PURPOSE: The AVSS with 3-D HMD is considered to provide a more realistic image and more comfortable circumstances in which the subjects are absorbed in the stimulation. We investigated the efficacy of using 3-D combined with oral medication and a stimulation (COS) test for the evaluation of vasculogenic erectile dysfunction (ED). MATERIALS AND METHODS: 66 patients with complaints of ED, 28 patients diagnosed with vasculogenic ED and 38 patients diagnosed with psychogenic ED were included in this study. The patients were randomly divided into the 2-D group and the 3-D group. The 2-D group patients were examined with using 2-D combined an injection and a stimulation (CIS) test. The 3-D group patients were examined with 3-D CIS test. Then a week later, the patients underwent the AVSS with 3-D HMD 1 hour after oral PDE 5 inhibitor medication. The degree of erection was monitored using the Nocturnal Electrobioimpedance Volumetric Assessment (NEVA) system. RESULTS: On the 2-D CIS tests, 12 of 27 patients showed normal erection, and this resulted in a sensitivity and specificity of 72.7% and 56.3%, respectively. On the 3-D CIS tests, 20 of 39 patients showed normal erection and on the 3-D COS tests, 17 patients showed normal erection and this resulted in a sensitivity and specificity of 88.2% and 81.8%, and 94.1% and 72.7%, respectively. No significant difference were present in the results of the diagnosis between the 3-D CIS and 3-D COS tests. CONCLUSIONS: Both the 3-D CIS and 3-D COS tests offer the advantage of higher sensitivity and specificity than the conventional CIS test. The 3-D COS test may be used as a substitute for the conventional CIS test due to its simplicity and less invasive nature.
Diagnosis* ; Erectile Dysfunction* ; Genetic Complementation Test ; Humans ; Male ; Photic Stimulation ; Sensitivity and Specificity ; Vardenafil Dihydrochloride

Primary carcinoma of the male urethra are rare. Among the malignant tumors of the male urethra, squamous cell carcinoma is the most common. Transitional cell carcinoma is very rare, particularly in the distal urethra. We experienced a case of distal urethral transitional cell carcinoma, arising at the fossa navicularis of the penis, which we report here with a review of the literature. A 68-year-old male patient presented with bloody discharge from the prepuce for 1 month. Ultrasonography showed a poorly marginating, heterogeneous mass, invading the glans penis and the corpus spongiosum. The mass encircled the glandular urethra of the penis glans, and obstructed the glandular urethra and the fossa navicularis. A Doppler ultrasonogram revealed hypervascularity in this mass. The mass was isointense to the corpus carvernosum on the T1-weighted images and slightly hypointense to the corpus carvernosum on the T2-weighted images. Contrast-enhanced MR imaging showed a poorly enhancing mass in the glans penis. This mass was confirmed as a transitional cell carcinoma by histologic study and a partial penectomy was performed.
Aged ; Carcinoma, Squamous Cell ; Carcinoma, Transitional Cell* ; Humans ; Magnetic Resonance Imaging* ; Male ; Penis ; Ultrasonography ; Urethra

We report the successful treatment by percutaneous aspiration and antibiotics of a penile abscess in an elderly man attributed to misapplication of sildenafil citrate. The etiology, diagnosis, and management of penile abscess are discussed.
Abscess* ; Aged ; Anti-Bacterial Agents ; Citric Acid* ; Diagnosis ; Humans ; Sildenafil Citrate

Kohler's disease is an uncommon idiopathic osteochondrosis of the tarsal navicular. The diagnosis is clinical and the natural history is benign. The treatment is symptomatic, including shoe supports when the symptoms are mild and initial cast immobilization for at least 8 weeks when the symptoms are more intensive. The final clinical outcome is always favorable. Although it has been fully described both clinically and radiologically, There have been a few long-term follow-up reports in worldwide. This case report presents a Kohler's disease of the tarsal navicular with long-term follow-up of 12 years.
Diagnosis ; Follow-Up Studies* ; Immobilization ; Natural History ; Osteochondrosis ; Shoes

Kohler's disease is an uncommon idiopathic osteochondrosis of the tarsal navicular. The diagnosis is clinical and the natural history is benign. The treatment is symptomatic, including shoe supports when the symptoms are mild and initial cast immobilization for at least 8 weeks when the symptoms are more intensive. The final clinical outcome is always favorable. Although it has been fully described both clinically and radiologically, There have been a few long-term follow-up reports in worldwide. This case report presents a Kohler's disease of the tarsal navicular with long-term follow-up of 12 years.
Diagnosis ; Follow-Up Studies* ; Immobilization ; Natural History ; Osteochondrosis ; Shoes

Although sporadic cases of transient fetal ascites have been described, pulmonary hypoplasia or hydrops fetalis may occur as potentially lethal complications of isolated fetal ascites. Antenatal fetal paracentesis may be useful in improving neonatal pulmonary function, however rapid accumulation of fluid after paracentesis usually required repetitive invasive procedures. We successfully treated an isolated fetal ascites with peritoneo- amniotic shunt. Under the ultrasonographic guidence, we inserted a Double-Basket Catheter into the left lower quadrant of fetal abdominal wall at the end of second trimester. Shunt remained in place until the fetus was delivered at term. The peritoneo-amniotic shunt can improve fetal outcome and avoid repeated paracentesis before delivery.
Abdominal Wall ; Ascites* ; Catheters ; Female ; Fetus ; Humans ; Hydrops Fetalis ; Paracentesis ; Pregnancy ; Pregnancy Trimester, Second

