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

Genitourinary gangrene is an uncommon, potentially lethal disorder characterized by the abrupt onset of a rapidly progressive necrotizing soft tissue infection caused by the synergistic action of various organisms that spread along fascial planes, causing subfascial soft tissue necrosis and destruction. Many factors, debilitating condition such as carcinoma, diabetes and alcoholism, contribute to the development and perpetuate the course of Fournier's gangrene. In our two cases , predisposing causes were as follow ; chronic liver disease, diabetes mellitus, chronic alcoholism, perianal abscess. The patients were hemodynamically unstable and extensive necrosis was noted. After aggressive debridement of the wound and triple antibiotic therapy, general condition became improved and then we performed split thickness skin grafts and the results of reconstructive surgery were satisfactory.
Abscess ; Alcoholism ; Debridement ; Diabetes Mellitus ; Fournier Gangrene* ; Gangrene ; Humans ; Liver Diseases ; Necrosis ; Skin ; Soft Tissue Infections ; Transplants ; Wounds and Injuries

PURPOSE: Many different scoring systems have been proposed for assessing the severity of atopic dermatitis. The SCORAD (SCORing Atopic Dermatitis) is one of the best validated systems, but is too complicated and time-consuming for routine clinical use. The aim of this study is to evaluate the Three Item Severity (TIS) score in routine clinical practice and to investigate the correlation with SCORAD and quality of life. METHODS: The study was done on 69 cases of atopic dermatitis randomly selected by SCORAD severity in Kangdong Sacred Heart Hospital pediatric allergy clinic from March 2003 to August 2003. Patients were from three months old to 15 years old. A trained pediatrician assessed the TIS score and simultaneous 10 item questionnaire about quality of life (QOL) was checked. RESULTS: According to the SCORAD, there were 21 (30.4%) mild cases, 26 (37.7%) moderate cases and 22 (31.9%) severe cases out of total 69 patients. According to the TIS score, 21 (30.4%) cases were 0-2 point, 16 (23.2%) were 3 point, 11 (16.0%) were 4-5 point and include 21 (30.3%) were 6-9 point. In QOL score, 21-30 points were most common (36.2%). There was significant positive correlation between TIS score and SCORAD (Spearman's rs= 0.86, P< 0.01). There was significant positive correlation between TIS score and QOL (Spearman's rs=0.89, P< 0.01). CONCLUSION: The TIS score is a reliable and simple scoring system for atopic dermatitis. It is particularly suitable in general practice, for routine clinical use.
Adolescent ; Child* ; Dermatitis, Atopic* ; General Practice ; Heart ; Humans ; Hypersensitivity ; Quality of Life ; Surveys and Questionnaires

PURPOSE: The prostate specific antigen, PSA, may be elevated in patients with benign prostatic diseases. Prostatic calculi are very common, but little is known for their effect on the level of PSA. The relationship between prostatic calculi and PSA were analyzed. MATERIALS AND METHODS: A total of 486 patients were evaluated with transrectal an ultrasound (TRUS), and the PSA determined. The patients were divided into the calculi (n=198, 40.6%) and non calculi groups (n=288, 59.4%), according to the presence of prostatic calculi in the TRUS. These groups were further divided into low PSA (PSA<4ng/ml) (n=417) and high PSA groups (PSA=4ng/ml) (n=69), according to serum PSA levels. The prostatic calculi volume was calculated using a transrectal ultrasonographic volume determination, based on the HWL principle (HeightxWidthxLengthx pi/6). RESULTS: The mean volume of the prostatic calculi was 257mm3, which was correlated with the age (p<0.01). The median serum PSA concentration was 2.11ng/ml for all the patients: 2.16ng/ml for the calculi group and 2.08ng/ml for the non-calculi group. The serum PSA concentration was higher in the calculi group, but there was no statistical significant between the two groups (p>0.05). The serum PSA concentration was not correlated with the calculi volume (p>0.05). The difference in the proportion of patients with prostatic calculi was not statistically significant between the low and high PSA groups (p>0.05). The mean volumes of prostatic calculi were 264 and 214mm3 in the low and high PSA groups, respectively, but these were not significantly different between the two groups (p>0.05). CONCLUSIONS: The presence, or volume, of prostatic calculi, as detected by TRUS, has no significant effect on the serum PSA level.
Calculi* ; Humans ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Diseases ; Ultrasonography*

