PURPOSE: The aim of this study was to evaluate the long-term results of endoscopic primary realignment of a posterior urethral rupture accompanied by a pelvic bone fracture. MATERIALS AND METHODS: Our study population consists of 7 patients who were able to be followed up for at least 5 years, of an initial 8 that underwent endoscopic primary realignment of a posterior urethral rupture due to a pelvic bone fracture. Operations were carried out in the following order; the bladder was incised to allow a metal sound, with stitching fiber then tied at its end so it could be advanced into the injured proximal urethra through the bladder neck. The fiber was then traced using a cystoscope and connected to a urethral catheter, which could be indwelled in the bladder by pulling the sound back. RESULTS: The mean follow-up period was 8.1 (5.2-9.7) years. The mean operation time was 48.3 (28-71) minutes. There were no severe disruptions of the pelvic hematoma, transfusions or other additive injuries during the operations. Post-operation complications were observed in 4 patients; 3 cases of mild urethral stricture, which were treated with an endoscopic intra-urethrotomy followed by clean intermittent catheterization, 3 cases of erectile dysfunction and 1 case each of urinary incontinence and a urethral stone. CONCLUSIONS: This study clearly implies that endoscopic primary realignment of a severe posterior urethral rupture accompanied by a pelvic bone fracture is less invasive and a safer method, without pelvic hemorrhage or additional injuries. Early endoscopic intervention also improves the quality of life by reducing the possibility of an invasive procedure, and also prevents severe urethral stricture and the resultant complications by maintaining the continuity of the urethra.
Cystoscopes ; Cystostomy* ; Erectile Dysfunction ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Humans ; Intermittent Urethral Catheterization ; Male ; Neck ; Pelvic Bones* ; Quality of Life ; Rupture* ; Urethra ; Urethral Stricture ; Urinary Bladder ; Urinary Catheters ; Urinary Incontinence

PURPOSE: To assess the accuracy of estimating postoperative deviation in large-angle exotropia over 40 prism diopters (PD). METHODS: A retrospective analysis was performed on 61 exotropia patients with over 40 PD exotropia who had undergone 2-muscle surgery by two surgeons and with at least 6 months follow-up. The accuracy was assessed by analyzing the discrepancy between preoperatively predicted residual deviation and deviation at postoperative 6weeks. Successful surgery was defined as deviation within +/- 10 PD at the last postoperative visit. RESULTS: More accurate residual deviation was predicted in exotropia with prism diopters between 40 and 59 (97.8%) than in exotropia with 60 PD or more (62.5%). And there was no significant difference between two surgeons. Surgical success rates at six months and one year after surgery were 96.8%, 94.7% in exotropia with 40 to 49 PD, 71.4%, 60.0%, 50 to 59 PD, 50.0%, 45.5%, 60 PD or more, respectively. There were four patients of whom the postoperative deviation angle exceeded more than 10 PD of the estimated deviation. CONCLUSIONS: The accuracy of estimating residual deviation prior to surgery was higher and more successful surgery was achieved in exotropia ranging in 40 to 59 PD than in exotropia with 60 PD or more. Therefore, 2- muscle surgery will be suitable for large-angle exotropia with less than 60 PD.
Exotropia ; Follow-Up Studies ; Humans ; Muscles ; Retrospective Studies

OBJECTS: The prevalence of asthma has increased in recent decades globally. The objective of the present study is to elucidate whether hospitalization for bronchiolitis in infancy and low socioeconomic status interact for bronchial hyperreactivity during teenage years. METHOD: We studied 522 children age 13-14 years attending schools in rural and urban areas to investigate the risk factors for bronchial hyperreactivity (BHR), defined as a provocation concentration of methacholine that causes a decrease of 20% (PC20) in forced expiratory volume within 1 second. Clinical examination, skin prick test, spirometry, and methacholine challenge were performed on all study subjects, who provided written consent. We used multivariate logistic regression to investigate the risk factors for BHR, and analyze the interaction between hospitalization for bronchiolitis in infancy and low socioeconomic status. RESULTS: Forty-six (10.3%) positive BHR cases were identified. In the multivariate logistic analysis, as independent predictors of BHR, adjusted odds ratio of bronchiolitis diagnosed before 2 years of age in low income families was 13.7 (95% confidence interval, 1.4 to 135.0), compared to reference group, controlling for age, gender, parental allergy history, skin prick test, and environmental tobacco smoke (ETS) exposure. Interaction was observed between bronchiolitis before 2 years old and low socioeconomic status on children's bronchial hyperreactivity (p-interaction=0.025). CONCLUSIONS: This study showed that bronchiolitis diagnosed before 2 years of age and low socioeconomic status interacted on children's bronchial hyperreactivity. Prevention of acute respiratory infection in early childhood in low socioeconomic status is important to prevent BHR as a precursor of asthma.
Asthma ; Bronchial Hyperreactivity ; Bronchiolitis ; Child ; Control Groups ; Forced Expiratory Volume ; Hospitalization ; Humans ; Hypersensitivity ; Logistic Models ; Methacholine Chloride ; Odds Ratio ; Parents ; Prevalence ; Risk Factors ; Skin ; Smoke ; Social Class ; Spirometry ; Tobacco

Natriuretic peptides comprise a family of three structurally related peptides; atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and C-type natriuretic peptide (CNP). The present study was performed to investigate the effect of ANP on the proliferation and activity of ROS17/2.8 and HOS cells which are well-characterized osteoblastic cell lines. ANP dose-dependently decreased the number of ROS17/2.8 and HOS cells after 48-hour treatment. ANP generally increased the alkaline phosphatase activity of ROS17/2.8 and HOS cells after 48 hr treatment, regardless of the fact that basal activity of alkaline phosphatase was much lower in HOS cells compared to that of ROS17/1.8 cells. ANP increased the NBT reduction by ROS17/2.8 and HOS cells. ANP showed the variable but no significant effect on the nitric oxide production by ROS17/2.8 and HOS cells. ROS17/2.8 and HOS cells produced and secreted gelatinase into culture medium, and this enzyme was thought to be the gelatinase A type with the molecular weight determination. The gelatinase activity produced by ROS17/2.8 cells was increased by the treatment of ANP. However, the enzyme activity was not affected by ANP treatment in the HOS cell culture. In summary, ANP decreased the proliferation and increased the alkaline phosphatase activity and NBT reduction of osteoblasts. These results indicate that ANP is one of the important regulators of bone metabolism.
Alkaline Phosphatase ; Atrial Natriuretic Factor ; Cell Culture Techniques ; Cell Line ; Gelatinases ; Humans ; Matrix Metalloproteinase 2 ; Metabolism ; Molecular Weight ; Natriuretic Peptide, Brain ; Natriuretic Peptide, C-Type ; Natriuretic Peptides ; Nitric Oxide ; Osteoblasts* ; Peptides