Acute Disease ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Myocarditis ; diagnosis ; diagnostic imaging ; Ultrasonography ; methods ; Virus Diseases ; diagnosis ; diagnostic imaging

The nerve root block or selective nerve root block is one of the primarily preoperative diagnostic tool to identify and confirm the lesion site of primary cause of pain and that is considered as one component of a comprehensive treatment program. The purpose of our study is to evaluate the effect and duration of the pain control by selective spinal nerve root block as a conservative treatment in patients presenting with chronic or recurrent sciatica. The authors performed 95 selective nerve root blocks in 72 patients from Sep. 1994 to May. 1996, (mean follow up 11.6 month) at the department of orthopedic surgery, Kosin University Gospel Hospital, and the results were as follows: 1. Among 72 cases, spinal stenosis was in 45 cases (62.5%), HIVD in 19 cases (26.4%), failed back syndrome in 5 cases (6.9%), spondylosis in 2 cases (2.8%), and spondylolisthesis in I case (1.4%). 2. In 72 cases, improved more than 50% of sciatica were 61 cases (84.7%) at 3 hours, 53 cases (73.6%) at I week, 35 cases (48.6%) at 1 month, 33 cases (45.8%) at 3 months, and 33 cases (45.8%) at 6 months respectively. 3. At last follow-up, excellent and good results were 35 cases (48.6%), fair results were 25 cases (34.7%) and poor results were 12 cases (16.7%) by the Kirkaldy-Willis criteria. 4. Complications were 1 case of transient hypotension, 2 cases of severe paresthesia, but subsided without residual complication. Therefore, the selective nerve root block is one of the valuable procedure that is helpful and extremely safe in useful treatment for radicular pain associated with lumbar disease. And the trial of selective nerve root block was recommended before deciding surgical intervention on an outpatient basis.
Follow-Up Studies ; Humans ; Hypotension ; Orthopedics ; Outpatients ; Paresthesia ; Sciatica* ; Spinal Nerve Roots* ; Spinal Nerves* ; Spinal Stenosis ; Spondylolisthesis ; Spondylosis

OBJECTIVETo study the effects of low concentration dopamine(DA) on hydrogen peroxide-induced apoptosis in cultured rat cardiomyocytes as well as the possible molecular mechanisms.

METHODSCultured neonatal rat cardiomyocytes were randomly divided into the following groups: control group (control), hydrogen peroxide group (H2O2), pretreated with low concentration dopamine ( DA + H2O2), dopamine receptor l(DR1) antagonist group (DR1 + DA + H2O2), dopamine receptor 2(DR2) antagonist group (DR2 + DA + H2O2). The cell apoptosis was then assessed by MTT and flow cytometry. The cellular ultrastructure changes were observed by transmission electron micro- scope. The activity of lactate dehydrogenase(LDH )and superoxide dismutase (SOD) in cell medium was analyzed by colorimetry. The protein expressions of Cytochrone c, Caspase 3 and Caspase 9 were obtained by Western blot.

RESULTSCompared with hydrogen peroxide group, low concentration dopamine(10 µmol/L) decreased the apoptosis rate and the expression of protein of apoptosis related protein, enhanced SOD activity, decreased LDH activity. DR1 antagonist SCH-23390 treatment inhibited dopamine induced cardiac protective effect. DR2 antagonist haloperido treatment had no changes compared with dopamine group.

CONCLUSIONAbove findings indicate that low concentration dopanine inhibits apoptosis induced by hydrogen peroxide in neonatal rat cardiomyocytes, which is partly associated with the activation of DR1.

Animals ; Apoptosis ; Benzazepines ; Caspase 3 ; metabolism ; Caspase 9 ; metabolism ; Cells, Cultured ; Dopamine ; pharmacology ; Hydrogen Peroxide ; L-Lactate Dehydrogenase ; metabolism ; Myocytes, Cardiac ; drug effects ; Rats ; Rats, Wistar ; Receptors, Dopamine D1 ; metabolism ; Superoxide Dismutase ; metabolism

