OBJECTIVE: This study was performed to investigate whether 1) estrogen induces the change of vascular tone in endothelium-denuded human uterine artery, and 2) endothelium-independent vascular reactivity may be mediated by intracellular calcium ion modulation. METHODS: The uterine arteries from 34 premenopausal women were obtained at the time of hysterectomy due to various indications and endothelium was denuded. Vascular reactivity was monitored by using Isometric force transducer and recorded by physiograph. Endothelial integrity was assessed by sequential administration of 1micrometer norepinephrine(alpha-adrenergic stimulant) and 10 micrometer acetylcholine (endothelium -dependent vasorelaxant). Integrity of smooth muscle was measured by administration of 10 micrometer sodium nitroprusside (endothelium - independent vasorelaxant) and 10 micrometer tamsulosin(alpha-adrenergic blocker). A dose-dependent action of estrogen was measured on denuded uterine arteries, pretreated with norepinephrine and potassium chloride. In media contained denuded uterine arteries pretreated with 70mM potassium chloride and estradiol(3X10-5M), nitric oxide and its inhibitor, N-nitro-L-arginine methyl ester(L-NAME) was administered, respectively, in order to verify the vasodilation effect. Statistical tests were performed at the 5% level of significance using the SPSS PC+ package. RESULTS: Acethylcholine has little effect but sodium nitroprusside & talmsulosin showed marked relaxation, which suggested loss of endothelial function and adequacy of smooth muscle function. The contraction by norephinephrine(1 M) revealed estrogen induced relaxation which was concentration-dependent from 3 10-8M to 3 10-5M in concentration of 17 -estradiol. The contraction by high potassium solution 70mM was also inhibited by estrogen in concentration-dependent manner. This vasorelaxant effect of estrogen on endothelium-denuded uterine artery was not affected by addition of nitric oxide(NO) precursor, L-arginine and nitric oxide synthase(NOS) inhibitor, L-NAME. CONCLUSION: The results of this study revealed that estrogen has vasorelaxant effect on endothelium endothelium-denuded uterine artery by calcium antagonistic property through direct inhibitory effect on receptor- and voltage dependent calcium ion channels of smooth muscles. This vasorelaxant effect of estrogen on endothelium-denuded uterine artery was NO independent.
Acetylcholine ; Arginine ; Calcium ; Calcium Channels ; Endothelium* ; Estrogens* ; Female ; Humans* ; Hysterectomy ; Muscle, Smooth ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitroprusside ; Norepinephrine ; Potassium ; Potassium Chloride ; Relaxation ; Transducers ; Uterine Artery* ; Vasoconstriction* ; Vasodilation

We examined 646 neonates 1~3 days after birth at Seoul National University Hospital and Chungnam National University Hospital between April 1, 1986 and Dec. 31, 1986. To make neonates attentive, they were examined before feeding and if neonate was not attentive, we used side to side rocking or up and down movement to stimulate attentiveness. Their eye positions were tested with Hirschberg method and extraocular muscle function was tested with oculocephalic maneuver. Of these 646 neonates, 288(44.6%) had orthophoria, 337(52.2%) had exotropia, 6(0.9%) hadesotropia, 12(1.9%) had intermittent exotropia, 2(0.3%) had intermittent esotropia, and 1(0.2%) had exo-esotropia. None had infantile esotropia. Four months after birth, we reexamined 198 infants. Two of 88 infants who were orthophoric on previous examination had intermittent exotropia and 101 of 103 infants who were exotropic after birth had orthophoria. Two infants who were esotropic and 5 infants who were intermittently exotropic after birth had orthophoria. None had infantile esotropia.
Chungcheongnam-do ; Esotropia ; Exotropia ; Humans ; Infant ; Infant, Newborn* ; Parturition ; Seoul

