No abstract available.

Continence and micturition involve urethral closure. Especially, insufficient strength of the pelvic floor muscles including the urethral sphincter muscles causes urinary incontinence (UI). Thus, it is most important to understand the main mechanism causing UI and the relationship of UI with the urethral sphincter. Functionally and anatomically, the urethral sphincter is made up of the internal and the external sphincter. We highlight the basic and clinical anatomy of the internal and the external sphincter and their clinical meaning. Understanding these relationships may provide a novel view in identifying the main mechanism causing UI and surgical techniques for UI.
Autonomic Nervous System ; Muscles ; Pelvic Floor ; Pudendal Nerve ; Urethra ; Urinary Incontinence ; Urination

Eleven cases of juvenile diabetes mellitus who were admitted Seoul National University Hospital from Jan., 1969 to Aug., 1978 were aha1yzed. The mean age of onset was 7 and female to male ratio was 8 to 3 with female preponderance. Four had family history of diabetes, although none had diabetic sibling. Polyuria and polydipsia were noted in all cases as initial symptoms, and symptoms of weight loss (6 cases), disturbances in consciousness (5), generalized weakness (5), anorexia (4) and enuresis (3) were noted in the order of frequency. Leucocytosis was noted in 5 cases, but only 2 among the 4 who had infection revealed leucocytosis, The mean blood glucose level was 320 mg% and serum osmolality was 293 mOsm/L. There was no significant difference in the level of blood sugar and serum osmolality according to the consciousness status. Eight episodes of ketoacidosis occured in 5 cases. Three episodes developed due to discontinuance of insulin and three episodes accompanied infection. The mean blood glucose level was 495 mg% and serum osmolality was 300 mOsm/L in ketoacidosis. The consciousness cleared in average 20 hours and ketonuria disappeared in average 26 hours after the administration of insulin (average 5 units/kg of body weight). At discharge, the average dose of insulin needed was 1.2 U/kg/d. Six patients were followed from 6 months to 6 years. Two developed pulmomary tuberculosis during the period of follow up.
Age of Onset ; Anorexia ; Blood Glucose ; Consciousness ; Diabetes Mellitus* ; Enuresis ; Female ; Follow-Up Studies ; Humans ; Insulin ; Ketosis ; Male ; Osmolar Concentration ; Polydipsia ; Polyuria ; Seoul ; Siblings ; Tuberculosis ; Weight Loss

No abstract available.

No abstract available.
Child* ; Humans ; Infant*

A hemorrhagic disease due to prothrombin complex deficiency os described in 4 infants from 1 to 11 months of age. This disease is different from the hemorrhagic disease of the newborn. The main differences are that it is found in an older age group and that intracranial hemorrhages are frequent. Rapid clinical and laboratory response after vitamin K therapy are observed. Severe prothrmbin complex deficiency due to vitamin K deficiency is a accounted for the pathogenesis of bleeding. Possible causes of vitaimn K deficiency are reviewed.
Hemorrhage ; Humans ; Infant ; Infant, Newborn ; Intracranial Hemorrhages ; Prothrombin ; Vitamin K ; Vitamin K Deficiency

We studied to know The prognostic factors of Wilms' tumor who admitted to the Seoul National University Children's Hospital from May 1985 to July 1992. We treated Wilms' tumor with surgery, anticancer chemotherapy and radiation therapy according to National Wilms' Tumor Study protocol and analysed survival or relapse rate versus prognostic factors (age at diagnosis, histology, lymph node involvement and stage). As a result, during median follow-up period of 31 months, two year relapse free survival rate was 64% and 2-year overall survival rate was 79%. Two year overall survival rate was 100% in stage I, 83% in stage II and III, 60% in stage IV. This tumor stage was statistically significantly correlated with survival rate(P<0.05). However, other prognostic factor was not correlated with the survival rate(P> 0.05). We concluded that stage is more valuable prognostic factor than age, histology and lymph node involvement.
Diagnosis ; Drug Therapy ; Follow-Up Studies ; Kidney ; Lymph Nodes ; Recurrence ; Seoul ; Survival Rate ; Wilms Tumor*

OBJECTIVE: To compare the safety and efficacy of intravaginally administered misoprostol (PGE1 analogue) versus intravenously administered oxytocin for labor induction at term. METHODS: Among 63 patients over 37 weeks, randomly selected 42 patients were vaginally administered 25 micro gram of misoprostol every 3 hours and the other 21 patients were intravenously administered every minute from 1 mIU/min to 10 mIU/min increasingly. RESULT: The average interval from initiation of induction to labor was notably shorter in oxytocin group than in misoprostol group (204.5+/-332.6 min versus 528.1+/-591.8 min, p<0.02). The average interval from initiation of induction to vaginal delivery was shorter in oxytocin group than in misoprostol group (414.4+/-309.4 min versus 528.1+/-519.8 min, P<0.01) and the difference has statistical meaning. Procedure of labor were divided by 3 stages. We checked the duration of each stage between the two comparative groups. 1st stage (242.7+/-150.14 min versus 605.5+/-805.8 min, P<0.05) 2nd stage (12.6+/-11.9 min versus 19.5+/-11.2 min, P<0.05) The stage duration of oxytocin group was shortened. There was no difference between two groups at the third stage. The incidence of tachysystole, hypertonics, hyperstimulation, meconium passage, abnormal fetal heart rate, fetal weight, apgar score, neonatal morbidity were not different between two group. CONCLUSION: Intravenously administered oxytocin was more effective in shortening labor time than intravaginally administered misoprostol in overall induction labor, but there was no notable difference in the effects on mothers and babies. Considering various situational factors, careful selection should be administered.
Apgar Score ; Female ; Fetal Weight ; Heart Rate, Fetal ; Humans ; Incidence ; Meconium ; Misoprostol* ; Mothers ; Oxytocin* ; Pregnancy