Effects of beta-adrenergic blockers and related agents were investigated on experimental convulsions of chicks induced with strychnine, pentylenetetrazol or electroshock and on thiopental sleeping time of rabbits. Convulsions of chicks due to strychnine were significantly inhibited by all beta-adrenergic blockers except dichloroisopreterenol. Propranolol inhibited electroshock convulsion as well, but none of the blockers inhibited pentylenetetrazol convulsion. Furthermore, the mortality of chicks due to large dose of pentylenetetrazol was greatly increased by treatment of beta-adrenergic blockers. Pindolol alone showed diazepam-like anticonvulsive effect against low doses of pentylenetetrazol. Pretreatment with beta-adrenergic blockers caused a marked increase in thiopental sleeping time in rabbits. Prolongation of thiopental sleep due to propranolol was abolished by premedication of animals with reserpine or tranylcypromine. Thiopental sleeping time was prolonged by Zizyphus extract, though less effective than beta-adrenergic blockers. It is felt that the anticonvulsive or sleep enhancing effect of beta-adrenergic blocking agents has an intimate relationship with endogenous adrenergic amines and the receptors.
Adrenergic beta-Antagonists/pharmacology* ; Anesthesia ; Animal ; Anticonvulsants* ; Blood Pressure/drug effects ; Chickens ; Convulsions/chemically induced ; Heart Rate/drug effects ; Male ; Propranolol/pharmacology* ; Rabbits ; Strychnine/antagonists & inhibitors ; Thiopental

The influence of intravesica1 pressure on urine for-mation was studied in dogs and rabbits prepared with ureteral fistulae and in man following ureteral cathe-terization. Reduction of urinary output following distension of the bladder occurred in all except two dogs. The mean rate of reduction in sixteen dogs was 37.3 +/- 4.9 per cent. The response was not blocked by tetracaine applied to the bladder mucosa or by systemic hexamethonium. The renal blood flow showed a significant reduction following distension of the bladder. After denervation or celiac ganglionectomy, the reduction of urinary output or of renal blood flow was prevented in the ipsilateral kidney. Coloring of the renal cortex by intravenously injected indigo carmine does not occur in animals with distended bladders. Adrenaline and serotonin produced and enhanced the effect on the urinary response of the distended bladder. The injection of a small amount of blood or urine from animals with distended bladders into undistended animals produced a significant decrease in urine formation in the recipients. In five human subjects, a marked reduction of urine flow was noted following bladder distension. We conchlde that the intravesical pressure may regulate the formation of urine through a short vesico-renal reflex mediated by the celiac ganglion and through a long vesico-hypothalamic reflex which releases the antidiuretic hormone.
Animals ; Denervation ; Dogs ; Epinephrine ; Fistula ; Ganglia, Sympathetic ; Ganglionectomy ; Hexamethonium ; Humans ; Indigo Carmine ; Kidney ; Mucous Membrane ; Rabbits ; Reflex ; Renal Circulation ; Serotonin ; Tetracaine ; Ureter ; Urinary Bladder

Objective To discuss the curative effect of different operative methods for the treatment of urethrocutaneous fistula (UCF) after urethroplasty.Methods Clinical data of 54 cases of UCF from January 2003 to July 2011 were collected.Simple suture,advancement skin flap,pedicle penile skin flap urethroplasty,tongue/buccal mucosa urethroplasty were performed according to the size,location,number and whether there was urethral stricture of UCF.The treatment effect was recored and analyzed.Results The success rate of UCF repair was 85％ (46/54).There were 4 patients cured after second surgery.The success rates of repair of UCF with simple suture,advancement skin flap,pedicle penile skin flap urethroplasty,tongue/buccal mucosa urethroplasty were 95％,76％,82％,and 83％,respectively.Postoperative recurrence was observed in 5 patients in 6 months after the surgery and 4 of them received the re-operation.Conclusion According to the principle and the individual circumstance,taking personalized operative methods may improve the success rate of the repair of all kinds of UCF.

