The ultrasonographic features in 26 cases of blunt testicular trauma were reviewed. Ultrasonography diagnosed correctly in 11 surgically proven cases of testicular rupture. There were three false-positive cases, two with a large scrotal hematocele and one with epididymis rupture. there were no false-negative cases. The sensitivity and specificity of ultrasonographic diagnosis were 100% and 80% respectively. The positive and negative predictive values were 78. 6% and 100% respectively. Therefore, the negative diagnosis by ultrasonography can warrant conservative therapy.
Diagnosis ; Epididymis ; Hematocele ; Male ; Rupture ; Sensitivity and Specificity ; Ultrasonography*

PURPOSE: Our purpose in this study is to evaluate the effectiveness of bronchial and nonbronchial systemic arteries for the control of hemoptysis. MATERIALS AND METHODS: Seventy patients with massive or recurrent hemoptysis underwent percutaneous transcatheter embolotherapy between 1991 and 1993. Retrospectively we reviewed 77 cases of bronchial artery embotization and 32 cases of nonbronchial systemic artery embolization in the 70 patients. RESULTS: Immdiate control of hemoptysis was achieved in 33 of 39 patients with massive hemoptysis(84.6%) and 20 of 24 patients with recurrent hemopt ysis(83.3%). In 32 cases, nonbronchial systemic arteries contributed significantly to areas of pathologic pulmonary tissue and frequently were the major arterial supply. CONCLUSION: Bronchial artery embolization is an effective and life saving procedure in non-surgical candidates. Recognition and occlusion of nonbronchial systemic arteries that feed to hypervascular pulmonary lesions is essential for successful percutaneous embolotherapy of hemoptysis.
Arteries ; Bronchial Arteries ; Embolization, Therapeutic ; Hemoptysis* ; Humans ; Retrospective Studies

Pelvic fistulas may result from obstetric complications, inflammatory bowel disease, pelvic malignancy, pelvic radiation therapy, pelvic surgery, or other traumatic causes, and their symptoms may be distressing. In our experience, various types of pelvic fistulas are identified after pelvic disease or pelvic surgery. Because of its close proximity, the majority of such fistulas occur in the pelvic cavity and include the vesicovaginal, vesicouterine, vesicoenteric, ureterovaginal, ureteroenteric and enterovaginal type. The purpose of this article is to illustrate the spectrum of imaging features of pelvic fistulas.
Bladder Fistula/diagnosis/etiology ; Female ; Fistula/*diagnosis/*etiology ; Human ; Intestinal Fistula/diagnosis/etiology ; *Pelvis ; Ureteral Diseases/diagnosis/etiology ; Urinary Fistula/diagnosis/etiology ; Uterine Diseases/diagnosis/etiology ; Vaginal Fistula/diagnosis/etiology

PURPOSE: The extent of ESWL(Extracorporeal Shock Wave Lithotripsy), a treatment for urinary calculus, shows gradual development and the treatment has become generally known as a noninvasive, safe, and efficacious method. Although the testicular effects are not within the vicinity of shock waves in carrying ESWL as a treatment for urinary calculus, research was initiated to examine effects which shock waves might cause on the testis. MATERIALS AND METHODS: After applying shock waves at intensity 4 for 1,000 times to the testis of Sprague Dawley immature rat, the histopathologic changes within the tissue of testis were observed after 1, 7, 14, 28 days, respectively. RESULTS: In the case of the experimental group having shock waves on the testis, destruction of seminiferous tubules, necrosis, and hemorrhage were found out a%or a day. One week later the atrophy of seminiferous tubules, interstitial fibrosis, and a small portion of chronic inflammatory cell appeared The capillary proliferation near the testis capsule also appeared. Two weeks later somewhat atrophied seminiferous tubules and proliferation of Leydig cells appeared. Diversely atrophied seminiferous tubules, diffusion of Leydig cell proliferation, calcified tubules, and foreignbody reaction were discovered after 4 weeks. As times went on, the tendency of recovery appeared. CONCLUSIONS: Noxious influences such as testicular atrophy and disturbance of spermatogenesis occurred in inflicting immediate shock wave on the testis. Therefore the need of more researches concerning long-term sequelae and the influences on the human body should be taken into consideration.
Animals ; Atrophy ; Capillaries ; Cell Proliferation ; Diffusion ; Fibrosis ; Hemorrhage ; Human Body ; Leydig Cells ; Male ; Necrosis ; Rats* ; Seminiferous Tubules ; Shock* ; Spermatogenesis ; Testis* ; Urinary Calculi

No abstract available.
Acyclovir ; Chickenpox* ; Child* ; Herpesvirus 3, Human* ; Humans

No abstract available.
Neurofibromatoses* ; Scoliosis*

To assess the correlation between the remaining serum testosterone and bone mineral density(BMD), and to determine the effect of exogenous testosterone on BMD in subjects with male hypogonadism, we evaluated the serum testosterone levels and BMDs of the femur neck, Ward's triangle and the spine(L1-4) in 20 subjects with Klinefelter's syndrome and 7 with hypogonadotropic hypogonadism before and after testosterone replacement. BMDs of the femur neck, Ward's triangle and the spine were below the age-matched normal mean at 77.8%(21/20), 74.1%(20/27) and 88.9%(24/27), respectively. There were significant differences in serum testosterone levels and the spinal BMD between the two groups and the BMD of the spine closely correlated with the serum testosterone level (R = 0.63, p < 0.001). Following a mean 11.8 +/- 4.9 months of testosterone replacement, the BMD at all sites increased significantly and the pretreatment difference in spinal BMD between the two groups disappeared. We conclude that, although testosterone may increases the bone density, it has a site-specific effect of maintaining and increasing the bone mass especially at the spine in male hypogonadism.
Adult ; Bone Density/*drug effects/physiology ; Human ; Hypogonadism/blood/*metabolism ; Klinefelter Syndrome/blood/drug therapy/*metabolism ; Male ; Middle Age ; Testosterone/blood/metabolism/*pharmacology

