No abstract available.
Hemorrhage* ; Pregnancy* ; Round Ligament of Uterus*

The diagnosis of diabetics itself was frequently delayed in diabetic patients diagnosed over 30 years old. Therefore, fundus examination should be carried out at the time of diagnosis. The purpose of this study was to determine the delayed time of the initial fundus examination by ophthalmologists after diagnosis of diabetes and the reason for not having fundus examination in diabetic patients diagnosed when they were over 30 years of age. From January, 1998 to July, 1998, two hundred fifty-seven such diabetic patients were examined fundus for the first time in Department of Ophthalmology of the Kyungpook National University Hospital. Among these patients,the average delayed time of the initial fundus examination by ophthalmologists after the diagnosis of diabetes was 6.2 years and the morbidity rate was 39.7% (102 patients). At these patients,mild,moderate and severe nonproliferative diabetic retinopathy were 22.6% (58 patients), 10.1% (26 patients),2.7% (7 patients)respectively and proliferative diabetic retinopathy was 4.3% (11 patients). In conclustion, the delayed fundus examination was due to not knowing about timely necessity of the fundus examination. Diabetic patients as well as doctors who treat them should beeducated for the fundus examination at the time of diagnosis.
Adult ; Diabetic Retinopathy* ; Diagnosis ; Gyeongsangbuk-do ; Humans ; Ophthalmology

No abstract available.
Female ; Laparoscopy* ; Methotrexate* ; Pregnancy ; Pregnancy, Ectopic*

PURPOSE: There is little data on the effects of botulinum toxin A (BoTx A) on detrusor muscle published in the literature. An experimental study was conducted to investigate the effect of BoTx A on the detrusor muscle in rats. MATERIALS AND MTHODS: Sprague-Dawley rats were used to make the detrusor muscle strip (length: 8mm, width: 2mm). An isometric force transducer in the physiologic salt solution was used to measure the contraction and relaxation of this muscle strip. A contraction was induced by acetylcholine (ACh) and electrical field stimulation (40V, 20Hz, 3sec), and relaxation was induced by verapamil and sodium nitroprusside. The BoTx A concentration was 0.1U/ml. The relaxation and contraction of the detrusor muscle in the BoTx A-treated group were analyzed and compared with those in the control group. RESULTS: The time to the maximum contraction induced by electrical field stimulation was lengthened and the time of recovery to the basal state after terminating electrical field stimulation was also increased by BoTx A (p<0.05). However, the contractile reaction induced by ACh and the relaxing reaction induced by verapamil and sodium nitroprusside after maintaining the maximum contraction induced by ACh 10 4M was not influenced by BoTx A. CONCLUSIONS: The results of this experimental study suggest that the time delay of the maximum contraction induced by electrical field stimulation occurred by blocking ACh release at the neuronal endings and the time delay of the recovery to the basal state after terminating electrical field stimulation occurred by reducing cholinesterase activity.
Acetylcholine ; Animals ; Botulinum Toxins* ; Cholinesterases ; Neurons ; Nitroprusside ; Rats* ; Rats, Sprague-Dawley ; Relaxation ; Transducers ; Urinary Bladder ; Verapamil

PURPOSE: There is little data on the effects of botulinum toxin A (BoTx A) on detrusor muscle published in the literature. An experimental study was conducted to investigate the effect of BoTx A on the detrusor muscle in rats. MATERIALS AND MTHODS: Sprague-Dawley rats were used to make the detrusor muscle strip (length: 8mm, width: 2mm). An isometric force transducer in the physiologic salt solution was used to measure the contraction and relaxation of this muscle strip. A contraction was induced by acetylcholine (ACh) and electrical field stimulation (40V, 20Hz, 3sec), and relaxation was induced by verapamil and sodium nitroprusside. The BoTx A concentration was 0.1U/ml. The relaxation and contraction of the detrusor muscle in the BoTx A-treated group were analyzed and compared with those in the control group. RESULTS: The time to the maximum contraction induced by electrical field stimulation was lengthened and the time of recovery to the basal state after terminating electrical field stimulation was also increased by BoTx A (p<0.05). However, the contractile reaction induced by ACh and the relaxing reaction induced by verapamil and sodium nitroprusside after maintaining the maximum contraction induced by ACh 10 4M was not influenced by BoTx A. CONCLUSIONS: The results of this experimental study suggest that the time delay of the maximum contraction induced by electrical field stimulation occurred by blocking ACh release at the neuronal endings and the time delay of the recovery to the basal state after terminating electrical field stimulation occurred by reducing cholinesterase activity.
Acetylcholine ; Animals ; Botulinum Toxins* ; Cholinesterases ; Neurons ; Nitroprusside ; Rats* ; Rats, Sprague-Dawley ; Relaxation ; Transducers ; Urinary Bladder ; Verapamil

