1. Thirty one fractures of the shaft of the tibia were treated by Küntscher intramedullary nailing (closed 26 cases) from Dec. 1979 to Oct. 1985. 2. The fractures were classified into extension type(62%) and flexion type(38%). 3. The straingt nail with bent proximally was used for the extension fractures and the nail with a curve near of each end for the flexion type. 4. In the most cases of simple fracture, we used Küntscher nail of 12mm diameter.interlocking were used in addition to a Küntscher nail(static 13 cases, dynamic 8 cases). In the case of interlocking, nail should be at least 13mm in diameter. 5. The nail was inserted just above or superolateral to the tibial tubercle. 6. The bony union was demonstrated radiographically at 14.4 weeks, and hopitalization period was less than 2 weeks in twelve cases and 3 weeks in the three cases. 7. The major complication were delayed union(1 case) and infection(2 cases).Posterior angulatory deformity greater than 5° appeared in two cases. 8. The cross leg pedicle graft combined with Küntscher nailing would be preferable procedure in the case of open fracture with skin defect.
Congenital Abnormalities ; Fracture Fixation, Intramedullary ; Fractures, Open ; Leg ; Skin ; Tibia ; Transplants

PURPOSE: Because cryptorchid testes are known to undergo histopathologic changes affecting development, maturation, and tertility, early surgical correction is usually recommended. However there are differing opinions concerning whether retractile testes are affected by similar changes and also whether there is a need for surgical treatment. We aimed to assess the histopathologic changes in retractile testis by studying the changes in testes artificially placed back in the abdomen after they have descended to scrotum in experimental rat models. MATERIALS AND METHODS: Male Sprague-Dawley rats were divided into 3 groups; a control group(controls), prepubertal ascent group (P) in which testis were placed back intraabdominally by bilateral inguinal canal obstruction at 6 weeks, a neonatal group(N) in which intraabdminal testis was induced by bilateral inguinal canal obstruction at birth. The relative weight of the testis, morphology of the seminiferous tubules including Leydig cells, tubular degeneration phase(TDP), spermatogonia per tubules(S/T), and Sertoli cell index (SCI) of these three groups were analyzed and compared. RESULTS: The relative weight of testis was significantly decreased in the group of N(0.0016+/-0.001) and P(0.0015+/-0.0002) compared to controls(0.0037+/-0.0002) (p<0.05). The S/T value was also decreased in P(2.05+/-18.2) and N(73.2+/-32.4) when compared to controls (360.2+/-21.3). Similar changes were observed in SCI of both P(64.5+/-6.4) and N (91.2+/-14.2) when compared to controls (227.9+/-31.1). Only minority of N and P showed higher TDP values. However, although statistically insignificant, TDP was increased in both P and N when compared to controls. The Leydig cells in N and P showed cellular distortion and hypertrophy. CONCLUSIONS: This study demonstrate that prepubertal ascent, similar to that of innate cryptorchid testis, also can induce histopathologic changes such as changes in testicular seminiferous tubule, decrease in the S/T value and decrease in SCI value. Our findings supports that hypothesis that retractile testis may cause histological damage thus surgical correction may also be warranted similar to in case of genuine cryptorchism.
Abdomen* ; Animals ; Cryptorchidism ; Humans ; Hypertrophy ; Inguinal Canal ; Leydig Cells ; Male ; Models, Animal ; Models, Theoretical ; Parturition ; Rats* ; Rats, Sprague-Dawley ; Scrotum ; Seminiferous Tubules ; Spermatogonia ; Testis*

Many physiologic studies have been carried out to identify the neurotransmitters involved in regulating the motility of the smooth muscle in the vas deferens, but the transmitter of a nonadrenergic and non-cholinergic inhibitory nerves has not been clearly identified. We investigated the role of nitric oxide in response to sympathetic motor activity in the rat vas deferens. 1. Nitroprusside and L-NAME had neither contractile nor relaxing effects directly. On the stabilized muscle strips of rat vas deferens, norepinephrine induced a phasic contraction for 10 seconds followed by the sustained tonic contraction. The phasic contraction of norepinephrine was increased by the pretreatment of nitroprusside(p>0.05) and decreased by LNAME(p<0.01). This tonic contraction was decreased dose-dependently by the pretreatment of nitroprusside(p<0.01), and increased by L-NAME(p<0.01). On the muscle strips of rat vas deferens, submaximally precontracted with norepinephrine, nitroprusside potentiated the contraction, followed by the delayed, sustained relaxation, which was blocked by L-NAME. 2. On the muscle strips of rat vas deferens, electrical field stimulation induced an initial phasic contraction for 2-3 seconds, followed by the tonic contraction, which was blocked by L-NAME dose-dependently. The phasic contraction of electrical field stimulation was increased by the pretreatment of nitroprusside(p>0.05) and decreased by L-NAME(p<0.01). This tonic contraction was decreased by the pretreatment of nitroprusside dose-dependently(p<0.01), and increased by L-NAME(.p<0.01). With these results, nitric oxide has the excitatory effect at the phasic contraction, and the inhibitory effect at the tonic contraction in response to sympathetic motor activity in the rat vas deferens partially.
Animals ; Motor Activity* ; Muscle, Smooth ; Neurotransmitter Agents ; NG-Nitroarginine Methyl Ester ; Nitric Oxide* ; Nitroprusside ; Norepinephrine ; Rats* ; Relaxation ; Vas Deferens*

