PURPOSE: To evaluate the feasibility of the interferon-gamma release assay (IGRA) as a supplementary diagnostic tool for the diagnosis of genitourinary tuberculosis (GUTB). MATERIALS AND METHODS: Fifty-seven patients who were tested with the IGRA to diagnose GUTB were included. All patients had clinical or radiologic features suspicious for GUTB. Signs and symptoms included chronic dysuria with long-standing sterile pyuria, renal calcification with distorted renal calyces and contracted renal pelvis, and chronic epididymitis. Patients who had a history of tuberculosis in other organs were excluded. Tests including IGRA, urine acid-fast bacilli (AFB) stain and culture, urine tuberculosis polymerase chain reaction (UT-PCR), and radiological examinations were performed to confirm GUTB. The medical records of the patients were reviewed retrospectively. RESULTS: The IGRA result was positive in 30 patients (52.6%). The results of the urine AFB stain and culture were positive in 5 patients (8.8%) and 7 patients (12.2%), respectively. The results of UT-PCR were positive in 9 patients (15.8%). The 7 patients who showed positive results in the urine AFB stain and culture also had positive results on the IGRA. A UT-PCR-negative patient was diagnosed with GUTB by positive results on both the IGRA and AFB stain and culture. CONCLUSIONS: The IGRA might feasibly be used as a supplementary or screening tool for the diagnosis of GUTB in addition to urine AFB stain and culture. Further studies for statistical evaluation of its sensitivity, specificity, and efficacy are needed.
Contracts ; Dysuria ; Epididymitis ; Humans ; Interferon-gamma ; Interferon-gamma Release Tests ; Kidney Pelvis ; Male ; Mass Screening ; Medical Records ; Polymerase Chain Reaction ; Pyuria ; Sensitivity and Specificity ; Tuberculosis ; Tuberculosis, Urogenital

This study was carried out to evaluate the diagnosis of acute clinical mastitis (ACM) which was based on the vital signs and complete blood count (CBC) tests in dairy cows. Twenty eight dairy cows diagnosed with ACM, were selected for the study between Jan 2003 and July 2006 in the National Institute of Animal Science. Based on their vital signs (rectal temperature, depression, rumen contraction and, dehydration status), ACM was divided into three different classes; mild, moderate and severe forms. In addition, ACM cows were subjected to CBC tests for further diagnosis of ACM. Of the 27 dairy cows diagnosed with ACM, 3 cows were determined to have a mild form, while moderate and sever forms were each observed in twelve cows. Among of them, 4 cows died, 5 cows were culled and 18 cows were recovered. In the mild form, all haematological parameters were comparable with normal values. However, leukopenia, due to neutropenia and lymphocytopenia, appeared characteristically in the moderate and severe forms. Using the observation of vital signs in conjunction with CBC tests, the diagnosis of ACM is more accurate, and is helpful in making decisions of whether treatment or culling of dairy cows infected with ACM is most appropriate.
Animals ; Blood Cell Count ; Contracts ; Dehydration ; Depression ; Female ; Leukopenia ; Lymphopenia ; Mastitis ; Neutropenia ; Reference Values ; Rumen ; Vital Signs

Muscularis propria of the esophagus is organized into circular and longitudinal muscle layers. Goal of this review is to summarize the role of longitudinal muscle in physiology and pathophysiology of esophageal sensory and motor function. Simultaneous manometry and ultrasound imaging that measure circular and longitudinal muscle contraction respectively reveal that during peristalsis 2 layers of the esophagus contract in perfect synchrony. On the other hand, during transient relaxation of the lower esophageal sphincter (LES), longitudinal muscle contracts independently of circular muscle. Recent studies provide novel insights, i.e., longitudinal muscle contraction of the esophagus induces LES relaxation and possibly descending relaxation of the esophagus. In achalasia esophagus and other motility disorders there is discoordination between the 2 muscle layers. Longitudinal muscle contraction patterns are different in the recently described three types of achalasia identified by high-resolution manometry. Robust contraction of the longitudinal muscle in type II achalasia causes pan-esophageal pressurization and is the mechanism of whatever little esophageal emptying that take place in the absence of peristalsis and impaired LES relaxation. It may be that preserved longitudinal muscle contraction is also the reason for superior outcome to medical/surgical therapy in type II achalasia esophagus. Prolonged contractions of longitudinal muscles of the esophagus is a possible mechanism of heartburn and "angina like" pain seen in esophageal motility disorders and possibly achalasia esophagus. Novel techniques to record longitudinal muscle contraction are on the horizon. Neuro-pharmacologic control of circular and longitudinal muscles is different, which provides an important opportunity for the development of novel pharmacological therapies to treat sensory and motor disorders of the esophagus.
Contracts ; Esophageal Achalasia ; Esophageal Motility Disorders ; Esophageal Sphincter, Lower ; Esophagus ; Hand ; Heartburn ; Hypogonadism ; Manometry ; Mitochondrial Diseases ; Muscle Contraction ; Muscles ; Ophthalmoplegia ; Peristalsis ; Relaxation

