In order to investigate a hemodynamic complication associated with the resection of a large arteriovenous malformation, we planed the following experiment. We divided the left common caroted artery and the internal jugular vein for microsurgical anastomsis between the rostral carotid and caudal jugular vessel ends : the 2 remaining wessel stumps were ligated. This created an arteriovenous shunt with afferent flow from the contralateral caroted and the basilar artery and retrograde down to the carotid-jugular anastomosis. And then, we occluded the shunt vessels at the each stage of the first and fourth week after anteriovenous shunt. Forty adult cats weighing from 2.2 to 2.4kg were used in this study The animals were devided into 4 groups : group 1(acute occlusion-1 week after shunt, n=10), group 2(staged occlusion-1 week after shunt, n=10), group 3(acute occlusion-4 week after shunt, n=10), group 4(staged occlusion-4 week after shunt, n=10) respectively. The regional cerebral blood flow(rCBF), cardiopulmonary function were measured in each animal group and also observed the response of the cerebral blood flow on induced changes of the blood pressure and the arterial bicarbonate. The arteriovenous shunt patency was evaluated by serial angiography. The results were as follows ; 1) Considerable increases in the mean arterial blood pressure(mABP) as well as bradycardia were observed in acute occlusion groups(group 1, 3). After induced hyercarbia, the increments of mABP in acute occlusion groups were less than staged occlusion groups, considerbly. 2) Significant decreases in the mean pulse rate were observed in acute occlusion groups. the mean pulse rate were the highest decrease in group 3. 3) The values of rCBF of left frontal cortex in acute occlusion groups were more greater increase than those of staged occlusion groups considerably. 4) After induced hypercarbia, considerable increases of the rCBF were demonstrated in all groups and increases of the rCBF were lowest in group 3 compared with the other groups. After induced hypercarbia, considerable increases of the rCBF were demonstrated in all groups and reductions of the rCBF were lowest in group 3 compared with the other groups. 5) After induced hypercarbia, considerable increases of the rCBF were demonstrated in all groups. The rCBFs were the highest increase in group3 and lowest increase in group 2 compared with the other groups. After induced hypotension, considerable reductions of the rCBF were demonstrated in all groups. The rCBFs were the highest reduction in group 3 and lowest reduction in group 2 compared with the other groups. It might be infered from these results that patients with large arteriovenous malformations, particulary those with cerebral steal symptoms, are at risk to develp neurologic defictis related to perfusion breakthrough if their malformed vessels are abruptly removed, and staged or gradual occlusion of feeding arteries may prevent this potentially devastating complication.
Adult ; Angiography ; Animals ; Arteries ; Arteriovenous Malformations ; Basilar Artery ; Blood Pressure ; Bradycardia ; Cats ; Heart Rate ; Hemodynamics ; Homeostasis* ; Humans ; Hypotension ; Jugular Veins ; Perfusion

No abstract available.
Dermabrasion* ; Eyebrows* ; Foreign Bodies* ; Foreign-Body Reaction*

The Author reports here the statistical observation of poliomyelitis from the 46 cases during a 3 month period (June, August, 1971) at the department of Orthopaedic Surgery, Korea General Hospital under the support of Shrine Club in Korea. The statistical results were as follows: 1. Among 46 cases, 30 were male, age of infection of poliomyelitis ranged from 2 month to age of five. The majority of cases were under the age of one and 95% of total patients were under the age of three. 2. Among 46 cases, 78.2% was not vaccinated fer poliomyelitis. The sequela of paralysis were more prevalent in this group. 3. tibialis anterior muscle and quadriceps femoris muscle were paralized predominently, 78.2% and 60.8% respectively. 4. Seventy eight and two tenth percent (78.2%) of patient seeked Chinese medicine practitionar with herb and acupunture, following paralysis, only 39.1% reported to the hospital and 4.4% did not see any treatment at all.
Asian Continental Ancestry Group ; Hospitals, General ; Humans ; Korea ; Male ; Paralysis ; Poliomyelitis ; Quadriceps Muscle

After the success of total hip replacement arthroplasty by John Charnley in 1962, it was well known fact that total hip replacement arthroplasty can be applied to degenerative arthritis, rheumatoid arthritis, post-traumatic arthritis, ankylosing spondylitis, even on the fused hip. However the old dislocated hip gives arise a few problem for its total hip replacement with the follwing causes:, 1. floor of the falad acetabulum is very thin and inadequate to receive a socket. 2. distorted anatomy of the acetabulum and proximal femur. 3. short and atrophic abductor mechanism. Total hip replacement arthroplasty could be successful for the old dislocated hip, if the adequate size of cup ard prosthesis are available and there is adequate length of the hip abductor. Preoperatively we can measure the size of the acetabulum and the distorted femur with roentgenogram. But it is not known how to measure or predict whether or not there is enough length of the abductor muscle mechanism preoperatively. Therefore the question arises how to measure or predict the length of the hip abductor in the old dislocated hip. Although this is a preliminary report, it is our feeling that the more the range of motion the hip has, the better the length of the hip abductor muscle. In our series acetabular socket can be positioned at the original site and the osteomized greater trochanter reduced to the femur easily in the cases more than 190 of total range of motion of the affected hips, The range of motion of the affected hip can be measured preoperatively.
Acetabulum ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Femur ; Hip ; Osteoarthritis ; Prostheses and Implants ; Range of Motion, Articular ; Spondylitis, Ankylosing

