PURPOSE: A clinical review was performed to evaluate the effectiveness of the partial neurectomy of the dorsal nerve of the penis on the treatment of premature ejaculation. PATIENTS AND METHODS: The study was made on 143 patients with premature ejaculation (mean age 38 years; range 22~53 years) who underwent the partial neurectomy of the dorsal nerve of the penis from January 1997 to September 1999. All patients were evaluated by change on pre- and post-operative ejaculatory latency and biothesiometry, postoperative satisfaction, management on unsatisfactory patients and postoperative complication. RESULTS: Pre- and post-operative vibration perception threshold of glans penis on biothesiometry was significantly decreased from mean 2~3 mA (range 1~6 mA) to 8~10 mA (range 3~15 mA) (p<0.01). Change on pre- and post-operative ejaculatory latency was prolonged from mean 1~3 minutes (55.2%) to 5~10 minutes (47.6%)(p<0.01). The postoperative results were satisfactory in 117 cases (81.8%). At follow-up 2 to 34 months postoperatively, 17 cases (11.8%) were complicated by glans pain, discomfort(7 cases), penile edema (6 cases), wound dehiscence(3 cases), and delayed ejaculation (1 case). CONCLUSION: The partial neurectomy of the dorsal nerve of the penis is an effective treatment in the comprehensive management of the premature ejaculation with glans hypersensitivity, for good results, a simple operative technique and a few postoperative complication. However, it must be followed up for long-term effectiveness and its complication.
Edema ; Ejaculation ; Follow-Up Studies ; Humans ; Hypersensitivity ; Male ; Penis* ; Postoperative Complications ; Premature Ejaculation* ; Vibration ; Wounds and Injuries

The orchid symbiotic fungi were isolated from the roots of Korean native orchid (Cymbidium goeringii) collected and Chinese orchid (C. sinense) obtained from greenhouses. They were identified as a species of Rhizoctonia, based on the sequences of 18r rDNA, the microscopic observations of mycelia, and the symbiotic relationships with commercial orchids. The isolate collected from Chinese orchids was revealed to be a species of Ceratobasidium endophytica, and to be different from the other isolates at the thickness of the mycelia stained in the root cells of Korean native orchids. The other isolates collected from the Korean native orchids were considered to be a species of Tulsanella repens (anamorphic: Epulorhiza repens) or its related one. The physiologic or microscopic variations were oftenly observed among them, but the tendency of grouping these in the 18s rDNA sequences were observed to be consistent with those of the localities collected. The further taxonomical segregating for Korean symbiotic fungi was not made because the information concerned were limited in this moment, but was recognized as based on the sequences of 18s DNA.
Asian Continental Ancestry Group ; DNA ; DNA, Ribosomal ; Fungi* ; Humans ; Mycorrhizae ; Rhizoctonia ; Symbiosis

BACKGROUND: Hemophagocytic lymphohistiocytosis(HLH) is a rare and fatal disorder in children. Recently its clinical characteristics and etiology of uncontrolled activation of cellular immune system in genetically predirected patients have keen elucidated. The authors analyzed the clinical characteristics and response to immunosuppressive agents of HLH patients in single institute. METHODS: The authors retrospectively analyzed various clinical data including CSF and bone marrow examination at diagnosis and follow up period in the 6 patients who were diagnosed as HLH at Asan Medical Center during last 2 years. Antithymocyte globulin(ATG : 10 mg/kg/day) and methylprednisolone(methyl-PD: 5 mg/kg/day) for 5 consecutive days as induction treatment and cyclosporin A(CsA) as maintenance treatment after induction with weekly intrathecal methotrexate for 5-6 weeks were given to the recently diagnosed 3 patients. RESULTS: All the patients except one were infants. Persistent fever, hepatosplenomegaly and pancytopenia were observed in all the patients. Family history of suspicious HLH was observed in 4 patients(67%). The characteristic elevated serum triglyceride(TG) level and/or decreased fibrinogen level were noted in all. Mild to moderate CSF pleocytosls with increased lymphocytes and monocytes was also observed in all during the disease course. Variable degree of nonqr-Langerhans cell histiocytic infiltration and hemophagocytosis were observed in all the cases. Of the 3 patients treated with ATG and methyl-PD, one achieved complete remission and the others achieved partial remission within 2 weeks of treatment, but all expired after 5 months, remission with CsA. Regardless of treatment regimen, all the 6 patients expired due to CNS sequelae of HLH. CONCLUSIONS: HLH mainly developed in infants. Persistant fever, hepatosplenomegaly and pancytopenia were observed in most cases with the characteristic change of serum TG and/or fibrinogen level. HLH should be included in the differential diagnosis in patients with these features especially when the family history of suspicious HLH is present, and histologic comfirmation of HLH could be easily accomplished with bone marrow study in most cases. Remission induction of HLH could be achieved with immunosuppressive treatment but it was difficult to maintain long term remission.
Bone Marrow ; Bone Marrow Examination ; Child ; Chungcheongnam-do ; Cyclosporine ; Diagnosis ; Diagnosis, Differential ; Fever ; Fibrinogen ; Follow-Up Studies ; Humans ; Immune System ; Immunosuppressive Agents ; Infant ; Lymphocytes ; Lymphohistiocytosis, Hemophagocytic* ; Methotrexate ; Monocytes ; Pancytopenia ; Remission Induction ; Retrospective Studies

