No abstract available.
Diagnosis, Differential* ; Humans ; Lower Urinary Tract Symptoms*

No abstract available.
Kidney Pelvis* ; Metaplasia* ; Ureter*

To evaluate the regional differences in the stereometric parameters of optic nerve head in primary open angle glaucoma, we retrieved rim area, disc area, cup volume/disc area, and maximum depth in 6 predefined segements using mean topography measured with Heidelberg Retina Tomograph. Eleven eyes from 11 primary open angle glaucoma patients, whose mean defect in Humphrey C30-2 visual field was -4.2 +/- 2.6dB and intraocular pressure was 18.7 +/- 3.2mmHg, were enrolled in this study. The values of rim area/disc area were significantly different between segments(p<0.05), and increased in the order of temporal. temporoinferior, temporosuperior, nasal nasosuperior, and nasoinferior segment. The values of cup volume/disc area were also significantly different between segments(p<0.05), and decreased in the order of temporoinferior, temporosuperior, temporal, nasosuperior, nasal, and nasoinferior segment. However, the values of maximum depth were not significantly different between segments. These results suggest that optic nerve head damage in primary open angle glaucoma may be different according to the region.
Glaucoma, Open-Angle* ; Humans ; Intraocular Pressure ; Optic Disk* ; Optic Nerve* ; Retina ; Visual Fields

PURPOSE: To investigate the correlation between the severity of diabetic retinopathy and the responses of multifocal electroretinogram (mERG). METHODS: The amplitude and peak time of mERG was evaluated in a group of 88 diabetics and 20 control subjects. The severity of diabetic retinopathy was determined according to the ETDRS scale using color fundus photographs and fluorescein angiograms. RESULTS: The amplitudes of the summed mERG and the central seven hexagons were significantly lower in diabetic patients compared with control subjects, and the more severe the diabetic retinopathy was , the less the amplitude was (P<0.05). The peak times of the summed mERG and the central seven hexagons were significantly delayed in diabetic patients, and the peak time was increased in parallel with the severity of retinopathy (P<0.05). These significant correlations between mERG responses and the severity of diabetic retinopathy was maintained even after the exclusion of patients with diabetic macular edema. CONCLUSIONS: The macular function in diabetic patients is correlated with the grade of diabetic retinopathy, and mERG may have a clinical application in evaluating macular function in these patients.
Diabetic Retinopathy* ; Fluorescein ; Humans ; Macular Edema

Cryptococcus is native to the environment and thrives in any type of environment inhabited by birds. Cryptococcal genito-urinary infection has been reported in immunnocompromised patients and can involve the adrenal gland, kidney, prostate, or penis. To our knowledge, there have been no reports of cases where cryptococcal epididymo-orchitis infects an uncompromised healthy host. Here, we report a case of primary cryptococcal epididymo-orchitis in a healthy male.
Adrenal Glands ; Birds ; Cryptococcus ; Humans ; Kidney ; Male ; Orchitis ; Penis ; Prostate

The diagnosis of ejaculatory duct obstruction(EDO) may be suspected on clinical grounds from the characteristic seminal analysis and is being confirmed by vasoseminal vesiculography. Through the analysis of our experienced cases, we defined the new characteristics of EDO in semen analysis and we investigated the role of TRUS in diagnosing this entity. We analyzed 23 EDO patients we experienced during the last 5 years. All cases were diagnosed by vasoseminal vesiculography. In last 16 patients, transrectal ultrasonography(TRUS) was performed before vasoseminal vesiculography and 15 patients(94% ) were suspected to be EDO. The cause of EDO were identified as midline cyst in 7 patients, Wolffian malformation in 4, previous genitourinary infection in 5, and unknown causes in 7. We have treated 21 patients. Fourteen patients were treated by transurethral resection (TUR), 5 patients by forceful lavage through vasotomy site, 2 patients by transseptal vasovasostomy. Eight (57%) of 14 patients treated by TUR achieved an improvement in semen volume and/or semen quality and 3 patients( 10% ) produced pregnancy. Six(86%) of 7 patients caused by midline cyst achieved improvement in semen parameters and 3 patients(43% ) produced pregnancy. Overall, ten of 21(48%) patients achieved improvement in semen characteristics, 3 patients(12%) produced pregnancy. Among our cases, six patients presented with a subtle and mild abnormalities in seminal fluid Their sperm density was above 10xl0'/ml while ejaculated volume was low to normal. Their sperm motility was consistently diminished(less than 35%) and semen fructose was low(less than 140). TRUS enabled to detect midline cyst or seminal vesicle dilatation in these partial EDO cases before vasoseminal vesiculography. Based on our experience of EDO we suggest that TRUS is the initial diagnostic procedure if infertile patients were suspected as EDO according to semen parameters. We suggest that if semen fructose was low in the athenospermic patient who has high sperm density( >0.000001/ml), TRUS should be performed.
Diagnosis ; Dilatation ; Ejaculatory Ducts* ; Fructose ; Humans ; Infertility, Male ; Male ; Pregnancy ; Semen ; Semen Analysis ; Seminal Vesicles ; Sperm Motility ; Spermatozoa ; Therapeutic Irrigation ; Vasovasostomy

