No abstract available.
Echocardiography* ; Heart*

No abstract available.

PURPOSE: We designed this study to evaluate efficacy of sphincter repair and factors influencing in patients with postobstetric fecal incontinence. METHODS: Twenty-one patients (mean age 42 years; range 23~67) undergoing sphincter repair for postobstetric fecal incontinence (mean duration 12 years; range 6 months~46 years) were evaluated prospectively. Preoperatively, standardized interviews, anorectal manometry and measurement of pudendal nerve terminal motor latency (PNTML) were performed. Incontinence was graded according to the Parks' classification: Grade 1 - continence to stool and flatus; Grade 2 - incontinent to flatus, some urgency to stool present but no incontinence; Grade 3 - incontinent to liquid stool; Grade 4 - incontinent to formed stool. Sphincter repair methods were overlap repair of external anal sphincter (EAS) in 4 patients, overlap repair of EAS with anterior levatorplasty in 15 patients, and overlap repair of EAS with anterior levatorplasty and postanal repair in 2 patients. Anorectal manometry at 3 months, and interviews at 3 months and 6 months after sphincter repair were performed again. Patients' satisfaction was classified as excellent, good, fair, and no improvement. RESULTS: Difficulty in first delivery was noticed in 18 patients and history of previous sphincter repair was noticed in 5 patients. Preoperatively, most patients showed high grade incontinence (grade 3 in 13 and grade 4 in 8 patients). After sphincter repair, 18 patients (85.7%) became grade 1 or 2, and 16 patients (76.2%) replied their functional satisfaction excellent or good. There were no difference between the results at 3 months and 6 months. Poor functional outcome was in 2 of 3 patients with bilaterally prolonged preoperative PNTML. Short duration of incontinence and young age at the time of repair favored good results. Previous sphincter repair did not influence the outcome. Postoperatively both anal pressure and high pressure zone length were significantly increased in patients with improved continence Postoperative complications were wound infection in 2 patients and necrosis at the apex of the advancement skin flap in 1 case but these did not influence the outcome. CONCLUSIONS: Most postobstetric fecal incontinence can be successfully treated with sphincter repair. Excellent results are expected when the duration of incontinence is short and the patients are young. Pudendal neuropathy seemed to be related to poor outcome.
Anal Canal ; Classification ; Fecal Incontinence* ; Flatulence ; Humans ; Manometry ; Necrosis ; Postoperative Complications ; Prospective Studies ; Pudendal Nerve ; Pudendal Neuralgia ; Skin ; Wound Infection

BACKGROUND: Seborrheic dermatitis is a very common chronic inflammatory disease. The causal factor of the disease is still unknown, but early investigators focused on the role of Malassezia yeasts. These yeasts are also normal skin commensals, thus their importance as pathogens in this disorder came to be doubted. However, it was subsequently found that treatment of seborrheic dermatitis with an antifungal agent not only resulted in clinical improvement but also reduced the number of Malassezia yeasts on the skin. OBJECT: The purpose of this study is to confirm relationship between seborrheric dermatits and Malassezia yeast, and to evaluate the therapeutic efficacy of oral itraconazole in the seborrheic dermatitis. METHODS: Using the scrub-wash technique in the glabella and swabbing technique in the scalp, the number of cultured Malassezia yeasts were counted in 30 patients with seborrheic dermatitis and 20 control persons. The patients took itraconazole, 100mg/day, during 4weeks. The clinical and mycologic score were measured at the initial evaluation, followed after 2weeks and 4weeks RESULT: The number of Malassezia yeasts in patient with seborrheic dermatits were significantly higher than in normal control group. There was statistically significant decrease in the clinical and mycological score after a 4 week trial of oral itraconazole in the seborrheic dermatitis group. CONCLUSION: This study indicates that Malassezia yeast may be one of the important causative factor of seborrheic dermatitis and itraconazole plays an important role in the treatment of seborrheic dermatitis
Dermatitis, Seborrheic* ; Humans ; Itraconazole* ; Malassezia ; Research Personnel ; Scalp ; Skin ; Yeasts