Many physiologic studies have been carried out to identify the neurotransmitters involved in regulating the motility of the smooth muscle in the vas deferens, but the transmitter of a nonadrenergic and non-cholinergic inhibitory nerves has not been clearly identified. We investigated the role of nitric oxide in response to sympathetic motor activity in the rat vas deferens. 1. Nitroprusside and L-NAME had neither contractile nor relaxing effects directly. On the stabilized muscle strips of rat vas deferens, norepinephrine induced a phasic contraction for 10 seconds followed by the sustained tonic contraction. The phasic contraction of norepinephrine was increased by the pretreatment of nitroprusside(p>0.05) and decreased by LNAME(p<0.01). This tonic contraction was decreased dose-dependently by the pretreatment of nitroprusside(p<0.01), and increased by L-NAME(p<0.01). On the muscle strips of rat vas deferens, submaximally precontracted with norepinephrine, nitroprusside potentiated the contraction, followed by the delayed, sustained relaxation, which was blocked by L-NAME. 2. On the muscle strips of rat vas deferens, electrical field stimulation induced an initial phasic contraction for 2-3 seconds, followed by the tonic contraction, which was blocked by L-NAME dose-dependently. The phasic contraction of electrical field stimulation was increased by the pretreatment of nitroprusside(p>0.05) and decreased by L-NAME(p<0.01). This tonic contraction was decreased by the pretreatment of nitroprusside dose-dependently(p<0.01), and increased by L-NAME(.p<0.01). With these results, nitric oxide has the excitatory effect at the phasic contraction, and the inhibitory effect at the tonic contraction in response to sympathetic motor activity in the rat vas deferens partially.
Animals ; Motor Activity* ; Muscle, Smooth ; Neurotransmitter Agents ; NG-Nitroarginine Methyl Ester ; Nitric Oxide* ; Nitroprusside ; Norepinephrine ; Rats* ; Relaxation ; Vas Deferens*

No abstract available.
Catheters*

The crossing laminar screw fixation might be the most recently developed approach among various fixation techniques for C2. The new construct has stability comparable to transarticular or transpedicular screw fixation without risk of vertebral artery injury. Quantitative anatomical studies about C2 vertebra suggest significant variation in the thickness of C2 lamina as well as cross sectional area of junction of lamina and spinous process. We present an elderly patient who underwent an occipito-cervical stabilization incorporating crossed C2 laminar screw fixation. We preoperatively recognized that she had low profiles of C2 lamina, and thus made a modification of trajectory for the inferiorly crossing screw. We introduce a simple modification of crossing C2 laminar screw technique to improve stability in patients with low laminar profiles.
Aged ; Humans ; Spine ; Vertebral Artery

No abstract available.
Female ; Humans

Intercourse without ejaculation may be the result of anejaculation, retrograde ejaculation, nonemission, or aspermia. Twelve patients complaining ofnonejaculatory intercourse were studied. Two of them presented primarily with complaints of sexual dysfunction and 10 with infertility. All of them had primary infertility. Eight patients were anejaculation, which was primary in three and secondary in five. Four patients had nonemission. Six patients wanted early treatment for their infertility and underwent electroejaculation, which produced ejaculates in five. Intrauterine insemination was performed with the processed semen in three of the wives, but there are no pregnancies so far. We intend to keep trying such artificial insemination until we succeed.
Aspermia ; Ejaculation ; Humans ; Infertility ; Insemination ; Insemination, Artificial ; Male ; Pregnancy ; Semen ; Spouses

Rat cystometry is increasingly being used in research on overactive bladder and is a research tool for investigating bladder functions during the storage and voiding phases. Measurement of the pressure in the bladder is an essential part of cystometry, although that pressure is the sum of both detrusor and intra-abdominal pressures. In anesthetic cystometry, measurement of the intra-abdominal pressure is not necessary, because the values of this variable are negligible. In awake cystometry, however, it is mandatory to separate the changes in intra-abdominal pressure from those in intravesical pressure, because consciousness causes much variability in intra-abdominal pressure. This review describes why we use the term "detrusor overactivity" in animal research with intra-abdominal pressure and presents evidence for the role of intra-abdominal pressure in the cystometry of normal rats and in animal models of overactive bladder directed at understanding the pathogenesis of the overactive bladder condition. The methodology is also briefly reviewed.
Animal Experimentation ; Animals ; Consciousness ; Models, Animal ; Rats ; Urinary Bladder ; Urinary Bladder, Overactive ; Urodynamics

No abstract available.
Anencephaly* ; Humans ; Pregnancy, Twin* ; Twins*