Although replacement therapy with insulin can prevent acute metabolic disorder in patients with IDDM (insulin dependent diabetes mellitus), it does not permanently restore glucose homeostasis. Recently it has been reported that islet transplantation could completely correct the glucose metabolic abnormalities and prevent further progression of the secondary complications of IDDM. For successful transplantation, the isolated islets should be prepared without loss of viability, while their immunogenicity being suppressed to reduce graft rejection. The present study was aimed to determine the optimal condition of islet culture, and to transplant them into the digestive organs including gastroin-testinal wall and salivary gland. For islet culture, pancreatic islets were isolated by a modified collagenase digestion technique from rats and cultured for 24, 48 and 72 hours in RPMI-1640 containing 0, 5.6 and 16.7 mM glucose. The viability of islets was evaluated by detection of insulin mRNA expressed in islet beta-cells using the in-situ hybridization and northern blot analysis, while their insulin content was examined by immunocytochemistry. Insulin mRNA was significantly reduced after 48 hours of culture in the islets incubated with absence of glucose, while distinct immunoreaction for insulin remained in the same islet. On the other hand, the islets cultured with normoglycemic (5.6 mM glucose) and hyperglycemic (16.7 mM glucose) conditions showed a normal or excessive transcription of insulin gene after 72 hours, respectively. These results indicate that biosynthetic activity of islets could be maintained longer than 72 hours without alteration of viability when they were cultured in normoglycemic condition. Therefore, we used islets cultured for 72 hours with 5.6 mM glucose for transplantation. The islets were implanted into the submucosal wall of the stomach and duodenum as well as into the parenchyme of the submandibular gland of the streptozotocin-induced diabetic rats. The transplanted islets in the gastrointestinal wall were abolished in 72 hours, while the islets injected into the submandibular gland retained normal cellular structure with viability for longer period. The beta-cell in the submandibular gland showed similar immunoreactivity for insulin compared to that of normal islets. However, they showed gradual infiltration of lymphocytes and beta-cell destruction at 10~14 days after transplantation. We suggested that the submandibular gland could be recommended as an alternative site for islet transplantation, because it is very easy to access for transplantation and provides the structural and functional similarities to pancreas in which the islets spontaneously grow.
Animals ; Blotting, Northern ; Cellular Structures ; Collagenases ; Diabetes Mellitus, Type 1 ; Digestion ; Duodenum ; Glucose ; Graft Rejection ; Hand ; Homeostasis ; Humans ; Immunohistochemistry ; Insulin ; Islets of Langerhans ; Islets of Langerhans Transplantation ; Lymphocytes ; Pancreas ; Rats* ; RNA, Messenger ; Salivary Glands ; Stomach ; Submandibular Gland ; Transplantation

INTRODUCTION: To report the result of the thigh perforator free flap for the reconstruction of the soft tissue defect of the lower extremities and usefulness of this flap. MATERIALS AND METHODS: We have performed 23 cases of thigh perforator free flap to reconstruct the soft tissue defect of the lower extremities between February 2004 and July 2005. The anterior aspect of the legs were 9 cases, the ankle joints were 4 cases, the dorsal aspect of the feet were 6 cases, the sole of the feet were 4 cases as recipient sites. The anterolateral thighs were 13 cases, the anteromedial thighs were 10 cases as donor sites. The size of the flap ranged from 4 x 5 cm to 12 x 18 cm. The mean flap area was 73.2 cm2. The length of the pedicle ranged from 5 cm to 15 cm. Every patient except children was operated under the spinal anesthesia. RESULTS: 21 flaps (91.3%) survived, 2 flaps (8.7%) failed. In the 21 flaps that had survived, there were partial necrosis in 4 cases, which healed without any additional operation. In the 13 anterolateral thigh perforator flaps, 9 cases survived totally, 3 cases had the partial necrosis, 1 case failed. In the 10 anteromedial thigh perforator flaps, 8 cases survived totally, 1 case had the partial necrosis, 1 case failed. CONCLUSION: The authors had a good result with the thigh perforator free flap and believe that this flap is a good option for the reconstruction of the soft tissue defect of the lower extremities, because this flap has a thin thickness and it is easy to dissect the vessels. Moreover the patients can be operated with supine position.
Anesthesia, Spinal ; Ankle Joint ; Child ; Foot ; Free Tissue Flaps* ; Humans ; Leg ; Lower Extremity* ; Necrosis ; Perforator Flap ; Supine Position ; Thigh* ; Tissue Donors