BACKGROUND: An increase in oxidative stress has been suggested to play major roles in the complications of diabetes. The bulk of the experimental data favors enhanced free radicals in diabetes and antioxidant defense mechanisms may be reduced in diabetes. Melatonin, the major secretory product of the pineal gland has been shown to be a potent and specific hydroxyl radical scavenger. The purpose of our study was to determine the antioxidative effeet of melatonin in streptozotocin-induced diabetic rats. METHODS: Sprague-Dawley rats weighing 200-240 g were divided into 3 groups: normal controls(n-7), diabetic contmls(n-9), melatonin-treated diabetic animals(n-9). Diabetes was induced by intraperitoneal injection of streptozotoein(55 mg/kg body weight) and melatonin(6 mg/kg body weight) was orally administered for 20 days. At day 20 after streptozotocin administration, blood was collected for the assay of glucose, albumin and cholesterol. Erythrocyte membrane lipid peroxidation was determined by malonyldialdehyde(MDA) reactivity. RESULTS: 1) The MDA resctivity of erytbrocyte membrane in melatonin-treated diabetic animals (meanstandard deviation: 5.52+-1.52nmol/ml packed cells) were lower(p<0.05) than that in diabetic controls(7.68+-1.16nmol/mL packed cells). But, there was no significant difference between melatonin-treated diabetic animals and normal contls(4.93+-1.19 nmol/mL packed cells). 2) There were no significant differences of blood glucose and body weight between diabetic controls and melatonin-treated diabetic animals. CONCLUSION: These results show the antioxidative effect of melatonin in streptozotocin-induced diabetic rats. Further clinical and long-term experimental studies are needed to assess the effect of melatonin on development and progression of diabetic complications.
Animals ; Blood Glucose ; Body Weight ; Cholesterol ; Defense Mechanisms ; Diabetes Complications ; Erythrocyte Membrane ; Free Radicals ; Glucose ; Hydroxyl Radical ; Injections, Intraperitoneal ; Lipid Peroxidation ; Melatonin* ; Membranes ; Oxidative Stress ; Pineal Gland ; Rats* ; Rats, Sprague-Dawley ; Streptozocin

BACKGROUND AND OBJECTIVES: Cochlear implantation is regarded as a safe and effective treatment for patients with profound sensorineural hearing loss. However, a few patients, especially with inner ear anomalies, suffer from complications with variable degrees after operation. This study reports various complications encountered in patients with inner ear anomalies undergoing cochlear implantation in 3rd referreral center. SUBJECTS AND METHOD: We retrospectively analyzed 342 patients who had cochlear implantation between April 1999 and December 2005. There were 70 patients with various inner ear anomalies. Immediate and delayed complications were defined according to their onset which happened within or over 1 week. Minor and Major complications were defined according to their severity which needed further operation or management. RESULTS: Among 342 patients, there were 35 cases (10.2%) with various postoperative complications. In patients with inner ear anomalies, the total number of complications was 20 cases (28.6%). There were 4 cases (5.7%) of major complications including facial nerve palsy, recurrent meningitis, device failure, and cerebrospinal fluid leakage. Reimplantation was performed in 3 cases (4.3%). CONCLUSION: Although the rate of postoperative complications in patients with inner ear anomalies was higher than in patients with normal inner ear, most of them were minor and could be managed with conservative treatments. The tolerable rate of major complications suggests that cochlear implantation is a safe operation even for patients with inner ear anomalies.
Cerebrospinal Fluid ; Cochlear Implantation* ; Cochlear Implants* ; Ear, Inner* ; Equipment Failure ; Facial Nerve ; Hearing Loss, Sensorineural ; Humans ; Meningitis ; Paralysis ; Postoperative Complications* ; Replantation ; Retrospective Studies

No abstract available.
Biopsy* ; Cytoplasm* ; Follow-Up Studies* ; Glomerulonephritis* ; Kidney Transplantation*

