This study was performed to investigate the effect of octreotide on the contractility of rat vas deferens. The -smooth muscle strips isolated from the prostatic portion were myographied in isolated organ bath. Electric -field stimulation (monophasic square wave, duration : 1. mSec, voltage : 50 V, frequency : 5 Hz or 30 Hz, train : 10 Sec) produced reproducible contraction. The contraction was composed of two component, first phasic component (FPC) and second tonicc component (STC).. These contractions were abolished by -tetrodotoxin (1 microM). Octreotide inhibited the field stimulation induced contractions both FPC and STC concentration- dependently. The FPC was decreased by a desentization of purinergic receptor by pretreatment of mATP, and the STC was decreased by pr,,creatment of reserpine (3 mg/kg, EP) 24 hours before experiments. Octreotide reduced the field stimulation induced contraction in the presence of mATP and of reserpinized muscle strips. The inhibitory effect of octreotide was more potent at 5 Hz than at 30 Hz. Octreotide did not affect basal ton and exogenous norepinephrine- or ATP-induced contraction. These results suggest that octreotide inhibit the contractility of the isolated rat vas deferens by inhibition of the release of neurotransmitters, both ATP and norepinephrine from adrenergic nerve terminal.
Adenosine Triphosphate ; Animals ; Baths ; Neurotransmitter Agents ; Norepinephrine ; Octreotide* ; Rats* ; Reserpine ; Vas Deferens*

Keratoconus (conical cornea) is a condition, beginning about puberty and developing mainly in females, in which the apex of the cornea thins gradually and usually bilaterally. The etiology is unknown. The presenting symptom is a reduction of the patient's vision owing to the development of a high degree of irregular myopic astigmatism. Early in the course of the disease the cornea does not look conical. The diagnosis of Keratoconus is confirmed by the distorted reflex observed with a Placido's disc and abnormal keratometer readings. In more advanced stages, signs include the obvious cone-shaped cornea and indentation of the lower lid by the cornea. By slit lamp biomicroscopy, vertical lines are noted in the deep layers of the stroma: the corneal nerve fibers are increasingly visible; and in about 50% of cases a yellow or green line is present around the base of the corn (Fleischer's ring). In advanced cases Bowman's membrane and Descemet's membrane rupture. Microscopically there is thinning of the tissue spaces between the corneal lamellae, fragmentation of the basement membrane of the comeal epithelium, fibrillation of Bowman's membrane, and folds or ruptures in Descemet's membrane. Acute hydrops may occur when Descemet's membrane ruptures. This is characterized by sudden cloudiness of vision due to imbibition of aqueous in the corneal stroma. However, as Descemet's membrane regenerates, the edema subsides. Permanent scarring may result if Bowman's membrane ruptures. Acute hydrops of the cornea was developed respectively in left eye on Oct, 1976 and in right eye on Dec, 1976 in a 13 year old Korean girl with Keratoconus O.U.
Adolescent ; Astigmatism ; Basement Membrane ; Bowman Membrane ; Cicatrix ; Cornea* ; Corneal Stroma ; Descemet Membrane ; Diagnosis ; Edema* ; Epithelium ; Female ; Humans ; Keratoconus* ; Nerve Fibers ; Puberty ; Reading ; Reflex ; Rupture ; Zea mays

Total 1950 cases of general, spinal and epidural anesthesia for cesarean section were performed in Department of Anesthesiology, Yonsei University, Wonju College of Medicine from June 1982 to May 1987. The followings are results of the observations on 1950 cases. 1) The incidence of cesarean section was 21.76 percent of total deliveries and the tendency is increasing. 2) Types of anesthesia are General anesthesia(1004 cases), Spinal anesthesia(557 cases), Epidural anesthesia(389 cases). 3) One minute Apgar score in spinal, epidural anesthesia are better than in general anesthesia. 4) Perinatal mortality of total deliveries is 1.007%. 5) Painless delivery: 50 cases. 6) Postoperative pain control: Spinal anesthesia: 48 cases. Epidural catheter: 335 cases(Ketamine:50 cases)
Anesthesia ; Anesthesia, Epidural ; Anesthesia, General ; Anesthesia, Obstetrical* ; Anesthesia, Spinal ; Anesthesiology ; Apgar Score ; Catheters ; Cesarean Section ; Female ; Gangwon-do ; Incidence ; Pain, Postoperative ; Perinatal Mortality ; Pregnancy

