No abstract available.
Female* ; Humans ; Urinary Incontinence*

Coronary spasm may be induced by a variety of physiologic and pharmacologic stimuli but specific receptor blockade has not been consistently shown to prevent the attacks. Most patients with variant angina respond well to treatment with calcium antagonists and nitrates. A small proportion of patients are refractory to this therapy. We report a case of the patient with a 9-year-history of variant angina who has been refractory to high doses of calcium antagonists and nitrates. The repeated addition of clonidine was consistently effective in abolishing both symptoms and objective evidence of myocardial ischemia in this particular patient.
Calcium ; Clonidine* ; Humans ; Myocardial Ischemia ; Nitrates ; Spasm

No abstract available.
Anemia* ; Child* ; Hospitalization* ; Humans

Pheochromocytomas can arise wherever chromaffin cells are found, and most of them(90%) are in one or both adrenal glands. But they may be located anywhere along the sympathetic chain and rarely in aberrant sites. One of the common extra-adrenal sites from which these tumors can arise is a collection of para-aortic and para-ganglion cells around the origin of the inferior mesenteric artery. We experienced a case of extra-adrenal pheochromocytoma located at the organ of Zukerkandl in a 21-year-old female patient with abdominal colic and paroxysmal hypertension, whose symptoms and blood pressure returned to normal after successful surgical excision of the tumor.
Adrenal Glands ; Blood Pressure ; Chromaffin Cells ; Colic* ; Female ; Humans ; Hypertension* ; Mesenteric Artery, Inferior ; Pheochromocytoma* ; Young Adult

No abstract available.
Echocardiography, Doppler, Color* ; Mitral Valve Insufficiency*

As the productive activities have vastly increased following industrialization and urbanization in the modem society, the resulting high mobility of people and goods have caused a sharp increase in the accidents in the work places as well as traffic accidents. In particular, deaths caused by injuries are generally concentrated in the economically active young peoples, producing incalculable losses to the society and nation as a whole. Advanced nations with superior medical care systems have succeeded in reducing incidents of such deaths by operating trauma centers. Especially noteworthy is the case of the United States where such specialized trauma centers have greatly contributed to reducing deaths from injuries in the non-urban areas with less access to medical facilities. At present Korea has no medical centers specializing in injuries. In large cities, the injuries are being treated tertiary medical facilities while in the provinces they are referred to small and medium-sized hospitals that constitute secondary medical facilities. Currently in Korea the Trauma patients are treated at general hospitals that consist of 726 secondary medical facilities and 40 tertiary medical centers nationwide. The secondary medical facilities which tend to take most responsibility for the treatment of trauma are generally deficient in medical staff and facilities (including operating and intensive care facilities). Despite such deficiency and limitations, no regulations exist regarding treatment or transportation of trauma patients. This article reports the outcome of a comparative analysis of the results of trauma treatments among different types of medical facilities based on objective data in the hope that such study would facilitate a comparison with the treatment systems of advanced countries and thereby contribute to a precise formulation of problems that must be addressed in this area.
Accidents, Traffic ; Hope ; Hospitals, General ; Humans ; Critical Care ; Korea ; Medical Staff ; Modems ; Social Control, Formal ; Transportation ; Trauma Centers ; United States ; Urbanization ; Workplace ; Industrial Development

AIMS OF STUDY: During reflex micturition, the urethral outlet remains open (relaxed) to promote urinary emptying. The mechanisms involved in the relaxation of urethral outlet is thought to be complex including nitric oxide (NO) pathway and beta-adrenergic activity. The aims of the study focused on these several issues related to the neural control of urethral outlet in vivo. MATERIALS & METHODS: Female rats weighing 200~300 gm were anesthetized wish urethane. Catheters were inserted into femoral artery for drug administration.4 two-way catheter (16 G angiocath) was inserted into the bladder for saline infusion and pressure monitoring. A separate cannula (PE 50) was placed into the urethra via external urethral meatus or proximal urethrat opening to record urethral pressure. The bladder was filled with saline at a rate of 0.1 ml/min to induce reflex micturition. Urethral pressure was recorded via cannula through which saline was infused at a rate of 0.05 ml/min. Isovolumetric bladder contraction and urethral pressure were recorded simultaneously. After an equilibration period of 30 minutes, baseline intravesical and urethral pressure were recorded for 10 minutes prior to drug administration. NG-nitro-L-arginine methylester (L-NAME, 10 to 15 mg/kilrogram, i.v.), L-arginine (150 mg/kilrogram, i.v.), propranolol (1 microM., 0.1 ml/250 mg, i.a.), and phenylephrine (1 0~100 microM, i.a.) were administrated. RESULTS: During isovolumetric bladder contraction, urethral pressure was decreased simultaneously, and then returned to the resting states in conjunction with end of the bladder contraction. After the administration of L-NAME, the magnitude of reflex urethral relaxation was decreased significantly (42.6 +/- 15.1% of the control, p<0.01), and this effect was reversed by addition of L-arginine. Administration of propranolol also inhibited urethral relaxation (66.4% of the control). Administration of L-NAME followed by propranolol almost completely abolished the urethral relaxation. Administration of phenylephrine increased the resting urethral tone (mean; 4 cmH2O) significantly, and the magnitude of urethral relaxation was decreased substantially. CONCLUSION: These RESULTS suggest that urethral relaxation is mediated by several neural factors. NO seems like to a potent mediator in a reflex relaxation of the urethral smooth muscle during micturition. Also, beta-adrenergic stimulation play an important role for urethral relaxation. alpha-adrenergic nerve discharge, contributed to contraction of urethral smooth muscle, shows inhibitory effect against the reflex urethral relaxation.
Animals ; Arginine ; Catheters ; Female ; Femoral Artery ; Humans ; Muscle, Smooth ; NG-Nitroarginine Methyl Ester ; Nitric Oxide* ; Nitroarginine ; Phenylephrine ; Propranolol ; Rats ; Reflex ; Relaxation* ; Urethane ; Urethra ; Urinary Bladder ; Urination