Saponin has been known to be a major antioxidant component in panax ginseng. Recent experimental study suggests that some antioxidant materials prevent Parkinson's disease caused by 1-methyl-4-phenyl-1,2,3,6- tetrahydropyridine (MPTP) in an animal model. The present study was performed to demonstrate the effect of ginseng saponins in the Parkinson's disease model induced by MPTP. To verify the effect of ginseng saponin on dopaminergic neurons in the mice brain, the tyrosine hydroxylase-immunoreactive (TH-ir) neurons were observed by immunohistochemical stain and immunoelectron microscopy (preembedding method). Also, in order to estimate the immunoreactivity of dopaminergic neuropils, they were quantified by image analysis. The number of TH-ir neurons of substantia nigra was significantly increased in the high-dose (0.46 mg/kg) ginseng saponin group compared with the MPTP injected group. The immunoreactivity of TH-ir neuropils in striatum was significantly increased in both high and low-dose (0.1 mg/kg) ginseng saponin groups compared with the MPTP injected group. In immunoelectron microscopic observation, TH-ir neurons of the control and both ginseng saponin injected group showed normal nuclei and well preserved cytoplasmic organelles. In the MPTP injected group, dying dopaminergic neurons showed destroyed nuclei and cytoplasmic organelles. These results suggest that ginseng saponin has a protective effect on the Parkinson's disease model induced by MPTP.
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine ; Animals ; Brain ; Cytoplasm ; Dopaminergic Neurons* ; Mice* ; Microscopy, Immunoelectron ; Models, Animal ; Neurons ; Neuropil ; Organelles ; Panax* ; Parkinson Disease* ; Saponins* ; Substantia Nigra ; Tyrosine ; Tyrosine 3-Monooxygenase

BACKGROUND AND OBJECTIVES: It has been known that the motility of the outer hair cell controls the physiological characteristics of the organ of Corti. Motility can be divided into two different types: fast and slow motility. Slow motility can be induced by high concentration of KCl and increase of intracellular Ca2+ concentration. In this study, authors aimed to define the effect of acetylcholine, one of the efferent neurotransmitters, on the slow motility of the outer hair cells of guinea pig. MATERIALS AND METHOD: Outer hair cells were isolated from guinea pigs by enzymatic and mechanical dissociation. The length of the hair cells was recorded by CCD camera equipped on an inverted microscope. Slow motility was induced by 10 (micro)M of ionomycin and 150 mM of KCl. Carbamylcholine (1 mM), a non-hydrolyzable derivative of acetylcholine, was used to observe the effect of acetylcholine and choline chloride (1 mM) was used as control. RESULTS: The length of outer hair cell was decreased after adding 150 mM of KCl and increased after adding 10 (micro)M of ionomycin. Stimulation of carbamylcholine (1 mM) did not induce the length change of the outer hair cells. Preincubation of 1 mM of carbamylcholine also did not affect the length change induced by ionomycin or KCl in outer hair cells. CONCLUSION: We could suggest that carbamylcholine does not have an effect on the slow motility of outer hair cell induced by the change of osmotic pressure which was elicited by high potassium, or intracellular Ca2+ increase.
Acetylcholine ; Animals ; Calcium* ; Carbachol ; Choline ; Guinea Pigs ; Hair* ; Ionomycin ; Neurons, Efferent ; Neurotransmitter Agents ; Organ of Corti ; Osmotic Pressure ; Potassium Chloride ; Potassium*

Pacemaker Runaway is a rare, but potentially lethal complication after pacemaker implantation. Pacemaker runaway was one of the common manifestations of malfunctioning pacemaker at the time of fixed rate pacemaker, but has been less common after the demand type pacemaker had replaced the fixed rate model. The early recognition of runaway pacemaker is very important because runaway pacemaker can cause bradyarrhythmia, ventricular tachycardia-fibrillation and asystole resulting in syncope or death. We report a clinical experience of runaway pacemaker in 68 year-old woman, who received permanent pacemaker implantation(fixed rate 72/min, VVI, Micropulse 22U, Edwards system) due to sick sinus syndrome eight years ago. She complained of sudden chest tightness and dyspnea 10 days prior to admission. On physical examination, increased jugular venous pressure, rapid heart beats, basal rales on both lung fields and three finger-breath tender hepatomegaly. Electrocardiogram showed a rapid pacemaker rhythm of 140 beats per minute. So, the malfunctioning pacemaker was removed and replaced with a new programmable demand type pacemaker(VVI, OPTIMA-MP, Telectronics) in the same pocket under the diagnosis of pacemaker runaway. Her subject symptoms were relieved and electrocardiogram showed a regular pacemaker rhythm of 71 BPM. She was discharged ten days after pacemaker replacement.
Aged ; Bradycardia ; Child ; Diagnosis ; Dyspnea ; Electrocardiography ; Female ; Heart ; Heart Arrest ; Hepatomegaly ; Homeless Youth* ; Humans ; Lung ; Physical Examination ; Respiratory Sounds ; Sick Sinus Syndrome ; Syncope ; Thorax ; Venous Pressure