No abstract available.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Trachea*

No abstract available.
Takayasu Arteritis*

This study was designed to evaluate the clinical manifestations and results of operative treatment in penile injury during erection. We reviewed 18 cases of penile injury during erection from December 1992 to June 1996. Of 18 patients, 14 patients were treated with early operation, 3 patients with conservative treatment and followup was 1 to 31 months (mean: 14.1 months). Patients age ranged from 23-76 years old (mean: 39.6 years), common cause of the injury was sexual intercourse (8 cases), masturbation (3 cases) and finger-pressure (2 cases) in order. Of 8 patients who occurred during sexual intercourse, 7 patients were married. The injury developed at midnight in 8 cases (44%), early morning in 7 cases (39%) and the other times in 3 cases (~7%). Of 14 patients who received with early operation, 13 patients revealed rapture of the corpus cavernosum and 1 patient revealed rupture of superficial dorsal vein. The site of penile fracture showed proximal shaft in 8 cases (62%), midshaft in 3 cases (23%) and distal shaft in 2 cases (15%) in order. The overall complication rate of early operative treatment was 15% (2 of 13 cases) compared to a complication rate of 100% (2 of 2 cases) for conservative treatment. In conclusion, our experience demonstrates that the most common cause and site of penile injury are sexual intercourse and proximal shaft, early operative treatment would be an effective treatment of penile injury to prevent complications.
Coitus ; Follow-Up Studies ; Humans ; Masturbation ; Rupture ; Veins

No abstract available.
Mucocele* ; Paranasal Sinuses*

No abstract available.
Mucocele* ; Paranasal Sinuses*

The kidney and balances of fluid and volume are the basic components of bloocl pressure control, and the kidney is the primary site that initiates the hypertensive process and is affected by hypertensive vascular disease. In the kidney, the dopamine is a potent natriuretic and vasodilating agent, participat- ing in renal sodium excretion and maintenance of cardiovascular homeostasis. And the dopamine receptors in central nervous system and peripheral organs were identified by physiological, biochernical and radioligand binding techniques. Rut previous morphological and biochemical studies have been unable to characterize or determine the tissue distribution of the dopamine receptor subtypes because no selective ligands are available yet. Furthermore, the cellular distribution of the dopamine receptor subtypes in the rat kidney is not demonstrated well. In the SHR, the ability of exogenous and endogenous renal dopamine to engender a natriuresis is impaired. Since renal dopamine levels in genetic models of hypertension are not lower than their normotensive controls, the impaired intrarenal paracrine effect of dopamine in these animal models of hypertension appears to be receptor or postreceptor mediated. And renal dopamine derives mainly from renal tubular dopamine production and to a lesser extent from dopaminergic nerves. The present study utilizes imrnunohistochemistry with specific antibodies to characterize the renal distribution of dopamine receptor subtypes and recognize the role of dopamine receptor defect in the pathogenesis of hypertension in 14-week-old WKY (mean HP 108+/-5mmHg) and SHR (mean RP 174+/-7 mmHg) kidneys. Also it utilizes antibody of tyrosine hyclroxylase (TH) to recognize the site of the dopamine production mediated by TH using light microscopic immunohistochemistry. In the immunohistochemistry of the WKY kidney, dopamine D1 receptor protein is localized to glomerulus, proximal tubule, distal tubule, renal vessels, cortical and medullary collecting duct. And in the SHR kidney, dopamine D1 receptor protein is localized to glomerulus, distal tubule, renal vessels, cortical and medullary collecting duct, and juxtaglomerular apparatus (JGA). But there is no demonstrable positive reaction in the proximal tubule and weakly positive reactions in the renal arterioles of SHR compared with WKY kidney. In the immunohisto-chemistry of the WKY kidney, dopamine D1 receptor protein is localized to glomerulus, proxirnal tubule, distal tubule, renal vessels, cortical and rnedullary collecting duct. And in the SHR kidney, dopamine D2 receptor protein is localized to glomerulus, distal tubule, renal vessels, cortical and medullary collecting duct, and JGA. So, there is no demonstrable positive reaction in the proximal tubule of SHR compared with WKY. In the glomerulus of the WKY and SHR kidneys, both dopamine D1 and D2 receptors are localized. In the in situ hybridization of the WKY and SHR kidneys, dopamine D and D receptors are only demonstrated at the renal vessels. The positive reaction to TH immunohistochemistry of the WKY and SHR kidneys is only observed in the renal medulla compared with negative reaction on the renal cortex. Considering the excretion of sodium up to 65-70% with volume expansion may be mediated by dopamine D1-like receptors in the proximal tubule, our immunohistochemistry findings for the dopamine receptors may support the failure of natriuretic response in the SHR due to an abnormal dopamine receptor. Also our results rnay mean that the glornerular filtration rate is mediated by both dopamine D1 and Dz receptors comparing with the previous studies that the glomerular filtration rate was mediated by dopamine D2 receptor. I'here are some differences in the receptors expressing sites on the previous radioligand binding and pharmacologic studies, but our results suggest that at least some of the renal dopamine DA and DAz receptors correspond structurally to the central dopamine D1 and D2 receptors. Finally the result of TH immunohisto-chemistry suggests that the production of dopamine in the proximal tubule is not mediated by TH.
Animals ; Antibodies ; Arterioles ; Central Nervous System ; Dopamine* ; Filtration ; Glomerular Filtration Rate ; Homeostasis ; Hypertension ; Immunohistochemistry* ; In Situ Hybridization ; Juxtaglomerular Apparatus ; Kidney* ; Ligands ; Models, Animal ; Models, Genetic ; Natriuresis ; Rats* ; Rats, Inbred SHR* ; Receptors, Dopamine ; Receptors, Dopamine D1 ; Receptors, Dopamine D2 ; Sodium ; Tissue Distribution ; Tyrosine ; Vascular Diseases