PURPOSE: This study was done to develop and test validity and reliability of on instrument for predicting nursing intention for SARS patient care. METHOD: The psychometric properties of a SARS patient care attrition prediction tool, based on the Theory of Planned Behavior, were examined in this study. The Three-phase design involved a) salient beliefs generated from clinical nurses (n=43) b) content validation by expert panel evaluations(n=5) c) face validation by plot testing (n=10) d) and instrument validation in a cross sectional survey (n=299). Psychometric analysis of survey data provided empirical evidence of the construct validity and reliability of the instrument. RESULT: Principal component analysis verified the hypothesized 6-factor solution, explaining 68.2% of variance, and Alpha coefficients of .7538 to .9389 indicated a high internal consistency of the instrument. CONCLUSION: The instrument can be used by nurse administrators and researcher to assess clinical nurses' salient beliefs about caring for SARS patients, guide tailored intervention strategies to effective caring, and evaluate the effectiveness of interventions.
Severe Acute Respiratory Syndrome/*nursing ; Reproducibility of Results ; *Questionnaires ; Nursing Methodology Research ; Nursing Care ; Nurses/*psychology ; Humans ; Female ; Attitude of Health Personnel ; Adult

In order to investigate the efficacy and safety of oral fosinopril, a new phosphorus containing angiotensin converting enzyme inhibitor, a single dose of 10 to 20mg was administered in 23 hypertensive patients with diastotic blood pressure above 95mmHg and all other anti-hypertensive agents were not administered during 4 weeks of study. Blood pressure and heart rate were measured on the 2nd and 4th week of therapy. The complete blood count with platelet count, blood chemistry by SMA-12 and serum electrolytes were performed at the begining and 4th week of therapy. The urinalysis and electrocardiography were performed at the beginning and 4th week of therapy. Any kinds of side effects were actively questioned by the examining physicians. The following results were obtained : 1) At the beginning and 4th weeks of therapy, the average systolic and diastolic pressure were 170.0+/-17.6/101.6+/-6.1mmHg, 142.7+/-15.1/87.3+/-6.7mmHg respectively. The systolic and diastolic blood pressure were declined statistically significantly(p<0.05) throughout the period of treatment and diastolic blood pressure of all subjects except 3 patients(86%) was maintained below 90mmHg after 4th week of treatment. 2) There was no significant change in the pulse rate before and after therapy. 3) There were no significant changes in blood chemistry, serum electrolytes, hematologic findings, urinalysis and electrocardiographic findigns. 4) side effect were developed in 5 patients(23%) with dry cough, 3 patients(13%) with headache and 2 patients with facial edema but side effects were mostly mild in nature without potenitally serious episodes. These results suggested that antihypertensive therapy with onec-daily fosinopril was effective and well tolerated in essential hypertensive patients.
Antihypertensive Agents ; Blood Cell Count ; Blood Pressure ; Chemistry ; Cough ; Edema ; Electrocardiography ; Electrolytes ; Fosinopril* ; Headache ; Heart Rate ; Humans ; Hypertension ; Peptidyl-Dipeptidase A ; Phosphorus ; Platelet Count ; Urinalysis

Primary squamous cell carcinoma of the thyroid gland (PSCCT) is a rare malignancy that presents with advanced disease and poor prognosis. It is difficult to diagnose PSCCT in its early stage because of its rarity and lack of typical imaging findings. We experienced an elderly woman with PSCCT confirmed by surgery. Although preoperative fine-needle aspiration revealed no malignancy, surgical resection was performed because the ultrasonogram showed diffuse microcalcifications, which suggested malignancy, and clinically, the mass grew rapidly to compress the trachea. Local tumor recurrence was noted at 3 months after surgery. Surgical resection or repeat biopsy should be considered if a cytologically benign thyroid mass shows imaging or clinical features of malignancy.
Aged ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Squamous Cell* ; Female ; Humans ; Neoplasm Recurrence, Local ; Prognosis ; Recurrence* ; Thyroid Gland* ; Trachea ; Ultrasonography

OBJECTIVE: Recently some behavioral features and affective traits are considered important for the phenotype of obsessive-compulsive disorder (OCD). The purpose of this study was to assess some specific behavioral, temperamental, emotional features of OCD patients and to investigate if there is any change in patterns of temperament-character after 4-month pharmacotherapy. METHODS: Fifty-six patients with OCD and 70 normal controls were enrolled in this study. Four self-report questionnaires were employed to assess temperamental characteristics and affective traits: The behavioral inhibition system and behavioral activation system scale, the Baratt impulsiveness scale, state-trait anger expression inventory, emotional intelligence inventory. Among 56 OCD patients, 21 subjects started pharmacotherapy and 4 months later, they repeated 4 self-report tests as the same above and Yale-Brown obsessive compulsive scale (Y-BOCS). And then we investigated the changes from initial results. RESULTS: Patients with OCD showed significantly greater expression of behavioral inhibition system (p<0.0001), more cognitive impulsiveness (p<0.0001), motor impulsiveness (p=0.0067) and increased level of state anger (p<0.0001), trait anger (p<0.0001) than healthy controls. Compared to the controls, the OCD patients also expressed significantly lower level of emotional intelligence for using to facilitate thinking (p<0.0001) and managing emotions (p<0.0001). After 4-month pharmacotherapy for 21 OCD patients, Y-BOCS scores significantly decreased while self-report tests showed no meaningful differences from baseline assessments. CONCLUSION: Our results suggest that patients with OCD may have some differences in behavioral and affective tendencies including behavioral inhibition, impulsiveness, anger experiences, and emotional patterns. And short term pharmacotherapy during 4 months improved the severity of obsessive-compulsive symptoms but didn't influence these traits. These results provide some perspectives about possible vulnerability or trait markers of OCD. Further research is needed to examine the effects of long term treatment and other investigation might be helpful to assess the relationships between these behavioral and affective aspects and clinical phenotypes of OCD.
Anger ; Emotional Intelligence ; Humans ; Obsessive-Compulsive Disorder ; Phenotype ; Surveys and Questionnaires ; Temperament ; Thinking

