Urge incontinence with uninhibited detrusor contraction has been known to be a typical findings observed in the supraspinal neurologic disorders such as cerebrovascular accident(CVA). However, voiding difficulty with significant amounts of residual urine are frequently noted in the patients with organic brain diseases. Also, little is known about the exact causes of voiding difficulty in aged people without obstruction. Herein, Resnik at all have identified a specific physiological abnormality-detrusor hyperreflexia with impaired contractility (DHIC)- a distinct physiological subset of detrusor hyperreflexia. DHIC presents with a seemingly paradoxical set of findings: the bladder is overactive but empties ineffectively. We evaluated the symptoms and urodynamic findings for the 50 patients with supraspinal neuropathies and, also for the 28 elderly peoples complaining voiding dysfunction without evidence of bladder outlet obstruction or, pathologies in the brain. Of the 50 patients with parenchymal brain disease, 41 had CVA, 6 had Parkinson's disease and, 3 had senile dementia. Age of patients ranged from 52 to 89 years and 63 patients of them was man. As a results of urodynamic study; DHIC was noted in 36, DH (detrusor hyperreflexia) in 24, DH with obstructive pattern in 8, ID (impaired detrusor contractility) in 5, normal findings in 5 patients. Of the 36 patients with DHIC, CVA were noted in 19, senile dementia in 1, and, normal aged peoples in 16 cases. In 24 patients with DH, CVA were noted in 9, senile dementia in 1, Parkinson's disease in 6 and, normal aged peoples in 8 cases. Of the 8 patients showed DH with obstruction, CVA was present in 7 and, senile dementia in 1 cases. Of the 5 patients with IDC, CVA was present in 2 and, normal aged peoples in 3 cases. Patients showed DHIC, DH with obstruction and IDC complained obstructive symptoms more frequently than irritative symptoms. On the contrary, DH patients complained irritative symptoms more frequently than obstructive symptoms. Mean fraction of volume voided was 48% in DHIC and 23% in DH with obstruction, which were significantly less than 77% in DH. With this study, hyperreflexic contraction of detrusor was observed in 68(87%), and decreased contractility in 41 patients(53%). The fact that the patients showed DHIC was substantially older than those with DH may imply the decreased contractile function of the detrusor muscle by the aging process. It is also interesting that more than 90% (27/28) of the aged peoples without any pathologies exhibited abnormal findings in urodynamic study explain that the aging process itself may induce the changes of the bladder contractility. Urge incontinence due to DH has been known to be the most common findings in supraspinal lesion. However, these results showed that the impairment of detrusor contractility was also commonly found in the patients with supraspinal lesions and, in aged peoples. Treatment for the DHIC seem to be a dilemma for both the patients and physicians, and it may need emptying of residual urine in addition to the administration of anticholinergics or smooth muscle relaxants.
Aged ; Aging ; Alzheimer Disease ; Brain ; Brain Diseases ; Cholinergic Antagonists ; Humans ; Muscle, Smooth ; Nervous System Diseases ; Parkinson Disease ; Pathology ; Reflex, Abnormal* ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Incontinence, Urge ; Urodynamics

Surgical treatment have been gold standard in most cases of ureteral stricture and it`s effects were not satisfactory. Recently nonoperative dilatation offer attractive alternatives to surgery in the treatment of urodynamically significant ureteral strictures. Wide spread acceptance of balloon and other catheter techniques in dilating stenotic blood vessels, biliary tree and urinary tract led us to try these modalities for the treatment of ureteral strictures. So we tried percutaneous balloon dilatation in 5 failed retrograde ureteral dilatation cases. 4 tuberculous ureteritis and 1 postureterolithotomy state. We used the balloon catheter with techniques of percutaneous transluminal manipulation for dilatation of the ureteral stricture under fluoroscopic guidance. The results of dilatation were successful in 4 cases and failed in 1 tuberculous ureteral stricture. In successfu1 4 cases, there was no evidence of symptomatic and radiologic recurrence for 7 to 29 months of follow up period. The percutaneous balloon dilatation can be useful in case of alternative to surgery and failed retrograde balloon dilatation.
Biliary Tract ; Blood Vessels ; Catheters ; Constriction, Pathologic* ; Dilatation* ; Follow-Up Studies ; Recurrence ; Ureter* ; Urinary Tract

