BACKGROUND: We have previously demonstrated the isoflurane and halothane may be detrimental to in vitro fertilization of mouse oocytes in high concentrations. The aim of this study is to compare the toxic effects of volatile anesthetics on mouse embryos using in vitro growth model of two cell mouse embryos. METHODS: Mouse two-cell embryos exposed to three volatile anesthetics, enflurane(0.5 mM; 1.5 mM), isoflurane(0.26 mM; 0.78 mM) and halothane(0.24 mM; 0.72 mM). Mouse two-cell embryos unexposed to any drugs were included as controls. RESULTS: The percentages of two-cell mouse embryos developed over morula stages on the third day after exposure of high concentrations of isoflurane and halothane decreased significantly compared with controls. The rates of embryos arrested at 2-8 cell stage in these groups were significantly higher than that of controls. There were no significant differences in these rates between enflurane group, isofiurane and halothane group of lower concentrations and controls. The hatching and/or hatched blastocysts development were significantly lower in isoflurane and halothane group than in controls. No significant differences in the hatching rate of blastocyst developed were observed among groups. CONCLUSIONS: Our data show that isoflurane and halothane in high concentrations have harm effects of the in vitro growth of two cell mouse embryos.
Anesthesia* ; Anesthetics ; Animals ; Blastocyst ; Embryonic Development ; Embryonic Structures ; Enflurane ; Female ; Fertilization in Vitro ; Halothane ; Isoflurane ; Mice ; Morula ; Oocytes ; Pregnancy

BACKGROUND: We have previously demonstrated the isoflurane and halothane may be detrimental to in vitro fertilization of mouse oocytes in high concentrations. The aim of this study is to compare the toxic effects of volatile anesthetics on mouse embryos using in vitro growth model of two cell mouse embryos. METHODS: Mouse two-cell embryos exposed to three volatile anesthetics, enflurane(0.5 mM; 1.5 mM), isoflurane(0.26 mM; 0.78 mM) and halothane(0.24 mM; 0.72 mM). Mouse two-cell embryos unexposed to any drugs were included as controls. RESULTS: The percentages of two-cell mouse embryos developed over morula stages on the third day after exposure of high concentrations of isoflurane and halothane decreased significantly compared with controls. The rates of embryos arrested at 2-8 cell stage in these groups were significantly higher than that of controls. There were no significant differences in these rates between enflurane group, isofiurane and halothane group of lower concentrations and controls. The hatching and/or hatched blastocysts development were significantly lower in isoflurane and halothane group than in controls. No significant differences in the hatching rate of blastocyst developed were observed among groups. CONCLUSIONS: Our data show that isoflurane and halothane in high concentrations have harm effects of the in vitro growth of two cell mouse embryos.
Anesthesia* ; Anesthetics ; Animals ; Blastocyst ; Embryonic Development ; Embryonic Structures ; Enflurane ; Female ; Fertilization in Vitro ; Halothane ; Isoflurane ; Mice ; Morula ; Oocytes ; Pregnancy

STUDY DESIGN: Retrospective study of 72 patients treated for the acute lower cervical spinal injury with or without spinal cord injury. OBJECTIVES: We designed this study to evaluate the determining factors in the prognosis of the acute cervical spinal cord injury. We hypothesized as the prognosis is dependent on the severity of injury, not by time-related for the initiation of the treatment. SUMMARY OF BACKGROUND DATA: There is still controversies in the management of the acute cervical spinal cord injury. And the prognosis is generally considered to depend on the severity of trauma to the spinal cord. METHODS: We divided neurologic status into 4 groups; complete, incomplete, root injury and no neurologic deficit group. And there were complete cord injury in 12, incomplete cord injury in 34, single root injury in 14 and no neurologic deficit in 12 patients. The time to operation since injury was 24 hours in 7, 7 days in 32, 3 weeks in 15, 6 weeks in 8, and more than 6 weeks in 5 cases. The operation was indicated mainly for the patients with irreducible fracture-dislocation or for the patients with bony fragments, and disc materials impinging on the spinal cord. Surgical treatment were done in 67 cases with anterior cervical discectomy and fusion(ACDF), ACDF with anterior stabilizaiton, posterior wiring, and circumferential fusion. We statistically analyzed the relationship hetween the time to surgery after injury and the degree of neurologic recovery after surgical treatment by chi square test. RESULTS: There were no neurologic recovery in complete cord injury. There were incomplete cord injury in 34 patients, 8 anterior cord syndrome had no neurologic recovery, among 24 patients with central cord syndrome(CCS) 18(22/24 operated) had neurologic recovery in various degrees and 2 of Brown-Sequard syndrome showed significant neurologic recovery. In nerve root injury, all except l (1/12) patient had complete neurologic recovery. There were neurologic recovery in 2/2 CCS when operated within 24 hours, 8/10 CCS when operated between 2-7 days and 4/5 CCS when operated between 2-3 weeks. There were neurologic recovery in 3/3 CCS when operated between 4-6 weeks and 1/2 CCS when operated more than 7 weeks after injury. There was no significant difference in the relationship between the time to surgery after injury and the degree of neurologic recovery after operation(X2=2.48, df=4, P=0.65). CONCLUSION: Spinai cord injury is directly related with the magnitude of injury at the time of trauma, and the prognosis is determined entirely at the time of injury, And the prognosis is not altered hy time of the treatment.
Brown-Sequard Syndrome ; Diskectomy ; Humans ; Neurologic Manifestations ; Prognosis* ; Retrospective Studies ; Spinal Cord Injuries* ; Spinal Cord* ; Spinal Injuries

