PURPOSE: It is reported that 65% of diabetic male patients over 60 of their age are impotent. However, there is no report concerning the effect of serum glucose control on erectile dysfunction in diabetic patient. This study was performed to evaluate the effects of serum glucose control on erectile dysfunction. MATERIALS AMD METHODS: The development of Diabetes mellitus was defined that the serum glucose level was above 200mg/dL in random test at 25 weeks. We designed the experimental specimen into 3 groups; group I: diabetic OLETF (Otsuka Long Evans Tokushima Fatty) rats without blood sugar control (n=10), group II: diabetic OLETF rats with blood sugar control with 4U insulin subcutaneous injection daily from 26 to 46 weeks (n=10), group III: diabetic OLETF rats with blood sugar control with 10U insulin subcutaneous injection daily from 26 to 46 weeks (n=10). We estimated the collagen content of penile tunica albuginea with the scanning electron microscopy and observed the endothelial layers of corpus cavernosum with the transmission electron microscopy in each group. RESULTS: The serum glucose level was 249 +/- 4.1mg/dL, 234 +/- 2.7mg/dL, 215 +/- 3.0mg/dL respectively in group I, II, III, and decreased in order of group II, III. The differences among groups were statistically significant (p<0.05). The thickness of collagen bundles of penile tunica albuginea was 0.98 +/- 0.1 micrometer, 0.94 +/- 0.3 micrometer, 0.92 +/- 0.1 micrometer respectively in group I, II, III, and decreased in order of group II, III. The differences among groups were statistically significant (p<0.05). The endothelial layers of corpus cavernosum were decreased in II, III. CONCLUSIONS: The serum glucose control in diabetic rats decreases the collagen con tents in penile tunica albuginea and the endothelial layers of corpus cavernosum.
Animals ; Blood Glucose* ; Collagen* ; Diabetes Mellitus ; Endothelium ; Erectile Dysfunction ; Humans ; Injections, Subcutaneous ; Insulin ; Male ; Microscopy, Electron, Scanning ; Microscopy, Electron, Transmission ; Rats* ; Rats, Inbred OLETF

A study of the effectivity and reliability of discectomy and anterior interbody fusion with autogenous iliac bone graft for spondylogenic and discogenic back pain and/or radiating pain has been done on 48 patients who had been hospitalized at Severance Hospital between January 1976 to June 1978. To the preoperative symptoms and signs such as the presence of back pain, sciatica, muscle atrophy, sensory change, motor change, spinal motion, deep tendon reflex, S.L.R., knee-chest compression test and Patricks test were checked, and after the operation, the same symptoms and signs were checked as to how they were improved or not. The age range of patients was 17 to 64 years and 40% of them were in the 3rd decade. Before the operation, for the confirmation of the origion of the back pain, we did perform dynamograms for instability and myelograms for root compression and spinal stenosis. The approach to the lesion was mainly retroperitoneal with anterior approach. Bony union after the operation was decided by a plane roentgenogram or clinical signs, and a dynamogram in some cases. The following results were obtained from analysis of the cases studied. 1. Eighty percent of the cases showed improved back pain in postoperative 3rd day and 83% showed improved sciatica in 6 months after the operation. 2. During the operation, the operative dislcogram could be done to verify the level of the lesion and the disc degeneration, disc protrusion, bony spur, narrowing of the joint space and instability during the operation could be confirmed in direct vision, so we could perform the operation for the accurate lesion. 3. Rather than the posterior approach, the anterior approach could allow all the remnants of the disc to be removed thoroughly. 4. In anterior interbody fusion, the strut of iliac bone was firmly impacted with two blocks, so its stability could be maintained, and patient could be mobilized earlier. 5. Clinical union of bone grafts was obtained in between 3 to 6 months and 96% of the cases showed bony union in 9 months. In 14 cases of two level fusions, the bony union was delayed compared to the one level fusion. 6. After the operation, the patient could return with the brace on to the office only within three months. The brace was taken off after the bony union was verified by plane roentgenogram and dynamogram.
Back Pain ; Braces ; Diskectomy ; Humans ; Intervertebral Disc Degeneration ; Joints ; Muscular Atrophy ; Reflex, Stretch ; Sciatica ; Spinal Stenosis ; Transplants

