To evaluate the effect of steroid and alpha adrenergic blockade in experimental spinal cord trauma, pathological change was observed after 500 gm-cm force was impacted on the exposed cord of the 30 Mongoreal adult dogs. The progression of the pathological changes was compared in time lag with the groups of steroid adminstered and phenoxybenzamine treatment. In the group of the spinal cord trauma without treatment, histopathological findings were classical evolution namely from the central hemorrhage and necrosis to peripheral involvement up to amorphous necrotic pattern of entire cord at 24 hours preparation. In the steroid therapy group after the trauma, the pathological changes were confined in the gray matter around and posterior portion of the central canal in all intervals. Moreover the edematous changes and hemorrhagic necrosis were far less severe than the group without treatment. Although the pathologic change was somewhat less severe in the group which received phenoxybenzamine prior to the trauma than the group administered phenoxybenzamine afterward, these group revealed much severe edema and hemorrhagic necrosis than steroid therapy group. The pathologic change, however, in the groups which received phenoxybenzamine was less severe than the group of the spinal cord trauma without treatment.
Adult ; Animals ; Dogs ; Edema ; Hemorrhage ; Humans ; Necrosis ; Phenoxybenzamine ; Spinal Cord Injuries* ; Spinal Cord*

PURPOSE: Peritoneal recurrence has been reported to be the most common form of recurrence of gastric cancer. Peritoneal recurrence can generally be suggested by several types of image studies and also if there is evidence of ascites or Bloomer's rectal shelf. It can be confirmed by explorative laparotomy, but diagnostic laparoscopy is a good alternative method and laparoscopic surgery has also been widely used. We reviewed and analyzed the ability of diagnostic laparoscopy to detect peritoneal recurrence or carcinomatosis, and especially for gastric cancer. MATERIALS AND METHODS: We performed a retrospective review the 45 gastric cancer patients who were operated via diagnostic laparoscopy between 2004. 2. and 2009. 3. We analyzed the perioperative clinical characteristics and the accuracy of the diagnostic methods. RESULTS: The study groups included 14 patients who had confirmed gastric cancer, but they suspected to have carcinomatosis, and 31 patients who had previously underwent gastric resection, but they suspected to have recurrence. The mean operation time was 44.1+/-6.9 minutes and the mean postoperative hospital stay was 2.7+/-.8 days. There was one case of operation-related complication and no postoperative mortality occurred. The sensitivities for detecting peritoneal recurrence or carcinomatosis were 92.1% for diagnostic laparoscopy, 29.7% for detecting ascites and rectal shelf on the physical examination, 86.5% for abdominal computed tomography, 69.2% for PET CT and 18.8% for CEA. CONCLUSION: Diagnostic laparoscopy does not require a long operation time or a long hospital stay, and it showed a low complication rate in our study. It has high sensitivity for detecting peritoneal recurrence of gastric cancer. It can be an alternative diagnostic confirmative method and it is useful for deciding on further treatment.
Ascites ; Carcinoma ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Physical Examination ; Recurrence ; Retrospective Studies ; Stomach Neoplasms

An experiment was planned to observe the histopathological alteration with administration of the Rheomacrodex and blood pressure changes in induced cerebral infarct after occlusion. Eighty well developed cats, weighing 2.3 to 3.5kg, were used in this experiment. The right MCA was exposed through temporal approach and the proximal part of the MCA was occluded with a silver clip. The animals were divided into 4 groups: The control group was comprised of 20 cats with occlusion of the right MCA alone, Rheomacrodex-treated group was comprised of 20 cats after occlusion of right MCA, induced hypotension and hypertension groups consisted in each 20 cats following occlusion of the MCA. The animals were sacrificed at intervals of 3 hours, 6 hours, 24 hours, 1 week and 2 weeks respectively after occlusion of the MCA. The animals were studied for clinical deficits and histopathological changes of the cerebral infarct according to the time courses. The results obtained were as follows: 1) In the control group, severe contralateral hemiplegia was developed in the early stage following the MCA occlusion, however the neurological deficits were progressively improved to the state of abnormal walking in 24 hours to 2 weeks. The hemorrhagic infarct was involving the basal ganglia, internal capsule and extending to the cortex with mild brain edema in the early stage and the area of the infarct was gradually enlarged from 6 hours to 24 hours following the MCA occlusion. Although the brain edema of surrounding area of the lesion was remained unchanged, the size and distribution of the infarct were decreased in one week to 2 weeks. Extensive ischemic neuronal damage was observed in the control group. 2) In the Rheomacrodex-treated group, mild to moderate neurological deficit was developed in the early stage after MCA occlusion and the deficit was less severe than control group. The clinical deficit was improving in the time course and one case had shown completely normal activity in 2 weeks. The distribution of the infarct was well defined and it was smaller than control group. The infarct mainly involved the basal ganglia and internal capsule. The area of the infarct was gradually enlarged from 6 hours to one week after MCA occlusion, then the extent of the infarct was decreased in 2 weeks. The ischemic neuronal change in this group was less severe than control group. 3) In the induced hypotension group, the early neurological deficit was worse than that of the control group and severe hemiplegia was developed in one week. There was minimal improvement of the neurological deficit in 2 weeks. The area of the infarct was ill-defined and hemorrhagic extending a large portion of the brain with severe brain edema. The infart was involving the basal ganglia, internal capsule, claustrum and the cortex from 3 hours to 24 hours after the occlusion and the area of the infarct was not changed during the observation. Severe ischemic nerve cell change or resolution of the cells was oserved in this group. 4) In the induced hypertension group, the neurological deficit was mild and it was better than that of the control group. The distribution of the infarct was well localized and minimum in extent. The extent of the infarct was not changed during the observation. There was no observable gross brain edema and the ischemic nerve cell changes were not severe.
Animals ; Basal Ganglia ; Blood Pressure* ; Brain ; Brain Edema ; Cats ; Dextrans* ; Hemiplegia ; Hypertension ; Hypotension ; Internal Capsule ; Middle Cerebral Artery* ; Neurons ; Silver ; Walking