Ultrasound is over 20 khz, which represents the upper frequency limit of human hearing. Acoustic vibrations are generated when piezoelectric materials on the thin disc-shaped transducers expand and contract. Although low frequency ultrasound devices have been used widely in the dermatologic area for a long time, the mechanism and side effects have been overlooked. A low-frequency ultrasound device has many benefits on the cosmetic dermatology area by thermal effect, vibration effect, and increase of transdermal delivery of lipophilic drugs or cosmetics. However, there have been reports of dermatitis, dyspnea, dizziness, and burns after treatment with ultrasound. Therefore, the use of this device should be under a doctor's supervision.
Acoustics ; Burns ; Contracts ; Cosmetics ; Dermatitis ; Dermatology ; Dizziness ; Dyspnea ; Hearing ; Humans ; Organization and Administration ; Transducers ; Ultrasonics ; Vibration

BACKGROUND/AIMS: Asthmatics have abnormal esophageal motility and increased prevalence of gastroesophageal reflux disease (GERD). The contribution of gastric motility is less studied. We studied gastric myoelectrical activity, gastric emptying (GE) and their association with GERD symptoms and vagal function in adult asthmatics. METHODS: Thirty mild, stable asthmatics and 30 healthy controls underwent real-time ultrasonography and 1 hour pre- and post-prandial cutaneous electrogastrography, following a test meal (480 kcal, 60% carbohydrate, 20% protein, 20% fat and 200 mL water). The percentage of normal slow waves and arrhythmias, dominant frequency and power, frequency of antral contractions, gastric emptying rate (GER) and antral motility index (MI) was calculated. Twenty-seven asthmatics underwent gastroscopy and in all subjects GERD symptoms were assessed by a validated questionnaire. Vagal function parameters were correlated with gastric motility parameters. RESULTS: The asthmatics (37% male; 34.8 +/- 8.4 years) and controls (50% male; 30.9 +/- 7.7 years) were comparable. None had endoscopic gastric pathological changes. Twenty asthmatics described GERD symptoms. Twenty-two (73.3%) asthmatics showed a hypervagal response. Compared to controls, asthmatics had delayed GER and lower MI, lower percentage of normal gastric slow waves, more gastric dysrythmias and failed to increase the post-prandial dominant power. There was no correlation of GE and cutaneous electrogastrography parameters with presence of GERD symptoms or with vagal function. CONCLUSIONS: Asthmatics showed abnormal gastric myoelectrical activity, delayed GE and antral hypomotility in response to a solid meal compared to controls. There was no association with vagal function or GERD symptom status.
Adult ; Arrhythmias, Cardiac ; Asthma ; Carbamates ; Cohort Studies ; Contracts ; Eating ; Gastric Emptying ; Gastroesophageal Reflux ; Gastroscopy ; Humans ; Meals ; Organometallic Compounds ; Prevalence ; Surveys and Questionnaires

