Incarceration of the gravid uterus is a rare but serious complication of pregnancy. Reported is the case of a gravid 2, para 0, abortus 1 with known uterine subserosal myoma(5.3 x5.5cm sized) 26-year-old woman presented with acute dysuria and urinary retention. The patient was 14 weeks and 3 days pregnant and presented several week history of urinary frequency and sensation of incomplete bladder emptying. Examination revealed a retroflexed uterus with cervical opening pointing toward the anterior abdominal wall. An ultrasound revealed a thin, elongated maternal bladder and a uterus incarcerated between the sacral promontary and the pubis. The incarceration was successfully reduced by tenaculum traction of the cervical posterior lip without surgical intervention and had a normal infant of appropriate weight at term.
Abdominal Wall ; Adult ; Dysuria ; Female ; Humans ; Infant ; Leiomyoma ; Lip ; Myoma* ; Pregnancy ; Sensation ; Traction ; Ultrasonography ; Urinary Bladder ; Urinary Retention ; Uterine Retroversion ; Uterus*

Primary ovarian transitional cell carcinoma is extremely rare tumor. The histologic subtype was divided from malignant Brenner tumor due to it's own histologic characteristics and chemosensitive nature. Most of recent studies revealed that transitional cell carcinoma has a good response to chemotherapy and long-term survival. Recent histopathologic reports show that transitional cell carcinoma of the bladder and of the ovary are immunophenotypically different. We experienced a case of primary ovarian transitional cell carcinoma, and report this case with a brief review of the concerned literatures.
Brenner Tumor ; Carcinoma, Transitional Cell* ; Drug Therapy ; Female ; Ovary ; Urinary Bladder

BACKGROUND: It has become generally accepted that cigarette smoking contributes to accelerated coronary and peripheral vascular disease, pulmonary fibrosis and periodontal disease. Moreover, it has been postulated that cigarette smoking causes skin-aging. Many of cutaneous manifestations of nicotine which is a major component of the particulate phase of tobacco smoke are related to its vasoconstrictive and thrombotic effects on the peripheral vascular system. How-ever, direct effect of nicotine on extracellular matrix (ECM) proteins including collagens is not well established. OBJECTIVE: To evaluate the effect of nicotine on type I collagen gene expression in cultured human skin fibroblasts. METHODS: After exposure to different doses of nicotine on cultured human skin fibroblasts, we examined the expressions of α1(I) procollagen gene and fibronectin gene by Northern blot analysis and chloramphenicol acetyltransferase (CAT) assay with CAT construct containing the 3.5 kb COL1A2 promoter. RESULTS: In Northern blot hybridization, steady-state levels of α1(I) procollagen mRNA were decreased 0.8-fold at 1 µg/mL of nicotine, 0.5-fold at 10 µg/mL and 0.2-fold at 100 µg/mL, compared to untreated control. Those of fibronectin mRNA were decreased 0.9-fold, 0.7-fold, and 0.3-fold, respectively. In CAT assay, the relative COL1A2 CAT activity was 1.0 in the untreated control, 0.7 at a concentration of 1 µg/mL of nicotine, 0.5 at 10 µg/mL, and 0.3 at 100 µg/mL. CONCLUSION: These results indicate that nicotine is a down-regulator of collagen gene expression at transcriptional level in vitro. We speculate that nicotine may contribute to the skin-aging by modulation of extracellular matrix gene expression including collagen as well as by its vasoconstrictive and thrombotic effects.
Animals ; Blotting, Northern ; Cats ; Chloramphenicol O-Acetyltransferase ; Collagen ; Collagen Type I ; Extracellular Matrix ; Fibroblasts* ; Fibronectins ; Gene Expression ; Humans* ; Nicotine* ; Periodontal Diseases ; Peripheral Vascular Diseases ; Procollagen ; Pulmonary Fibrosis ; RNA, Messenger ; Skin* ; Smoke ; Smoking ; Tobacco