Chronic bronchiolitis is a condition associated with cigarette smoking, and later associated with pulmonary parenchymal alteration and progressive deterioration of lung function. Early respiratory bronchiolitis was produced in Sprague-Dawley rats by indirect inhalation of cigarette smoke daily in a smoke exposure chamber designed by authors for 1 month. Experimental group A (n=5) was sacrificed after having smoked 30 cigarettes, group B (n=5) after 80 cigarette, and group C (n=7) after 140 cigarettes, respectively. Examination of morphologic changes in the lungs was done on light microscope, transmission and scanning electron microscopes. Light microscopically, increase in number of goblet cells in the bronchial mucosa, brown-pigmented macrophages in the alveoli, multifocal alveolar collapse adjacent to the bronchioles, dilatation of alveolar ducts and alveolar spaces were observed. Transmission electron microscopically, irregularly shaped Clara cells, alveolar wall collapse, and focally type I epithelial cell injury were seen. Scanning electron microscopically, scattered alveolar collapse, irregular dilatation of alveolar ducts, alveolar spaces and interalveolar pores (pores of Kohn) were seen. The terminal and respiratory bronchioles showed morphological alteration of Clara cells, but no evidence of cellular bronchiolitis or bronchiolar obstruction. We conclude that sidestream smoke induces an early respiratory bronchiolitis including aggregates of brown pigmented macrophages and varying degrees of structural alteration of adjacent pulmonary parenchyma.
Bronchioles ; Bronchiolitis ; Dilatation ; Epithelial Cells ; Goblet Cells ; Inhalation ; Lung ; Macrophages ; Mucous Membrane ; Rats, Sprague-Dawley ; Smoke* ; Smoking ; Tobacco Products*

No abstract available.
Keratoacanthoma*

Pain from cancer is a major problem of managing the oral cancer patients in terminal stage. Overall, pain is reported by about 50% of patients at all stages of cancer and by over 70% with advanced neoplasms. Unrelieved pain can be incapaciting and preclude a satisfying quality of life. But, pain is often poorly assessed, and many clinicians lack sufficient knowledge to optimize cancer pain treatment. There are three basic approaches to the control of pain : modifying the source of pain, altering the central perception of pain, and blocking the transmission of pain to the central nervous system. The optimal use of these approaches and an individualized plan for pain control can maximize both quality and duration of life in dying patients. Opioid analgesics are are the mainstay of pharmacologic treatment. Practical opioid therapy include selection of both drug and route, dose titration, and management of side effects. We present our experienced pharmacologic treatment protocol for cancer pain management that collaborated by Dept. of Hospice, Catholic Medical Center. It will acts as a guideline for our colleague to facilitate the translation of current knowlegde into the clinical practice.
Analgesics, Opioid ; Central Nervous System ; Clinical Protocols ; Hospices ; Humans ; Mouth Neoplasms* ; Pain Management ; Quality of Life

The purpose of this study was to identify the relationship between the clinical response to neoadjuvant chemotherapy and PCNA and VEGF protein expression, apoptosis and its related gene expression such as Bcl-2 and Bax in cervical cancer. We retrospectively reviewed 30 patients with locally advanced or bulky cervical cancer treated with three courses of neoadjuvant chemotherapy followed by radical hysterectomy or radiation therapy at Seoul National University Hospital from June 1995 to June 1998. The specimen were obtained before chemotherapy by colposcopy directed biopsy. The protein expressions of Bcl-2, Bax, VEGF and PCNA were examined by immunohisto- chemical staining and the apoptosis was examined by TUNEL staining. These results were compared with chemotherapeutical response which was evaluated by colposcopy or CT/MRI. There were 2 CR(complete response), 19 PR(partial response) and 9 NC(no change) and there was no progressive disease. There was no significant difference between responder and nonresponder according to the age, tumor size and FIGO stage. The 3 year survival rates of responder and nonresponder were 90.0% and 66.7% respectively and there was significant difference between two groups(p=0,015). The expression of Bcl-2 and Bax was positive in 23.3%(7/30) and 46.7%(14/30). The expression of VEGF was positive in 83.3%(25/30). PCNA PI(positive index), defined as PCNA positive cells in percentage was more than 25.0% in 20 cases. Apoptotic index, defined as the number of the cells undergoing apoptosis per 1,000 tumor cells, ranged from 3 to 53(mean 22.3). Although there was no significant relationship between the clinical response to neoadjuvant chemotherapy and the expre- ssion of Bcl-2, Bax, VEGF and PCNA PI, apoptotic index was significantly higher in responder than nonresponder when the cutoff value of positive was defined as apoptotic index more than 5(p=0.032). In conclusion, the evaluation of the pattern of apoptosis before neoadjuvant chemothera- py is potentially useful for the prediction ofz tumor response to neoadjuvant chemotherapy for cervical cancer.
Apoptosis* ; Biopsy ; Colposcopy ; Drug Therapy* ; Gene Expression ; Humans ; Hysterectomy ; In Situ Nick-End Labeling ; Proliferating Cell Nuclear Antigen* ; Retrospective Studies ; Seoul ; Survival Rate ; Uterine Cervical Neoplasms* ; Vascular Endothelial Growth Factor A*

