Many symptoms of age related bladder dysfunction may be associated with urethral dysfunction. We compared the contractile responsiveness of urethral strips from young adults (6-9 months) and old (24-27 months) male Fisher 344 rats. Circularly and longitudinally oriented urethral strips from proximal (bladder neck) and distal urethra were obtained and suspended in organ baths containing Tyrodes buffer. Contractile responses to field stimulation (FS), phenylephrine, bethanechol and KC1 were recorded. Results were as followed: 1. Contractile responses of proximal urethral strips from old rats to FS, bethanechol, phenylephrine, KCI were greater than those of young rats. In young rats, general order of responsiveness was FS >KC1 = phenylephrine >bethanechol. In old rats, it became FS >bethanechol >KCI = phenylephrine. 2. Magnitude of the contractile responses for distal urethral strips were significantly lower than for proximal urethra and there were no significant differences of the responses between two age group. 3. For the circularly oriented strips, responses of old rats to FS, bethanechol, phenylephrine and KC1 also were greater than those of young rats. In young rats, general order of responsiveness was FS>KCl =phenylephrine =bethanechol. In old rats, it became FS>bethanechol >KC1 >phenylephrine. 4. For the longitudinally oriented strips, responsiveness to FS and bethanechol was similar between younger and old rats. However, responses to phenylephrine were greater for young rats than for old ones. For both young and old rats, general order of contractile responsiveness was FS>phenylephrine=KCl>bethanechol, In old rats contractile responses of proximal, circular urethral strips to various stimulation were greater than those in young ones. 5. Degree of field stimulated relaxant responses of the urethra precontracted by phenylephrine were similar between two age groups at higher frequencies(16-64 Hz.): whereas higher degrees of relaxation were observed in young rats at lower frequencies(1-8 Hz.). Circularly oriented urethral strips showed better relaxation with FS than did longitudinal ones. Relaxant responses were only partially (50%) blocked by preincubation of L-NAME. These results suggest that as male became older, their urethra responds to various stimulation with obstructive pattern than did the younger ones and also, lesser degree of urethral relaxation may causes obstructive voiding due to poor Opening of bladder outlet. Also it can be said that the ratio of the receptor density of cholinergic and adrenergic nerves varies as one become old.
Aging* ; Animals ; Baths ; Bethanechol ; Humans ; Male* ; NG-Nitroarginine Methyl Ester ; Phenylephrine ; Rats* ; Relaxation ; Urethra ; Urinary Bladder ; Young Adult

Many symptoms of age related bladder dysfunction may be associated with urethral dysfunction. We compared the contractile responsiveness of urethral strips from young adults (6-9 months) and old (24-27 months) male Fisher 344 rats. Circularly and longitudinally oriented urethral strips from proximal (bladder neck) and distal urethra were obtained and suspended in organ baths containing Tyrodes buffer. Contractile responses to field stimulation (FS), phenylephrine, bethanechol and KC1 were recorded. Results were as followed: 1. Contractile responses of proximal urethral strips from old rats to FS, bethanechol, phenylephrine, KCI were greater than those of young rats. In young rats, general order of responsiveness was FS >KC1 = phenylephrine >bethanechol. In old rats, it became FS >bethanechol >KCI = phenylephrine. 2. Magnitude of the contractile responses for distal urethral strips were significantly lower than for proximal urethra and there were no significant differences of the responses between two age group. 3. For the circularly oriented strips, responses of old rats to FS, bethanechol, phenylephrine and KC1 also were greater than those of young rats. In young rats, general order of responsiveness was FS>KCl =phenylephrine =bethanechol. In old rats, it became FS>bethanechol >KC1 >phenylephrine. 4. For the longitudinally oriented strips, responsiveness to FS and bethanechol was similar between younger and old rats. However, responses to phenylephrine were greater for young rats than for old ones. For both young and old rats, general order of contractile responsiveness was FS>phenylephrine=KCl>bethanechol, In old rats contractile responses of proximal, circular urethral strips to various stimulation were greater than those in young ones. 5. Degree of field stimulated relaxant responses of the urethra precontracted by phenylephrine were similar between two age groups at higher frequencies(16-64 Hz.): whereas higher degrees of relaxation were observed in young rats at lower frequencies(1-8 Hz.). Circularly oriented urethral strips showed better relaxation with FS than did longitudinal ones. Relaxant responses were only partially (50%) blocked by preincubation of L-NAME. These results suggest that as male became older, their urethra responds to various stimulation with obstructive pattern than did the younger ones and also, lesser degree of urethral relaxation may causes obstructive voiding due to poor Opening of bladder outlet. Also it can be said that the ratio of the receptor density of cholinergic and adrenergic nerves varies as one become old.
Aging* ; Animals ; Baths ; Bethanechol ; Humans ; Male* ; NG-Nitroarginine Methyl Ester ; Phenylephrine ; Rats* ; Relaxation ; Urethra ; Urinary Bladder ; Young Adult