BACKGROUND/AIMS: Achalasia is a primary motility disorder of esophagus. Many parameters represent esophageal function and morphologic changes, but their interrelationship is not yet established. We hypothesized that esophageal body would need to generate unusual pressure to empty the food bolus through the non-relaxing lower esophageal sphincter in patients with achalasia; therefore, higher is the residual lower esophageal sphincter pressure, greater would be the contraction pressure in the esophageal body in these patients. To verify the hypothesis, correlations among parameters from esophageal manometry, esophagography and esophageal transit study had been investigated. METHODS: A retrospective review of 34 patients was conducted. Resting lower esophageal sphincter pressure and contraction pressure of esophageal body were obtained from conventional esophageal manometry. Diameter of esophageal body was measured from barium column under esophagography. Radionuclide imaging was performed to assess the esophageal transit, designated as R30, which was the residual radioactivity at 30 seconds after ingesting radioactive isotope. RESULTS: In vigorous achalasia group, contraction pressure of esophageal body was negatively correlated to dilated diameter of esophageal body (P = 0.025, correlation coefficient = -0.596). Esophageal transit was more delayed as dimensions of esophageal body increased in classic achalasia group (P = 0.039, correlation coefficient = 0.627). CONCLUSIONS: Diameter of esophageal body in classic achalasia was relatively wider than that of vigorous achalasia group and the degree of delayed esophageal transit was proportionate to the luminal widening. Patients with vigorous achalasia had narrower esophageal lumen and relatively shorter transit time than that of classic achalasia group. Proper peristalsis is not present in achalasia patients but remaining neuromuscular activity in vigorous achalasia patients might have caused the luminal narrowing and shorter transit time.
Barium ; Contracts ; Esophageal Achalasia ; Esophageal Sphincter, Lower ; Esophagus ; Humans ; Manometry ; Peristalsis ; Phenobarbital ; Radioactivity ; Retrospective Studies

BACKGROUND/AIMS: Lubiprostone, a chloride channel type 2 (ClC-2) activator, was thought to treat constipation by enhancing intestinal secretion. It has been associated with increased intestinal transit and delayed gastric emptying. Structurally similar to prostones with up to 54% prostaglandin E2 activity on prostaglandin E receptor 1 (EP1), lubiprostone may also exert EP1-mediated procontractile effect on intestinal smooth muscles. We investigated lubiprostone's effects on intestinal smooth muscle contractions and pyloric sphincter tone. METHODS: Isolated murine small intestinal (longitudinal and circular) and pyloric tissues were mounted in organ baths with modified Krebs solution for isometric recording. Basal muscle tension and response to electrical field stimulation (EFS; 2 ms pulses/10 V/6 Hz/30 sec train) were measured with lubiprostone (10(-10)-10(-5) M) +/- EP1 antagonist. Significance was established using Student t test and P < 0.05. RESULTS: Lubiprostone had no effect on the basal tension or EFS-induced contractions of longitudinal muscles. With circular muscles, lubiprostone caused a dose-dependent increase in EFS-induced contractions (2.11 +/- 0.88 to 4.43 +/- 1.38 N/g, P = 0.020) that was inhibited by pretreatment with EP1 antagonist (1.69 +/- 0.70 vs. 4.43 +/- 1.38 N/g, P = 0.030). Lubiprostone had no effect on circular muscle basal tension, but it induced a dose-dependent increase in pyloric basal tone (1.07 +/- 0.01 to 1.97 +/- 0.86 fold increase, P < 0.05) that was inhibited by EP1 antagonist. CONCLUSIONS: In mice, lubiprostone caused a dose-dependent and EP1-mediated increase in contractility of circular but not longitudinal small intestinal smooth muscles, and in basal tone of the pylorus. These findings suggest another mechanism for lubiprostone's observed clinical effects on gastrointestinal motility.
Alprostadil ; Animals ; Baths ; Chloride Channels ; Constipation ; Contracts ; Dinoprostone ; Gastric Emptying ; Gastrointestinal Motility ; Humans ; Intestinal Secretions ; Intestine, Small ; Isotonic Solutions ; Mice ; Muscle Tonus ; Muscle, Smooth ; Muscles ; Pylorus ; Receptors, Prostaglandin E ; Receptors, Prostaglandin E, EP1 Subtype ; Lubiprostone

