PURPOSE: Introduction of shock wave lithotripsy has provided an avenue for dealing with many urinary stones noninvasively. Although shock wave is known to cause pathologic changes in various organ, little is k nown about its effect on the ureter and recovery after shock wave, the target organ in SWL of injury induced by shock wave and the potential protective effect of allopurinol and nifedipine against shock wave. MATERIALS AND METHODS: A total 24 rabbits were assigned to 2 groups. 12 rabbits received allopurinol(10mg.each) and nifedipine (1mg.each) that were given orally 3 times a day for 5 days starting the night before SWL. The other 12 rabbits reseived no medication. The left lower Ureter segments of 24 rabbits were removed ureter. Groups of 8 rabbits(4were medication group and 4, no medication group) were sacrificed 1, 3 and 5 days after shock wave exposure. The histomorphological alterations were examined under light and transmission electron microscopy. RESULTS: The epithelial cells disclosed no change after shock wave application. Histologically the muscular layer was the most affected part of ureter. There was interstitial and intracellular edema on light microscopy and made chromatin and mitochondrial changes at the subcellular level. The adventitial layer wes also edematous. This chanfes were prominent on day 1and 3 and returned to normal on day 5. The medication group showed less severe features of injury, compared with the no medication group. CONCLUSIONS: Electromagnetic shock waves produce reversible morphological changes in rabbit ureteric muscle and allopurinol and nifedipine may have its role in protecting the tissue injury produced by high energy shock waves.
Allopurinol* ; Chromatin ; Edema ; Epithelial Cells ; High-Energy Shock Waves ; Lithotripsy ; Magnets ; Microscopy ; Microscopy, Electron, Transmission ; Nifedipine* ; Rabbits ; Shock* ; Ureter* ; Urinary Calculi

From January, 1972 to August 1983, 12 cases of ovarian pregnancy out of 1202 total ectopic pregnancy were studied and the incidence constituted 0.9%. The gross and microscopic findings were reviewed according to gross description and gross photographs, and microscopic description and reviewing all microscopic slides. All cases were shown to meet Spiegelberg's criteria for primary ovarian pregnancy.
Pregnancy ; Female ; Humans ; Incidence

To assess the likelihood of procedural success in patients with multivessel coronary artery disease, 46 consecutive patients (male 34, female 12, mean age 60+/-9 years) umderwent single or multiple site angioplasty. The clinical diagnosis of unstable angina was in 20(44%), stable angina in 10 and acute or old myocardial infarction in 16. Coronary angiographic findings of 2 vessel disease was in 38(83%), triple vessel disease in 8. Left ventricular function was generally well preserved (mean ejection fraction 65+/-12%, range 30-82%) and mean 2.0 stenosis per patient angic, lasty had attempted. Single vessel angioplasty (SVA) was performed in 13 and multivessel angioplasty (MVA) in 33. Procedural success was achieved in 79(86%) out of total 92 stenoses. Sixty-six(88%) out of 75 stenoses in MVA and 13(76%) out of 17 stenoses in SVA had procedural success respectively. According to angiographic morphology of lesions, procedural success of type A stenoses was 17/17(100%), type B stenoses 57/66(86%) and type C stenoses was 5/9(33%). In 13 failures included inability to pass the guide wire cross the lesion in 7, inability to guide the griding catheter in 2 and inability to dilate lesions in 4. Before and after angioplasty, treadmill test (modified Bruce protocol)could be performed in 29 patients. Total duration of exercise and maximal double product improved significantly from 8.5+/-2.3 minute 5188+/-2403 to 12.2+1.3 min., 23,062+/-4111 respectively (p<0.001). 17 out of 24 patients who had positive treadmill test before angioplasty showed negative conversion after procedure. Complications included dissection in 29, prolongd chest pain in 5, acute closure in 3, cardiac tamponade in 1 and ventricular fibrillation due to side branch oclusion in 1. Thus, coronary angioplasty in selected paients with multivessel coronary artery disease might be useful and have relatively good immediate results, but the long-term efficacies with other forms of treatment must be evaluated prospectively.
Angina, Stable ; Angina, Unstable ; Angioplasty* ; Cardiac Tamponade ; Catheters ; Chest Pain ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis ; Exercise Test ; Female ; Humans ; Myocardial Infarction ; Ventricular Fibrillation ; Ventricular Function, Left

