A clinical evaluation has been undertaken of 41 patients with urethral stricture who have been treated with visual urethrotomy in the Department of Urology, Seoul National University Hospital during 3 years periods from 1983 to 1985. The over all success rate was 54%. The results were unrelated to the sites of the lesion, the causes of the stricture and the durations of the catheter drainage. However, the results of the obliterated strictures (12.5%) are more poor than the non-obliterated strictures (64%), and patients with nonobliterated stricture less than 2cm long had the best results (22%). The overall morbidity rate was 20%, six cases of false way, one case of incontinence, one case of penile hematoma. Twenty seven cases were followed up over 6 months and its success rate showed 44.4%.
Catheters ; Constriction, Pathologic ; Drainage ; Hematoma ; Humans ; Seoul ; Urethral Stricture ; Urology

To understand the expression of hoth TGF-beta l and II ligands and the receptors, artificial fracture was made on rat femur. Fracture callus and epiphyseul plate were stained immunohistochemically on 3rd. 7th, 14th, 21st, 42nd and 56th day after trauma. Polyclonal antibody was used to stain TGF-beta I and II ligands and receptors. At epiphyseal plate, both ligand and receptor were expressed from each cell in proliferating and maturing zone. But there was no difference between type I and II except expression time. TGF-beta II ligand and receptor were expressed earlier: they were expressed mostly by the cells at the zone of proliferating cartilage but TGF-beta1 ligand and receptor were expressed mostly hy the cells at zone of maturing cartilage. At fracture site, TGF-beta expression was observed from 3rd day after trauma and it reached its maximum intensity at 2 weeks. It decreased thereafter and disappeared at 6 weeks after trauma. In enchondral ossification area, TGF-beta expressing cells were scattered throughout the enchondral mass. In intramembranous ossification area, the ligands and receptors were expressed from the osteohlasts just heneath the periosteum. ln summary, TGF-beta ligands and receptors were expressed at epiphyseal plate and fracture callus. There was no difference between TGF-beta 1 and 2 expres.ion except the appearance time at epiphyseal plate. We could not draw any conclusion about ligand and rcceptor mechanism with this immunohistochemical staining.
Animals ; Bony Callus* ; Cartilage ; Femur ; Growth Plate* ; Ligands* ; Periosteum ; Rats ; Receptors, Artificial ; Transforming Growth Factor beta ; Transforming Growth Factor beta1

PURPOSE: To verify the changes of segmental motion after posterolateral lumbar fusion. MATERIALS AND METHODS: Thirty-eight cases of lumbar posterolateral fusion with good postoperative results and full range of motion, followed up for at least one year were reviewed. We measured the translation and angulation by the Dupuis method on flexion extension radiographs. RESULTS: 1) The motion at adjacent segments was 0.75 mm translation and 6.5 degree angulation at L1-2, 0.75 mm and 8.62 degree at L2-3, 0.95 mm and 9.67 degree at L3-4, 1.17 mm and 10.67 degree at L4-5 and 0.41 mm and 7.41 degree at L5-S1. The motion at L5-S1 was less than that in the control group, but at other levels it was not different. 2) The total range of motion of lumbar spine in the control group was 47.8 degree. In one-segment fusion the range of motion was 31.1 degree(64.9%), in two-segment fusion was 26.8 degree(56.1%) and in three-segment fusion was 14.3 degree(29.8%). The longer the fusion level was, the smaller the total range of motion of lumbar spine was. 3) The percentage of motion at adjacent mobile segments in the fusion group increased more significantly than that in the control group. CONCLUSIONS: Segmental motion at adjacent segment in the fusion group was similar to the motion in the control group. The compensatory increased motion at adjacent mobile segment was not definite, however, the percentage of motion at adjacent segment increased after spinal fusion.
Range of Motion, Articular ; Spinal Fusion ; Spine

OBJECTIVES: Exposure to light at night has become pervasive in modern society. The impact of dim artificial light at night (dALAN) exposure on sleep and fatigue is not well recognized. We aim to study the impact of dALAN exposure during sleep on human fatigue. METHODS: 30 healthy young male volunteers from 21 to 29 years old were enrolled in the study. They were randomly divided into two groups depending on light intensity (Group A : 5 lux and Group B : 10 lux). Data were gathered from each participant after each night with no light (Night 1) followed by the next night (Night 2) with two different dim light conditions (5 or 10 lux) by means of self-reported fatigue scale. RESULTS: Exposure to dALAN during sleep was significantly associated with increased overall fatigue (F = 19.556, p < 0.001) and ocular discomfort (F = 5.671, p = 0.028). CONCLUSION: We found that dALAN during sleep likely affects human fatigue in some aspects. These findings indicate that dALAN during sleep exerts a negative effect on human fatigue.
Fatigue* ; Humans* ; Male ; Volunteers