Several reports have described the usefulness of tumor markers detected in pancreatic juice for diagnosis of pancreatic cancer. We performed this study to evaluate the usefulness of tumor markers in pure pancreatic juice collected by duodenoscopic cannulation of pancreatic duct before and after injection of secretin. From April 1993 to July 1995, 8 cases of pancreatic cancer, 5 cases of benign pancreatic lesions, and 5 cases of benign biliary diseases without pancreatic lesion were involved. CEA and CA 19-9 immunoreactivity were measured by radioimmunoassay. Concentrations of CA 19-9 in pure pancreatic juice were significantly higher in patients with pancreatic cancer(median value; 3582, range 88.4-10410 IU/ml) than in control patients(median value 231, range 30.4-682 IU/ml)(p<0.05). Concentrations of CEA in pure pancreatic juice were not significantly different between patients with pancreatic cancer(median value: 6,5, range 1.0-152ng/ml) and control patients(median value: 4.0, range 1-17.2 ng/ml)(p>0.05). There was no significant correlation between levels of CA19-9, CEA in pancreatic juice and those levels in serum. The amounts of juice collected by duodenoscopic cannulation in patients with pancreatic cancer were 1.5+/- 0.9ml during 5 minutes before infusion of secretin, 11.3+/- 3.9ml, 10.8+/- 4.0ml, 10.6+/- 4.0ml in 5 minute interval after infusion of secretin. These results indicated that measurement of CA19-9 in pure pancreatic juice may be used as a marker for pancreatic cancer. Adequate amount of pancreatic juice was collected by duodenoscopic cannulation for evaluation of tumor marker, enzyme studies and cytology.
Catheterization ; Diagnosis ; Humans ; Pancreatic Diseases ; Pancreatic Ducts ; Pancreatic Juice* ; Pancreatic Neoplasms ; Radioimmunoassay ; Secretin ; Biomarkers, Tumor

OBJECTIVE: The purpose of this research was to investigate the differences of symptoms and neurocognitive functions with good and poor social functioning schizophrenic outpatients. METHOD: 152 schizophrenic outpatients were divided to good social functioning group(n=26) and poor social functioning group(n=126) based on the instrumental role of workers or students. Neurocognitive functions of these patient groups were compared with normal control group, which was composed of 30 healthy persons without a history of psychiatric illness. Schizophrenic symptoms were assessed by the Positive and Negative Syndrome Scale(PANSS). Neurocognitive function tests include the sustained attention, sensory register, executive function, concentration and attention, and verbal memory and learning assessed with Degraded Stimulus Continuous Performance Test(DS-CPT), Span Apprehension Task(SAT), Wisconsin Card Sorting Test(WCST), Digit Span(DS), and Rey Auditory Verbal Learning Test(RAVLT). RESULTS: 1) No significant differences were noted in the symptom subtypes of PANSS between good and poor social functioning patient groups. 2) The poor social functioning patient group showed significant deficits in the sustained attention, sensory register, concentration and attention, and verbal memory and learning as manifested in the data of DS-CPT, SAT, DS, and RAVLT compared with normal control and good social functioning patient groups. But there were no differences in these neurocognitive functions between good social functioning patient group and normal control group. CONCLUSIONS: These results suggested that some neurocognitive deficits such as sustained attention, sensory register, concentration and attention, and verbal memory and learning may be more important factors than symptoms for social functioning in the stable schizophrenic outpatients.
Executive Function ; Humans ; Learning ; Memory ; Outpatients ; Schizophrenia ; Verbal Learning ; Wisconsin

