No abstract available.
Decompression* ; Facial Nerve* ; Recovery of Function*

PURPOSE: The aim of this study was to demonstrate that the combined systemic administration of apomorphine (APO) and sildenafil have a synergistic effect on the erection in conscious rabbits. MATERIALS AND METHODS: The erections of the male New Zealand White rabbits (2-3kg, n=12) were assessed by measuring the length of the uncovered penile mucosa (LUPM) and duration of the erection, both before and after the intravenous administration of agents. After the injection of APO (0, 0.05, 0.1, 0.4mg/kg), sildenafil was administered intravenously in a dose-response manner (0.5, 1, 5mg/kg), followed by measurements for 0-120 minutes. In additional experiments, the effect of increasing the dosages of sildenafil, combined with APO, on blood pressure were evaluated. RESULTS: The intravenous administration of sildenafil caused a concentration dependent increase in the LUPM. There was a statistically significant increase in the LUPM with the administration of APO compared with no administration. The dosages of sildenafil and APO showing the greatest efficacy of sildenafil potentiation were 1mg/kg and 0.1 mg/kg, respectively. The intravenous administration of APO at a dose of 0.1mg/kg was more effective than those of 0.05 and 0.4mg/kg, with dosages of sildenafil of 0.5 and 1mg/kg. There was no additional increase in the duration of erection on the administration of APO. The intravenous administration of sildenafil caused a concentration dependent decrease in blood pressure, but there was no additional decrease on administration of the APO. CONCLUSIONS: We have shown that apomorphine elicits a stronger response on the erection induced by sildenafil in conscious rabbits, with no additional decrease in blood pressure.
Administration, Intravenous ; Apomorphine* ; Blood Pressure ; Humans ; Male ; Mucous Membrane ; Penile Erection* ; Rabbits* ; Sildenafil Citrate

No abstract available.
Arthroplasty* ; Arthroplasty, Replacement, Hip*

BACKGROUND: Magnesium is a noncompetitive antagonist of the N-methyl-D-aspartate (NMDA) receptor. Magnesium is thought to be involved in opioid tolerance by way of inhibiting calcium entry into cells. METHODS: The patients were randomly assigned to three groups according to the anesthetic regimens: Group M received magnesium sulfate and Group C received saline intravenously under remifentanil-based anesthesia. Group S received saline intravenously under sevoflurane based anesthesia in place of remifentanil. The patients in the group M received 25% magnesium sulfate 50 mg/kg in 100 ml of saline, and those patients in groups C and S received an equal volume of saline before induction of anesthesia; this was followed by 10 mg/kg/h infusion of either magnesium sulfate (group M) or an equal volume of saline (groups C and S) until the end of surgery. Pain was assessed on a visual analog scale at 1, 6, 12, 24, and 36 hours after the operation. The time to the first postoperative analgesic requirement and the cumulative analgesic consumption were evaluated in the three groups. RESULTS: The visual analog scales for pain and the cumulative analgesic consumption were significantly greater in group C than in other groups. The time to first postoperative analgesic requirement was significantly shorter in group C than that in the other groups. There were no differences between group M and S for side effects. CONCLUSIONS: A relatively high dose and continuous remifentanil infusion is associated with clinically relevant evidence of acute opioid tolerance. NMDA-receptor antagonist, magnesium sulfate as an adjuvant analgesic prevents opioid tolerance in patients who are undergoing major abdominal surgery under high dose and continuous remifentanil infusion-based anesthesia.
Anesthesia ; Calcium ; Humans ; Hypogonadism ; Magnesium ; Magnesium Sulfate ; Methyl Ethers ; Mitochondrial Diseases ; N-Methylaspartate ; Ophthalmoplegia ; Piperidines ; Weights and Measures

