No abstract available.
Snake Bites* ; Snakes*

Intrinsic plus deformity, which results in severe functional impairment of the hand, is caused by contracture of intrinsic muscles. This deformity can be resulted from many causes such as ischemic damage, spasm of intrinsic muscles, thermal injury, and so on. The surgical release of tightened intrinsic muscles, may be the only solution to make usable hand, especially for severe cases. Sixty five digits in 22 patients who were operated on from 1982 to 1992, were evaluated retrospectively, to analyse the effects of surgery for intrinsic plus hand. Among 65 digits, 13 were thumbs and 52 fingers. The mean age of the patients was 26 years and 8 months and 17 cases were males and 6 females. The causes were ischemic damage by laceration or crushing injuries in 11 patients, compartment syndrome in 5, cerebral palsy in 5, and burn in one. Involved digits were thumb only in 4 patients, thumb and fingers in 9, and fingers in nine. All the digits were classified preoperatively by Zancolli's classification. In 13 thumbs retropulsion contracture was 4 and adduction-antepulsion contracture was nine. All of the thumbs were treated by intrinsic release and Z plasty(or rotational flap). Other procedures including arthrolysis, arthrodesis and tendon reconstruction were combined in 9 thumbs. In 52 fingers, in addition to distal release, arthrolysis was combined in 12 fingers, and arthrolysis plus volar plate release were combined in 4 fingers. For the assessment, our criteria, based on subjective satisfaction of the patient and range of motion, was used. The duration of follow up was from one year to 9 years with the average of 26 months. In 14 thumbs the results were excellent in 2, 6 good, 4 fair, and one poor. In 52 fingers excellent was 12, 24 good, 13 fair, and 3 poor. In summary we could improve the function of intrinsic plus deformity by appropriate sugery, and their results were good.
Arthrodesis ; Burns ; Cerebral Palsy ; Classification ; Compartment Syndromes ; Congenital Abnormalities ; Contracture ; Female ; Fingers ; Follow-Up Studies ; Hand ; Humans ; Lacerations ; Male ; Muscles ; Range of Motion, Articular ; Retrospective Studies ; Spasm ; Tendons ; Thumb

Primary intimal sarcoma of the pulmonary artery is a rare disease and there has been no report of any case originating from the pulmonary valve. Recently we experienced a 62 year-old female patient who had a primary intimal sarcoma of the pulmonary valve with distal metastasis. She was brought to medical attention due to exertional dyspnea facial edema productive coughing and general weakness for 1 month. Chest CT and echocardi-ography suggest an acute pulmonary thromboembolism or tumor. Exploration showed a large polypoid mass arising from the pulmonary leaflets and multiple masses on distal pulmonary arteries. We replaced the pulmonary valve and reconstructed the pulmonary artery. She received radiotherapy 1 month postoperatively and now 4 months after surgery she has begun receiving chemotherapy.
Cough ; Drug Therapy ; Dyspnea ; Edema ; Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; Pulmonary Artery ; Pulmonary Embolism ; Pulmonary Valve* ; Radiotherapy ; Rare Diseases ; Sarcoma* ; Tomography, X-Ray Computed

