No abstract available.

PURPOSE: To evaluated the effectiveness of abdominal ultrasonography as the initial diagnostic method in blunt renal trauma. MATERIALS AND METHODS: This study was undertaken to compare computerized tomography with abdominal ultrasonography in radiographic staging of blunt renal trauma(Renal Injury scale grade I-V by Moor) except vascular injury. During 3-years period(May 1994 to March 1997), emergency computerized tomography was performed in 66 patients with blunt renal trauma, simultaneously 34 patients among 66 patient were scanned by abdominal ultrasonography. RESULTS: Gross hematuria were present 48% of renal trauma cases. The degree of hematuria showed not correlation with the severity of renal injury(p-value=0.213, by Chi-square test). In diagnostic agreement of abdominal ultrasonography compared to computerized tomography, the diagnostic agreement of minor renal injury(x=0.544, by k2 statistics) was higher than that of major renal injury(r=0.375, by k2 statistics). The overall diagnostic agreement of abdominal ultrasonography in detecting adjacent organ injury was 0.321 (k value). CONCLUSIONS: In ultrasonography imaging, we concluded that minor blunt rectal trauma is not necessary other radiologic evaluation, but major blunt renal trauma should be evaluated by computerized tomography for proper diagnosis of combined injury and diagnostic staging of renal trauma. Renal trauma associated Intraabdominal injury should undergo with ultrasonography-guided paracentesis. Based under result of our study, we suggest the use of abdominal ultrasonography as the initial diagnostic method in blunt renal trauma compatible for prompt diagnosis and treatment.
Diagnosis ; Emergencies ; Hematuria ; Humans ; Paracentesis ; Ultrasonography* ; Vascular System Injuries

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*

No abstract available.

PURPOSE: The aim of this work was to evaluate nuclear histone acetylation level and total histone acetyltransferase (HAT) and deacetylase (HDAC) activity in ejaculated sperm and their relevance to conventional sperm parameters. MATERIALS AND METHODS: Thirty-three normozoospermic men were included in this study. Semen samples were processed by swim-up and then immunostained by six acetylation antibodies (H3K9ac, H3K14ac, H4K5ac, H4K8ac, H4K12ac, and H4K16ac). Our preliminary study verified the expression of HAT/HDAC1 in mature human sperm. From vitrified-warmed sperm samples, total HAT/HDAC activity was measured by commercially available kits. Nuclear DNA integrity was also measured by TUNEL assay. RESULTS: The levels of six acetylation marks were not related with conventional sperm parameters including sperm DNA fragmentation index (DFI) as well as HAT/HDAC activity. However, sperm DFI was positively correlated with HAT activity (r=0.038 after adjustment, p<0.02). HAT activity showed a negative relationship with HDAC activity (r=-0.51, p<0.01). Strict morphology was negatively correlated with acetylation enzyme index (=HAT activity/HDAC activity) (r=-0.53, p<0.01). CONCLUSION: Our works demonstrated a significant relationship of acetylation-associated enzyme activity and strict morphology or sperm DFI.
Acetylation ; Adult ; DNA Fragmentation ; Epigenesis, Genetic ; Histone Acetyltransferases/*metabolism ; Histones/*metabolism ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Protein Processing, Post-Translational ; Semen Analysis ; Spermatozoa/*metabolism

BACKGROUND: The purpose of this study was to describe a pure lower motor neuron disease in adults that is isolated to the upper limbs over time and to emphasize a differential diagnosis from other motor neuron diseases or motor neuropathies. METHODS: We reviewed retrospectively five male patients who had a bilateral upper limb weakness without any sensory changes confirmed by clinical and electrophysiological examinations at least 2 years after onset. RESULTS: Initially weakness remained largely confined to the arms. It then progressed slowly during the follow-up periods ranging from about 5 to 7 years since onset. However, weakness and muscle atrophy spared the lower limbs, respiratory and bulbar musculatures. The patients did not develop any bulbar dysfunctions or pyramidal tract signs. They were still able to ambulate at the end of follow-up. CONCLUSIONS: Brachial amyotrophic diplegia presenting with severe weakness that is completely confined to the upper limbs over time, without upper motor neuron signs, might be a stable and relatively benign variant of motor neuron disease. It should be differentiated from other motor neuropathies.
Adult ; Amyotrophic Lateral Sclerosis ; Arm ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Lower Extremity ; Male ; Motor Neuron Disease ; Motor Neurons ; Muscular Atrophy ; Pyramidal Tracts ; Retrospective Studies ; Upper Extremity

