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

Muscle pain is one of the most common, as well as elusive, clinical complaints. Pain can be experienced in muscles by any dysfunction of the muscle itself, peripheral nerves, or central nervous system. Persistent inflammation of the muscle increases nerve endings of the nociceptors and can develop allodynia or hyperalgesia. Myofascial trigger points are formed by perpetuating contraction of the sarcomeres and local ischemia and can result in regional pain. Disorders of the peripheral nervous system can entail muscle pain in the innervated territory. The central nervous system can also modulate or generate muscle pain. Gate-control theory provides an explanation as to how pain can be affected by the nervous system. Fibromyalgia is believed to be related to a lowered pain threshold in the central nervous system. Clinicians, during their diagnostic approach, should not unduly attribute muscle pain to pathology confined to the muscle merely because pain is perceived and evoked from the muscle. Even in cases where abnormalities are confirmed in the muscle, such as myofascial trigger points, clinicians should seek the underlying etiology. In particular, diagnosis of myofascial pain syndrome does not rule out primary musculoskeletal disorders. Rather, arthropathies or radiculopathies are known to frequently involve myofascial pain syndrome, which would not improve unless they are resolved. After accurate diagnosis of muscle pain is obtained, appropriate treatment should be implemented. A multi-disciplinary, individualized approach, including physiotherapy, exercise, education, and behavioral modification, is recommended.
Central Nervous System ; Contracts ; Fibromyalgia ; Hyperalgesia ; Inflammation ; Ischemia ; Muscles ; Myofascial Pain Syndromes ; Nerve Endings ; Nervous System ; Nociceptors ; Pain Threshold ; Peripheral Nerves ; Peripheral Nervous System ; Radiculopathy ; Sarcomeres ; Trigger Points

OBJECTIVE: To investigate the effect of gastrocnemius muscle fatigue on postural control ability in elderly people. METHODS: Twenty-four healthy elderly people participated in this study. The postural control ability of single leg standing was evaluated with Health Improvement & Management System (HIMS) posturography before and after fatiguing exercises. After evaluating initial postural control ability, the maximal voluntary contraction (MVC) of ankle plantarflexion was assessed using a surface electromyogram from the medial belly of the gastrocnemius muscle. After a 5-minute resting period, subjects began submaximal isometric ankle plantarflexion (40% MVC) until 40% of MVC was dropped below 95% for 5 seconds, or subject couldn't continue working out due to muscle fatigue. And postural control ability was assessed after fatiguing exercise. The mean deviation of center of pressure (COP), length of COP movement, occupied area of COP were measured, and analyzed by paired t-test. RESULTS: Mediolateral deviation, length of COP movement, and area of COP occupied were increased after fatiguing exercise of the gastrocnemius muscle. Anteroposterior deviation and length of COP movement were also increased, but had low statistical significance. CONCLUSION: These findings suggest that the gastrocnemius muscle fatigue affects mediolateral stability and accuracy during single leg standing in elderly people. Therefore muscle endurance training is necessary to prevent falls in elderly people.
Aged ; Animals ; Ankle ; Contracts ; Exercise ; Fatigue ; Humans ; Leg ; Muscle Fatigue ; Muscle, Skeletal ; Muscles ; Posture

As we face a rapidly aging population in the Republic of Korea, the number of patients with the need to prevent or alleviate periorbital changes due to aging will grow. The periorbital changes that occur with aging comprise a dynamic process involving the aging of facial tissue and bony structures. Epidermal thinning and decreases in collagen cause the skin to lose its elasticity. Loss of fat, coupled with gravity and muscle pull, leads to wrinkling and the formation of dynamic lines. The aging process has also been shown to affect the facial bones. Multiple studies suggest that aging of the orbit and midface bones occurs primarily due to contraction and morphologic changes. This loss of bony volume and projection may contribute to an aged appearance. The effort to understand each patient's individual involutional changes, which differ by age and gender, is mandatory. Identifying the patient's personal needs and selecting the appropriate treatment accordingly is crucial for achieving the best outcome both for the clinician and the patient.
Aging* ; Collagen ; Contracts ; Elasticity ; Eyelids ; Facial Bones ; Gravitation ; Humans ; Muscles ; Orbit ; Republic of Korea ; Skin

