PURPOSE: Many investigators suggested that changes in hormonal environment in the postmenopausal women functionally or histologically effect the clitoris and vagina. We investigated the mechanism of female se xual dysfunction occurring in the decreased hormonal status, and aimed to establish and experimental base for the hormone replacement in postmenopausal women to correct sexual dysfunction. MATERIALS AND METHODS: Twenty mature female New Zealand white rabbits were randomly divided into three groups; control group, oophorectomy group, estrogen replacement group after oophorectomy. Nitric oxide synthase (NOS) activity and the degree of expression of neuronal NOS (nNOS) and endothelial NOS (eNOS), collagen content in clitoral tissues were analysed. RESULTS: nNOS and eNOS were significantly increased in the oohporectomized group while decreased in the estrogen replacement group (p<0.01). NOS activity showed the similar pattern of change (p<0.05). Oophorectomy induced a significant increase in collagen content, while the ratio of smooth muscle content was increased significantly after the estrogen replacement (p<0.01). CONCLUSIONS: Estrogen deficiency induces collagen synthesis and decreases the content of smooth muscle in clitoris, resulting in a structural relaxation difficulty. We believe that NOS becomes more active to improve the relaxation difficulty and that hormone replacement helps to restore the normal state of smooth muscle relaxation. Considering these findings, we suggest that estrogen down-regulates NOS and its activity.
Clitoris* ; Collagen ; Estrogen Replacement Therapy ; Estrogens* ; Female ; Humans ; Muscle, Smooth ; Neurons ; Nitric Oxide Synthase ; Ovariectomy ; Rabbits ; Relaxation ; Research Personnel ; Vagina

The pattern of periodic sharp wave complexes (PSWC) was widely accepted as the most characteristic electroencepalographic(EEG) abnormality in Creutzfeldt-Jakob disease (CJD) although it may be lacking in prodromal and terminal stages. The EEG abnormalities are often asymmetric. We compared PSWC with 18F-FDG PET and brain MRI finding to know the signifcance of PSWC. All the patients had typical clinical courses and symptoms of CJD. Three patients were pathologically verified. Three patients were in full stage and two in terminal stage of CJD. We analysed PSWC in digital EEG and compared the regions of maximal PSWC amplitudes with 18F-FDG PET and brain-MRI finding in regard to lateralization and localization. Regarding lateralization, the maximal amplitudes of PSWC were observed over left frontal area in two patients and over right frontal region in three. Three patients in full stage had PET hypometabolism in the same hemisphere as PSWC were lateralized. Their brain MRI showed abnormal basal ganglia intensities but no sever brain atrophy. Two patients in terminal stage had PSWC lateralized in right frontal region but in PET one had left frontoparietal and the other bilateral global hypometabolism. Their brain-MRI showed severe cortical atrophy in the same hemisphere as PET hypometabolism was observed. Regarding all patients in full or terminal stage had maximal PSWC in frontal region, which were not consistent with PET and MRI findings. Cortical lesions in MRI were well corresponding with PET hypometabolism but not with PSWC. These results suggest that PSWC could reflect the hemisphere with more CJD activities in full stage, but could not localize the region where PET and MRI showed abnormalities, suggesting that the generation of PSWC could be related with the involvement of subcortical structures in CJD.
Atrophy ; Basal Ganglia ; Brain ; Creutzfeldt-Jakob Syndrome* ; Electroencephalography ; Fluorodeoxyglucose F18 ; Humans ; Magnetic Resonance Imaging

