PURPOSE: We investigated the direct labeling method of antibody with 99mTc and 188Re and examined the stability and function of these labeled compounds in in vitro and in vivo. MATERIALS AND METHODS: Disulfide bond of nonspecific human IgG was reduced to -SH group by 2-mercaptoethanol. Stannous ion was used to reduce 99mTc and 188Re. The stability of 99mTc-IgG and 188Re-IgG was estimated upto 24 hrs. Biodistribution was evaluated in abscess bearing rats at 4 and 24 hr post-injection of 99mTc or 188Re labeled IgG. RESULTS: The number of -SH group per reduced IgG molecule was 2.34. The labeling yield of 99mTc-IgG and 188Re-IgG were 90% and 95%, respectively. The stability of 99mTc-IgG at 1, 4, 6 and 24 hr was 91%, 83%, 78%, 7% and that of 188Re-IgG, high uptake was found on kidney, blood, stomach and abscess (9.42+/-0.68, 1.43+/-0.24, 0.86+/-0.18, 0.72+/-0.10 %ID/g, respectively). The uptakes at 24 hr were kidney, abscess, stomach, and blood in descending order. In case of 188Re-IgG, high uptake at 4 hr post injection appeared on kidney, blood, abscess and stomach (3.92+/-0.62, 1.32+/-0.08, 0.88+/-0.01, 0.26+/-0.06, respectively). The upatkes at 24 hr were kidney, abscess, blood abd stomach in descending order. The abscess to blood uptake ratio of 99mTc-IgG was 0.5 at 4 hr and 2.02 at 24 hr and that of 188Re-IgG was 0.67 and 1.29. CONCLUSION: 99mTc-IgG and 188Re-IgG and 188Re-IgG canbe labeled efficiently with direct labeling method. However, 99mTc-IgG and 188Re-IgG, labeled with direct method, was unstable. Further study in needed to enhance the stability of the antibody labeling.
Abscess ; Animals ; Humans ; Immunoglobulin G ; Kidney ; Mercaptoethanol ; Rats ; Stomach

Acute colonic pseudoobstruction was first reported in 1948 by Sir H. Ogilvie. It is characterized by an acute, abrupt right-sided colonic distention in the absence of physical reasons for obstruction. If untreated, it may progress to cecal perforation, peritonitis, and death. Although primary cases have been reported, 87 percent of cases were secondary results of medical or surgical conditions. The most common medical conditions were infections, cardiac disease, and neurologic problems. In surgical conditions, cesarean section has been reported as the most common cause of Ogilvie's syndrome. In 1995, the first case of Ogilvie's syndrome complicated after a cosmetic surgical procedure(abdominoplasty) was reported by Bradley et al. We report a case of Ogilvie's syndrome complicated after breast reconstruction with TRAM flap that developed in the postoperative third day in 35-year old woman. The complications are primarily related to decreased flap perfusion. No reference of intestinal pseudoobstruction was found in the literature conducted in regard to complications of TRAM flap breast reconstruction.
Adult ; Breast* ; Cesarean Section ; Colon ; Colonic Pseudo-Obstruction ; Female ; Heart Diseases ; Humans ; Intestinal Pseudo-Obstruction ; Mammaplasty* ; Perfusion ; Peritonitis ; Pregnancy

No abstract available.
Eating* ; Liver* ; Pneumonia* ; Sharks*

No abstract available.
Immunoglobulin G* ; Pentetic Acid* ; Polymers*

A 27-year-old woman developed Wemicke's encephalopathy in the 16th week of her first pregnaney. She had thyroid storm and abnormal liver function. Her thyrotoxic symptom and abncemal liver function was recovered after medication of antithyroid drug, steroid, hepatotonic drug and administration of thiamine(fursulthiamin), but the fetus was lost, Thereafter her thyroid function returned to normal and euthyroid state was maintained without medication of antithyroid drug, but her neurological defect was remained. We suggest that severe hyperemesis gravidarum is a possible risk factor of the thyroid storm and Wemicke's encephalopathy in patients with hyperthyroidism, and consider the check of the thyroid function. The need for parenteral thiamine supplementation and medication of antithyroid drug is warranted in patients with severe hyperemesis gravidarum which lasts longer than 3 weeks and abnormal thyroid function.
Adult ; Female ; Fetus ; Humans ; Hyperemesis Gravidarum* ; Hyperthyroidism ; Liver* ; Pregnancy ; Risk Factors ; Thiamine ; Thyroid Crisis* ; Thyroid Gland* ; Wernicke Encephalopathy*

Segmental Spinal Instrumentation(S.S.I.) is more effective means of managing unstable thoraco-lumbar spine fractures than traditional Harrington Rod Instrumentation as an operative procedure which afforded rigid internal fixation with stability and needed minimal external immobilization. Early return to normal activity and successful rehabilitation are facilitated by efficient stabilization with S.S.I. Fifty-nine patients with fractures and fracture-dislocations of thoraco-lumbar spine were treated by Harrington Rod Instrumentation (29 patients) and S.S.I. (30 patients) at this hospital from June 1979 to July 1984. We have analysed the results of these treatment and obtained following conclusions: 1. S.S.I. is more rigid internal fixation than Harrington Rod Instrumentation. a) no or minimal external immobilization b) early ambulation and rehabilitation c) lowered complications 2. There was no significant difference in correction rate, loss of correction, and neurologic recovery between Harrington Rod Instrumentation and S.S.I.
Early Ambulation ; Humans ; Immobilization ; Rehabilitation ; Spine ; Surgical Procedures, Operative

