We performed erotic stimulation that in 63 patients with erectile dysfunction in order to investigate erectile responses to visual sexual stimulation in patients with psychogenic and organic impotence and to elucidate valuable parameters for differential diagnosis between psychogenic and organic impotence. After the test using polygraph system and erotic film, subjective sexual drive in each patient was evaluated as grade I (poor), grade II (moderate), grade III (good). Following parameters were statistically analyzed : degree of maximal rigidity, degree of maximal tumescence, T -up phase (time taking place from the beginning of the erection to maximal level). The T-max phase (time taking place for the plateau phase of maximal erection). The results obtained were summarized as follows. Regardless of sexual drive of each patient, psychogenic impotence group showed better maximal rigidity and shorter T-up phase of rigidity than organic impotence group (p<0.05}. Of patients with psychogenic impotence, good sexual drive group showed better maximal rigidity and maximal tumescence than poor sexual drive group (p<0.06). Psychogenic impotence group showing good sexual drive revealed much better maximal rigidity and shorter T-up phase of rigidity than organic impotence group with same degree of sexual drive (p<0.05). These results indicate erotic stimulation test is highly valuable method for differential diagnosis between psychogenic and organic impotence, especially when the patient shows sexual drive in moderate or good degree. And it is suggested that maximal rigidigity and T-up phase of erection parameters in erotic stimulation test provide high validity for the differention.
Diagnosis, Differential ; Erectile Dysfunction* ; Humans ; Male

Ureteroscopic removal of the stone is now popular for the management of the lower ureteral stone. A clinical study was performed on our 75 patients with lower ureteral stone treated with ureteroscopy. Of the 75 stone manipulations 62 (83%) were immediately successful and the final success rate including spontaneous delivery of stone or fragment after the procedure was 87 percents (65 cases). Of 57 smaller calculi than 1 cm (radiographic largest diameter) 50 (88%) were removed successfully. Mean duration of postoperative hospitalization was 5.6 days. There were no interrelations between the success rate and anesthetic methods. Significant complications during or after procedure were not identified. We conclude that ureteroscopic removal of stones under direct vision can be done safely and be the first choice of procedure for the lower ureteral stones.
Calculi ; Clinical Study ; Hospitalization ; Humans ; Ureter* ; Ureteroscopy

Since the nose is the most prominent part in the face, the plastic surgeons are interested in the continued effort for rhinoplasty. Nasal tip projection is essential to optimal nasal for the patient's face. But, the nasal tips of Orientals are characterized by bulbous appearance due to thick and tense skin, flaring of nostril. and restriction of nasal tip projection due to underdevelopment of medial crus of alar cartilage and short columella. Most orientals want to correct their nasal tip as well as shape of nose. We present clinical cases of various nasal tip deformities which were corrected with various operative methods through either alar rim incision of open rhinoplasty incision depending upon the severity of tip deformity in order to achieve more natural tips and good nasal tip projection. And the clinical cases were categorized into causes of nasal tip deformity and methods of nasal tip augmentation. We are reporting these reporting these cases with review of literatures.
Cartilage ; Congenital Abnormalities ; Nose ; Rhinoplasty ; Skin ; Transcutaneous Electric Nerve Stimulation

BACKGROUND: Phenol is the most commonly used neurolytic agent for the management of intractable somatic pain, but side effects such as motor dysfunction and potential loss of bladder or rectal sphincter function develop following their application. This study observed functional changes of hind limb and neuropathologic changes in the sciatic nerve after phenol application, highlighting the time of nerve regeneration. METHODS: Functional changes in hind limbs were observed for 6 weeks and the distal part of the phenol-injected or dripped sciatic nerve was severed in 3 rats of each group respectively at 10 minutes, 1 hour, 24 hours, 3 days, 1 week, 2 weeks, 4 weeks and 6 weeks. The pathologic changes in the severed nerves were observed under the electron microscope. RESULTS: The phenol-injected or-dripped hind limbs showed more pronounced motor weakness and more obvious gait changes. About 2 weeks after the phenol application, gradual improvement of gait changes began, and after 6 weeks, motor weakness and gait changes were no longer perceptible. In the group with phenol injection, at 10 minutes after injection, destructive lesions were confined to unmyelinated fibers and the myelin sheath of small myelinated fibers. On the 3rd day and at 1 week, pathologic changes on axonal fibers and Schwann cells were in progress with phagocytosis in spite of myelin restitution. From 2 to 4 weeks, axonal regeneration and remyelination appeared concurrent with myelin disintegration and axonolysis, and histologic findings at 6 weeks were similar to those of the control group. In the group with phenol drip, the histologic changes in the sciatic nerve were very similar to the injection group. CONCLUSIONS: These results suggest that histopathologic lesions after a phenol application on the peripheral nerves are not influenced by application methods. The progress of histopathologic changes is obvious according to the time interval following the phenol application. Accordingly, side effectsthat developed following the use of phenol may be improved around the time when the nerve regeneration occurs, between the second and fourth weeks after the injection. The course of histopathologic changes and clinical findings following the application of phenol is very similar to the previous experiment using alcohol.
Animals ; Axons ; Extremities ; Gait ; Myelin Sheath ; Nerve Regeneration ; Nociceptive Pain ; Peripheral Nerves ; Phagocytosis ; Phenol* ; Rats ; Regeneration ; Schwann Cells ; Sciatic Nerve* ; Urinary Bladder