No abstract available.
Craniocerebral Trauma* ; Head* ; Hematoma*

This is a clinical study of 129 cases of colorectal cancer who were treated in the department of surgery, Inchon Christian Hospital from January 1989 to December 1996. The results were as follows; 1) The peak age incidence was 7th decade and the ratio between male and female was 1.87 : 1 2) The most frequent site of the tumor was the rectum(59.7%). 3) In the right and left colon cancer the most frequent symptom was abdominal pain and in the rectal cancer the most frequent symptom was bloody stool. 4) The duration of symptoms prior to admission was within 3months(58%). 5) The diagnostic methods were digital examination, sigmoidoscopy colonofiberscopy, barium enema and abdominal CT scanning. 6) The most frequently performed operation was Abdominoperineal resection(27%). 7) The staging of tumors was performed according to modified Dukes' classification and Dukes C was most frequent(55.1%). 8) The most common histopathologic type was adenocarcinoma(98%). 9) The most common macroscopic finding was ulcerative pattern. 10) The most common distant metastatic site was pelvic organ(12%). 11) The most common post-operative complication was wound infection(10.1%). 12) The 5year survival rate was analyzed by Kaplan-Meier's method : the overall 5year survival rate was 60.7%.
Abdominal Pain ; Barium ; Classification ; Colonic Neoplasms ; Colorectal Neoplasms* ; Enema ; Female ; Humans ; Incheon ; Incidence ; Male ; Rectal Neoplasms ; Sigmoidoscopy ; Survival Rate ; Tomography, X-Ray Computed ; Ulcer ; Wounds and Injuries

Extraskeletal bone-forming lesions are myositis ossificans, fibrodysplasia(myositis) ossificans progressiva, and extraskeletal osteosarcoma. It is of paramount importance to clearly distinguish these lesion from extraskeketal osteosarcoma. Myositis ossificans, by far the most common among these lesions, is a benign, ossifying process that is generally solitary and well circumscribed. It is found most commonly in the musculature, but it may also occur in other tissue, especially in tendons and subcutaneous fat. It occur as the result of various kinds of soft tissue injury(surgical scars, burns, dislocation of joints etc.) and also observed in patients with tetanus, in paraplegics secondary to traumatic spinal injury. Although there is general agreement that myositis ossificans is a nonprogressive benign process without nerplastic potential, its pathogenesis is still poorly understood.We experienced a myositis ossificans associated with chronic, extensive pressure sore in patient with paraplegia secondary to spinal injury.
Burns ; Cicatrix ; Dislocations ; Humans ; Joints ; Myositis Ossificans* ; Myositis* ; Osteosarcoma ; Paraplegia ; Pressure Ulcer* ; Spinal Injuries ; Subcutaneous Fat ; Tendons ; Tetanus

BACKGROUND: Glutaraldehyde is used most commonly as a high-level disinfectant for semicritical patient-care equipments. However, its potential toxicity to healthcare workers and a long exposure time needed to kill mycobacteria can be problematic. Recently, Perasafe(R) (Antec International, UK) has been introduced in the market as a safe and very effective disinfectant. This study was to evaluate the efficacy of Perasafe(R) against not only bacteria and yeast but also mycobacteria and bacterial spores and compare it with glutaraldehyde. MATERIAL AND METHOD: Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Candida albicans, Mycobacterium tuberculosis, and Bacillus subtilis were used for the test. Perasafe(R) and Cidex(R) were used at the final concentration of 1.62% and 2.25%, respectively; the disinfectants were neutralized by Tween 80 (0.5%) in the mycobacterial test and by lecithin (0.75%) in all other tests. Bacterial suspensions were made in phosphate buffer with or without fetal bovine serum (1%) to simulate dirty or clean conditions, respectively. The disinfectants were tested at 0, 24 and 48 hr of preparation to check stability. An effective disinfectant activity was defined as a 5 log10 reduction in viable counts. RESULTS: E. coli, S. aureus, P. aeruginosa and C albicans were effectively disinfected in less than 5 min by both Perasafe(R) and Cidex(R) and the both disinfectants remained equally effective under the dirty conditions or at 48 hr of preparation. Perasafe(R) was effective in 1 min against B. subtilis spores compared to Cidex(R) which took 30 min for the same activity. M. tuberculosis was effectively disinfected in 10 min by Perasafe(R) and 20 min by Cidex(R). CONCLUSIONS: Perasafe(R) showed greater tuberculocidal and sporicidal activities than Cidex(R), although both disinfectants were equally effective against common bacterial and yeast pathogens. Perasafe(R) may be an outstanding high-level disinfectant for endoscopes and other semicritical medical equipment.
Bacillus subtilis ; Bacteria* ; Candida albicans ; Delivery of Health Care ; Disinfectants ; Endoscopes ; Escherichia coli ; Glutaral ; Lecithins ; Mycobacterium tuberculosis ; Polysorbates ; Pseudomonas aeruginosa ; Spores ; Spores, Bacterial* ; Staphylococcus aureus ; Suspensions ; Tuberculosis ; Yeasts*