BACKGROUND: Despite the development of empiric antibiotics in treatment of neutropenic fever(NF) in pediatric cancer patients, bacterial infection is still the most important cause of death in these patients. In this study the authors analyzed clinical characteristics and tried to find out the possible risk factors of the pediatric cancer patients who succumbed to the documented bacterial infection after episodes of neutropenic fever. METHODS: 17 pediatric cancer patients expired after episodes of neutropenic fever(NF) in the pediatric department of Asan Medical Center from Mar. 1990 to Feb. 1996 were grouped by the results of bacterial culture. 7 cases (Group A) had documented bacterial culture results and 10 cases (Group B) had negative culture results. The clinical characteristics of these two groups were analyzed retrospectively. RESULTS: There were no differences in the types of cancer between the two groups. All the documented bacteria were gram negative organisms and all cultured from the blood. There were no differences between the two groups in the treatment duration, known risk factors of infection before and at the onset of fever, antibiotics administered, and interval from the onset of NF to the administration of antibiotics. The response rate of initial empiric antibiotics was lower in group A(14%) compared to Group B(40%), even though all the cultured organisms except 2 cases in Group A were sensitive to initial empirical antibiotics. Septic shock was the cause of death in 86% of Group A patients, but only in 10% of Group B patients. The other causes of death were progression of cancer, bleeding, hepatic failure, adult respiratory distress syndrome and multiple organ failure, which showed no difference between the 2 groups. The interval from the onset of fever to death was significantly shorter in Group A(6.2+/-2.3 days) compared to Group B(24.9+/-18.6 days). CONCLUSIONS: Bacterial infection is still the most frequent cause of death after NF. Most patients succumbed to the documented bacterial infection showed rapid progression of bacteremia to septic shock despite administration of sensitive antibiotics. The known risk factors of infection before the onset of NF and other treatment factors shows no differences between the two groups in this study. These results suggest that the bacteremia is obvious risk factor of poor outcome after NF episode, and antibiotics alone may be insufficient to prevent the rapid progression of septic shock in these patients.
Anti-Bacterial Agents ; Bacteremia ; Bacteria ; Bacterial Infections ; Cause of Death* ; Chungcheongnam-do ; Fever* ; Hemorrhage ; Humans ; Liver Failure ; Multiple Organ Failure ; Respiratory Distress Syndrome, Adult ; Retrospective Studies ; Risk Factors ; Shock, Septic

PURPOSE: A clinical review was performed to evaluate the importance and effectiveness of early nephrectomy & the result of short-term chemotherapy on unilateral, nonfunctioning tuberculous kidneys. METHODS: Retrospective study was made on 34 patients with nonfunctioning tuberculous kidneys who underwent nephrectomy from February 1986 to December 1998. All patients were evaluated by annual frequency, age, sex and site distribution, presenting symptoms, tuberculous lesion on organs other than kidney, cystoscopic finding, urinalysis and urine AFB smear & culture, urine Tb-PCR, CBC & ESR finding, perioperative morbidity and mortality, treatment distribution(Group 1 and 2) and drug toxicity. RESULTS: In pathologic findings of the 39 cases in which nonfunctioning tuberculous kidneys were suspected, 5 cases had no evidence of tuberculosis. Those were xanthogranulomatous pyelonephritis(2 cases), chronic pyelonephritis with hydronephrosis(2 cases) and complicated multilocular cyst(1 case). Coexisting renal cell carcinoma was found in 1 case. 4 cases(11.7%) were hypertensive at the time of presentation and 3 cases of them had a decrease in blood pressure after nephrectomy. 7 cases(20.5%) had febrile symptom, 5 cases of them had renal & perirenal abscess(4 cases) and cutaneous fistula(1 case). No perioperative mortality occurred and perioperative complications(sinus arrhythmia, wound infection, wound dehiscence, ileus) were in 5 cases(14.7 %). There was no evidence of recurrence during follow-up periods(Follow-up mean periods : 18.5 months). CONCLUSION: Early nephrectomy is an effective treatment in the comprehensive management of the unilateral, nonfunctioning tuberculous kidneys, for accurate diagnosis, removal of infection focus, early control of presenting symptoms and prevention of tuberculosis recurrence. And this should be followed by postoperative, acceptable short-term antitubercul ous chemotherapy.
Arrhythmias, Cardiac ; Blood Pressure ; Carcinoma, Renal Cell ; Diagnosis ; Drug Therapy* ; Drug-Related Side Effects and Adverse Reactions ; Follow-Up Studies ; Humans ; Kidney* ; Mortality ; Nephrectomy* ; Pyelonephritis ; Recurrence ; Retrospective Studies ; Tuberculosis ; Urinalysis ; Wound Infection ; Wounds and Injuries