PURPOSE: To evaluate prospectively the role of prostate-specific antigen (PSA) density in predicting Gleason score upgrading in prostate cancer patients eligible for active surveillance (T1/T2, biopsy Gleason score< or =6, PSA< or =10 ng/mL, and < or =2 positive biopsy cores). MATERIALS AND METHODS: Between January 2010 and November 2013, among patients who underwent greater than 10-core transrectal ultrasound-guided biopsy, 60 patients eligible for active surveillance underwent radical prostatectomy. By use of the modified Gleason criteria, the tumor grade of the surgical specimens was examined and compared with the biopsy results. RESULTS: Tumor upgrading occurred in 24 patients (40.0%). Extracapsular disease and positive surgical margins were found in 6 patients (10.0%) and 8 patients (17.30%), respectively. A statistically significant correlation between PSA density and postoperative upgrading was found (p=0.030); this was in contrast with the other studied parameters, which failed to reach significance, including PSA, prostate volume, number of biopsy cores, and number of positive cores. Tumor upgrading was also highly associated with extracapsular cancer extension (p=0.000). The estimated optimal cutoff value of PSA density was 0.13 ng/mL2, obtained by receiver operating characteristic analysis (area under the curve=0.66; p=0.020; 95% confidence interval, 0.53-0.78). CONCLUSIONS: PSA density is a strong predictor of Gleason score upgrading after radical prostatectomy in patients eligible for active surveillance. Because tumor upgrading increases the potential for postoperative pathological adverse findings and prognosis, PSA density should be considered when treating and consulting patients eligible for active surveillance.
Aged ; Biopsy, Needle ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Invasiveness ; Neoplasm, Residual ; Organ Size ; Predictive Value of Tests ; Prospective Studies ; Prostate/*pathology ; Prostate-Specific Antigen/*blood ; Prostatic Neoplasms/*blood/*pathology/surgery ; ROC Curve ; Watchful Waiting/*methods

Testicular teratoma is characterized that has more than one germ cell layer in various stages of maturation and differentiation. The incidence of mature teratoma varies from 2 to 9% of all germinal testicular tumor. Only 3 cases of bilateral teratoma have been reported in the literature to date. The teratoma can occurs at all ages but is most common between the age of 15-35 year. It is relatively infrequently seen in childhood and infancy. In these age group, teratoma tends to be a benign. Recently, we experienced one case of bilateral testicular teratoma in 4 month-old infancy. We report a case of bilateral testicular teratoma found infancy with review of related literatures.
Germ Cells ; Humans ; Incidence ; Infant* ; Teratoma* ; Testis

Background: Pigmented purpuric dermatosis (PPD) is a chronic disorder characterized by distinct petechial hemorrhage and brownish pigmentation. The cause of PPD is unclear, but several underlying conditions are associated with it. Previous reports suggest that venous insufficiency (VI) might be related to PPD; however, a clear correlation remains unelucidated. Objective: To elucidate the causal relationship between PPD and VI. Methods: A total 118 patients diagnosed with PPD in the Department of Dermatology, Pusan National University Hospital from November 2006 to July 2019 were retrospectively reviewed. Doppler ultrasonography of the lower extremities was performed in 56 PPD patients, who were then divided into two groups: PPD with and without VI. We compared the clinical features between the two groups. In the PPD with VI group, we assessed the correspondence ratios between PPD and VI lateralities, and between the PPD distribution and the veins involved. Results: VI was detected in 35 of the 56 patients (62.5%). The PPD with VI group was significantly associated with wider distribution, darker coloration and longer disease duration. There was a positive correlation of laterality between PPD and VI, and between PPD distribution and the vein involved. Conclusion This findings suggest that VI is a clear provoker of PPD.

The mammographic or physical evaluation of breast parenchymal abnormalities in the presence of radiopaque implants or silicone injections is difficult; mammography often fails to discriminate between breast cancer and a radiopaque dense breast. Although the sonographic evaluation of a palpable mass in an augmented breast may be impaired by the presence of posterior acoustic shadowing, the modality may be helpful in evaluating such masses, and dynamic contrast-enhanced MR imaging facilitates differentiation. FDG-PET is a possible alternative diagnostic tool for the evaluation of parenchymal lesions under these circumstances, but its drawbacks are its high cost and limited availability. The sensitivity and specificity of both FDG-PET and MRI can be improved by correlating their findings with those of radiological studies, and through an awareness of potential false-negative and false-positive causes.
Acoustics ; Breast Neoplasms* ; Breast* ; Foreign Bodies* ; Granuloma, Foreign-Body* ; Magnetic Resonance Imaging* ; Mammography* ; Sensitivity and Specificity ; Shadowing (Histology) ; Silicones ; Ultrasonography