BACKGROUND AND OBJECTIVES: Most reports about coronary angiographic findings in acute myocardial infarction were done after thrombolytic therapy or several days after onset of symptom. The aim of this study is to evaluate coronary angiographic findings in patients with AMI within 24 hours after onset of symptoms and without thrombolytic therapy. Also we evaluated the correlation between the risk factors and severity of coronary artery disease. MATERIALS AND METHODS: We studied 70 patients with acute myocardial infarction admitted to Kyungpook National University Hospital (KNUH) from November 1997 to January 1999, and evaluated the clincial and coronary angiographic findings. We analyzed risk factors of coronary artery disease: age, total cholesterol, tiglyceride, high density lipoprotein (HDL)-cholesterol, low density lipoprotein (LDL)-cholesterol, hypertension, smoking, diabetes and family history of CAD. Coronary angiography was done immediately after the arrival at emergency room (door-to- angiography time). Exclusion criteria were delayed arrival (more than 24 hours after symptom onset), previous history of anticoagulation or medication of antiplatelet agents. RESULTS: 1) Among 70 patients (M/F: 53/17), 59 patients had Q wave myocardial infarction (QMI) (84%), 11 patients had non-Q wave-MI (NQMI) (16%). 2) The mean age was 61+/-12.2 years (range: 26 to 82 years). 3) The mean time from the onset of chest pain to angiography was 6.2+/-4.7 hours. 4) Twenty eight patients (40%) had one-vessel disease, 25 (36%) had two-vessel disease and 17 (24%) had three-vessel disease. 5) The location of infarct related arteries were as follows: LAD in 33 (47%), LCX in 13 (19%) and RCA in 24 (34%). 6) The mean diameter stenosis of infarct related artery (IRA) was 95+/-10.9%. According to the American College of Cardiology/American Heart Association (ACC/AHA) classification of IRA, type B lesion occurred most commonly in 56 patients (80%). 7) Thrombus was observed in 44 patients (63%) with QMI versus 3 patients (27%) with NQMI (p=0.006). 8) Calcifications of the wall of coronary arteries were observed in 28 patients (40%) and correlated with ages of patients. 9) History of cigarette smoking was present in 73%, hypertension in 31% and hypercholesterolemia in 15% of patients. The mean number of risk factor for each patient was 1.3. 10) Multivessel disease was significantly more frequent in patients who had two more risk factors. 11) The frequency of cigarette smoking was greater and the level of plasma triglyceride were higher in patients under 50 years of age. 12) One patient died during coronary angiography and another 2 patients died at 5 and 8 days after coronary angiography due to cardigenic shock. CONCLUSION: In immediate coronary angiographic findings in patients with AMI, multivessel disease and thrombus, and severe stenosis of IRA were observed more frequently than other studies after thrombolytic therapy or after several days of delay. Multivessel disease was significantly more frequent in the patients who had two or more risk factors of atherosclerosis.
Angiography ; Arteries ; Atherosclerosis ; Chest Pain ; Cholesterol ; Classification ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Emergency Service, Hospital ; Gyeongsangbuk-do ; Heart ; Humans ; Hypercholesterolemia ; Hypertension ; Lipoproteins ; Myocardial Infarction* ; Plasma ; Platelet Aggregation Inhibitors ; Risk Factors ; Shock ; Smoke ; Smoking ; Thrombolytic Therapy ; Thrombosis ; Triglycerides

BACKGROUND AND OBJECTIVES: The intracoronary stent may be useful in the preventing of abrupt closure and coronary restenosis after coronary angioplasty, and recently primary stenting has been one of therapeutic modalities. We assessed the clinical and angiographic results of primary NIR stenting in patients with acute myocardial infarction (AMI). MATERIALS AND METHODS: Between November 1997 to January 1999, 55 stentings with NIR stents were done in 51 patients with acute myocardial infarction. Angiographic follow-up was available at 7+/-2.3 days in 35 patients. RESULTS: 1) Among 51 patients (M/F: 37/14), 44 patients had Q-wave MI (86%), 7 patients had non-Q-wave MI (14%). 2) The mean age was 61+/-12.4 years (range: 26 to 82 years). 3) The mean time from the onset of chest pain to the arrival at emergency room was 4.6 +/- 4.2 hours. The mean door-to-balloon time was 93+/-46 minutes 4) Treated vessels were as follows: 28 in LAD, 17 in RCA, 10 in LCX. 5) The indications for stent implantation were suboptimal angiographic results after PTCA in 38 lesions (69%), dissection in 9 lesions (16%), abrupt vessel closure in 1 lesion and elective in 7 lesions (13%). 6) Single stent implantation was done in 47 patients. Overlapping stents were done in 4 patients. 7) A procedure related complication occurred in one patient, peri-stent dissection without flow limitation. 8) Full expansion of the stent failed in three lesions with coronary calcifications and the residual stenosis was 35, 40, 50% in each case. In these cases, in-stent thrombus was not demonstrated in follow up angiography. 9) The minimal lumen diameter increased from 0.11+/-0.39 to 2.96+/-0.40 mm. 10) Angiographic follow-up on 38 stents in 35 patients demonstrated in-stent thrombus in 3 stents, in-stent restenosis in 1 stent. But in-stent flow limitations were not found in these 4 cases and TIMI III flow were maintained. Patients with Q-wave MI and coronary thrombus on initial angiography were more prone to subacute thrombosis. CONCLUSION: The NIR stent could be used successfully in primary coronary stenting in acute myocardial infarction. The present study shows relatively low risk of subacute stent thrombosis. The rate of restenosis needs to be confirmed by long term study.
Angiography ; Angioplasty ; Chest Pain ; Constriction, Pathologic ; Coronary Restenosis ; Emergency Service, Hospital ; Follow-Up Studies ; Humans ; Myocardial Infarction* ; Stents* ; Thrombosis

