Bladder exstrophy is a rare condition with an incidence of between 1 in 10,000 and 1 in 50,000 live births and the male-to-female ratio ranges 2.3:1 to 6:1. The basic defect of bladder exstrophy is an abnormal overdevelopment of the cloacal membrane, preventing medial migration of the mesenchymal tissue and proper lower abdominal wall development. Although there are some recent successful reports of the one-stage repair of bladder exstrophy that involves complete primary repair of exstrophy and total disassembly of the epispadiac penis, staged repair still represents the most common operation for correction of this anomaly. A successful initial closure of the infant born with bladder exstrophy is the single most important determinant of continence in the staged repair of exstrophy patient. We report a case of bladder exstrophy with successful initial closure of bladder using posterior iliac osteotomy and paraexstrophy skin flap.
Abdominal Wall ; Bladder Exstrophy* ; Humans ; Incidence ; Infant ; Live Birth ; Male ; Membranes ; Osteotomy ; Penis ; Skin ; Urinary Bladder*

PURPOSE: We analyzed our experience of surgically corrected impalpable testes to evaluate our results and to determine the best possible surgical approach for impalpable testes. MATERIALS AND METHODS: Medical records of 97 boys who had undergone surgery for impalpable testes were reviewed with respect to the age at presentation, localization procedure, surgical approach, testicular location and volume. Minimal follow-up was 6 months. RESULTS: The average age at presentation was 47.7 months. Surgical locations of testes included preperitoneum in 46 testes, intraabdomen in 18 testes and inguinal canal in 1 testis. Fifty-three testes were absent at exploration. Surgical procedures consisted of 59 orchiopexies, 53 excision of blind-ended spermatic vessel and 6 orchiectomies. The average volume of abdominal testes was reduced to 44.0% of contralateral normally descended testicular volume. Compensatory hypertrophies were seen in 45 contralateral testes among 53 unilateral absent testes. The inguinal exploration was successful in defining the location of all the testes in the last 41 consecutive boys. Laparoscopy did not help to avoid surgical exploration. Of 38 impalpable testes at office examination, 18 testes turned out to be palpable when examined under anesthesia while ultrasonography detected 14 testes with 1 false positive finding. Of 51 regular orchiopexies 49 testes showed excellent or acceptable results. Of 8 Fowler-Stephens orchiopexies 3 testes resulted in atrophies. CONCLUSIONS: Most pexed impalpable testes showed successful results in terms of testicular position and growth. However, there were more testicular atrophies in cases whose spermatic vessels were ligated. Inguinal exploration with or without intraperitoneal extension was successful in the management of impalpable testes in this series.
Anesthesia ; Atrophy ; Cryptorchidism ; Follow-Up Studies ; Hypertrophy ; Inguinal Canal ; Laparoscopy ; Male ; Medical Records ; Orchiectomy ; Orchiopexy ; Testis* ; Ultrasonography

No abstract available.
Brachial Plexus* ; Golf*

PURPOSE: This study was performed to determine the effects of phytoestrogen on seminal vesicle excitability. MATERIALS AND METHODS: Single smooth muscle cells of seminal vesicle were obtained from rabbits using proteolytic enzymes(collagenase). Using single cell and channel recording methods of patch clamp, the various currents of potassium channels in smooth muscle cells were recorded. Potassium currents were divided into calcium dependent and independent. RESULTS: Most of the calcium dependent K currents were maxi-K currents and most of calcium independent ones were delayed rectifier K currents. Inside-out patch clamp technique was used to characterize the maxi-K channel. The channel showed outward rectification and calcium dependency. The single-channel conductance of this channel estimated from slope conductance was 119.4+/-11.7 pS under physiological conditions. These characteristics were typical properties of maxi-K channels. Application of genistein(10micronM) rarely affected the delayed rectifier K channel activities, but it evoked significant increase of maxi-K channel activities at both single cell and channel levels. CONCLUSIONS: From these results it is strongly suggested that the excitability and contractility of seminal vesicle might be modulated by genistein through a mechanism of maxi-K channel activation.
Calcium ; Genistein ; Large-Conductance Calcium-Activated Potassium Channels ; Muscle, Smooth* ; Myocytes, Smooth Muscle* ; Phytoestrogens* ; Potassium Channels* ; Potassium* ; Rabbits ; Seminal Vesicles*