This study was designed to clarify the dependency of hypoxic coronary vasodilation (HCD) on the endothelium and the role of the K+ channels on HCD in the rabbit coronary artery. HCD was investigated in an isolated left circumflex coronary artery precontracted with prostaglandin F2 alpha. Vascular rings were suspended for isometric tension recording in an organ chamber filled with Krebs-Henseleit (KH) solution. Hypoxia was induced by gassing the chamber with 95% N2 + 5% CO2 and was maintained for 15 approximately 25 min. Hypoxia elicited a vasodilation in the precontracted coronary artery with and without endothelium. There was no difference between the amplitude of the HCD induced by two consecutive hypoxic challenges and the effects of 20% O2 + 5% CO2 + 75% N2 and 95% O2 + 5% CO2 control K-H solution of subsequent responses to hypoxia. Inhibition of the cyclooxygenase pathway by treatment with indomethacin had no effect on HCD. Blockades of the tetraethylammonium chloride-sensitive K+ channel abolished HCD. Apamin, a blocker of the small conductance Ca(2+)-activated K+ (KCa) channel, and iberiotoxin, a blocker of the large conductance KCa channel had no effect on HCD, respectively. Glibenclamide, a blocker of the ATP-sensitive K+ (K+ATP) channel, reduced HCD. Cromakalim, an opener of the K+ATP channel, relaxed the coronary artery precontracted with prostaglandin F2 alpha. The degree of relaxation by cromakalim was similar to that by hypoxia while glibenclamide reduced both hypoxia- and cromakalim-induced vasodilatations. In conclusion, these results suggest that HCD is independent on endothelium and HCD is considered to be induced by activation of K+ATP channel.
Animal ; Anoxia/physiopathology* ; Coronary Vessels/physiopathology* ; Coronary Vessels/drug effects ; Cyclooxygenase Inhibitors/pharmacology ; Enzyme Inhibitors/pharmacology ; Female ; Indomethacin/pharmacology ; Male ; Nitroarginine/pharmacology ; Rabbits ; Tetraethylammonium/pharmacology ; Vasodilation/physiology*

A patient is described who was presented with a little finger tip sized palpable nodular mass on left calf muscle for 2 years of duration. The pathologic result of the biopsy specimen for nodular mass showed a clear cell carcinoma. The full metastatic work up demonstrated tumor in the right kidney, with no other detectable primary focus. Result of the radical nephrectomy exhibited renal cell carcinoma confined within renal parenchyme. The patient was treated with IFN-alpha-2b as adjuvant therapy and now is on close observation without the evidence of tumor recurrence.
Biopsy ; Carcinoma, Renal Cell* ; Fingers ; Humans ; Kidney ; Neoplasm Metastasis* ; Nephrectomy ; Recurrence

