The Effects of Botulinum Toxin-A on Calcium Channel and KDR Channel of the Detrusor Muscle in Rat Bladder Body / 대한비뇨기과학회지

PURPOSE: Botulium toxin-A (BoTx A) is useful in treating detrusor-sphincter dyssynergia, detrusor hyperreflexia, and refractory overactive bladder. Only the blocking action of acetycholine (ACh) release from nerve endings is the well known aspect of the action mechanism. The aim of this study is to investigate the effects of BoTx A on the detrusor muscle itself. MATERIALS AND METHODS: Sprague-Dawley rats were divided into 3 groups: the control group, the low dose injection group (1unit/ml of BoTx A, 0.5cc), and the high dose injection group (5units/ml of BoTx A, 0.5cc). All rats were either injected with normal saline (control group) or BoTx A (injection groups). Ten days after injection, a strip of the detrusor muscle was harvested. Contraction and relaxation responses of the strips were measured by an isometric force transducer. Contractions were induced by various concentrations of ACh, bethanechol, phenylephrine (PE), high concentrations of potassium (35, 70, 105, 140mM), tetraethylammonium (TEA, 0.1, 1, 10mM), 4-aminopyridine (4-AP, a delayed rectifier K+ antagonist, 0.1, 1, 10mM), and Bay K8644 (a L-type voltage dependent calcium channel opener, 0.1, 1, 10mM). The results were analyzed by ANOVA and the Student's t test. RESULTS: Contractions of the strips were noted when concentrations were above 1mM for TEA and above 0.1mM for 4-AP. A high dose injection as well as a low dose injection of BoTx A had no significant effects on the Ach or bethanechol-induced contractions of the strips compared to the control group. Denervation supersensitivity was not found in the injection groups after the Ach and bethanechol treatments, but the contractility was decreased in high concentrations of potassium (70, 105, 100mM), TEA (10mM), 4-AP (10mM), and Bay K8644 in both the high and low dose injection groups. There was no significant difference in the decrease of contractility between the high and low dose groups with the exception of the Bay K8644 1M treatment. CONCLUSIONS: BoTx seems to have some direct effects on decreasing the contractility of the detrusor muscle by increasing the delayed rectifier K+ channel activity and decreasing the L-type voltage dependent calcium channel activity.

A case of Hyperstimulated Corpus luteal cyst torsion in Pregnancy after In vitro Fertilization / 대한산부인과학회잡지

Ovarian torsion is the fifth most common condition in gynecologic surgical emergencies, with an incidence of 2.7% occuring mainly in women of reproductive age. It is an uncommon but well recognized complication of ovarian stimulation, especially when ovarian hyperstimulation syndrome occurs. Patients with ovarian torsion normally present with an acute abdomen, necessitating an exploratory laparotomy, with removal of the organ when necrosis is evident. Ultrasound may suggest the diagnosis of adnexal torsion. If the ovarian tumor is a luteal cyst, it is also standard to administer progesterone after surgical treatment, although how efficient this treatment is in preventing miscarriage is questionable. A documented case of adnexal torsion associated with in vitro fertilization is hyperstimulated enlarged corpus luteal cyst. Emergency left salpingo-oophorectomy was done and have concluded a successful pregnancy after exogenous progesterone support. We report a case of enlarged corpus luteal cyst torsion in early pregnancy with a brief review of literatures.

The Role of Urine Osmolality as a Predictor of the Effectiveness of Desmopressin Treatment in Enuretic Children / 대한비뇨기과학회지

No abstract available.

A Case of Mooren's Ulcer

Mooren's ulcer is a chronic, painful ulceration of unknown etiology beginning in the corneal periphery and progressing relentlessly, first circumferentially and then centrally, to involve the entire cornea. The treatment of Mooren's ulcer has had limited sucess. We have experienced a case of bilateral Mooren's ulcer in 68-year-old female, who has been poor general condition. Delimiting lamellar keratectomy and conjunctival excision have been performed. Excised tissues have been examined by histopathologic and immunopathologic method. A brief review of literature is discribed.

Early Developed Candida Endophthalmitis Following Intracapsular Cataract Extraction

Candida albicans endophthalmitis following cataract surgery is fortunately rare complication, but once the infection is established, its course is unrelenting and the prognosis for a good visual result is usually very guarded. The authors experienced a case of culture-proved Candida albicans endophthalmitis following intracapsular cataract extraction in a 74-year old man. Endophthalmitis was resolved after treatment with intravitreal injection of amphotericin B, intravenous amphotericin B, oral Ketoconazole and 2% of topical Ketoconazole.

Clinical Evaluation of Zoster Ophthalmicus

Herpes zoster is a localized vesicular eruption limited to the dermatome of a singl spinal or cranial sensory nerve. It is thought that the varicella-zoster virus enters the sensory nerve ending during the course of chickenpox and spreads up to theganglion and remains there in a latent state. If immunity is impaired, the virus replicates and migrates along sensory nerves to the skin or eye causing the lesins of zoster. The ophthalmic branch of the trigeminal nerve can be affected in the zoster patients. If ocular involvement occurs in association with a varicella-zoster infection of the ophthalmic branch of the trigeminal nerve, a number of clinical changes may take place in the eye and adnexa. Therefore, authors analyzed 320 cases of the herpes zoster patients who had visited Chon Buk National University Hospital from 1981 to 1986. The results were as follows: 1. The sex distribution was 149(46.6%) male patients and 171(54.4%) females. 2. The peak incidence was in the 6th decades. 3. Thoracic nerve was involved in 134(41.9%) patients, lumbosacral in 65(20.3%), ophthalmic division of the trigeminal nerve in 59(18.4%), other trigeminal nerve, in 59(18.4%), and cervical in 28(8.8%). 4. 36 patients were associated with systemic diseases: tuberculosis in 12, diabetis mellitus in 8, steroid therapy for arthritis in 6, hepatitis in 5, malignancy in 4, physical trauma in 2, CO poisoning in 1, and chronic renal failure in 1. 5. Zoster ophthalmicus patients were 32 among 59 involved in ophthalmic division of the trigeminal nerve. 6. The ocular leions were conjunctivities in 27(84.4%), keratitis in 13(40.6%), iritis in 10(31.3%), scleritis and episc1eritis in 9(28.1%), ptosis in 9(28.1%), and pupil distortion in 5(15.6%). 7. Complications and sequelae ensued in 23 patients: corneal opacity in 8, lid scar with retraction in 7, chronic ptosis in 3, post-herpetic neuralgia in 2, iris atrophy in 2, and chronic glauooma in 1.