OBJECTIVE: This study investigated changes of Biochemical Markers of Bone turnover in Pre-, Peri-and Postmenopausal Women METHOD: The levels of Urinary deoxypyridinoline(Dpd), serum total alkaline phosphatase(TALP), osteocalcin(OC), serum calcium(Ca++) and phosphorus(P) were determined. Bone mineral density(BMD) were also measured by dual energy X-ray absorptiometry (DEXA) RESULTS: There were negative correlation between Biochemical markers of bone turnover and BMD, Biochemical markers of bone turnover in osteoporosis group were significantly higher than normal groups. Biochemical marker of bone turnover except serum calcium increased after menopause and remains elevated in late postmenopausal and elderly women. An increased bone turnover rate to sustained serum calcium in constant level is related to a high rate of bone loss in postmenopausal women and to a decreased bone mass in elderly women. CONCLUSION: Bone turnover increased not only at the time of menopause but also in the elderly women. This subsequent abnormalities of bone resorption and formation in the elderly women suggest their potential role in osteoporosis.
Absorptiometry, Photon ; Aged ; Biomarkers* ; Bone Resorption ; Calcium ; Female ; Humans ; Menopause ; Osteoporosis

OBJECTIVE: The effects on spermatogenesis by expression of vascular endothelial growth factor (VEGF) and endothelin-1 (ET-1) were investigated. MATERIALS AND METHODS: Testicular specimens were obtained from 40 infertile males due to primary testicular failure and from 10 fertile males with other urologic problems. The specimens of infertile males were devided into 4 groups according to histologic findings; Sertoli cell only syndrome (A), maturation arrest (B), hypospermatogenesis (C) and sloughing and disorganization (D). VEGF and ET-1 expression were detected with immunohistochemical stain. RESULTS: VEGF expression on Leydig cell was detected in all cases. But, VEGF expression rates on germ cell were significantly higher in infertile group B, C, D compared to that of the control group (p<0.05). ET-1 expression rates on Leydig cell was significantly lower in all infertile group compared to that of the control group (p<0.05). But, ET-1 expression rates on Sertoli cell was significantly higher in all infertile group compared to that of the control group (p>0.05). In germ cell of infertile group, LH, FSH and prolactin were significantly decreased, and estradiol is increased in positive stain group on ET-1 immunohistochemical stain (p<0.05). VEGF and ET-1 expression were not correlated mean seminiferous tubule diameter (p>0.05). CONCLUSIONS: Abnormal spermatogenesis would be reflected in VEGF expression in germ cell.
Endothelin-1* ; Estradiol ; Germ Cells ; Humans ; Male ; Oligospermia ; Prolactin ; Seminiferous Tubules ; Sertoli Cell-Only Syndrome ; Spermatogenesis ; Testis* ; Vascular Endothelial Growth Factor A

OBJECTIVE: Rebamipide is a propionic acid derivative that has an action of the inhibition of superoxide production and removal of hydroxyl radical with the sperm incubation and cryopreservation. In the present study, to investigate whether rebamipide is useful to treat male infertility and sterility, the author observed the antioxidative effects in patient with male infertility and also examined its absorption and distribution in rat genital organ. METHODS: To measure the distribution of rebamipide in reproductive organ in the rat, carbon indicated rebamipide, 14C-OPC-12759, was orally administered to 10 Spraque-Dawley rats and its organ concentration in serum, liver, kidney, stomach, duodenum, colon, urinary bladder, seminal vesicle, epididymis and testicle were measured each time after 0.5, 1, 2, 4, 8 and 24 hours by using HPLC fluorescent method. The concentrations in semen were measured by HPLC fluorescent method in a sample of 50 infertile males who took 900 mg of rebamipide daily for 3 months. To measure the antioxidative effect and fertility rate for 3 months, each month before and after the treatment, sperm motility, vitality, the oxygen free radical formation, level of peroxidation, fetilizing capacity of semen sample which were obtained from infertile male patients by masturbation after at least 48 hours abstinence were analyzed by computer assisted semen analyzer, eosin-nigrosin stain, chemiluminescence, thiobarbituric acid method and hypo-osmotic swelling test. Simultaneously in a sample that wanted baby, both pregnancy and delivery were researched. RESULTS: The 14C-OPC-12759 concentration in the body of white rats was highest in gastrointestinal organ like stomach, smal intestine and duodenum and followed by genital organ like seminal vesicle, testis and epididymis. The rebamipide concentration in semen of infertile males was 220.77+/-327.84 ng/mL (SD) which showed a large deviation but it was higher than serum which was 126+/-76 ng/mL (SD). In the infertile males, after the treatment with rebamipide, the level of seminal reactive oxygen species (ROS) and lipid peroxidation have significantly decreased in duration of the treatment (p<0.05) and sperm vitality and fertilizing capacity except sperm motility significantly improved on post treatment of 2~3 months (p<0.05). Out of the 41 cases who hoped for pregnancy, 15 cases (36.6%) became pregnant and 12 cases had childbrith, 2 cases had miscarriage and one case is ongoing. The side effect was observed in 1 case (2%) which experienced diarrhea but it was lost spontaneously. CONCLUSIONS: We conclude from this study that rebamipide showed relatively high tendancy of absorption and excretion in the genital organ. In infertile males who had elevated ROS in semen, by specifically inhibiting the cell damage from the antioxidation, a way to preserve sperm motility, vitality and fertilizing capacity was confirmed.
Abortion, Spontaneous ; Absorption* ; Animals ; Birth Rate ; Carbon ; Chromatography, High Pressure Liquid ; Colon ; Cryopreservation ; Diarrhea ; Diethylpropion ; Duodenum ; Epididymis ; Female ; Genitalia ; Hope ; Humans ; Hydroxyl Radical ; Infertility ; Infertility, Male ; Intestines ; Kidney ; Lipid Peroxidation ; Liver ; Luminescence ; Male ; Masturbation ; Oxygen ; Pregnancy ; Rats ; Reactive Oxygen Species ; Semen ; Seminal Vesicles ; Sperm Motility ; Spermatozoa ; Stomach ; Superoxides ; Testis ; Urinary Bladder