A rubber tip disconnection of Arrow-Trerotola percutaneous thrombolytic device (PTD) may occur occasionally. We experienced 5 cases of a rubber tip disconnection among 453 mechanical thrombectomy sessions with the use of PTD. We present a report about these five cases and suggest possible causes for the occurrences.
Aged ; Catheter Obstruction/*etiology ; Equipment Failure Analysis/*methods ; Female ; Humans ; Male ; Middle Aged ; Renal Dialysis/*instrumentation ; Rubber ; Thrombectomy/*instrumentation ; Treatment Outcome

PURPOSE: Regarding for erectile dysfunction(ED), Sildenafil has produced satisfactory clinical results. However, Some patient discontinue sildenafil treatment for a variety of reasons after successful restoration of erectile function. We investigated the reasons for such discontinuations of sildenafil after restoration of erectile function by sildenafil medication. MATERIALS AND METHODS: After sildenafil medication, one hundred fifty six patients whose score of erectile function domain of the 15-item International Index of Erectile Function(IIEF) increased to 26 or more, were included in this study. Six-months after the first sildenafil prescription, compliance to medication and the reason for discontinuity were reviewed by chart or surveyed by telephone. RESULTS: In 156 successfully treated patients, 54(34.6%) discontinued sildenafil medication. The 2 most common reasons for discontinuation were trouble in the partners' or patients' emotional readiness for restoration of sexual activity after long-term abstinence and fear of possible side effects. CONCLUSIONS: After restoration of erectile function, many patients discontinued the use of sildenafil medication. The reasons for discontinuing the medication were primarily emotional or relationship-oriented issues. The counseling of both partners and education about the effects and side effects of the drugs are recommended to promote the successful recovery of sexual activity.
Compliance* ; Counseling ; Education ; Erectile Dysfunction ; Humans ; Male ; Prescriptions ; Sexual Behavior ; Telephone ; Sildenafil Citrate

PURPOSE: Nitric oxide (NO) and phosphodiesterases (PDEs) play key roles in mediating relaxation of corpus cavernosal smooth muscle by increasing intracellular cGMP level. Here, we investigated effects of NO-donor (sodium nitroprusside, SNP) and penile specific type-V PDE inhibitor (zaprinast) in human and rabbit corpus cavernosal cells and tissues in vitro. MATERIALS AND METHODS: The cultured smooth muscle cells and tissues of human and rabbit corpus cavernosum were treated with increasing concentrations of SNP or zaprinast for 5 and 20 minutes, respectively, and intracellular cGMP levels were measured by radioimmunoassay. Organ bath study was performed to measure the relaxation effects of drugs on precontracted corpus cavernosal muscle strips. RESULTS: Although both NO-donor and type-V PDE inhibitor effectively stimulated the accumulation of cGMP in a dose-dependent manner, magnitude of cGMP increase and specificity of drug were found to be species-dependent. In human corpus cavernosal tissues, cGMP was increased upto 10- and 5-folds by SNP and zaprinast, respectively. However, magnitude of increase was much less in cultured smooth muscle cells. In rabbit, SNP effect was most prominent in cultured cells and effects of SNP and zaprinast were modest in tissues. Both agents also resulted in effective relaxation of human and rabbit cavernosal tissue strips. Similar patterns of dose-response curves were shown between results from the organ bath studies and cGMP radioimmunoassay with cavernosal smooth muscle cells. CONCLUSIONS: Present results show that effects of SNP and zaprinast are not coincident in different species, suggesting possible species-specificities of these two agents. Measurement of cGMP changes in cultured cavernosal smooth muscles cells could be reflected to the relaxation effects of drugs on corpus cavernosal muscle strips.
Baths ; Cells, Cultured ; Cyclic GMP ; Erectile Dysfunction ; Humans* ; Male ; Muscle, Smooth* ; Myocytes, Smooth Muscle ; Negotiating ; Nitric Oxide ; Nitroprusside ; Phosphoric Diester Hydrolases ; Radioimmunoassay ; Relaxation* ; Sensitivity and Specificity ; Signal Transduction*