BACKGROUND: Many studies in severe acute pancreatitis have demonstrated an increase in intestinal permeability, but not in mild acute pancreatitis. The current methods to measure intestinal permeability need much time and also laborious work. Therefore, we investigate the changes of intestinal permeability in patients with mild acute pancreatis and clinical predictive factor for the intestinal permeability in patients with acute pancreatitis. METHODS: The intestinal permeability were measured in 14 normal heathy controls, 41 patients with mild acute pancreatitis (alcoholic 14, biliary 12, idiopathic 15) by measuring 24 hour urine excretion of 51Cr-EDTA (51Cr-ethylenediaminetetraacetic acid) for evaluation of the gut barrier dysfunction. We compared the intestinal permeability with clinical characteristics of patients. RESULTS: The intestinal permeability was significantly increased in patients with mild acute pancreatitis (6.01+/-4.11%, p<0.001) versus control subjects (1.86+/-0.52%). There was no significant difference in the intestinal permeability among the patients with alcoholic, biliary and idiopathic pancreatitis. The correlation was not found between intestinal permeability and clinical characteristics in patients with mild acute pancreatitis. CONCLUSIONS: The intestinal permeability is increased in patients with mild acute pancreatitis regardless of etiology of pancreatitis. The predictive factor for gut barrier dysfunction is not detected in patients with mild acute pancreatitis.
Alcoholics ; Humans ; Pancreatitis* ; Permeability*

To define if the signs of sacral cord involvement have any predictive values in the behavior of bladder and sphincter function after spinal cord injury, we analysed results of neurologic signs and urodynamic studies from 45 patients with spinal cord injuries. Patients were classified based on the anatomical level (suprasacral vs. infrasacral), and the presence or absence of sacral cord sign (SCS) (bulbocavemous reflex latency time, perineal sense, anal sphincter tone). Urodynamic findings were classified as either detrusor hyperreflexia (DH), detrusor sphincter dyssynergia (DSD), detrusor areflexia (DA) or normal. Results were as follows; 1) Of the 15 suprasacral cord lesioned patients 6 (40%) had DA, of the 30 infrasacral cord lesioned patients 9 (20%) had either DA or DH with DSD. 2) SCS was positive in 16 out of 30 infrasacral, and in 3 out of 15 suprasacral cord lesioned patients. Of the 26 SCS negative patients, suprasacral cord lesioned patients comprised 46%. 3) Of the 30 infrasacral lesioned patients, 21 had DA and 16 had positive SCS. Incidence of positive SCS in the patients with DA was 72%. 4) Incidence of negative SCS with DH or DH+DSD was 100% in suprasacral lesion. But of the 15 suprasacral lesioned patients, 6 had DA and 3 had positive SCS. 5) In all levels of the injury, positive predictive value for the DA in positive SCS was 95%. However, negative predictive value for DA or DA+DSD in negative SCS was only 62%. These results indicate that there were poor correlation between the level of the cord injury and types of urodynamic abnormalities. Also, the correlation of the SCS with anatomical level of the injury was relatively poor. Correlation of the Positive SCS with DA was very significant for both levels of the cord injury; whereas there were poor correlation of the negative SCS with DH or DH+DSD. In conclusion, the positive SCS in itself are thought to be valuable tool in predicting infrasacral lesion and/or detrusor areflexia However, the results of negative SCS may not exclude infrasacral lesion or detrusor areflexia completely. Thus, combination of the sacral cord sign and results of urodynamic evaluation will provide a more precise diagnosis and treatment plan for the patients of spinal cord lesions.
Anal Canal ; Ataxia ; Diagnosis ; Humans ; Incidence ; Neurologic Manifestations ; Reflex ; Reflex, Abnormal ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder ; Urodynamics*

No abstract available.
Coronary Artery Bypass* ; Coronary Vessels* ; Echocardiography*