This study was performed to evaluate the induction time, hemodynamic responses and local venous complications after intravenous induction with midazolam, comparing with those after intravenous induction with thiopental. Sixty adult surgical patients received either 5 mg/kg thiopental sodium(group I) or 0.2 mg/kg midazolam hydrochloride(group II) as an induction agent. The results were as follows. 1) The induction time(loss of palpebral reflex) of the group II(68.2+/-21.5 sec) was significantly longer than those of group I(29.6+/-8.3 sec) 2) The magnitude of rises in the systolic blood pressure, 1 and 2 minute after intravenous administration of induction agent, of group II were significantly smaller than those of group I. 3) The magnitude of rises in the diastolic blood pressure, 2 minute after intravenous administration of induction agent,of group II were significantly smaller than those of group L 4) The magnitude of rises in the pulse rate, 1 and 2 minute after intravenous administration of induction agent, of group II was not significantly differ from those of group I. 5) In three patients of the group I complained of pain during injection, but no patients of the group II complained of pain. There was no significant difference in the incidence of the postoperative local venous complication.
Administration, Intravenous ; Adult ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Midazolam* ; Thiopental*

No abstract available.
Uremia*

No abstract available.
Uremia*

The correlation between serum anti-tuberculosis (TB) drug levels and the drug-induced hepatotoxicity (DIH) remains unclear. The purpose of this study was to investigate whether anti-TB DIH is associated with basal serum drug levels. Serum peak levels of isoniazid (INH), rifampicin (RMP), pyrazinamide (PZA), and ethambutol (EMB) were analyzed in blood samples 2 hr after the administration of anti-TB medication. Anti-TB DIH and mild liver function test abnormality were diagnosed on the basis of laboratory and clinical criteria. Serum anti-TB drug levels and other clinical factors were compared between the hepatotoxicity and non-hepatotoxicity groups. A total of 195 TB patients were included in the study, and the data were analyzed retrospectively. Seventeen (8.7%) of the 195 patients showed hepatotoxicity, and the mean aspartate aminotransferase/alanine aminotransferase levels in the hepatotoxicity group were 249/249 IU/L, respectively. Among the 17 patients with hepatotoxicity, 12 showed anti-TB DIH. Ten patients showed PZA-related hepatotoxicity and 2 showed INH- or RMP-related hepatotoxicity. However, intergroup differences in the serum levels of the 4 anti-TB drugs were not statistically significant. Basal serum drug concentration was not associated with the risk anti-TB DIH in patients being treated with the currently recommended doses of first-line anti-TB treatment drugs.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alanine Transaminase/blood ; Antitubercular Agents/adverse effects/*blood/therapeutic use ; Aspartate Aminotransferases/blood ; Drug-Induced Liver Injury/*blood ; Ethambutol/adverse effects/blood/therapeutic use ; Female ; Humans ; Isoniazid/adverse effects/blood/therapeutic use ; Liver/*pathology ; Liver Function Tests ; Male ; Middle Aged ; Pyrazinamide/adverse effects/blood/therapeutic use ; Retrospective Studies ; Rifampin/adverse effects/blood/therapeutic use ; Tuberculosis, Pulmonary/drug therapy ; Young Adult

The correlation between serum anti-tuberculosis (TB) drug levels and the drug-induced hepatotoxicity (DIH) remains unclear. The purpose of this study was to investigate whether anti-TB DIH is associated with basal serum drug levels. Serum peak levels of isoniazid (INH), rifampicin (RMP), pyrazinamide (PZA), and ethambutol (EMB) were analyzed in blood samples 2 hr after the administration of anti-TB medication. Anti-TB DIH and mild liver function test abnormality were diagnosed on the basis of laboratory and clinical criteria. Serum anti-TB drug levels and other clinical factors were compared between the hepatotoxicity and non-hepatotoxicity groups. A total of 195 TB patients were included in the study, and the data were analyzed retrospectively. Seventeen (8.7%) of the 195 patients showed hepatotoxicity, and the mean aspartate aminotransferase/alanine aminotransferase levels in the hepatotoxicity group were 249/249 IU/L, respectively. Among the 17 patients with hepatotoxicity, 12 showed anti-TB DIH. Ten patients showed PZA-related hepatotoxicity and 2 showed INH- or RMP-related hepatotoxicity. However, intergroup differences in the serum levels of the 4 anti-TB drugs were not statistically significant. Basal serum drug concentration was not associated with the risk anti-TB DIH in patients being treated with the currently recommended doses of first-line anti-TB treatment drugs.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alanine Transaminase/blood ; Antitubercular Agents/adverse effects/*blood/therapeutic use ; Aspartate Aminotransferases/blood ; Drug-Induced Liver Injury/*blood ; Ethambutol/adverse effects/blood/therapeutic use ; Female ; Humans ; Isoniazid/adverse effects/blood/therapeutic use ; Liver/*pathology ; Liver Function Tests ; Male ; Middle Aged ; Pyrazinamide/adverse effects/blood/therapeutic use ; Retrospective Studies ; Rifampin/adverse effects/blood/therapeutic use ; Tuberculosis, Pulmonary/drug therapy ; Young Adult