The workplace exposure of chemicals has steadily increased, therefore the concern for subsequent effect on reproductive outcome has been an important issue in occupational medicine. In previous studies, higher rates of spontaneous abortion, reduced fertility and menstrual disorder among women, and an impairment of sperm quantity and quality among men have been associated with a wide variety of chemical agents. This study was conducted to evaluate the effects of toluene, xylene and trichloroethylene (TCE) injection on the mRNA levels of GnRH, GnRH receptor and Pit-1 genes in male rats hypothalamus and pituitary and the effects on the plasma levels of FSH, LH, prolactin and testosterone. Sprague-Dawley male rats were divided into five groups of five each according to concentration of toluene, xylene and TCE. The rats were injected subcutaneously to 0, 50, 100, 200, 400 mg/kg body weight/day of toluene, xylene and TCE, respectively for 6 days. Rat brains were excised and hypothalamus and pituitary were separated. Reverse transcription-polymerase chain reaction (RT-PCR) and RNase protection assay (RPA) were used to evaluate the GnRH, GnRH receptor and Pit-1 mRNA levels. Plasma concentrations of FSH, LH, prolactin and testosterone were assayed by radioimulunoassay (RIA). The results were as follows; 1. GnRH, GnRH receptor and Pit-1 mRNA levels in toluene and xylene injected groups, and GnRH receptor mRNA levels in TCE injected group were lowered dose-dependently. Especially, GnRH receptor and Pit-1 mRNA levels in 200 mg/kg of toluene injected group, and GnRH, GnRH receptor and Pit-1 mRNA levels in 400 mg/kg of toluene injected group were significantly lowed than control group (p<0.05). GnRH receptor and Pit-1 mRNA levels in 400 mg/kg of xylene injected group, and GnRH receptor mRNA levels in 400 mg/kg of TCE injected group were significantly lower than control group (p<0.05). 2. The plasma levels of prolactin and testosterone in 400 mg/kg of toluene injected group, and LH in 100, 200 and 400 mg/kg of xylene injected group, and testosterone in 400 mg/kg of TCE injected group were significantly lower than control group (p<0.05). In conclusion, we speculated that toluene and xylene affected reproductive system secondarily through hypothalamus-pituitary axis, and TCE affected directly through steroidogenesis. And we recomended that further study for assessment of the reproductive toxiclty of mixed organic solvent exposures should be conducted.
Abortion, Spontaneous ; Animals ; Axis ; Brain ; Female ; Fertility ; Gene Expression* ; Gonadotropin-Releasing Hormone* ; Humans ; Hypothalamus* ; Male* ; Occupational Medicine ; Plasma ; Pregnancy ; Prolactin ; Rats* ; Rats, Sprague-Dawley ; Receptors, LHRH* ; Ribonucleases ; RNA, Messenger ; Spermatozoa ; Testosterone ; Toluene* ; Trichloroethylene* ; Xylenes*