An in vitro pharmacologic study was conducted to investigate the effect of phentolamine on norepinephrine induced contraction of human corpus cavernosum. The isometric muscle tension of corpus cavernosum from 4 potent volunteers were recorded after stimulation with various concentrations of norepinephrine and phentolamine. The results are summarized as follows. Contractile response of corpus cavernosum was observed to begin in the concentration of 10(-6) M and to reach maximal level in the concentration of 10(-4)M norepinephrine. Compared to it, contractile activity of corpus cavernosum to norepinephrine was observed to be gradually decreased in response to pretreatment with phentolamine from 10(-6)M to 10(-4)M. These indicate that norepinephrine causes a dose dependent contraction of corpus cavernosum and phentolamine had a relaxant effect on norepinephrine-induced contraction of corpus cavernosum in dose dependent manner.
Humans ; Muscle Tonus ; Norepinephrine* ; Phentolamine* ; Volunteers

We report two cases of cutaneous Mycobacterium(M.) marinum infections in a 43-year-old man and a 31-year-old woman who had multiple subcutaneous nodules on the left upper extremity and an erythematous ulcer on the right elbow, respectively. Skin biopsy specimens revealed chronic granulamatous inflammation and AFB positive bacilli in the dermis. The culture from tissue specimens on Lowenstein-Jensen media at 30'C for 10 days, yielded cream-colored colonies, which became yellow when exposed to light. The organism was identified as M. marinum by selected biochemical reactions. The patients were treated with surgical excision followed by administration of minocycline and administration of minocycline, respectively.
Adult ; Biopsy ; Dermis ; Elbow ; Female ; Humans ; Inflammation ; Minocycline ; Mycobacterium marinum* ; Mycobacterium* ; Skin ; Ulcer ; Upper Extremity

Light chain deposition disease (LCDD) is a systemic disorder characterized by the deposition of monoclonal immunoglobulin light chains (LCs) in various organs. As LCs are overproduced by an abnormal clone of B cells, LCDD is usually described in the course of plasma cell dyscrasias or other lymphoproliferative disorders. However, it can occur in the absence of any detectable hematological disorder even during prolonged follow-up. We experienced a case of 62-year-woman who presented generalized edema, massive proteinuria and renal insufficiency. The histologic findings showed nodular glomerular mesangial expansion and prominent ribbon like immunohistochemical staining for kappa-light chain in the glomerular capillary wall. There was no evidence of multiple myeloma in bone marrow biopsy specimen. Because she refused the intensive chemothrapy, low dose of prednisolone and cyclophosphamide were prescribed for 6 months. Her renal function was maintained relatively well without renal replacement therapy for 7 months. We report a case of idiopathic LCDD not associated with multiple myeloma or other plasma cell dysclasia.
B-Lymphocytes ; Biopsy ; Bone Marrow ; Capillaries ; Clone Cells ; Cyclophosphamide ; Edema ; Follow-Up Studies ; Immunoglobulin Light Chains ; Lymphoproliferative Disorders ; Multiple Myeloma ; Nephrotic Syndrome ; Paraproteinemias ; Plasma Cells ; Prednisolone ; Proteinuria ; Renal Insufficiency ; Renal Replacement Therapy