An experimental ischemic model in cats is described in which we have attempted to produce acute cerebral ischemia by occlusion of the middle cerebral artery(MCA) through the orbit. The main objectives of this experiment were:to observe the effect of thiopental in the tophographic distribution of infarct;the size of the infarct;histological changes of ischemic nerve cells following occlusion of a major cerebral artery;to investigate the best timing of the administration and dosage of thiopental after the occlusion. 80 adult cats weighing 2.7 to 4.0kg, were used in this study. The components of the pathophysiological responses, systemic changes, cerebral infarct size and histopathological ischemic neuronal changes were studid in these groups of animals. We observed the protective effect of the thiopental on acute focal cerebral ischemia in 40 cats by effecting permanent occlusion of MCA. The EEG was monitored continuously using bifrontal electrodes from the time of administration of thiopental(10mg/kg). The animals were divided into 4 groups of 20 cats each. The 4 different groups were used to investigate the effects of thiopental on focal ischemia according to different time interval. The time intervals were 6 hours, 24 hours, 48 hours, and 72 hours after occlusion of MCA. Each animal group were divided into two groups, which one was control(n=10) the other, thiopental treated group(n=10). The results obtained were as follows: 1) Blood gases, artrial pressure, body temperature, and intracranial pressure differed among groups only as follows: (a) Normal blood pressure was maintained but pulse rate was slightly fast in each control group. (b) Blood pressure and pulse rate in the thiopental treated groups were significantly lower than in the control groups. In the thiopental treated groups, the value of PaO2 was significantly higher than control groups, however, PaCO2 was not significantly higher in the thiopental treated groups as compared to the control group. 2) In the control groups, severe contralateral hemiplegia(grade III) developed in the early stage of MCA occlusion, however the neurological deficit progressively improved to the state of abnormal climbing(neurological grade II) 48 hours to 72 hours after the occlusion. In the thiopental treated groups, minimum to mild neurological deficit significantly developed in the early stage of MCA occlusion and in one case walking ability was regained. 3) The size and distribution of the infarct significantly decreased to 60% in the thiopental treated groups(p<0.01). The value of the size of the size of the infarct in the thiopental treated groups 72 hours after occlusion was minimized to 0.3+/-0.6%(p<0.01). In 80 percent of the control group cases severe extensive ischemic neuronal damage(score 3 or 4), was observed, 70 percent in the thiopental treated groups showed mild ischemic nerve cell changes(score 1 or 2) when the histological examination was given. Although the severity of the ischemic neuronal damage was gradually improved from 6 hours to 72 hours after occlusion of the MCA in the control, the thiopental treated group was not significantly affected to the time factor. 4) Significantly reduction of experimentally induced acute focal cerebral ischemia was associated in the cat model with the administration of thiopental at 5 minute, 30 minute, and one hour postocclusion. Also we have defined the best barbiturate, best does, and best timing of administration to protect the acute focal ischemia.
Adult ; Animals ; Blood Pressure ; Body Temperature ; Brain Ischemia ; Cats ; Cerebral Infarction* ; Electrodes ; Electroencephalography ; Gases ; Heart Rate ; Humans ; Intracranial Pressure ; Ischemia ; Middle Cerebral Artery* ; Neurons ; Orbit ; Thiopental* ; Time Factors ; Walking

We report the case of a rectal teratoma. A 62-year-old woman was referred to our department for evaluation of a rectal mass. She had a 3-month history of rectal bleeding and constipation. No palpable mass was detected using digital rectal examination. Colonoscopic examination demonstrated a protruding mass with a broad stalk in the posterior wall about 12 cm from the anal verge. A computed tomography scan showed a mass, which contained calcifications and fatty components, protruding into the rectal lumen. On operation, the mass was located in the upper rectum, and the right lateral portion of the upper rectum was adhesed to the right ovary. Thus, she had undergone a low anterior resection and right oophorectomy. The pathologic results confirmed a teratoma arising in the muscularis mucosa and the submucosa of the rectal wall.
Constipation ; Digital Rectal Examination ; Female ; Hemorrhage ; Humans ; Middle Aged ; Mucous Membrane ; Ovariectomy ; Ovary ; Rectum ; Teratoma*