Voltage dependent calcium channels mediate wide variety of physiological functions including neurotransmitter release, neurite outgrowth, and gene expression in neurons. omega-Conotoxin-sensitive N-type calcium channels are exclusively expressed in nervous system and involved in the control of neurotransmitter release from neurons. In this experiment, I have investigated human chromosomal location and rat neuronal distribution of N-type voltage dependent calcium channel alpha1, subunit [alpha1B]. I have localized human alpha1B subunit gene to the long arm of chromosome 9[9q34] by fluorescent in situ hybridization. The distribution of rat alphaB1 subunit mRNA has been examined in the rat brain by in situ hybridization histochemistry and high level of alpha1B subunit mRNA has been observed in olfactory bulb, anterior olfactory nucleus, cerebral cortex, piriform cortex, hippocampus, dentate gyrus, parabrachial nucleus, and cerebellum and low level of expression was also found in other areas of rat brain.
Animals ; Arm ; Brain* ; Calcium Channels* ; Calcium Channels, N-Type ; Calcium* ; Cerebellum ; Cerebral Cortex ; Dentate Gyrus ; Gene Expression ; Hippocampus ; Humans ; In Situ Hybridization ; In Situ Hybridization, Fluorescence ; Nervous System ; Neurites ; Neurons ; Neurotransmitter Agents ; Olfactory Bulb ; Rats ; RNA, Messenger

Persistent cloaca is a very rare congenital malformation with the incidence of 1/50,000-250,000 births. This malformations have a single common perineal opening for the genital, urinary and gastrointestinal tracts. Because of wide spectrum of abnormal anatomy involving upper urinary tract, gastrointestinal systems, cardiovascular system, central nervous system, and respiratory system, prenatal diagnosis is difficult through ultrasound during pregnancy. It has been reported that if the anomalies are diagnosed early, they can be corrected surgically. We present a case of persistent cloaca with meconium peritonitis and hydrometrocolpos confirmed by neonatal surgery after emergency cesarean section.
Cardiovascular System ; Central Nervous System ; Cesarean Section ; Cloaca* ; Emergencies ; Female ; Gastrointestinal Tract ; Incidence ; Meconium* ; Parturition ; Peritonitis* ; Pregnancy ; Prenatal Diagnosis ; Respiratory System ; Ultrasonography ; Urinary Tract

Hypobaric spinal anesthesia for fifty patients(spinal group) undergoing total hip replacement were compared with general anesthesia(general group) in respect to intraoperative blood loss, changes of blood pressures, postoperative analgesics, etc. Furthermore, the technical aspects were evaluated for hypobaric spinal anesthesia in the lateral position when 1% tetracaine in distilled water (epinephrine 1: 200,000) was administered. The lowest blood pressure parameters were significantly lower in the spinal group(29%) than in the general group(22%). The amount of blood loss in the spinal group was less than that in the general group even though there was no difference in blood replacement between groups. The time period before analgesic use longer in the spinal group(4.1 hours)than the general group(2.7 hours). The most common complication in either group was urinary retention(50% in the spinal and 44% in the general) in which urinary catheterization was necessary. In the general group, thirty-six per cent of the patients had mild fever in the first or second postoperative day which were not consistently related to pulmonary complications. For spinal anesthesia, 5 or 6 mg of 1%-tetracaine in distilled water mixed to 1: 200,000 epinephrine was used. The spinal puncture was performed by a 22G needle on the L2-3 or L3-4 in- tervertebral space with lateral aproach in the position of the operation. Injection speed was controlled to 1 ml/sec in all patients. Sensory levels were reached to T7-8 and T9-10 in the non-dependent and dependent side, respectively. Motor funetion on knee and ankle was lost in the non-dependent side, but not in the dependent side. There were some intraoperative complaintments including positional discomfort on hip rest and shoulder bar. However, there was no remarkable problem in hypobaric spinal anesthesia intraoperatively. The results of our study indicate that hypobaric spinal anesthesia in lateral decubitus position is a recommendable anesthetic technique for total hip replacement surgery.
Analgesics ; Anesthesia ; Anesthesia, Spinal* ; Ankle ; Arthroplasty, Replacement, Hip* ; Blood Pressure ; Epinephrine ; Fever ; Hip ; Humans ; Knee ; Needles ; Shoulder ; Spinal Puncture ; Tetracaine ; Urinary Catheterization ; Urinary Catheters ; Water