Objective To evaluate the selection and outcome of procedures for the treatment of female patients with low urovaginal fistulas.Methods Between Jan.1999 and Dec.2012,a total of 94 low urovaginal fistula patients with mean age 28(5-58)years and the duration of the condition for mean 4(1-23)years were treated using a variety of procedures.Of the 94 patients,the etiology was trauma in 57 patients,iatrogenic injuries in 34,local inflammation in 2 and congenital in 1.Urethral stricture was associated with urethrovaginal fistulas in 61 patients(Group of urethra)and vesicovaginal fistula in 33 (Group of bladder).Of the group of urethra,it was associated with ileovaginal fistula in 2 patients,rectovaginal fistula in 3 and veginal strictures in 8.Of the group of bladder,the fistula was simple or incipient in 15 cases and complex or recurrent in 18 cases.In group of urethra,pedicle labial skin grafs urethroplasty was used in 30 cases,island flap of vulva urethroplasty in 4 cases,vaginal wall flap urethroplasty in 18 cases,end to end anastomotic urethroplasty in 6 cases,and anterior bladder flap uretbroplasty in 3 cases.At the same time of urethroplasty,bladder neck reconstruction was performed in 6 cases with pre-existing traumatic sphincter incompetence,intestovaginal fistula repair was performed in 5 cases.In the group of vesicovaginal fistula,the fistula repairing was performed by transabdominal approach in 18 cases and by transvaginal approach in 15 cases.Results There were no serious complications postoperatively.Patients were followed up with mean 45(5-140)months.Of the 34 cases underwent pedicle labial or an island flap of vulva urethroplasty,fistulas was recurrent in 3 cases and urethral strictures was happened in one case,3 cases had frequent and stress incontinence,however,all 3 cases achieved urinary continence in 3-8 months postoperatively;of the 18 cases underwent urethroplasty using vaginal flap repairs,all patients achieved anatomical success,and continence in 15 patients and stress incontinence in 3 patients;of the 6 patients underwent urethral end to end anastomosis,all patients achieved urethral anatomical repair success and the continence was achieved in 5 patients,stress incontinence in one patient;and the left 3 patients underwent bladder anterior wall urethroplasty,urethral anatomical repair success was in all 3 patients and continence in one,stress incontinence in one and dysuria in one.Endoscopic resection was performed in the patient with voiding difficulty,after which the patient could void smoothly.In the group of urethra,successful urethral anatomical recovery rate was 91.8％(56/61)and successful functional recovery rate was 83.6％(51/61).In the group of bladder,the fistulas were successfully repaired by one procedure in 29 patients(87.9％)and recurrence in 4 patients.Conclusions The selection of procedures for treatment of female patients with low urovaginal fistulas should be determined by stricture characteristics,including location,length and vaginal condition.It is very important to prevented fistulas reformation during operation by using tissue flaps as a bulk.

Objective To investigate the efficacy and safety of using combined lingual mucosa and buccal mucosa onlay grafts or foreskin flap urethroptasty for the treatment of long or multi-seg-ment urethral strictures. Methods Seven patients with long and 4 cases with multi segment urethral strictures(range 10 to 15 cm,mean 12)underwent substitution urethroplasty using combined lingual mucosa and buccal mucosa onlay grafts or foreskin flap urethroplasty.The patients'age ranged 24 to 56,mean 32 and the course of disease was from 6 to 96 months.Of the 11 patients 7 underwent com-bined lingual mucosa and buccal mucosa grafts urethroptasty,4 patients underwent combined lingual mucosa graft and foreskin flap Urethroplasty. Results The patients were followed up 5-1 2(mean 10)months postoperatively. Meatal stenosis developed 3 months postoperatively in 1 patient who un-derwent combined lingual mucosa and foreskin flap urethroplasty.The patient could void well after re-operation.The other patients could void well and the peak flow rate ranged from 2 1 to 3 6 ml/s(mean 26.8 ml/s). Conclusions Combined lingual mucosa and buccal mucosa onlay grafts or foreskin flap substitution urethroplasty may have the advantage of easier harvest,less trauma.It could be a good U- rethral substitution technique for the treatment of long or multi-segment urethral stricture.

Aim. A neurobehavioral test for workers exposed to organic solvents in the workplace can be affected by many factors : age, education, motivation, ethnicity, etc. To apply more suitable neurobehavioral test for Korean workers, we evaluated the validity of several items of computerized and traditional neurobehavioral tests. Methods. We have applied eleven tests : four items of computerized neurobehavioral test(Swedish Performance Evaluation System) including Addition, Symbol-Digit, Digit Span, and Finger tapping speed, and seven items of traditional neurobehavioral test consisting of Addition, Digit-Symbol , Digit Span, Benton visual retention test, Pursuit aiming, Pegboard, and Tapping. These tests were performed on 96 workers exposed to solvents, and 100 reference workers. The concurrent and construct validities were evaluated by group difference, correlation with age, educational level, hippuric acid level, neurotoxic symptom, current exposure level, multitrait-multimethod matrix, factor analysis, and discriminant analysis. Results. Statistically significant differences were observed between the workers exposed to solvents and referents in computerized Symbol-Digit, Finger tapping speed, traditional Digit-Symbol and Pegboard. The computerized Symbol-Digit, traditional Digit-Symbol, Addition, Benton visual retention test, and Pegboard were found to be related to the age. The performance of computerized Symbol-Digit, Addition, and traditional Digit-Symbol were found to be related to the educational level significantly. The computerized Symbol-Digit, Finger tapping speed, and traditional Digit-Symbol were found to be related to hippuric acid, and neurotoxic symptom. The discriminability of Finger tapping speed, and Pegboard was better than the other tests. In discriminant analysis, the model with two variables, the computerized Symbol-Digit and Pegboard, classified almost 70 percent of the workers correctly. Conclusions. These results suggest that the computerized Symbol-Digit, Finger tapping speed, and Pegboard are more satisfactory for our purpose, and the Addition, Tapping, Benton visual retention test, and Pursuit aiming are less valid than other items. These may allow the reasonable selection of core neurobehavioral tests for workers exposed to solvents in Korea.
Education ; Fingers ; Korea ; Motivation ; Solvents