BACKGROUND: Cardiac hypertrophy is an adaptive mechanisms in response to an increased cardiac work load. Alterations in gene expression play an important role in this adaptive process. Recent investigations have indicated that the alpha-1 adrenergic stimulation in vitro induces hypertrophic change of neonatal cardiomyocytes. The signalling mechanisms of this alpha-1 agonist induced cardiomyocyte hypertrophy are largely unknown. however, recent evidence favors an effector pathway that involves phospholipase C(PLC) mediated hydrolysis of phosphatidylinositol 4,50 bisphosphate. It should be recognized that the demonstration of enhanced phosphoinositol turnover in the presence of alpha-1 adrenergic agonist in vitro does not necessarily imply that a similar response is operative in vivo. Furthermore, the role of subtypes of phospholipase C in this system should be determined. In this context, we produced in vivo cardiac hypertrophy by repeated injection of alpha-1 adrenergic agonist, phenylephrine, and tried to evaluate any change of phospholipase C subtypes by immunohistochemistry and immunoblotting technique and also measured the phosphatidylinositol hydrolyzing activity of the enzyme. METHOD: To produce cardiac hypertrophy, we injected phenylephrine 12mg/kg i.p. to the 28 female S-D rats weighing 150-250g daily for 5 days. This measures produced 22% increase of heart weight/body weight ratio. After 5 days. rats were sacrificed and hearts were rapid excised and freezed for next procedure. The immunohistochemical stainings of myocardium were carried out using monoclonal antibodies against PLC-beta1,-gamma1,-delta1 with Avidine-Biotin Complex method. Immunoblotting was done with monoclonal anti-PLC-gamma1 antibody after immnoprecipitation. The activity of PLC-gamma1 was determined in the assay mixture containing [3H] phosphatidylinositol of 20,000 cpm. The reaction was performed by incubating with resuspended immunoprecipttol of 20,000 cpm. The reaction was performed by incubating with resuspended immunoprecipitate for 10 min and supernatant was collected for -scintillation counting. RESULTS: Immunohistochemical staining demonstrated increased staining of PLC-gamma1 in the phenylephrine induced hypertrophied heart as compared with normal control heart. PLC-beta1 and-o1 did not showed any change. Elghteen out of 20 hypertrophied cardiac tissue(90%) demonstrated increased expression of the PLC-gamma1 compared with control heart tissue in immunoblotting. [3H] PI hydrolyzing activity of PLC-gamma1 in the immunoprecipitates of the hypertrophied hearts(4650+/-614 cpm) were increased consistently in 6 samples as compared with control normal hearts (2387+/-651 cpm). CONCLUSION: In the present experiments we demonstrated that Phospholipase C-gamma1 was overexpressed compared with control normal heart of rat by immunohistochemistry and immunoblotting technique and showed that the activity of this isoenzyme was elevated. Our findings of increased PLC-gamma1 expression in the alpha1-adrenergic agonist induced cardiac hypertrophy tissue suggest that the phosphatidylinositol signalling pathway is important in the genesis of cardiac hypertrophy and the isoenzyme of PLC-gamma1 may play a central role in this mechanism.
Adrenergic Agonists ; Animals ; Antibodies, Monoclonal ; Cardiomegaly* ; Female ; Gene Expression ; Heart ; Humans ; Hydrolysis ; Hypertrophy ; Immunoblotting ; Immunohistochemistry ; Myocardium ; Myocytes, Cardiac ; Phenylephrine* ; Phosphatidylinositols ; Phospholipases* ; Rats* ; Signal Transduction ; Type C Phospholipases

We assessed the efficacy of trabeculectomy with mitomycin C in the management of congenital glaucoma of which prognosis is known to be poor. Twelve consecutive eyes of 7 primary congenital glaucoma patients who underwent trabeculectomy with mitomycin C were retrospectively reviewed. The mean age was 3.2 years(ranging from 1 to 10 years) and the mean follow-up period was 31.6 months (ranging from 15 to 42 months). The mean postoperatie intraocular pressure (IOP) at the end of follow-up period was 11.0 +/-3.0mmHg, significantly lower than the mean preoperative IOP which was 25.4 +/-6.3mmHg (P<0.01). The overall success rate was 50% after a single procedure. All the 6 failed eyes underwent the same operation again and the overall success rate was 83%. The complications included hypotony in 4 eyes (33.3%) and shallow anterior chamber in 2 eyes (16.6%), and they were all resolved spontaneously. There was no evidence of hypotonic maculopathy and endophthalmitis. Trabeculectomy with mitomycin C successfully lowered the IOP in congenital glaucoma patients without serious complication and further investigation will be required to determine ling-term effects in terms of successful filtration and possible late complications.
Anterior Chamber ; Endophthalmitis ; Filtration ; Follow-Up Studies ; Glaucoma* ; Humans ; Intraocular Pressure ; Mitomycin* ; Prognosis ; Retrospective Studies ; Trabeculectomy*

No abstract available.
Child* ; Humans ; Orbit*