BACKGROUND: Oxygen free radicals may play important role in coronary reperfusion resulting in cell death or dysfunction, and they believed that one specific mechanism for producing oxygen free radicals in myocardium is the xanthine oxidase system. Allopurinol, inhibitor of xanthine oxidase system, may limit myocardial dysfunction and injury produced by oxygen free radicals during coronary reperfusion. METHODS: Thirty isolated rabbit hearts undertook the retrograde nonworking perfusion for 15 minutes and followed by 15 minutes of working mode. After measurement of the hemodynamic values as baseline, all heart were arrested with cold cardioplegic solution for 60 minutes. Hearts were then revived with 15 minutes period of nonworking reperfusion, followed by 30 minutes of working reperfusion. The hemodynamic values were measured again at 20 minute of working period and expressed as percent of baseline values. Oxygen content of arterial perfusate and coronary effluent were measured and leakage of creatine kinase was measured from coronary effluent for 15 minutes of nonworking reperfusion. Wet and dry weight of the heart were obtained to determine for tissue water and water content. Animals were randomized as followings ; control(n=10), allopurinol PO(n=10, 100mg/kg before 24hr.), allopurinol IV(n=10, 10mg/kg before 1 hr.) RESULTS: 1) There were no significant differences in recovery of aortic pressure and heart rate between 3 groups. But there were significant differences in percent recovery of aortic flow, coronary flow, cardiac output and stroke volume between control group and allopurinol groups. 2) The leakage of creatine kinase following ischemic arrest was significantly lower in the allopurinol groups than the control group(control : 36.8+/-6.2IU, PO:19.7+/-3.1IU, IV : 22.2+/-4.6IU, p<0.001). 3) The allopurinol groups were significantly increased in oxygen extraction and oxygen consumption compared with the control((p<0.002, p<0.004)). 4) The tissue water and water content were significantly diminished in the allopurinol groups compared with the control group(p<0.003, p<0.001). 5) The electron micrograph showed more considerable structural damages of myocardial cell in the control group than the allopurinol groups. CONCLUSION: It is suggested from the results that allopurinol, inhibitor of xanthine oxidase, plays a inhibiting role in the production of oxygen free radicals, and improves myocardial protection during global ischemia and reperfusion in the isolating working rabbit heart model.
Allopurinol* ; Animals ; Arterial Pressure ; Cardiac Output ; Cardioplegic Solutions ; Cell Death ; Creatine Kinase ; Free Radicals ; Heart Rate ; Heart* ; Hemodynamics ; Ischemia ; Myocardial Reperfusion ; Myocardium ; Oxygen ; Oxygen Consumption ; Perfusion ; Reperfusion ; Stroke Volume ; Xanthine Oxidase

No abstract available.
Heart Failure* ; Heart*

BACKGROUND: Studies of human coronary plaque specimens have shown that T lymphocytes and macrophages are present in all types of lesions, from fatty streaks to advanced plaques. There is growing evidence for a pathogenic role for immune response in progression of atherosclerosis. This study was designed to investigate cytokine production by mononuclear leukocytes from patients with myocardial infarction. METHOD: We measured the kinetics of secretion of tumor necrosis factor-alpha (TNF-alpha) and interferon-r (IFN-r) by mononuclear leukocytes from 8 control subjects and 12 patients with acute myocardial infarction. Mononuclear leukocytes were isolated and incubated with plant lectin mitogen concanavalin-A for 24 and 48 hours. TNF-alpha and IFN-r secretions were measured by ELISA. RESULTS:There were no significant differences between TNF-alpha and IFN-r secretions by mononuclear leukocytes at and before 24 hours of incubation from both patients and control subjects, but TNF-alpha and IFN-r secretions at 48 hours of incubation were higher (p<0.005, p<0.05) in patients when compared with control subjects. TNF-alpha and IFN-r secretions by mononuclear leukocytes after incubation correlated with the peak level of creatine phosphokinase (CK) and CK-MB. CONCLUSION: Increased cytokine secretory capacity of mononuclear leukocytes may be due to the acute inflammatory response of myocardial infarction. Further trials may be needed to determined the effects of increase in secretory capacity of mononuclear leukocytes before myocardial infarction.
Atherosclerosis ; Creatine Kinase ; Enzyme-Linked Immunosorbent Assay ; Humans ; Kinetics ; Leukocytes, Mononuclear* ; Macrophages ; Myocardial Infarction* ; Plants ; T-Lymphocytes ; Tumor Necrosis Factor-alpha*

The suprapatellar plica is a synovial membrane that lies between the suprapatellar pouch and the true knee joint, but pathologic suprapatellar plica has been reported not frequently. We experienced one case of arch type of pathologic suprapatellar plica which was excised by arthroscopic technique, and report it with review of literature.
Knee Joint ; Synovial Membrane

