Vasectomy is one of the accepted simple procedure as a contraceptive method. However, there have been no reliable reports on the rate of sperm disappearance from the ejaculate following vasectomy. Rieser found the 14 of the 21 patients with follow-up semen studies required an average of 8 weeks to be azoospermic, and Freund and Davis described that sperm free semen was noted after 6 to 10 ejaculations following bilateral vasectomy. In order to determine the exact end point in terms of the frequency of ejaculations after vasectomy to be sperm free in the ejaculate, a clinical observation was made on the 50 vasectomized patients for the last 3 years. Bilateral vasectomy was performed through a midline incision in the scrotal raphe under local anesthesia (2% procaine). Each semen specimen was collected by coitus using condom. The results obtained were as follows; l) The fourth decade was the most prevalent age group to have had vasectomy(44 cases). The mean number of children was 3. 3 (male 2.2, female 1.1). The 25 patients (38.5%) had two sons and a daughter, and there were no patients without a son. 2) The postoperative first specimen was obtained in all of the 50 cases, the second in 35, the third in 27. the fourth in 20, the fifth in 15, the sixth in 10, the seventh in 3, and the eighth in only one. 3) The meat volume of the semen was not varied with the frequency of ejaculations. The average number of the spermatozoa on the first ejaculate following vasectomy was 43 millions, 23 millions on the second, 16 millions on the third, and 2 millions on the fourth. 4) On the rate of sperm free in the ejaculates in terms of the number of the ejaculations, 7.4 per cent became azoospermic on the third, 20 per cent on the fourth, 33 per cent on the fifth, 60 per cent on the sixth, and 67 per cent on the seventh ejaculation.
Anesthesia, Local ; Child ; Coitus ; Condoms ; Contraception ; Ejaculation ; Female ; Follow-Up Studies ; Humans ; Male ; Meat ; Nuclear Family ; Semen ; Spermatozoa* ; Vasectomy*

Macrodactyly, a disproportionate enlargement of one or more fingers or toes, is generally regarded as a rare congenital malformation. The skin, finger nail, subcutaneous fat tissue, vessels, nerves, tendons and phalanges are all enlarged. and the basic lesion appears to be the accumulation of fibrofatty tissue. The authors have recently experienced a case of pedal macrodactyly occured in the 4th and 5th toes of right foot, which was treated with ablation of the involved toes at the level of 4th and 5th metatarsal shaft. Postoperative course was uneventful. This paper is to present a case of pedal macrodactyly in 18 years old boy, experienced recently at our department and review the references relevant to macrodactyly.
Fingers ; Foot ; Humans ; Male ; Metatarsal Bones ; Skin ; Subcutaneous Fat ; Tendons ; Toes

Lidocaline if frequently administered as a component of an anesthetic : for local or regional nerve blocks, to mitigate the autonomic response to laryngoscopy and tracheal intubation, to suppress the cough reflex, and for antiarrythmic therapy. Diazepam dectease the potential central nervous system (CNS) toxicity of local anesthetic agents but -may modify the sitmulant action of lidocaine in addition to their own cardiovascular depressant. The potential cardiovascular toxicity of local anesthetics may be enhanced by the concomitant administration of diazepam. This study was designed to investigate the effects of lidocaine dose and pretreated diazepam to cardiovascular system and plasma concentration of lidocaine. Lidocaine in 100 mcg/kg/min, 200 mcg/kg/min, and 300 mcg/kg/min was given by sequential infusion to dogs anesthetized with halothane-nitrous oxide (Group I). And in group II, after diazepam pretreatment, lidocaine was infused by same way when lidocaine was administered in 100 mcg/kg/min, the low plasma levels (3.97+/-0.22-4.48+/-0.36 mcg/ml) caused a little reduction in cardiovascular hemodynamics. As administered in 200 mcg/kg/min, 300 mcg/kg/min, the higher plasma levels (7.50+/-0.66-11.83+/-0.59 mcg/ml) reduced mean arterial pressure (MAP), cardiac index (CI), stroke index (SI), left ventricular stroke work index (LVSWI), and right ventricular stroke work index (PVSWI) and incresed pulmonary artery wedge pressure (PAWP), central venous pressure (CVP), systemic vascular resistance index (SVRI), but was assciated with little changes of heart rate (HR), mean pulmonary artery pressure (MPAP), and pulmonary vascular resistance index (PVM). When lidocaine with pretreated diazepam was administered in 100 mcg/kg/min, the low plasma level, the lower level than when only lidocaine administered. reduced MAP, but was not changed other cardiovascular hemodynamics. While lidocaine was infused in 200 mcg/kg/min, 300 mcg/kg/min in dogs pretreated diazepam, the higher plasma level (7.64+/-0.79-13.79+/-0.82 mcg/ml) was maintained and was associated with reduced CI, SI, LVSWI and incresed PAWP, CVP, SVRI but was a little changes of HR, MPAP, PVRI. After CaCl2 administeration, CI, SI, SVRI, LVSWI was recovered but PAWP, UP was rather incresed than recovered. The foregoing results demonstrate that pretreated diazepam imposes no additional burden on cardiovascular system when a infusion of large dose of lidocaine is given to dogs anesthetized with halothanenitrous oxide. But caution may be advised if the addition of lidocaine is indicated in subjects who have impared autonomic nervous system and who are in hypercarbic, hypoxic, or acidotic states.
Anesthetics ; Anesthetics, Local ; Animals ; Arterial Pressure ; Autonomic Nervous System ; Cardiovascular System* ; Central Nervous System ; Central Venous Pressure ; Cough ; Diazepam* ; Dogs* ; Heart Rate ; Hemodynamics ; Intubation ; Laryngoscopy ; Lidocaine* ; Nerve Block ; Plasma* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Reflex ; Stroke ; Vascular Resistance