A case of histologically proved primary reticulum cell sarcoma is presented. A female patient with headache and left hemiplegia was proved to have reticulum cell sarcoma after surgery. The tumor was single in the frontal cortex and showed peculiar contrast enhancement pattern on computed tomogram. Near-total extirpation was verified by post-operative CT.
Female ; Headache ; Hemiplegia ; Humans ; Lymphoma, Non-Hodgkin* ; Prognosis ; Reticulum*

A 38-year-old woman presented with massive hemoptysis ( 200 mL/ 24 hours) occurring abruptly after generalized tonic clonic seizure. She experienced similar episodes of hemoptysis on three later occasions. Although the coexistence of hemoptysis and seizure has been reported, albeit rarely, as a clinical manifestation of postictal neurogenic pulmonary edema, massive hemoptysis after seizure is an extremely rare event with no recurrent cases of such episodes having ever been reported. The coexistence of hemoptysis and seizure increases the difficulty in diagnosis for the clinician. We describe the differential diagnosis among the diseases capable of causing seizure and hemoptysis.
Adult ; Case Report ; Diagnosis, Differential ; Epilepsy, Tonic-Clonic/*complications ; Female ; Hemoptysis/*diagnosis/etiology ; Human ; Pulmonary Alveoli ; Pulmonary Edema/complications ; Recurrence ; *Respiration, Artificial

PURPOSE: The rising prevalence of childhood obesity may be due to an energy imbalance between food intake and energy expenditure. Recently, consumption of beverages in children has increased. The aim of this study is to provide useful information for the prevention and the control of childhood obesity by assessment of variable beverage consumption. METHODS: Fight hundred seventy seven children(M : F=1 : 1.02, mean age; 9.7 years) from two primary schools in Seoul in May 2003 were enrolled. Body mass index(BMI) was calculated and the degree of obesity was classified into normal, overweight and obese groups by BMI percentile. Parental BMI, socio-economic factor, 3-day dietary intake, calory intake and beverage intake were examined by questionnaires. We researched beverages and classified them into six categories, milk, other milk products, soda, sports beverage, other beverage. RESULTS: The prevalence of obesity was 7.2%. The parental BMI of the obese group were higher than those of the other groups. There was no significant difference in birth weight, or parents' intellectual and economic levels between the obese group and the other groups. There was no significant difference in daily total calory intake between the obese group and the other groups. The obese group of 7-9 year-old-males was higher than the other groups in sodas, and sports beverages intake. The obese group of 10-12 year-old-males was higher than the other groups in total beverage intake and other beverage intakes. The obese group of 10-12 year-old-females was higher than the other groups in other milk products. CONCLUSION: Excessive intake of beverages is associated with childhood obesity. Efforts to decrease intake of beverages may be important approaches to counter the rise in the prevalence of obesity.
Beverages* ; Birth Weight ; Body Mass Index ; Child ; Eating ; Energy Metabolism ; Fast Foods ; Humans ; Milk ; Obesity ; Overweight ; Parents ; Pediatric Obesity* ; Prevalence ; Surveys and Questionnaires ; Seoul ; Sports

The therapeutic efficacy and significance of intraprostatic fosfomycin injection in treating patients with chronic prostatitis were reviewed. During the last 6 years, 350 patients were treated with intraprostatic fosfomycin injection for chronic prostatitis, and among them, 218 patients who could be followed up at least for 3 months were analysed. As for chronic prostatitis, when a patient's WBC count of EPS per high power field remains invariable below 15 for at least 3 months, he is said to be cured. Intraprostatic injection was performed once or twice in all patients and 153 (70.2%) cases were responsive to this treatment. But eleven patients recurred immediately within 3 months after the response. Therefore, final cure rate reached 65.1% (142/218): Adverse effects were rare, if any, they were just trivial symptoms such as mild suprapubic pain or discomfort, transient hematuria and hemospermia. These facts demonstrate that intraprostatic fosfomycin injection has much advantage in patients with chronic prostatitis as treatment modality compared with ordinary method.
Fosfomycin* ; Hematuria ; Hemospermia ; Humans ; Prostatitis*