Dumb-bell shaped tuberculous abscess across the greater sciatic notch compressing both sciatic nerves.

We report an instructive case of a 65-year-old man who presented with a dumb-bell shaped tuberculous abscess across the greater sciatic notch bilaterally compressing both sciatic nerves. Clinical symptoms progressed slowly and mimicked lumbar radiculopathy, thus delaying an accurate diagnosis. Anterolateral retroperitoneal and posterolateral gluteal approaches of the greater sciatic notch as well as the acetabulum on both sides were followed in order to provide safe viewing and resection of the abscess.

[Experimental study on 5-FU intraperitoneal injection for liver metastasis].

The 5-FU concentrations in peripheral blood and portal blood were determined in rats after 5-FU injection via three routes. Rats were given 1 ml of 5-FU (250 mg/kg) via the subphrenic, Douglas or intravenous routes. From comparison of 5-FU concentrations between the intravenous injection group and the intraperitoneal group (subphrenic injection group + Douglas injection group), the intraperitoneal group had a lower concentration than the intravenous one in peripheral blood.

The end-systolic pressure-volume relationship and ventriculoarterial coupling in patients undergoing coronary artery bypass graft surgery.

Background: The end-systolic pressure-volume relationship and analysis of ventriculoarterial coupling have been established as a useful tool to determine the left ventricular performance and arterial loading conditions. The purpose of this study was to evaluate the end-systolic pressure-volume relationship and ventriculoarterial coupling in anesthetized patients with either a normal heart or coronary artery disease (CAD) using a transesophageal echocardiography (TEE) monitor.

Methods: Sixteen patients with CAD and 4 patients without ischemic disease were studied.

A new approach to dynamic graciloplasty.

The reestablishment of anal function by transposition of the gracilis muscle, combined with the implantation of electrodes and a neuromuscular stimulator (dynamic graciloplasty), has recently been developed. With this method, the transposed muscle maintains contraction by electrical stimulation to maintain neoanal pressure without fatigue. It is necessary to convert the fatigue-prone gracilis muscle to fatigue-resistant muscle by long-term electrical stimulation (conditioning).

Clinical significance of hepatitis GB virus C infection in alcoholic liver disease.

Recently, hepatitis GB virus C (HGBV-C) has been recovered from patients with non-A-E hepatitis. However, it has been unclear whether HGBV-C may be related to the development of alcoholic liver disease (ALD) or not. In this study, we determined HGBV-C RNA in sera from alcoholic patients without markers for hepatitis C and B viruses to evaluate the role of HGBV-C in ALD.

Characteristics of serum hyaluronate concentrations in patients with alcoholic liver disease.

It has been reported that serum hyaluronate [hyaluronic acid (HA)] concentrations are increased in liver diseases, especially in alcoholic liver disease (ALD). However, the characteristics of serum HA concentration in patients with ALD have not been studied. In this study, first, we measured serum HA concentrations in patients with different stages of both ALD and non-ALD to clarify the characteristics of serum HA concentration in patients with ALD.

New pathway for leads in dynamic graciloplasty.

Dynamic graciloplasty is one of the methods now used to re-establish anal function. Among complications, pain in the local tissue and skin irritation have been reported, both caused by lead wires. By passing the leads posterior to the adductor longus muscle, the wires do not irritate the local skin and are fixed well without sutures.

Esophageal atresia in Osaka: a review of 39 years' experience.

Background: One hundred fifty-nine patients who had esophageal atresia with or without tracheoesophageal fistula have been treated at Osaka University Medical School and its affiliated hospitals since the initial (Japanese) experience of Dr T. Ueda in 1957.

Methods: These cases were divided chronologically into three groups.

Extraforaminal lumbar disc herniation at two contiguous intervertebral levels.

We describe two unusual surgical cases who presented with extraforaminal lumbar disc herniation that occurred at two adjacent vertebral levels simultaneously and unilaterally. Magnetic resonance imaging and selective nerve root infiltration followed by radiculography helped to outline the herniated disc material. Lateral fenestration and microsurgical foraminal widening of the affected vertebral levels allowed a complete and safe relief of the compressed nerves.

The differential effects of prostaglandin E1 and nitroglycerin on regional cerebral oxygenation in anesthetized patients.