Random biopsy of normal-looking mucosa of the bladder at the time of T.U.R.B. in the patients with bladder cancer have been used as a routine assessment of the tumor behavior. To investigate mucosal abnormalities of normal-looking mucosa in bladder cancer. we performed random mucosal biopsies during transurethral resection of the bladder cancer. The following results were obtained. 1. In Group 1 (Solitary, Stalk, Papillary ca). no CIS lesion was found in biopsy specimens. 2. In Group 2 (Solitary. Sessile. Papillary ca) and Group 3 (Solitary. Sessile. Non-papillary ca). some positive results were obtained. On the consideration of above results and the potentiality of implantation. we can raise an issue that the bladder cancer patients with a solitary, papillary shape do not necessarily undergo the mucosal biopsy during T.U.R.B. Instead, close follow up for the patients will be recommended.
Biopsy* ; Humans ; Mucous Membrane ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Cutaneous fistula of dental origin is the most common type of cutaneous fistula that is formed on the face and neck. This lesion can be a diagnostic challenge to clinicians who are not familiar with cutaneous fistula since many patients with cutaneous fistula of dental origin do not have any complaints such as toothache. Diagnostic errors may result in multiple excisions, biopsies, and ineffective long-term antibiotic therapy. However, if the lesion could be suspected of being of dental origin, the diagnosis can be easily confirmed by radiologic examinations. We report four cases of cutaneous fistula of dental origin. All four patients had a characteristic cutaneous findings with chronically draining, fixed, erythematous papule on their nasolabial fold or submental region. Ultrasonography, fistulography or plain roentgenography were needed to confirm the diagnosis of cutaneous fistula originating from dental problems.
Biopsy ; Cutaneous Fistula* ; Diagnosis ; Diagnostic Errors ; Humans ; Nasolabial Fold ; Neck ; Radiography ; Toothache ; Ultrasonography

PURPOSE: Combined chemoradiotherapy is standard management for locally advanced non-small cell lung cancer (LA-NSCLC), but standard treatment for elderly patients with LA-NSCLC has not been confirmed yet. We evaluated the feasibility and efficacy of concurrent chemoradiotherapy (CCRT) for elderly patients with LA-NSCLC. MATERIALS AND METHODS: Among patients older than 65 years with LA-NSCLC, 36 patients, who underwent CCRT were retrospectively analyzed. Chemotherapy was administered 3-5 times with 4 weeks interval during radiotherapy. Thoracic radiotherapy was delivered to the primary mass and regional lymph nodes. Total dose of 54-59.4 Gy (median, 59.4 Gy) in daily 1.8 Gy fractions and 5 fractions per week. RESULTS: Regarding the response to treatment, complete response, partial response, and no response were shown in 16.7%, 66.7%, and 13.9%, respectively. The 1- and 2-year overall survival (OS) rates were 58.2% and 31.2%, respectively, and the median survival was 15 months. The 1- and 2-year progression-free survivals (PFS) were 41.2% and 19.5%, respectively, and the median PFS was 10 months. Regarding to the toxicity developed after CCRT, pneumonitis and esophagitis with grade 3 or higher were observed in 13.9% (5 patients) and 11.1% (4 patients), respectively. Treatment-related death was not observed. CONCLUSION: The treatment-related toxicity as esophagitis and pneumonitis were noticeably lower when was compared with the previously reported results, and the survival rate was higher than radiotherapy alone. The results indicate that CCRT is an effective in terms of survival and treatment related toxicity for elderly patients over 65 years old with LA-NSCLC.
Aged ; Carcinoma, Non-Small-Cell Lung ; Chemoradiotherapy ; Disease-Free Survival ; Esophagitis ; Humans ; Lymph Nodes ; Pneumonia ; Retrospective Studies ; Survival Rate

