A 46-year-old male patient developed jaundice after 23 days' treatment of propylthiouracil (PTU) for Graves' disease. Serum alkaline phosphatase was elevated markedly with moderate increase in serum aminotransferase, and the peak level of total bilirubin was 7.3 mg/dL. After withdrawal of PTU, serum aminotransferase and bilirubin began to decrease simultaneously, and completely normalized. One week after the discharge from hospital, he received radioiodine treatment for Graves' disease, but he showed aggravation of hyperthyroidism and ophthalmopathy. So we prescribed methimazole inevitably 16 days' after the radiodiodine treatment. He developed jaundice again after 69 days' treatment of methimazole, but the pattern of hepatotoxicity was slightly different from that of the previous PTU-nduced hepatotoxicity. Serum aminotransferase increased slightly and quickly normalized after discontinuance of methimazole, but serum total bilirubin increased continuously and reached to 24.6 mg/dL. Eosinophilia was prominent and the result of liver biopsy was compatible with cholestatic jaundice. The patient was treated with prednisolone and recovered from jaundice rapidly.
Alkaline Phosphatase ; Bilirubin ; Biopsy ; Eosinophilia ; Graves Disease ; Humans ; Hyperthyroidism ; Jaundice ; Jaundice, Obstructive ; Liver ; Male ; Methimazole* ; Middle Aged ; Prednisolone ; Propylthiouracil*

PURPOSE: Carbon monoxide (CO) is produced during the degradation of hemoglobin to heme (iron protoporphyrin) and present in various tissues including brain. CO is believed to activate soluble guanylate cyclase to exert its action on the smooth muscles. the effects of CO and its relationships to adrenergic or cholinergic mechanisms were studied using the isolated rabbit corpus cavernosal strips, and the effects of CO and NO were further investigated. MATERIALS AND METHODS: Using adult New Zealand rabbits, the corpus cavernosal strip was carefully prepared from rabbit penis and suspended in an 10ml organ bath containing Tyrode solution. When a stable tension level of the strip had been attained, drugs were added to the organ bath the change of motility of the strip was recorded on a computerized polygraph. RESULTS: The NO donor, sodium nitroprusside (SNP) and CO caused a dosedependent relaxation of the cavernosal strip of the rabbit penis. Pretreatment of SNP and CO had no effect on contraction induced by adrenergic drugs and the effects of SNP and CO was not affected by atropine. The relaxation effects of SNP were inhibited by NO scavenger pyrogallol, inhibitor of soluble guanylate cyclase 1H-[1,2,4] oxadiazolo[4,3-a] quinoxalin-1-one (ODQ) and methylene blue. The relaxation effects of CO were significantly inhibited by ODQ and methylene blue. the relaxation effects by acetylcholine were inhibited by NO synthase inhibitor L-nitroarginine methyl ester (NAME) and deendothelialization, but not affected by zinc protoporphyrin (ZnPP), the heme oxidase inhibitor. On the immunostaining of heme oxidase (HO) in corpus cavernosal smooth muscle strip, the positive staining for HO was observed in the perivascular nerve fibers. CONCLUSIONS: The relaxation effect of NO was confirmed, and CO exerts an endothelium dependent relaxing effect on the cavernosal strip of the rabbit penis similar to NO. This action is seem to be mediated by soluble guanylate cyclase, and the actions of CO is also mediated by similar guanylate cyclase system.
Acetylcholine ; Adrenergic Agents ; Adult ; Atropine ; Baths ; Brain ; Carbon Monoxide* ; Carbon* ; Endothelium ; Guanylate Cyclase ; Heme ; Humans ; Male ; Methylene Blue ; Muscle, Smooth ; Nerve Fibers ; Nitric Oxide ; Nitric Oxide Synthase ; Nitroprusside ; Oxidoreductases ; Penis ; Pyrogallol ; Rabbits ; Relaxation ; Tissue Donors ; Zinc

No abstract available.
Choriocarcinoma* ; Female ; Pregnancy

No abstract available.
Disasters*

Adenoviridae ; Adhesives ; Cell Culture Techniques ; Culture Media, Serum-Free ; Fluorescence ; Vero Cells

In 1957, human skin infection by M. canis were firstly reported in Kyungsang province in Korea. Later, in 1960 new cases were also reported in the other province, the Choongchung. However, M. canis infection has been reported only sporadically in Seoul city. This extremely low incidenc in this area may not represent true negative rate but reflect lack of the alertness of .M. canis infection. During the years 1978 and 1979, 15 out-patients were diagnosed as M canis infection of the skin at the Department of Dermatology of Severance Hoapital, Yonsei University. These 15 patients were found to belong to six different families residing in the central Korea and never resided outside of that area, The Kyungki province. Majority of the cases(11/15) were clinically diagnosed as tinea corporis, as Kerion celsi and 4 cases were tinea capitis. Among them, combined infection by tinea capitis and tinea corporis were confirmed in two patients. Although the ages of the pateints were widely distributed from 2 to 36 years, children under age 10 were the major population among thern. Five domestic cats from 5 families were examined and confirmed to be infected by M. cams.
Animals ; Cats ; Child ; Dermatology ; Humans ; Korea* ; Microsporum* ; Outpatients ; Seoul ; Skin ; Tinea ; Tinea Capitis