Objectives: ：We investigated relationship between sleep time and depression in the aged 65 years or older. Methods: ：This study was based on the data from seventh Korean National Health and Nutrition Examination Survey (KNHANES). 3,285 people aged 65 years or older were selected as the subjects of this research. The demographic characteristics, sleep time and Patient Health Questinnaire-9 (PHQ-9) were administered for each subjects. Depression was defined as above 10 points of PHQ-9. Results: ：All the demographic variables such as age, sex, education, household income, marital status, drinking and smoking except Body Mass Index (BMI) were correlated with the depression. When we corrected the variables, inadequate sleep time groups (less than 6 hours or more than 9 hours) tended to be depressed. Conclusions ：The study results showed the significant correlation between sleep time and depression in the aged 65 years or older. Adequate sleep time is important to prevent the depression of the aged.

The Mentor inflatable penile prosthesis was designed to decrease the incidence of mechanical failures associated with the Scott inflatable penile prosthesis. The penile cylinders of the Mentor prosthesis are manufactured from Bioflex polyurethane, which is more resistant to abrasion and relatively in elastic than silicone. the material of the Scott prosthesis. The Mentor prosthesis also has a connector system which employs plastic snap-lock ring clamps rather than suture ties to fix tubings to connector. We experienced a case of Mentor inflatable penile prosthesis for vasculogenic erectile impotence in a42 year old male.
Erectile Dysfunction* ; Humans ; Incidence ; Male ; Mentors* ; Penile Prosthesis* ; Plastics ; Polyurethanes ; Prostheses and Implants ; Silicones ; Sutures

PURPOSE: The aim of this study was to compare testicular volumes measured by Prader orchidometer and scrotal ultrasound. MATERIALS AND METHODS: The volumes of 467 adult male testes were measured by Prader orchidometer and scrotal ultrasound. The testicular volumes on ultrasound were calculated by the formula: length x width x height x 0.71. The testicular volumes of the Prader orchidometer were divided into two groups: 15 ml or less, and over 15 ml. The two measurements were compared for each group. RESULTS: In the group with testicular volumes of 15 ml or less, the testicular volumes measured by orchidometer(13.29+/-1.94 ml) were significantly smaller than those measured by ultrasound(14.83+/-2.76 ml). In contrast, the group with over 15 ml did not show any significant difference in the volumes measured by orchidometer(21.21+/-2.58 ml) versusultrasound(20.77+/-4.26 ml). Mean paired differences of the testicular volumes between the orchidometer and ultrasound were 1.54+/-2.65 ml for the group with 15 ml or less and -0.44+/-3.38 ml for the group over15 ml these values are significantly different. CONCLUSIONS: In cases of testicular volume of 15 ml or less measured by Prader orchidometer, scrotal ultrasound is necessary for an accurate measurement of the volume.
Adult ; Humans ; Male ; Testis ; Ultrasonography*

BACKGROUND: Lidocaine is often administered intravenously to suppress airway reflexes associated with tracheal intubation or tracheal suction. In addition, lidocaine is known to have airway relaxant effects through a direct relaxant mechanism on the smooth muscle. The presence of airway epithelium has been reported to reduce the sensitivity and maximum contractile response to histamine or acetylcholine(ACh). The purpose of this study was to determine whether the cumulative application of lidocaine may cause a concentration-dependent relaxation of the rat tracheal smooth muscle strips with intact or rubbed epithelium. METHODS: Using the rat tracheal smooth muscle strips, the effects of 10 6~3 10 3M of lidocaine pretreatment on isometric tension induced by 40 mM of K+ or 10 5M of ACh in presence or absence of adherent epithelium, and the influences of 10 6M of propranolol, 10 4M of L-NAME and 10 6M of atropine on relaxing response of lidocaine were studied. RESULTS: The tracheal smooth muscle concentration induced by K+ and ACh was similar magnitude both in presence or absence of adherent epithelium. The removal of epithelium did not affect the relaxant effect of lidocaine on the K+ and ACh-induced tracheal smooth muscle contraction. Lidocaine pretreatment reduced Ca2+-dependent contraction of the rat tracheal smooth muscle. Following pretreatment of the tracheal smooth muscle preparations respectively with propranolol, L-NAME and atropine the relaxing responses to lidocaine of tracheal smooth muscle were not depressed. CONCLUSIONS: These results suggest that the effect of the epithelium on lidocaine-induced relaxation of the tracheal smooth muscle is not significant and lidocaine may directly relax tracheal smooth muscle by the influences on the Ca2+ mobilization.
Anesthetics ; Animals ; Atropine ; Epithelium* ; Histamine ; Intubation ; Lidocaine* ; Muscle, Smooth* ; NG-Nitroarginine Methyl Ester ; Propranolol ; Rats* ; Reflex ; Relaxation ; Suction