OBJECTIVES: The purpose of this experimental study was to investigate the toxic effects of toluene on the placental functions and reproductionin the rat. In this study, the expression of placental prolactin-growth hormone (PRL-GH) and Pit-1 genes, the frequency of placental trophoblast cells, and the reproductive data were analyzed. METHODS: The pregnancy of the Sprague-Dawley rats (250+/-25 g) was determined by verifying the presence of the copulatory plug or sperm in the vaginal smear and the day on which this was observed was defined as pregnancy day 0. The pregnant rats were divided into three groups. The control group was intraperitoneally (ip) injected with sesame oil, and the other two groups were given either 150 or 750 mg/kg BW/day of toluene resuspended in sesame oil during pregnancy days 7-11 and 16-20. The rats from the three experimental groups were sacrificed on pregnancy days 11 and 20, respectively. The mRNA levels of the PRL-GH, Pit-1a and b isotype genes were analyzed by Northern blot hybridization and Reverse transcription-polymerase chain reaction (RT-PCR), respectively. The hormonal concentration was analyzed by Radioimmunoassay. The frequency of the placental trophoblast cells was determined by means of a histochemical study. Reproductive data, such as the placenta and infnat weight, pregnancy period and litter size were surveyed at pregnancy day 20 and after birth. Statistical analysis was carried out by means of the SAS program (version 8.1). RESULTS: The mRNA levels of the PRL-GH family genes were reduced in a linear fashion by exposure to toluene. The mRNA levels of the Pit-1a and b isotype genes, which induce the expression of the PRL-GH family genes, were also reduced by exposure to toluene. The placental lactogen Iv and II concentrations in the rat placenta, fetus and maternal blood were also decreased by exposure to toluene. During the last stage of gestation, exposure to a high dose of toluene reduced the frequency of the spongiotrophoblast cells that secrete the PRL-GH hormones. Reproductive data such as the placenta and infant weight, and litter size were reduced, and the pregnancy period was extended in the toluene exposed group as compared with the control group. CONCLUSIONS: Toluene disrupts the PRL-GH hormone metabolism in the rat placenta and this leads to reproductive disorder.
Animals ; Blotting, Northern ; Fetus ; Humans ; Infant ; Litter Size ; Metabolism ; Parturition ; Placenta ; Placental Lactogen ; Pregnancy ; Radioimmunoassay ; Rats* ; Rats, Sprague-Dawley ; Reproduction* ; RNA, Messenger ; Sesame Oil ; Spermatozoa ; Toluene* ; Trophoblasts ; Vaginal Smears

OBJECTIVES: This study was conducted to estimate the characteristics of work-related musculoskeletal disorders and the effect of intervention program in shipyard workers. METHODS: Information on work related absences,due to musculoskeletal disorders, were collected between January, 1 2000 and August, 31 2002. Age, duration of work, job type, anatomical site of disease, cause and duration of absence due to sickness were investigated. RESULTS: From a total of 158 cases there were 108(68.4%)and 50(31.6%)cases of back, and other musculoskeletal complaints,respectively. 55(34.8%)of the cases were caused by repetitive trauma and 103(65.2%)were due to non-repetitive causes. 90(83.3%)of the back complaint cases were due to non-repetitive causes, but there was a repetitive cause of other musculoskeletal complaints in 37(74.0%)cases. Back complaints were higher in workers carrying heavy materials, but other musculoskeletal complaints were higher in painting workers.Half of workers after an absence due to sickness had returned to work within 32.0 weeks and 25.4 weeks,in the cases of back and other musculoskeletal complaints, respectively. After the application of an intervention program for musculoskeletal disease, the incidence rate of absence due to work-related musculoskeletal disorders was reduced significantly. CONCLUSION: The introduction of a musculoskeletal intervention program reduced absences due to work-related musculoskeletal disorders.
Incidence ; Musculoskeletal Diseases ; Paint ; Paintings