OBJECTIVES: Thioperamide is used as an antagonist to the histamine H3 receptor. During administration of the drug, the trachea may be affected via nasal or oral inhalation. This study was to determine the effects of thioperamide on the trachea of rats in vitro. METHODS: We tested the effectiveness of thioperamide on isolated rat trachea submersed in Kreb's solution in a muscle bath. Changes in tracheal contractility in response to the application of parasympathetic mimetic agents were measured. The following assessments of thioperamide were performed: 1) effect on tracheal smooth muscle resting tension; 2) effect on contraction caused by 10(-6) M methacholine as a parasympathetic mimetic; 3) effect of the drug on electrically-induced tracheal smooth muscle contractions. RESULTS: Thioperamide induced a significant relaxation response at a preparation concentration up to 10(-4) M. The drug also inhibited the electrical field stimulation induced spike contraction. However, thioperamide alone had a minimal effect on the basal tension of the trachea at increasing concentrations. CONCLUSION: The study indicated that high concentrations of thioperamide might actually antagonize cholinergic receptors and block parasympathetic function of the trachea.
Animals ; Asthma ; Baths ; Contracts ; Inhalation ; Methacholine Chloride ; Muscle, Smooth ; Muscles ; Piperidines ; Rats ; Receptors, Cholinergic ; Receptors, Histamine H3 ; Relaxation ; Trachea

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

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

Electrogastrography (EGG) is a non-invasive method for the measurement of gastric myoelectrical activity. It was first discovered in 1921 and popularized in 1990s. EGG is attractive because it is non-invasive. However, due to its non-invasive nature, there have also been controversies regarding validity and applications of EGG. The aim of this review is to discuss the methodologies, validation and applications of EGG. Pros and cons of EGG will also be discussed in detail. First, the gastric slow wave and its correlation with gastric motility are presented. The association between gastric dysrhythmia and impaired gastric motility is reviewed. Secondly the method for recording the electrogastrogram is presented in detail and pitfalls in the recording and analysis of EGG are discussed. Thirdly, findings reported in the literature demonstrating the accuracy of EGG in recording gastric slow waves and gastric dysrhythmia are reviewed and discussed. The correlation of the electrogastrogram with gastric contraction is carefully discussed. Finally, applications of EGG in a few major areas are reviewed.
Contracts ; Gastrointestinal Motility ; Ovum

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

PURPOSE: The location of acetylcholinesterase-containing nerve fibers suggests a role for acetylcholine in both contractility and secretion in the prostate gland. The colocalization of nitrergic nerves with cholinergic nerves, and the cotransmission of nitric oxide with acetylcholine in cholinergic nerves, has been demonstrated in the prostate glands of various species. Thus, we investigated the effects of acetylcholine on phenylephrine-induced contraction and the correlation between cholinergic transmission and nitric oxide synthase by using isolated prostate strips of rabbits. MATERIALS AND METHODS: Isolated prostate strips were contracted with phenylephrine and then treated with cumulative concentrations of acetylcholine. Changes in acetylcholine-induced relaxation after preincubation with NG-nitroarginine methyl ester, 7-nitroindazole, and aminoguanidine were measured. The effects of selective muscarinic receptor antagonists were also evaluated. RESULTS: In the longitudinal phenylephrine-contracted strip, the cumulative application of acetylcholine (10(-9) to 10(-4) M) elicited a concentration-dependent relaxation effect. Acetylcholine-induced relaxation was inhibited not only by nitric oxide synthase inhibitors (10 microM L-NAME or 10 microM 7-nitroindazole) but also by 10 microM atropine and some selective muscarinic receptor antagonists (10(-6) M 11-([2-[(diethylamino)methyl]-1-piperdinyl]acetyl)-5,11-dihydro-6H-pyrido[2,3-b][1,4]benzodiazepine-6-one and 10(-6) M 4-diphenylacetoxy-N-methyl-piperidine). In contrast, relaxation was significantly increased by pretreatment of the strips with 10 mM L-arginine. CONCLUSIONS: Acetylcholine relaxed phenylephrine-induced contractions of isolated rabbit prostate strips. This relaxation may be mediated via both cholinergic and constitutive nitric oxide synthase with both the M2 and M3 receptors possibly playing key roles.
Acetylcholine ; Atropine ; Contracts ; Guanidines ; Indazoles ; Nerve Fibers ; Neurons ; NG-Nitroarginine Methyl Ester ; Nitrergic Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type I ; Phenylephrine ; Prostate ; Receptor, Muscarinic M2 ; Receptor, Muscarinic M3 ; Receptors, Muscarinic ; Relaxation