PURPOSE: The aim of this study was to investigate time-dependent changes in erectile function and responsiveness to type 5 phosphodiesterase (PDE5) inhibitor in streptozotocin-induced diabetic rats. MATERIALS AND METHODS: Seventy-five 8-week-old male Sprague-Dawley rats were randomly divided into two groups: diabetic (n=50) and control (n=25). The diabetic group received a single intraperitoneal injection of streptozotocin. The diabetic rats and age-matched control rats underwent cavernosometry before and after administration of DA-8159 (a novel PDE5 inhibitor) at 6, 8, 10, 12, and 14 weeks after induction of diabetes. The erectile response elicited by electrical stimulation of the cavernous nerve (3 V, width 0.2 msec, duration 30 seconds) was measured at several frequencies (2.5, 5, 10, and 20 Hz). Intracavernous pressure (ICP) and mean arterial pressure (MAP) were continuously monitored. Comparisons were made for ICP/MAP and areas under the curve (AUC) corresponding to the duration of electrical stimulation. The AUC was also corrected by the MAP. RESULTS: Diabetic rats maintained normal erectile responses until 6 weeks after diabetic induction. Following 8 weeks of diabetes, the rats showed significantly lower ICP/MAP and AUC/MAP at higher frequencies of nerve stimulation, which were normalized to controls by administration of DA-8159. In contrast, both physiologic parameters were significantly decreased in the 10-week diabetic rats and ICP/MAP at 20 Hz stimulation frequency recovered only by injection of DA-8159. At more than 12 weeks of diabetes, the rats demonstrated severe deterioration of erectile function, which did not fully respond to PDE5 inhibitor. CONCLUSIONS: Findings from this study indicate that impairment of erectile function is followed by decreased responsiveness to PDE5 inhibitor during the course of diabetes.
Animals ; Area Under Curve ; Arterial Pressure ; Caves ; Diabetes Mellitus ; Electric Stimulation ; Erectile Dysfunction ; Humans ; Injections, Intraperitoneal ; Male ; Phosphodiesterase Inhibitors ; Pyrimidines ; Rats ; Rats, Sprague-Dawley ; Streptozocin ; Sulfonamides

No abstract available.
Kidney* ; Neuroectodermal Tumors, Primitive*

Cerbral embolism in the patient with rheumatic heart disease is a serious complication and has poor prognosis. In view of the abundance of rheumatic heart disease in Korea, a retrospective clinical study was done on 49 cases of cerebral embolism with rheumatic heart disease admitted to Severance Hospital from 1970 through 1977. The resultls were as follows; 1. The age distribution of the 49 patients ranged from 20 to 70 years and the mean age was 48.7 years. Twenty-five patients, more than half of the total number, were in their 5th and 6th decades, and the peak of the incidence was in the 6th decade. Male to female ratio was 1:1.3. 2. Mitral stenosis was by far the most predominant valvular lesion representing 33 of the 49 cases, and 25 of the 33 patients had "pure" mitral stenosis. Mitral valve involvement represented 43 of the 49 cases. 3. Seventeen of the total 49 cases were in regular sinus rhythm whereas 32 of the 49 were in atrial fibrillation at the time of admission. 4. Twenty-two of the 49 patients expired during the hospitalization whereas only six made complete recovery and the other 21 made variable degrees of recovery. The anticoagulant treatment did not appear to make any significant difference in the mortality probably due to inadequacy of timing, completeness and followup.
Age Distribution ; Atrial Fibrillation ; Embolism ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Incidence ; Intracranial Embolism* ; Korea ; Male ; Mitral Valve ; Mitral Valve Stenosis ; Mortality ; Prognosis ; Retrospective Studies ; Rheumatic Heart Disease*

No abstract available.
Antigens, CD4*

No abstract available.
Blister*

A 54-year-old male patient who was suffering from bipolar I disorder for 19 years and was admitted to the National Bugok Mental Hospital due to a depressive episode, was referred to the Kosin University Gospel Hospital. On arrival at the emergency room, he had confused mentality with disorientation, memory impairment, hypomania, marked anxiety and hyperirritability. The change of neuromuscular activity such as ataxia, gait disturbance, tremor, shivering, myoclonus and epileptic seizures was also shown. In addition, the symptoms and signs of autonomic instability including diaphoresis, tachycardia, hypotension, fever and facial flushing were noticed. The above symptoms developed after the administration of sertraline successive to the discontinuation of fluoxetine without any washout period. The degree of severity seemed to be severe because he had epileptic seizures, fever and hypotension. He was recovered from the severe serotonin syndrome by the supportive symptomatic treatment with sodium valproate, clonazepam, lorazepam and cyproheptadine after cessation of the selective serotonin reuptake inhibitors during hospitalization. Therefore, this rare case of severe serotonin syndrome was reported and related literatures were also reviewed.
Anxiety ; Clonazepam ; Cyproheptadine ; Emergency Service, Hospital ; Epilepsy ; Fever ; Fluoxetine* ; Flushing ; Gait Ataxia ; Hospitalization ; Hospitals, Psychiatric ; Humans ; Hypotension ; Lorazepam ; Male ; Memory ; Middle Aged ; Myoclonus ; Serotonin Syndrome* ; Serotonin Uptake Inhibitors ; Serotonin* ; Sertraline* ; Shivering ; Tachycardia ; Tremor ; Valproic Acid