OBJECTIVES: Our goal was to determine the effectiveness of using the auditory steady state response (ASSR) as a measure of hearing thresholds in infants who are suspected of having significant hearing loss, as compared with using the click-auditory brainstem response (C-ABR). METHODS: We retrospectively analyzed the audiologic profiles of 76 infants (46 boys and 30 girls, a total of 151 ears) who ranged in age from 1 to 12 months (average age: 5.7 months). The auditory evaluations in 76 infants who were suspected of having hearing loss were done via the C-ABR and ASSR. In addition, for reference, the mean ASSR thresholds were compared to those of 39 ears of infants and 39 ears of adults with normal hearing at 0.5, 1, 2, and 4 kHz. RESULTS: The highest correlation between the C-ABR and ASSR thresholds was observed at an average of 2-4 kHz (r=0.94). On comparison between the hearing of infants and adults at 0.5, 1, 2, and 4 kHz, the mean ASSR threshold in infants was 12, 7, 8, and 7 dB higher, respectively, than that in adults. CONCLUSION: ASSR testing may provide additional audiometric information for accurately predicting the hearing sensitivity, and this is essential for the management of infants with severe to profound hearing loss.
Adult ; Auditory Threshold ; Brain Stem ; Ear ; Evoked Potentials, Auditory, Brain Stem ; Hearing ; Hearing Loss ; Humans ; Infant ; Retrospective Studies

Alcohol beverages have been used since the dawm of history and the pharmacology of alcohol has been studied extensively and the question whether alcohol is a stimulant has long been debated. now there seems little couble that alcohol is a primarys and continuous depressant of the CNS, and the general pharmacologic action of alcohol on the body is one of depression. The effects of various concentrations and type of alcoholic beverages on the gastrointestinal motor and secretory functions are influenced by a number of factors such as the state by the digestive processes, the presence or absence or gastrointestinal diseases, the amount and type of food present, the degree of tolerance for alcohol, accompanying psychological factiors, and so forth. it is generally accepted that gastirc secretion is stimulated by ehanol, but effects of ethanol on the motility of the gastrointestinal tract has not been clarified yet. Hence the present study was undertaken to investigate the effects of ethanol on gastrointestinal motility. The rabbits of either sex, weighting about 2kg, were killed by air embolism after 72 hours deprivation of food except water. The stomach and duodenum were isolated and cut into two parts, i.e. antrum and duodenum. Each strip of antrum and duodenum, sized 0.5X2.0cm, was placed in temperature controlled uscle chamber(37 degrees C) Containing Tyrode's solution and its contractile movement was recorded on Grass Polygraph(Model 7) via force displacement transducer(FT.03). The results are summarized as follows: 1) The strips of gastric antrum and duodenum showed spontaneous regular movement through the experimental period. Administration of ethanol from 0.1 to 1.0% inhibited the amplitude and frequency of both strips with dose-dependent manner. Most strips of the duodenum and 6 strips of the antrum showed relaxations of tone by ethanol and 4 strips of the antrum showed increased tone. 2) Tonic contraction of antral strips by ethanol was abolished only by the combined pretreatment of atropine and chlorpheniramine, or atropine and cimetidine, not by the phentolamine, proproanolol, atropine, hexamethonium, chlorpheniramine or cimetidine alone. 3) Inhibition of antral and duodenal motility by ethanol was not abolished by anyy one of the receptor blocking agents such as adrenergic alpha and beta, buscarinic, or histaminergic H-1 and H-2 receptor blocking agents. By the above resutls, it may be concluded that ethanol inhibits the motility of the duodenum, but excites or inhibits the motility of the gastric antrum. It is likely that the inhibitory effect of ethanol is it derect action on the smooth muscle, and the excitatory effect is mediated by a mechanism related with histamine and acetylcholine.
Acetylcholine ; Alcoholic Beverages ; Atropine ; Beverages ; Chlorpheniramine ; Cimetidine ; Depression ; Duodenum* ; Embolism, Air ; Ethanol* ; Gastrointestinal Diseases ; Gastrointestinal Motility ; Gastrointestinal Tract ; Hexamethonium ; Histamine ; Muscle, Smooth ; Pharmacology ; Phentolamine ; Poaceae ; Pyloric Antrum ; Rabbits ; Relaxation ; Stomach