Periodontal ligament cells may have a role in the regulation of hard and soft periodontal tissues, but their specific function has not yet to be determined. To evaluate further their role in periodontal regeneration, they were examined for osteoblast-like behavior. Periodontal ligament cells and gingival fibroblasts were primarily cultured from extracted premolar with non-periodontal diseases. Cells were cultured with DMEM at 37degrees C, 5% CO2, 100% humidity incubator, and as a measure of cell characterization, it was examined that the morphology, alkaline phosphatase activity, collagen synthesis, and immunocytochemistry for osteonectin, osteocalcin, and collagen type I. Healthy periodontal ligament cells has more osteoblastic-like cell property in alkaline phosphatase activity, and collagen synthesis than gingival fibroblast. Immunocytochemistry localization explained that calcitonin were expressed in periodontal ligament cells only, and osteonectin and type I collagen were produced in both cells simultaneously. This results indicate that the growth characteristics of periodontal ligament cells and gingival fibroblasts exhibit some differences in proliferative rates and biochemical synthesis. The differences may help to calrify the role such cells play in the regenearation of periodontal tissues.
Alkaline Phosphatase ; Bicuspid ; Calcitonin ; Collagen ; Collagen Type I ; Fibroblasts ; Humans* ; Humidity ; Immunohistochemistry ; Incubators ; Osteocalcin ; Osteonectin ; Periodontal Ligament* ; Population Characteristics* ; Regeneration

The main goal for the treatment of periodontal diseases is the regeneration of lost cementum, bone and connective tissue. Clinical and histological research suggests that it is possible to restore periodontal structures. Seeds of Carthamus tinctorius L. has been used for the treatment of bone fracture and osteoporosis in traditional Korean medicine. The purpose of this study is to examine the effect of extract of seeds of Carthamus tinctorius L. on mineralization in periodontal ligament cells and osteoblastic cells. Periodontal ligament cells were primarily obtained from a extracted premolars with non-periodontal diseases. Osteoblastic cells were obtained from calvariae of a fetal rat. Cells were cultured with DMEM at 37degrees C with 5% CO2 in 100% humidity incubator. Alkaline phosphatase(ALP) level and the number of calcification nodules were examined and western blot analysis using osteonectin was performed. Measurements of ALP levels and calcification nodules showed that extract of seeds of Carthamus tinctorius L. had significantly higher activity than control in all of both cells. In western blot analysis, protein expression of osteonectin indicated that extract of seeds of Carthamus tinctorius L. showed an increased pattern than control in all of both cells. From the above results, it seems that extract of seeds of Carthamus tinctorius L. has excellent effect on mineralization in periodontal ligament cells and osteoblastic cells.
Animals ; Bicuspid ; Blotting, Western ; Carthamus tinctorius* ; Carthamus* ; Connective Tissue ; Dental Cementum ; Fractures, Bone ; Humidity ; Incubators ; Osteoblasts* ; Osteonectin ; Osteoporosis ; Periodontal Diseases ; Periodontal Ligament* ; Rats ; Regeneration ; Skull

The present study was performed to evaluate the clinical effects following local application of 30% minocycline strip(polycaprolactone), 2% minocycline gel(hydro-carbon gel) and 12% minocycline strip(polylactide, Minodent) to augment scaling and root planing in patients with chronic adult periodontitis. Forty teeth with periodontitis were enrolled in the study anddistributed into 4 groups including control group. All patients performed standardized oral hygiene instructions and mechanical debridement at the beginning of the study and then each local delivery drugs were inserted into periodontal pocket in each groups. Examinations regarding plaque index(PI), papillary bleeding index (PBI), probing pocket depth (PPD) were carried out at 0, 2, 4 weeks. All experimental groups showed statistically significant differences between baseline and 2 and 4 weeks in every clinical indices. Especially, 30%minocycline strip and Minodent group showed a significant improvement in PBI at 2 weeks and in PPD at 2 and 4 weeks. In conclusion, highly bio-resorbable Minodent delivered subgingivally as an adjunct to scaling and root planing induces better clinical effects for periodontal health than 2% minocycline gel and control group.
Adult ; Male ; Female ; Humans