Among many underlying conditions associated with status epilepticus, thyroid storm is quite rare. If unrecognized, thyroid storm is highly fatal. We report 56 year-old woman with history of uncontrolled Graves' disease, who initially presented with recurrent generalized seizures and followed by altered consciousness, sweating, generalized rigidity, fever and hemiplegia due to cerebral infarct. She slowly recovered after anti-convulsant medication, and anti-thyroid treatment and supportive care. There was no in need of continuous anticonvulsant medication except scute phase.
Consciousness ; Female ; Fever ; Graves Disease ; Hemiplegia ; Humans ; Middle Aged ; Seizures ; Status Epilepticus* ; Sweat ; Sweating ; Thyroid Crisis*

The aim of this study was to examine the hypoglycemic effect of chlorella in 6 week-old type 2 diabetic Goto-Kakizaki (GK, n=30) rats and 6 week-old normal Wistar (n=30) rats. Animals were randomly assigned to 3 groups respectively, and were fed three different experimental diets containing 0%, 3% or 5% (w/w) chlorella for 8 weeks. In diabetic GK rats, the insulinogenic-indices were not significantly different among the groups. The concentrations of fasting plasma glucagon and hepatic triglyceride, and the insulin/glucagon ratios of the GK-3% chlorella and GK-5% chlorella groups were significantly lower than those of the GK-control group. The HOMA-index and the concentrations of fasting blood glucose and plasma insulin of the GK-3% chlorella and GK-5% chlorella groups were slightly lower than those of the GK-control group. In normal Wistar rats, the insulinogenic-indices were not significantly different among the normal groups, but that of the Wistar-5% chlorella group was slightly higher than the other groups. The concentrations of fasting blood glucose and plasma insulin, and the HOMA-index of the Wistar-5% chlorella group were a little higher, and the fasting plasma glucagon concentration and the insulin/glucagon ratio of the Wistar-5% chlorella group were significantly higher than those of the Wistar-control and Wistar-3% chlorella groups. In conclusion, this study shows that the glucose-stimulated insulin secretion was not affected by the intake of chlorella, which could be beneficial, however, in improving insulin sensitivity in type 2 diabetic GK and normal Wistar rats.
Animals ; Blood Glucose ; Chlorella ; Chlorella vulgaris ; Diet ; Fasting ; Glucagon ; Hypoglycemic Agents ; Insulin ; Insulin Resistance ; Plasma ; Rats ; Rats, Wistar

Aloe products are one of the top selling health-functional foods in Korea, however the adequate level of intake to achieve desirable effects are not well understood. The objective of this study was to determine the intestinal uptake and metabolism of physiologically active aloe components using in vitro intestinal absorption model. The Caco-2 cell monolayer and the everted gut sac were incubated with 5-50 micrometer of aloin, aloe-emodin, and aloesin. The basolateral appearance of test compounds and their glucuronosyl or sulfated forms were quantified using HPLC. The % absorption of aloin, aloe-emodin, and aloesin was ranged from 5.51% to 6.60%, 6.60% to 11.32%, and 7.61% to 13.64%, respectively. Up to 18.15%, 18.18%, and 38.86% of aloin, aloe-emodin, and aloesin, respectively, was absorbed as glucuronidated or sulfated form. These results suggest that a significant amount is transformed during absorption. The absorption rate of test compounds except aloesin was similar in two models; more aloesin was absorbed in the everted gut sac than in the Caco-2 monolayer. These results provide information to establish adequate intake level of aloe supplements to maintain effective plasma level.
Absorption ; Aloe ; Caco-2 Cells ; Chromatography, High Pressure Liquid ; Chromones ; Emodin ; Glucosides ; Humans ; Intestinal Absorption ; Korea ; Plasma

