BACKGROUND: The paired vestibular end organs lie within the semicircular canal of the inner ear in the temporal bones. It plays a role on the control of posture through the vestibuloocular reflex and the vestibulo-spinal reflex. Motion sickness-like symptoms induced by the abnormal stimulation of the vestibular system suggested that the vestibular system participate in the autonomic nervous function. The present study was carried out to determine the role of the vestibular system on the control of blood pressure by way of the autonomic nervous system. METHODS: Blood pressure was measured by means of pressure transducer during stimulation of the vestibular system or following bilateral labyrinthectomies in Sprague-Dawley rats weighing from 200 to 300g. RESULTS: 1) Blood pressure was elevated by electrical stimulation of the vestibular nerve. 2) Also, the pressure was elevated when the vestibular system was excited or inhibited by rotatory stimulation or galvanic stimulation. 3) The pattern of elevation in blood pressure which induced by electrical stimulation of the vestibular nucleus showed a dynamic response at stimulation frequency of 200Hz and a static response at 50Hz. 4) Elevation of blood pressure induced by vestibular sitmulation was more inhibited following bilateral cervical sympathectomies than following bilateral vagotomies. 5) Decreasing the blood pressure induced by positional change of the body was reinforced following bilateral labyrinthectomies. CONCLUSION: These results suggest that the vestibular system plays a role on the control of blood pressure by way of the autonomic nervous system as well as on the control of posture, therefore, the vestibular system prevents blood pressure from decreasing by positional change of the body.
Animals ; Autonomic Nervous System ; Blood Pressure* ; Ear, Inner ; Electric Stimulation ; Posture ; Rats* ; Rats, Sprague-Dawley ; Reflex ; Reflex, Vestibulo-Ocular ; Semicircular Canals ; Sympathectomy ; Temporal Bone ; Transducers, Pressure ; Vagotomy ; Vestibular Nerve

PURPOSE: To evaluate the radiological patterns of vascular invasion in peripheral cholangiocarcinomas. MATERIALS AND METHODS: Hepatic arteriography and portography in 20 cases with cholangiocarcinoma including 12 cases with anglographic CT were retrospectively analized. RESULTS: The arteriography showed no arterioportal shunt, hypertrophy of tumor vessel, or tumor staining extending to central portion of the mass in all cases. However, doughnut shaped peripheral tumor staining was seen until late hepatogram phase in 12 cases and compensatory hyperperfusion around the mass was seen in six cases(eight cases if include arterial CT). Encasement of tumor vessel was seen in 12 cases, and hypertrophy of feeding vessel in nine cases. On portogrphy, the filling defect on segmental portal branch could be demonstrated only in 11 cases. Shape of the portal defect was tapered narrowing in six cases, abrupt narrowing in two cases but intraluminal nodular filling defect was not seen. Remainning three cases were difficult to define the shape. On seven cases of CT during arterial portography, three cases showed mass shaped defect and four showed segmental defect but three of them could demonstrate the partially preserved portal flow in defective portal area. CONCLUSION: Hepatic arteriography in peripheral cholagiocarcinoma showed no evidence of hypertrophy of tumor vessels and tumor stain extending to central portion but peripheral staining on late hepatogram phase and compensatory hyperperfusion could be seen. Portal vein was more commonly involved through perivascular connective tissue invasion rather than by direct extension into the portal lumen.
Angiography* ; Cholangiocarcinoma* ; Connective Tissue ; Hypertrophy ; Portal Vein ; Portography ; Retrospective Studies

PURPOSE: To evaluate the radiological patterns of vascular invasion in peripheral cholangiocarcinomas. MATERIALS AND METHODS: Hepatic arteriography and portography in 20 cases with cholangiocarcinoma including 12 cases with anglographic CT were retrospectively analized. RESULTS: The arteriography showed no arterioportal shunt, hypertrophy of tumor vessel, or tumor staining extending to central portion of the mass in all cases. However, doughnut shaped peripheral tumor staining was seen until late hepatogram phase in 12 cases and compensatory hyperperfusion around the mass was seen in six cases(eight cases if include arterial CT). Encasement of tumor vessel was seen in 12 cases, and hypertrophy of feeding vessel in nine cases. On portogrphy, the filling defect on segmental portal branch could be demonstrated only in 11 cases. Shape of the portal defect was tapered narrowing in six cases, abrupt narrowing in two cases but intraluminal nodular filling defect was not seen. Remainning three cases were difficult to define the shape. On seven cases of CT during arterial portography, three cases showed mass shaped defect and four showed segmental defect but three of them could demonstrate the partially preserved portal flow in defective portal area. CONCLUSION: Hepatic arteriography in peripheral cholagiocarcinoma showed no evidence of hypertrophy of tumor vessels and tumor stain extending to central portion but peripheral staining on late hepatogram phase and compensatory hyperperfusion could be seen. Portal vein was more commonly involved through perivascular connective tissue invasion rather than by direct extension into the portal lumen.
Angiography* ; Cholangiocarcinoma* ; Connective Tissue ; Hypertrophy ; Portal Vein ; Portography ; Retrospective Studies

