No abstract available.
Cholesterol* ; Female ; Hypertension, Pregnancy-Induced* ; Lipoproteins* ; Metabolism* ; Pregnancy ; Pregnancy*

Eisenmenger's syndrome is defined as pulmonary hypertension with right-to-left or bidirectional shunting of blood through an intracardiac or aorto-pulmonary commumication. It can occur with complex congenital cardiac malformations, such as septal defect and patent ductus arteriosus. Parturients with Eisenmenger's syndrome are at high risk for peripartum morbidity and mortality. We experienced a case of parturient for cesarean section with Eisenmenger's syndrome and performed epidural anesthesia with fractionated doses of 2% lidocaine and fentanyl. The sensory block reached to T10 level and blood pressure was maintained with intravenous phenylephrine. After baby out, sudden hypotension with severe bradycardia developed and arterial oxygen saturation dropped. Immediate intubation and resuscitation was done, but cardiac rhythm disturbance, hypoxemia, and acidosis did not corrected. Cardiac standstill developed and stopped resuscitation. The neonate's Apgar score was 7 and he was transferred to pediatric ICU.
Acidosis ; Anesthesia, Epidural* ; Anoxia ; Apgar Score ; Blood Pressure ; Bradycardia ; Cesarean Section* ; Ductus Arteriosus, Patent ; Eisenmenger Complex* ; Female ; Fentanyl ; Hypertension, Pulmonary ; Hypotension ; Intubation ; Lidocaine ; Mortality ; Oxygen ; Peripartum Period ; Phenylephrine ; Pregnancy ; Resuscitation

PURPOSE: Transurethral resection of the prostate (TURP) is the gold standard for the surgical treatment for benign prostatic hyperplasia (BPH), but the procedure's limitations are its invasiveness and the high prevalence of complications. Photoselective vaporization of the prostate (PVP) using an 80w high power potassium-titanyl-phosphate (KTP) laser has recently been developed as a less invasive treatment. We assessed the efficacy of PVP as an alternative to TURP for the treatment of BPH. MATERIALS AND METHODS: The medical records of 324 patients who were surgically treated for BPH from July 2005 to December 2007 were retrospectively reviewed. Among the 324 patients, 190 patients of Group I were treated by TURP and 134 patients of Group II were treated by PVP. Before treatment, assessing the serum PSA level transrectal ultrasound and urodynamic study were done. The primary efficacy parameters were the postoperative international prostatic symptom score and the uroflow parametersat 6 months after the operation. The secondary efficacy parameters were perioperative factors such as the duration of the hospital stay, the operative time and the catheter-indwelling period. Any adverse reactions were monitored. RESULTS: There was no significant difference in the basal characteristics of the study subjects between both the groups. The primary efficacy parameters, the IPSS, the Qmax and thepostvoid residual urine volume were significantly improved in both groups, but there were no significant differences between both the groups. In group II, the perioperative parameters such as the operation time, the hospitalization day and the catheter-indwelling periodwere significantly shorter than those of group I (p<0.05). But the urethral complications such as urethral stricture, dysuria and bladder neck contracture were more common in group II. CONCLUSIONS: These results suggest that PVP using an 80w high power KTP could be an alternative for TURP in terms of efficacy. For the general, safe use of PVP, PVP should be carefully done until the causes of the urethral complications of PVP are determined.
Contracture ; Dysuria ; Hospitalization ; Humans ; Laser Therapy ; Length of Stay ; Medical Records ; Neck ; Operative Time ; Prevalence ; Prostate ; Prostatic Hyperplasia ; Retrospective Studies ; Transurethral Resection of Prostate ; Urethral Stricture ; Urinary Bladder ; Urodynamics ; Volatilization

No abstract available.
Kidney Failure, Chronic*

BACKGROUND: Protease-activated receptor 2 (PAR2) belongs to a family of G protein- coupled receptors activated by proteolytic cleavage. Trypsin-like serine proteases interact with PAR2 expressed by a variety of tissues and immune cells. The aim of our study was to investigate whether PAR2 stimulation can lead to the activation of human macrophages. METHODS: PAR2-mediated proliferation of human macrophage cell line THP-1 was measured with MTT assay. We also examined the extracellular regulated kinase (ERK) phosphorylation and cytokine production induced by trypsin and PAR2-agonist using western blot and enzyme-linked immunosorbent assay (ELISA), respectively. RESULTS: Treatment of trypsin or PAR2-activating peptide increased cell proliferation in a dose-dependent manner, and induced the activation of ERK1/2 in THP-1 cells. In addition, trypsin-induced cell proliferation was inhibited by pretreatment of an ERK inhibitor (PD98059) or trypsin inhibitor (SBTI). Moreover, PAR2 activation by trypsin increased the secretion of TNF-alpha in THP-1 cells. CONCLUSION: There results suggest that PAR2 activation by trypsin-like serine proteases can induce cell proliferation through the activation of ERK in human macrophage and that PAR2 may play a crucial role in the cell proliferation and cytokine secretion induced by trypsin-like serine proteases.
Blotting, Western ; Cell Line* ; Cell Proliferation ; Enzyme-Linked Immunosorbent Assay ; Humans* ; Macrophages* ; Phosphorylation ; Phosphotransferases ; Receptor, PAR-2* ; Serine Proteases ; Trypsin ; Tumor Necrosis Factor-alpha

