PURPOSE: Many investigators suggested that changes in hormonal environment in the postmenopausal women functionally or histologically effect the clitoris and vagina. We investigated the mechanism of female se xual dysfunction occurring in the decreased hormonal status, and aimed to establish and experimental base for the hormone replacement in postmenopausal women to correct sexual dysfunction. MATERIALS AND METHODS: Twenty mature female New Zealand white rabbits were randomly divided into three groups; control group, oophorectomy group, estrogen replacement group after oophorectomy. Nitric oxide synthase (NOS) activity and the degree of expression of neuronal NOS (nNOS) and endothelial NOS (eNOS), collagen content in clitoral tissues were analysed. RESULTS: nNOS and eNOS were significantly increased in the oohporectomized group while decreased in the estrogen replacement group (p<0.01). NOS activity showed the similar pattern of change (p<0.05). Oophorectomy induced a significant increase in collagen content, while the ratio of smooth muscle content was increased significantly after the estrogen replacement (p<0.01). CONCLUSIONS: Estrogen deficiency induces collagen synthesis and decreases the content of smooth muscle in clitoris, resulting in a structural relaxation difficulty. We believe that NOS becomes more active to improve the relaxation difficulty and that hormone replacement helps to restore the normal state of smooth muscle relaxation. Considering these findings, we suggest that estrogen down-regulates NOS and its activity.
Clitoris* ; Collagen ; Estrogen Replacement Therapy ; Estrogens* ; Female ; Humans ; Muscle, Smooth ; Neurons ; Nitric Oxide Synthase ; Ovariectomy ; Rabbits ; Relaxation ; Research Personnel ; Vagina

Although many techniques are available to assess enamel erosion in vitro, a simple, non-destructive method with sufficient sensitivity for quantifying dental erosion is required. This study characterized the bovine dental enamel erosion induced by various acidic beverages in vitro using attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy. Deionized water (control) and 10 acidic beverages were selected to study erosion, and the pH and neutralizable acidity were measured. Bovine anterior teeth (110) were polished with up to 1 200-grit silicon carbide paper to produce flat enamel surfaces, which were then immersed in 20 mL of the beverages for 30 min at 37 °C. The degree of erosion was evaluated using ATR-FTIR spectroscopy and Vickers’ microhardness measurements. The spectra obtained were interpreted in two ways that focused on the ν1, ν3 phosphate contour: the ratio of the height amplitude of ν3 PO4 to that of ν1 PO4 (Method 1) and the shift of the ν3 PO4 peak to a higher wavenumber (Method 2). The percentage changes in microhardness after the erosion treatments were primarily affected by the pH of the immersion media. Regression analyses revealed highly significant correlations between the surface hardness change and the degree of erosion, as detected by ATR-FTIR spectroscopy (Po0.001). Method 1 was the most sensitive to these changes, followed by surface hardness change measurements and Method 2. This study suggests that ATRFTIR spectroscopy is potentially advantageous over the microhardness test as a simple, non-destructive, sensitive technique for the quantification of enamel erosion.

BACKGROUND: To compare flexible ring with rigid ring for annular remodeling and hemodynamic changes of left ventricle (LV) in mitral valve repair (MVR) at short term interval. METHODS: From January 1998 to March 2001, 35 patients with mitral valve prolapse underwent mitral valve repair with ring annuloplasty. The mean age of these patients was 49 years. Eighteen patients underwent mitral annuloplasty with Carpentier-Edwards Classic-ring (Group A). Seventeen patients underwent mitral annuloplasty with Physio-ring (Group B). LV fun-ction and annulus size were assessed by echocardiography on the day before operation and 2 to 3 months later. Mitral annular motion had been examined by means of the extent of mitral annular systolic excursion (MASE) as measured in two longitudinal LV segments (septal and lateral). RESULTS: 1) In valve pathology, anterior leaflet lesion was 14 cases, posterior was 14, combined lesion was 7 cases. 2) At all, left ventricular end-systolic dimension, left ventricular end-diastolic dimension and LV mass decreased postoperatively. But, no differences existed between the groups. 3) Postoperatively (after 2-3 months), echocardiograms in 35 patients demonstrated no mitral regurgitation (MR) in 16 cases, trace to mild MR in 17 cases, moderate MR in 2 patients. In Classic-ring group, MR was demostrated in 11 cases (61%). In Physio-group, MR was demonstrated in 8 cases (47%). 4) Postoperatively, mitral valve area increased significantly only in patients with Physio-ring (1.93+/-0.33 vs 2.38+/-0.92, p<0.05). 5) No differences existed between the groups in MASE. CONCLUSION: There are the significant reduc-tion in cardiac chambers and annulus size and improvement of LV function after both types of ring annuloplasty at short term result. There are no significant differences between Classic-ring and Physio-ring except 2 cases postrepair SAM (systolic anterior motion) of mitral valve in Classic-ring.
Echocardiography ; Follow-Up Studies* ; Heart Ventricles* ; Hemodynamics* ; Humans ; Mitral Valve Annuloplasty ; Mitral Valve Insufficiency ; Mitral Valve Prolapse* ; Mitral Valve* ; Pathology

