PURPOSE: The artificial erection is critical to chordee repair. We report the use of a natural erection induced by prostaglandin E(1)(PGE1) in the diagnosis and treatment of penile curvatu re as an alternative to artificial erection in children and adult patients. MATERIALS AND METHODS: Pharmacological erection was induced 14 children with a mean age of 5 years (range 1-10) and 8 adults with a mean age of 33 years (range 18-58) to diagnose and repair anomalies, such as simple penile curvature, chordee with or without hypospadias, webbed penis and Peyronie's disease. Alprostadil (1-16ng) as a agent for induce erection was used exclusively, but no agents were routinely given to reverse the erection was used exclusively, but no agents were routinely given to reverse the erections. The dose injected intracavernosally was dependent on the patient's age, penile size and response, and ranged from 0.5 to 10 micrograms. Time to and adequacy of erection, detumescence, changes in blood pressure and pulse rate were monitored. RESULTS: A dilatation of erectile tissue was achieved within 8 minutes and was judged adequate in 2 and excellent in 20. The mean duration of erection was 107 minutes, while a prolonged erection, for up to 2.5 hours, occured on 2 patients who were treated conservatively. Detumescence were occurred when the corpora were opened, but re-erected penis after closure of corpora in 7 cases who treated with Nesbit's corporeal plication or fibrous plaque excision and dermal graft. Although there were the impression of increased bleeding, there were no specific changes in blood pressure or pulse rate. CONCLUSIONS: Pharmacological erection in penile curvature is effective and reliable with no significant complications. Although PGE1 is expensive and induced slightly increased bleeding, pharmacological erection has the advantage of tumescence of the entire penis and consequently a constant and natural representation of chordee without corporeal or urethral injury. Therefore, the erection achieved by injecting PGE1 into the corpora cavemosa is a useful alternative to artificial erection in the diagnosis and treatment of penile anomalies.
Adult ; Alprostadil ; Blood Pressure ; Child ; Diagnosis ; Dilatation ; Female ; Heart Rate ; Hemorrhage ; Humans ; Hypospadias ; Male ; Penile Induration ; Penis ; Transplants

No abstract available.
Anemia, Aplastic* ; Preleukemia*

STATEMENT OF PROBLEM: Proper proximal contact is important for maintaining and stabilizing the dental arch. However, the proximal contact strength (PCS) is not a constant value and can be affected by a variety of factors. PURPOSE: This study examined the influences of postural changes on the posterior PCS. MATERIAL AND METHODS: Twelve adults with a normal occlusion and had not undergone prosthetic treatment or proximal restoration were participated in this study. A metal strip was inserted into the proximal surface and removed at a constant velocity. The contact strength was measured in every contact point between canine to second molar in both arches. The PCSs were obtained initially in the upright position, secondly in the supine position and finally in the upright position again. All measurements were repeated after a 2 hour period. Statistical analysis was carried out using the Friedman test (P < .05). RESULTS: Generally, a decrease in PCS occurred when the posture was changed from the initial upright to supine position, while it increased when the posture was changed from the supine to upright position. A significant change was observed in all areas except for between the canine-first premolar in the maxilla and between the first molarsecond molar in the mandible areas. CONCLUSION: The posterior PCS, which dentists generally believe to be a static feature of occlusion, is affected significantly by posture.
Adult ; Bicuspid ; Dental Arch ; Dentists ; Humans ; Mandible ; Maxilla ; Molar ; Posture ; Supine Position

Familial periodic vertigo and ataxia is a rare, disabling condition of autosomal dominant episodes of vertigo and/or ataxia, sometimes associated with other brain stem symptoms such as diplopia, weakness and dysarthria. These attacks typically begin in early childhood or early adulthood, last for hours to days. Attacks may occur daily, or may be separated by longer intervals. We present a family with familial periodic vertigo and ataxia. A 20-year-old woman presented recurrent paroxysmal vertigo, nausea, vomiting and ataxia lasting for 2 to 4 hours since middle school age. Recently daily attacks disabled her from daily living activity. Neurologic examination in the attack-free interval revealed downbeat nystagmus at neutral position and bilateral gaze evoked coarse horizontal nystagmus. Her mother, 47-year-old female also had recurrent vertigo, ataxia and dysarthria lasting for 1 to 2 hours since childhood. Their symptoms are precipitated by fatigue, exertion, emotional stress and alcohol. Both patients showed good response to acetazolamide and flunarizine even though showed persistent objective nystamus
Acetazolamide ; Activities of Daily Living ; Ataxia* ; Brain Stem ; Diplopia ; Dysarthria ; Fatigue ; Female ; Flunarizine ; Humans ; Middle Aged ; Mothers ; Nausea ; Neurologic Examination ; Nystagmus, Pathologic ; Stress, Psychological ; Vertigo* ; Vomiting ; Young Adult

