BACKGROUND: Oxygen-derived free radicals are known to contribute to tissue injury during myocardial ischemia and reperfusion. Recent in vitro studies have shown that propofol has potent antioxidant properties. The present study was aimed to investigate the effects of propofol on recovery of mechanical and coronary endothelial function in a myocardial stunning model. METHODS: Thirty-five dogs were acutely instrumented under halothane anesthesia to measure aortic and left ventricular pressure, pulmonary and left anterior descending coronary artery (LAD) flow, and subendocardial segment length. After completion of the surgery, halothane was replaced by fentanyl- midazolam. Animals were then subjected to 15 min of LAD occlusion and 3 hrs of reperfusion under either intracoronary (i.c.) propofol (5 microgram/mL, n=11; 20 microgramg/mL LAD flow, n=12) or vehicle (saline, n=12) for 1 hr beginning 30 min before LAD occlusion. Percent segment shortening (%SS) and the slope of the preload recruitable stroke work (Mw), as an index of regional myocardial contractility, and peak lengthening rate (dL/dtmax) and percent post-systolic shortening (%PSS), as an index of regional diastolic function, were evaluated. Coronary endothelial function was assessed by examining LAD flow response to i.c. acetylcholine (ACh, 1 microgram over I min) and i.c. sodium nitroprusside (SNP, 20 microgram over I min). The myocardial content of malondialdehyde (MDA) from LAD area was measured to evaluate lipid peroxidation. RESULTS: Despite equally severe ischemic dysfunction during LAD occlusion, recovery of %SS was significantly improved during reperfusion by either dose of propofol compared to controls. However, Mw recovered to the baseline within 60 min of reperfusion in all three groups. In addition, propofol-treated dogs showed better recovery of both indices of regional diastolic function (dL/dtmax and %PSS) as compared to controls. Ischemia-reperfusion similarly attenuated the increases in the LAD flow by ACh in all the groups, whereas it had no significant effect on these increases in LAD flow by SNP. The increase in MDA induced by ischemia and reperfusion was significantly suppressed by either dose of propofol. CONCLUSIONS: The results indicate that propofol attenuates mechanical but not coronary endothelial dysfunction in postischemic, reperfused myocardium in an open-chest canine model. The protective action of propofol against mechanical dysfunction is probably due to its effect to reduce lipid peroxidation.
Acetylcholine ; Anesthesia ; Animals ; Coronary Vessels ; Dogs* ; Endothelium* ; Free Radicals ; Halothane ; Ischemia ; Lipid Peroxidation ; Malondialdehyde ; Midazolam ; Myocardial Ischemia ; Myocardial Stunning* ; Myocardium ; Nitroprusside ; Propofol* ; Reperfusion ; Stroke ; Ventricular Pressure

The use of the interlocking intramedullary nails expand the possibilities for treatment of femoral shaft fractures, as illustrated by consistent and satisfactory clinical results. However, the technique is relatively complex compared to conventional nails and frequently poses technical problems. A retrospective review was undertaken of twenty-eight patients with femoral shaft fractures which had technical problems after undergoing the closed reduction and internal fixation with interlocking intramedullary nail procedure. We studied the types of the problems. Their causes, the frequency of problems with various kinds of nails, and discussed solutions of the problems. There were 21 additional comminutions and intraop erative splinterings, 8 angular deformities, 3 malpositioned nails, 3 loosened distal locked screws, 2 brocken drill bits, and 1 femoral neck fracture. Bone-union was attained in all cases (28 patients), but the period of treatment to attain bone-union was protracted to an average of 6.8 (5-12) months. In 3 cases, the knee joint range of motion was of limited flexion, 70 to 90 degrees, but in all other cases full range of motion was realized. 7 cases required 2 or more operations. The hospitalization period was for an average of 3.6 months. In conclusion, the importance of careful preoperative planning and experienced surgical technique cannot be overemphasized because we could see no significant difference in the occurence of technical problems in several kinds of the nail.
Congenital Abnormalities ; Femoral Neck Fractures ; Fracture Fixation, Intramedullary ; Hospitalization ; Humans ; Knee Joint ; Range of Motion, Articular ; Retrospective Studies

Thymic cyst is relatively rare tumor which usually occurs in the neck or mediastinum. Cervical thymic cyst is usually situated laterally and deep to the anterior border of the sternocleidomastoid muscle, simulating a branchial cyst. Thymic cyst of the mediastinum is usually detected incidentally and differential diagnoses include cystic degeneration of thymoma, and cystic teratoma. Two case of a cervical and a mediastinal thymic cysts were reported. The one was a cervical thymic cyst developed slowly growing mass in a 53-year-old male a for 10 years. The cyst was unilocular and measures 5.4x2.9x2.8 cm with columnar or squamous cell linings. The other is a mediastinal thymic cyst developed in a 37-year-old female with chest discomfort for 7 months. The cyst was uniocular and measures 2.8x2.2x2.0 cm. The epithelial lining of the cyst was largely desquamated and covered by macrophages with cholesterol granuloma. Involutional thymic stissue in their walls were noted in both cysts. In both cases presence of thymic tissue in the wall of the cyst thought to be the most important diagnostic feature.
Female ; Male ; Humans ; Diagnosis, Differential ; Cysts