BACKGROUND AND OBJECTIVE: The knowledge about the effects of the nebulized B2-agonist on serum potassium is limited. We aimed to assess the possible hypokalemia following nebulization of salbutamol. METHOD: Seven patients(mean age 60 +- 7.1years) with acute exacerbated asthma were treated with salbutamol nebulization(5mg nebulization at 1 hour interval, 3 times) without concomitant use of steroid or other bronchodilator such as theophylline. RESULTS: There was a significant increase in FEV1, from 46.41+-25.91% at baseline to 62.86+-22.38% at 3 hours after treatment. Serum potassium concentration was significantly decreased, from 3.93+-0.58mEq/L at baseline to 3.41+-0.62mEq/L and 3.46+-0.53mEq/L at 1 hour and 3 hours after third nebulization, repectively. There was a significant prolongation of the QTc interval in EKG from 454.36+-27.07msec at baseline to 479.41+-35.64msec and 505.09+-58. 69msec at 1 hour and 3 hours after third nebulization, respectively. Serum salbutamol concentration was 4.18+-3.39ng/ml at baseline, and increased to 7.69+-6.94ng/ml and 9.84+10.34ng/ ml at 1 hour and 3 hours after treatment, respectively. Magnitude of the hypokalemia and the degree of prolongation of the electrocardiographic QTc interval were significantly correlated with the level of serum salbutamol concenturation. CONCLUSION: The results suggest that cardiac complication could develop due to hypokalemia during repeated salbutamol nebulization. Caution should be done in monitoring of serum potassium concentration when using nebulized salbutamol repeatedly for the treatment of acute exacerbated bronchial asthma.
Albuterol* ; Asthma ; Electrocardiography ; Hypokalemia ; Potassium* ; Theophylline

Both Mycoplasma hominis (M. hominis) and Ureaplasma urealyticum (U. urealyticum) are important genital mycoplasmas which are found in the cervix, vagina and the urogenital tracts of females. It has been associated with various disease states including non-gonococcal urethritis, spontaneous abortion, low birth weight and chorioamnionitis. Moreover they can be transmitted up to 40% of infants born to infected mothers. The culture methods which is commonly used for the determination of above mycoplasmas requires special culture media and can take up to 7 days. Recently the polymerase chain reaction (PCR) has been successfully applied for the detection of pathogenic microorganisms. In this study, M. hominis and U. urealyticum were determined using PCR in 70 vaginal swabs and 48 urine samples. In a total of seventy vaginal swabs, thirteen (18.5%) and twenty four (34.3%) samples were positive for M. hominis and U. urealyticum, respectively. In forty eight urine samples, M. hominis and U. urealyticum were found in 3 cases (6.3%), respectively. Among vaginal swab and urine samples, one case was found to be coinfectious state. Amplified DNA bands were more frequently found in vaginal swabs than urine samples. This study shows that PCR is a relatively simple, fast and practical tool for the detection of M. hominis and U. urealyticum in a clinical materials instead of culture method.
Abortion, Spontaneous ; Cervix Uteri ; Chorioamnionitis ; Culture Media ; DNA ; Female ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Mothers ; Mycoplasma ; Mycoplasma hominis ; Polymerase Chain Reaction* ; Pregnancy ; Ureaplasma urealyticum ; Urethritis ; Vagina

