Although tubuloglomerular feedback (TGF) is involved in ureteral obstruction-induced increase in renal blood flow (RBF), its contribution to RBF is not well established due to the concommitant increases in prostaglandin (PG) and renal interstitial fluid pressure (Pisf), both of which affect RBF one way or the other. Since Pisf and TGF are closely affected by renal hemodynamics, RBF will respond differently to increases in ureteral pressure depending on renal hemodynamic conditions. Therefore, the purpose of the present study was to investigate how the changes in renal hemodynamics affect the response of RBF to increases in ureteral pressure. The effect of PG on RBF was assessed by comparing the effects obtained before and after indomethacin, a cyclooxygenase inhibitor. Six anesthetized dogs were prepared with flow probes and inflatable silastic occluder around the renal artery, the ureteral catheter with its free end attached to a water reservoir, and the arterial and venous catheters. RBFs were obtained at ureteral pressures of 0, 15, and 40cmH2O during the maintenance of the renal artery pressure (RAP) at the level of systemic arterial pressure, 10mmHg above and below the lower autoregulatory limit of RBF (65+/-4 mmHg) both before and after indomethacin administration (10mg/kg). In response to the ureteral pressure of 40cmH2O, RBF increased from 172+/-6 to 185+/-10ml/min when RAP's were equal to systemic arterial pressure and decreased from 162+/-10 to 120+/-9 ml/min when RAP's were 55+/-4mmHg. Indomethacin pretreatment, depending on the level of RAP either prevented an increase or augmented a decrease in RBF in response to ureteral pressure elevation. This suggests that RAP-dependent changes in susceptibility of the renal venous system to compression by increased Pisf is the main mechanism by which the changes in renal perfusion pressure modulate the response of RBF to ureteral pressure elevation.
Animals ; Arterial Pressure ; Catheters ; Dogs* ; Extracellular Fluid ; Hemodynamics ; Indomethacin ; Perfusion ; Prostaglandin-Endoperoxide Synthases ; Renal Artery ; Renal Circulation* ; Ureter* ; Ureteral Obstruction* ; Urinary Catheters ; Water

OBJECTIVE: Vitamin C is an essential agent for cell differentiation for cell. However, for osteogenic differentiation a combined medium of vitamin C, phosphoglyceride and dexamethasone is used. Individual effect of vitamin C can be observed in terms of cell growth and proliferation and eventual differentiation to assess the effect of this chemical agent for using as bone growth. This work investigates the dose dependent effect of vitamin C on MC3T3-E1 type pre-osteoblast cell on cell proliferation and differentiation. METHODS: To investigate the dose dependent effect of vitamin C on MC3T3-E1 type pre-osteoblast cell predetermined amount of vitamin C was added to the medium and the medium was used for cell culture and cell differentiation. Relative cell viability and cell proliferation were checked to see the effect of vitamin C. Effect of dose dependent gene expression was carried out by reverse transcription-polymerase chain reaction with osteogenic differentiation specific genes. RESULTS: Cell viability and cell proliferation was increased in all culture time. The pre-osteoblast cells show significantly higher expression of osteoblast formation specific gene alkaline phosphatase, osteocalcin, and osteopontin at a higher dose of vitamin C. CONCLUSION: Higher doses of vitamin C with 50 microg/uL could significantly enhance the cell proliferation.
Alkaline Phosphatase ; Ascorbic Acid* ; Bone Development ; Cell Culture Techniques ; Cell Differentiation ; Cell Proliferation ; Cell Survival ; Dexamethasone ; Gene Expression ; Osteoblasts* ; Osteocalcin ; Osteopontin

Ureteral obstruction causes increase in renal blood flow (RBF) and partial impairment of the autoregulation of RBF. Although increased renal prostaglandin production is responsible for the former, it is not clear whether or not it is also responsible for the latter. Therefore, we investigated the role which prostaglandins play in the autoregulation of RBF during an ureteral pressure elevation (40 cmH2O). Since the major mechanism of RBF autoregulation is the tubuloglomerular feedback studying the interaction between ureteral pressure and RBF autoregulation may reveal the role of prostaglandin in tubuloglomerular feedback. To pursue the purpose, six anesthetized dogs were prepared for the measurements of RBF, mean systemic and renal arterial pressure (RAP) and the manipulation of ureteral pressure. The autoregulation curves were determined during both control and elevation of the ureteral pressure, before and after the pretreatment with indomethacin, a cyclooxygenase inhibitor. The desired ureteral pressure was achieved by vertically elevating the water-filled reservoir connected to the ureteral catheter to 40 cm above the kidney level. In response to the elevation of the ureteral pressure, RBF increased from 170 +/- 8 ml cntdot min -1 to 189+/-8, and the systemic arterial pressure didn't change significantly. During spontaneous urine flow, RBF autoregulation was abolished when RAP was reduced to 59+/-3 mmHg. On the other hand, during the ureteral pressure elevation, the autoregulation curves shifted upward and rightward from control, and the pressure when RBF autoregulation was abolished was 74 +/- 3 mmHg. The pretreatment of the dogs with indomethacin failed to affect the lower limit of RBF autoregulation during both control (63 +/- 5 mmHg) and the elevated ureteral pressure (77 +/- 5 mmHg). Since RBF failed to increase in response to the elevated ureteral pressure, RBF autoregulation curves obtained during the elevated ureteral pressure shifted only rightward from indomethacin control. The results indicate that the increased intrarenal level of prostaglandin or prostaglandin-induced vasodilation does not appear to bear any relation to the reduction in the autoregulatory capacity during partial ureteral obstruction. It seems that the partial impairment of the autoregulation during acute ureteral obstruction is due to the consumption of tubuloglomerular feedback mechanism at spontaneous RAP and that prostaglandin is neither mediator nor effector of tubuloglomerular feedback mechanism.
Animals ; Arterial Pressure ; Dogs* ; Hand ; Homeostasis ; Indomethacin ; Kidney ; Prostaglandin-Endoperoxide Synthases ; Prostaglandins ; Prostaglandins I ; Renal Circulation* ; Social Control, Formal* ; Ureter* ; Ureteral Obstruction* ; Urinary Catheters ; Vasodilation