PURPOSE: Past studies have reported that S-allylcysteine (SAC) inhibits the migration and invasion of cancer cells through the restoration of E-cadherin, the reduction of matrix metalloproteinase (MMP) and Slug protein expression, and inhibition of the production of reactive oxygen species (ROS). Furthermore, evidence is emerging that shows that ROS induced by radiation could increase Met activation. Following on these reports of SAC and Met, we investigated whether SAC could suppress Met activation. MATERIALS AND METHODS: Wound healing, invasion, 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium (MTT), soft agar colony forming, western blotting, and gelatin zymography assays were performed in the human nasopharyngeal cancer cell lines HNE1 and HONE1 treated with SAC (0, 10, 20, or 40 mM) and hepatocyte growth factor (HGF). RESULTS: This study showed that SAC could suppress the migration and invasion of HNE1 and HONE1 cell lines by inhibiting p-Met. An increase of migration and invasion induced by HGF and its decrease in a dose dependent manner by SAC in wound healing and invasion assays was observed. The reduction of p-Met by SAC was positively correlated with p-focal adhesion kinase (p-FAK) and p-extracellular related kinase (p-ERK in both cell lines). SAC reduced Slug, MMP2, and MMP9 involved in migration and invasion with the inhibition of Met-FAK signaling. CONCLUSION: These results suggest that SAC inhibited not only Met activation but also the downstream FAK, Slug, and MMP expression. Finally, SAC may be a potent anticancer compound for nasopharyngeal cancer treated with radiotherapy.
Agar ; Blotting, Western ; Cadherins ; Cell Line ; Emigration and Immigration ; Gastropoda ; Gelatin ; Hepatocyte Growth Factor* ; Hepatocytes* ; Humans ; Nasopharyngeal Neoplasms* ; Phosphotransferases ; Radiotherapy ; Reactive Oxygen Species ; Wound Healing

Abscess of prostate has become a rare disease due to development of modern antibiotics and decreasing incidence of gonococcal infection. Recently the pathogen of prostatic abscess is almostly E. coli, the others are pseudomonas, staphylococcus, obligate anaerobic bacteria. Staphylococcus aureus infected rostatic abscess arises from other inflammatory focus as a complication of a skin infection by hematogenous route most commonly. We encountered two cases of Staphylococcus aureus infected prostatic abscess in diabetes mellitus patients. There had been no primary inflammatory focus in both cases moreover no fever in the first case. He did not complain of specific symptoms of prostatic abscess such as fever, dysuria, pyuria and perineal pain. The other one complained of fever and acute urinary retention. In both cases, prostatic abscess was suspected by transrectal ultrasonography and confirmed by percutaneous needle aspiration. The patients were treated with pathogen sensitive antibiotics combined with transurethral resection drainage of prostate.
Abscess* ; Anti-Bacterial Agents ; Bacteria, Anaerobic ; Diabetes Mellitus ; Drainage ; Dysuria ; Fever ; Humans ; Incidence ; Needles ; Prostate ; Pseudomonas ; Pyuria ; Rare Diseases ; Skin ; Staphylococcus ; Staphylococcus aureus ; Ultrasonography ; Urinary Retention

We studied the guidelines on the serum bilirubin concentration of 12mg% for the management of neonatal jaundice and compared the effectiveness of oral phenobarbital and continuous phototherapy with singularly phototherapy, in reducing neonatal hyperbilirubinemia in the 100 cases admitted to the department of pediatrics, St. Benedict Hospital from April 1977 to August 1977. The results were as follows; 1. Among the 35 full term normal newborn infants without any risk factors for kernicterus, 14 infants had serum bilirubin concentration below 12mg%. In this group, 5 infants received phototherapy (35.7%). 21 infants had serum bilirubin concentration above 12mg%. In the latter group, 5 infants received phototherapy (71.4%) 2. The mean rate of fall of serum bilirubin per day was 1.81mg% in phototherapy plus phenobarbital groups and 1.57mg% in singularly phototherapy. 3. The mean peak rate of fall of serum bilirubin was 2.28mg% per day in the third to fourth day of phototherapy and phenobarbital groups and 2.76mg% per day in the fourth to fifth day of singularly phototherapy. 4. The mean duration of phototherapy was 74 hours in phototherapy plus phenobarbital groups and 82 hours in singularly phototherapy.
Bilirubin* ; Humans ; Hyperbilirubinemia, Neonatal ; Infant ; Infant, Newborn ; Jaundice, Neonatal* ; Kernicterus ; Pediatrics ; Phenobarbital* ; Phototherapy* ; Risk Factors

