No abstract available.
Rabbits ; Transplants

No abstract available.
Carcinoma, Hepatocellular* ; Collagen* ; Liver Cirrhosis* ; Liver*

BACKGROUND: Amrinone is a nonglycosidic noncatecholamine with both vasodilator and positive inotropic effects that has not been evaluated widely in pediatric patients with intracardiac left to right shunts. The present study was performed to evaluate the hemodynamic effects of amrinone in infants and children with intracardiac left to right shunts. METHODS: Twenty patients (aged 2 months to 24 months) who underwent open heart surgery to correct one or more intracardiac left to right shunts were evaluated. Before cardiopulmonary bypass, a 22 gauge angiocatheter was placed at the main pulmonary artery by surgeons to measure pulmonary arterial pressure. Patients with a mean pulmonary arterial pressure < 25 mmHg were assigned to Group A (n = 10) and > or = 25 mmHg were assigned to Group B (n = 10). Mean systemic arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), central venous pressure (CVP) and heart rate (HR) were measured before loading of amrinone (3 mg/kg), 5 minutes, and 15 minutes after continuous infusion of amrinone (10 microgram/kg). The mean pulmonary arterial pressure to mean systemic arterial pressure ratio (MPAP/MAP) and rates of changes of mean arterial pressure (delta MAP) and mean pulmonary arterial pressure (delta MPAP) were calculated. RESULTS: Amrinone reduced MAP, MPAP, CVP and increased HR. MPAP/MAP increased in Group A but decreased in Group B (P < 0.05). In Group A, delta MAP was significantly greater than that of Group B (P < 0.005). In Group B, delta MPAP was significantly greater than that of Group A (P < 0.005). CONCLUSION: In infants with intracardiac left to right shunts, amrinone reduces MAP, MPAP, CVP and increases HR. Amrinone appears to have a potent vasodilating effect on the pulmonary artery in infants with pulmonary hypertension. However, more hemodynamic measurements such as cardiac output, vascular resistance and doppler echocardiographic study are necessary to evaluate the hemodynamic effects of amrinone precisely.
Amrinone* ; Arterial Pressure* ; Cardiac Output ; Cardiopulmonary Bypass ; Central Venous Pressure ; Child ; Echocardiography ; Heart Rate ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Infant* ; Pulmonary Artery ; Thoracic Surgery ; Vascular Resistance

This is to report a case of immediate reconstruction after hemimandibulectomy by using of bicorticocancellous block bone harvested from the iliac crest in the case of an ameloblastomaon the mandible. Because the lesion involved condylar area, it was reconstructed with titanium artificial condyle attached to A/O metal plate. Three weeks after the operation, infection developed with suppuration and was well treated with adequate antibiotic therapy and drainage. The patient has been followed up over a four-year period and taken an orthopantomogram every three or six month for the examination of mandibular movement, the potentiality of recurrence and the remodeling of the grafted bone. At present, the patient is satisfied with her appearence and has a normal occlusion with proper masticatory function, and there is no sign of recurrence.
Ameloblastoma* ; Drainage ; Humans ; Mandible ; Mandibular Osteotomy ; Recurrence ; Suppuration ; Titanium ; Transplants*

OBJECTIVES: The aim of this study was to compare the osteogenic effects of demineralized dentin matrix (DDM) combined with recombinant human bone morphogenetic protein-2 (rhBMP-2) in rabbit calvarial defects with DDM and anorganic bovine bone (ABB) combined with rhBMP-2. MATERIALS AND METHODS: Four round defects with 8-mm diameters were created in each rabbit calvaria. Each defect was treated with one of the following: 1) DDM, 2) ABB/rhBMP-2, or 3) DDM/rhBMP-2. The rhBMP-2 was combined with DDM and ABB according to a stepwise dry and dip lyophilizing protocol. Histological and microcomputed tomography (µCT) analyses were performed to measure the amount of bone formation and bone volume after 2- and 8-week healing intervals. RESULTS: Upon histological observation at two weeks, the DDM and ABB/rhBMP-2 groups showed osteoconductive bone formation, while the DDM/rhBMP-2 group showed osteoconductive and osteoinductive bone formation. New bone formation was higher in DDM/rhBMP-2, DDM and ABB decreasing order. The amounts of bone formation were very similar at two weeks; however, at eight weeks, the DDM/rhBMP-2 group showed a two-fold greater amount of bone formation compared to the DDM and ABB/rhBMP-2 groups. The µCT analysis showed markedly increased bone volume in the DDM/rhBMP-2 group at eight weeks compared with that of the DDM group. Notably, there was a slight decrease in bone volume in the ABB/rhBMP-2 group at eight weeks. There were no significant differences among the DDM, ABB/rhBMP-2, and DDM/rhBMP-2 groups at two or eight weeks. CONCLUSION: Within the limitations of this study, DDM appears to be a suitable carrier for rhBMP-2 in orthotopic sites.
Dentin* ; Humans* ; Osteogenesis ; Skull ; X-Ray Microtomography