We report a case of bacteriologically proven salmonella infection on the thoracic vertebra in a patient with previous history of pulmonary tuberculosis, in the non-endemic area with no history of sickle cell disease and typhoid fever. A forty-three years old female patient was admitted because of severe back pain, chest pain, lower extremity weakness and intermittent high fever elevation. On plain X-ray there was narrowing of T11-12 disc space with adjacent vertebral body destruction localized centrally around the disc and paravertebral abscess. She had an old history of pulmonary tuberculosis and treated with antituberculosis medication twenty years ago. We treated this patient by abscess drainage, anterior curettage and iliac corticocancellous strut bone graft over the T11 to T12 by anterior transthoracic approach. Histopathological diagnosis was chronic vertebral osteomyelitis with chronic inflammatory reaction. Pus culture reported to have grown salmonella typhi group D, sensitive to ampicillin, chloramphenicol, gentamicin and tetracycline. We could establish the diagnosis and effectively treat the disease with early surgical intervention.
Abscess ; Ampicillin ; Anemia, Sickle Cell ; Back Pain ; Chest Pain ; Chloramphenicol ; Curettage ; Diagnosis ; Drainage ; Female ; Fever ; Gentamicins ; Humans ; Lower Extremity ; Osteomyelitis ; Salmonella Infections ; Salmonella typhi ; Salmonella* ; Spine* ; Spondylitis* ; Suppuration ; Tetracycline ; Transplants ; Tuberculosis, Pulmonary ; Typhoid Fever

PURPOSE: To evaluate the degree of injury of the spinal cord in relation with the space available for the spinal cord at the level of injury, the sagittal diameter of the spinal canal at the uninjured levels, and the Pavlov ratio at the uninjured levels in fractures and dislocations of the lower cervical spine. MATERIALS AND METHODS: We retrospectively reviewed the records and radiographs of patients who had sustained an acute fracture or dislocation of the cervical spine from 1990 to 1995. We collected patients from Orthopedic and Neurosurgical department of Chonbuk University Hospital and at Orthopedic department of Presbyterian Medical Center. Of the 69 patients analyzed, twelve had no neurological deficit, eleven had an isolated nerve-root injury, twenty-two had an incomplete injury of the spinal cord, and twenty-four had a complete injury. We measured above three parameters from the plain lateral radiographs and assessed the difference by one-way ANOVA and unpaired t-test. RESULTS: 1. The mean space available for the spinal cord at the level of injury was 12.9 millimeter for the complete injury of the spinal cord,13.8 millimeter for the incomplete injury, 14.7 millimeter for an isolated nerve-root injury, and 15.7 millimeter for no neurological deficit group. The overall difference among the groups was significant (F=6.98, P=0.0004). The patients who had a complete injury of the spinal cord and those who had an incomplete injury of the spinal cord were significantly different from the patients who had an isolated nerve-root injury and those who had no neurologic deficit (P=0.002). 2. The mean sagittal diameter of the canal at the proximal and distal uninjured level was 14.3 and 14.6 millimeter for the complete injury of the spinal cord, 14.9 and 14.9 millimeter for the incomplete injury, 15.5 and 16.6 millimeter for an isolated nerve-root injury, and 16.9 and 16.5 millimeter for no neurological deficit group. The patients who had a complete injury of the spinal cord and those who had an incomplete injury of the spinal cord were significantly different from the patients who had an isolated nerve-root injury and those who had no neurologic deficit (P=0.001). 3. The mean Pavlov ratio at the proximal and distal uninjured level was 0.90 and 0.86 for no neurologic deficit group, 0.85 and 0.87 for an isolated nerve-root injury, 0.76 and 0.75 for the incomplete injury of the spinal cord, and 0.76 and 0.76 for the complete injury. The patients who had a complete injury of the spinal cord and those who had an incomplete injury of the spinal cord were significantly different from the patients who had an isolated nerve-root injury and those who had no neurologic deficit (P=0.001). CONCLUSIONS: The patients who sustained a permanent injury of the cord usually had had a narrower sagittal diameter (<14mm) and a lower Pavlov ratio (<0.80) of the spinal canal before injury. Patients who had a large sagittal diameter of the canal may be more likely to be spared a permanent injury of the spinal cord following a fracture or dislocation of the cervical spine compared with patients who have a narrow canal. These findings demonstrated that the severity of the injury of the spinal cord was in part associated with the space available for the cord (at risk:<13mm) after the injury, as measured on plain lateral radiographs.
Dislocations* ; Humans ; Jeollabuk-do ; Neurologic Manifestations ; Orthopedics ; Protestantism ; Retrospective Studies ; Spinal Canal ; Spinal Cord* ; Spine*