Congenital anomaly of the extrahepatic biliary system is relatively common, especially vascular variations are much more frequent than anatomic variations. The normal anatomical structure is encountered in only 35 percent of individuals, many of these variations have little or no clinical improtance, but some cases induce symptoms and signs or may lead to incorrect diagnosis and inappropriate management. These are very important to correct diagnosis of biliary variations observed during ultrasonography, cholangiography and endoscopic retrograde cholangiopancreatography(ERCP) and to accurate management by surgeon or endoscopist since accidental section or ligation of aberrant structures can lead to serious complications. We experienced a very rare case of extrahepatic bile duct anomaly confirmed by ERCP. The right and left extrahepatic ducts were connected at the level of the pancreatic segment of the common bile duct and the cystic duct drains to the right extrahepatic duct. There were several stones in the distal portion of the left extrahepatic duct and gallbladder.
Bile Ducts, Extrahepatic* ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Common Bile Duct ; Cystic Duct ; Diagnosis ; Gallbladder ; Ligation ; Ultrasonography

Congenital anomaly of the extrahepatic biliary system is relatively common, especially vascular variations are much more frequent than anatomic variations. The normal anatomical structure is encountered in only 35 percent of individuals, many of these variations have little or no clinical improtance, but some cases induce symptoms and signs or may lead to incorrect diagnosis and inappropriate management. These are very important to correct diagnosis of biliary variations observed during ultrasonography, cholangiography and endoscopic retrograde cholangiopancreatography(ERCP) and to accurate management by surgeon or endoscopist since accidental section or ligation of aberrant structures can lead to serious complications. We experienced a very rare case of extrahepatic bile duct anomaly confirmed by ERCP. The right and left extrahepatic ducts were connected at the level of the pancreatic segment of the common bile duct and the cystic duct drains to the right extrahepatic duct. There were several stones in the distal portion of the left extrahepatic duct and gallbladder.
Bile Ducts, Extrahepatic* ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Common Bile Duct ; Cystic Duct ; Diagnosis ; Gallbladder ; Ligation ; Ultrasonography

PURPOSE: This study was conducted to investigate the relationship between serum total testosterone levels and scores on the Aging Male's Symptom (AMS) scale and the International Index of Erectile Function (IIEF) in men with erectile dysfunction with testosterone deficiency syndrome (TDS). MATERIALS AND METHODS: From January 2005 to July 2008, 134 patients who complained of sexual dysfunction such as erectile dysfunction or decreased libido as the main symptoms of TDS with serum total testosterone levels less than 3.5 ng/ml were evaluated by independent t-test and linear regression analysis, respectively. Patients with treated hypogonadism within 6 months, with a history of taking a PDE5 inhibitor or an antidepressant for a depressive disorder, or who had metabolic syndrome were excluded from this study. RESULTS: The AMS scale and its 3 subdomain scores were not significantly correlated with the total testosterone level. By contrast, the total IIEF score and the score of each IIEF domain except sexual desire showed a weakly significantly positive correlation with serum total testosterone. CONCLUSIONS: In TDS patients with erectile dysfunction, there was a low relationship between serum total testosterone levels and the AMS scale and a weakly positive correlation between total testosterone levels and all IIEF domains except sexual desire. There was a low relationship between the AMS scale, the sexual desire domain score of the IIEF, and total testosterone. We should understand these limitations when evaluating patients with erectile dysfunction with TDS. New scales should be developed for the evaluation of erectile dysfunction in these patients.
Aging ; Depressive Disorder ; Erectile Dysfunction ; Humans ; Hypogonadism ; Libido ; Linear Models ; Male ; Sorbitol ; Testosterone ; Tyramine ; Weights and Measures

The level of P4 at the time of embryo transfer (ET) is important. P4 concentrations and numbers of corpora lutea for 126 recipients were evaluated. Nuclear transfer embryos were transferred into 126 surrogates. 11 maintained their pregnancy until full-term delivery, 17 miscarried, and implantation failed in 98 animals. P4 levels in the full-term group were significantly different from those of the pigs that aborted or in which implantation failed (p < 0.05). However, the numbers of corpora lutea were not significantly different. These findings indicate that the concentration of progesterone can be an important factor for successful ET in pigs.
Animals ; Corpus Luteum/*physiology ; Embryo Transfer/*veterinary ; Embryo, Mammalian/*physiology ; Female ; Nuclear Transfer Techniques ; Pregnancy ; *Pregnancy Rate ; Progesterone/*blood ; Retrospective Studies ; Sus scrofa/*physiology

Parosteal lipoma is a rare kind of lipoma that occurring adipous tissue around the periosteum. It has been reported most commonly in the femur, the radius, the tibia and the fibular. Treatment consists of resecting the lipomatous tumor with further exeresis of the bone and periosteal excrescence in cases with hyperostosis. The authors report a rare case of parosteal lipoma occurring at the medial portion of the femur shaft with a review of the relevant literatures.
Femur ; Hyperostosis ; Lipoma ; Periosteum ; Radius ; Tibia