High septal deformities exert pressure on upper lateral cartilages and nasal bones and cause external deviation of the nose. However, detection of high septal deformities causing deviated noses is very difficult if a detailed intranasal examination is not performed. As well, the high septal border is a difficult area to approach via the endonasal rhinoplasty and is the weakest portion in the septum resulting in much difficulty in correcting deformities and in frequent later recurrence of deviation secondary to the healing process. In order to solve the above problems in 33 cases of deviated nose associated with high septal deformities, the authors evaluated deformities in the high septal border after separation of the septum from upper lateral cartilages and nasal bones. The high septal border is centralized by scoring after resection of the mid or lower-septal portion. And spreader grafts were applied to the convex sides of deviated septal borders to stabilize the high septal border and to prevent long-term recurrence of deviation. Also, to balance the traction force of side walls, the length of both upper lateral cartilages and nasal bones were equalized by resection in the longer side and grafting in the shorter side. Clinical follow-up ranged from 3 to 31 months. There was no surgical or septal complication. Also, there was no incomplete correction, recurrence of deviation, or compromized nasal support. All patients except 2 were satisfied with the aesthetic and functional results. We found that separation of septum from side walls allows detection and correction of higher septal deformities and that spreader graft allows long-term support and prevents later recurrence of deviation.
Cartilage ; Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Nasal Bone ; Nose* ; Recurrence ; Rhinoplasty ; Traction ; Transplants*

Currently, phosphodiesterase type 5 (PDE5) inhibitors are the initial treatment option for erectile dysfunction. The reported efficacy of PDE5 inhibitors is about 70%, although it is significantly lower in difficult-to-treat subpopulations. Treatment failures might be due to the severity of the underlying pathophysiology, improper use of medication, unrealistic patient expectations, difficult relationship dynamics, severe performance anxiety, and other psychological problems. Physicians must address these issues to identify true treatment failures attributable to the drugs. This article discusses factors that might affect the response to PDE5 inhibitors and develops a strategy to maximize the overall efficacy of PDE5 inhibitors in initial non-responders to PDE5 inhibitors.
Carbolines ; Erectile Dysfunction ; Humans ; Imidazoles ; Male ; Performance Anxiety ; Phosphodiesterase 5 Inhibitors ; Piperazines ; Purines ; Sulfones ; Treatment Failure ; Triazines ; Sildenafil Citrate ; Tadalafil ; Vardenafil Dihydrochloride

PURPOSE: To examine the centrally elicited erectile effects of alpha-MSH, oxytocin, prostagladin E1, and anabolic steroids after intracerebroventricular administration. MATERIALS AND METHODS: We used anesthetized male Sprague-Dawley rats. After intracerebroventricular administration of normal saline (NS), alpha-melanocyte stimulating hormone (alpha-MSH), oxytocin acetate (OT), prostaglandin E1 (PGE1), methylprednisolone (MP), testosterone enanthate (TE) or 17beta-estradiol (E2) under stereotaxis, the intracavernosal pressure (ICP), systolic femoral artery pressure (FAP), heart rate (HR), time to first response, duration, and number of erectile responses and adverse reactions were evaluated for 60 minutes. To show whether erections were centrally elicited, the above criteria were re-evaluated after a bilateral pelvic neurotomy and bilateral orchiectomy. RESULTS: A cerebral proerectile effect was elicited only by alpha-MSH and OT with no significant changes of FAP or HR. With PGE1, significant changes in FAP and HR were observed. The ICP/FAP ratio was highest (0.49 0.03) with alpha-MSH. The mean time latency was shortest with OT (20.6 5.6 min). The mean duration was longest in alpha-MSH (11.6 8.7 min). The number of responses was highest with OT (3.6 0.7). Adverse reactions, such as stretching, yawning and ejaculation, were simultaneously observed during increases in ICP. In the cases of a bilateral pelvic neurotomy or bilateral orchiectomy, these elicited erectile responses disappeared. CONCLUSIONS: alpha-MSH had the most potent proerectile effect compared to OT and PGE1 as assessed by highest intracavernosal pressure as well as duration of erectile response. The results suggest that testosterone and the pelvic nerve were essential for the central proerectile response.
alpha-MSH ; Alprostadil ; Animals ; Ejaculation ; Femoral Artery ; Heart Rate ; Humans ; Male ; Methylprednisolone ; Orchiectomy ; Oxytocin ; Penile Erection ; Rats* ; Rats, Sprague-Dawley ; Steroids ; Testosterone ; Yawning

