Stricture of the prostatomembranous urethra following pelvic fractures presents major problems in surgical management owing to their relatively inaccessible position above the urogenital diaphragm and behind the pubis. In 1973 Waterhouse and associates described transpubic approach to posterior urethral stricture, which has been usefully modified by Blandy as partial pubectomy for urethroplasty. Blandy`s method gives the extra room which needed to effect a tension-free anastomosis between bulbar and prostatic urethra and which was easily provided by taking away an arch of bone from the inferior of the symphysis. This method leaves pelvic ring intact, so avoids (a) subsequent pelvic instability and (b) the deformity that may result if an entire segment of symphysis is taken out and the penis falls into the defect. Our experience with 8 such cases has convinced us of the superiority of partial pubectomy for urethroplasty.
Congenital Abnormalities ; Constriction, Pathologic ; Diaphragm ; Male ; Penis ; Urethra ; Urethral Stricture

OBJECTIVE: To verify the expression of leptin receptor (OB-R) in oocytes and preimplantation embryos, the involvement of mitogen activated protein kinase (MAPK or Erk1/2) in the leptin signaling, and effect of leptin on the oocyte maturation in mice. METHOD: RT-PCR analysis of OB-R was conducted in germinal vesicle (GV)-intact and MII stage oocytes, and 1, 2, 8-cell embryos and blastocysts. Germinal vesicle breakdown (GVB), polar body extrusion, monitored in the presence or absence of leptin (1 microM). Following the leptin treatment, temporal changes in MAPK activity were verified by immunoprecipitation and in vitro kinase assay in MII oocytes. RESULTS: The expression of OB-R mRNA was found in GV and MII oocyte but not in the embryos. MAPK activity of the MII oocytes was significantly increased by brief incubation in the HTF supplemented with leptin (1 microM). Priming of PD098059, a MEK inhibitor to leptin treatment attenuated the activation of MAPK by leptin in MII oocytes. Following 24 hrs of culture of the GV oocytes, leptin significant increased the GVB and 1st polar body extrusion. CONCLUSION: This result suggested that functional interaction between leptin and OB-R resulted in potentiation of MAPK (Erk1/2) activity in MII oocytes through MEK activation and that leptin might be a local regulator of meiotic maturation of the mouse oocytes.
Animals ; Blastocyst ; Embryonic Structures ; Immunoprecipitation ; Leptin* ; Mice* ; Oocytes* ; Phosphotransferases ; Polar Bodies ; Protein Kinases* ; Receptors, Leptin ; RNA, Messenger

32 year-old male patient has experienced the repeated swelling of the skin on the eyelid, both hand, foot, lower and upper extrimities and testicle spontaneously without any trauma since 17 years old. This happening has subsided with or without treatment after 2-3 days. His great grandfather had suffered from the same events but grandfather or father or even his two brothers and one sister didn't have any swellings like him. Two days after this attack, he visited emergency room, his serum complement level was decreased such as C1q 9.7mg/dl (10-20mg/dl), C3 52mg/dl (55-120mg/dl), C4 4mg/dl (20-50mg/dl) measured by single radial immunodiffusion (SRID), but two weeks after full recovery, C1q 11.2mg/dl, C3 79mg/dl, C4 5mg/dl. The level of C1 esterase inhibitor was decreased upto 8.1 mg/dl (> 11 mg/dl) measured by nephlemeter(Mitshibishi Co., Japan). Now he is just under the close observation without androgen treatment because the attack of HAE(hereditary angioedema) happens much less and less severe after adolescence.
Adolescent ; Adult ; Angioedemas, Hereditary* ; Complement C1 Inhibitor Protein ; Complement System Proteins ; Emergency Service, Hospital ; Eyelids ; Fathers ; Foot ; Hand ; Humans ; Immunodiffusion ; Male ; Siblings ; Skin ; Testis

Retina, a part of CNS, has served valuable and accessible tissue for elucidating the cellular properties of neurons and glia due to its similarity to brain. Unlike mammalian counterpart, avian retina is devoid of vessels and astrocytes. However little is known about glial reaction to neuronal injuries in this species. Therefore, this study was performed to investigate the microglial responses in the quail retina following neuronal injuries. The retinae from normal and optic nerve transected adult quails were studied immunohistochemically with anti-QH1, a marker known to be specific for microglia. In the normal retina, QH1-labeled microglial cells displayed typical feature of ramified (resting) form and were localized mainly in the inner plexiform layer. After optic nerve transection (ONT) morphology of microglial cells changed from the ramified to the amoeboid form. This feature of microglial cells maintained throughout the post operational periods until 28 days after ONT. Particularly, at 14 and 21 days after ONT amoeboid microglia displayed cell bodies with stout and bushy processes, suggesting active phagocytosis. The distribution pattern of microglia also changed in accord to ganglion cell degeneration: they gradually moved to layers of ganglion cells and optic nerve fibers where ganglion cell bodies and axons were under degeneration. This change of microglial distribution was most prominent at 14 days of ONT. The result of this study is generally consistent with that reported in mammalian counterpart and this similarity between the avascular avian retina and the vascularized mammalian counterpart suggests that processes of microglial activation, such as migration and phagocytosis, can occur in the vessel-free CNS tissue.
Adult ; Astrocytes ; Axons ; Brain ; Ganglion Cysts ; Humans ; Microglia* ; Neuroglia ; Neurons ; Optic Nerve Injuries* ; Optic Nerve* ; Phagocytosis ; Quail ; Retina ; Retinaldehyde*