Recently, many natural medicines, which have advantage of less side effects and possibility of long-term use have been studied for their capacity of anti-bacterial, anti-inflammatory and regenerative potential of periodontal tissues. Olibanum has the effects to hemostasis, analgesic and anti-inflammatory, and it also has been traditionally used as a drug for the treatment of bone disease in oriental medicine. The purpose of the present study was to investigate the effects of Olibanum extracts on the activity and differentiation of MC3T3-E1 cells, alkaline phosphatase(ALP) synthesis, formation of bone nodules and expression of type I collagen of MC3T3-E1 cells. To examine the cellular activity, MC3T3-E1 cells were cultured with alpha-MEM(control) and each concentration of Olibanum for 2 days and 4 days. To compare the ALP synthesis, MC3T3-E1 cells were cultured with alpha-MEM(negative control), dexamethasone(positive control), and each concentration of Olibanum for 2 days and 4 days. To compare the bone nodule formation, MC3T3-E1 cells were cultured for 21 days, and to compare the type I collagen expression, MC3T3-E1 cells were cultured for 4 days. The cellular activity of MC3T3-E1 cells treated with 1 microgram/ml of Olibanum extracts was significantly increased at 4-day(p<0.05) to control. The activity of ALP in MC3T3-E1 cells treated with 1 microgram/ml Olibanum extracts was significantly increased at 4-day(p<0.05). All the experimental groups showed much more bone nodule formation than control groups. The group treated with 1 microgram/ml of Olibanum extracts was the highest bone nodule formation, and showed much more type I collagen expression than negative control. These results indicate that Olibanum extracts may be considered effective in the activity and differentiation of MC3T3-E1 cells.
Bone Diseases ; Boswellia* ; Collagen Type I ; Hemostasis ; Medicine, East Asian Traditional

Bone remodeling is characterized by the coupling of osteoclast-mediated bone resorption and osteoblast-mediated bone formation. The process is tightly regualted at the local level by an incompletely known netwotk of peptide and non-peptide fators. Nitric oxide(NO), synthesized by nitric oxide synthetase(NOS) from L-arginine, is becoming recognized as an important bioregualtory molecule in a variety of tissue, but little is known about its possible role in periodontal tissue. The purpose of this study is to investigate the expression of nitric oxide synthetase(NOS) in inflamed gingiva and the effects of cytokine on the expression of NOS protein. The expression of NOS in gingival tissue was evaluated by immunohistochemical staining for NOS1, NOS2, NOS3. The effect of cytokine on the expression of NOS in human periodontal ligament cells and osteoblast-like HOS cells by western blot analysis. Further, we studied that NO functions in periodontal ligment cells as a regulatory molecule. PDL cells incubated with NOS inhibitor and donor. The protein expression, type I collagen & non-collagenous protein, nitrate production and cell proliferation were evaluated The results were as follows. 1. NOS1, NOS2, NOS3 was rarely distributed in healthy gingiva, but stronger stained in gingival epithelium, endothelial cells, and mononuclear cells of inflammed gingiva. 2. The cytokine stimulated NOS1, and NOS3 protein were not inducing or inhibitory effect to compared with control in PDL and HOS cells. 3.Incubation of cells with combination of TNF-alpha, IFN-gamma, LPS result in a time dependant increase in NOS2 expression, reaching a maximal level after 24 hours of stimulation. 4. The osteonectin protein inhibitory effect of NMA, inhibitor of NOS, was reversed by Larginine in dose dependant manner. 5. NMA decreased cell proliferation and nitrate production, but the inhibitory efffect of NMA was also prevented by the NO donor, sodium nitropruiside. These results suggest that exogenously synthesized NO was playing a stimulating effect on cell proliferation or on non-collagenous protein expression. Therefore NO have an important role in mediation of localized bone destruction associated inflammatory bone disease such as periodontitis
Arginine ; Blotting, Western ; Bone Diseases ; Bone Remodeling ; Bone Resorption ; Cell Proliferation ; Collagen Type I ; Endothelial Cells ; Epithelium ; Gingiva ; Humans ; Negotiating ; Nitric Oxide Synthase* ; Nitric Oxide* ; Osteogenesis ; Osteonectin ; Periodontal Ligament ; Periodontitis ; Sensitivity and Specificity* ; Sodium ; Tissue Donors ; Tumor Necrosis Factor-alpha