A case of spinal meningeal melanocytoma is reported along with clinicopathologic, immunohistochemical and ultrastructural studies. This patient presented clinically with paraparesis, tingling sensation and numbness of both lower extremities of 4 months duration. No mucocutaneous pigmented nevi were found. On operation, scattered coal-black pigmented lesions were found in the meninges between T3 and T4-5 interspace level. Nearly total removal was carried out. The tumor was composed of spindle and epithelioid cells with heavy brown-black pigmentation. There was no pleomorphism, mitosis, hemorrhage, necrosis or invasion to the underlying cord tissue. In Korea, this case appears to be the first example of this disease. Neurologic deficit improved after surgical excision.
Adult ; Female ; Humans ; Immunoenzyme Techniques ; Meningeal Neoplasms/chemistry/*pathology/ultrastructure ; Microscopy, Electron ; Spinal Cord

Papillary ependymoma is a rare variant of ependymoma and often gives rise to confusion with choroid plexus papilloma because of topographic, light microscopic and ultrastructural similarities. Here, we report two cases of papillary ependymomas regarding their unique clinicopathologic features and differential points from choroid plexus papilloma. Brain MRI revealed a large mass in the left lateral ventricle in one case and a 3cm sized mass in the pineal area and the 3rd ventricle in the other. Microscopically, the tumor was characterized by papillary and tubular structures. Immunohistochemically, the tumor cells in both cases expressed cytokeratins(CK22 and CAM 5.2) but did not express glial fibrillary acidic protein(GFAP), vimentin, epithelial membrane antigen, and S100 protein. This is a very unusual immunohistochemical feature for papillary ependymoma. Ultrastructurally, the tumor showed a mosaic pattern of tumor cells with frequent intercellular microrosettes having a few stubby microvilli, a few cilia and zonulae adherentes. The cytoplasmic processes were markedly reduced compared to conventional ependymoma. The cytoplasm did not contain intermediate filaments. Interestingly, the mitochondria showed abnormal features with a pleomorphic shape and abnormal cristae in both cases. These ultrastructural features enabled differentiation between papillary ependymoma and choroid plexus papilloma in addition to the light microscopic findings.
Adult ; Carcinoma, Papillary/*pathology/surgery ; Case Report ; Diagnosis, Differential ; Ependymoma/*pathology/surgery ; Fatal Outcome ; Female ; Follow-Up Studies ; Glioma/*pathology ; Human ; Magnetic Resonance Imaging ; Middle Age

Inclusion body myositis is a rare myopathy that clinically resembles a chronic polymyositis and histopathologically is characterized by the presence of rimmed vacuoles containing ultrastructural cytoplasmic degradation products with filamentous intranuclear and cytoplasmic inclusions. Since clinical features are not uniform, histopathologic and ultrastructural studies are necessary to confirm the diagnosis. We report a typical case of inclusion body myositis with histopathologic and ultrastructural study. The patient was a 31 year old male who presented with progressive weakness of both forearms, hands and lower extremities for 10 years.
Adult ; Case Report ; Human ; Male ; Muscles/pathology ; Myositis, Inclusion Body/*pathology/physiopathology

No abstract available.
Electric Stimulation* ; Tendons*

Invasive aspergillosis (IA) is most commonly seen in patients with risk factors, such as cytotoxic chemotherapy, prolonged neutropenia, corticosteroids, transplantation and acquired immune deficiency syndrome. IA commonly occurs in the respiratory tract. Extrapulmonary aspergillosis is usually a part of a disseminated infection, and primary invasive intestinal aspergillosis is very rare. Herein, we report a case of an immunocompetent 53-year-old male who suffered recurrent septic shock in the intensive care unit (ICU) and was finally diagnosed as invasive intestinal aspergillosis without dissemination. IA is rarely considered for patients who do not have an immune disorder. Thus, when such cases do occur, the diagnosis is delayed and the clinical outcome is often poor. However, there is a growing literature reporting IA cases in patients without an immune disorder, mostly among ICU patients. Primary intestinal aspergillosis should be considered for critically ill patients, especially with severe disrupted gastrointestinal mucosal barrier.
Acquired Immunodeficiency Syndrome ; Adrenal Cortex Hormones ; Aspergillosis* ; Critical Illness ; Diagnosis ; Drug Therapy ; Gastrointestinal Diseases ; Humans ; Immune System Diseases ; Immunocompromised Host* ; Intensive Care Units ; Male ; Middle Aged ; Neutropenia ; Respiratory System ; Risk Factors ; Shock, Septic

We found an error in this article. The Fig. 1A.

This study was undertaken to estimate the effects of the induction agents on the bioparameters such as changes in blood pressure, pulse rate, Apgar score, patients movement, fetal arterial and venous blood gas analysis, memory and emergence reactions. 116 parturients undergoing cesarian section were divided into two groups: ketamine group and thiopental group, and were given 1.2 mg/kg ketamine in ketamine group and 4 mg/kg thiopental sodium in thiopental group as an induction agent respectively. The results were as follows; I) Blood pressure increased in both groups, but ketamine group less increased than thiopental group statistically. Pulse rate did not increased in skin incision in ketamine group statistically. 2) The patient's movement were 5 case(9%) in ketamine group and 17 cases(29%) in thiopental group. 3) There was not significant difference in fetal arterial and venous blood gas analysis. 4) In Apgar score, ketamine group is better than thiopental group. 5) There was no psychologic side reactions in both groups. 6) Postoperative recalling of intraoperative awareness occured in seven patients(12%) only in the thiopental group.
Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Cesarean Section ; Female ; Heart Rate ; Humans ; Intraoperative Awareness ; Ketamine* ; Memory ; Pregnancy ; Skin ; Thiopental*