Patent ductus arteriosus(PDA) is a common congenital heart disease encountered in premature neonates infants and children. Patent ductus arteriosus was the first surgically managed congenital heart disease,. Classic surgical interruption of patent ducturs arteriosus was partially replaced by a transcatheter endovascular closure, After a 5-7 mm video-assisted thoracoscopic interruption of the patent ductus arteriosus first applied in 1991, this minimally invasive technique came to be used in many centers, Video-assisted thoracoscopic interruption of the patent ductus arteriosus is feasible in low-weight infants whereas transcatheter endovascular closure of the ductus is usually not possible. We experienced successful outcome for the treatment of patent ductus arteriosus with 2 mm video-assisted thoracoscopic titanium clipping, We believed that this technique is a simple safe and rapid method for closure of the patent arteriosus.
Child ; Ductus Arteriosus, Patent ; Heart Defects, Congenital ; Humans ; Infant ; Infant, Newborn ; Thoracoscopes* ; Thoracoscopy ; Titanium

A bronchial blocker (BB) is preferred for lung separation in patients with difficult airways. However, BBs, unlike double-lumen tubes, must be placed in the bronchus of the lung being operated on, hence can be damaged by surgical manipulation. Intubation was unexpectedly difficult in this male patient, so a Coopdech BB was placed in the right mainstem bronchus through a single-lumen tracheoscopic ventilation tube for a thoracoscopic right upper lobectomy. During the bronchial resection, however, the distal tip of the BB was transected and pinched in the staple line, so the staple line was partially opened, and the BB was withdrawn into the trachea. The opened bronchial stump was sutured manually under apnea without conversion to an open thoracotomy, and there was no significant air leakage through the suture line. This case underlines the importance of frequently evaluating the position of a BB during lung surgery.
Airway Management ; Apnea ; Bronchi ; Humans ; Intubation ; Lung ; Male ; One-Lung Ventilation ; Sutures ; Thoracoscopy ; Thoracotomy ; Trachea ; Ventilation

Tailgut cysts in retrorectal or presacral space are rare and the derivatives of the embryonic post-anal gut. It is thought to arise from vestiges of embryonic hindgut. The lesions were usually multicystic and lined by a variety of epithelial types, including ciliated columnar, mucin-secreting columnar, transitional, and squamous epithelium. Tailgut cyst has been found in men and women of various ages but is more common in women and is usually associated with middle age. They may be the source of the chronic perirectal symptoms and rarely undergo malignant change, so early diagnosis and accurate evaluation is important. Complete surgical resection should be considered because of a long term risk of malignant change. We report two cases of tailgut cyst.
Early Diagnosis ; Epithelium ; Female ; Humans ; Male ; Middle Aged

Purpose: Herein is reported our initial experience of the CyberKnife to show its safety and feasibility as a treatment modality for non-metastatic prostate cancer. Materials and Methods: Twenty patients, with biopsy-proven prostate cancers, were recruited into a phase I clinical trial using the CyberKnife. The distribution of clinical risks, as assessed using the ASTRO criteria, was as follows: low (4), intermediate (5) and high (11). The mean age and follow up of the patients were 71.4 years and 15 months, respectively. The patients received 7.5-9Gy of radiation in a single fraction for 4-5 days. The total radiation dose to the prostate was 34-37.5Gy, which approximates to 86.4Gy in 2Gy fractions. The rectal and bladder acute toxicities were graded using the criteria of the Radiation Therapy Oncology Group (RTOG). The results of acute toxicities were compared to those of the historical control, which had been treated with conventional four field box techniques (received median dose 70.2Gy). The prostate-specific antigen (PSA)- based short-term efficacy was described. Results: The acute rectal toxicity scores were 0, 1 and 2 in 13, 5, and 2 patients, respectively. The acute bladder toxicity scores were 0, 1 and 2 in 16, 3 and 1 patient, respectively. No grade 3 or 4 acute toxicity was noted. These figures contrast sharply with those found for the historical control. All toxicities spontaneously subsided within 3 months after treatment. Continuous PSA reduction was noted in all patients, and no PSA failure was noted during the follow up period. Conclusions: Our data show the feasibility of the CyberKnife in terms of its efficacy and acute toxicity. Moreover, the capability of using a hypo-fractionation schedule lead to marked improvement in patient convenience, with substantial resource savings.
Appointments and Schedules ; Follow-Up Studies ; Humans ; Income ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Urinary Bladder

