In a series of 20 young rats, three cortical lesions were made in each hemisphere. Two of these lesions were filled with avitene and gelfoam, while the third was left empty as a control. The animals were killed successively on weeks 1, 2, 4 and 8 after the operation. The results were as follows : 1) Although there was no difference in the type of tissue reactions, avitene was more rapid and profound than gelfoam in the process and degree of inflammatory reaction at the same periods. 2) Avitene biodegradaded more rapidly than gelfoam. 3) The extent of fibrosis and adhesion to the surrounding brain tissues were not grossly different between these two agents but more profound histopathologically in avitene at the same periods. With these results, we could conclude that the avitene was superior to the gelfoam as the hemostatic agent in neurosurgical area.
Animals ; Brain* ; Collagen ; Fibrosis ; Gelatin Sponge, Absorbable ; Rats

The outcome of acute subdural hematoma(SDH) had been generally unsatisfactory. The authors have analyzed the factors influencing the outcome of 70 patients who underwent acute SDH evacuation. Thirty five patients(50%) died and twenty two(31.4%) had a favorable outcome. A significant correlation was found between the outcome and the motor score at operation, the time interval to operation papillary response, type of operation and the Glasgow Coma Scale(GCS) at operation. But the patient's age, the mode of injury, the skull fracture, the degree of midline shift, the hematoma location, the type of brain swelling, the hematoma thickness, and the systolic blood pressure did not correlate with the outcome scale.
Blood Pressure ; Brain Edema ; Coma ; Hematoma ; Hematoma, Subdural, Acute* ; Humans ; Skull Fractures

The authors performed this preliminary study to investigate the effect of softening E.C.T. and propofol was compared to pentothal for induction of anaesthesia for E.C.T on seizure duration. The results were follows ' 1) E.C.T. was performed in 60 psychiatric inpatients who were admitted during the study period. Of them 51.7% were diagnosed as schizophrenia, 21.6% as major depressive disorder, 16.7% as bipolar I disorder, manic and 10% of others. 2) Mean number of E.C.T. was 12.2 times a patient. 3) The most common target symptoms were persecutory delusion in schizophrenia, psychomotor retardation or agitation in major depressive disorder, and violent aggressive behavior in bipolar I disorder, manic. 4) Pre-ECT medication usually used were atropine 0.0093mg kg(-1), pentothal 2.76mg kg(-1) or propofol 1.42mg kg(-1). 5) The duration of seizure, as measured clinically, was reduced with propofol(20.5 sec) in comparison with pentothal(35.7 sec)(p<0.001). This suggest the possibility that additional treatment may be needed for the same clinical effect in psychiatric illness when propofol is used as the induction agent.
Atropine ; Bipolar Disorder ; Delusions ; Depressive Disorder, Major ; Dihydroergotamine ; Electroconvulsive Therapy ; Humans ; Inpatients ; Propofol* ; Schizophrenia ; Seizures* ; Thiopental*

OBJECTIVES: In order to standardize the CRP, ESR and WBC count after three types of spinal surgery and get clinical usefulness from these laboratory dadas after spinal surgery and clincal usefulness of laboratory datas. MATERIAL AND METHODS: Three groups of patients(microdisectomy, anterior and posterior fusion) were chosen for the study. CRP, ESR and WBC levels were prospectively determined before surgery and at days 1-5, 10, 14,21 and 42 after surgery. RESULTS: In all patients, preoperative normal CRP level(<10mg/L) increased, reaching peak levels on the second day after anterior fusion(84.6mg/L), and at the third day after microdiscectomy(54.5mg/L) and posterolateral intercorporal fusion(152.2mg/L), with normalization in 5-10 days. Preoperative normal ESR level increased to peak level on the forth day after microdiscectomy(33.0mm/hr), and increased double peak levels after anterior(postoperative days 2&5) and posterolateral intercorporal fusion(postoperative days 3&5). ESR followed by a slow and irregular decrease, and at 42 days after surgery often remained elevated. WBC increased to variable peak level within normal limit in all patients. CONCLUSIONS: The rapid decline in CRP will probably be interrupted by a second rise or persisting elevation if infection occurs. CRP is presumably a better test than ESR for early detection of postoperative infection.
Blood Sedimentation* ; C-Reactive Protein* ; Erythrocytes* ; Humans ; Prospective Studies

BACKGROUND: Propofol is an alternative to thiopental as an intravenous induction agent for cesarean section. It is also used as a sedative for supplementation of regional blockade during cesarean section. It has been reported that propofol relaxes not only vascular smooth muscle but also other smooth muscles. The aim of this study was to investigate the effect of propofol on rat uterine smooth muscle in an isolated preparation in the rat. METHODS: Uterine smooth muscle tissues were obtained from rats (n = 21). The muscle strips were suspended in tissue baths and isometric tension was recorded. After spontaneous or oxytocin induced activity had been accomplished in the buffer solution as a control, propofol (1 to 20microgram/ml) in fat emulsion was applied cumulatively to the bath and the effects were continuously recorded. RESULTS: In vitro, propofol induced a dose-dependent inhibition of spontaneous as well as oxytocin induced myometrial contractile activity. Propofol concentration of 1microgram/ml had no significant effects on the resting tension, active tention, and frequency of contraction developed by spontaneous and oxytocin induced uterine contractility. However, Complete muscular relaxations on spontaneous and oxytocin induced contractility were obtained at a concentration of 10microgram/ml and 20microgram/ml, respectively. CONCLUSIONS: Propofol inhibits spontaneous and oxytocin-induced uterine smooth muscle contractions in dose dependent pattern.
Animals ; Baths ; Cesarean Section ; Female ; Muscle, Smooth* ; Muscle, Smooth, Vascular ; Oxytocin ; Pregnancy ; Propofol* ; Rats* ; Relaxation ; Thiopental