BACKGROUND: There have been a few reports suggesting involvement of neutrophil as well as eosinophil in inducing bronchoconstriction aft,er inhalation of TDI. OBJECTIVE: In order to observe the source of chemokines in TDI-induced asthma, this investigation was designed to determine whether IL-8 and RANTES could be produced by human bronchial epithelial cells and whether dexamethasone had any effects on their production. Materials and METHODS: We cultured Beas-2B, a bronchial epithelial cell line, with five concentrations of TDI-human serum albumin (HSA) conjugate and compared them with those having no conjugate. The levels of IL-8 and RANTES in the supernatant were measured by ELISA. To evaluate the effect of pro-inflammatory cytokines, cells were incubated with peripheral blood mononuclear cell (PBMC) culture supernatant, which was derived from PBMC culture of a TDI -induced asthmatic subject under exposure to TDI-HSA conjugate, and then compared to those without PBMC supernatant addition. To evaluate the effect of dexamethasone, four concentrations of dexamethasone were pre-incubated and the same steps were repeated. RESULTS: There was significant production of IL-8 from bronchial epithelial cells with addition of TDI-HSA conjugate in a dose-dependent manner (p<0.05, respectively), which was significantly augmented with additions of PBMC supernatant (p<0.05, respectively) at each concentration. RANTES production was negligible, however, it increased significantly with addition of PBMC supernatant and TDI-HSA conjugate in a dose response manner(p<0.05, respectively). Compared to the untreated sample, pre-treatment of dexamethasone induced remarkable inhibitions of IL-8 and RANTES production. CONCLUSION: These results suggest that IL-8 and RANTES released from bronchial epithelial cells may contribute to neutrophil and eosinophil recruitment occurring in TDI-induced airway.
Asthma ; Bronchoconstriction ; Chemokine CCL5* ; Chemokines ; Cytokines ; Dexamethasone ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Epithelial Cells* ; Humans ; Inhalation ; Interleukin-8 ; Neutrophils ; Serum Albumin ; Toluene 2,4-Diisocyanate* ; Toluene*

BACKGROUND: As single donor platelets (SDP) has been increasingly used, the quality of SDP, especially apheresis-induced platelet activation, has become a major issue. This study evaluated the activation of SDP platelets prepared with three different cell separators that are currently being used at the Korean Red Cross. METHODS: CD62p, CD63 and CD42 were measured in 35 units of SDP prepared with Amicus (Baxter, Deerfield, IL, USA), MCS+ (Haemonetics, Braintree, MA, USA), or Trima (Gambro BCT, Lakewood, USA) using flow cytometry. RESULTS: Expression of CD62p gradually increased with storage time, but no difference in expression was noted between cell separators. Expression of CD63 also increased with storage time and platelets prepared with the Amicus displayed significantly higher CD63 expression 72 and 120 hours after collection compared to those prepared with MCS+ and Trima. Expression of CD42b tended to decrease with storage time, but this was only significant for Amicus 120 hours after collection. No difference in CD42b expression was noted between cell separators. CONCLUSIONS: Platelet activation increased with storage time, and platelet activation was more pronounced in the platelets prepared with the Amicus. However, because in vitro results of platelet activation does not necessarily reflect in vivo platelet function and survival, additional studies are needed to clarify clinical effectiveness of activated platelets.
Blood Platelets* ; Flow Cytometry ; Humans ; Platelet Activation* ; Plateletpheresis* ; Red Cross ; Tissue Donors