BACKGROUND: Bisphosphonates are now well established as successful antiresorptive agents for the prevention and treatment of osteoporosis. We investigated the effect of cyclic intravenous treatment with an aminobisphosphonate, pamidronate in cases of primary osteoporosis. METHODS: Eighteen patients with primary osteoporosis (bone mineral density BMD t-score < -2.5) received four courses of pamidronate (30 mg with 500 mL normal saline over 2 hours every 3 months). The serum biochemical parameters and bone turnover markers were measured before each treatment. The bone pain score, medication score, and the side effects were also monitored. BMD and simple spine X-ray were performed before and 1 year after of treatment. RESULTS: BMD at the lumbar spine (L2-4) significantly increased from 0.798+/-0.110 g/cm2 to 0.860+/-0.107 g/cm2 after 1 year of treatment with pamidronate: by +8.3+/-9.4% of baseline. BMDs at the femoral neck, Ward s triangle and the trochanter also increased, but not significantly. Serum total alkaline phosphatase (p<0.05) and urine deoxypyridinoline/creatinine (p=0.069) decreased with treatment. Other bone turnover markers were unchanged. The bone pain score decreased significantly. None of the patients experienced a new fracture during treatment. The frequency of the side effects following the first infusion was 61.1% (a transient fever and myalgia with flu-like symptoms in 10 patients and mild phlebitis in 1 patient). However, only two patients complained of flu-like symptoms after second infusion, and no patient complained following the third infusion. CONCLUSION: Cyclic intravenous treatment of pamidronate every three months was effective in increasing BMD and in the decreasing bone turnover rate, and was relatively well tolerated in primary osteoporotic women.
Alkaline Phosphatase ; Bone Density ; Bone Density Conservation Agents ; Diphosphonates ; Female ; Femur ; Femur Neck ; Fever ; Humans ; Myalgia ; Osteoporosis ; Phlebitis ; Spine

Familial combined hyperlipidemia is one af the manogenic disorders frequently found in humans and is seen in 0.5~2% of the general populatian, accounting for at least 10% of persons with pemature atlmmcletusis. The distinguishing feature of familial combined hyperlipidemia, in camparison with other single-gene abnarmalities of lipoprotein metabolism, is that not all affected members have the same plasma lipid phenotype; some individuals have an elevation of cholesterol concentration alane(type IIa lipoprotein pattern), while some athers have an elevation of triglyceride concentration alone(type IV pattem), and still others have elevations of both values(type IIb pattem). In any one persan, the lipid phenotype can change as a result of dietary or drug treatment. Familial combined hyperlipidemia should be suspected in those subjects with moderate hypertriglyceridemia and/or moderate hypercholestaolemia (lipoprotein types IIa, Ilb, IV), especially when premature coronary heart disease is evident in the family histary. Low plasma HDL-cholesterol, obesity, insulin resistance and hyperuricemia are often . Family members affected by familial combined hyperlipidemia should be identified and be treated, since tbe condition is associated with premature caronary heart diasease. We have found one family of familial combined hyperlipidemia with one member(case 1) associated with insulin resistance, hyperuricemia and gout, and another member(case 2) associated with diabetes mellitus and infertiTity.
Cholesterol ; Coronary Disease ; Diabetes Mellitus ; Gout ; Heart ; Humans ; Hyperlipidemia, Familial Combined* ; Hypertriglyceridemia ; Hyperuricemia ; Insulin Resistance ; Lipoproteins ; Metabolism ; Obesity ; Phenotype ; Plasma ; Triglycerides

