GABA is an inhibitory neurotransmitter in central nervous system and produce sedative, antianxiety and muscle relaxing effects via GABA(A) receptor or GABA(B) receptor. Recently it is known that GABA is widely distributed throughout peripheral organs and may play a physiological role in certain organ. The vas deferens is innervated by species-difference. These study, therefore, was performed to investigate the mode and the mechanism of action of GABA on the norepinephrine-, ATP- and electric stimulation-induced contraction of vas deferens of rat. Sprague-Dawley rats were sacrificed by cervical dislocation. The smooth muscle strips were isolated from the prostatic portion and were mounted in the isolated muscle bath. PSS in the bath was aerated with 95/5%-O₂/CO₂ at 33℃. Muscle tensions were measured by isometric tension transducer and were recorded by biological recording system. 1. GABA, muscimol, a GABA(A) agonist, and baclofen, a GABA(B) agonist inhibited the electric field stimulation (EFS, 0.2Hz, 1mSec, 80V, monophasic square wave)-induced contraction with a rank order of potency of GABA greater than baclofen greater than muscimol. 2. The inhibitory effect of GABA was antagonized by delta aminovaleric acid (DAVA), a GABA(B) antagonist, but not by bicuculline, a GABA(A) intagonist. 3. The inhibitory effect of baclofen was antagonized by DAVA, but the effect of muscimol was not antagonized by bicuculline. 4. Exogenous norepinephrine (NE) and ATP contracted muscle strip concentration dependently, but the effect of acetylcholine was negligible and GABA did not affect the NE-and ATP-induced contractions. 5. GABA, baclofen and muscimol did not affect basal tone, and GABA did not affect the NE-and ATP-induced contractions. 6. EFS-induced contraction was inclucling 2 distinctable components. The first phasic component was inhibited by beta gamma-methylene ATP (mATP), a desensitizing agent of APT receptor and the second tonic component was reduced by pretreatment of reserpine (3 mg/Kg, IP). 7. GABA inhibited the EFS-induced contraction of reserpinized strips, but not the mATP-treated strips. These results suggest that in the prostatic portion of the rat vas deferens, adrenergic and purinergic neurotransmissions are exist, and GABA inhibits the release of ATP via presynaptic GABA(B) receptor on the excitatory neurons.
Acetylcholine ; Adenosine Triphosphate ; Animals ; Baclofen ; Baths ; Bicuculline ; Central Nervous System ; Dislocations ; gamma-Aminobutyric Acid ; Muscimol ; Muscle, Smooth ; Neurons ; Neurotransmitter Agents ; Norepinephrine ; Rats* ; Rats, Sprague-Dawley ; Receptors, GABA-A ; Reserpine ; Transducers ; Vas Deferens*

Syphilis was known to be generalized disease and it had been decreased until 1960's. But, it has been increased again recently. The author analysed the 22 cases of congenital syphilis which were treated at department of orthopaedic surgery at Ewha Womans University Hospital from Jan. 1979 to July 1983 and the following results were obtained. 1. There were no significant changes of the number of patient by years. 2. Common symptom and sign were hepatosplenomegaly(84%), fever(62%) and skin changes(50%), and pseudoparalysis was observed in one case. 3. Radiologic bone changes were observed in 11 cases (50%) and the following results were obtained: a. Below the two week old, there was relatively low incidence of bone change with 22%. b. There was high incidence of bone change in prematurity with 75%. c. Common features of bone changes were periosteal reaction, osteochondritis and metaphysitis (91%). Pathologic fracture was observed. in one case. 4. Although we have observed the bone changes only in 50% of cases, all the other reports has reported more than 80% and we thought that radiologic bone change would aid the diagnosis of congenital syphilis.
Clinical Study ; Diagnosis ; Female ; Fractures, Spontaneous ; Humans ; Incidence ; Osteochondritis ; Skin ; Syphilis ; Syphilis, Congenital

STUDY DESIGN: A case report. OBJECTIVES: To report a case of diagnostic, clinical and radiologic follow-up of a non-traumatic atlanto-axial rotatory subluxation. SUMMARY OF LITERATURE REVIEW: Atlanto-axial rotatory subluxation, caused by a non-traumatic inflammation or infectious diseases, has been branded as "Grisel's syndrome". However, the pathophysiology of the syndrome has not been clearly understood, and its diagnostic criteria and appropriate treatment plans are not established. MATERIALS AND METHODS: The patient suffering from antlanto-axial subluxation without any neurological symptoms was treated with halter traction and Miami J brace. RESULTS: The patient maintained a normal reduction state, and a normal cervical movement was observed after undergoing 4 weeks of non-surgical treatment. CONCLUSION: Early detection and treatment are essential and critical in avoiding catastrophic outcomes. It requires a combination of clinical assessment and appropriate radiographic imaging.
Communicable Diseases ; Follow-Up Studies ; Humans ; Inflammation ; Stress, Psychological ; Traction