We present an ultrastructure of an incidentally found renomedullary interstitial tumor also called as medullary fibroma in a 77 year-old female who had a metastatic adenocarcinoma of colon to the ureter. This tumor was a small and grayish white nodule in renal medulla, measuring 0.4 x 0.4 cm. Microscopically the tumor composed of spindle cells, with some vacuolation and intercellular collagen fibers. The electron microscopic observation of the spindle cells reveal that nuclei are spindle to oval shape and cytoplasm contain abundant rough endoplasmic reticulum, polyribosome without microfilaments and cisterna like structures supporting that the renomedullary interstitial cell tumor is renal interstitial cell origin than fibroblasts.
Female ; Humans ; Adenocarcinoma ; Neoplasm Metastasis

A histopathological study of erythema nodosum-like lesions in Behcet's disease was performed on 55 patients with incomplete and suspect types of Behcet's disease. Relatively common characteristics in histopathology of erythema nodosum-like lesions could be found in the patients with incomplete type of Behcet's disease. The histopathologic findings of erythema nodosum-like lesions in 21 patients with incomplete type of Behcet's disease were as follows : l. A moderate lymphocytic infiltration was found around the blood vessels and the sweat glands in the dermis. In the subcutaneous tissue, besides lymphohistiocytic infiltration, neutrophils were present in significant number in 9 cases (42.9%) 2. Vasculitis of small vessels was found within the periphery of fat lobules in 7 cases (81.0%), Five cases (23.8%) also showed thrombophlebitis. Seven cases (33.3%) showed histiocytic granuloma formation within the fat lobules. Microabscess formation in the subcutaneous tissue was seen in 5 cases (23.8 %), but it was not certain whether this was the charateristic feature.
Blood Vessels ; Dermis ; Erythema Nodosum* ; Erythema* ; Granuloma ; Humans ; Neutrophil Infiltration ; Subcutaneous Tissue ; Sweat Glands ; Thrombophlebitis ; Vasculitis

No abstract available.
Humans ; Mucin-1*

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*

The utility of computed axial tomography(CAT) in the diagnosis of spinal disorders has been the subject of considerable interest since the introduction of CAT scanning. Computed tomographic guided needle biopsy of 12 consecutive patients with a variety of undermined spinal disorders resulted in a 100% yield of positive tissue diagnoses, without signlficant complications. The principal advantage of cat guidance is the continuous direct observation of the needle tip position in relation to the target volume. We think that the application of computed tomographic guided needle biopsy in the lesions of the spine is of great value, because it is the single most accurate method of obtaining diagnosis other than by open surgical biopsy.
Animals ; Biopsy ; Biopsy, Needle ; Cats ; Diagnosis ; Humans ; Methods ; Needles ; Spine

We studied the results in forty-three knees in thirty patients-three male and twenty seven femalewho had rheumatoid arthritis, osteoarthritis, traumatic arthritis and osteonecrosis in the knee and were treated by total knee joint replacement. The average age of the patients was 56.7 years. The results were anaysed after follow-ups ranging from one year to three years and seven months, average being 23.6 months. The assessment was made upon the knee rating system of the Hospital for Special Surgery; the results were excellent in 29 knees, good in 12, fair in one and poor in one. The improvement of the flexion contractures was significant (postoperative average 1.7 degrees compared with preoperative average 20.1 degrees). The postoperative active flexion ranged from 70 degrees to 140 degrees (mean 110.2 degrees). One knee had a deep wound infection. The radiological loosening demonstrated in three cases, two of them had incomplete, nonprogressive radiolucent line, being less than one millimeter in width in the tibial component, one who had a deep infection showed three millimeters radiolucent line.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Contracture ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Male ; Osteoarthritis ; Osteonecrosis ; Wound Infection

Hepatitis viruses are most important cause of acute and chronic hepatitis. In past, hepatitis B virus was one of the major causes of acute hepatitis. Recently, around 60-70% of acute hepatitis is attributed to hepatitis A virus infection. In this article, we will discuss the route of hepatitis virus infection, how to prevent transmission of viral hepatitis and who should be immunized to each hepatitis viruses.
Hepacivirus ; Hepatitis ; Hepatitis A virus ; Hepatitis B virus ; Hepatitis Delta Virus ; Hepatitis E virus ; Hepatitis Viruses ; Hepatitis, Chronic ; Vaccination