Diagnostic value of the pressure difference (PDBC) between brachial artery systolic pressure (BASP) and cavernosal artery systolic occlusion pressure (CASOP) was comparatively analyzed with penile brachial index (PBI), cavernosal artery duplex ultrasonography (CADU) and selective internal pudendal arteriography in 60 cases (30 patients) with suggestive arteriogenic impotence. 1. When arteriogram set as a standard control. the specificity and sensitivity of PDBC were 58.8% 61.8%, those of CADU were 57.1%, 59.4% and those of PBI were 55.8%, 70.6%. 2. When PDBC set as a standard control, the specificity and sensitivity of internal pudendal arteriography were 43.5%, 75.0%, those of CADU were 34.8%, 67.9% and those of PBI were 34.3%. 68.8%. Those results suggest that PDBC is not significantly correlated with internal pudendal arteriogram and it has a limitation in evaluation of arteriogenic impotence. Thus, PDBC should be interpreted in comparison with PBI, CADU and/or arteriogram.
Angiography* ; Arteries* ; Blood Pressure ; Brachial Artery ; Female ; Impotence, Vasculogenic ; Male ; Sensitivity and Specificity ; Ultrasonography

PURPOSE: To compare the effects of various serotonergic drugs on the inhibition of intraluminal pressure rise in the rat vas deferens induced by electrical stimulation of the hypogastric nerve. MATERIAL AND METHODS: Twenty-five Sprague Dawley rats (250-300 gm) were randomly divided into five groups of five animals each, which received intravenous injection of normal saline, clomipramine, sertraline, paroxetine, or fluoxetine. Before (baseline pressure) and 30 minutes after intravenous injection of four different doses (0.1 to 20 the therapeutic dose) of each agent, the hypogastric nerve, identified using microsurgical technique, was electrically stimulated, and the intraluminal pressure of the vas deferens was measured (central effect group). To evaluate the peripheral effects of clomipramine and sertraline, intraluminal vasal pressure was also measured after transection of all proximal sympathetic nerves projecting to the hypogastric nerve and the commissural branches between the right and left major and accessory pelvic ganglia. The adrenal veins were ligated bilaterally. RESULTS: Repeated stimulation of the hypogastric nerves, anesthesia of long duration (3hours), and repeated intravenous injection of normal saline did not result in significant changes in the intraluminal pressure of the vas deferens in a dose-dependent manner (p<0.05). The extent of inhibition by 20-fold therapeutic doses of clomipramine, sertraline, paroxetine, and fluoxetin were 74.4 1.8%, 34.1 8.3%, 24.8 7.8%, and 8.1 3.5%, respectively. At doses 10- and 20-fold the therapeutic dose, clomipramine had the strongest inhibitory effect, followed by sertraline and paroxetin, then fluoxetine (p<0.05). Definite inhibition was noted in all rats receiving clomipramine at 10- and 20-fold the therapeutic dose; the degree of inhibition was 80% in the sertraline-, 60% in the paroxetine-, and 20% in the fluoxetin-treated group. The inhibitory effect of sertraline on the elevation of the intraluminal vasal pressure in the peripheral-effect group was significantly (p<0.01) less than that in the central-effect group. However, there was no difference in the inhibitory effect of clomipramine in the two groups. CONCLUSIONS: Clomipramine was the most potent inhibitor of the elevation of the intraluminal pressure of the rat vas after electrical stimulation of the hypogastric nerve. The greater effect might be attributable to an additional peripheral effect of this drug on the vas deferens.
Anesthesia ; Animals ; Clomipramine ; Electric Stimulation* ; Fluoxetine ; Ganglia ; Injections, Intravenous ; Paroxetine ; Rats* ; Rats, Sprague-Dawley ; Serotonin Agents* ; Sertraline ; Vas Deferens* ; Veins