OBJECTIVE: The objective of this study is to evaluate the clinical and angiographic outcomes after primary balloon angioplasty in patients with symptomatic middle cerebral artery (MCA, M1 segment) stenosis refractory to medical therapy. MATERIALS AND METHODS: Eleven patients with intracranial stenosis were treated with primary balloon angioplasty. All patients had MCA stenosis with recurrent transient ischemic attack (TIA). The indication for balloon angioplasty was patients with significant MCA stenosis: 1) age older than 18 years with recurrent or progressive TIA or infarction despite optimal medical therapy, including anti-coagulation, dual anti-platelet, and anti-lipid medication; 2) previous ischemic events or asymptomatic severe stenosis (more than 50%) with poor collateral cerebral circulation, or diminished cerebral perfusion on single photon emission computed tomography before and after administration of the intravenous dosage of acetazolamide. RESULTS: The median age of patients was 53 years (range 44-79). The technical success rate was 100%. Mean pretreatment stenosis degree was 83.63 +/- 9.53% and 29.1 +/- 15.4% before and after angioplasty, respectively. Procedural-related complications occurred in four of 11 patients (36%), but none of the patients had permanent neurological deficit. All patients were available for an average follow-up period of 19.4 +/- 5.1 months. One patient had a stroke in the territory of angioplasty at two months after angioplasty. The stroke free survival rate at 30 days and 12 months was 100% and 91%, respectively. Restenosis over 50% was observed in three of 11 patients (27%); all were asymptomatic. CONCLUSION: Intracranial angioplasty for symptomatic MCA stenosis refractory to medical therapy can be a treatment option to reduce the risk of further TIA or stroke.
Acetazolamide ; Angioplasty* ; Angioplasty, Balloon ; Atherosclerosis ; Constriction, Pathologic* ; Follow-Up Studies ; Humans ; Infarction ; Ischemic Attack, Transient ; Middle Cerebral Artery* ; Perfusion ; Stroke ; Survival Rate ; Tomography, Emission-Computed, Single-Photon

STUDY DESIGN: A retrospective study. OBJECTIVES: Using computed tomography, it is to measure pedicle size of lower cervical spine in Koreas to find ideal insertion point and angle in fixating pedicular screws. SUMMARY OF LITERATURE REVIEW: Although techniques in pedicular screw fixation and pedicle's anatomical shape in foreign populations have been well documented and studied, no anatomical study on lower cervical pedicle in Korean population has been reported. MATERIALS AND METHODS: A total of 180 patients with computed tomography taken at our institution were selected for the study. Width, total length, and length of pedicle, insertion point and angle, and safe insertion angles were measured on axial view. On sagittal view, height of pedicle, insertion point and angle, and safe insertion angles were determined. RESULTS: Mean height of study subject was 164.2cm. Mean width of pedicle was 5.5mm, mean height 7.2mm, mean total length 31.2mm, and mean length 14.8mm. Mean insertion point from 3rd to 7th cervical spines was medially 3.3mm from lateral mass and downward 4.7mm from margin of upper facet. Mean insertion angles from 3rd to 7th cervical spines were 41.6degrees axially and 6.4degrees sagittally. Calculated safe insertion angles were 8degrees on medial and lateral sides and 14degrees on superior and inferior sides. CONCLUSIONS: Using computed tomography images, ideal insertion point and angle were measured for pedicular screw insertion, but, due to individual variation, preoperative measurement of insertion point and angle on computed tomography is necessary.
Humans ; Korea ; Retrospective Studies ; Spine

An angiomyolipoma of the kidney is a benign tumor composed of tissues normally present in an organ but abnormal in quantity, arrangement or degree of maturation. Neither laboratory nor clinical findings provide enough material to diagnose angiomyolipomas so it is very difficult to make correct presurgical diagnosis. A 51 year old housewife was admitted with chief complain of right flank pain and palpable mass for a week duration After urologic and radiologic studies, a presumptive diagnosis of renal cell carcinoma was made and operation was performed. On histologic examination of the removed kidney, it turned out as a angiomyolipoma of the kidney. So we report this case with review of literatures.
Angiomyolipoma* ; Carcinoma, Renal Cell ; Diagnosis ; Flank Pain ; Humans ; Kidney ; Middle Aged