PURPOSE: To evaluate the factors influencing periosteal interposition in distal tibial physeal fractures of children. MATERIALS AND METHODS: 34 cases of distal tibial physeal fractures were analysed. We confirmed the presence of periosteal interposition with MRI in all cases and accessed the relationship between periosteal interposition and gender, age, cause of injury, type of fracture, degree of initial displacement and after closed reduction. RESULTS: 9 (26.5%) of 34 fractures had interposed periosteum. There was no statistically significant correlation between periosteal interposition and gender, age, cause of injury (p>0.05). 5 (83.3%) of 6 pronation-eversion-external rotation type of fractures according to Dias-Tachjian classification had interposed periosteum and that was a statistically significant correlation (p=0.006). As Salter-Harris type was toward to high degree, there were decreasing tendency of periosteal interposition (p=0.026). There was high rate of periosteal interposition in case of displacement more than 2 mm in each initial and after closed reduction (p<0.05). CONCLUSION: There was high incidence of periosteal interposition in pronation-eversion-external rotation type with displacement more than 2 mm in distal tibial physeal fractures of children. But, periosteal interposition could occur in fractures with mild displacement less than 2 mm, if initial fracture displacement was more than 2 mm, the methods of treatment should be decided after confirm the presence of periosteal interposition with MRI after closed reduction.
Child ; Displacement (Psychology) ; Humans ; Incidence ; Periosteum

The clinical effect of doxazosin mesylate, a selective long acting alpha-1 adrenergic blocker, were evaluated in 31 patients with symptomatic benign prostatic hyperplasia ranging from 49- 85 years old. All patients underwent a urodynamic evaluation and symptom score checking before enrollment into the study. The dose of doxazosin was 2mg per day. And the mean duration of treatment was 157 days. 31 patients were followed on doxazosin for 3 to 12 months with mean 7.5 months. The adverse drug reactions were observed only 1 case. The parameters used to assess the effectiveness of doxazosin included peak and mean urinary flow rates, micturition symptom scores and residual urine, and global assessment by the patient The peak and mean urinary flow rates increased by 77% and 86%, respectively. The obstructive and irritative symptom scores were improved by 51% and 41% respectively. The improvements in urinary flow rates and symptom scores were maintained for this interval. Although this preliminary experience with doxazosin is encouraging, the ultimate role of doxazosin for the long term treatment of benign prostatic hyperplasia needs further evaluation.
Adrenergic Antagonists ; Aged, 80 and over ; Doxazosin* ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Prostatic Hyperplasia* ; Urination ; Urodynamics