Since Pare's first report on Achilles tendon rupture in 1575, many authors have presented numerous operative and nonoperative methods for its treatment. Numerous controversies following its treatment have been concerned with the selection of its treatment method, which could minimizing the complications and enable early ambulation. We analysed 98 cases of Achilles tendon rupture in adults which were treated by direct repair, three-tissue bundle technique, or Plantaris/Peroneus augmentation repair for 3(1)/4 years from Oct. 1986 to Dec. 1989. We compared with types of cast after operation, periods for immobilization, and ankle motion of dorsiflexion at postoperative 6 weeks & long-term follow up. The results obtained from this study were as follows; l. After repair by three-tissue bundle technique, a short leg cast was applied, and then a weight bearing was started at postoperative 3 weeks. It can be demonstrated to shorten hospitalization and early ambulation when compared to other surgical techinques. 2. The patients who were repaired with the three-tissue bundle techinque averaged 12.5° dorsiflexion at the time of cast removal at postoperative 6 weeks, compared to 0°, 1° plantar flexion, and 4.4° plantar flexion with other techniques. The former group was significantly better than that of the latter group, and these differences were not present at long-term follow up. 3. On follow up period, discoverd complications were rerupture of Achilles tendon in 8 cases and mild wound infection in 3 cases, but the patients who were repaired by the three-tissne bundle technique showed no complications except mild wound infection in one case.
Achilles Tendon ; Adult ; Ankle ; Early Ambulation ; Follow-Up Studies ; Hospitalization ; Humans ; Immobilization ; Leg ; Methods ; Rupture ; Weight-Bearing ; Wound Infection

Chronic complication of diving and working in compressed air is dysbaric osteonecrosis. Dysbaric osteonecrosis could be diagnosed by simple bone x-ray, in the case of exposure history to dysbaric atmosphere. The case is 44 years old man who worked as a shell fish diver for 20 years. He was exposed dysbaric atmosphere during diving. He had bone necrosis in both femur head, both distal femur and proximal tibia. He had multiple attacks of decompression sickness. Other causes of bone necrosis are ruled out. We conclude that diver's bone necrosis is dysbaric osteonecrosis.
Adult ; Atmosphere ; Compressed Air ; Decompression Sickness ; Diving ; Femur ; Femur Head ; Humans ; Necrosis ; Osteonecrosis* ; Tibia

An 18-year-old man had suffered from intense burning with redness and an increased temperature of both the lower legs, forearms and hands since the age of 5. Symptoms were exacerbated by exposure to heat or walking. The patient obtained temporary relief by immersing his feet and hands in cold water. We observed the increase of skin temperature in relation to pain by thermography. No specific abnormalities were noted in laboratory studies. Treatment with aspirin was ineffective. We report a rare case of primary erythermalgia with typical features.
Adolescent ; Aspirin ; Burns ; Erythromelalgia* ; Foot ; Forearm ; Hand ; Hot Temperature ; Humans ; Leg ; Skin Temperature ; Thermography ; Walking ; Water

No abstract available.
Bacteria, Anaerobic*

To investigate the effect of hyperoxia on EKG findings and to evaluate the applicability of EKG as noninvasive monitoring index of oxygen toxicity, 38 rabbits were continuously exposed to 6 different conditions-3 hyperbaric oxygenations (HBO-2.5, 3.5 and 5ATA, 100% O2), normobaric oxygenation (NBO, 100% O2), hyperbaric aeration (HBA-5ATA, 21% O2) and normobaric aeration (NBA, 21% O2)-for 120 minutes and their EKG and time to dyspnea and convulsion were recorded. Dyspnea and death were observed in exposure conditions of HBO-3.5 and HBO-5 (Positive rate of dyspnea; 10%, 100%, death; 10%, 25%, respectively) only, and convulsion in 4 oxygenation groups (NBO; 20%, HBO-2.5; 20%, HBO-3.5; 20%, HBO-5; 88%). Abnormal EKG findings included arrhythmia and ST-T changes and the incidences was increasing with doses(partial pressure of oxygen). In addition to EKG change, findings observed during exosure were dyspnea and convulsion in the order of appearence and when non specific ST-T change was accepted as positive (abnormal) finding, the frequency of abnormal EKG was statistically significant(p<0.01), but when it was excluded from positive results, the frequency of EKG change was not significant(p>0.05). These results suggest that the effect of hyperoxia on heart is myocardial ischemia and arrhythmia, that oxygenation more than 3.5ATA causes myocardial damage in 120 minutes exposure, and that EKG is valuable as monitoring index of oxygen toxicity.
Arrhythmias, Cardiac ; Dyspnea ; Electrocardiography* ; Heart ; Hyperbaric Oxygenation ; Hyperoxia* ; Incidence ; Myocardial Ischemia ; Oxygen ; Rabbits* ; Seizures