BACKGROUND: Flecainide is an antiarrhythmic agent that is used primarily in the treatment of cardiac arrhythmias. Some evidences also suggest that flecainide can participate in alveolar fluid clearance and inflammatory responses. This experiment was aimed to evaluate the effects of flecainide on sepsis induced acute lung injury in a rat model. METHODS: Rats were treated with subcutaneous infusion of saline or flecainide (0.1 or 0.2 mg/kg/hr) by a mini-osmotic pump. Subcutaneous infusion was started 3 hours before and continued until 8 hours after intraperitoneal injection of saline or endotoxin. Animals were sacrificed for analyses of severity of acute lung injury with wet to dry (W/D) ratio and lung injury score (LIS) in lung and inflammatory responses with level of leukocyte, polymorphonuclear neutrophils (PMNs) and inteleukin-8 (IL-8) in bronchoalveolar lavages fluid (BALF). RESULTS: Flecainide markedly improved dose dependently sepsis induced acute lung injury as analysed by W/D ratio (from 2.24 ± 0.11 to 1.76 ± 0.09, p < 0.05) and LIS (from 3 to 1, p < 0.05), and inflammatory response as determined by leukocyte (from 443 ± 127 to 229 ± 95, p < 0.05), PMNs (from 41.43 ± 17.63 to 2.43 ± 2.61, p < 0.05) and IL-8 (from 95.00 ± 15.28 to 40.00 ± 10.21, p < 0.05) in BALF. CONCLUSIONS: Flecanide improve sepsis induced acute lung injury in rats by controlling inflammatory responses.
Acute Lung Injury* ; Animals ; Arrhythmias, Cardiac ; Bronchoalveolar Lavage ; Flecainide* ; Infusions, Subcutaneous ; Injections, Intraperitoneal ; Interleukin-8 ; Leukocytes ; Lung ; Lung Injury ; Models, Animal ; Neutrophils ; Rats ; Sepsis*

Lymphagiomas are composed of multiple lymphatic channels lined by benign-appearing endothelial cells. The lisions can occur anywhere in body and extremely rarely affect the colon. But lymphangiomas of the colon have been reported more frequently since the development and widespread use of the colonofiberscope. In the past, most lympangioma have been removed surgically, But now that transendoscopic snare polyectomy is possible, diagnosis by total biopsy constitutes the treatment. In the present paper, we reported the case af colonic lymphangioma in 51-year old woman who underwent endoscopic resection.
Biopsy ; Colon* ; Diagnosis ; Endothelial Cells ; Female ; Humans ; Lymphangioma* ; Middle Aged ; SNARE Proteins

McArdle's disease is a disorder of carbohydrate metabolism, which is inhented as an autosomal recessive or occasionally an autosomal dominant trait. Hallmark of clinical features is exercise intolerence, I.e. muscle pain following strenuous exercise. Electrophysiologically insertion of an EMG needle shows that there is no electrical activity, differentiating this contracture from a muscle cramp. Histological examination of muscle biopsy specimen shows increase in glycogen and the presence of subsarcolemrnal blebs. We report a 23-year-old, male patient who presented clinical, electrophysiological, and histological findings compatible with McArdle's disease.
Biopsy ; Blister ; Carbohydrate Metabolism ; Contracture ; Glycogen ; Glycogen Storage Disease Type V* ; Humans ; Male ; Muscle Cramp ; Myalgia ; Needles ; Young Adult

The T cell antigen receptor (TcR) in combination with costimulatory signals triggered by accessory molecules present on the surface of the antigen-presenting cells (APC) regulates the activation and growth of T lymphocytes. Calyculin A and Okadaic acid is known to be an inhibitor of serine/threonine phosphatase and RK-682 specifically blocks functions of tyrosine phosphatase. To investigate roles of these inhibitors in TcR-mediated signaling cascade, chimeric molecule CD8-5 which contains the extracellular and transmembrane domains of the human CD8a molecule and the cytoplasmic tail of TcR 5 chain were stably expressed in Jurkat cell line. CD8-5 chimeric protein induced tyrosine phosphorylation of various cytoplasmic substrates and IL-2 gene expression in a NFAT dependent manner by stimulation with anti-CD8 mAb OKT8 as seen in TcR stimulation. When CD8-5 transfectants were preincubated with Okadaic acid, Calyculin or RK682, they differentially affected tyrosine phosphorylation of signaling mediators including CD8-5 molecule. When Jurkat Tag cell line was used where SV40 T antigen is stably expressed and the expression of p-galactosidase is driven by the multiple NFAT binding sites plus minimal IL-2 promoter, these phosphatase inhibitors -RK682, Calyculin A, Okadaic acid- effectively inhibited IL-2 gene expression at the concentration of 1.2832 x 10 ' M, 3.9924 x 10 M, 7.2707 x 10 M respectively. These results suggested that Okadaic acid, Calyculin or RK682 modulate TcR-proximal as well as TcR-distal signaling events during T cell activation.
Antigen-Presenting Cells ; Antigens, Viral, Tumor ; Binding Sites ; Cell Line ; Cytoplasm ; Gene Expression ; Humans ; Interleukin-2 ; Jurkat Cells ; Okadaic Acid* ; Phosphorylation ; Receptors, Antigen, T-Cell ; T-Lymphocytes ; Tyrosine