It is generally accepted that in acute pancreatitis, the enzymes normally excreted by the pancreas are released from the disrupted parenchyma into the extraductal space and taken up by way of the lymphatics and capillaries. The enzymes in the blood stream may appear in high concentration in the serum. Therefore, serum amylase and lipase determinations has long been a mainstay in the diagnosis of acute pancreatitis and other pancreatic diseases. However, many investigators have claimed that the urinary output of amylase may be elevated more consistently in acute pancreatitis than in the serum concentration of either amylase or lipase, and urinary amylase measurement is a more sensitive reflection of the presence of pancreatitis and of its clinical course than is the measurement of serum amylase or lipase. Clinically, one of the ominous signs which may develop during the early course of acute pancreatitis is severe hypotension. But, no agreement has been reached among investigators as to the cause of the hypotension, although several investigators have implicated a blood volume deficiency resulting form inflammatory process, and hypercalcemia. Perhaps, the majority have attributed the hypotension to systemic effect of some of the pancreatic enzymes, especially trypsin. Nevertheless, the correction of these factors sometimes fail to restore a normal blood pressure clinically. The purpose of the present investigation was to observe the relationships between serum concentration and urinary output of pancreatic enzymes, and to determine the degree of hypotension resulting from the systemic administration of pancreatic enzymes. These experimental procedures, consisted of heteroinfusion of human pancreatic juice and homoinfusion of canine pancreatic emulsion intravenously, and pancreatic ductal ligation in dogs. Blood and urine samples for the enzyme analysis were collected serially thorough the femoral vein and ureteral catheter before and after the procedure. Blood pressure was measured consistently by the kymograph before and after infusion of pancreatic juice. Activities of amylase and lipase were determined by methods of Nelson and, Cherry and Crandall, respectively. The results obtained are summarized as follows; 1. Following intravenous infusions of pancreatic juice exogenously. serum and urine concentrations of amylase and lipase increased rapidly, but these enzymes decreased rapidly in urinary excretion and gradually in serum concentration. Urinary recovery of amylase was approximately 10% of the total infused amount of pancreatic juice at the end of 4 hours. 2. Following ligation of the pancreatic duct, the amylase and lipase levels of serum rose gradually and reached the maximum at 24-48 hours after ligation and then gradually fell. The output of these enzymes in the urine were relatively constant while serum enzymes were increased. 3. When the human pancreatic juice was infused, hypotension was pronounced, and it was deeper and more prolonged in hypotensive effect with infusion of highly concentrated juice in the enzyme activities. With human pancreatic juice, a more sustained hypotension occurred than was observed after infusion of canine pancreatic emulsion. As a result of this investigation, it is felt that the hypotension in acute pancreatitis is probably the result of pancreatic enzymes itself. 4. In postinfusion period, the urine volume was markedly decreased following hypotension, and the urine volume was increased following blood pressure to normal level. This suggests that urine volume may diminish resulting from transient acute renal failure due to hypotensive effect by pancreatic enzymes.
Acute Kidney Injury ; Amylases ; Animals ; Blood Pressure ; Blood Volume ; Capillaries ; Diagnosis ; Dogs* ; Femoral Vein ; Humans ; Hypercalcemia ; Hypotension ; Infusions, Intravenous ; Ligation ; Lipase ; Pancreas ; Pancreatic Diseases ; Pancreatic Ducts ; Pancreatic Juice ; Pancreatitis ; Prunus ; Research Personnel ; Rivers ; Trypsin ; Urinary Catheters