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second*

BACKGROUND: The diastolic transmitral flow velocity pattern has been commonly used to assess left ventricular(LV) diastolic function. The effects of multiple factors(such as, LV preload, afterload and heart rate, etc.) make difficulties in accurate interpretation. METHODS: In order to investigate the diastolic transmitral filling patterns according to the changes of the proload or heart rate, we studied 27 normal subjects with pulsed Doppler echocardiography after the administration of nitroglycerin(0.6mg/tab.) sublingually or atropine(0.5mg/amp.) intravenously. RESULTS: 1) After nitroglycerin administration, the folowings were obtained. ; The systolic blood pressure and LV diastolic filling time(DFT) decreased by 10.1% and 15.3%, respectively(p<0.001), compared with baseline data. The ratio of peak early to late diastolic transmitral flow velocities (E/A) and time-velocity integrals(TVIE/TVIA) decreased by 10.3% and 14.8%, respectively(p<0.01). The early diastolic filling time(Time E) was unchanged. Therefore, we suggest that time E is helpful, compared with the increments of the preload or the diastolic dysfunction. 2) After atropin administration, the heart rate, peak late diastolic transmitral flow velocity(PA) and percent atrial contribution(%AC) significantly increased by 43.6%, 25.1% and 41.4%, respectively(p<0.001). The E/A, TVIE/TVIA and DFT significantly decreased by 42.9%, 38.9% and 43.0%, respectively(p<0.001) compared to the data before drug administration. 3) The heart rate correlated negatively to the E/A, TVIE/TVIA and DFT. It was correlated positively to %AC(r=+0.63; p<0.001). The normalized E/A ratio by DFT(E/A/DFT) didn't correlate. Therefore, E/A/DFT is helpful on the exclusion of the influences of heart rate by the administration of the atropine. CONCLUSION: The decrement of preload or the increment of heart rate changes the diastolic transmitral flow velocity patterns. Therefore, when the diastolic function is assessed by interpretation of the Doppler transmitral flow velocity pattern with pulsed Doppler echocardiogram, the potential influences of preload and heart rate must be taken into account.
Atropine* ; Blood Pressure ; Echocardiography ; Echocardiography, Doppler* ; Echocardiography, Doppler, Pulsed ; Heart Rate ; Humans* ; Nitroglycerin* ; Time

Although many approaches have been attempted in the evaluation of liver size such as measurement of length,area and volume, the linear measurements have been used most frequently because of simplicity. We measured theliver size using 4 linear measurements for evaluation of hepatic pliability on plain abdominal film in the erectand the supine position. Our cases consisted of 125 persons who have no symptom or signs clinically and havenormal liver function test. The results were as follows: 1. The measurements of the liver size using diagonaldiameter(DD), oblique diameter of right lobe(OD), midline vertical diameter(MD) and height of right dome of theliver(HD) were ; 19.6+-1.8cm, 13.7+-1.6cm, 2.03+-0.4cm in the supine position; and 20.5+-2.1cm, 21.9+-2.1cm,15.4+-2.1cm, 1.87+-0.4cm in the erect position, respectively. 2. The differences of each diameter between erectand supine position were 0.9+-1.0cm in DD, 0.9+-1.0cm in OD and 1.7+-1.4cm in MD, and they were longer in thesupine position (p<0.001). 3. The HD was slinghtly longer in the supine position than in the erect position(p<0.001). 4. Among the 4 measurements, the largest difference of linear diameter between the erect and the supineposition was by MD. 5. We found the change or size and shape of the normal liver in the different position.
Humans ; Liver ; Liver Function Tests ; Pliability ; Supine Position

The term "choristoma" is used to describe a mass of histologically normal tissue presenting in an aberrant site. The authors have experienced a case of lingual osseous choristoma in a 17-year-old female patient, which was totally removed and followed up for 12 months without any evidence of recurrence or developments to other disease.
Adolescent ; Choristoma* ; Female ; Humans ; Recurrence

