Post-micturition dribble is defined as leakage coming after voiding has been completed. Such leakage is often associated with bending or sitting down, and is seldom associated with any demonstrable abnormality. The diagnosis can be made by videourodynamic study. The patient is instructed to press the bulbar urethra manually in the perineum after micturition and evacuate the residue, and symptomatic relief is almost always obtained. We report three cases of patient with postmicturition dribble.
Diagnosis ; Humans ; Perineum ; Urethra ; Urination

PURPOSE: Beraprost Sodium (BPS) is an orally stable prostacyclin (PGI2) analogue and exerts an inhibitory effect on platelet aggregation as well as a potent vasodilatory effect. We investigated the efficacy and safety of BPS in patients with erectile dysfunction (ED). MATERIALS AND METHODS: A total of 74, consecutive patients subjected to have impotence work-ups including history taking, penile duplex ultrasonography, pharmacological erection test, and cavernous nicotinamide adenosine dinucleotide phosphatase (NADPH) diaphorase staining. Sixty-six patients continuously received BPS for more than 4weeks (range 4-32 weeks, average 8.4+/-5.8 weeks), bid or tid (a total 80-120microgram/day) for long-term control of ED. Remaining 8 patients intermittently received 40-60microgram of BPS an hour prior to intercourse to obtain immediate erection for on-demand treatment. Sexual function was compared by analysis of an International Index of Erectile Function (IIEF) and general efficacy based on patient's subjective evaluation after treatment. RESULTS: IIEFs of all patients were significantly improved after BPS treatment for ED. Erectile function with IIEF question No. 3 and 4 were improved by 1.7+/-1.3 to 3.2+/-1.8 and 1.4+/-0.9 to 2.7+/-1.6, respectively (p<0.05). General efficacy of BPS was shown as full effect in 23%, moderate effect in 31%, mild effect in 26%, and no effect in 20% of the patients. Better sexual function including IIEF and general efficacy were observed in continuous treatment group than on-demand treatment group. Better result was also found in diabetics than non-diabetics (p<0.05) while no difference was observed among psychogenic, vasculogenic, and neurogenic group. The side effect of BPS was minimal; flushing in 8%, headache in 5%, indigestion in 4%, and insomnia in 1% of total patients. CONCLUSIONS: Oral BPS is a safe and effective agent to treat ED. It remains to be investigative, to determine desirable treatment method and to elucidate long term control of ED in association with oral BPS.
Adenosine ; Administration, Oral* ; Dyspepsia ; Epoprostenol ; Erectile Dysfunction* ; Flushing ; Headache ; Humans ; Male ; Niacinamide ; Platelet Aggregation ; Sleep Initiation and Maintenance Disorders ; Sodium* ; Ultrasonography

BACKGROUND: Antituberculous therapy is set a short-term therpy used isoniazid(INH), rifampin(RFP), ethambutol(EMB), pyrazinamide(PZA) from 1970s' and treatment rate has been very improved. But drug interruption or irregular medication due to side effects and resistance of drug are serious problem to retreatment cases, specially. Ofloxasine(OFX), developed from Quinolone at 1980's is effective not only other respiratory infectious disease but also pulmonary tube rculosis. And this is useful drug instead of injection agents for retreatment patients who have side effects to other drugs, lived far distance from medical clinics. So, we will evaluate theffectiveness as four oral drags involving OFX. METHOD: A retrospective study was made through the regular follow up of smear positive cases,who treated by four drag, namely, prothionamide (PTA) cycloserine(CS), OFX, paraminosalicylic acid(PAS). RESULTS: 1) Out of 66case with positive sputum AFB smear, 42(64%)cases achieved the negative conversion. 2) Considering the negative conversion in all group, 34 case (52%) of sputum conversion occured within first 6 months, on the extent of diease was minimal, moderate, far advavanced pulmonary tuberculosis, sputum AFB smear negative response to treatment was 100%, 78% , 46% respectively. 3) The roentgenological improvement occured in 38(58%), extent of diease was minimal, moderately, far advanced pulmonary tuberculosis, Roentgenological improvement to retreatment was 75%, 64%, 46%. 4) When the duration of patients illness was less than 1 year, 1 to 3 years, 3 to 5 years and more than 5 years, sputum AFB smear negative response to retreatment was 100%, 88%, 80%, 52%. 5) On side effects, major problems are gastrointestinal troubles, mild liver function abnormality, psychotic problemes, and skin problem(urticaria, itching sensation). CONCLUSION: The duration & extents of patients illness was shorter & minimal, sputum AFB smear negative response rate was better. Radiologic response is better as shorter duration and minimal extent of diease. But, as diease is longer duration & far advanced, sputum negative conversion & Roentgenological improvement is poor and limited. The adverse reaction was mainly observed gastrointestinal troubles(indigestion, abdominal pain, nausea, vomiting, diarrhea) and are well controled by symptomatic management in most patients, as regard to tolerance to the secondary drugs.
Abdominal Pain ; Aminosalicylic Acid* ; Communicable Diseases ; Cycloserine* ; Follow-Up Studies ; Humans ; Liver ; Nausea ; Prothionamide ; Pruritus ; Retreatment* ; Retrospective Studies ; Skin ; Sputum ; Tuberculosis, Pulmonary* ; Vomiting