OBJECTIVE: This study examines the risk factors of the falls of the dementic elderlies in the nursing home. Especially we investigated how the psychotropics affect them in the aspect of the falling tendency. METHODS: We investigated the falls of the 262 patients living in the Seoul JungGae Nursing Home for six month since March 1 1999. Among these we recruited 182 patients whom the exclusion criteria was applied to, and then we measured the relative risks of risk factors known from the previous studies. RESULTS: The incidence rate of falls is 40.1/100person year. The relative risk of gender, age, disease of central nervous system, chronic illness, cognitive function, antipsychotics, antidepressants and anxiolytics had no significance (p>0.05). BADL, mobility, mood stabilizers were related with the falls significantly, and the relative risks were 0.904 (95%CI 0.840-0.973), 1.744 (95%CI 1.064-2.858), 4.683 (95%CI 1.412-15.532) relatively. CONCLUSIONS: The average rate of falling was 40.1/100person year showing less frequent accidents than that of other foreign studies, which was assumed the large number the care-givers and sitting life style on the floor helped preventing the elderlis' falling. Although The gender, age, disease of central nervous system, chronic illness, cognitive function, antipsychotics, antidepressants and anxiolytics did not influence the rate of the falling tendendy of the elderlies, the mobility and impaired activity of daily living increased the rate of their falling. The elderlies taking psychotropics more fell than others not taking pills. The imbalance between the mobile potency and imposed real activity causes the falls. When the psychotropics affect negatively on the mobility, it increases the falling rate of the elderlies. On the other hands, when these affect positively, these prevent elderlies falling.
Anti-Anxiety Agents ; Antidepressive Agents ; Antipsychotic Agents ; Central Nervous System ; Chronic Disease ; Dementia ; Hand ; Humans ; Incidence ; Life Style ; Nursing Homes* ; Nursing* ; Risk Factors* ; Seoul

One hundred patients who have a urethral stone lesser than 1.0cm in diameter were evaluated for spontaneous passage during 8 months between July, 1991 and February, 1992. The spontaneous, passage in accordance with duration of follow-up, the stone site, size, shape and degree of urethra obstruction was investigated. The overall rate of spontaneous passage was 56.0 % with the duration or 39.3 days ranging from 2 days to 8 months. Among these 56 patients, 48(85.7% ) obtained a spontaneous passage within 8 weeks. The rate and duration of spontaneous passage according to stone site were 57.7%, 67.4 days in upper ureter, 25.0%, 64.0 days in mid ureter and 57.1%. 21.9 days in lower ureter, respectively. Spontaneous passage rate was insignificantly correlated with the increment of stone size, but the duration requiring for spontaneous passage of lower ureteral stone was shorter than those of upper or mid ureteral stones. For stone shape the smooth surface or cylindrical shaped stone was more easily passed out spontaneously than the irregular or round shaped one. And, the severer ureteral obstruction, the poorer spontaneous passage was observed. Therefore, the ureteral stone which is smaller than 1.0cm in diameter could be expected a spontaneous passage for 8 weeks at least unless there are specific symptoms or impairment of renal function, especially when the stone has smooth-cylindrical shape and the ureter shows minimal obstruction.
Follow-Up Studies ; Humans ; Ureter* ; Ureteral Obstruction ; Urethra

