PURPOSE: Abnormalities of the relaxation and contraction of the corpus cavernosum can lead to erectile dysfunction. Therefore, we induced a partial bladder outlet obstruction(PBOO) in male rats, and investigated the mechanisms of penile dysfunction with endothelial nitric oxide synthase(eNOS), vascular endothelial growth factor(VEGF), endothelin-1(ET-1), and apoptosis of peri-vascular smooth muscle and connective tissue cells in the corpus cavernosum. MATERIALS AND METHODS: PBOO was induced in 13 Sprague-Dawley rats by placing a 25 gauge needle sheath around the urethra, then ligating the bladder neck with a 3-0 suture. Three week after surgery, distal penile tissues were dissected for immunohistochemical staining, immunoblotting, and TUNEL staining. RESULTS: The expression of eNOS and VEGF were significantly decreased, whereas the expression of ET-1 and apoptosis of perivascular smooth muscle and connective tissue cells were significantly increased in the corpus cavernosum. CONCLUSIONS: The significant increase of ET-1 and apoptosis along with decreased eNOS and VEGF could mediate erectile dysfunction.
Animals ; Apoptosis ; Connective Tissue Cells ; Contracts ; Endothelin-1 ; Erectile Dysfunction ; Humans ; Immunoblotting ; In Situ Nick-End Labeling ; Male ; Muscle, Smooth ; Neck ; Needles ; Nitric Oxide ; Nitric Oxide Synthase Type III ; Rats ; Rats, Sprague-Dawley ; Relaxation ; Sutures ; Urethra ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Vascular Endothelial Growth Factor A

PURPOSE: The National Institute of Health (NIH) category III chronic nonbacterial prostatitis/chronic pelvic pain syndromes (CPPS) are commonly seen disorders; however, there has been no consensus on how to manage these patients. The purpose of this trial was to compare the efficacy of antibiotic monotherapy and antibiotic plus alpha-blocker combination therapy for the treatment of CPPS patients. MATERIALS AND METHODS: The study was comprised of 54 patients who were randomly placed into two groups: group I was treated with levofloxacin alone (28 patients), and group II was treated with levofloxacin and alfuzosin (26 patients). The levofloxacin, or the levofloxacin and alfuzosin were given to the respective groups for 8 weeks. The NIH Chronic Prostatitis Symptom Index (NIH-CPSI) was evaluated both before and after the treatment. RESULTS: Before the treatment, the mean CPSI of the group I patients was 23.1+/-8.1, and after the treatment, it was 15.6+/-5.6. For the group II, the mean CPSI before the treatment was 23.9+/-8.3, and after the treatment, it was 11.0+/-4.5. The difference between the pre-and post-treatment CPSI scores of group II was significantly larger than that of group I (p=0.001). The mean differences of the CPSI from the initial scores to the final scores in both groups were followed: 2.2 in group I and 4.3 in group II for the pain domain, 1.5 in group I and 2.8 in group II for the urinary domain, and 3.8 in group I and 5.7 in group II for the quality of life domain. CONCLUSIONS: Combination therapy of levofloxacin with alfuzosin appeared more effective for treating patients with chronic prostatitis/chronic pelvic pain syndrome than just administering antibiotic alone.
Adrenergic alpha-Antagonists ; Anti-Bacterial Agents ; Chronic Disease ; Consensus ; Humans ; Levofloxacin ; Pelvic Pain* ; Prospective Studies* ; Prostatitis ; Quality of Life

Some aneurysms with peculiar shapes, large sized or in unusual location cannot be obliterated by ordinary methods. We present four cases using two kinds of fenestrated clips. There were 4 aneurysms in the 4 patients:3 saccular and 1 fusiform aneurysm. Two aneurysms were located in anterior communicating artery, one left carotico-opthalmic artery, and one distal middle cerebral artery. All of the aneurysms were successfully obliterated. Our results suggest that the various shape of fenestrated clips may be benefit for clipping difficult aneurysms, which would not be clipped with ordinary one.
Aneurysm ; Arteries ; Intracranial Aneurysm* ; Middle Cerebral Artery

Ankylosing spondylitis is a chronic and systemic disease invloving the axial skeleton. In patient with involved cervical spine of the ankylosing spondylitis, endotracheal intubation by direct laryngoscope may be difficult or impossible because they have a limitation of cervical movement and anatomical anomalies. Additionally, ossification of the interspinous ligaments and the formation of bony bridges (syndesmophytes) between vertebrae, resulting in a classic "bamboo spine" appearance make difficult or impossible placement of an epidural or spinal needle. We report a case of a patient with long standing ankylosing spondylitis who underwent revision arthroplasty of the hip using combined continuous psoas compartment block and sciatic nerve block.
Arthroplasty* ; Hip* ; Humans ; Intubation, Intratracheal ; Laryngoscopes ; Ligaments ; Needles ; Sciatic Nerve* ; Skeleton ; Spine ; Spondylitis, Ankylosing*

