PURPOSE: We evaluated the effects of amitriptyline in patients with urinary frequency or pelvic pain syndrome and compared with propiverine hydrochloride (BUP-4(R)) and diazepam (Valium(R)). MATERIALS AND METHODS: One-hundred and sixty-eight patients with urinary frequency or pain were included and 38 out of 168 patients were lost to follow up. The patients with interstitial cystitis, UTI and neurogenic bladder were excluded. Amitriptyline group were instructed to take 25mg to 75mg of amitriptyline before bed. Propiverine hy drochloride and diazepam group were instructed to take 20mg, 4-6mg before bed, respectively. The clinical effects and side effects were evaluated after 4 weeks of medication. RESULTS: In the amitriptyline group, 73.1% in 78 patients with frequency, 68.3% in 60 pain, 65.6% in 32 nocturia, 53.8% in 26 weak urinary stream, 53.8% in 13 dysuria, 72.7% in 11 urgency showed symptom improvement. Urinary frequency and pain score were significantly decreased in the amitriptyline group. In the propiverine hydrochloride group, 66.7% in 21 patients with frequency, 38.8% in 18 pain showed symptom improvement. In the diazepam group, 37.5% in 24 patients with frequency, 31.3% in 16 pain showed symptom improvement. Side effects of amitriptyline had appeared in 24 (27.6%) out of 87 patients; 17 cases of dry mouth, 10 drowsiness, 2 agitation, 2 nausea, 1 constipation and 1 skin rash. CONCLUSIONS: Amitriptyline is useful in vague voiding symptoms especially in urinary frequency and chronic pelvic pain syndrome. It is equally effective in both men and women. Side effects are minimal and tolerable. A double-blind placebo-controlled trial is necessary for general acceptance in the future.
Amitriptyline* ; Constipation ; Cystitis, Interstitial ; Diazepam ; Dihydroergotamine ; Dysuria ; Exanthema ; Female ; Humans ; Lost to Follow-Up ; Male ; Mouth ; Nausea ; Nocturia ; Pelvic Pain* ; Rivers ; Sleep Stages ; Urinary Bladder, Neurogenic

We report a case of a 41-year-old female with acrogeria. She was in good health except for the prominent atrophy over the hands and feet. On microscopic examination of a biopsy specimen from the atropl6c skin, elastic fibers were clumped and fragmented. Electronmicroscopy revealed amorphous and granulous pseudoelastin, which is presumed to be consistent with acrogeria. Our patient had acro-osteolysis and an extra chromosome in addition to the normal 23 pairs of chromosomes in one of 20 cells examined, which have been very rarely reported in the literature. Further studies are needed to find out whether this chromosomal aberration might contribute to the pathogenesis.
Acro-Osteolysis ; Adult ; Atrophy ; Biopsy ; Chromosome Aberrations ; Elastic Tissue ; Female ; Foot ; Hand ; Humans ; Skin

BACKGROUND: Sun exposure and therapeutic irradiation have been shown to induce alterations in extracellular matrix (ECM) proteins, including elastin, glycosaminoglycan and collagens. The integrity of the connective tissue mainly depends on balanced rates of matrix synthesis and degradation of the extracellular matrix. Therefore, matrix metalloproteinases (MMPs) may be involved in ultraviolet irradiation (UVR)-induced alterations in ECM proteins. OBJECTIVE: To evaluate the effects of UVA as well as UVB irradiations on ST-1 gene expression in cultured human skin fibroblasts. METHODS: After exposure of different doses of UVA and UVB on cultured human skin fibroblasts, we examined the expression of ST-1 gene by Northern blot analysis, chloramphenicol acetyltransferase (CAT) assay with CAT construct containing AP-1 binding site. Additionally, we carried out the gel mobility shift assay to investigate the effects of UVR on the DNA-binding activity of AP-1. RESULTS: After UVR on fibroblasts, the steady-state levels of ST-1 mRNA were in-creased in response to UVA and UVB by 2.5-fold and 4.2-fold, respectively, as compared with controls. Similar results were obtained by CAT assay showing that CAT activity increased as the UVA and UVB doses increased. Furthermore, gel mobility shift assay demonstrated that both UVA and UVB increased AP-1 DNA binding complexes. CONCLUSION: UVB as well as UVA up-regulated ST-1 gene expression at transcriptional levels in vitro. We speculate that modulation of MMPs, including ST-1, gene expression by UVR may contribute to the connective tissue damage related to photoaging and other photocutaneous disorders.
Animals ; Binding Sites ; Blotting, Northern ; Cats ; Chloramphenicol O-Acetyltransferase ; Collagen ; Connective Tissue ; DNA ; Elastin ; Electrophoretic Mobility Shift Assay ; Extracellular Matrix ; Fibroblasts* ; Gene Expression ; Humans* ; In Vitro Techniques ; Matrix Metalloproteinases ; RNA, Messenger ; Skin ; Solar System ; Transcription Factor AP-1

The case of a 56-year-old woman with a keratoacarithoma(KA) of the labial mucosa is herein reported, The tumor was excised and the pathological features were characteristic of a KA, This case is reported because the oral mucosa is such an unexpected location for solitary KA and the labial mucosa of this patient received chronic actinic damage, which suggested an etiological relationship. Follow-up examination of the patient after four months showed no recurrence.
Actins ; Female ; Follow-Up Studies ; Humans ; Keratoacanthoma* ; Middle Aged ; Mouth Mucosa ; Mucous Membrane* ; Recurrence ; Solar System*