PURPOSE: To investigate perceptions of erectile dysfunction(ED) treatment of patients visiting a university hospital in the era of multiple oral agents. MATERIALS AND METHODS: Using a questionnaire, this study was conducted on 103 new outpatients(average age 45.5 years) with ED who visited a university hospital between January 2004 and March 2005. RESULTS: The patients with ages in the 50's, 60's and 70's were 33%, 33%, and 6.8%, respectively. Forty percent indicated that they had discussed their ED with their wives. Prior to visiting the general hospital, only 19% of the patents had visited physicians to seek ED treatment, while 29% had taken oriental or folk medicines, and 26% had used exercise to enhance their potency. The remaining 24% had not attempted any management. Among 71 patients who had experience with phosphodiesterase type 5 inhibitors(PDE5I), 30% had obtained them without prescriptions, and 57% were not aware of the fact that proper sexual stimulation is required for effective drug action. The majority of the patients(83%) had felt embarrassment when they had presented their prescriptions to pharmacists. Fifty five percent of wives were not aware! of their husbands took the PDE5I. Among those wives who were aware, 62% felt favorably toward the treatment. CONCLUSIONS: Aging patients with ED are changing their attitude positively toward seeking treatment. However, their understanding of sexual health and ED treatment is still considerably low, suggesting a need for more active and continuous education. A sense of shame for having ED was still high. Thus, changing men's perception that their sexual problems are not shameful but a medical condition to be solved through discussion with their wives and doctors, is needed to lead to a healthy sexual culture.
Aging ; Education ; Erectile Dysfunction* ; Hospitals, General ; Humans ; Male ; Pharmacists ; Prescriptions ; Surveys and Questionnaires ; Reproductive Health ; Shame ; Spouses

Neutrophils and eosinophils, 2 prominent granulocytes, are commonly derived from myelocytic progenitors through successive stages in the bone marrow. Our previous genome-wide transcriptomic data unexpectedly showed that genes encoding a multitude of neutrophil primary granule proteins (NPGPs) were markedly downregulated during the end period of eosinophilic terminal differentiation when cord blood (CB) cluster of differentiation (CD) 34+ cells were induced to differentiate toward the eosinophil lineage during a 24-day culture period. Accordingly, this study aimed to examine whether NPGP genes were expressed on the way to eosinophil terminal differentiation stage and to compare their expression kinetics with that of genes encoding eosinophil-specific granule proteins (ESGPs). Transcripts of all NPGP genes examined, including proteinase 3, myeloperoxidase, cathepsin G (CTSG), and neutrophil elastase, reached a peak at day 12 and sharply declined thereafter, while transcript of ESGP genes including major basic protein 1 (MBP1) attained maximum expression at days 18 or 24. Growth factor independent 1 (GFI1) and CCAAT/enhancer-binding protein α (C/EBPA), transactivators for the NPGP genes, were expressed immediately before the NPGP genes, whereas expression of C/EBPA, GATA1, and GATA2 kinetically paralleled that of eosinophil granule protein genes. The expression kinetics of NPGPs and ESGPs were duplicated upon differentiation of the eosinophilic leukemia cell line (EoL-1) immature eosinophilic cells. Importantly, confocal image analysis showed that CTSG was strongly coexpressed with MBP1 in differentiating CB eosinophils at days 12 and 18 and became barely detectable at day 24 and beyond. Our results suggest for the first time the presence of an immature stage where eosinophils coexpress NPGPs and ESGPs before final maturation.
Bone Marrow ; Cathepsin G ; Cell Line ; Eosinophils* ; Fetal Blood ; Granulocytes ; Hypereosinophilic Syndrome ; Kinetics ; Leukocyte Elastase ; Myeloblastin ; Neutrophils* ; Peroxidase ; Trans-Activators

In the management of the traumatized gravid and her fetus, diagnostic tests and therapy should be directed primarily at the care of the mother and should not be delayed or compromised because of the pregnancy. Because many factors can damage when the mother is unconscious, fetal well-being should be assessed by serial biophysical profile scoring. If the mother's condition is stable as in the chronic vegetative state, elective delivery might best be performed at a gestational age of 32 to 34 weeks.
Diagnostic Tests, Routine ; Fetus ; Gestational Age ; Humans ; Mothers ; Persistent Vegetative State* ; Pregnancy*