A rat model of focal cerebral ischelma has been established by mhe tecbnique of elecvrocamtery for me middle oerebral artery occlusion (MCAO). We investigated mhe effect of naloxone pretreatment on the size of infarction and the regional cerebral blood flow (rCBF) Another purpose of this study was to determine the effecbve dose (high-or lowdose) in focal cerebral ischemia. The rats were given Img/Kg I.v. (low-dose), 4mg/Kg I.v. (high-dose) of naloxone 30 min before MCAO and infused continuously with 0.5mg/Kg/hr (low dose) or 2mg/Kg/hr (high-dose) over next I hour by am infusion pump. The control group was given normal salin of the same amount by the same method. Dunng the peDod of saline amd naloxone infusion, mean arterial blood pressure was monitored. Arterial blood gas analysis and blood glucose measuremert were performed just after MCAO. The rectal temperature of rat was maintained within 37)0.5C by a heating lamp. Twenty-fow hours after MCAO, eight 2mm-thick coronal sections of one rat brain were stained by TTC solution and the size of infarction was described as the percentage of ipsilateral hemisphere. The rCBFs were measured by an autoradiography using 14C-iodoantipyrine and the chamges of rCBFs were analyzed by three methods of (1) rCBF ratio, (2) 1 mm-serial rCBF measurement of cerebral cortex, and (3) areas of rCBF below critical values(<25, 25-50, <50ml/100g/min). The results were as follows; 1. There was no significamt chamge of blood pressure during the infusion of saline. Iow-dose and high-dose naloxones 2. Arterial blood gas amalysis amd blood glucose measurement showed that there were no significant differences of pH, PC02, PO2 and blood glucose between saline and low dose and high-dose naloxone groups 3. High-dose naloxone pretreatment reduced significantly the size of infarction(p<0.05 vs saline-treated group by Mann-Whitney U test). 4. High-dose naloxone pretreatment improved significantly the rCBF ratios of caudate head and CA 3 area (p<0.05 vs. saline-treated group by Mann-Whitney U test) There was no significant improvement of rCBF ratios in the low-dose naloxone treated group. 5. One-mm serial rCBF measurement of cerebral cortex indicated that while low-dose naloxone group showed no improvement of rCBF of cerebral cortex, high-dose nalox one pretreatment produced an improvement of rCBF in penumbra and its neighboring area 6. The area below 25ml/100g/min or rCBF was reduced significantly by high-dose naloxone pretreatment(high-dose naloxone group: 15.0+4.1mm2, saline group:23.3)5.3 mm2, p <0.05). In summary these results indicate that high-dose naloxone pretreatment reduced the size of infarction and improved the rCBFs in the focal cerebral ischemia of rats.
Animals ; Arterial Pressure ; Arteries ; Autoradiography ; Blood Gas Analysis ; Blood Glucose ; Blood Pressure ; Brain ; Brain Ischemia* ; Cerebral Cortex ; Head ; Heating ; Hot Temperature ; Hydrogen-Ion Concentration ; Infarction* ; Infusion Pumps ; Models, Animal ; Naloxone* ; Rats*

PURPOSE: The object of this study was to determine the clinical characteristics of Korean children with urolithiasis. METHODS: From August 1989 to August 1999, 50 patients diagnosed with urolithiasis in a radiologic study were studied retrospectively. We described age, sex distribution, family history, underlying cause, initial symptoms, location of stones, stone analysis and treatment. RESULTS: The total number of patients was 50 cases. Male to fernale ratio was 1.8 and mean age was 6.2+/-4.7 years. Symptoms were hematuria in 23(46%) patients, abdorninal pain in 10(20%), flank pain in 7(14%), fever in 8(16%), dysuria in 1(2%), and incidental in 1(2%). Stones were found in the kidney in 26(52%) patients, ureters in 21(42%), urethra in 1(2%), and kidney and ureter in 2(4%). Hydronephrosis and hydroureter was present in 14(28%) patients, hydronephrosis in 11(22%), vesicoureteral reflux in 2(4%), nonfunctioning kidney in 1(2%), ureterocele in 1(2%), and duplex kidney in 1(2%). Extensive studies, including 24hr urine chemical analysis, were done to find the cause of urolithiasis in 32 patients. Causes were hypercalciuria in 18(56.3%) patients, idiopathic in 9(28.1%), and urinary tract infection in 5(15.6%). Stones were analysed biochemically in 10 patients. Calcium oxalate stones were present in 7 patients, calcium phosphate stones in 1, and struvite stones in 2. Extracoporeal shock wave lithotripsy was performed in most(40%) of the cases, and 26% of the cases passed their stones spontaneously. CONCLUSION: Hematuria is the most common symptom of pediatric urolithiasis. Upper urinary tract is the main site of urolithiasis. The main cause of urolithiasis is hypercalciuria. The main composition of urolithiasis is calcium oxalate.
Calcium ; Calcium Oxalate ; Child* ; Dysuria ; Fever ; Flank Pain ; Hematuria ; Humans ; Hydronephrosis ; Hypercalciuria ; Kidney ; Lithotripsy ; Male ; Retrospective Studies ; Sex Distribution ; Shock ; Ureter ; Ureterocele ; Urethra ; Urinary Tract ; Urinary Tract Infections ; Urolithiasis* ; Vesico-Ureteral Reflux