The minor fissure is an important anatomical landmark in the localization of the pulmonary diseases. For the evaluation of the normal feature of the minor fissure, we analyzed the high-resolution computed tomography (CT) scans in 51 normal patients. The purposes of this study are to evaluate the normal appearance of the minor fissure on high-resolution CT scans and to compare it with that on the coventional CT and chest radiographs. We analysed the morphologic feature of the minor fissure on the high-resolution CT scans in 51 normal patients, and compared it with that on the conventional CT scans. On the high-resolution CT scans, we particularly paid attention to the completeness and types according to Berkmen classification. And finally, we compared the types determined by the high-resolution CT scans with those by the plain radiographs. In most patients (n=47), the minor fissure was seen as a hyperattenuating line or hand on the high-resolution CT scans. In contrast, it was mostly seen as a lucent zone on the conventional CT scans (n=44). Of 47 patients having a hyperattenuating line or band on the high resolution CT scans, the minor fissure was considered to be complete in 17 patients (36%), and incomplete in 30 patients (64%), who had defect at medial portion of the minor fissure. The most common type of the minor fissure seen on the high-resolution CT scans was type I variety (n=23), followed by type IIa (n=10) and type II (n=8). We could not determine the type in six patients. The type determined by the high resolution CT scans was highly well correlated with that determined by the plain radiographs (p<0.05). In conclusion, the minor fissure was seen on CT studies as variable appearances and high-resolution CT scans were superior to the conventional CT scans in the evaluation of the minor fissure. The type of the minor fissure determined by the high-resolution CT scans were well correlated with those seen on the radiographs.
Classification ; Hand ; Humans ; Lung Diseases ; Radiography, Thoracic ; Tomography, X-Ray Computed

The minor fissure is an important anatomical landmark in the localization of the pulmonary diseases. For the evaluation of the normal feature of the minor fissure, we analyzed the high-resolution computed tomography (CT) scans in 51 normal patients. The purposes of this study are to evaluate the normal appearance of the minor fissure on high-resolution CT scans and to compare it with that on the coventional CT and chest radiographs. We analysed the morphologic feature of the minor fissure on the high-resolution CT scans in 51 normal patients, and compared it with that on the conventional CT scans. On the high-resolution CT scans, we particularly paid attention to the completeness and types according to Berkmen classification. And finally, we compared the types determined by the high-resolution CT scans with those by the plain radiographs. In most patients (n=47), the minor fissure was seen as a hyperattenuating line or hand on the high-resolution CT scans. In contrast, it was mostly seen as a lucent zone on the conventional CT scans (n=44). Of 47 patients having a hyperattenuating line or band on the high resolution CT scans, the minor fissure was considered to be complete in 17 patients (36%), and incomplete in 30 patients (64%), who had defect at medial portion of the minor fissure. The most common type of the minor fissure seen on the high-resolution CT scans was type I variety (n=23), followed by type IIa (n=10) and type II (n=8). We could not determine the type in six patients. The type determined by the high resolution CT scans was highly well correlated with that determined by the plain radiographs (p<0.05). In conclusion, the minor fissure was seen on CT studies as variable appearances and high-resolution CT scans were superior to the conventional CT scans in the evaluation of the minor fissure. The type of the minor fissure determined by the high-resolution CT scans were well correlated with those seen on the radiographs.
Classification ; Hand ; Humans ; Lung Diseases ; Radiography, Thoracic ; Tomography, X-Ray Computed

Nocturia is usually considered to be just one of the symptoms included with lower urinary tract symptoms (LUTS) and is treated with therapy based on LUTS. Recent research suggests, however, that nocturia is not merely a simple symptom of LUTS but is a multifactorial condition with many contributing etiological factors. The causes of nocturia can be classified into bladder storage problems, increased urine output, sleep disturbance problems, and other potential diseases. The frequency-volume chart (FVC) is very important in evaluating and diagnosing nocturia. Patients usually record the volume and timing of voids for a period of 1 to 3 days on the FVC. The FVC data can provide information on voiding patterns and clues about the etiology and treatment of nocturia. It is doubtful that alpha-blockers will have clinical significance for treatment because the difference in nocturia episodes between treatment with alpha-blockers and placebo is too small. Antimuscarinics also exert no effect on nocturnal polyuria, and the evidence supporting the efficacy of antimuscarinics for the treatment of nocturia is limited. However, several randomized placebo-controlled trials have shown the efficacy of oral desmopressin in the treatment of adults with nocturia. Short-acting hypnotics may be helpful for patients with sleep disturbances. Although surgical or interventional therapy is not indicated for nocturia, transurethral resection of the prostate appears to confer a greater improvement in benign prostatic hyperplasia symptoms including nocturia. The management of nocturia may require a team approach by making optimal use of multidisciplinary expertise.
Adult ; Deamino Arginine Vasopressin ; Humans ; Hypnotics and Sedatives ; Lower Urinary Tract Symptoms ; Muscarinic Antagonists ; Nocturia ; Polyuria ; Prostate ; Prostatic Hyperplasia ; Urinary Bladder

PURPOSE: To report one case of bilateral acute retinal necrosis (ARN) syndrome in the patient with acquired immunodeficiency syndrome (AIDS). METHODS: Bilateral retinal necrosis, occlusive vasculitis, vitreous opacity and inflammatory reaction in anterior chamber were noted in a 48-years old man with AIDS. RESULTS: The patient was diagnosed as bilateral ARN, but did not respond to intravenous acyclovir therapy. However, the patient was successfully treated with intravenous ganciclovir at a dosage of 5 mg/kg/day, which resulted in resolution of retinal lesion and improvement of visual acuity without complications such as retinal detachment. CONCLUSIONS: CMV retinitis, progressive outer retinal necrosis, ocular syphilis should be considered in the differential diagnosis of ARN syndrome in the AIDS patients and alternative treatment with ganciclovir should be considered promptly when the patient do not respond to acyclovir therapy.
Acquired Immunodeficiency Syndrome* ; Acyclovir ; Anterior Chamber ; Diagnosis, Differential ; Ganciclovir ; Humans ; Middle Aged ; Necrosis ; Retinal Detachment ; Retinal Necrosis Syndrome, Acute* ; Retinaldehyde ; Retinitis ; Syphilis ; Vasculitis ; Visual Acuity