Unlabelled: We evaluated the effects of prostaglandin E1 (PGE1) and nitroglycerin (NTG) on regional tissue oxygenation and use in the brain using near infrared spectroscopy (NIRS). Twenty-four patients who underwent elective cardiac surgery were randomly divided into two groups. The study was performed after the induction of anesthesia and before the start of the surgical procedure.

[Acute necrotizing encephalopathy with horizontal gaze palsy].

Acute necrotizing encephalopathy (ANE) of childhood is a newly proposed disease entity characterized by symmetrically distributed necrotic brain lesions in the thalamus, cerebral white matter, brainstem, and cerebellum. We report a 4-year-old girl with severe psychomotor delay and horizontal gaze palsy as sequelae of ANE at 17 months of age. The computed tomography showed bilaterally symmetrical low density areas in the thalamus and low density areas in the left middle cerebral artery (MCA) region and the posterior cerebral artery (PCA) region.

A case of a dialysis patient with sclerosing peritonitis successfully treated with corticosteroid therapy alone.

Sclerosing peritonitis (SCP) is a rare complication of peritoneal dialysis. Most of the patients with this serious complication have been treated in a symptomatic and conservative manner. Other patients have undergone risky surgical interventions.

Mechanisms responsible for gastroesophageal reflux in children.

Background & Aims: There is limited information about the motor mechanisms responsible for gastroesophageal reflux (GER) in children. The aim of this study was to evaluate the relationship between esophageal body and lower esophageal sphincter (LES) motor events and the occurrence of GER.

Methods: Concurrent esophageal manometry and pH monitoring was conducted for 4 hours postprandially in 37 children referred for evaluation of suspected pathological GER.

The locus coeruleus noradrenergic system in the rat brain studied by dual-probe microdialysis.

A dual-probe microdialysis technique was applied to the locus coeruleus (LC) and prefrontal cortex (PFC) of the brain of conscious rats. One probe was implanted close to the LC and was used to apply receptor-specific compounds by retrograde microdialysis. The effects of the LC infusions were recorded by a sampling noradrenaline by a second probe that was implanted in the ipsilateral prefrontal cortex.

Purification and properties of an aminopeptidase from a protamine-degrading marine bacterium.

A protamine-degrading marine bacterium was isolated from marine soil and identified as Aeromonas salmonicida subsp. based on its taxonomical characteristics. An alanine-specific aminopeptidase, called aminopeptidase K, from an extract of the strain was purified and characterized.

Inhibition of bone resorption by pamidronate cannot restore normal gain in cortical bone mass and strength in tail-suspended rapidly growing rats.

To clarify how the changes in bone formation and resorption affect bone volume and strength after mechanical unloading, the effect of inhibition of bone resorption by a potent bisphosphonate, pamidronate, on bone mineral density (BMD), histology, and strength of hind limb bones was examined using tail-suspended growing rats. Tail suspension for 14 days reduced the gain in the BMD of the femur at both the metaphysis rich in trabecular bone and the diaphysis rich in cortical bone. Treatment with pamidronate increased the total BMD as well as that of the metaphysis of the femur but had almost no effect on the BMD of the diaphysis in both control and tail-suspended rats.

Responses of the rat lower oesophageal sphincter (LOS) to vagal efferent activation.

Nitric oxide (NO) is a major candidate in vagal-induced LOS relaxation. Vagal adrenergic fibres also innervate the gastrointestinal tract including the LOS. This study investigates the role of these two and other mechanisms in LOS responses to vagal activation in the rat, and provides functional and anatomical evidence for a smooth muscle LOS in this species.

Effects of continuous distraction on cartilage in a moving joint: an investigation on adult rabbits.

An animal model, using distraction force on adult rabbits, was developed to study the effects of nonweight-bearing on articular cartilage in a moving joint. Histologic evaluation was used to compare the morphology of chondrocytes, safranin O intensity, cartilage thickness, and structural changes between the test and contralateral joints. At 3 and 6 weeks, the chondrocytes in superficial and intermediate zones were round, with an increase in cellular volume density and mean cell volume and with less metachromasia; the safranin O intensity and cartilage thickness were the same as in the controls.

Continuous isoproterenol inhalation therapy in children with severe asthmatic attack.

We studied the 1-type isoproterenol inhalation therapy for patients with severe asthmatic attacks who were admitted at the Department of Allergy of National Children's Hospital from 1981 to 1991. One hour after l-type isoproterenol inhalation therapy, statistically significant effects were noted with regard to the asthmatic status. Moreover, no side effect was found amoung the subjects.