INTRODUCTION: To evaluate the skeletal stability after a bilateral sagittal split osteotomy (BSSO) setback of the mandible fixed with a biodegradable internal fixation device or metal internal fixation device. MATERIALS AND METHODS: Thirty consecutive patients underwent mandibular setback via BSSO. Fifteen patients were fixed with a biodegradable internal fixation device or metal internal fixation device respectively. Posteroanterior (PA) and lateral cephalograms were taken preoperatively and at two days, 5.5 months and 14.5 months postoperatively. The relevant skeletal points were traced and digitized to evaluate the skeletal changes postoperatively. The relapse rates were analyzed and compared statistically. RESULTS: There was no statistically significant differences in postoperative stability between the two groups.(P<0.05) CONCLUSION: The biodegradable internal fixation device may make an effective device alternative to a metal internal fixation device for setback BSSO.
Humans ; Internal Fixators ; Mandible ; Osteotomy ; Osteotomy, Sagittal Split Ramus ; Recurrence ; Sitosterols

A melanotic neuroectodermal tumor of infancy (MNTI) is a uncommon osteolytic pigmented neoplasm that primarily affects the jaws of newborn infants. Most patients (> 90%) present with the tumor in the first year of life. Approximately 65% form in the maxilla, 11% in the mandible, 5% in the brain and elsewhere. MNTI is normally benign, but up to 15% may recur and a few have metastasized. Approximately 200 cases of MNTI have been reported but only 2 of them presented as multifocal. A case of MNTI in a 7 month old boy was encountered. The chief complaint was maxillary anterior ridge swelling. The incisional biopsy findings were MNTI. Two months after the first operation, mild swelling of another site was observed. The infant was examined periodically since undergoing two procedures with no recurrence. This case demonstrates the possibility of a multicentric MNTI. We report a multicentric MNTI with a review of the relevant literature.
Biopsy ; Brain ; Humans ; Infant ; Infant, Newborn ; Jaw ; Mandible ; Maxilla ; Neuroectodermal Tumor, Melanotic ; Polyenes ; Recurrence

PURPOSE: To survey epidemiologic characteristics about varicocele and identified several characteristics in young men. MATERIALS AND METHODS: Between May and December 2001, 2,700 were randomly selected at a 10.0% sampling fraction by census district of 27,202 men aged 19 years. A total of 2,080 (a response rate 77.0%) men underwent a standard evaluation including testicular volume. Of men with unilateral varicocele, testicular atrophy was defined as a testis 25% or more smaller (volume/volume) than its contralateral mate. RESULTS: Among participants, 169 (8.1%) men with 199 varicoceles were observed to have varicoceles on physical examination or had a history of varicocelectomy. The varicocele was on the left side in 136 (80.5%), right side in three (1.8%), and bilateral in 30 (17.7%). Of 125 men with unilateral varicocele, physical examination revealed grade I varicocele in 34 men (27.2%), grade II in 45 (36.0%), and grade III in 46 (36.8%). Testicular volume (13.6 +/- 4.6mL) of affected side in varicocele group was significantly smaller than that of contralateral side (16.3 +/- 4.5 mL) in varicocele group as well as right (15.9 +/- 4.5 mL) or left side (15.3 +/- 4.6 mL) in normal group (p<0.001). Testicular volume of contalateral side in varicocele group was significantly larger than that of left side in normal group (p<0.05). Comparing with testicular parameters according to grades of varicocele, testicular volume of affected side was not dependent on grades of varicoceles. However, rate of testicualr atrophy was dependent on grades of varicocele. However, the ratio of testicular atrophy was present in four (12.9%) of grade I, 14 (29.2%) of grade II, and 19 (41.3%) of grade III. These differences were statistically significant (p=0.028). CONCLUSIONS: The prevalence of varicocele in this population was found to 8.1%. It is important to measure the volume of both testes of an adolescent with a varicocele to determine the effect of varicocele on the testicular volume. Our findings suggest that men with higher grades of varicocele have hypertrophied testis of contralateral side.
Adolescent ; Atrophy ; Censuses ; Epidemiologic Studies* ; Epidemiology ; Humans ; Male ; Physical Examination ; Prevalence ; Testis ; Varicocele* ; Young Adult*