BACKGROUND: Reperfusion after brief periods within 20 minutes of myocardial ischemia can result in prolonged depression of contractile function without causing myocardial necrosis-myocardial stunning. It has been also demonstrated that low reflow phenomenon and the impairment of coronary flow reserve(CFR) can occur as the consequences of brief ischemia-reperfusion on the coronary vasculature. Although these vascular functional derangements may occur after various periods of ischemia, a 15-min episode of ischemia is known to be long enough to induce microvascular dysfunction and a briefer 10-min occlusion is not. Whether reperfusion after ischemia for 15-min or 20-min results in structural damage to the large and microvessels, as well as vascular function, and their relationship with contractile dysfunction, remains uncertain. PURPOSE: This study was performed to determine whether 1) c5-min and 20-min coronary occlusion followed by 60 minutes of reperfusion in vivo would result in injury of coronary vasculature, evident as functional and ultrastructural derangements, 2) there are any differences in the severity of vascular alterations by the duration of ischemic period, and 3) these vascular alterations relate to the regional myocardial dysfunction. METHODS: Open chest dogs underwent a 15-min(n=8) and 20-min(n=10) left circumflex coronary artery occlusion followed by reperfusion for 60 minutes. Coronary blood flow(CBF) was measured with electromagnetic flow probes. At 30 minutes and 60 minutes of reperfusion, CFR was determined after intracoronary acetylcholine(ACH, 0.01microg/kg), adenosine(ADE, 1.5microg/kg) and reactive hyperemia(RH) after 20 seconds coronary occlusion. Segmental LV function was assessed with % myocardial thickening and % endocardial wall motion by 2D echocardiography. The ultrastructure of epicardial artery and the microvessels in the endocardium was examined. RESULTS: Following reperfusion, increase in CBF and decrease in coronary vascular resistance in reponse to ACH, endothelium dependent vasodilator, was significantly impaired in both 15-min and 20-min occlusion groups. The CBF response to ADE, endothelium independent vasodilator, was intract in 15-min occlusion group, whereas significantly impaired in 20-min occlusion group. The CBF response to RH was significantly depressed in both groups. On ultrastructural examination, there was no evidence of injury in the microvessels of the subendocardium in all subjects. In the large epicardial arteries, the endothelium was damaged in all subjects and its severity was milder in 15-min occlusion group than those with 20-min occlusion. Furthermore, in 50% cases of 20-min occlusion group, the injury of superficial layer of medial smooth muscle was accompanied. There was no difference in the severity of segmental LV dysfunction between two groups, and there was no appreciable correlation between myocardial dysfunction and the depressed CBF responses to ACH, ADE and RH. CONCLUSION: 1) Reperfusion after occulsion for 15 minutes produced selective dysfunction and damage to the endothelium of epicardial artery, whereas those after 20 minutes significantly decreased coronary flow reserve and induced more pronounced damage to the epicardial artery, indicated that the severity of vascular alterations is determined by the duration of ischemic period even within 20 minutes. 2) These vascular derangements are not related to the severity of contractile dysfunction, suggesting that brief ischemia-reperfusion precipitates vascular stunning as an independent phenomenon of myocardial stunning.
Animals ; Arteries ; Coronary Occlusion ; Coronary Vessels ; Depression ; Dogs ; Echocardiography ; Endocardium ; Endothelium ; Ischemia ; Magnets ; Microvessels ; Muscle, Smooth ; Myocardial Ischemia* ; Myocardial Stunning ; Reperfusion* ; Thorax ; Vascular Resistance

No abstract available.
Ceramics* ; Metals*

No abstract available.
Cardiovascular System* ; Polymers*

No abstract available.
Polymers*

No abstract available.
Fathers* ; Friends* ; Humans ; Memory* ; Orthopedics* ; Shoulder*

Defecography evaluates in real time the morphology of rectum and anal canal in a physiologic setting by injection of a thick barium paste into the rectum and its subsequent evacuation. Because of its ability of structural and functional evaluation, defecography is primarily performed for work up of patients with longstanding constipation, unexplained anal or rectal pain, residual sensation after defecation or suspected prolapse. Technique and interpretation of this examination are outlined in this review.
Anal Canal ; Barium ; Constipation ; Defecation ; Defecography ; Humans ; Pelvic Floor ; Prolapse ; Rectum ; Sensation