OBJECTIVE: To analyze the clinical characteristics of total laparoscopic hysterectomy. METHODS: Clinical data about 600 cases who received TLH were collected and the hospital stay, operation time and complication were evaluated. RESULTS: The most common indications for TLH were uterine myomas, adenomyosis, severe endometriosis and cervical intraepithelial neoplasia. Mean operating time was 90 minutes (range 35-200 min) and hospital stay was 3 days (range 2 days-10 days). The most important factors for the surgery time were uterine size, assistant's skill and presence of adhesions (obliteration of the cul-de-sac due to severe pelvic endometriosis). Several techniques were used, including bipolar coagulation of the ovarian and uterine vessels, and suture of the stump. A special uterine manipulator (RUMITM uterine manipulator with colpotomizer and pneumooccluder balloon) used in all procedures aided in anatomic definition and performing the circumferential colpotomy. We had two cases of ureteral obliteration by using bipolar coagulator, and 3 cases of bladder injuries during operation which was diagnosed and immediately repaired laparoscopically. We had two cases of ureterovaginal fistula, two cases of postoperative ileus and one case of bowel perforation. But there were no cases of death, thrombophlebitis or other pulmonary complications. CONCLUSIONS: Total laparoscopic hysterectomy can be performed safely and effectively when the surgical team is sufficiently trained. And we believe that total laparoscopic hysterectomy offers benefits to the patients in the form of less post-operative pain, shorter time in hospital.
Adenomyosis ; Cervical Intraepithelial Neoplasia ; Colpotomy ; Endometriosis ; Female ; Fistula ; Humans ; Hysterectomy* ; Ileus ; Leiomyoma ; Length of Stay ; Sutures ; Thrombophlebitis ; Ureter ; Urinary Bladder

No abstract available.
Humans ; Stress, Psychological* ; Suicide*

PURPOSE: As the incidence of primary hyperparathyroidism is on the increase, a 26-year experience of primary hyperparathyroidism is described along with a review of the literature. METHODS: A total of 113 patients underwent surgery at Seoul National University Hospital from 1981 to 2006. Age, sex, presenting symptoms, biochemical analyses, imagefindings, operative findings, histopathology, and information on follow-ups were retrospectively investigated. Furthermore, patients were divided into two period groups and comparative analysis was performed. RESULTS: Among the 113 patients, 41 patients (36.3%) were male and 72 patients (73.7%) were female. The mean age of the patients was 51 years. Thirty-two patients (28.3%) were incidentally discovered and among the symptomatic patients, the presence of a urinary stone was the most frequent presentation. The average serum calcium level and PTH level were 12.4 mg/dl and 452.36 pg/ml, respectively. The calcium level of all patients was normalized the day after surgery, and the PTH level of all patients was reduced remarkably after surgery. Preoperative imaging studies included ultrasonography, computer tomography (CT), and scans such as a (99m)Tc-sestamibi scan and a ²⁰¹Tl-⁹⁹Tc subtraction scan. The sensitivities of CT, the (99m)Tc-sestamibi scan and ²⁰¹Tl-⁹⁹Tc subtraction scan were 80.2%, 68.8% and 75.4%, respectively. Unilateral neck exploration was performed in 97 cases (85.8%), and bilateral neck exploration was carried out in the remaining 16 cases (14.2%). Histopathology revealed 102 cases (90.3%) of adenoma, 3 cases (2.7%) of hyperplasia, 7 cases (6.2%) of carcinoma, and one case that was indeterminate between adenoma and hyperplasia. Fifty-six patients (49.6%) developed transient hypocalcemia, and onepatient required a second surgery due to postoperative bleeding. There was one case of a recurrent carcinoma during a mean follow-up period of 18.7 months. CONCLUSION: Primary hyperparathyroidism is on the increase and is a surgically curative disease. Understanding the nature of the disease is necessary for detection and management.
Adenoma ; Calcium ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Hyperparathyroidism, Primary* ; Hyperplasia ; Hypocalcemia ; Incidence ; Male ; Neck ; Parathyroidectomy ; Retrospective Studies ; Seoul* ; Ultrasonography ; Urinary Calculi