BACKGROUND: Both remifentanil and sevoflurane are known for their rapid recovery characteristics, and the bispectral index (BIS) has been used as an indicator of the sedative state during anesthesia. Therefore, it is expected that if they are used together, the anesthetic-sparing effect of remifentanil and titration of the sevoflurane concentration using the BIS monitor will contribute to a faster recovery. This study examined the effect of a remifentanil infusion on the hemodynamics, the decrease in the sevoflurane concentration, and the recovery from BIS-guided sevoflurane anesthesia. METHODS: Thirty patients undergoing laparoscopic gynecologic surgery were assigned to receive a remifentanil (0.1microng/kg/min)(Group I) or saline infusion (Group II) with sevoflurane. The sevoflurane concentration was adjusted to maintain a BIS value between 40 and 60. The mean arterial pressure, heart rate, BIS, and end-tidal sevoflurane concentration were recorded during anesthesia. The eye opening time and the incidence of postoperative nausea, vomiting and shivering were checked. RESULTS: During anesthesia, the hemodynamics were more stable in Group I than in Group II with the reduced use of cardiovascular drugs. The BIS value was lower and the end tidal sevoflurane concentration was higher in group II than in group I. Group I had a shorter eye opening time and there was a similar incidence of postoperative nausea, vomiting and shivering in both groups. CONCLUSIONS: A remifentanil infusion with BIS-guided sevoflurane anesthesia produces more stable hemodynamics, reduced sevoflurane concentration, and a more rapid recovery without side effects than in BIS-guided sevoflurane anesthesia alone.
Anesthesia* ; Arterial Pressure ; Cardiovascular Agents ; Female ; Gynecologic Surgical Procedures ; Heart Rate ; Hemodynamics* ; Humans ; Incidence ; Postoperative Nausea and Vomiting ; Shivering ; Vomiting

Necrotizing fasciitis is a rare disease characterized by rapidly progressive soft tissue infection primarily involving the superficial fascia and is associated with significant morbidity and mortality. Necrotizing fasciitis of the genitalia and the perineum, also known as Fournier's gangrene, usually occurs after local trauma, perirectal or perineal infections, and complicated surgery, such as circumcision and herniorraphy. The lack of initial external clinical signs, because the process begins in the deep subcutaneous tissue, make early diagnosis and adequate surgical management difficult. The progression of the disease is often fulminant, and the prognosis hinges on accurate diagnosis and immediate surgical debridement. The present case report documents the rare development of fulminant necrotizing fasciitis associated with a rectal cancer surgery and radiation therapy.
Circumcision, Male ; Debridement ; Diagnosis ; Early Diagnosis ; Fasciitis, Necrotizing* ; Female ; Fournier Gangrene ; Genitalia ; Male ; Mortality ; Perineum* ; Prognosis ; Rare Diseases ; Rectal Neoplasms* ; Soft Tissue Infections ; Subcutaneous Tissue

PURPOSE: Intimal hyperplasia (IH) due to vascular smooth muscle cell proliferation is a leading cause of late vascular graft failure. Transforming growth factor-beta1 (TGF-beta1), known to influence smooth muscle cell growth in vascular wall has been subjected for experimental research as a cause of IH. It has been also showed that IH can be mediated by local renin-angiotensin system in vascular intimal injury. Under the assumption that TGF-beta1 and local angiotensin II (ANG II) have a major role as a cause of IH, we carried out this study to see if there are any relationship between intimal hyperplasia and TGF-beta1 mRNA expression, and effect of angiotensin-converting enzyme inhibitor (ACEI) on IH. METHODS: 14 New Zealand White rabbits were subjected for this experiment. The right carotid arteries of 14 rabbits had been bypass grafting with polytetrafluoroethylene. 14 rabbits were allocated into two groups: 7 rabbits had bypass grafting only (graft only) and the other 7 rabbits had bypass grafting with ACEI (graft with ACEI). The rabbits, graft with ACEI were on Captopril (10 mg/kg/day PO) from day of operation to 8 weeks when to harvest. There were patent 9 carotid bypass grafts at harvest, and the studies were performed in patent grafts. Intimal hyperplasia was defined by the intima to media height ratio (IMHR). The mRNA expression of TGF-beta1 was determined by semiquantitative RT-PCR. RESULTS: IMHR of graft with ACEI was lower than that of graft (p<0.05). The mRNA expression of TGF-beta1 in graft with ACEI was lower than that in graft only (p<0.05). In summary, there was evidence that TGF-beta1 is closely related with intimal hyperplasia and there is also relationship between ANG II and TGF-beta1. CONCLUSION: ANG II and TGF-beta1 may mediate intimal hyperplasia of vascular graft, and ACE inhibitor may be a armamentarium for inhibition of intimal hyperplasia in vascular graft procedures.
Angiotensin II ; Captopril* ; Carotid Arteries* ; Cell Proliferation ; Hyperplasia ; Muscle, Smooth, Vascular ; Myocytes, Smooth Muscle ; Polytetrafluoroethylene* ; Rabbits ; Renin-Angiotensin System ; RNA, Messenger* ; Transforming Growth Factor beta1* ; Transplants*