PURPOSE: To assess the relationships between optic cup-to-disc ratio (CDR) and age, sex, and other demographic and health characteristics in the healthy Korean population. METHODS: The study design was retrospective and population-based. A total of 28,377 subjects who participated in the Korea National Health and Nutrition Examination Survey between 2008 and 2011 were enrolled in this study. Participants underwent structured interviews as well as systemic and ophthalmic examinations. Patients with glaucoma who were diagnosed using the International Society of Geographical and Epidemiological Ophthalmology classification were excluded. Changes in vertical CDR were examined by age in relation to systemic variables on multiple regression analysis. RESULTS: The mean vertical CDR was 0.34 +/- 0.12. The vertical CDR increased with age from subjects in their 20s to those in their 80s (p < 0.001). The mean CDR in males was significantly higher than that of females (p < 0.001). On multiple regression analysis, the vertical CDR was positively associated with age (p < 0.001), male sex (p < 0.001), diastolic blood pressure (p = 0.009), and intraocular pressure (p < 0.001) but was negatively associated with body mass index (p < 0.001). CONCLUSIONS: Greater vertical CDR was related to age, male sex, higher diastolic blood pressure, higher intraocular pressure, and lower body mass index in healthy Koreans.
Age Distribution ; Cross-Sectional Studies ; Female ; Glaucoma/diagnosis/*epidemiology ; Humans ; *Intraocular Pressure ; Male ; Morbidity/trends ; Optic Disk/*pathology ; Optic Nerve Diseases/diagnosis/*epidemiology ; *Population Surveillance ; Reference Values ; Republic of Korea/epidemiology ; Retrospective Studies ; Sex Distribution ; Tonometry, Ocular

OBJECTIVES: It is well known that allergic rhinitis (AR) has positive association with adenotonsillectomy. However, the impact of AR on symptom improvement after adenotonsillectomy is not well documented. Hence, we aimed to evaluate the effect of AR on the symptom improvement after adenotonsillectomy between AR and nonallergic patients. METHODS: A retrospective analysis was performed on 250 pediatric patients younger than 10 years old who received adenotonsillectomy from June 2009 to June 2014 in a tertiary referral hospital. All patients underwent skin prick test or multiple allergen simultaneous test (MAST) before surgery and classified into AR group and control group. Obstructive and rhinitis symptoms including snoring, mouth breathing, nasal obstruction, rhinorrhea, itching, and sneezing were evaluated before and 1 year after surgery using questionnaire and telephone survey. RESULTS: AR group was 131 and control group was 119, showing higher prevalence (52.4%) of AR among adenotonsillectomized patients. Both groups showed dramatic improvement of symptoms such as snoring and mouth breathing after surgery (all P < 0.05). However, AR group showed significantly less improvement than control group in snoring, mouth breathing, nasal obstruction, and rhinorrhea (all P < 0.05). Multivariate analysis showed that preoperative mouth breathing and snoring were dependent on tonsil grade and postoperative symptoms were mainly dependent on presence of AR. Nasal obstruction was dependent on tonsil grade and presence of AR preoperatively and presence of AR postoperatively. These suggest the importance of AR as a risk factor for mouth breathing, snoring, and nasal obstruction. CONCLUSION: AR has positive association with adenotonsillectomy and not only allergic symptoms but also obstructive symptoms such as snoring and mouth breathing improved less in AR group than control group. Hence, patients with AR should be monitored for long-term basis and more carefully after adenotonsillectomy.
Adenoidectomy ; Child ; Humans ; Mouth Breathing ; Multivariate Analysis ; Nasal Obstruction ; Palatine Tonsil ; Prevalence ; Pruritus ; Retrospective Studies ; Rhinitis ; Rhinitis, Allergic* ; Risk Factors ; Skin ; Sneezing ; Snoring ; Telephone ; Tertiary Care Centers ; Tonsillectomy

This study was designed to investigate the expression and production of interleukin-1beta (IL-1beta) in human peripheral blood of trained runners and untrained controls after temporary moderate intensity exercise. Male long-distance trained runners (TR) and untrained sedentary control subjects (SED) ran for 1 h at 70% of heart rate reserve (HRR). IL-1beta gene and protein expressions were significantly higher in TR than those with SED at all 3 intervals examined independently. Significant increases in total sweat volume and oral temperature were observed after exercise in both groups, however, there were some differences between the groups. We conclude, therefore, that sweating due to exercise is associated with increase of IL-1beta and it is correlated with decrease of oral temperature.
Body Temperature* ; Heart Rate ; Humans ; Interleukin-1beta* ; Male ; Sweat* ; Sweating*