Many of the patients with extensive abrasion need comprehensive restorative treatment. The abrasion is usually caused by attrition, besides of it, there are many reasons for it. The plan of treatment should be started on assessment of the type of attrition and the etiologic analysis. Patient with well-developed masticatory muscle, alveolar process, and high occlusal force and also with little muscle length difference between the stable and the contracted state should be carefully assessed for the vertical dimensional loss and the restoration should be carefully designed. Decrease of tooth length can be compensated by the growth of the alveolar bone height; therefore, consistency of the occlusal vertical dimension is maintained. Accordingly, a careless increase of the vertical dimension can produce muscle fatigue, depressed tooth and pain, and fracture of the restoration. In this case, the patient with multiple tooth abrasion and clenching habit, the edentulous maxillary area is restored with amalgam inserted RPD, and the dentulous area of the maxilla and mandible are treated with fixed restoration accompanying with the increase of vertical dimension. Consequently, we are going to report about the satisfying result in both functional and esthetic aspects.
Alveolar Process ; Bite Force ; Contracts ; Humans ; Mandible ; Masticatory Muscles ; Maxilla ; Mouth ; Mouth Rehabilitation ; Muscle Fatigue ; Muscles ; Tooth ; Tooth Abrasion ; Vertical Dimension

PURPOSE: In patients with neurogenic bladder due to spinal cord injury or disease who undergo augmentation cystoplasty (AC) for not only bladder dysfunction but also sphincteric incontinence, the need for concomitant bladder neck reconstruction at the time of AC has not yet been established. The aim of this study was to evaluate whether concomitant bladder neck reconstruction is necessary when performing AC. MATERIALS AND METHODS: We retrospectively investigated 35 patients who underwent AC from January 2006 to September 2010. Medical history, preoperative and postoperative fluoroscopic urodynamic study (FUDS) parameters, and responses to an incontinence questionnaire (ICIQ Korean version) were reviewed. RESULTS: A final analysis was performed on 17 patients (9 male, 8 female) who were diagnosed with sphincteric incontinence. Continence status, the number of pads used, and the bother score were significantly improved postoperatively in this subpopulation. Preoperatively, all patients used pads, and the average daily number was 2.2 (median; range 0 to 6). Postoperatively, the number of pads used decreased significantly to 0.9 (median; range 0 to 3) pads a day (p=0.002). Urodynamic parameters including bladder capacity, compliance, involuntary detrusor contraction, and bladder neck incompetence proven by FUDS were also significantly improved. CONCLUSIONS: Our study demonstrated that both objective urodynamic parameters and subjective incontinence symptoms improved significantly after the completion of AC as a single procedure in patients with sphincteric incompetence. This implies that anti-incontinence bladder outlet surgery does not have to be performed simultaneously and can be considered later as a staged operation.
Compliance ; Contracts ; Humans ; Male ; Neck ; Retrospective Studies ; Spinal Cord Injuries ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urinary Incontinence ; Urodynamics

PURPOSE: We investigated the effects of mirodenafil, a phosphodiesterase-5 inhibitor developed in South Korea, on the female rat bladder in a partial bladder outlet obstruction (BOO) model. MATERIALS AND METHODS: Thirty-six female Sprague-Dawley rats were divided into four groups: the control group, BOO without medication group, BOO with mirodenafil 1 mg/kg group, and BOO with mirodenafil 4 mg/kg group. Mirodenafil was administered orally for 2 weeks after the induction of BOO. Two weeks after BOO, the rats in each group underwent cystometry under urethane anesthesia. After cystometry, the bladder was excised to perform immunohistochemical staining for connexin 43. RESULTS: The three BOO groups showed significant increases in mean bladder weight compared with the control group. Baseline pressure, threshold pressure, and maximum contraction pressure were not significantly different between the four groups. Although the contraction interval was decreased in all BOO groups compared with the control group, it was prolonged in the two groups treated with mirodenafil compared with the untreated BOO group. In the immunohistochemical examination, connexin 43 staining intensity in the lamina propria increased in the three BOO groups compared with the control group. The two groups treated with mirodenafil, however, showed decreased connexin 43 staining compared with the untreated BOO group. CONCLUSIONS: Mirodenafil may increase the contraction intervals of female rat bladders in a partial BOO model. Decreasing bladder overactivity by mirodenafil may be related to intracellular communication mechanisms involving connexin 43.
Anesthesia ; Animals ; Connexin 43 ; Contracts ; Cyclic Nucleotide Phosphodiesterases, Type 5 ; Female ; Humans ; Mucous Membrane ; Phosphodiesterase Inhibitors ; Pyrimidinones ; Rats ; Rats, Sprague-Dawley ; Republic of Korea ; Sulfonamides ; Urethane ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Bladder, Overactive