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  • 1
    ISSN: 0942-0940
    Keywords: CT-guided stereotaxic surgery ; postoperative complications ; indications ; limitations
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The authors have studied the indications and limitations for computerized tomography (CT) -guided stereotaxic surgery (CTGS Surgery) of hypertensive intracerebral haematomas (ICH), based on the analysis of 158 patients in our institutions. Of 158 patients, 120 had putaminal haemorrhage, 21 thalamic, 14 subcortical and 3 in other locations. The patients ranged in age from 37 to 82 years (average 60). Haematoma volume ranged from 8 to 140 ml (average 43). Eleven patients in the series worsened postoperatively because of rebleeding in 6 cases, cerebral infarction in 2, and unknown causes in the remaining 3 cases. Seven of the 11 patients pre-operatively had untreated hypertension and 3 had mild liver dysfunction without major haemorrhagic tendency. Most postoperative complications were seen in older patients and in those with severe neurological deficit or chronic disease. All these cases ended in poor outcome. From our study, we propose three indications for CTGS Surgery: absolute, aggressive and passive indications. The absolute indication is applied to those who would have been operated on by conventional open surgery. The aggressive indication is for those with mild neurological deficit so that early rehabilitation can be started to regain higher cerebral function. The passive indication is for elderly patients and those with severe neurological deficit or chronic disease. This indication must be decided carefully because poor outcome is likely.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2013
    Keywords: Key words Cardiac myocytes ; Ca2+ sensitivity ; Contraction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  To estimate myofibrillar responsiveness to Ca2+, we used the relation between cell length and intracellular [Ca2+] ([Ca2+]i) during tetanic contractions of isolated ventricular myocytes. Enzymatically isolated rat ventricular myocytes were loaded with fura-2 AM (4 µM for 10 min) and excited alternately at 340 nm and 380 nm. The ratio (R) of fura-2 fluorescence at these wavelengths [F(340)/F(380), an index of [Ca2+]i] and cell length (L) were measured simultaneously. Following treatment with thapsigargin (0.2 µM), myocytes were stimulated at 10 Hz for 10 s to produce a tetanic contraction every min and an instantaneous plot of R vs L (R-L trajectory) was constructed. The R-L trajectory followed the same path during cell shortening and re-lengthening, suggesting that dynamic equilibrium between R and L was achieved during tetanus. Increasing the extracellular [Ca2+] from 1 to 8 mM extended the R-L trajectory without a substantial shift of the relation. The Ca2+-sensitizing thiadiazinone derivative, EMD57033 (1 µM), shifted the R-L trajectory to the left (sensitization of the myofibrils to Ca2+), whereas the non-selective phosphodiesterase inhibitor, 3-isobutyl-1-methylxantine (200 µM), shifted the R-L trajectory to the right (desensitization of the myofibrils to Ca2+), in agreement with previous results obtained using skinned preparations. We conclude that the R-L trajectory is useful for estimating the myofibrillar responsiveness to Ca2+ in isolated myocytes and may be beneficial for the evaluation of inotropic agents.
    Type of Medium: Electronic Resource
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