No abstract available.
Humans

OBJECTIVE: Chlamydia trachomatis is one of the most common causative microorganism in pelvic inflammatory disease (PID). In this infection tubal obstruction, infertility, tubal pregnancy and recurrent pelvic infection has involved. Also, perinatal infection, spontaneous abortion and preterm labor of pregnant women increased in chlamydia infection. This study was performed to investigate the prevalence rate and clinical characteristics of Chlamydia trachomatis in symptomatic women. METHODS: From March, 2003 to March, 2004, in OB-Gyn development, endocervical swab were obtained in 218 patients (137 impatients of PID and 81 outpatients) by Amplicor Chlamydia Transfer Kits and Human papilloma virus kit. They were studied on history taking, physical examination, laboratory test, and polymerase chain reaction for the detection of Chlamydia trachomatis. Also, in this study we investigated the prevalence of human papilloma virus and N. gonorrhea in the Chlamydia infection group. RESULTS: The prevalence rate of Chlamydia trachomatis was 27.5% (61/218) in pelvic inflammatory disease. As regarding the age distribution of Chlamydia trachomatis positive group was the high prevalence rate in twenties (52.8%). Chlamydia infection was related to the history of artificial abortion, oral contraception, occupation status, history of gynecologic disease (PID, Ectopic pregnancy). Women with chlamydial infection were 2.5 times greater risk of coincidal HPV infection and 2 times greater risk of coincidal N. gonorrhea infection and both were statistically significant. CONCLUSION: The prevalence rate of Chlamydia infection is higher than any other sexually transmitted disease and Chlamydia infection has serious complication on reproduction. It appears weak symptom and detection is difficult. Therefore the screening and treatment of Chlamydia trachomatis are necessary to decrease the prevalence and prevention of complication.
Abortion, Spontaneous ; Age Distribution ; Chlamydia Infections ; Chlamydia trachomatis* ; Chlamydia* ; Contraception ; Fallopian Tube Diseases ; Female ; Genital Diseases, Female ; Gonorrhea ; Humans ; Infertility ; Mass Screening ; Obstetric Labor, Premature ; Occupations ; Papilloma ; Pelvic Infection ; Pelvic Inflammatory Disease* ; Physical Examination ; Polymerase Chain Reaction ; Pregnancy ; Pregnancy, Tubal ; Pregnant Women ; Prevalence ; Reproduction ; Sexually Transmitted Diseases

PURPOSE: To evaluate the role of repetitive vascular surgery in below-knee amputation for critical lower-limb ischemia. METHODS: The data of the 39 below-knee amputee despite receiving one more vascular surgery for critical limb ischemia from Jaunary 1990 through October 1995 were retrospectively reviewed. A total of 102 surgical operation was included. RESULTS: The mean age was 46 years old ranged from 21 through 78 and the forth decade was the most prevalent group by proportion of 33% (13 cases). The frequency of Buerger's disease is 20, and that of atherosclerotic occlusion (ASO), ASO with diabetes, and diabetic arteriopathy (DA) were 11, 4, 3, respectively. The number of operative procedures before amputation and the total mean duration (TMD: days) from initial operation to final amputation for femoral, popliteal and tibial occlusion were 45/485, 26/921 and 13/1725, respectively. Those for Buerger's disease, ASO, ASO with diabetes and DA were 42/960, 25/865, 9.1027, and 7/251 respectively. The proportions of duration between initial vascular procedure and second one in the TMD for the patients of tibial occlusion and ASO with diabetes revealed 95.0% and 98.4%. Smoking revealed shortened the duration until amputation in cases of popliteal artery involvement. CONCLUSION: The frequency of below-knee amputation due to critical limb ischemia is high in Buerger's disease and in the age of fourth decade. Patients of the tibial artery involvement and ASO with diabetes may not have benifits from repetitive operative procedures after initial vascular surgery in postponing the below-knee amputation. More study is needed with incresed number of cases.
Amputation* ; Amputees ; Extremities ; Humans ; Ischemia* ; Lower Extremity* ; Middle Aged ; Popliteal Artery ; Retrospective Studies* ; Smoke ; Smoking ; Surgical Procedures, Operative ; Thromboangiitis Obliterans ; Tibial Arteries