BACKGROUND: The C7-T1 interspinous space is commonly chosen for cervical epidural blockade, usually regarding the vertebral prominence as C7. But determining the vertebral prominence itself is confusing and unreliable because of individual variances. For this reason, we decided to look into the accuracy of estimating segmental level from palpating the surface anatomy. METHODS: 1. When the neck was flexed in the sitting position, cervical spinous processes were palpated and the first and most prominent spinous processes were marked. 2. In the same position, the estimated location of the C7 vertebral spinous process was marked, counting cephalads from the lower end of scapular (known to be at the T7 level, customarily). 3. By using the radiologic imaging method, actual cervical vertebral levels were confirmed and the results were compared with the vertebral spinous processes palpated and marked by the above methods. RESULTS: The first prominent spinous process was most commonly the C6 spinous process in both male and female subjects. The most prominent spinous processes palpated were C7 in males and C6 in females in the largest number of subjects. Estimates from the lower end of the scapular were correct in only 47.2% of cases. CONCLUSIONS: Because of considerable individual variances, estimates from the surface references can be incorrect in many circumstances, and radiologic imaging methods are suggested for the correct determination of the cervical vertebral levels.
Female ; Humans ; Male ; Neck ; Palpation*

BACKGROUND: The C7-T1 interspinous space is commonly chosen for cervical epidural blockade, usually regarding the vertebral prominence as C7. But determining the vertebral prominence itself is confusing and unreliable because of individual variances. For this reason, we decided to look into the accuracy of estimating segmental level from palpating the surface anatomy. METHODS: 1. When the neck was flexed in the sitting position, cervical spinous processes were palpated and the first and most prominent spinous processes were marked. 2. In the same position, the estimated location of the C7 vertebral spinous process was marked, counting cephalads from the lower end of scapular (known to be at the T7 level, customarily). 3. By using the radiologic imaging method, actual cervical vertebral levels were confirmed and the results were compared with the vertebral spinous processes palpated and marked by the above methods. RESULTS: The first prominent spinous process was most commonly the C6 spinous process in both male and female subjects. The most prominent spinous processes palpated were C7 in males and C6 in females in the largest number of subjects. Estimates from the lower end of the scapular were correct in only 47.2% of cases. CONCLUSIONS: Because of considerable individual variances, estimates from the surface references can be incorrect in many circumstances, and radiologic imaging methods are suggested for the correct determination of the cervical vertebral levels.
Female ; Humans ; Male ; Neck ; Palpation*

BACKGROUND: Orthostatic intolerance is a debilitating problem that can occur after prolonged bed-rest, exposure to microgravity, and in the elderly. This study examined the integrated cardiovascular response to baroreceptor activation in a hind-limb unweighing (HLU) mouse model of microgravity to test the hypothesis that both the pressor and contractility response are attenuated in HLU mice. METHODS: C57BL/6 mice (25-30 g body wt, 8-10 wk old) were exposed to HLU for 2 weeks. A bilateral carotid artery occlusion and open-loop baroreceptor stimulus was performed to measure the myocardial contractile responses using a left ventricular micromanometer-conductance catheter in the mice. In isolated myocytes simultaneous sarcomere shortening and calcium transient were measured in response to increasing concentrations of the beta-agonist isoproterenol. RESULTS: In the controls, bilateral carotid artery occlusion increased the heart rate and mean arterial pressure. These responses were markedly attenuated in the HLU mice. A bilateral carotid artery occlusion also increased the slope of the end-systolic pressure volume relationship (Ees) by 70 +/- 11% and the slope was markedly attenuated to 10 +/- 8% in the HLU mice. Isoproterenol increased the sarcomere shortening in both control and HLU mice in a dose-dependent manner. However the contractile response to isoproterenol was significantly attenuated in the HLU mice than the controls. CONCLUSIONS: Both the pressor and myocardial contractile responses appear to be impaired in a mouse model of microgravity.
Aged ; Animals ; Arterial Pressure ; Baroreflex ; Calcium ; Carotid Arteries ; Catheters ; Heart Rate ; Humans ; Isoproterenol ; Mice* ; Muscle Cells ; Orthostatic Intolerance ; Pressoreceptors ; Sarcomeres ; Weightlessness