BACKGROUND AND OBJECTIVES: Although it is well known that mitral valve repair provides a better postoperative outcome than valve replacement for mitral valve prolapse with mitral regurgitation, there haven't been much studied the nature of remnant regurgitation and the change of heart function and structure by remnant regurgitation after mitral valve repair surgery. We tried to research for it. METHODS AND RESULTS: Retrospective analysis of echocardiographic data and medical records was done in patients who underwent repair surgery for mitral valve prolapse with significant mitral regurgitation at the Keimyung University Dong-san Medical Center from February 1996 to February 2000. Patients who underwent echocardiography before and after the surgery were selected for the analysis. Of patients who underwent mitral valve repair surgery for mitral valve prolapse with mitral regurgitation during that period, 30 patients (male 15, female 15) were included in this study. The average age of them was 44.30+/-14.30 year old. After surgery, heart chamber size was decreased significantly in all patients (e. g. LVDd 6.25+/-1.06 cm vs. 5.14+/-0.62 cm, LV mass 272.46+/-107.36 gm vs. 197.30+/-75.16 gm). Remnant mitral regurgitation after repair surgery was found in 22 patients (73.3%). Remnant mitral regurgitation above trivial flow was found in 10 patients. Such case as involving ant. leaflet was found in 5 patients (16.7%), as involving post. leaflet, in 2 patients (6.7%), as involving both leaflet, in 3 patients (10%) among 10 ones. Eccentric flow among remnant regurgitation, was observed in 2 patients who underwent repair surgery for ant. leaflet, 1 patient who underwent repair surgery for both leaflet. CONCLUSION: Mitral valve repair surgery reduce the left ventricular chamber size and left ventricular mass. Postoperatively, patients who involve ant. leaflet were much remnant regurgitation above trivial flow more than others.
Ants ; Echocardiography ; Female ; Heart ; Humans ; Medical Records ; Mitral Valve Insufficiency* ; Mitral Valve Prolapse* ; Mitral Valve* ; Retrospective Studies ; Thoracic Surgery

Rapid induction,complete loss of conciousness,and stability of cardiovascular system are the variables that should be considered in choosing anesthetics and method of induction for patients with cardiovascular diseases. The great attention should be given because elevation of blood pressure and tachycardia during induction of anesthesia can deteriorate patients cardiovascular system. High-dose of fentanyl was used for the induction of open heart surgery since 1978 and showed effectiveness in stabilizing cardiovascular changes. Many authors argued that fentanyl may not induce unconciousness. As endeavor to shorten the oneset time of unconsciousness, commonly used intravenous anesthetics with fentanyl were tried. Among patients scheduled for open heart surgery, 30 patients with ejection fraction higher than 0.5 were randomly selected and divided into three groups. For the induction of anesthesia, group 1 was given fentanyl alone; group 2 fentanyl with diazepam(0.1mg/kg); and group 3 fentanyl with thiopental sodium (0.2mg/kg). Loss of conciousness (oneset time of unconciousness and dosage of fentanyl) and cardiovascular responses(systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, and rate pressure product) just before induction,before intubation, and immediately after intubation were compared and results were as followes. l. It took 322 seconds to induce unconciousness in group 1, 213 seconds in group 2,and 87 seconds in group 3. It was shortened significantly in group 2 and group 3 as compared to group 1 and in group 3 as compared to group 2(p<0.05). 2. Dosage of fentanyl was 30 mcg/kg in group 1, 20 mcg/kg in group 2, and 8 mcg/kg in group 3. As compared to group 1 and group 2, it was significantly decreased in group 3 (p<0.05). 3. Systolic blood pressures before tracheal intubation in gmup 2 and group 3 significantly decreased as compared to the level of preinduction(p<0.05), 4. Diastolic blood pressure before tracheal intubation in group 3 significantly decreased as compared to the level of preinduction(p<0.05). 5. Mean arterial blood pressure before tracheal intubation in group 2 and group 3 significantly decreased as compared to the level of preinduction(p<0.05). 6. There was no significant change in heart rate. 7. Rate pressure product before tracheal intubation in group 3 significantly decreased as compared to the level of preinduction and rate pressure product after tracheal intubation in group 1 significantly increased as compared to the level of preinduction(p<0.05). Considering above results, it is difficult to choose specific anesthetics and methods for the induction of open heart surgery. It depend on the patients cardiovascular function and physicians experience and their preference. Meticulous observation and continuous monitoring of cardiovascular response are very important when intravenous anesthetics are used with fentanyl.
Anesthesia ; Anesthetics ; Anesthetics, Intravenous ; Arterial Pressure ; Blood Pressure ; Cardiovascular Diseases ; Cardiovascular System ; Fentanyl ; Heart Rate ; Heart* ; Humans ; Intubation ; Tachycardia ; Thiopental ; Thoracic Surgery* ; Unconsciousness*

