the patients were usually allowed to ambulate on the following day and were discharged within 4 days. There were three major complications; one ureter injury, one retroperitoneal hematoma and one osteomyelitis. With an average 10 months follow up, 42 out of 50 patients(84%) have shown relief of symptomatic back pain. And 27 out of 28 patients with degenerative disc disease and degenerative spondylolisthesis(96%) had successful results. CONCLUSIONS: Minimal invasive retroperitoneal ALIF with video-assistance offers an attractive method to significant decreased postoperative pain and hospital stay compared with conventional anterior approaches. The patients with degenerative disc disease or degenerative spondylolisthesis were more likely to have a successful outcome than those with Grade I lytic spondylolisthesis or failed back syndrome(p=0.02).
Allografts ; Back Pain ; Carbon ; Diskectomy ; Follow-Up Studies ; Hematoma ; Humans ; Length of Stay ; Osteomyelitis ; Pain, Postoperative ; Retroperitoneal Space ; Spine ; Spondylolisthesis ; Ureter

Fiber-reinforced composite(FRC) was developed as a structural component for dental appliances such as prosthodontic framework. FRC provides the potential for fabrication of a metal-free, excellent esthetic prostheses. It has demonstrated success as a result of its simple fabrication, natural colour, and marginal integrity, and fracture resistance of veneering composite resin and the FRC material. Although it has lots of merits, clinical and objective data are insufficient. The purpose of this study was to evaluate the fracture strength and marginal fitness of fiber-reinforced composite bridge in the posterior region for clinical application. Sixteen bridges of each group, Targis/Vectris(R), Sculpture-fibrekor(R)and In-Ceram, were fabricated. All specimens were cemented with Panavia 21 to the master dies. Strength evaluation was accomplished by a universal testing machine (Instron). The marginal fitness was measured by using the stereoscope (X50). The results were as follows. : 1.The fracture strength according to the materials was significantly decreaed in order In-Ceram(238.81+/-82). Targis Vectris(176.25+/-18.93), Sculpture-Fibrekor(120.35 +/-20.08) bridges. 2.FRC resin bridges were not completely fractured, while In-Ceram bridges were completely fractured in the pontic joint. 3.The marginal accuracy was significantly decreased in order Targis/Vectris (60.71micrometer), Sculpture-Fibrekor(73.10micrometer). In-Cream Bridge(83.81micrometer). 4.The fitness of occlusal sites had a lower value than the marginal sites(P<0.001), and the marginal gaps of inner site of the pontic were greater than that of outer sites of the pontic. Fiber reinforced composite bridges are new, esthetic prosthesis and can be clinically used in anterior regions and short span bridges. However, caution must be exercised when extrapolating laboratory data to the clinical situation because there are no long term clinical data regarding the overall success of the FRC.
Denture, Partial, Fixed ; Joints ; Prostheses and Implants ; Prosthodontics