BACKGROUND: Total intravenous anesthesia with propofol can cause respiratory depression and apnea especially during induction of anesthesia. To study the possibility of reversal of respiratory depression during anesthesia with propofol, pretreated with nabuphine or not, the respiratory effects of doxapram to spontaneously ventilating patients were investigated. METHODS: Patients were divided into 4 groups - saline-propofol-saline group (SPS), saline-propofol- doxapram group (SPD), nalbuphine-propofol-saline group (NPS), and nalbuphine-propofol-doxapram group (NPD). After saline or nalbuphine pretreatment, anesthesia was induced with propofol and then doxapram or saline was intravenously injected. Apneic time interval, blood pressure, heart rate, respiratory rate, minute ventilation, end tidal CO2 partial pressure and oxygen saturation were measured in every minutes during induction of anesthesia. Percent changes of each values were compared. RESULTS: There is no differences in apneic time intervals in each groups. The percent change of first minute ventilation in SPD group after doxapram injection unchanged significantly compared with those depressions of SPS, NPS and NPD group (p<0.05). Respiratory rates increased in SPD and SPS groups after laryngeal mask insertion. There is no differences in minute ventilation, respiratory rate and end-tidal CO2 concentration between nalbuphine pretreated groups regardless of doxapram injection. CONCLUSIONS: Doxapram has effect in increasing minute ventilation after propofol induction within first few minutes, but it cannot reverse respiratory depression during propofol induction pretreated with nalbuphine.
Anesthesia ; Anesthesia, Intravenous* ; Apnea ; Blood Pressure ; Depression ; Doxapram* ; Heart Rate ; Humans ; Laryngeal Masks ; Nalbuphine* ; Oxygen ; Partial Pressure ; Propofol* ; Respiratory Insufficiency ; Respiratory Rate ; Ventilation

No abstract available.
Ankle*

Since 1983, the transtrochanteric rotational osteotomy has been performed in 38 hips of 36 patients for the nontraumatic avascular necrosis of the femoral head at the department of orthopaedic surgery of Seoul National University Hospital. Out of them, 26 hips(18 cases of Sugioka grade I and 8 cases of Sugioka grade II ) were followed up for more than 1 year. The average period of follow-up was 3 years and 5 months(range, 1 year and 2 months to 7 years). These cases include 3 cases of failure before 2 years after operation. Overall, the result was satisfactory in 20 cases(77%)out of a total of 26 cases(success in 18 cases(69%)and good in 2 cases(8%)). The results of the grade I lesions(14 cases of success and 1 case of good result out of 18 cases) were better than those of the grade I lesions(4 cases of success and 1 case of good result out of 8 cases). Complications occurred in 5 cases. These include an ectopic ossification, a stress fracture of the neck, a nonunion of the osteotomy site, a nonunion of the greater trochanter and a delayed union of the greater trochanter. There were 6 cases of failure. For the 4 cases of them, hip replacement arthroplasy was performed. The MRI images axial to the longitudinal axis of the femoral neck gave excellent information for the operation.
Femur ; Femur Neck ; Follow-Up Studies ; Fractures, Stress ; Head ; Hip ; Humans ; Magnetic Resonance Imaging ; Neck ; Necrosis ; Ossification, Heterotopic ; Osteotomy ; Seoul

No abstract available.
Alcoholics* ; Humans

OBJECTIVES: The purpose of this study was to evaluate and classify the synovium-like membrane as either inflammatory (foreign body-like) or immune (T-cells present), generated during the development of aseptic loosening in the patients with joint replacement arthroplasties. METHODS: We used the murine air-pouch model, developed in BALB/c mouse, to make artificial synovial cavity and assessed the cytokine responses of the synovium-like membrane to the particulate biomaterials such at pure titanium, Ti6Al4V alloy, CoCr alloy and UHMWPE. Each biomaterial injected into air-pouch of 20 mice respectively. The mRNAs of various cytokines (IL-1 beta, IL-6, TNFalpha, IL-4, gammaIFN) and TCR Calpha chain were extracted from the synovium-like membranes and RT-PCR reactions were carried out using appropriate primers. RESULTS: IL-1beta, IL-6 and TNFalpha showed an increased response to the all kinds of particulate biomaterials. IL-4, gammaIFN and TCR Calpha chain did not show any distinct responses compared to control group and various kinds of biomaterials failed to show any, significant differences from each other in cytosine responses. CONCLUSION: T-cell or immune cytokine responses had not been found in this particle reaction and it seemed to be that the osteolysis in aseptic loosening would be a biologic reaction to the particulate biomaterials due to an inflammatory process.
Alloys ; Animals ; Arthroplasty, Replacement ; Biocompatible Materials ; Cytokines ; Cytosine ; Humans ; Interleukin-4 ; Interleukin-6 ; Joints ; Macrophages ; Membranes* ; Mice ; Osteolysis ; RNA, Messenger ; T-Lymphocytes ; Titanium ; Tumor Necrosis Factor-alpha