Epidural narcotics has been most widely used for the control of postoperative pain. However, patients have been treated insufficiently because of the fear of respiratory depression. Urinary retension, nausea and vomiting, pruritus are other complications of epidural narcotics. Epidural local anesthetics may be an alternative to epidural narcotics. But the duration of action is usually too short, although epinephrine can prolong the analgesic effect. Clonidine, an a2-adrenergic agonist has its own analgesic effect and can prolong the effects of epidurally administered drugs. Therefore epidural clonidine may be expected to lessen the requirement of epidural narcotics and hence reduce the complications of narcotics. 75 ug or 150ug of clonidine was added to 0.125% bupivacaine or 2 mg of morphine. 6ml of mixed solution was administered epidurally during and after operation for the control of pain following upper abdominal surgery. Clonidine caused increase in the analgesic duration of epidural bupivacaine and morphine. Clonidine also cause decrease in systolic pressure in dose-dependent manner, especially during anesthesia without significant alterations in heart rate. Clonidine may be an useful adjunct to epidural narcotics, provided the dosage is carefully titrated in the range of modest hemodynamic change.
Anesthesia ; Anesthetics, Local ; Blood Pressure ; Bupivacaine* ; Clonidine* ; Epinephrine ; Heart Rate ; Hemodynamics ; Humans ; Morphine* ; Narcotics ; Nausea ; Pain, Postoperative ; Pruritus ; Respiratory Insufficiency ; Vomiting

STATEMENT OF PROBLEM: Insertion of endosseous implants in the atrophic maxilla is often complicated because of lack of supporting bone. Augmentation of the floor of the maxillary sinus with autogenous bone & bone substitute graft has been proven to be a reliable treatment modality, at least in the short term. The aim of this study is to evaluate the factors of implant survival rate associated with maxillary sinus lift with grafts. MATERIAL AND METHODS: The sinus floor was augmented with bone grafts derived from modified Caldwell-luctechnique (71 subject, 93 sinus, 180 implants), the autogenous bone or autogenous + Bio-oss. Before implant installation the width and height of the alveolar crest were increased in the first stage procedure in 10 patients while in the other 61 patients augmentation and implant installation could be performed simultaneously width and height of the alveolar crest > 4 mm) or delayed installation. RESULTS: In all case bone volume was sufficients for implant insertion. 14 of 180 inserted implants were lost during follow up and the healing period Patient received implant supported overdenture (5 patients) or fixed bridge (62 patients). CONCLUSION: Within the limit of the result of this study, we conclude that bone grafting of the floor of the maxillary sinus floor with bone for the insertion of implants might be a reliable treatment modality and the autogenous bone graft and delayed installation method might be the factors for good results.
Bone Substitutes ; Bone Transplantation ; Denture, Overlay ; Denture, Partial, Fixed ; Floors and Floorcoverings ; Follow-Up Studies ; Humans ; Maxilla ; Maxillary Sinus ; Minerals ; Retrospective Studies ; Survival Rate ; Transplants

No abstract available.

PURPOSE: Recently, a self-expandable metallic stent has allowed an elective single-stage resection avoiding the risk of emergency operation and stoma formation in patients with obstructive colorectal cancer (CRC). But, forceful expansion of stent may increase the possibility of tumor cell exfoliation and dissemination through bowel lumen, lymphatic and blood vessels. Aim of study is to evaluate the short-term outcome of curative resection for obstructive colorectal cancer followed by stent in terms of oncologic safety. METHODS: Twenty-seven patients who underwent curative resection for obstructive CRC followed by stent insertion were included in 'stent group' and control group included 87 patients who underwent surgery for non-obstructive CRC. The clinicopathologic characteristics and prognosis were compared between two groups. RESULTS: There was no significant difference in clinicopathologic characteristics between two groups. No difference was found in postoperative complications between two groups. Overall survival rate of two groups showed no statistically significant differences (P=0.1254). Stage-matched survival rates (stage II & III) were also showed no differences between two groups. CONCLUSION: Stent insertion itself does not compromise the survival of patients with obstructive CRC. Oncologic safety of stent insertion for obstructive CRC is acceptable. A further large-scaled prospective study and long-term follow-up is necessary to evaluate the oncologic safety of stent insertion in obstructive CRC.
Blood Vessels ; Colorectal Neoplasms ; Emergencies ; Follow-Up Studies ; Humans ; Postoperative Complications ; Prognosis ; Stents ; Survival Rate