Purpose: To clarify (phospho-) glycogen synthase kinase-3 (GSK3) isoform variants in the germline and soma of human testes and spermatozoa. Materials and Methods: GSK3 isoform variants in normospermatogenic and Sertoli cell-only (SCO) testicular biopsies and spermatozoa were examined. Results: In normospermatogenic testes, GSK3α and GSK3β variants 1 and 2 different in low complexity region (LCR) were expressed and their levels were decreased in SCO testes. GSK3β variant 3 was only expressed in SCO testes. GSK3β as well as GSK3α, the dominant isoforms in testes were decreased in SCO testes. In normospermatogenic testes, GSK3β were found in spermatogonia and markedly decreased in meiotic germ cells in which GSK3α was dominant. p-GSK3α/β were marginal in spermatogonia and early spermatocytes. In SCO testes, GSK3α/β immunoreactivity in seminiferous epithelia was weaker than those of normospermatogenic testes whereas p-GSK3α/β(Ser) immunoreactivity was visibly increased in Sertoli cells.GSK3α was dominant in ejaculated spermatozoa in which GSK3α and p-GSK3α(Ser) were found in the head, midpiece, and tail. In acrosome-reacted spermatozoa, GSK3α was found in the equatorial region of head, midpiece, and tail, and p-GSK3α(Ser) was only found in midpiece. During sperm capacitation, p-GSK3α(Ser) was significantly increased together with phosphotyrosine proteins and motility. Conclusions In human male germ cells, GSK3 isoforms different in LCRs switch from GSK3β to GSK3α during meiotic entry, suggesting the isoform-specific roles of GSK3α and GSK3β in meiosis and stemness or proliferation of spermatogonia, respectively. In dormant Sertoli cells of SCO testes kinase activity of GSK3 might be downregulated via inhibitory phosphorylation. In spermatozoa, inhibitory phosphorylation of GSK3α might be coupled with activation of motility during capacitation.

Purpose: To unravel the mechanism regulating the phosphorylation of glycogen synthase kinase 3 (GSK3) and the correlation between the inhibitory phosphorylation of GSK3α and sperm motility in human. Materials and Methods: The phosphorylation and priming phosphorylated substrate-specific kinase activity of GSK3 were examined in human spermatozoa with various motility conditions. Results: In human spermatozoa, GSK3α/β was localized in the head, midpiece, and principal piece of tail and p-GSK3α(Ser21) was enriched in the midpiece. The ratio of p-GSK3α(Ser21)/GSK3α was positively coupled with normal sperm motility criteria of World Health Organization. In high-motility spermatozoa, p-GSK3α(Ser21) phosphotyrosine (p-Tyr) proteins but p-GSK3α(Tyr279) markedly increased together with decreased kinase activity of GSK3 after incubation in Ca2+ containing medium. In high-motility spermatozoa, p-GSK3α(Ser21) levels were negatively coupled with kinase activity of GSK3, and which was deregulated in low-motility spermatozoa. In high-motility spermatozoa, 6-bromo-indirubin-3′-oxime, an inhibitor of kinase activity of GSK3 increased p-GSK3α(Ser21) and p-Tyr proteins. p-GSK3α(Ser21) and p-Tyr protein levels were decreased by inhibition of PKA and Akt. Calyculin A, a protein phosphatase-1/2A inhibitor, markedly increased the p-GSK3α(Ser21) and p-Tyr proteins, and significantly increased the motility of low-motility human spermatozoa. Conclusions Down regulation of kinase activity of GSK3α by inhibitory phosphorylation was positively coupled with human sperm motility, and which was regulated by Ca2+, PKA, Akt, and PP1. Small-molecule inhibitors of GSK3 and PP1 can be considered to potentiate human sperm motility.

With the advances of digital scanning technology in dentistry, the interests in facial scanning in orthodontics have increased.There are many different manufacturers of facial scanners marketing to the dental practice. How do you know which one will work best for you? What questions should you be asking? We suggest a clinical guideline which may help you make an informed decision when choosing facial scanners. The characteristics of 7 facial scanners were discussed in this article. Here are some considerations for choosing a facial scanner. *Accuracy: For facial scanners to be of real value, having an appropriate camera resolution is necessary to achieve more accurate facial image representation. For orthodontic application, the scanner must create an accurate representation of an entire face. *Ease of Use: Scanner-related issues that impact their ease of use include type of light; scan type; scan time; file type generated by the scanner; unit size and foot print; and acceptance of scans by third-party providers. *Cost: Most of the expenses associated with facial scanning involve the fixed cost of purchase and maintenance. Other expenses include technical support, warranty costs, transmission fees, and supply costs. This article suggests a clinical guideline to make the right choice for facial scanner in orthodontics.