BACKGROUND: Lead is a common environmental metal and has been used for various purposes for a long time, leading to frequent reports of lead poisoning. The concern about lead poisoning starts has been mostly focused on occupational exposure and is linked to the prevention and management of lead exposure in refining and manufacturing processes. Nowadays, however, there is growing concern about nonoccupational lead exposure by many pollutants. Especially, lead poisoning by herb medicine has commonly been observed in clinics in Southeast Asia and South Korea. This case report contains diagnosis of inpatients who suffered from lead poisoning from a herb medicine, arthritis remedy and who complained of abdominal symptoms and dizziness. The study purpose was to awaken our healthful interest in lead poisoning. CASE REPORT: A 53-year-old female patient complaining of abdominal pain, dizziness, and numbness of hand and foot came to our hospital due to the continuation of her anemic finding symptoms while undergoing treatment at a secondary hospital. Her past medical history was unremarkable except she had taken herb pills for about a year which were administered by herb medicine to treat arthritis. Physical examination was unremarkable except for oral ulcer finding. Hemoglobin was 8.5 g/dl, reticulocyte count was 4.10%, bilirubin was 1.3 mg/dl (direct 0.3 mg/dl), and Zinc protoporphyrin 169.12 ug/dl. In urinalysis results, WBC increased to 30~39 /HPF, While AST/ALT, BUN/Cr, PT/aPTT, and nerve conduction velocity were normal. Basophilic stippling was observed through peripheral blood smear. The blood lead level was 80.4 microgram/dl and the urine lead level continued to increase to 541 microgram/l. Analysis of the pills that the patient had been taking showed that they contained 30 mg/g lead. By oral chelation therapy with D-penicillamine four times per day for five days, the patient's hemoglobin increased to 11.8 g/dl, while blood lead level decreased to 39.2 microgram/dl, and urine level to 196 microgram/l. Although the soles of her feet remained cold, but other symptoms and anemia finding were improved considerably. However, after discontinuing D-penicillamine medication, the blood lead level increased to 41.4 microgram/dl again. The further administration of D-penicillamine for five days reduced the blood lead level to 31.5 microgram/dl. At two years after the discontinuance of D-penicillamine, the followup findings were normal; hemoglobin was 13.1 g/dl, hematocrit 39.6%, reticulocyte count 1.22%, blood lead level 13.3 microgram/dl, and urine lead level 9.17 microgram/l. CONCLUSION: After taking herb medicine pills for one year, the patient was admitted to hospital chiefly complaining of abdominal pain, dizziness, and numbness of the hand and foot. The high blood and urine and lead levels and lead chemical analysis of the herb pills confirmed lead poisoning which was treated with D-penicillamine for five days. The follow-up result after two years indicated normal blood and urine lead levels.
Abdominal Pain ; Anemia ; Arthritis ; Asia, Southeastern ; Basophils ; Bilirubin ; Chelation Therapy ; Diagnosis ; Dizziness ; Eating* ; Female ; Follow-Up Studies ; Foot ; Hand ; Hematocrit ; Humans ; Hypesthesia ; Inpatients ; Korea ; Lead Poisoning* ; Middle Aged ; Neural Conduction ; Occupational Exposure ; Oral Ulcer ; Penicillamine ; Physical Examination ; Reticulocyte Count ; Urinalysis ; Zinc

BACKGROUND: Menopause is an independent risk factor in metabolic syndrome which induced an alteration of the lipid metabolism by hormonal changes. Apolipoprotein A5 gene (APOA5) was related to the regulation of triglyceride and high density lipoprotein cholesterol (HDL-C) level with biosynthesis and decomposition. This study was conducted to investigate the relationship between APOA5 polymorphism and metabolic syndrome in Korean postmenopausal women. METHODS: This study included 307 postmenopausal women with anthropometric and biochemical measurement in 2010-2011. The polymorphism of APOA5 was analyzed by polymerase chain reaction-restriction fragment length polymorphism method with MseI restriction enzyme. RESULTS: The metabolic syndrome prevalence with TT genotype was significantly lower than the frequency in those with TC/CC (27.09%, 38.46%, and 45.71% for TT, TC, and CC, respectively; P < 0.05). Multiple regression analysis of metabolic syndrome risk factors indicated that postmenopausal women with CC genotype had a higher risk with 3 times than that in TT genotype (P < 0.05). APOA5 C carriers showed an increased risk of triglyceride level (odd ratio, 2.93 and 1.85 for CC and TC+CC, respectively; P < 0.05). Interestingly, HDL-C was related to triglyceride directly in comparison to APOA5. CONCLUSION: The results of this study indicate that APOA5 has an influence on serum triglyceride and HDL-C, which contribute to metabolic syndrome in Korean postmenopausal women.
Apolipoproteins ; Apolipoproteins A ; Cholesterol ; Cholesterol, HDL ; Female ; Genotype ; Humans ; Lipid Metabolism ; Lipoproteins ; Menopause ; Metabolic Syndrome X ; Polymorphism, Single Nucleotide ; Prevalence ; Risk Factors ; Triglycerides