Subtrochanteric fractures of the femur are difficult to manage successfully. Two factors, involvement of cortical bone tissue and concentration of stress, frequently have been mentioned as reasons for the high incidence of failure in the treatment of these fractures. We studied 37 patients with 38 subtrochanteric fractures treated at the Seoul Red Cross Hospital from Feb. 1978 to Nov. 1983. The results were obtained as follows: 1. Of the 37 patients studied, 29 were male and 8 female. The majority of male patients (representing 62.1%) were between 21 and 50 years of age, while 7 of 8 female patients were after 50years of age. 2. In 27 (73.0%) of our patients, the fracture resulted from high-energy trauma, traffic accident or fall from height. 3. Many fractures in the present series could not be classified in the manners described by Fielding, Zickel or Seinsheimer. So, we could not find any correlation between fracture type and used fixation device or its prognosis. 4. The associated injuries, which were relatively common in lower limb (10 cases) and pelvis (8 cases), made the fractures more difficult to treat. 5. Of the 38 fractures, 35 (92.1%) were treated by operative means. The Jewett nail was the device most commonly used, with a total of 11(31.4%) fractures being so treated. 6. The average time from operation to partial weight bearing was 12.9 weeks. 7. The average time untill clinical union was about 14 weeks and radiographic union about 24 weeks. 8. From these series, it was considered that, although early weight bearing is frequently impossihle, Jewett nail, plate and screw, compression hip screw, Judet plate or blade plate can be applied successfully to the treatment of subtrochanteric fractures of the femur if the most proper one which can stabilize the lesion effectively is selected and weight bearing is delayed for a sufficient period.
Accidents, Traffic ; Bone and Bones ; Clinical Study ; Female ; Femur ; Hip ; Hip Fractures ; Humans ; Incidence ; Lower Extremity ; Male ; Pelvis ; Prognosis ; Red Cross ; Seoul ; Weight-Bearing

The diagnosis of soft tissue osteochondroma should be considered when a well-defined osseous mass is located in the soft tissues. The differential diagnosis includes myositis ossificans, tumoral calcinosis, synovial chondromatosis, and soft tissue osteosarcoma, true osteochondroma which arises from bone. One case of soft tissue osteochondroma in the knee, a lesion of uncertain pathogenesis is reported.
Calcinosis ; Chondromatosis, Synovial ; Diagnosis ; Diagnosis, Differential ; Knee ; Myositis Ossificans ; Osteochondroma* ; Osteosarcoma

With the recent increase of coronary artery disease in Korea, coronary arteriography israpidly gaining importance as a diagnostic procedure in the management of ischemic heart disease in this country. In order to delineate normal angiographic anatomy of the coronary arteries in Korean adults, the author reviewed 63 normal or near normal coronary angiograms out of 113 consecutive cases done at the cardiac laboratory of Yonsei University Severance Hospital from February, 1976 through September, 1982 and obtained the following results. 1) The diameter of the main stems of the left and the right coronary arteries measured 2.7-6.3mm(mean, 4.0mm) and 2.1-6.0mm(mean, 3.6mm) respectively, and the length of the left main stem measured 0-23mm(mean, 9.3mm). 2) The conus branch was visualized to originate from the proximal right coronary artery in 50 cases(79.4%), and in the other 13(20.6%) in whom the conus branch was not visualized, it was assumed to have a separate ostium directly from the aortic root. 3) The sinus node artery originated from the right coronary artery in 35 cases(55.5%) and from the left circumflex 20(31.7%). The remaining 8 cases(12.7%) appeared to have dual blood supply. 4) The artery to the A-V node arose from the proximal part of the posterior descending artery as a branch of the right coronary artery in 59 cases(93.7%) and of the left circumflex in only 4(6.3%), and the pattern of the A-V node blood supply coincided with the dominancy(crossing the crux of the heart and giving rise to the posterior descending artery) of the right or the left circumflex arteries. 5) In 33 cases(52.4%), both of the arteries to the SA and the AV nodes arose from the right coronary, and in 19(30.2%), the SA node artery came from the right, whereas the AV node artery originated from the left circumflex. 6) The number of ramifications(furcation) of the main left coronary artery was two in 53 cases(83.1%), three in 9(14.3%), and four in 1(1.6%). 7) The number of diagnoal branches of the left anterior descending artery was one in 34 cases(54%), two in 28(44.4%) and 3 in 1(1.6%).
Adult* ; Angiography ; Arteries ; Atrioventricular Node ; Conus Snail ; Coronary Angiography* ; Coronary Artery Disease ; Coronary Vessels* ; Heart ; Humans ; Korea ; Myocardial Ischemia

There are various congenital anomalies of the biliary system, but an ectopic opening of the common bile duct into the duodenal bulb is an extremely rare finding. Despite the recent improvement in the diagnosis and management of pancreatobiliary lesions, the general lack of knowledge and understanding about these variations is undoubtedly responsible for many of the problems that occur during the medical and surgical management of these lesions. We report here on a case of a 65-year-old man who had an ectopic opening of the common bile duct into the duodenal bulb, and this cause acute cholangitis with bile duct sludge, and also recurrent duodenal ulcer. In this case, we used abdomen CT, MRCP, duodenoscopy, EUS and ERCP for making the diagnosis. The cholangitis and duodenal ulcer was improved with medical therapy, and the patient was discharged without any surgical procedure. We report here on this unusual case and we include a review of the relevant medical literature.
Abdomen ; Aged ; Bile Ducts ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Common Bile Duct ; Duodenal Ulcer ; Duodenoscopy ; Humans ; Pancreatic Ducts ; Sewage