If manometric profiles of sphincter of Oddi(SO) measured from the pancreatic duct and the bild duct are essentially equal, then measurement of manometric profiles from only one duct would be adequate in evaluating SO dysfunction. We report a series of 9 patients whom we evaluate with SO manometry. Cannulation of both the biliary sphincter segment and pancreatic sphincter segment was archived consecutively in one session and we compared the manometric parameters of choledochal sphincter from those of pancreatic sphincter. 1) In 7 out of 9 patients(78%), normal manometric finding of SO were seen in both choledochal and pancreatic sphincters. However, in 2 out of 9 cases(22%) abnormal manometric findings were noted in only one sphincter segment. Elevation of basal pressure(n = l) and increased retrograde propagation(n = 1) were found in the pancreatic sphincter segment alone. 2) Tbe mean intraductal pressure in the pancreatic duct was significantly greater(12.6+/- 5.8mmHg) than that of common bile duct(3.8+/- 3.3mmHg)(p<0.01). However, basal pressure, amplitude, frequency and propagation sequence in the phasic contraction of SO were not different significantly between choledochal and pancreatic sphincter segment. In conclusion, SO manometry of both the pancreatic and bile duct is needed if complete manometric information is desired. Selective cannulation of common bile duct and pancreatic duct during SO manometry is necessary in order to diagnose segmental 50 dysfunction.
Bile ; Bile Ducts ; Catheterization ; Common Bile Duct ; Humans ; Manometry ; Pancreatic Ducts ; Sphincter of Oddi

Objectives: The sphincter of Oddi(SO) manometry via transpapillary route is performed usually for a period of several minutes. To investigate whether there is a considerable variation in the manometric measurements of SO over a longer period of time, we have performed long-term manometry of SO via transpapillary(n=5) as well as percutaneous(n=7) route. Methods: Transpapillary manometry of SO was carried out by conventional low- compliant continuously perfused techni~que. The location of the manometric catheter was maintained at the same level by observing the video monitor. SO manometry and the duodenal migrating motor complex(MMC) was simuitaneously measured with specially designed catheter via pereutaneous route. Results: The mean recording time was 41 minutes(range 11-72 minutes). The frequency of phasic contractions of SO varied from 0 to 12/min. Throughout the whole recording period, high-frequency contractians(over 8/min) were noted in 14.9 % of the time. In the eases of percutaneous transductal SO manometry, the periods of high-frequency contractions coincided with the phase III of duodenal MMC. The interval between the first high-frequency contractions and the second was 47 minutes. The mean duration of high-frequency contractions was 6 minutes and 4~2 seconds. There as no significant change in the amplitude, basal pressure and contraction sequence among the various periods of frequencies. Conclusions: Long-term continuous recording of SO manometry via transpapillary and percutaneous route showed that the contraction frequency of SO was not constant and tachyoddia appearde periodically. In the interpretation of tachyoddia, it is necessary to consider the period of phase III of the duodenal MMC.
Catheters ; Manometry* ; Sphincter of Oddi*

We report two cases of mucinous ductal ectasia of the pancreas which showed characteristic pancreatoscopic findings. They also showed characteristic duodenoscopic findings such as patulous ampullary orifice and mucus leakage from the papilla, and underlying pathology was hyperplasia in one case and adenoma in the other case, The insertions of pancreatoscope into the main pancreatic duct were easy without previous sphincterotomy and whitish frog egg-like mucosa was noted in one case and finger-like papillary projection was noted in the other case.
Adenoma ; Dilatation, Pathologic* ; Hyperplasia ; Mucins* ; Mucous Membrane ; Mucus ; Pancreas* ; Pancreatic Ducts ; Pathology

PURPOSE: The association of varicoceles and subfertility has been well documented. Although varicoceles remain the most common surgically correctable cause of male infertility the subjective diagnosis of varicocele, especially the small ones remains a challenge. MATERIALS AND METHODS: We evaluated 40 young men (16 volunteers, 24 varicocele patients) with scrotal blood pool scan using 99mTc RBC. RESULTS: Complete correlation between physical findings and the scrotal scan was found. The postoperative scans of 12 patients with surgically corrected high grade varicoceles demonstrated symmetrical photon accumulation in the scrotum. The technique which most accurately correlated the clinical grade was the varicocele index using total count at Valsalva maneuver. CONCLUSIONS: We believe that the 99mTc RBC scrotal scan with technical refinement is a useful procedure in the objective diagnosis and followup of varicoceles.
Diagnosis ; Follow-Up Studies ; Humans ; Infertility ; Infertility, Male ; Male ; Scrotum ; Valsalva Maneuver ; Varicocele* ; Volunteers