A renal lesion of neoplasm-related nephrotic syndrome usually presents as membranous nephropathy. Neoplasm-related nephrotic syndrome exhibiting focal segmental glomerulosclerosis (FSGS) has been reported mainly in patients with hematological malignancies. But reports of an association between FSGS and neoplasm are extremely rare. We report a 66-year-old woman with FSGS who presented with nephrotic syndrome and was subsequently found to have carcinoid tumors in the duodenum, confirmed by tissue biopsy. After resection of carcinoid tumor, the patient received initial treatment with oral prednisolone for 2 months but her nephrotic syndrome persisted. The patient was then treated with oral cyclophosphamide. One month later, she was in complete remission of nephrotic syndrome as indicated by a normal serum albumin and no proteinuria. This case may be a coincidence or the lesions may be linked with each other but since little is known about the pathogenesis of FSGS and neoplasm, it is difficult to speculate on a pathogenetic link between these two lesions. We report a case of FSGS with nephrotic syndrome in a patient with carcinoid tumor.
Aged ; Biopsy ; Carcinoid Tumor* ; Cyclophosphamide ; Duodenum ; Female ; Glomerulonephritis, Membranous ; Glomerulosclerosis, Focal Segmental* ; Hematologic Neoplasms ; Humans ; Nephrotic Syndrome ; Prednisolone ; Proteinuria ; Serum Albumin

BACKGROUND: Epithelial mesenchymal transition (EMT) has an important role in invasion and metastasis of tumor cells. The purpose of this study was to evaluate the roles of EMT-associated proteins on progression and metastasis as a prognostic/predictive factor in curatively-resected (R0) head and neck squamous cell carcinoma (HNSCC). METHODS: A total of 118 patients who received curative surgery for HNSCC at Inha University Hospital between January 1996 and December 2011 were included. We used protein immunohistochemistry to evaluate the expression of E-cadherin, vimentin, and EZH2 on tissue microarrays. Also, we reviewed all medical records and analyzed the relationship between the expression of EMT-associated proteins and prognosis. RESULTS: The E-cadherin-negative group showed more moderate/poor differentiation of cancer cell type than the higher E-cadherin-expressing group (p=.016) and high EZH2 expression was significantly correlated with nodal metastasis (p=.012). Our results demonstrate a significant association between high expression of EZH2 and vimentin and presence of distant progression (p=.026). However, expression of E-cadherin, vimentin, and EZH2 was not significantly associated with overall survival. CONCLUSIONS: These findings suggest that an EMT-associated protein expression profile is correlated with aggressiveness of disease and prognosis, and could be a useful marker for determination of additional treatment in curatively-resected HNSCC patients.
Cadherins ; Carcinoma, Squamous Cell* ; Epithelial-Mesenchymal Transition* ; Head* ; Humans ; Immunohistochemistry ; Medical Records ; Neck* ; Neoplasm Metastasis ; Prognosis ; Vimentin

BACKGOUND: Cobalt chloride (COCL) has hypoxia-mimetic effects by inhibiting degradation of HIF-1alpha, which is a master regulator of genes activated by low oxygen tension. Heme oxygenase-1 (HO-1), an inducible heat shock protein, is known to have cytoprotective effects against ischemic injury. This study evaluated the efficacy of COCL in a bilateral renal ischemia-reperfusion (I-R) injury model of male Sprague-Dawley rats. METHODS: I-R renal injury was induced by 45 min clamping of both renal arteries. Rats in the sham (n=6) and I-R control groups (n=8) had been drinking tap water, whereas rats in the COCL treated sham (n=6) and COCL treated I-R groups (n=9) had been drinking water containing 2 mM COCL from day -10 to day 1. RESULTS: The serum level of creatinine 24 hrs after surgery was 2.6+/-1.1 (mean+/-SD) mg/dL in I-R COCL treated group, significantly lower than that in I-R control group (4.8+/-1.6 mg/dL, p<0.05). The renal HO-1 gene expression and protein signal were significantly upregulated in the COCL treated sham group compared to sham operated control rats (all, p<0.05). The expressions of TGF-beta MCP-1, TNF-alpha endothelin-1 and Fas genes in COCL treated I-R rats were significantly lower than those of I-R control rats (all, p<0.05). The level of Bcl-2 gene expression of COCL treated I-R rats was significantly higher than the level of I-R control rats (p<0.05). CONCLUSION: It is speculated that the pretreatment of COCL in I-R rat model attenuates ischemic renal injury and at least in part, upregulation of renal HO-1 is involved in this mechanism.
Animals ; Cobalt* ; Constriction ; Creatinine ; Drinking ; Drinking Water ; Endothelin-1 ; Gene Expression ; Genes, bcl-2 ; Heat-Shock Proteins ; Heme Oxygenase-1 ; Humans ; Kidney ; Male ; Models, Animal ; Oxygen ; Rats ; Rats, Sprague-Dawley ; Renal Artery ; Transforming Growth Factor beta ; Tumor Necrosis Factor-alpha ; Up-Regulation ; Water