Pierre Robin syndrome presents in the neonatal period with upper airway obstruction and feeding difficulties. Infants with pronounced micrognathia may fail to thrive because of chronic airway obstruction, or experience severe respiratory distress and feeding difficulties. This is potentially fatal and surgical intervention in these cases is necessary. We experienced two newborns with pronounced micrognathia who were managed with tongue-lip adhesion and tracheostomy. Herein, we report these two cases with literature reviews.
Airway Obstruction ; Humans ; Infant ; Infant, Newborn ; Pierre Robin Syndrome* ; Tracheostomy*

BACKGROUND: In Anesthetic state, many hemodynamic parameters including blood pressure, heart rate and arterial compliance are changed. Moreover pulse transit time (PTT) is influenced by heart rate, blood pressure changes, and the compliance of the arteries. METHODS: In this study, we investigated PTT changes in patients under enflurane anesthesia. PTT of the finger was measured by photoplethysmography (PPG) and electrocardiography (ECG). PTT values were calculated as the time interval between the peak of the ECG R wave and the peak of the second derivatived of the PPG in the finger tip. RESULTS: ECG amplitude and heart rate increased reflecting hemodynamic chnages after enflurane anesthesia, and the PTT increased after enflurane anesthesia treatment by 16.68 ms (n = 24). Moreover, PTT was found to be inversely proportion to aging. CONCLUSIONS: The increase of PTT in the finger due to relaxation of the arterial wall muscle after enflurane anesthesia was used as an indicator of sympathetic block on muscle tone. This result suggests that PTT is strongly related with anesthetic state. And PTT may be one of useful surrogative methods for anesthetic monitoring, but PTT is unfortunately only qualitative.
Aging ; Anesthesia ; Arteries ; Blood Pressure ; Compliance ; Electrocardiography ; Enflurane* ; Fingers ; Heart Rate ; Hemodynamics ; Humans ; Photoplethysmography ; Pulse Wave Analysis* ; Relaxation

BACKGROUND: In the severe community-acquired pneumonia, it has been known that the immune status is occasionally suppressed. This study was performed to identify the immunologic markers related with the prognostic factors in severe community-acquired pneumonia. METHODS: 23 patients with severe community-acquired pneumonia were involved in this study, and divided into survivor (16) and nonsurvivor (7) groups. In this study, the medical history, laboratory tests(complete blood counts, routine chemistry profile, immunoglobulins, complements, lymphocyte subsets, cytokines, sputum and blood culture, urine analysis), and chest radiographs were scrutinized. RESULTS: 1) Both groups had lymphopenia(total lymphocyte count 995.6±505.7/mm2 in the survivor and 624.0±287.6/mm2 in the nonsurvivor group). 2) The T-lymphocyte count of the nonsurvivor group(295.9±203.0/mm2) was lower than the survivor group(723.6±406.5/mm2) (p<0.05). 3) The total serum protein(albumin) was 6.0±1.0(2.7±0.7) g/dl in the survivor and 5.2±1.5(2.3±0.8)g/dl in the nonsurvivor group. The BUN of the noncurvivor group(41.7±30.0mg/dl) was higher than that of the survivor group(18.9±9.8mg/dl)(p<0.05). The creatinine concentration was higher in the nonsurvivor group(1.8±1.0mg/dl) than that in the survivor group(1.0±0.3mg/dl)(p<0.05). 4) The immunoglobulin G level was higher in the survivor group (1433.0±729.5mg/dl) than in the nonsurvivor group(849.1±373.1mg/dl)(p<0.05). 5) The complement C3 level was 108.0±37.9mg/dl in the survivor group and 88.0±32.1mg/dl in the nonsurvivor group. 6) A cytokine study showed an insignificant differenne in both groups. 7) Chronic liver disease, DM, and COPD were major underlying diseases in both groups. CONCLUSION: These results suggest that decreased a T-lymphocyte count and immunoglobulin G level, and an increased BUN and creatinine level may be associated with the poor prognosis of severe community-acquired pneumonia.
Biomarkers ; Chemistry ; Complement C3 ; Complement System Proteins ; Creatinine ; Cytokines ; Humans ; Immunoglobulin G ; Immunoglobulins ; Immunologic Factors* ; Liver Diseases ; Lymphocyte Count ; Lymphocyte Subsets ; Pneumonia* ; Prognosis* ; Prospective Studies* ; Pulmonary Disease, Chronic Obstructive ; Radiography, Thoracic ; Sputum ; Survivors ; T-Lymphocytes