Cardiovascular disease (CVD) is the major cause of mortality in type 2 diabetes mellitus. CVD is a clinical manifestation of atherosclerosis, a chronic and progressive inflammatory disease characterized by a long asymptomatic phase. Progression of atherosclerosis can lead to the occurrence of acute cardiovascular events. Atherosclerosis can be identified during the subclinical phase by several methods, including using biomarkers, pulse wave velocity, augmentation index, flow-mediated dilation, carotid ultrasound, and calcium score. The appropriate criteria for identifying asymptomatic patients with type 2 diabetes who should undergo CVD screening and therapeutic intervention remain controversial. Non-invasive methods, such as markers of subclinical atherosclerosis, may aid in risk stratification and the design of tailored therapies for patients with type 2 diabetes mellitus.
Atherosclerosis ; Biomarkers ; Calcium ; Cardiovascular Diseases ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Humans ; Mass Screening ; Pulse Wave Analysis ; Risk Assessment

No abstract available.
Meconium* ; Prospective Studies* ; Statistics as Topic*

PURPOSE: This study was designed to investigate the direct effects of ethanol and its metabolites, acetaldehyde and acetic acid, on isolated rat bladder muscle. MATERIALS AND METHODS: For measuring of isometric tension change, rat bladder muscle strips were used. Following ethanol(0.25-3%) was applied to bethanechol(0.1mM)-precontracted muscle strips, acetaldehyde(0.1 to 10mM) and acetic acid(0.1 to 10mM) were applied to resting muscle strips respectively, and were applied to bethanechol(0.1 mM)-precontracted muscle strips respectively. RESULTS: Bladder contraction of tissue strips induced by bethanechol was reduced by ethanol in a dose-dependent manner. Acetaldehyde(1 to 10mM) and acetic acid(5 to 1 0mM) increased the rssting tension(control group), and acetaldehyde(0.1 to 10mM) and acetic acid(0.1 to 10mM) applied to bethanechol-induced contraction enhanced significantly contraction compared to control group. CONCLUSIONS: The results of this study indicate that responses of the rat bladder muscle were reduced by exposure to ethanol, and however, acetaldehyde and acetic acid affect the resting tension itself and show synergistic effect to bethanechol in bladder contractility. These suggest that all of the acute ethanol intoxication did not cause to urinary retention in human with benign prostatic hyperplasia.
Acetaldehyde ; Acetic Acid ; Animals ; Bethanechol ; Ethanol* ; Humans ; Prostatic Hyperplasia ; Rats* ; Urinary Bladder* ; Urinary Retention

PURPOSE: The goal of cystometry is the reproduction of the patient's clinical status to improve diagnosis and therapy. However practitioner should know that various factors such as temperature and speed of saline infusion can change the cystometry finding. The ice water test(IWT) is known as a simple method that it discriminate between upper and lower motor neuron lesion. The aim of this study is to clarify the relationship of factors occurred during cystometry and the usefulness of IWT. Materials and Methods: On the first study(Apr 1997 to Jun 1997), cystometry was performed in 60 patients with voiding difficulty. In this study we determined cystometry finding according to alteration of temperature(1 degrees C, 37 degrees C) and speed (20ml/min, 50ml/min) of saline infusion during consecutive cystometry. On the second study(Jun 1997 to Aug 1997), IWT was performed in 68 patients with voiding difficulty. The IWT was performed after cystometry with the patient in the supine position. The bladder was completely emptied, and 100ml of sterile 1 degrees C saline was infused within 250-300ml/min. In patient with a maximal cystometry capacity below 200ml, a volume of about half the capacity was infused. The test was considered positive if a sustained bladder contraction above 20cmH2O was registered or some of the cold saline was expelled within 1 minute. RESULTS: There was no relation between speed and temperature of infused saline about maximal bladder capacity, detrusor pressure and compliance during cystometry. Positive result of IWT was found in 31 (54.4%) among 57 patients with neurologic lesion and in 29(63.0%) among 46 patients with upper motor neuron lesion. In contrast, 10(90.9%) among 11 patients with non-neurological lesion and 8(72.7%) among 11 patients with lower motor neuron lesion was negative. Specificity for discrimination of upper motor neuron lesion and lower motor neuron lesion was 72.7%. CONCLUSIONS: It is concluded that cystometry finding was no relation between speed and temperature of infused saline about maximal bladder capacity, detrusor pressure and compliance during consecutive cystometry. The IWT is a simple supplementary urodynamic test that increases the precision of the diagnosis of upper motor neuron lesion. Thus, it was close enough to be used as a available procedure for subclinical upper motor neuron lesion.
Compliance ; Diagnosis ; Discrimination (Psychology) ; Humans ; Ice* ; Motor Neurons ; Reproduction ; Sensitivity and Specificity ; Supine Position ; Urinary Bladder ; Urodynamics ; Water*