Graves disease is the most common clinical feature of hyperthyroidism in childhood. Clinical manifestations include emotional lability, hyperactivity, tremor, excessive sweating, exophthalmos and weight loss. In Graves disease, osteoporosis could occur because of a disturbance of mineral homeostasis which rarely develops from reduced calcium absorption of the gastrointestinal tract and increased urinary calcium excretion related to an increased bone resorption. We report a case of Graves disease with spinal deformity caused by osteoporosis in a 12-year-old female who was presented with back pain, anterior neck mass and kyphosis. Laboratory findings revealed hyperthyroidsm, hypercalciuria in 24-hour urine and normal serum parathyroid hormone. On radiologic examination, multiple osteoporosis and a spinal compression fracture were observed. The bone mineral density was decreased at the hip and lumbar spine on the bone densitometry. After initiating antithyroid drug, calcitonin and vitamin D, she returned to a euthyroid state and her back pain was improved. Bone density was also increased one year later.
Absorption ; Back Pain ; Bone Density ; Bone Resorption ; Calcitonin ; Calcium ; Child ; Congenital Abnormalities ; Densitometry ; Exophthalmos ; Female ; Fractures, Compression ; Gastrointestinal Tract ; Graves Disease* ; Hip ; Homeostasis ; Humans ; Hypercalciuria ; Hyperthyroidism ; Kyphosis* ; Neck ; Osteoporosis* ; Parathyroid Hormone ; Spine ; Sweat ; Sweating ; Tremor ; Vitamin D ; Weight Loss

Melkersson-Rosenthal syndrome(MRS) is a rare disorder, having a symptom triad of recurrent facial palsy, orofacial swelling and fissured tongue(lingua plicata). This disorder is usually recurrent or progressive, and monosymptomatic or oligosymptomatic forms have been reported to be more common than classic forms. Generally, MRS occurs in young adults at the end of the second decade of life and incidence of the disease in childhood is known to be very low. Although the clinical manifestation of MRS in children is similar to that in adults, early diagnosis and management is essential to avoid long-lasting functional disorders and psychological problems. We experienced MRS in a 13 year old boy with a history of recurrent facial palsy. We report this case with review of related literature.
Adolescent ; Adult ; Child ; Early Diagnosis ; Facial Paralysis ; Humans ; Incidence ; Male ; Melkersson-Rosenthal Syndrome* ; Young Adult

BACKGROUND/AIMS: Liver stiffness (LS) as assessed by transient elastography (TE) can change longitudinally in patients with chronic hepatitis B (CHB). The aim of this study was to identify the factors that improve LS. METHODS: Between April 2007 and December 2012, 151 patients with CHB who underwent two TE procedures with an interval of about 2 years were enrolled. Ninety-six of the 151 patients were treated with nucleos(t)ide analogues [the antiviral therapy (+) group], while the remaining 55 patients were not [the antiviral therapy (-) group]. The two groups of patients were stratified according to whether they exhibited an improvement or a deterioration in LS during the study period (defined as an LS change of < or =0 or >0 kPa, respectively, over a 1-year period), and their data were compared. RESULTS: No differences were observed between the antiviral therapy (+) and (-) groups with respect to either their clinical characteristics or their initial LS. The observed LS improvement was significantly greater in the antiviral therapy (+) group than in the antiviral therapy (-) group (-3.0 vs. 0.98 kPa, P=0.011). In the antiviral therapy (+) group, the initial LS was higher in the LS improvement group (n=63) than in the LS deterioration group (n=33; 7.9 vs. 4.8 kPa, P<0.001). However, there were no differences in any other clinical characteristic. In the antiviral therapy (-) group, the initial LS was also higher in the LS improvement group (n=29) than in the LS deterioration group (n=26; 8.3 vs. 6.5 kPa, P=0.021), with no differences in any other clinical characteristic. CONCLUSIONS: A higher initial LS was the only factor associated with LS improvement in patients with CHB in this study.
Adult ; Aged ; Alanine Transaminase/blood ; Antiviral Agents/therapeutic use ; DNA, Viral/blood ; Elasticity Imaging Techniques ; Female ; Hepatitis B e Antigens/blood ; Hepatitis B virus/genetics ; Hepatitis B, Chronic/drug therapy/pathology/*ultrasonography ; Humans ; Logistic Models ; Longitudinal Studies ; Male ; Middle Aged