BACKGROUND: The purpose of this study was to compare prospectively two different anesthetic techniques with isoflurane or propofol for postoperative nausea, vomiting and recovery after tonsillectomy in children. METHODS: Sixty children, ASA physical status I, were assigned randomly to one of two groups. In group I, anesthesia was induced with thiopental 5 mg/kg and maintained with isoflurane 1~1.5 vol%. In group P, anesthesia was induced with fentanyl 1 mcg/kg, propofol 2 mg/kg and maintained with propofol infusion 5~10 mg/kg/hr. Both group received vecuronium 0.1 mg/kg for tracheal intubation and were ventilated with 33% O2 in N2O. The time to extubation, time to eye opening, PACU time, incidence and numbers of postoperative nausea and vomiting, and degree of sedation were recorded as well as perioperative complications. RESULTS: There were no significant difference in the duration of anesthesia and PACU time between two groups. The time to extubation and eye opening of group P were significantly shorter than group I (p<0.05). The degree of sedation and incidence of postoperative nausea and vomiting of group P were significantly lower than group I (p<0.05). But the frequency of intraoperative bradycardia was significantly higher in group P than group I (p<0.05). CONCLUSIONS: Propofol-fentanyl anesthesia results in less nausea and vomiting during postoperative period and more rapid recovery compared to isoflurane anesthesia and may be recommended in children undergoing tonsillectomy and adenoidectomy.
Adenoidectomy ; Anesthesia* ; Bradycardia ; Child* ; Fentanyl ; Humans ; Incidence ; Intubation ; Isoflurane* ; Nausea ; Postoperative Nausea and Vomiting* ; Postoperative Period ; Propofol* ; Prospective Studies ; Thiopental ; Tonsillectomy* ; Vecuronium Bromide ; Vomiting*

Disseminated intravascular coagulation (DIC) is a pathological syndrome in which activation of coagulation cascade leads to fibrin clot formation, consumption of platelets and coagulation factors, and secondary fibrinolysis. We report a case of severe postoperative hemorrhagic diathesis due to DIC. A 59-year-old man was scheduled for reduction of tibia fracture and anatrophic nephrolithotomy of staghorn calculi. On the fifth postoperative day, second operation was performed for nephrectomy due to perirenal hematoma. Two days later, third operation was performed for hemostasis because of the continuous bleeding. Coagulation tests showed positive DIC profiles of thrombocytopenia, hypofibrinogenemia, increased fibrin degradation products, and prolonged prothrombin time and thrombin time. The patient recovered uneventfully and discharged on the 59th postoperative day.
Blood Coagulation Factors ; Calculi ; Dacarbazine ; Disseminated Intravascular Coagulation* ; Fibrin ; Fibrin Fibrinogen Degradation Products ; Fibrinolysis ; Hematoma ; Hemorrhage* ; Hemorrhagic Disorders ; Hemostasis ; Humans ; Middle Aged ; Nephrectomy ; Postoperative Complications ; Prothrombin Time ; Thrombin Time ; Thrombocytopenia ; Tibia

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

Dentocutaneous fistula of the face neck is an infrequent manifestation of chronic dental infection. A periapical dental abscess may be initiated by disease, trauma, or thermal or chemical injury and develops into an extensive necrosis of surrounding tissue. Diagnostic errors can result in multiple excision, biopsies, and ineffective long-term antibiotic therapy. Awarness that periapical dental abscess is the most common etilolgic factor of cutaneous sinus tracts involves the face & neck will facilitate their early diagnosis and prevent needless treatment or anxiety for the patient. From 1994 to 1998, we have performed 6 cases of dentocutaneous fistula. Among of them, three were men and the others were women, age ranged from 18 to 66-year-old, and morbidity period was from 3 weeks to 3 years, the follow-up period ranged from 5 to 18 months (mean period 11 months). In conclusion, an understanding of the pathogenesis of cutaneous fistulae arising from dental infections will lead to proper early diagnosis and treatment without unnecessary surgery.
Abscess ; Aged ; Anxiety ; Biopsy ; Cutaneous Fistula ; Diagnostic Errors ; Early Diagnosis ; Female ; Fistula* ; Follow-Up Studies ; Humans ; Male ; Neck ; Necrosis ; Unnecessary Procedures