PURPOSE: To evaluate the MRI findings of acute facial nerve paralysis in Bell's palsy and herpes zosteroticus, and to correlate these with the clinical findings. MATERIALS AND METHODS: We retrospectively reviewed theMRI findings in six cases of Bell's palsy(BP) and two of herpes zoster oticus(HZO), and compared them with thefindings for 30 normal facial nerves. This nerve was considered abnormal when its signal intensity was greaterthan that of brain parenchyma or the contralateral normal side on Gd-enhanced T1-weighted axial and coronal MRimages. We analysed the location and degree of contrast enhancement, interval change, and clinical progression incorrelation with House-Brackmann(HB) grade and electroneuronography(ENoG) findings. RESULTS: Fifteen of 30 normalfacial nerves(50%) seen on Gd-enhanced MRI were mildly enhanced in the geniculate ganglion, the proximal tympanic,and the proximal mastoid segment of the facial nerve. No enhancement of the internal auditory canal(IAC) orlabyrinthine segment of the facial nerve was noted, however. In BP and HZO, Gd-enhanced MR images revealed fair tomarked enhancement for more than two segments from the internal auditory canal to the mastoid segment of thefacial nerve. During follow-up MRI, enhancement of the facial nerve varied in location and signal intensity,though gradually decreased in intensity approximately eight weeks after the onset of facial nerve palsy. Nocorrelation between clinical HB grade, ENoG, and follow up MRI findings was noted. CONCLUSION: Except in theinternal auditory canal and labyrinthine segment, normal facial neve may show mild and relatively symmetricalenhancement. In BP and HZO, the facial nerve showed diffuse enhancement from the IAC to the mastoid segment.
Bell Palsy* ; Brain ; Facial Nerve ; Follow-Up Studies ; Geniculate Ganglion ; Herpes Zoster Oticus* ; Herpes Zoster* ; Magnetic Resonance Imaging* ; Mastoid ; Paralysis ; Retrospective Studies

No abstract available.
Classification* ; Female ; Hydatidiform Mole* ; Pregnancy

OBJECTIVES: A number of investigators have examined the possible pathophysiological mechanisms in patients who died from asthma, but the reasons for the increased incidence of death in patients with asthma are largely unknown. To elucidate the risk factors and possible causes of fatal asthma, we reviewed the clinical data of patients with potentially fatal asthma(PFA). METHODS: We retrospectively studied the clinical and laboratory profiles of 35 PFA patients(43 episodes) who had been admitted at the Kyungpook University Hospital and Taegu Fatima Hospital in recent 5 years(1989. 7-1994. 6). Our criteria of PFA were defined as either respiratory arrest or an arterial carbon dioxide tension(PaCO2) greater than 50 mmHg or an altered state of consciousness, due to acute asthma. RESULTS: 1) Twenty four patients with PFA were female and 11 male. At the time of PFA episode, age distribution was between 16-65 year (42% between 36-49). 2) Seasonal distribution was 13 episodes between March and May, 13 June and August, 6 September and November, 11 December and February. 3) Previous hospitalization history due to asthmatic attack was noted in 81 percent, and 75 percent were relatively compliant to their therapy. 5) At visiting emergency room, 81 percent satisfied the criteria of PFA, whereas 19 percent during hospitalizatoin. 77 percent required mechanical ventilation, and 52 percent of them within 30 minutes after visiting. 6) Initial arterial blood gas analysis at emergency room showed marked hypercapnia(75 +/- 29 mmHg), hypoxemia(50 +/- mmHg) and acidosis(pH 7.14 +/- 0.15). Serum potassium levels were within normal ranges in 75 percent. 7) All, except one, showed no significant cardiac arrthymias. 8) Possible precipitating factors leading to PFA were respiratory tract infection in 31 episodes, ingestion of NSAIDs in 2, emotional upsets in 2, irritant air pollutions in 2, withdrawal of anti-asthma drugs in 1, and unknown causes in 5. 9) Nine of 16 patients were atopic, and majority of them showed positive reaction to Dermatophagoides antigen. CONCLUSIONS: These results may suggest that PFA is mainly due to airway obstruction, and upper respiratory infection is an important precipitating factor leading to PFA. It is necessary to establish an appropriate plan for preventing PFA and related deaths.
Age Distribution ; Air Pollution ; Airway Obstruction ; Anti-Inflammatory Agents, Non-Steroidal ; Asthma* ; Blood Gas Analysis ; Carbon Dioxide ; Consciousness ; Daegu ; Eating ; Emergency Service, Hospital ; Female ; Gyeongsangbuk-do ; Hospitalization ; Humans ; Incidence ; Male ; Potassium ; Precipitating Factors ; Pyroglyphidae ; Reference Values ; Research Personnel ; Respiration, Artificial ; Respiratory Tract Infections ; Retrospective Studies* ; Risk Factors ; Seasons