A spinal epidural hemangioma is rare. In this case, a 51 year-old female patient had low back pain and right thigh numbness. She was initially misdiagnosed as having a ruptured disc with possible sequestration of granulation tissue formation due to the limited number of spinal epidural hemangiomas and little-known radiological findings. Because there are no effective diagnostic tools to verify the hemangioma, more effort should be put into preoperative imaging tests to avoid misdiagnosis and poor decisions).
Diagnostic Errors ; Female ; Granulation Tissue ; Hemangioma ; Humans ; Hypesthesia ; Low Back Pain ; Thigh

The Kawasaki disease has been reported worldwide since the first description in 1967 in Japan. Approximately 20% of the children with untreated Kawasaki disease are believed to develop coronary artery aneurysm of which 2-3% progress to coronary artery stenosis. The Kawasaki disease rarely affects adults and accordingly, there have been only a few cases reported in literatures. The present case describes a successful surgical treatment of a 43-year-old female patient with coronary artery aneurysm and stenosis, which resulted from an episode of the Kawasaki disease that occurred 20 years earlier. The patient was well at 5 months followup.
Adult* ; Aneurysm ; Child ; Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Disease* ; Coronary Stenosis ; Coronary Vessels ; Female ; Follow-Up Studies ; Humans ; Japan ; Mucocutaneous Lymph Node Syndrome*

OBJECTIVE: To evaluate whether co-culture of oocytes on vero cell monolayers from Day 0 (Day 0 group) after egg retrieval results in an increase in developmental capacity such as fertilization rate, embryo quality, blastulation and clinical pregnancy rate compared with co-culture of oocytes from Day 1 (Day 1 group). METHODS: Sperms were treated with Hams F-10 supplemented with 10% human follicular fluid (hFF). Vero cells for co-culture were prepared in TCM-199 with 10% FBS. Oocytes were co-cultured from Day 0 and fertilized oocytes were co-cultured from Day 1 on vero cell monolayers in DMEM with 10% and 20% hFF, respectively after egg retrieval. On day 1, 2 and 5, fertilization rate and grade of embryos and blastocysts were evaluated. Results (fertilization rate, cleavage rate, grade of embryos and blastocysts and pregnancy rate) were considered statistically significant when p value was less than 0.05 using t-test and ci2. RESULTS: In sibling oocytes of same cycles, no differences were found in fertilization rate (94.6 vs. 91.4%), cleavage rates (94.6 vs. 91.4%), embryo grade (on day 2 and 3) and blastulation (65.6 vs. 57.0%) and their grade. In different oocytes of different cycles (patients), no differences were found in fertilization (79.8 vs. 78.3%), cleavage rates (77.7 vs. 76.4%) and blastulation (56.0 vs. 45.3%), but pregnancy rate was higher in the Day 0 group than in the Day 1 group (60.0 vs. 42.9%). CONCLUSIONS: This study revealed that the embryonic development capacities were not affected by the different co-culture time in the sibling oocytes of same cycles. Although no statistical significance, because of small size of study, there was a trend for higher pregnancy rates in Day 0 group compared to Day 1 group in different oocytes of different cycles.
Blastocyst ; Coculture Techniques* ; Embryonic Development* ; Embryonic Structures ; Female ; Fertilization ; Follicular Fluid ; Humans ; Oocytes* ; Ovum ; Pregnancy ; Pregnancy Rate ; Siblings ; Spermatozoa ; Vero Cells