Periventricular-intraventricular hemorrhage (PV-IVH)is one of the most important neurologic lesion of the low birth weight infants. Serial neurosonographic exeaminations were performed in 113 low birth weight infants who were admitted to the neonatal intensive care unit of Presbyterian Medical Center from November 1, 1990to July 31, 1991. The results were summarized as follows: 1) The incidence of PV-IVH in the study was 54% 2) According to Papile's grading system of PV-IVH, grade I was 32.8%, grade II was 45.9%, grade IIIwas 11.5% and grade IV was 9.8%. 3) The onset of PV-IVH was within the first 7 days of life in 82%. 4) Poor activity, apnea, bradycardia and hypotension were statistically significant clinical findings associated with PV-IVH(P<0.05). 5) The risk factors associated with PV-IVH were gestational age, birth weight, hyaling membrane disease, patent ductus arteriosus and artifical ventilation. 6) The mortality of PV-IVH was 0% for grade I, 10.7% for grade II,42.9% for grade III and 83.3% for gradeIV.
Apnea ; Birth Weight ; Bradycardia ; Diagnosis* ; Ductus Arteriosus, Patent ; Gestational Age ; Hemorrhage* ; Humans ; Hypotension ; Incidence ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Intensive Care, Neonatal ; Membranes ; Mortality ; Protestantism ; Risk Factors ; Ventilation

A fabrication method of inner and outer crown using CAD/CAM is presented. The information of abutment teeth is transferred to a computer through a 3-dimensional scanner. A Konus inner and outer crown is designed on a computer and a real crown is machined based on this design using CAM. This method can save laboratory time and reduce inaccuracies compare to conventional casting procedure. A stone model with six prepared abutment teeth from a patient was used in this study. Three dimensional information from the model was transferred to a computer using a contact type 3dimensional scanner with a 25micrometer accuracy. All margins were identified on a computer image where there is a change in surface taper of a model. To provide a cement space, the image of a inner surface of a Konus inner crown was duplicated 25micrometer apart from the surface of a prepared abutment teeth image. The cement space was 20micrometer at the cervical margin. All Konus crowns were machined with a 10micrometer accuracy. It was concluded that this method can reduce working-time for the laboratory process and increase accuracy. A further research is required to make a simplified process for a more complex prosthesis.
Computer Graphics* ; Crowns* ; Humans ; Prostheses and Implants ; Tooth

A lateral chest radiograph is frequently useful and sometimes decisive in detecting chest pathology. Certainparts, such as the posterior wall of the bronchus intermedius (PWBI) and subcarinal regions, can be evaluated onlyon lateral chest radiograph. The authors present and emphasize the findings of PWBI and subcarinal abnormalities. Abnormal PWBI, more than 3 mm thick, is seen in cases of minor degree of oblique position, pulmonary edema, inflammation, neoplasm and enlarged lymph nodes. It can also be seen in patients with subcarinal mass. The findings of subcarinal mass on lateral view are ill-defined increased opacity, fullness of the inferior hilarregion, doughnut sign, extra-density and thickening of the PWBI. Detection of changes in the PWBI and subcarinalregion may be the only diagnostic evidence of hilar and subcarinal disease and helps in its early detection priorto computed tomography.
Bronchi* ; Humans ; Lymph Nodes ; Pathology ; Radiography, Thoracic* ; Thorax*

PURPOSE: It is important to know for transurethral resection of prostate (TURP) affecting the serum prostate specific antigen (PSA) value how long one should wait before being able to ~ obtain an accurate and meaningful serum PSA level. We evaluated the change of serum PSA concentration in patients with benign prostate hypertrophy(BPH) before and after TURP in association with time course and resected prostatic weight. MATERIALS AND METHOD: The effect of TURP was examined in 27 patients with BPH (mean age: 64 years; range: 55-79 years). The serum PSA levels were measured serially (before and 1, 3, 5, 7, 14, 30, 60, 90 days after TURP) by Abott IMX assay. RESULTS: The level of serum PSA appeared to be consistent with prostatic volume by transrectal ultrasonography(TRUS) and was elevated by about 0.16 ng/mL for each gram of hyperplastic tissue present (p=0.375, p=0.058). TURP caused an immediate elevation in the serum PSA concentration, with a median increase of 19 ng/mL (p=0.0001). The larger resected group showed a dramatic and statistically significant PSA rise immediately after TURP than the smaller resected group (p=0.023). From the 15 post-operative day, the PSA concentrations continued slightly lower than that of pre-operative day (p=0.0001), and was still decreased on 30 days (p=0.0001). The median time to return to a baseline level of PSA was 30 days (range: 1460 days) after TURP. CONCLUSION: These findings indicate that TURP caused an immediate increase in the serum PSA level, which generally return to stable, baseline level within 30 days. However, because in some patients the serum PSA still remained elevated than upper normal limit after 30 days, it is recommended that a serum PSA determination should be obtained for at least 60 days after TURP.
Humans ; Hypertrophy* ; Prostate* ; Prostate-Specific Antigen* ; Transurethral Resection of Prostate*