PURPOSE: To determine the clinical efficacy of SS-cream, the topical agent made from the extracts of natural products for treating premature ejaculation(PE), a double blind, randomized placebo controlled phase III study on the patients with primary PE was performed in three medical centers. MATERIALS AND METHODS: Mean age of patient with primary PE was 38.7+/-0.6 years and duration of suffer from PE was 15.8+/-0.4 years. We investigated the ejaculatory latency calculated by stop watch and sexual satisfaction rate after the treatment(1 placebo and 5 SS-cream 0.2gm). Patients were instructed to apply the cream on the glans penis 1 hour before sexual intercourse in double blind randomized fashion. Clinical efficacy was compared with the prolongation of ejaculatory latency and improvement of sexual satisfaction rate. RESULTS: 106 patients with primary premature ejaculation completed this study. Mean ejaculatory latency tested at screening period was 1.37+/-0.1 min and both of patient and partner were not satisfied with their sexual lives. The mean ejaculatory latency was significantly prolonged as 10.92+/-1.0 min with SS-cream, while 2.45+/-0.3 min with placebo. In 79.8%, there was prolongation of ejaculatory latency longer than 2 minutes with SS-cream, while in 15.1% with placebo. The sexual satisfaction rate was also significantly improved as 82.2% with SS-cream, while 12.6% with placebo. 103 (16.2%) out of 636 trials of SS-cream showed mild local irritation including 82 mild burning senses and 21 mild pain, which disappeared in less than 1 hour. No adverse effect on sexual function and partner and no systemic side effects were observed. CONCLUSIONS: With these results, SS-cream is effective and safe in the treatment PE with mild local side effect.
Biological Products ; Burns ; Coitus ; Humans ; Male ; Mass Screening ; Penis ; Premature Ejaculation*

SS-cream is a topical agent for treating premature ejaculation (PE) which is made with extracts from 9 natural products. We evaluated the efficacy of SS-cream in the treatment of PE. An open pilot study was performed in 186 patients with PE. The mean ejaculatory latency from intromission to ejaculation was 1.5 minutes. Sixty-four of the 186 patients (34.4%) were combined with mild erectile dysfunction in whom penile rigidity was not sufficient to be satisfied in sexual activity. Patients were instructed to apply 0.1 gm. of SS-cream on the glans penis 1 hour before sexual contact and to wash out the cream before sexual intromission. Patients were asked to complete a report form including ejaculatory latency, the degree of satisfaction in the sexual lives of both themselves and their partners, and any adverse effects after each application. One hundred and sixty-six out of 186 patients (89.2%) reported they were satisfied with the application of the SS-cream and the mean ejaculatory latency was significantly prolonged to 10.89 +/- 5.60 minutes. The mean ejaculatory latency was 9.85 +/- 3.58 minutes in 52 out of 64 patients (81.2%) with mild erectile dysfunction. There was no significant difference in the changes of ejaculatory latencies between patients with pure PE and patients with mild erectile dysfunction. Twenty patients (10.8%) claimed to have no changes of ejaculatory latencies after the application of SS-cream. Adverse effects were noted in 11 patients (5.9%), which were mild local irritation symptoms in 7 patients, and delayed ejaculation of more than 30 minutes in 4 patients, the symptoms subsided spontaneously within 4 hours. These results indicate SS-cream is effective in the treatment of PE and also PE combined with mild erectile dysfunction with a few side effects. Further studies on the action mechanisms of SS-cream and a double blind placebo-controlled trial are needed.
Administration, Topical ; Adult ; Drugs, Chinese Herbal/administration & dosage* ; Ejaculation/drug effects* ; Human ; Male ; Middle Age ; Penile Erection/drug effects

Recurrent episodes of venoocclusive priapism have been described previously in patients who have had repeated exposure to a recognized stimulus such as intracavernosal injections of vasoactive agents, or pathologic conditions such as spinal stenosis or hematological disorders. Three patients were referred for evaluation of an unusual sequoia of an initial episode of idiopathic venoocclusive priapism, occurred with a frequency ranging from several times per month to once per year and were symptomatically disabling. We reviewed the characteristics and the possible pathophysiology of this syndrome and some therapeutic options in the management of these patients.
Humans ; Priapism* ; Sequoia ; Spinal Stenosis

PURPOSE: To study the MR findings to predict the site of dural attachment in meningiomas. MATERIALS AND METHODS: We retrospectively reviewed MR findings of 23 patients with surgically confirmed meningiomas and analysed the characteristics of dural attachment site of meningiomas and tumor growing vector against dura. RESULTS: In the 10 cases that tumor had a single dural base, the dural base was tumor bed. in the 2 cases that tumor had more than two dural bases, wider, irregular and thicker enhancing dura was tumor bed. In the 7 of the 11 cases of diffuse dural bases with tumor, we could predict tumor bed considering the degree of compression to the brain parenchyma and the tumor growing vector. CONCLUSIONS: In the case of tumor having more than two surfaces contacting the dura or with narrow attachment site, it is possible to predict the site of dural attachment if we consider the characteristrics of dural attachment site and tumor growing vector against dura.
Brain ; Humans ; Meningioma* ; Retrospective Studies