PURPOSE: To analyze the Paecilomyces keratitis cases in Korea and compare cases from foreign literature. METHODS: The records of 3 patients diagnosed with Paecilomyces keratitis at our hospital and other reported cases in Korea were evaluated to examine the predisposing factors, clinical aspects, antifungal therapy, therapeutic surgery, and visual outcome and compared with previously reported foreign cases. RESULTS: In Korea, 1 patient was female, 4 patients were male and had predisposing factors including prior corneal trauma or surgery, except 1 spontaneous occurrence. All 5 eyes of 5 patients had poor initial visual acuity, less than finger count, and deep corneal infiltration. The patients were treated with multiple topical and systemic antifungal treatments such as intracameral or intrastromal voriconazole injections and required evisceration and penetrating keratoplasty. However, the final outcomes were unsatisfactory. Previously reported cases from foreign literature also had predisposing factors such as corneal surgery, trauma, and soft contact lens use. They were resistant to antifungal therapy and eventually led to surgeries such as penetrating keratoplasty and the final outcomes were poor. CONCLUSIONS: Frequently, Paecilomyces keratitis has direct risk factors and is resistant to many topical and systemic antifungal agents. In the majority of cases, therapeutic surgery was required and the final visual outcomes were poor. When Paecilomyces keratitis is suspected, we suggest aggressive therapy including intracameral and intravitreal injections of voriconazole in the initial treatment.
Antifungal Agents ; Causality ; Contact Lenses, Hydrophilic ; Corneal Ulcer ; Female ; Fingers ; Humans ; Intravitreal Injections ; Keratitis* ; Keratoplasty, Penetrating ; Korea* ; Male ; Paecilomyces* ; Risk Factors ; Visual Acuity

PURPOSE: Superior oblique myokymia is intermittent spontaneous contractions of the superior oblique muscle presenting as rapid and small-amplitude intorsions and depressions of the eye. The authors report a case of superior oblique myokymia that was objectively and quantitatively diagnosed with slit lamp examination and video-oculography and completely resolved with medical treatment. CASE SUMMARY: A 44-year-old woman presented with a seven-year history of intermittent oscillopsia which continued for few seconds. She had no history of head trauma or systemic ocular disease, and the anterior segment and fundus examination were unremarkable. Right eye intorsion lasting for a few seconds as detected by slit lamp examination. Eye movements were recorded using video-oculography, which showed a torsional nystagmus of 5 to 10 degrees with 2 to 5 vertical components in the right eye. Based on these findings, the patient was diagnosed with superior oblique myokymia. The patient was prescribed topical timolol ophthalmic solution, one drop twice per day, but the symptoms persisted. Timolol ophthalmic solution was stopped and replaced with carbamazepine, 200 mg twice a day, which resolved her symptoms. CONCLUSIONS: Slit lamp examination and video-oculography can be used as objective and quantitative diagnostic tools in order to confirmed a diagnosis and lead to proper treatment.
Adult ; Carbamazepine ; Craniocerebral Trauma ; Depression ; Diagnosis* ; Eye Movements ; Female ; Humans ; Slit Lamp ; Timolol ; Trochlear Nerve Diseases*

PURPOSE: In the present study, a case of IgG4-related ophthalmic disease which met the 2015 IgG4-related ophthalmic disease diagnostic criteria is reported and literature review performed. CASE SUMMARY: A 51-year-old female presented with both upper eyelid swelling, redness, and a palpable mass. Eye movements were normal and exophthalmos was not observed. Facial computed tomography showed both lacrimal gland hypertrophy. The patient underwent left anterior orbitotomy with incisional biopsy. Immunostained biopsy showed the ratio of IgG4+ to IgG+ cells was 50% and the mean number of IgG4-positive plasma cells was approximately 150 per high-power field. Hematological examination showed elevated serum IgG4 concentrations of 6,930 mg/dL, however, other organs were not involved. The patient satisfied the diagnostic criteria for IgG4-related ophthalmic disease. The patient was given an oral steroid and immunosuppressant and the symptoms improved. CONCLUSIONS: IgG4-related ophthalmic disease is currently receiving increased attention. The authors of the present study report a case of IgG4-related ophthalmic disease which met the 2015 IgG4-related ophthalmic disease diagnostic criteria.
Biopsy ; Exophthalmos ; Eye Movements ; Eyelids ; Female ; Humans ; Hypertrophy ; Immunoglobulin G ; Lacrimal Apparatus ; Middle Aged ; Plasma Cells