PURPOSE: Adverse sexual experiences such as erectile dysfunction (ED), loss of libido, and ejaculation disorders have been consistent side effects of 5-alpha reductase inhibitors (5ARI). The aim of this study was to evaluate the effects of 5ARI (finasteride) treatment on semen parameters and contraction of the corpus cavernosum and seminal vesicles in male rabbits. MATERIALS AND METHODS: Adult male New Zealand White rabbits (n=10) were randomized into 2 groups: finasteride-treatment (5ARI) group and vehicle-treatment (control) group. The 5ARI group received daily oral finasteride (10 mg/day) by gavage for 4~6 weeks, and the control group received the same concentration of the vehicle. The semen volume and semen parameters between the 2 groups were compared; thereafter, contraction or relaxation responses of smooth muscle strips of the corpus cavernosum and seminal vesicles were observed in an organ bath. RESULTS: Semen magnesium (14.2 vs 5.1 mg/dl) and protein (2.2 vs 1.6 g/dl) concentrations were significantly lower in the 5ARI group than in the control group. The concentrations of other parameters such as electrolytes (Na/K/Cl), fructose, and citrate did not differ between the 2 groups. The contractile responses to norepinephrine (NE) significantly increased in the 5ARI group compared to the control group and the relaxation responses to acetylcholine (ACh) or sodium nitroprusside (SNP) also increased in the 5ARI group. The contractile responses of the seminal vesicular strips to NE significantly decreased in the 5ARI group compared with the control group. CONCLUSIONS: The results suggest that finasteride may decrease contraction of seminal vesicle tissue and alter semen parameters. The effect of finasteride on erectile tissue was double-faced; enhancing both contraction and relaxation. Further study is needed in this respect.
5-alpha Reductase Inhibitors ; Acetylcholine ; Adult ; Citric Acid ; Contracts ; Ejaculation ; Electrolytes ; Erectile Dysfunction ; Finasteride ; Fructose ; Humans ; Libido ; Magnesium ; Male ; Muscle, Smooth ; Nitroprusside ; Norepinephrine ; Oxidoreductases ; Rabbits ; Relaxation ; Semen ; Seminal Vesicles

Objectives: The aim of this study was to evaluate the effectiveness of aripiprazole long-acting injection in patients with schizophrenia undergoing antipsychotics combination therapy. Methods: We conducted a retrospective analysis using electronic medical records of patients with schizophrenia who initiated aripiprazole long-acting injectable and were treated with antipsychotics combination therapy. These patients were either admitted to a psychiatric hospital or treated as outpatients between June, 2019 and December, 2019. Results: Seventeen patients met the inclusion criteria. The mean number of antipsychotics significantly decreased from 2.53 use to 1.81 at month 12 (p=0.018). Total antipsychotics olanzapine equivalent dose significantly decreased from 46.96 to 27.54 at month 12 (p=0.005). The number of combined medications including antidepressants, mood stabilizers, anxiolytics, and anticholinergics did not significantly change. Both the Positive and Negative Syndrome Scale (PANSS) score and The Global Assessment of Functioning (GAF) score significantly improved until month 24 (p=0.004, 0.038; respectively). Conclusions This observational study confirmed that aripiprazole long-acting injection is an effective treatment option for patients with schizophrenia undergoing antipsychotic combination therapy. Well-controlled clinical trials are necessary in the near future.