Total hip arthroplasty for ankylosed hip has a higher risk of failure due to the poor condition of the hip abductors and the altered configuration of the bone, which lead to poor positioning or fixation of the prosthesis. Fifty-one hips (42 patients) converted to total hip arthroplasty between March 1983 and March 1994 have been reviewed three to thirteen years six months after operation. The average period of follow-up was four years nine months. Twenty six of the patients were men and sixteen were women. The average age at the time of operation was 40 years old (range,19 to 70 years). Among the 51 hips, bony ankylosis were 27 hips and fibrous ankylosis were 24 hips, spontaneous ankylosis were 40 hips and surgical ankylosis were 11 hips. The duration of hip fusion was 13 years six months in the bony ankylosis and 16 years one month in the fibrous ankylosis. Preoperatively 33 cases had low back pain, ipsilateral or contralateral knee or hip pain. In asymptomatic 18 cases, conversion total hip arthroplasty was also performed for the management of functional disabilities due to severe malpositioned ankylosis. At the time of the last follow-up, 25 cases were free from pain and six patients had a mild degree pain on the hip, knee or thigh. In bony ankylosis, the postoperative average hip motion ranged from 1.1 degrees to 93.2 degrees (average arc of motion of 92.1 degrees). In fibrous ankylosis, the postoperative average hip motion ranged from 1.7 degrees to 96.6 degrees (average arc of motion of 94.9 degrees). The average Harris hip score was improved from 66 to 86.9 in bony ankylosis and from 49 to 89.5 in fibrous anklyosis. The postoperative leg length discrepancy was 1.1 cm in average. The postoperative complications included heterotropic ossification in 25 cases (49%), cup loosening in two cases (3.9%) and stem loosening in three cases (5.6%). As for the clinical results, 24 cases (89%) of bony ankylosis and 23 cases (96%) of fibrous ankylosis had satisfactory functional results at the last follow-up. In conclusion, the conversion total hip arthroplasty could provide functional improvement, pain relief and especially correction of leg length discrepancy in most cases of ankylosed hip.
Adult ; Ankylosis ; Arthroplasty, Replacement, Hip* ; Female ; Follow-Up Studies ; Hip* ; Humans ; Knee ; Leg ; Low Back Pain ; Male ; Postoperative Complications ; Prostheses and Implants ; Thigh

Purpose: This study compared the radiologic and clinical outcomes of metacarpal fractures treated with two minimally invasive surgical techniques: Kirschner wire (K-wire) fixation and headless screw fixation. Materials and Methods: This study included 52 patients (46 males and 6 females; age 18-55 years) with distal metacarpal fractures (middle and distal shaft, including the neck) who had undergone K-wire fixation or headless screw fixation. All subjects were followed up for at least six months. The radiologic assessments were performed to evaluate the angular deformity and shortenings. The total active motion (TAM), grip strength, and patients’ subjective functional assessment were measured to evaluatethe hand function. The time taken to return to work (RTW) and adverse events were analyzed. Results: Of the 52 cases, metacarpal fractures treated with headless screw fixation and K-wire fixation showed a significant difference associated with early RTW (p<0.05). There were no significant differences between the subjects treated with K-wire fixation and those with headless screw fixation in terms of the radiologic measurement, hand function examinations, complications, and adverse events (p>0.05). Conclusion After a six-month follow-up, minimally invasive K-wire fixation and headless screw fixation produced similar clinical and radiologic outcomes in subjects with metacarpal fractures. Compared to K-wire fixation, however, headless screw fixation led to earlier functional recovery and might be a better option for treating metacarpal fractures in this regard.

Purpose: This study examined the differences in pathogen survival between single and revision amputations in diabetic foot infections.Current research lacks data on the postoperative pathogen profiles, particularly in cases involving repeated surgeries, making this study essential for targeted infection management. Materials and Methods: The medical records of 168 diabetic foot ulcer patients treated at a single center, divided into single (n=113) and revision amputation groups (n=55) were analyzed retrospectively. Preoperative deep tissue samples and postoperative wound swab samples were collected to analyze the pathogens. The C-reactive protein (CRP) levels were measured as an inflammation marker. The pathogen diversity, frequency, and survival rate were compared. The ‘survival rate’ was defined as the frequency of postoperative persistence of pathogens relative to the preoperative detection frequency. Results: Revision amputation cases showed a higher diversity (p=0.0029) and persistence of pathogens, with methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa, and most other detected pathogens displaying higher survival rates. The CRP levels generally decreased postoperatively, but the variability was more pronounced in the revision group, suggesting that CRP may not consistently correlate with infection control in complex cases. Conclusion These findings revealed significant differences in the pathogen profiles between single and revision amputations, with revision cases facing more significant infection challenges because of the higher resistant pathogen persistence.

Purpose: This study examined the differences in pathogen survival between single and revision amputations in diabetic foot infections.Current research lacks data on the postoperative pathogen profiles, particularly in cases involving repeated surgeries, making this study essential for targeted infection management. Materials and Methods: The medical records of 168 diabetic foot ulcer patients treated at a single center, divided into single (n=113) and revision amputation groups (n=55) were analyzed retrospectively. Preoperative deep tissue samples and postoperative wound swab samples were collected to analyze the pathogens. The C-reactive protein (CRP) levels were measured as an inflammation marker. The pathogen diversity, frequency, and survival rate were compared. The ‘survival rate’ was defined as the frequency of postoperative persistence of pathogens relative to the preoperative detection frequency. Results: Revision amputation cases showed a higher diversity (p=0.0029) and persistence of pathogens, with methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa, and most other detected pathogens displaying higher survival rates. The CRP levels generally decreased postoperatively, but the variability was more pronounced in the revision group, suggesting that CRP may not consistently correlate with infection control in complex cases. Conclusion These findings revealed significant differences in the pathogen profiles between single and revision amputations, with revision cases facing more significant infection challenges because of the higher resistant pathogen persistence.