Seventy-three uncemented total hip arthroplasties in the sixty-four patients were studied as a retrospective manner. Hydroxyapatite and tricalcium-phosphate (HA/TCP Calcicoat) coated titanium fiber-mesh stems were used in forty-eight cases and the identical components but without hydroxyapatite coating were used in the other twenty-five cases. The distribution of the patients in two groups showed no statistically significant differences and the same porous coated hemispherical acetabular components were used in two groups. At the time of two year follow-up after the operation, the mean Harris hip score and the Enghs radiographic assessment score were 95.5 and 19.8, respectively, in the HA/TCP Calcicoat tm group and 94.4 and 19.2, respectively, in the non-coated group. None of these differences were statistically significant. At three months after operation, the frequency of the thigh pain was 8.3% in the HA/TCP Calcicoat tm group and 20% in the non-coated group, which was also not significantly different (p=0.24). There were no revisions in either group. All the femoral components except one among the non-coated group showed stable bony fixation in both groups and no differences in Enghs radiographic assessment criteria were detected between the two groups. There seemed to be a tendency of early pain relief and more endosteal new bone formation in the HA/TCP Calcicoat TM group, which, however, failed to show a statistically significant clinical or radiographic differences. This result is considered as preliminary and longer follow-up should be required to uncover any hidden advantages or disadvantages of the HA/TCP Calcicoat TM coating on titanium fiber-mesh stem.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Durapatite* ; Follow-Up Studies ; Hip ; Humans ; Osteogenesis ; Retrospective Studies ; Thigh ; Titanium*

Fixation failure is a major complication of intertrochanteric fracture. The causes of fixation failure were assessed in a series of 80 patients with intertrochanteric fractures, which had been internally fixed with either a sliding hip screw or a Gamma interlocking nail. The overall rate of fixation failure was 16.3%, in which the cutting-out of the implant from the femoral head was the only cause of the instance. The cutting-out rate was influenced by the accuracy of fracture reduction, the position of implant placement within the femoral head, and the bone mineral density. Anatomical reduction and the central placement of implant within the femoral head showed the most excellent results compared to other treatment modalities. Age, gender, fracture type and a kind of fixation implant had no significant effect. Our results showed that the intertrochanteric fractures should be reduced as anatomically as possible and it is essential that the central placement of the implant within the femoral head be obtained.
Bone Density ; Head ; Hip ; Hip Fractures* ; Humans

We intended to evaluate the Young's modulus of trabecular bone and apparent density from Computed Tomography(CT) and Spherical Indentation test and to quantify relation ship between them. The distal femurs(31 age, male, left and right) were prepared for exprimentatin and were embedded with repect to anatomical orientation. Then the specimens were scnned at 1 mm intervals on GE9800 CT scanner and the Hounsfield Units(HU, or CT number) were extracted from each CT image. After scanning, the bones were sectioned with diamond saw, producing 8 mm cubes of trabecular bone(72 eachs) from the metaphyseal region of both distal femur. The cubes were mechanically tested in inferior-superior(IS), anteriorposterior(AP), and medial-lateral(ML) direction with custom-made device, Spherical Indentatin Tester. After testing, the real apparent density of specimens were measured. The results of this study showed that the IS modulus was singificantly greater than both the AP and ML modulus and the AP modulus was also greater than ML modulus significantly(p<0.01). A linear relation ship between HU and real apparent density was found to be significant(R2=0.68) and significant power relationship between the apparent density and the tangent moduli(either by CT or physical measures) was also found.
Diamond ; Elastic Modulus* ; Femur ; Humans* ; Male ; Ships

No abstract available.
T-Lymphocytes* ; Transplantation*

The whole cell extract of Helicobacter pylori strain 26695 was treated with the hemin-agarose resin and the bound fraction was analyzed by 2-Dimensional electrophoresis. The 2-D-PAGE-displayed spots were eluted and analyzed by matrix-assisted laser desorption ionization mass spectrometry (MALDI-MS). Among the 120 spots processed, 94 protein spots were identified to represent 58 genes. Forty-five protein spots that represented thirty-four genes were newly identified in this study, including iron-containing proteins and hemin-containg proteins such as fumarate reductase, iron-sufur subunit(FrdB), ribonucleoside diphosphate reductase, beta subunit (NrdB), glutamyl-tRNA reductase (HemA), nikel-cobalt-cadnium resistance protein (NccB), and porphobilinogen deaminase (HemC).
Chromatography, Affinity* ; Electrophoresis ; Helicobacter pylori* ; Helicobacter* ; Hydroxymethylbilane Synthase ; Mass Spectrometry ; Oxidoreductases ; Proteome* ; Ribonucleoside Diphosphate Reductase ; Succinate Dehydrogenase