OBJECTIVE: The tolerance and the safety of temporary arterial occlusion in aneurysm surgery are variable among patients because of individual variations of their collateral circulation. We recorded continuous intraoperative regional cortical blood flow(rCoBF) with thermal diffusion flowmetry(TDF) in patients with aneurysmal subarachnoid hemorrhage to determine a safe time limit for temporary occlusion in relation to rCoBF. PATIENTS AND METHODS: From Oct. '97 to Sep. '98, 40 patients with cerebral aneurysm at anterior cerebral artery(ACA) or middle cerebral artery(MCA) were included in this study. The TDF probe was placed over the cortex which was supplied by corresponding arteries. For data analysis, we included only the patients with Hunt-Hess grade I or II on admission. RESULTS: The total occlusion time of the proximal parent artery in 24 patients was on average 21.8 minutes, ranging between 9 minutes and 68 minutes. The lowest rCoBF in relation to temporary occlusion time in patient with excellent outcome was as follows: 0ml/100mg/min for 13 minutes and 6ml/100mg/min(11% of basal rCoBF) for 18 minutes in the middle cerebral artery and bilateral anterior cerebral arteries, respectively. The multiple regression equation regarding safe time for temporary clipping was as follows: safe time = 5.5 + 0.06 X rCoBF intra + 0.25 X rCoBF pre. And reperfusion time for the full recovery of rCoBF was within 4 minute in most cases, except some no-reflow cases. CONCLUSION: In our study with proper brain protection, a safe time limit for temporary occlusion was calculated 18 minutes even at 0ml/100mg/min in the MCA and this technique seems to be very useful to detect a continuous real time change of rCoBF during aneurysm surgery.
Aneurysm* ; Anterior Cerebral Artery ; Arteries ; Brain ; Collateral Circulation ; Humans ; Intracranial Aneurysm ; Middle Cerebral Artery ; Parents ; Reperfusion ; Statistics as Topic ; Subarachnoid Hemorrhage ; Thermal Diffusion

OBJECTIVE: The purpose of this study is to evaluate the findings of magnetic resonance(MR) perfusion study and relation with the prognosis in patients of head trauma. METHODS: Forty-two consecutive patients with head trauma were evaluated and the findings of brain computed tomography(CT) and MR image were compared with MR perfusion study. We classified perfusion MR findings into 5 categories and correlated with the prognosis. RESULTS: In all 42 patients with head trauma, 38 cases(90.5%) showed new lesions of abnormal perfusion pattern in MR perfusion study compared to CT and conventional MR image. Causes of the trauma were motor vehicle accident(73.8%) falling(16.7%), and blows to the head(7.1%) in order of frequency. The cumulative prevalent sites of focal abnormalities were frontal lobe in 11 cases(39.3%), basal ganglia and thalamus 9 cases(32.1%), temporal lobe 3 cases(10.7%) and parietal lobe 3 cases(10.7%) and occipital lobe 1 case(3.6%) and cerebellum 1 case(3.6%). The pattern of abnormalities in MR perfusion study were focal type in 18 cases(42.8%), diffuse type 18 cases(42.8%), mixed type 4 cases(9.5%). MR perfusion findings showed statistically significant correlation with initial Glasgow Coma Scale score and Glasgow Outcome Scale score(p<0.05). CONCLUSION: The patterns of perfusion MR abnormality show significant correlation with the prognosis. Further study is mandatory to define the meaning of perfusion defect area and clinical significance.
Basal Ganglia ; Brain* ; Cerebellum ; Craniocerebral Trauma* ; Frontal Lobe ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Head* ; Humans ; Motor Vehicles ; Occipital Lobe ; Parietal Lobe ; Perfusion* ; Prognosis ; Temporal Lobe ; Thalamus