BACKGROUND: It has been reported that nitroglycerin relaxes not only vascular smooth muscle but also uterine smooth muscle. The aim of the present study was to investigate the effect of nitroglycerin on rat uterine contractile activity in vitro. The effects of nitroglycerin on myometrial spontaneous activity and oxytocin-induced contractions were also observed. METHODS: Uterine smooth muscle tissues were obtained from non-pregnant female rats (n = 21). The uterine segments were mounted in tissue baths. After spontaneous or oxytocin-induced activity had been accomplished, nitroglycerin in various concentrations was added to the bath and the effects were continuously registered. RESULTS: Nitroglycerin induced a dose-dependent inhibition of spontaneous as well as oxytocin-induced myometrial contractile activity. Complete muscular relaxation on spontaneous contractility was obtained at a concentration of 50 microgram/ml. Complete muscular relaxation on oxytocin-induced contractility was obtained at a concentration of 75 microgram/ml. CONCLUSIONS: Nitroglycerin inhibited the uterine contractile response to exogenous oxytocin as well as spontaneous in the estrous rat.
Animals ; Baths ; Female ; Humans ; Muscle, Smooth* ; Muscle, Smooth, Vascular ; Nitroglycerin* ; Oxytocin ; Rats* ; Relaxation

No abstract available.
Pregnancy*

Intraaortic balloon counterpulsation (IAB) has been shown to prolong survival in the critically ill cardiac patients. Originally developed for use in the patients with cardiogenic shock, the indications have been expanded. But despite technical advances, the complication rate associated with IAB remains high. The most commonly reported complications include damage to the femoral artery and distal embolization. Other reported major complications are balloon rupture, limb loss, bleeding, systemic infection and bowel infarction. We report a patient complicated by ischemic colitis causing stenosis and intestinal obstruction after IAB insertion.
Colitis, Ischemic* ; Constriction, Pathologic* ; Counterpulsation* ; Critical Illness ; Extremities ; Femoral Artery ; Hemorrhage ; Humans ; Infarction ; Intestinal Obstruction ; Rupture ; Shock, Cardiogenic

BACKGROUND: Core temperature decreases rapidly after the induction of general anesthesia, because the heat is redistributed to peripheral tissues. Thermoregulatory responses of volatile anesthetics have been tested, but their effects have not been directly compared. Therefore, we evaluated the thermoregulatory responses to sevoflurane, desflurane, and isoflurane. METHODS: Sixty healthy patients scheduled for laparoscopic myomectomy or radical hysterectomy were allocated into three groups; Group S (sevoflurane, n = 20), Group D (desflurane, n = 20), and Group I (isoflurane, n = 20). Anesthesia was maintained with 1 minimum alveolar concentration (MAC) of sevoflurane, desflurane, and isoflurane in a 50/50 mixture of N2O/O2. Patients were maintained in a normovolemic and normocapnic state. The core temperature and forearm minus fingertip skin-temperature gradient (an index of peripheral vasoconstriction) were monitored after the induction of general anesthesia. RESULTS: Each of the seven patients given sevoflurane, desflurane, and isoflurane vasoconstricted at a core temperature of 35.3 +/- 0.5degrees C, 33.6 +/- 0.4degrees C, and 35.2 +/- 0.4degrees C, respectively. The vasoconstriction threshold was the lowest in patients anesthetized with desflurane. The core temperature gradient (Ti-Tf) was significantly higher in patients that were anesthetized with desflurane than in those that were anesthetized with sevoflurane or isoflurane. The core temperature of desflurane was significantly lower than that of sevoflurane or isoflurane 15 minutes after the induction of anesthesia until 180 minutes of anesthesia. CONCLUSIONS: These results indicate that the core temperature is maintained at a higher level in patients that have been anesthetized with sevoflurane or isoflurane than in those that have been anesthetized with desflurane.
Anesthesia ; Anesthesia, General ; Anesthetics ; Forearm ; Hot Temperature ; Humans ; Hysterectomy ; Isoflurane ; Laparoscopy ; Methyl Ethers ; Vasoconstriction

BACKGROUND: Lesions in distal target arteries hinder surgical bypass procedures in patients with peripheral arterial occlusive disease. METHODS: Between April 2012 and October 2015, 16 patients (18 limbs) with lifestyle-limiting claudication (n=12) or chronic critical limb ischemia (n=6) underwent femoral–above-knee (AK) polytetrafluoroethylene (PTFE) bypass grafts with a bridging stent graft placement between the distal target popliteal artery and the PTFE graft. Ring-supported PTFE grafts were used in all patients with no available vein for graft material. Follow-up evaluations assessed clinical symptoms, the ankle-brachial index, ultrasonographic imaging and/or computed tomography angiography, the primary patency rate, and complications. RESULTS: All procedures were successful. The mean follow-up was 12.6 months (range, 11 to 14 months), and there were no major complications. The median baseline ankle-brachial index of 0.4 (range, 0.2 to 0.55) significantly increased to 0.8 (range, 0.5 to 1.0) at 12 months (p<0.01). The primary patency rate at 12 months was 83.3%. The presenting symptoms resolved within 2 weeks. CONCLUSION: In AK bypasses with a diffusely diseased distal target popliteal artery or when below-knee (BK) bypass surgery is impossible, this procedure could be clinically effective and safe when used as an alternative to femoral-BK bypass surgery.
Angiography ; Ankle Brachial Index ; Arterial Occlusive Diseases ; Arteries ; Blood Vessel Prosthesis* ; Extremities ; Follow-Up Studies ; Humans ; Ischemia ; Polytetrafluoroethylene* ; Popliteal Artery* ; Stents* ; Transplants ; Veins