BACKGROUND: Antituberculous therapy is set a short-term therpy used isoniazid(INH), rifampin(RFP), ethambutol(EMB), pyrazinamide(PZA) from 1970s' and treatment rate has been very improved. But drug interruption or irregular medication due to side effects and resistance of drug are serious problem to retreatment cases, specially. Ofloxasine(OFX), developed from Quinolone at 1980's is effective not only other respiratory infectious disease but also pulmonary tube rculosis. And this is useful drug instead of injection agents for retreatment patients who have side effects to other drugs, lived far distance from medical clinics. So, we will evaluate theffectiveness as four oral drags involving OFX. METHOD: A retrospective study was made through the regular follow up of smear positive cases,who treated by four drag, namely, prothionamide (PTA) cycloserine(CS), OFX, paraminosalicylic acid(PAS). RESULTS: 1) Out of 66case with positive sputum AFB smear, 42(64%)cases achieved the negative conversion. 2) Considering the negative conversion in all group, 34 case (52%) of sputum conversion occured within first 6 months, on the extent of diease was minimal, moderate, far advavanced pulmonary tuberculosis, sputum AFB smear negative response to treatment was 100%, 78% , 46% respectively. 3) The roentgenological improvement occured in 38(58%), extent of diease was minimal, moderately, far advanced pulmonary tuberculosis, Roentgenological improvement to retreatment was 75%, 64%, 46%. 4) When the duration of patients illness was less than 1 year, 1 to 3 years, 3 to 5 years and more than 5 years, sputum AFB smear negative response to retreatment was 100%, 88%, 80%, 52%. 5) On side effects, major problems are gastrointestinal troubles, mild liver function abnormality, psychotic problemes, and skin problem(urticaria, itching sensation). CONCLUSION: The duration & extents of patients illness was shorter & minimal, sputum AFB smear negative response rate was better. Radiologic response is better as shorter duration and minimal extent of diease. But, as diease is longer duration & far advanced, sputum negative conversion & Roentgenological improvement is poor and limited. The adverse reaction was mainly observed gastrointestinal troubles(indigestion, abdominal pain, nausea, vomiting, diarrhea) and are well controled by symptomatic management in most patients, as regard to tolerance to the secondary drugs.
Abdominal Pain ; Aminosalicylic Acid* ; Communicable Diseases ; Cycloserine* ; Follow-Up Studies ; Humans ; Liver ; Nausea ; Prothionamide ; Pruritus ; Retreatment* ; Retrospective Studies ; Skin ; Sputum ; Tuberculosis, Pulmonary* ; Vomiting