BACKGROUND: Pyelonephritis is one of the major causes of chronic renal failure in children, and the transforming growth factor-beta1 (TGF-beta1) is a molecule with pivotal roles in fibrogenesis. This study was performed to investigate the alteration and clinical implications of urinary TGF-beta1/creatinine ratio in children with acute pyelonephritis. METHODS: Urine was collected from 67 normal children and 25 children with acute pyelonephritis. After routine urinalysis, urine TGF-beta1 was quantitated by ELISA method and creatinine was measured by alkaline picrate method. Urinary TGF-beta1/ creatinine ratios in children with pyelonephritis were compared with those of age-matched controls, and sequential changes of the ratios in pyelonephritic children were traced after antibiotic treatment. Correlation of urinary TGF-beta1/creatinine ratio with the degree of pyuria and renal scar was analyzed each. RESULTS: Neonates showed higher urinary TGF-beta1/creatinine ratios than older children. The ratio increased in acute pyelonephritis and gradually returned to the control level two days after antibiotic treatment. Urinary TGF-beta1/creatinine ratio in acute pyelonephritis was not correlated with the degree of pyuria and renal scar. CONCLUSION: The age should be considered in evaluation of urinary TGF-beta1/creatinine ratio in children. The ratio increases in acute pyelonephritis, and is independent of the degree of pyuria or renal scarring.
Child ; Cicatrix ; Creatinine ; Enzyme-Linked Immunosorbent Assay ; Humans ; Infant, Newborn ; Kidney Failure, Chronic ; Pyelonephritis* ; Pyuria ; Transforming Growth Factor beta1 ; Urinalysis

BACKGROUND: Intimal hyperplasia due to vascular smooth muscle cell proliferation is a leading cause of late vascular graft failure. Transforming growth factor-beta1 (TGF-beta1), known to influence smooth muscle cell growth in vascular wall has been the subject of experimental research as a cause of this intimal hyperplasia. Under the assumption that TGF-beta1 has a major role as a cause of intimal hyperplasia, we carried out this study to see if there were any relationship between intimal hyperplasia and TGF-beta1 mRNA expression in vascular bypass graft. METHODS: 21 New Zealand white rabbits were used for this experiment. The right carotid arteries of the 21 rabbits had been bypass grafted with polytetrafluoroethylene (PTFE graft), and the contralateral carotid arteries received sham operations (Control group). The 21 rabbits were allocated into three groups according so that the carotid artery grafts could be harvested at 1, 8, and 14 weeks, respectively. There were 14 patent carotid bypass grafts at harvest (4, 5, and 5 cases according to the postoperative period), and the studies were performed on those patent grafts. Intimal hyperplasia was defined by the intima-to- media height ratio (IMHR). The mRNA expression of TGF-beta1 was determined by semiquantitative RT-PCR. RESULTS: The IMHR in the PTFE graft groups increased as time went by from 1 to 14 weeks (p<0.01). The mRNA expressions of TGF-beta1 in PTFE grafts were higher than those in the controls at 1 and 8 weeks (p<0.05). According to sequential changes in the PTFE grafts, the expressions of TGF-beta1 were highest at 8 weeks and lowest at 14 weeks (p<0.05). CONCLUSIONS: There is evidence that TGF-beta1 is closely related with intimal hyperplasia in vascular bypass graft until 8 weeks after PTFE graft anastomosis.
Carotid Arteries* ; Cell Proliferation ; Hyperplasia* ; Muscle, Smooth, Vascular ; Myocytes, Smooth Muscle ; Polytetrafluoroethylene* ; Rabbits ; RNA, Messenger* ; Transforming Growth Factor beta1* ; Transplants*