OBJECTIVE: In recent years, the neurosurgeon's role in managing cerebrovascular diseases (CVD) has becomes rapidly challenged and overlapped with other specialists. Furthermore, the patterns of CVD and patient recruitment have also changed. We conducted a retrospective study regarding the practical trends of CVD with reference to the management paradigms at our institute. METHOD: We reviewed all the available data, including the annual reports, the daily department records, the medical records and the radiographic films of the CVD patients who had been admitted to our Neurosurgery Department during the five years between Jan. 2004 and Dec. 2008. RESULTS: The total numbers of CVD operations showed a slight initial increase, but then they remained steady for the latter 3 years. The number of cases of non-angiomatous hemorrhage has been relatively steady, regardless of surgery. The total numbers of treated aneurysms increased, but the main body of this increment was attributed to the initiation of endovascular treatment and increased identification of unruptured vascular lesions. Vascular malformations were sustained with a small number of cases due to referring them to other institutes for radiosurgery, except for the cases that required urgent hemorrhagic evacuation. CONCLUSION: Hemorrhagic CVDs tended to decrease either due to increasing identification before rupture or shifting such patients into a large volume hospital. The increasing awareness of ischemic CVD, the early detection of unruptured aneurysms, and the separation of medical responsibilities from neurologists have all pushed neurosurgeons to make treatment plans in a more cooperative fashion, instead of a competitive way. Neurosurgeons should be furnished with several revolutionary surgical options to widen their scope of managing patients with CVD.
Academies and Institutes ; Aneurysm ; Hemorrhage ; Humans ; Infarction ; Intracranial Aneurysm ; Medical Records ; Neurosurgery ; Patient Selection ; Radiosurgery ; Retrospective Studies ; Rupture ; Specialization ; Subarachnoid Hemorrhage ; Vascular Malformations ; X-Ray Film

Proliferating trichilernmal tumor is a rare benign solitary tumor that may be histopathologically misinterpreted as squarnous cell carcinoma. It affects frequently the scalp of elderly women. We present herein a case of proliferating trichilemmal tumor in an 87-year-old male who had had a slowly growing tumor on the scalp for 30 years.
Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Scalp

No abstract available.

We report cases of two patients with acute generalized exanthematous pustulosis(AGEP). One patient had localized cutaneous infection and the other rhinoplasty. Both were being treated with ampicillin and developed intense erythemas followed by generalized subcorneal pustulation associated with fever and a neutrophilic leukocytosis. Histopathological findings were subcorneal spongiform pustules showing preponderance of polymorphonuclear leukocytes. Generalized pustular psoriasis, subcorneal pustular dermatosis, impetigo and pemphigus foliaceus should be differentiated from AGEP. The causative drug in both of our cases was ampicillin and fast resolution of pustules was observed with a low dosage of systemic steroid within 5 days.
Acute Generalized Exanthematous Pustulosis* ; Ampicillin* ; Erythema ; Fever ; Humans ; Impetigo ; Leukocytosis ; Neutrophils ; Pemphigus ; Psoriasis ; Rhinoplasty ; Skin Diseases, Vesiculobullous

An experimental studies were carried out to observe the protective effects of malotilate, a new antihepatotoxic agent, on the chronic hepatic injury induced by CCl4 with or without ethanol. The rats used weighed about 200g were divided into 2 groups, 4 weeks & 8 weeks. Each group was given by orally with malotilate, 100 mg/kg, once a day, and was injected by subcutaneously with CCl4 1.5 mg/kg in a mixture with olive oil twice a week. Aqueous ethanol (20%) was administered in drinking water daily. The serochemical and histopathological studies were carried out in each experimental group. The results were as follows: 1. The chronic liver injuries induced by CCl4 with or without ethanol were significantly ameliorated by normalize serum values GOT, GPT. Alkaline phosphatase, Cholesterol, HDL-Cholesterol, and gamma glutamyl transpeptidase. 2. In Group of 4 weeks, malotilate manifested protective effects by significant inhibition of fatty changes, spotty necrosis and fibrosis in CCl4-intoxicated liver with or without additional ethanol. 3. In group of 8 weeks, malotilate significantly imoproved fatty changes, fibrogenic activity in the group administered with CCl4, followed by ethanol.
Rats ; Animals

The authors experienced 186 cases of Failed Back Surgery Syndrome(FBSS), which were 2.5% of all admitted patients in authors' clinic from 1983 to 1992. Among them, 173 patients were referred cases from other hospital and 13 patients were authors' cases which was 0.2% of authors' back surgery. About 75% of all was come to our clinic within 2 years after initial operation. The common cause of FBSS was resulted form inadequate surgery or surgical complications (51%). In these cases, incomplete decompression at initial operation was seemed to be a major factor. The next causes was due to inadequate patient selection(26.3%) and the FBSS was more prevalent when the patient had only back pain without leg pain. The other causes of FBSS was post-operative adhesion(8.6%), discitis(4.3%), and inadequate diagnosis(4.3%). So about 80% of FBSS seem to have preventable causes. 66 of 186 cases was performed reoperation and 70% of them had improvement.
Back Pain ; Decompression ; Humans ; Intervertebral Disc Chemolysis ; Leg ; Reoperation ; Tomography, X-Ray Computed