Endometriosis is an enigmatic disease of menstruating females affecting the reproductive life. We report herein a case of perineal endometriosis in a 33-year-old woman. The patient presented two rounded, thickened plaques bilaterally on the perineum for about four year. The plaque on the right side was located mainly at the episiotomy scar. Histologic examination showed confirmative feature of glandular structures embedded in the cellular stroma and predecidual changes of late secretory phase of endometrium. Radical operation of total hysterectomy with bilateral oophorectomy and partial excision of perineal lesions were performed. There was complete resolution with no relapse by the 6-month follow-up. This is of a very rare occurrence and three cases have been reported in the Korean literatures up to date.
Adult ; Cicatrix ; Endometriosis* ; Endometrium ; Episiotomy ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Ovariectomy ; Perineum ; Recurrence

Calcium channel blockers (CCBs) have a relaxatory effect on cardiovascular smooth muscles and newly developed Felodipine has more vascular selectivity than myocardiac effects. This study was undertaken to evaluate the effect of CCBs, including felodipine. on in-vivo penile erection and whether these drugs can be clinically applied to diagnosis and treatment of impotence in the future. We observed intracavernosal and systemic blood pressure changes to cavernous nerve stimulation (1Hz., 2-4V), intracavernosal injection of CCBs (felodipine, diltiazem, verapamil), calcium ionophore (A23187) and calcium channel promotor (Bay-K 8644) in Sprague-Dawley rats(weight: 250-350 gm) using polygraph with the biopac data analyzing system. The results were as follows. 1) Injections administered in dose dependent manner of felodipine (10(-10) - 10(-6)M, n=8). diltiazem (10(-10) - 10(-6)M. n=8) and verapamil (10(-10) - 10(-6)M, n=8) caused increases in intracavernosal pressuret(CP) (p<0.05) with no significant difference observed among the three drugs. In most effective dose, a transient drop of systemic blood pressure was observed by a degree of 30% to 33% of preinjection values, although systemic blood pressure was spontaneously recovered in one minute. However, a longer plateau phase of maximal pressure and a longer duration of detumescence were observed with injection of felodipine (18 min., 20 min.) than with diltiazem (5min., 4min.) or verapamil (5min., 3min, p<0.05). In comparison with ECh of the three drugs, felodipine also showed the effects of 3.4 to 4.4 times larger than diltiazem or verapamil. 2) Intracavemous injections of Bay-K 8644 (10(-6) - 10(-4)M, n=18) or A23187 (10(-6) - 10(-4)M, n=18) in dose dependent manner were found to suppress the most effective dose of felodipine, diltiazem or verapamil-induced erection. These results suggest that penile erection is related to the movement of calcium through its channel and CCBs, especially felodipine, may be useful for the diagnosis and treatment of impotence in the future, although the clinical effect remains to be investigated.
Animals ; Blood Pressure ; Calcimycin ; Calcium Channel Blockers* ; Calcium Channels* ; Calcium* ; Diagnosis ; Diltiazem ; Erectile Dysfunction ; Felodipine ; Male ; Muscle, Smooth ; Penile Erection ; Rats* ; Rats, Sprague-Dawley ; Verapamil

Measurement of the bulbocavernosus reflex is widely used to diagnose underlying neurologic disorders in erectile dysfunction. Because this single parameter of latency time in BCRL(bulbocavernosus reflex latency) testing has been used as the sole guideline to diagnose neurogenic impotence, problems in discriminating neurological disturbance from nonneurogenic impotence are frequently encountered especially when the value of latency time is within the borderline range, or when the outcome is difficult to interpret. In order to assess the useful parameters of conventional BCRL testing for the differential diagnosis of neurogenic impotence, we performed BCRL testing in 100 patients who compliance of poor erection. We compared these patients with a previously controlled group of 45 adult males without any erectile or neuronal disturbance. The results obtained were summarized as follows. . 1)Of 100 patients, 24 were diagnosed as neurogenic impotence. 2) In this neurogenic impotence group, as compared to the normal and non-neurogenic impotence group, there was a significant difference(P<0.05) in the values of sensory, pain, reflex threshold and bulbocavernosus reflex latency time. 3) The BCR measurement allowed to find lateralized neurologic disturbance. These results show that in BCRL testing the evaluated values of sensory, pain and reflex threshold, in addition to latency time, can be useful parameters for the differential diagnosis of neurogenic impotence.
Adult ; Compliance ; Diagnosis* ; Diagnosis, Differential ; Erectile Dysfunction* ; Humans ; Male ; Nervous System Diseases ; Neurons ; Reflex*