PURPOSE: Meconium aspiration syndrome (MAS), often progresses to respiratory failure and its' serious complication, persistent pulmonary hypertension of the newborn (PPHN) is a major cause of neonatal mortality. Early recognition of infants at the risk for respiratory failure in MAS patients is necessary for treatment. So we aimed to identify serum enzymes such as lactate dehydrogenase (LDH), aspartate transaminase (AST), and alanine transaminase (ALT) as serum biologic marker for early detection of respiratory failure in MAS patients. METHODS: Infants admitted within 24 hours after birth to Neonatal Intensive Care Unit of Dongguk University Ilsan Hospital and diagnosed with MAS from August 2005 to March 2014 were analyzed retrospectively. Serum enzymes were measured on admission. RESULTS: Of the total 60 patients diagnosed with MAS, 28 were in the positive pressure ventilation (PPV) group and 32 were in the non-PPV group. Six patients progressed to PPHN. Only serum LDH was significantly higher in the PPV group than the non-PPV group (median 1,123 vs. 831, P =0.01). Using the ROC curves, the cut-off value of 964 U/L for LDH offered the best predictive value for PPV requirement (sensitivity 61% and specificity 81%). Serum LDH was significantly higher in MAS with PPHN group than MAS without PPHN group (median 1,791 vs. 904, P =0.013). But serum AST, ALT were not predicting factor for the requirement of respiratory support and development of PPHN among MAS patients. CONCLUSION: LDH might be a good predicting factor for the requirement of respiratory support and development of PPHN among MAS patients.
Alanine Transaminase ; Aspartate Aminotransferases ; Biomarkers ; Humans ; Hypertension, Pulmonary ; Infant ; Infant Mortality ; Infant, Newborn ; Infant, Newborn* ; Intensive Care, Neonatal ; L-Lactate Dehydrogenase ; Meconium Aspiration Syndrome* ; Meconium* ; Parturition ; Positive-Pressure Respiration ; Respiratory Insufficiency ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity

Menopause is the time at which menstruation stops in women. After menopause, women are more susceptible to some diseases, especially osteoporosis and cardiovascular disease. Vitamin D has a protective effect against osteoporosis by facilitating the absorption of calcium and affecting parathyroid hormone. Vitamin D also affects cardiovascular function by lowering the blood pressure, which affects the renin–angiotensin system and alters the low-density lipoprotein receptor activity. This paper discusses supplemental vitamin D in postmenopausal women with osteoporosis and cardiovascular disease.
Absorption ; Blood Pressure ; Calcium ; Cardiovascular Diseases ; Female ; Humans ; Menopause ; Menstruation ; Osteoporosis ; Parathyroid Hormone ; Receptors, Lipoprotein ; Vitamin D* ; Vitamins*

Defensins, cysteine-rich cationic polypeptides released from neutrophils, are known to have powerful antimicrobial properties. In this study, we sacrificed 30 rats to investigate the effects of alpha-defensin 1 on detrusor muscle contractions in isolated rat bladder. From the experiments we found relaxing effects of alpha-defensin 1 on the contractions induced by phenylephrine (PE) but not by bethanechol (BCh) in the detrusor smooth muscles. To determine the mechanisms of the effects of alpha-defensin 1, the changes of effects on PE-induced contraction by alpha-defensin 1 pretreatment were observed after pretreatment of Rho kinase inhibitor (Y-27632), protein kinase C (PKC) inhibitor (Calphostin C), potent activator of PKC (PDBu; phorbol 12,13-dibutyrate), and NF-kappaB inhibitors (PDTC; pyrrolidinedithiocarbamate and sulfasalazine). The contractile responses of PE (10(-9) ~ 10(-4) M) were significantly decreased in some concentrations of alpha-defensin 1 (5x10(-9) and 5x10(-8) M). When strips were pretreated with NF-kappaB inhibitors (PDTC and sulfasalazine; 10(-7) ~ 10(-6) M), the relaxing responses by alpha-defensin 1 pretreatment were disappeared. The present study demonstrated that alpha-defensin 1 has relaxing effects on the contractions of rat detrusor muscles, through NF-kappaB pathway. Further studies in vivo are required to clarify whether alpha-defensin 1 might be clinically related with bladder dysfunction by inflammation process.
Animals ; Bethanechol ; Contracts ; Defensins ; Inflammation ; Muscle Contraction ; Muscle, Smooth ; Muscles ; Neutrophils ; NF-kappa B ; Peptides ; Phenylephrine ; Phorbols ; Protein Kinase C ; Pyrrolidines ; Rats ; rho-Associated Kinases ; Thiocarbamates ; Urinary Bladder