PURPOSE: To measure axial displacement of different implant-abutment connection types and materials during screw tightening at the recommended torque by using a contact scanner for two-dimensional (2D) and three-dimensional (3D) analyses. MATERIALS AND METHODS: Twenty models of missing mandibular left second premolars were 3D-printed and implant fixtures were placed at the same position by using a surgical guide. External and internal fixtures were used. Three implant-abutment internal connection (INT) types and one implant-abutment external connection (EXT) type were prepared. Two of the INT types used titanium abutment and zirconia abutment; the other INT type was a customized abutment, fabricated by using a computer-controlled milling machine. The EXT type used titanium abutment. Screws were tightened at 10 N·cm, simulating hand tightening, and then at the manufacturers' recommended torque (30 N·cm) 10 min later. Abutments and adjacent teeth were subsequently scanned with a contact scanner for 2D and 3D analyses using a 3D inspection software. RESULTS: Significant differences were observed in axial displacement according to the type of implant-abutment connection (P < .001). Vertical displacement of abutments was greater than overall displacement, and significant differences in vertical and overall displacement were observed among the four connection types (P < .05). CONCLUSION: Displacement according to connection type and material should be considered in choosing an implant abutment. When adjusting a prosthesis, tightening the screw at the manufacturers' recommended torque is advisable, rather than the level of hand tightening.
Bicuspid ; Dental Implant-Abutment Design ; Dental Implants ; Hand ; In Vitro Techniques ; Prostheses and Implants ; Titanium ; Tooth ; Torque

BACKGROUND: In this study, the optimal effect-site concentration of remifentanil for blunting hemodynamic responses to endotracheal intubation during total intravenous anesthesia using propofol were evaluated. METHODS: 137 ASA class I and II patients, aged 18-60 years, were randomly allocated to one of six groups according to the effect-site concentration of remifentanil. Remifentanil was then infused at a target effect-site concentration of 0, 1, 2, 3, 4 or 6 ng/ml in groups R0, R1, R2, R3, R4 and R6, respectively. Anesthesia was induced with propofol infusion at a target effect-site concentration of 4microgram/ml endotracheal intubation was performed 5 minutes after remifentanil administration. Blood pressure (BP), heart rate (HR) and cardiac index (CI) were recorded at the baseline and then every 30 seconds until 3 minutes after intubation. RESULTS: BP and HR in groups R0, R1 and R2 increased significantly after intubation when compared with the baseline values. The CI in group R0 also increased significantly after intubation when compared with the baseline values. Incidences of hypertension and hypotension were 50% and 5% in R0, 32% and 14% in R1, 18% and 32% in R2, 10% and 48% in R3, 8% and 54% in R4, and 0% and 81% in R6. There were also 2 cases in which the mean blood pressure was less than 50 mmHg in group R6. CONCLUSIONS: We suggest that the optimal target effect-site concentrations of remifentanil for blunting hemodynamic responses to endotracheal intubation are 3 or 4 ng/ml during total intravenous anesthesia using propofol at an effect-site concentration of 4microgram/ml.
Aged ; Anesthesia ; Anesthesia, Intravenous ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Hypertension ; Hypotension ; Incidence ; Intubation ; Intubation, Intratracheal ; Piperidines ; Propofol

OBJECTIVE: To investigate whether an audible cracking sound during shoulder manipulation following distention arthrography is clinically significant in patients with adhesive capsulitis of the shoulder. METHODS: A total of 48 patients (31 women, 17 men) with primary adhesive capsulitis of the shoulder completed the study. All participants underwent C-arm-guided arthrographic distention of the glenohumeral joint with injections of a corticosteroid and normal saline. After distention, we performed flexion and abduction manipulation of the shoulder. The patients were grouped into sound and non-sound groups based on the presence or absence, respectively, of an audible cracking sound during manipulation. We assessed shoulder pain and disability based on a Numeric Rating Scale (NRS), the Shoulder Pain and Disability Index (SPADI), and passive range of motion (ROM) measurements (flexion, abduction, internal and external rotation) before the procedure and again at 3 weeks and at 6 weeks after the intervention. RESULTS: The patients were divided into two groups: 21 were included in the sound group and 27 in the non-sound group. In both groups, the results of the NRS, SPADI, and ROM assessments showed statistically significant improvements at both 3 and 6 weeks after the procedure. However, there were no significant differences between the two groups except with respect to external rotation at 6 weeks, at which time the sound group showed a significant improvement in external rotation when compared with the non-sound group (p<0.05). CONCLUSION: These findings showed that manipulation following distention arthrography was effective in decreasing pain and increasing shoulder range of motion. In addition, the presence of an audible cracking sound during manipulation, especially on external rotation, was associated with better shoulder range of motion.
Adhesives* ; Arthrography* ; Bursitis* ; Female ; Humans ; Range of Motion, Articular ; Shoulder Joint ; Shoulder Pain ; Shoulder*