Two collateral ligaments, accessory collateral ligaments, volar plate which prevent hyperextension of digital joints, fibrous flexor sheath which attached to volar plate, intrinsic and extrinsic muscles were contribute to the stability of the digital joints. Among them, two collateral ligaments were most important as a static stabilizer. Especially, the instability of fingers due to the rupture of ulnar collateral ligament of metacarpophalangeal joint of thumb and radial collateral ligament of index will attenuate the pinch power and maybe a cause of chronic painful limited finger motions. So, they should be repaired if ruptured completely. During the period of May 1980 to Oct. 1985, 17 cases of ruptured collateral ligaments 5 cases in thumb, 12 cases in fingers were treated surgically and followed up for average 8 weeks. The results were that normal range of digital joint motion were obtained in 14 cases and instabilities were disappeared in 16 cases and pain free in 12 cases. Therefore, careful clinical evaluation to detact therupture of collateral ligament of dig.ital joint after hand injury and then appropriate management could restore the best function of hand.
Chronic Pain ; Clinical Study ; Collateral Ligaments ; Fingers ; Hand ; Hand Injuries ; Joints ; Metacarpophalangeal Joint ; Muscles ; Reference Values ; Rupture ; Thumb

BACKGROUND: Hemodynamic derangements of cardiac tamponade are generally believed to result from compression of the cardiac chambers, which limits diastolic filling. The character and magnitude of the alternation are determined by the compliance characteristics of the pericardium and the total pericardial fluid volume. During serial pericardial fluid withdrawal, improvement of hemodynamic alternations is expected in patients with pericardial effusion. Method : Hemodynamic study was performed before and during serial fluid drainage in 11 patients with chronic moderate to severe pericardial effusion. RESULTS: 1) Intrapericardial pressure was elevated and equal to mean right atrial ventricular diastolic, and pulmonary capillary wedge pressure. Pulmonary arterial and right ventricular systolic pressure were also midly elevated equal to one another. 2) Pericardial fluid was gradually removed in 50ml aliquots in all patients. The most significant hemodynamic improvement occured during intial 50mL withdrawal. Futher drainage of intrapericardial fluid was accompanied by slight hemodynamic improvement. 3) There were significant correlations between total pericardial fluid volume and intrapericardial and right atrial pressure (r=0.75 (p<0.005), r=0.71(p<0.01)). Correlations between intrapericardial pressure and right atrial, right ventricular diastolic and pulmonary capillary wedge pressure were also significant. 4) Two groups of patient could be distinguished based upon intrapericardial pressure as 7mmHg. More significant hemodynamic changes were in 6 patients with higher intrapericardial pressure after withdrawal of 200mL fluid. CONCLUSION: In chronic moderate to severe pericardial effusion, the most significant hemodynamic improvement occurred during initial fluid drainage. Early pericardiocentesis is important in management of pericardial effusion with high intrapericardial pressure.
Atrial Pressure ; Blood Pressure ; Cardiac Tamponade ; Compliance ; Drainage* ; Hemodynamics* ; Humans ; Pericardial Effusion* ; Pericardiocentesis ; Pericardium ; Pulmonary Wedge Pressure

No abstract available.
Congenital Abnormalities* ; Humerus*

The retinoic acid and retinoid(Ro 11-1430) were alternately applied topically on forty patients with acne vulgaris. Therapeutic effects and side reactions of this regimen were compared with our previous studies of the treatment with retinoic acid alone and with retinoid alone. Compared with the treatment with retinoic acid alone, the therapsutic effect of the alternating treatment was relatively superior as indicated by the markedly reduced severity of local side reactions.
Acne Vulgaris* ; Humans ; Tretinoin

This is to report the histo-pathologic findings of the degenerated inferior alveolar nerves(IAN) causing uncontrollable neuralgia persisted for over 3 years. The patients had sufferred from frequent attack of unbearable pain along the mandibular branches of the Vth nerve. The pain arised spontaneously 5-10 times a day and lasted for 2-5 minutes. The medications including Tegretol were neither so effective to alleviate the pain level, nor enough to keep free from pain all days. The peripheral neurectomies were preceded by diagnostic nerve block, and partial resection of the IAN in the mandibular canals were approached by sagittal split osteomy of the ramus. The histopathologic findings of the resected IAN were as follows ; 1. Special staining with Luxol Fast Blue (LFB) and Masson Trichrome (MT) disclosed marked degeneration of the axons, decreased in number and fibrosis between the nerve fibers. 2. EM study revealed destruction of myelin continuity surrounding axons, degeneration of Schwann cell and endoneureal sheath, and coarse collagen between the destructed axons. 3. The 3 of 6 patients presented again with recurred pain in 2-3 years after the peripheral neurectomies. Excisional biopsy of the retromolarpterygomandibular softtissues disclosed the collateralization neuropathy beside the long-buccal nerves and their neuromatous findings.
Axons ; Biopsy ; Carbamazepine ; Collagen ; Fibrosis ; Humans ; Mandibular Nerve* ; Myelin Sheath ; Nerve Block ; Nerve Fibers ; Neuralgia ; Trigeminal Neuralgia*

No abstract available
Constriction, Pathologic* ; Stents*