The ovarian hyperstimulation syndrome (OHSS) is a rare but serious complication of ovulation induction therapy with gonadotropin. The pathogenesis of OHSS is unclear, but the proposed mechanisms are the production of vasoactive substances that increase local capillary permeability resulting in shifting of fluid from the intravascular space to the third space. The clinical manifestations varies from ascites, hypovolemia, oliguria, hemoconcentration, thromboembolism, and even death. We have experienced a case of severe OHSS with severe ascites, pleural effusion and bilateral enlarged ovaries associated with spontaneous pregnancy without any ovarian stimulation for ovulation induction.
Ascites ; Capillary Permeability ; Female ; Gonadotropins ; Hypovolemia ; Oliguria ; Ovarian Hyperstimulation Syndrome* ; Ovary ; Ovulation Induction* ; Ovulation* ; Pleural Effusion ; Pregnancy* ; Thromboembolism

PURPOSE: The aim of this study was to investigate the clinical and laboratory findings of hereditary spherocytosis comparing those of different age groups. METHODS: The clinical and laboratory findings of hereditary spherocytosis from June 1989 to August 1998 at Asan Medical Center were analyzed retrospectively according to two different age groups, Group I (9 patients diagnosed under 10 years of age) and Group II (19 patients diagnosed at or over 10 years of age). RESULTS: 1) Mean age at diagnosis was 2.4+/-1.97 and 28.2+/-18.81 years, and family history was positive in 44% and 47% in Group I and II patients respectively. 2) Splenectomy was carried out in 33% and 79% of Group I and II patients respectively, and accessory spleen was found in 100% and 20% of splenectomized patients respectively. 3) Gallstone was found in 11% and 42% of Group I and II patients respectively, and aplastic crisis developed in 0% and 10% respectively. 4) Post-splenectomy hematological parameters improved as follows: Group I; from hemoglobin at diagnosis of 8.5+/-3.59 g/dL to post-splenectomy level of 12.6+/-0.86 g/dL, hematocrit 24.5+/-10.25% to 38.1+/-4.86%, corrected reticulocyte 9.0+/-4.16% to 1.2+/-0.84%, total bilirubin 3.2+/-1.53 mg/dL to 2.2+/-1.34 mg/dL. Group II ; from hemoglobin at diagnosis of 8.9+/-2.95 g/dL to post-splenectomy level of 12.6+/-1.27 g/dL, hematocrit 24.9+/-7.85% to 37.4+/-2.89%, corrected reticulocyte 4.8+/-2.74% to 2.0+/-1.12%, total bilirubin 5.2+/-5.05 mg/dL to 1.1+/-0.49 mg/dL. CONCLUSION: There were no age related differences in hematologic findings at diagnosis and many of the patients with milder form of the disease could be detected later in adult life. The frequency of gallstone was up to 42% in patients whose diagnosis was delayed after 10 years of age, and aplastic crisis was a rare complication. Splenectomy was an effective treatment leading to normal hemoglobin concentrations in all patients. Accessory spleen was found in 33% of splenectomized patients, which emphasizes the necessity of spleen scan before splenectomy.
Adult ; Bilirubin ; Chungcheongnam-do ; Diagnosis ; Gallstones ; Hematocrit ; Humans ; Reticulocytes ; Retrospective Studies ; Spleen ; Splenectomy