No abstract available in English.
Biofeedback, Psychology* ; Female ; Humans

We have checked levels of leukotriene(LT) C4, one of the arachidonic acid(AA) metabolites, in the lumbar, cisternal and ventricular cerebrospinal fluid(CSF) of 37 patients admitted with diagnosis of aneurysmal subarachnoid hemorrhage(SAH) and in lumbar CSF of 10 patients without aneurysmal SAH as the control group. We compared the levels of LTC4 in the CSF of the patients with aneurysmal SAH with those of the control group. We observed the changes of levels of LTC4 periodically after the onset of SAH. We devided the data of patients with aneurysmal SAH into 3 groups according to sampling days(respectively 1-4, 5-11, 12-24 days after SAH) and the clinical spasm group was compared with that of the non-spasm group. We also looked for the differences in the sampling sites and the correlation between the white blood cell counts and the levels of LTC4 in the CSF. The results of this study showed that the mean level of CSF LTC4(+/- standard deviation) of the SAH group was significantly higher than that of the control group(215.59+/-94.95 vs. 98.44+/-31.72pg/ml, respectively : P<0.001). The level of the CSF LTC4 progressively increased upto 7-8 days after SAH and decreased thereafter in the spasm group. The level of the CSF LTC4 of the spasm group was significantly higher than that of the non-spasm group(239.03+/-49.94 vs. 163.06+/-64.39pg/ml, respectively : P<0.05) in the first 4 days after SAH. There was no significant difference in the level of CSF LTC4 in the ventricular, cisternal, and lumbar CSF statistically(196.25+/-61.15 vs. 222.51+/-101.50 vs. 233.40+/-100.85pg/ml, respectively : P>0.05) even though we expected the level in the cisternal CSF to be higher than the lumbar CSF. There was no correlation between the white blood cell counts and the levels of LTC4 in the CSF(correlation coefficient=0.1240). From this study it is concluded that : 1) the AA metabolism via the lipoxygenase pathway is enhanced after SAH ; 2) the LTC4 may play a role in the pathogenesis of cerebral vasospasm, especially in the early days after SAH ; 3) the extraction of CSF via the external ventricular or cisternal drainage may decrease substances such as LTC4 which was thought to be vasoconstrictor material ; and 4) the granulocyte production of the LTC4 accounts for only a small part.
Aneurysm* ; Arachidonic Acid ; Cerebrospinal Fluid* ; Diagnosis ; Drainage ; Granulocytes ; Humans ; Leukocyte Count ; Leukotriene C4* ; Lipoxygenase ; Metabolism ; Spasm ; Subarachnoid Hemorrhage* ; Vasospasm, Intracranial

Diffuse plane xanthoma is a group of plane xanthomas that appear as yellow-brown flat patches or slightly elevated plaques with a wide-spread distribution. Cutaneous xanthomas may occur either hyperlipoproteinemic or normolipoproteinemic states. Diffuse plane xanthoma with normolipoproteinemia is often associated with multiple myeloma, other reticulo-endothelial malignancies and monoclonal gammopathy of unknown significance(MGUS). We report a case of diffuse plane xanthoma associated with monoclonal gammopathy of unknown significance(MGUS) and normolipoproteinemia.
Multiple Myeloma ; Paraproteinemias* ; Xanthomatosis*