BACKGROUND: Calcium channel blockers and volatile anesthetics have depressant effects on cardiac function. Both groups of drugs appear to exert both qualitatively and quantitatively different effects on electrophys-iologic and mechanical function. The authors examined the direct in-vitro effects of diltiazem in the presence of a desflurane using an isolated rat heart. METHODS: Isolated Sprague-Dawley rat hearts (N = 40) were perfused at a constant pressure with an oxygenated modified Krebs' solution. After the stabilization period, they were subdivided into two groups. The groups were subjected to different concentrations of desflurane (6, 12, 18 vol%) alone or 100 ng/ml diltiazem with the same concentrations of desflurane, respectively. Isovolumetric left ventric ular pressure (LVP), heart rate and rate of change of ventricular pressure (dp/dt) were measured via a thin, saline-filled latex balloon and transducer. Coronary flow and oxygen tension were measured at the coronary inflow and outflow sites. Oxygen delivery, myocardial oxygen consumption and percent oxygen extraction were calculated with each measurement. RESULTS: The combination of diltiazem and desflurane (6, 12 and 18 vol%) dose-dependently depressed LVP and dp/dt more than desflurane alone. Coronary flow and oxygen delivery increased in a dose- dependent fashion, but there was no statistical difference between the groups. The decreases of heart rate, myocardial oxygen consumption and percentage of oxygen extraction were dependent on the concentration of desflurane. Arrhythmias occurred only with a high desflurane (18 vol%) concentration and the high desflurane concentration plus diltiazem. CONCLUSIONS: These results demonstrate that the myocardial depressant effect of diltiazem plus desflurane is greater than desflurane alone. The authors suggest that administration of diltiazem during high concentrations of desflurane anesthesia could result in deleterious cardiac depression and arrhythmias.
Anesthesia ; Anesthetics ; Animals ; Arrhythmias, Cardiac ; Calcium Channel Blockers ; Depression ; Diltiazem* ; Heart Rate ; Heart* ; Latex ; Oxygen ; Oxygen Consumption ; Rats* ; Rats, Sprague-Dawley ; Transducers ; Ventricular Pressure

Inappropriate treatment of the injury of the lateral collateral ligaments of the ankle produce residual instability, which causes serious disability. There is considerable divergence of opinion as to whether fresh rupture of the lateral ligaments of the ankle are best treated by conservative or opreative method. We have conducted a trial to analyze thirty patients, who were treated by immediate open surgical rupair of rupture of the lateral ligaments of the ankle between April 1991 and February 1992. The results were as follows: 1. All patients were active, young men, Injuries to left ankle were three times more than right side. The most common cause of injury is occurred during sports, especially association football. 2. The decision to operate was based on 1)Talar tilt angle of the injured ankle measures 8-10 degrees more than that of the stress uninjured ankle. 2)A positive arthrogram showing contrast leakage into peroneal tendon she-aths & anterolateral aspect of the lateral malleolus. 3. Diagnostic accuracy rate of arthrography is 94.5%, stress radiography 61.1 %. Arthrography is more reliable than stress radiography in the diagnosis of acute injuries to the lateral ligament of the ankle. 4. At operation, isolated rupture of anterior talofibular ligament was in 5 cases, isolated rupture of middle calcaneofibular ligament in 3 cases, concomittant ruptures of anterior talofibular and middle calcaneofibular ligements in 22 cases. 5. Location of tears of anterior talofibular ligament was mostly mid-portion, middle calcaneofibular ligament in mid-portion or distal portion. 6. On radiologic results, average angle of talar tilt was 14.4° preoperatively, 5.2 preoperatively. There was correction of talar tilt angle of average 9.2°. 7. Clinical results of treatment were excellent in 9 patients, good in 6 patients, fair in 4 patients, poor in 2 patients by authors rating system. The satisfactory result was achieved in 15 patients(71.4%). 8. Postoperative complication was reduced mobility in 4 cases, functional instability 1 case, neuroma in operation scar in 2 cases, minor sensory loss in 4 cases. 9. Primary surgical repair gave good results in the aspect of radiologic & fun ctional instability, but clinical results were not satisfactory, due to high incidence of postoperative complication.
Ankle ; Arthrography ; Cicatrix ; Collateral Ligaments ; Diagnosis ; Football ; Humans ; Incidence ; Lateral Ligament, Ankle ; Ligaments ; Male ; Methods ; Neuroma ; Postoperative Complications ; Radiography ; Rupture ; Sports ; Tears ; Tendons

No abstract available.
Osteoarthropathy, Primary Hypertrophic*

We report a case of rare cervical isthmic spondylolisthesis of C6-7 combined occult spinal bifida at C6, and review the radiologic finding, different diagnosis and treatment. A 23-year old female presented nuchal, back pain after traffic accident. Radiologic finding showed the 6th cervical isthmic defect, spondylolisthesis and dysplasia. The patient was conservatively treated about 8 weeks, and 10 months after injury, she was symptom free with full range of motion of cervical spine and she was followed up. Cervical spondylolysis is a very rare condition. This clinical importance is vulnerable to trauma. For whatever reasons, symptomatic patients need to be treated by conservative or surgical option.
Accidents, Traffic ; Back Pain ; Cervical Vertebrae ; Female ; Humans ; Range of Motion, Articular ; Spine ; Spondylolisthesis ; Spondylolysis