OBJECTIVE: Magnetic resonance imaging (MRI) grading systems using sagittal images are useful for evaluation of lumbar foraminal stenosis. We evaluated whether such a grading system is useful as a diagnostic tool for surgery. METHODS: Between July 2014 and June 2015, 99 consecutive patients underwent unilateral lumbar foraminotomy for lumbar foraminal stenosis. Surgically confirmed foraminal stenosis and the contralateral, asymptomatic neuroforamen were assessed based on a 4-point MRI grading system. Two experienced researchers independently evaluated the MR sagittal images. Interobserver agreement and intraobserver agreement were analyzed using κ statistics. RESULTS: The mean age of patients (54 women, 45 men) was 62.5 years. A total of 101 levels (202 neuroforamens) were evaluated. MRI grades for operated neuroforamens were as follows: Grade 0 in 0.99%, Grade 1 in 5.28%, Grade 2 in 14.85%, and Grade 3 in 78.88%. Interobserver agreement was moderate for operated neuroforamens (κ=0.511) and good for asymptomatic neuroforamens (κ=0.696). Intraobserver agreement by reader 1 for operated neuroforamens was good (κ=0.776) and that for asymptomatic neuroforamens was very good (κ=0.831). In terms of lumbar level, interobserver agreement for L5–S1 (κ=0.313, fair) was relatively lower than the other level (κ=0.804, very good). CONCLUSION: MRI grading system for lumbar foraminal stenosis is thought to be useful as a diagnostic tool for surgery in the lumbar spine; however, it is less reliable for symptomatic L5–S1 foraminal stenosis than for other levels. Thus, various clinical factors as well as the MRI grading system are required for surgical decision-making.
Constriction, Pathologic* ; Female ; Foraminotomy ; Humans ; Lumbar Vertebrae ; Magnetic Resonance Imaging* ; Spinal Stenosis ; Spine

BACKGROUND: Pneumonia is a common medical complication after acute stroke, and makes a considerable influence on the prognosis. It is potentially preventable or treatable if early recognized. Thus, the identification of which patients are at risk for the development of pneumonia is clinically significant. METHODS: A total of 240 patients with an acute stroke who were consecutively admitted to a Seoul National University Hospital were studied. The following prognostic factors were accounted for in the statistical analyses: age, sex, hypertension, diabetes, cardiac disease, smoking, recurrent stroke, NIHSS, modified Rankin scale (mRS), the presence of dysphagia, blood pressure, body temperature, white blood cell count, blood sugar, fibrinogen, Levin tube insertion, Foley catheter insertion, and subtype of stroke. RESULTS: Pneumonia was diagnosed in 36 (17.0%) patients during the acute stage of stroke, particularly within 2 weeks. Average admission stay of patients with pneumonia was 38.7 days, whereas it was 19.3 days for those without pneumonia. By multivariate analysis, Levin tube insertion, body temperature, recurrent stroke, and mRS were significant predictor of pneumonia development. Forty percent of patients with four or five points of mRS developed pneumonia, compared to 6% in less than four points. CONCLUSIONS: Our results show that the patients who have Levin tube, high mRS, or recurrent stroke tend to develop pneumonia after acute stroke. It is important for early detection and prevention of pneumonia in patients with high mRS.
Blood Glucose ; Blood Pressure ; Body Temperature ; Catheters ; Deglutition Disorders ; Fibrinogen ; Heart Diseases ; Humans ; Hypertension ; Leukocyte Count ; Multivariate Analysis ; Pneumonia* ; Prognosis ; Seoul ; Smoke ; Smoking ; Stroke*