Cancer stem cells (CSCs) are resistant to chemo- and radio-therapy, and can survive to regenerate new tumors. This is an important reason why various anti-cancer therapies often fail to completely control tumors, although they kill and eliminate the bulk of cancer cells. In this study, we determined whether or not adenine nucleotide translocator-2 (ANT2) suppression could also be effective in inducing cell death of breast cancer stem-like cells. A sub-population (SP; CD44+/CD24-) of breast cancer cells has been reported to have stem/progenitor cell properties. We utilized the adeno-ANT2 shRNA virus to inhibit ANT2 expression and then observed the treatment effect in a SP of breast cancer cell line. In this study, MCF7, MDA-MB-231 cells, and breast epithelial cells (MCF10A) mesenchymally-transdifferentiated through E-cadherin knockdown were used. ANT2 expression was high in both stem-like cells and non-stem-like cells of MCF7 and MDA-MB-231 cells, and was induced and up-regulated by mesenchymal transdifferentiation in MCF10A cells (MCF10AEMT). Knockdown of ANT2 by adeno-shRNA virus efficiently induced apoptotic cell death in the stem-like cells of MCF7 and MDA-MB-231 cells, and MCF10AEMT. Stem-like cells of MCF7 and MDA-MB-231, and MCF10AEMT cells exhibited increased drug (doxorubicin) resistance, and expressed a multi-drug resistant related molecule, ABCG2, at a high level. Adeno-ANT2 shRNA virus markedly sensitized the stem-like cells of MCF7 and MDA-MB-231, and the MCF10AEMT cells to doxorubicin, which was accompanied by down-regulation of ABCG2. Our results suggest that ANT2 suppression by adeno-shRNA virus is an effective strategy to induce cell death and increase the chemosensitivity of stem-like cells in breast cancer.
ATP-Binding Cassette Transporters/*genetics/metabolism ; Adenine Nucleotide Translocator 2/antagonists & inhibitors/genetics ; Adenoviridae/*genetics ; Antineoplastic Agents/pharmacology ; Apoptosis/drug effects/genetics ; Breast Neoplasms ; Cadherins/antagonists & inhibitors/genetics ; Cell Line, Tumor ; Cell Survival/drug effects/genetics ; Cell Transdifferentiation/drug effects ; Doxorubicin/pharmacology ; Drug Resistance, Neoplasm/drug effects/*genetics ; Epithelial-Mesenchymal Transition/drug effects ; Female ; Gene Expression Regulation, Neoplastic/drug effects ; Gene Knockdown Techniques ; Humans ; Neoplasm Proteins/*genetics/metabolism ; Neoplastic Stem Cells/drug effects/*metabolism/pathology ; RNA, Small Interfering/*genetics ; Signal Transduction/drug effects

BACKGROUND/AIMS: The well-organized study to support that increased cholelithiasis and bile duct dilatation can occur after gastrectomy has not been reported. The aim of this study was to determine the incidence of cholelithiasis and the degree of common bile duct (CBD) dilatation in patients undergoing subtotal gastrectomy, compared to those undergoing endoscopic treatment for gastric cancer. METHODS: Patients who diagnosed with gastric cancer and received treatment at six academic referral centers were investigated for the incidence and time of cholelithiasis and the degree of CBD dilatation after treatment by analysis of 5-year follow-up CTs. The operation group underwent subtotal gastrectomy without vagotomy, while in the control group endoscopic treatment was administered for gastric cancer. RESULTS: A total of 802 patients were enrolled in 5-year analysis (735 patients in the operation group and 67 patients in the control group). Cholelithiasis occurred in 47 patients (6.39%) in the operation group and 3 patients (4.48%) in the control group (p=0.7909). The incidences of cholelithiasis were 4.28% in Billoth-I and 7.89% in Billoth-II (p=0.0487). The diameter of proximal CBD and distal CBD increased by 1.11 mm and 1.41 mm, respectively, in the operation group, compared to 0.4 mm and 0.38 mm, respectively, in the control group (p<0.05). Patients with increased CBD dilatation more than 5 mm showed statistically significant increases in alkaline phosphatase and gamma-glutamyltransferase. CONCLUSIONS: The incidence of cholelithiasis was not increased due to subtotal gastrectomy without vagotomy, but the incidence was higher after Billoth-II compared to Billoth-I. In addition, significant change in the CBD diameter was observed after subtotal gastrectomy.
Aged ; Alanine Transaminase/analysis ; Aspartate Aminotransferases/analysis ; Bilirubin/analysis ; Case-Control Studies ; Cholelithiasis/*diagnosis/epidemiology ; Common Bile Duct/diagnostic imaging/*physiopathology ; Endoscopy, Gastrointestinal ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Incidence ; Male ; Middle Aged ; Odds Ratio ; Stomach Neoplasms/*surgery ; Tertiary Care Centers ; Tomography, X-Ray Computed