Hepatoblastoma is a primary embryonic liver tumor usually found in children. It extremely rarely occurs in adults. We report a case of hepatoblastoma in a 56 year old man with chronic hepatitis B of 10years duration. Laboratory investigation of the patient on admission showed a marked elevation of alpha-fetoprotein in serum. Ultrasonography and Computerized tomography scan revealed a primary tumor, 6x7cm in size, in the right lobe. The tumor removed by a right lobectomy. Complete removal of the tumor is the treatment which is potentially curative provided that lesion is confined within the liver capsule. The literature revealed and a case of this tumor reviewed.
Adult* ; alpha-Fetoproteins ; Child ; Hepatitis B, Chronic ; Hepatoblastoma* ; Humans ; Liver ; Middle Aged ; Ultrasonography

No abstract available.
Nicotine* ; Smoke* ; Smoking Cessation* ; Smoking* ; Tobacco Use Cessation Products*

Body dysmorphic disorders can be often diagnosed among the group of patients seeking plastic surgery with excessiveness. For the correction of unrealistic body images tied up in their minds, they have a tendency to choose improper plastic operation or unlicensed procedures rather than the psychiatric intervention. So- called 'illegal injection' performed by the unlicensed has been readily accessible tempting alternatives, which could result in disastrous outcomes due to multiple compulsive injections. Nowadays injection of foreign materials, such as paraffin oil or liquid silicon, is thought to be obsolete in modern medical procedures. Nevertheless, these illegal procedures have been in extensive use among some Asian countries, including Korea, by the unlicensed. Local complication, particularly, granulomatous inflammatory responses of variable severity can occur, despite skillful techniques and even small amount of injection. Futhermore, these lesions frequently persist or recur after treatment. We have a case of a body dysmorphic disorder manifesting severe, huge foreign body granulomas caused by silicon, paraffin and oil injected. Our case was a 38- years-old woman who had multiple huge masses on head and neck which had slowly grown after multiple injections for about 16 years. After a psychiatric intervention, we performed partial resection of masses in cheek and neck area, followed by liposuction of forehead, neck and scalp. A brief history of case and the clinical significance of foreign body injection in body dysmorphic disorder were described.
Asian Continental Ancestry Group ; Body Dysmorphic Disorders* ; Body Image ; Cheek ; Female ; Forehead ; Foreign Bodies* ; Granuloma ; Granuloma, Foreign-Body ; Head ; Humans ; Korea ; Lipectomy ; Neck ; Paraffin ; Scalp ; Silicones ; Surgery, Plastic

PURPOSE: The inflammatory phase is considered an integral part of adult wound healing, but fetal wound healing studies have shown scarless healing results in the absence of the inflammation process. The COX-2 pathway is an essential component of inflammation. The purpose of this study is to identify the effect of a topical selective COX-2 inhibitor on inflammation in rabbit skin wound healing and scarring. METHODS: Full-thickness wounds were made on 6 New Zealand rabbits' ears. Topical 5% celecoxib + vehicle (experimental tissue) and vehicle only (controlled tissue) were applied daily for 14d on each side of the ears. Scar samples were harvested at 2 wks, 4 wks, and 8 wks after the wounding. Each sample was stained with hematoxylin and eosin and the Masson's trichrome stain to evaluate inflammation and scar formation. RESULTS: Histological analysis demonstrated a significant reduction of inflammation, neovascularization, and scar elevation in the experimental tissue as compared to the control. Additionally, experimental tissue exhibited faster improvement of collagen organization similar to that of normal tissue. CONCLUSION: This study suggests that the topical application of a selective COX-2 inhibitor on a rabbit ear wound resulted in decreased inflammation and had a positive effect on the reduction of scar formation.
Adult ; Azo Compounds ; Cicatrix ; Collagen ; Cyclooxygenase 2 ; Cyclooxygenase Inhibitors ; Ear ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Inflammation ; Methyl Green ; New Zealand ; Pyrazoles ; Skin ; Sulfonamides ; Wound Healing ; Celecoxib

Although dysphagia in patients with acute leukemia is usually related to reflux esophagitis, infectious esophagitis, chemotherapy1) and leukemic infiltration2), acute esophageal stricture resulting from chemotherapy in the patient with leukemia is very rare. A 40-year-old man with acute myelogenous leukemia was admitted for operation of esophageal stricture which was developed within 1 month of chemotherapy. An esophagectomy and esophagogastrostomy with pyloroplasty was carried out. Histology showed mucosal infiltration of mononuclear cells and transmural fibrosis involving submucosa and the muscle layer.
Adult ; Deglutition Disorders ; Drug Therapy ; Esophageal Stenosis* ; Esophagectomy ; Esophagitis ; Esophagitis, Peptic ; Fibrosis ; Humans ; Induction Chemotherapy* ; Leukemia ; Leukemia, Myeloid, Acute