PURPOSE: The purpose of this study is to investigate in vitro the effects of serotonin on the rat detrusor. In particular, this study examines what drugs inhibit the serotonin-induced detrusor contractions. MATERIALS AND METHODS: Isometric tension changes of isolated rat bladder muscle strips were recorded in an organ bath using a force transducer. Acute effects of serotonin (0.0001-0.01mM) were assessed on resting tension. Electrical field stimulation (EFS), bethanechol (0.0001-0.01mM), ATP (1-3mM) or KCl(63.5-254mM)-induced contractions using application in organ bath were compared with serotonin-induced contractions. In order to examine the action mechanism of serotonin-induced stimulation, EFS, bethanechol, ATP or KCl-induced contraction under serotonin (0.001mM) was assessed and serotonin (0.001 to 0.1mM) was cumulatively added to the organ bath following pre-incubation with propranolol, ketanserine, tropisetron, propiverine, sodium nitroprusside or doxazocin. RESULTS: There are two phases to the serotonin-induced responsean initial transient contraction and a prolonged tonic phase. Serotonin produced a reversible and dose-dependent contraction of the detrusor strips. Responses to bethanechol significantly increased with a concentration of 0.001mM serotonin (p<0.05). There was no effect on the responses to ATP, KCl, or EFS under 0.001mM serotonin. The 5-HT2 receptor is mainly responsible for serotonin-induced contractions of the detrusor (p<0.05), while the 5-HT1 receptor is partially responsible. Doxazocin and propiverine each significantly suppressed the responses to serotonin, while sodium nitroprusside and tropisetron each had no effect (p<0.05). CONCLUSIONS: Because the 5-HT2 antagonist blocked the effect of serotonin-induced bladder contractions and the stimulation of the adrenoreceptors, the 5-HT2 antagonist seems to improve lower urinary tract symptoms.
Adenosine Triphosphate ; Animals ; Baths ; Bethanechol ; Ketanserin ; Lower Urinary Tract Symptoms ; Nitroprusside ; Propranolol ; Rats ; Receptors, Serotonin, 5-HT1 ; Serotonin ; Serotonin 5-HT2 Receptor Antagonists ; Transducers ; Urinary Bladder ; Urinary Bladder, Overactive*

PURPOSE: The purpose of this study was to determinate a relationship of pelvic fracture, lower urinary tract injury and injury severity scale (ISS) in multiple organ injury patients. MATERIALS AND METHODS: We retrospectively reviewed the results collected from 54 cases with pelvic fracture associated with lower urinary tract injury during the period of 6 years. Emphasis was placed on the relationship of location of pelvic bone fracture, number of fractured rami, lower urinary tract injury and ISS. RESULTS: The most common cause of pelvic fracture was traffic accident giving the rate of 65.5% (38 cases). The highest score of ISS was 39.3 in pedestrian injury. Fracture of unilateral multiple rami was most common (29.3%). Among lower urinary tract injuries, urethral injury was most common giving the rate of 44.8% (26 cases). Among single urethral injuries, the type I injury was most common (50%). Suprapubic cystostomy was most common method (44.8%) in initial management. Complications of lower urinary tract injury were predominant in urethral injury and most common complication was urethral stricture (44.8%). Mortality rate was 5.2%. CONCLUSIONS: The risk of urethral injury is influenced by the number of broken pubic rami, but bladder injury by fractured bone site. ISS score was correlated with mortality rate.
Accidents, Traffic ; Cystostomy ; Humans ; Injury Severity Score ; Mortality ; Pelvic Bones ; Retrospective Studies ; Urethral Stricture ; Urinary Bladder ; Urinary Tract*

No abstract available.
Leukoencephalopathies*

No abstract available.
Interleukin-6* ; Lymphocytes*

PURPOSE: This study was to examine the effectiveness of exercise for bone mineral density (BMD). METHODS: Four investigators reviewed English articles from Pub Med and CINAHL, selecting randomized controlled trials on exercise programs for middle-aged and older women. Out of 25 studies identified, 14 that satisfied with the inclusion criteria were included in the meta-analysis. The quality of the studies was assessed using recognized methods and the effect size was calculated as a Hedges' g using Comprehensive Meta-analysis Version 2.0. Primary outcomes were changes in BMD at femoral neck, trochanter, and lumbar spine. Subgroup analysis included changes in BMD according to exercise style. RESULTS: Weight bearing exercise was effective (Q = 20.1, p > .05, ES = 0.32), and resistance exercise was effective in case of comparing to pre and post intervention (Q = 4.15, p = .98, ES = 0.14). At the femoral neck, 9 study groups were homogeneous and the experimental groups demonstrated a positive effect on BMD (Q = 19.5, p > .05, ES = 0.33). In contrast, marked heterogeneity (Q = 33.3, p < 0.01) was apparent in 7 study groups evaluating trochanter. CONCLUSION: These findings suggest that weight bearing is effective for BMD of the femoral neck, and is relevant to the non-pharmacological treatment of bone loss for middle-aged and older women.
Bone Density* ; Female ; Femur ; Femur Neck ; Humans ; Middle Aged ; Osteoporosis ; Population Characteristics ; Research Personnel ; Spine ; Weight-Bearing