PURPOSE: Botulium toxin-A (BoTx A) is useful in treating detrusor-sphincter dyssynergia, detrusor hyperreflexia, and refractory overactive bladder. Only the blocking action of acetycholine (ACh) release from nerve endings is the well known aspect of the action mechanism. The aim of this study is to investigate the effects of BoTx A on the detrusor muscle itself. MATERIALS AND METHODS: Sprague-Dawley rats were divided into 3 groups: the control group, the low dose injection group (1unit/ml of BoTx A, 0.5cc), and the high dose injection group (5units/ml of BoTx A, 0.5cc). All rats were either injected with normal saline (control group) or BoTx A (injection groups). Ten days after injection, a strip of the detrusor muscle was harvested. Contraction and relaxation responses of the strips were measured by an isometric force transducer. Contractions were induced by various concentrations of ACh, bethanechol, phenylephrine (PE), high concentrations of potassium (35, 70, 105, 140mM), tetraethylammonium (TEA, 0.1, 1, 10mM), 4-aminopyridine (4-AP, a delayed rectifier K+ antagonist, 0.1, 1, 10mM), and Bay K8644 (a L-type voltage dependent calcium channel opener, 0.1, 1, 10mM). The results were analyzed by ANOVA and the Student's t test. RESULTS: Contractions of the strips were noted when concentrations were above 1mM for TEA and above 0.1mM for 4-AP. A high dose injection as well as a low dose injection of BoTx A had no significant effects on the Ach or bethanechol-induced contractions of the strips compared to the control group. Denervation supersensitivity was not found in the injection groups after the Ach and bethanechol treatments, but the contractility was decreased in high concentrations of potassium (70, 105, 100mM), TEA (10mM), 4-AP (10mM), and Bay K8644 in both the high and low dose injection groups. There was no significant difference in the decrease of contractility between the high and low dose groups with the exception of the Bay K8644 1M treatment. CONCLUSIONS: BoTx seems to have some direct effects on decreasing the contractility of the detrusor muscle by increasing the delayed rectifier K+ channel activity and decreasing the L-type voltage dependent calcium channel activity.
3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethyl-5-nitro-4-(2-(trifluoromethyl)phenyl)-, Methyl ester ; 4-Aminopyridine ; Animals ; Ataxia ; Bethanechol ; Botulinum Toxins, Type A ; Calcium Channels* ; Calcium* ; Denervation ; Nerve Endings ; Phenylephrine ; Potassium ; Rats* ; Rats, Sprague-Dawley ; Reflex, Abnormal ; Relaxation ; Tea ; Tetraethylammonium ; Transducers ; Urinary Bladder* ; Urinary Bladder, Overactive

STUDY DESIGN: A retrospective study. SUMMARY OF THE LITERATURE REVIEW: The reports comparing short- and long-segment instrumentation are insufficient. OBJECTIVES: To determine the postoperative results and to analyze relative factors affecting results between short- and long-segment instrumentation in thoracolumbar fractures. MATERIALS AND METHODS: From March 2006 to March 2012, 97 patients with thoracolumbar fracture were treated with posterior instrumentation. They were divided into 2 groups, the short- (Group I) and long-segment groups (Group II). To analyze factors affecting results, several factors including age, anterior column height (ACH), and the kyphotic angle were reviewed. For radiologic evaluation, postoperative and follow-up radiographs were evaluated by measuring the kyphotic angle and ACH. Additionally, the presence of complications was reviewed. RESULTS: Groups I and II consisted of 45, 52 cases and had mean ages of 50.3, 55.8 years, respectively. In Group I, the ACH increased from 44.2% to 75.3% postoperatively, and remained 72.8% at follow-up. The kyphotic angle decreased from 19.4degrees to 10.6degrees postoperatively, and remained at 12.8degrees at follow-up. In Group II, the ACH recovered from 41.6% to 76.4% postoperatively, and was 74.8% at follow-up. The kyphotic angle decreased from 21.6degrees to 12.6degrees postoperatively, and was 13.9degrees at follow-up. The canal compromise, age, and comminution were not directly related with results. However, the mean age of the 7 cases showing complications was 72 years, and the 7 cases had severe comminuted fractures. CONCLUSIONS: The short- and long-segment instrumentations of thoracolumbar fractures are not significantly different with respect to the results attained. However, in order to decrease complications, we should pay attention to age and fracture comminution.
Follow-Up Studies ; Fractures, Comminuted ; Humans ; Retrospective Studies