To evaluate the change in valvular morphology and occurence and severity of mitral regurgitation produced by PMV, 45 patients(33 women and 12 men,mean age 38+/-10 years) were studied using two-dimensional(2-D) and Doppler echocaediography before and 1-2 days after this procedure. Mitral valve area after PMV increased in all patients, from 0.9+/-0.2 to 1.8+/-0.4cm2(P<0.0001). In valve area estimation, the correlation between Gorlin`s method and 2-Dechocardiography was better(r=0.61, p<0.0001) than that between Gorlin`s method and Doppler pressure halftime(r=0.38, P<0.01) before valvuloplasty, but after the procedure Gorlin`s and 2-D image valve area correlated less well(r=0.33, P<0.05) than Gorlin`s-Doppler pressure halftime correlation(r=0.46, P<0.002). Before PMV, 37 patients had no mitral regurgutation, 7 had grade 1 and 1 had grade 2 mitral regurgutation. After PMV, new mitral regurgutation occurred in 14 patients, increased in severity in 5 patients and so mitral regurgutation newly developed or increased in severity in 19(42%) patients. There were no differences between the patients with and those without an increase in mitral regurgutation after PMV, in age, sex, caediac rhythm, initial mitral valve area, increase in mitral valve area and fluoroscopic calcification. However, morphologic characteristics especially mobility(P<0.01) and thickening(P<0.05) of mitral leaflets were better pressured, and EBDA/BSA(effective balloon dilating area/body surface area) was significantly smaller(P<0.02) in patients without an increase in mitral regurgutation. Thus, an increase in mitral regurgutation after PMV might be related to the features of valve morphology especially and thickand EBDA/BSA.
Female ; Humans ; Mitral Valve ; Mitral Valve Insufficiency* ; Mitral Valve Stenosis

Adrenal myelolipoma is an uncommon, benign, hormonally non-active lesion that is composed of a mix of hemopoietic elements and mature adipose tissue. Most adrenal myelolipomas are incidentally found by ultrasonogram, computed tomography or magnetic resonance imaging. This tumor is commonly asymptomatic, although patients will occasionally present with nonspecific abdominal pain. We report here on a case of myelolipoma that was treated by Hand-assisted transperitoneal laparoscopic adrenalectomy.
Abdominal Pain ; Adipose Tissue ; Adrenal Glands ; Adrenalectomy* ; Humans ; Laparoscopy ; Magnetic Resonance Imaging ; Myelolipoma* ; Ultrasonography

PURPOSE: Gastric cancer is the most common malignant tumor in Korea. We reviewed the cases at our institution to identify the survival rates and clarify the prognostic factors of patients with gastric cancer. MATERIALS AND METHODS: We conducted a retrospective study of 6,918 patients who had received a diagnosis of gastric cancer, and they underwent surgery at Korea Cancer Center Hospital during a 15-year period from 1991 to 2005. RESULTS: The overall 5-year survival rate was 66.8%. The univariate analysis revealed that age, location of tumor, gross type of tumor, the histology according to the WHO classification, the Lauren classification, depth of invasion (T stage), lymph node metastasis (N stage), distant metastasis (M stage), the type of surgery, the UICC TNM stage, postoperative complications, adjuvant chemotherapy, lymphatic invasion, venous invasion and perineural invasion were the significantly different factors of the survival rates. The multivariate analysis revealed that age , Borrmann type 4, the histology according to the WHO classification, depth of invasion (T stage), lymph node metastasis (N stage), distant metastasis (M stage), the type of surgery, UICC TNM stage, postoperative complications, adjuvant chemotherapy and lymphatic invasion were the independent prognostic factors. CONCLUSION: We have shown a statistically significant association between the survival rates after operation for gastric cancer and the clinicopathologic factors. Early diagnosis of gastric cancer, appropriate surgeryand adjuvant therapy might improve the quality of life and the survival rates of gastric cancer patients.
Chemotherapy, Adjuvant ; Early Diagnosis ; Humans ; Korea ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Postoperative Complications ; Quality of Life ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate