INTRODUCTIONIn line with the effort to evaluate feasible surgical options for vasectomy reversal and to increase patients' willingness to undergo the procedure, this study reported on a technique for ambulatory mini-incision microsurgical vasovasostomy using a double-ringed clamp (i.e. Moon's clamp). This technique does not require the use of dilators, approximators and other accessory devices.

METHODSAmbulatory mini-incision microsurgical vasovasostomy was conducted on 263 patients who satisfied the surgical eligibility requirements for vasovasostomy and the safety criteria for local anaesthesia. The operation time, details on postoperative recovery and results of the postoperative semen analysis were recorded and retrospectively analysed.

RESULTSThe mean time used to isolate the bilateral vas deferens was 25.5 minutes. All patients were discharged on the day of surgery and all patients returned to their normal activities within 24-48 hours after surgery. No haematoma or infection occurred except in one patient. Postoperative semen analysis showed that the surgery was successful in 182 (96.8%) of the 188 patients who complied with the postoperative patient instructions.

CONCLUSIONAmbulatory mini-incision microsurgical vasectomy reversal using Moon's clamp and under local anaesthesia is a surgically feasible option that offers the advantages of a low-risk operation. It also achieves successful vasovasostomy without other accessory devices and allows patients to return to their daily activities quickly with minimal complications.

Adult ; Anesthesia, Local ; methods ; Equipment Design ; Feasibility Studies ; Follow-Up Studies ; Humans ; Male ; Microsurgery ; methods ; Middle Aged ; Retrospective Studies ; Surgical Instruments ; Suture Techniques ; instrumentation ; Vasovasostomy ; methods

The MR images of 13 patients with brain abscesses were retrospectively reviewed. The abscesses were solitary in 11 patients and multiple in 2 patients. They were located in the corticomedullary junction of the cerebral hemispheres(11) and cerebellum (2).: The sizes of the abscesses were variable, ranging from 1 cm to 5 cm in diameter. They were round (5), oblong (4) or multilobulated (4) in shape. Massive surrounding edema was found in 12 patients. The signal intensity of the abscess contents was hypointense to gray matter and hyperintense to CSF on T1-weighted images, and hyperintense to gray matter on both proton-density-and T2-weighted images. In 5 patients the abscess contents were heterogeneous on both T1-and T2-weighted images. The signal intensity of the abscess walls was isointense(11), slightly hyperintense (1) or hypointense (1) relative to gray matter on T1-weighted images, whereas they were isointense (4) or hypointense (9) on T2-weighted images. Of 10 patients with Gd-enhanced-T1-weighted images, 5 patients(50%) showed thin, smooth, rim enhancement, while the other 5 patients revealed somewhat irregular thick wall enhancement Satellite or daughter abscesses were found in 6 patients. Meningeal or ventricular wall enhancement suggesting meningitis or ventriculitis was associated in 3 and 1 patient, respectively. In conclusion, the characteristic morphology and intensity of the abscess capsule, massive surrounding edema, satellite abscess and associated meningitis or ventriculitis are characteristics of the brain abscess, even though they are not entirely specific to allow for accurate diagnosis in all patients.
Abscess ; Brain Abscess* ; Brain* ; Cerebellum ; Diagnosis ; Edema ; Gray Matter ; Humans ; Magnetic Resonance Imaging* ; Meningitis ; Nuclear Family ; Retrospective Studies

We retrospectively analyzed the Magnetic Resonance (MR) imaging findings in 41 cases of histologically proved malignant tumors of oral cariey. The diagnostic value of MR imaging in detection and delineation of the lesions was assessed. The value of MRI was compared with that of Computed Tomography (CT) in 14 patients. Thirty-four cases of 41 malignant tumors were squamous cell carcinomas. Adenoic cystic carcinomas (2 cases), malignant melanomas (2 cases), non-Hodgkin lymphomas (2 cases) and mucoepidermoid carcinoma(1 cases) were also included in this study. Most of the lesions were isointense or slightly hyperintense to muscle on T1 weighted images and showed variable degrees of high signal intensity on T2 weighted images. Two cases of malignant melanomas showed characteristic hyperintensity on T1 weighted images. T2 weighted image was better in detection and delineation of tumor in most of the cases. In 6 cases, Gd-DTPA-enhanced T1 weighted image was better than T2 weighted image. T2 weighted image was useful for the evaluation of deep tissue infiltration and T1 weighted image was useful for the evaluation of bone invasion and superficial tissue plane invasion. The lesion was detected only by MR in 3 cases of 14 in which CT was also performed. MR imaging was more sensitive in the evalustion of bone marrow involvement. MR imaging is very useful modality in evaluating oral cavity malignany and is superior to CT in delineation of the as well as in the evaluation of mandible invasion.
Bone Marrow ; Carcinoma, Squamous Cell ; Humans ; Lymphoma, Non-Hodgkin ; Magnetic Resonance Imaging* ; Mandible ; Melanoma ; Mouth* ; Retrospective Studies

Myotonic dystrophy is an autosomal-dominantly inherited neuromuscular disorder characterized by slowly progressive muscular dystrophy, muscle weakness and myotonia. The clinical features may vary from just cataracts to involvement of multiple organ systems such as various muscles, heart, lung and intestine. During pregnancy and delivery, serious maternal and obstetrical complications may occur. The myotonia is often aggravated during pregnancy and it leads to obstetrical complications such as fetal loss, preterm premature delivery, hydrops, in-utero fetal death, difficulties in fetal expulsion, postpartum hemorrhage and/or anesthetic accidents. The affected neonate may display severe hypotonia, facial displegia and respiratory distress. This report presents a woman with myotonic dystrophy complicated with congestive heart failure and preterm delivery during pregnancy.
Cataract ; Edema ; Estrogens, Conjugated (USP)* ; Female ; Fetal Death ; Heart Failure* ; Humans ; Infant, Newborn ; Intestines ; Lung ; Muscle Hypotonia ; Muscle Weakness ; Muscular Dystrophies ; Myocardium ; Myotonia ; Myotonic Dystrophy* ; Obstetric Labor, Premature* ; Postpartum Hemorrhage ; Pregnancy*

In complication of infective endocaditis splenomegaly and splenic infarction are not uncommon but splenic rupture is very rare. We report a case of splenic rupture complicated by infective endocarditis in 1 71-yr-old man who had been suffered from rheumatic heart disease (aortic regurgitation and stenosis and mitral regurgitation). The patient was admitted to mild fever and generalized weakness for 20 days. Diagnosis of infective endocarditis due to Staphylococcus epidermidis was made by clinical manifestaions and blood culture study.On 34th day of admissionthe patient suddenly displayed the symptoms and signs of massive intraperitoneal hemorrhage. Splenic rupture was revealed by paracentesis and radiologic studies. Rupture of spleen is an uncommon and usually fatal complication of infective endocarditis. Therefore early diagnosis and prompt treatment must be performed.
Constriction, Pathologic ; Diagnosis ; Early Diagnosis ; Endocarditis* ; Fever ; Hemorrhage ; Humans ; Paracentesis ; Rheumatic Heart Disease ; Rupture ; Spleen ; Splenic Infarction ; Splenic Rupture* ; Splenomegaly ; Staphylococcus epidermidis

No abstract available.
Lymphangioma, Cystic*

Pulmonary artery sling is an uncommon and potentially lethal vascular anomaly that can produce airway obstruction. Despite the availibility of a corrective operation, the mortality rate remains very high due to the high incidence of associated obstructive anomalies of the tracheobronchial tree. We experienced a 70-day-old male infant who was admitted to our unit because of sudden dyspnea, cyanosis, coarse expiratory wheezing and inspiratory stridor. At first, he was treated with bronchodilator and steroid under the impression of infantile asthma, but the symptoms went on without interval change. We performed magnetic resonance imaging study followed esophagography and two dimensional echocardiography. Finally he was diagnosed as a vascular sling. We report this with a brief review and related literatures.
Airway Obstruction ; Asthma ; Cyanosis ; Dyspnea ; Echocardiography ; Humans ; Incidence ; Infant ; Magnetic Resonance Imaging ; Male ; Mortality ; Pulmonary Artery ; Respiratory Sounds

Prepubertal male Sparague-Dawley rats were used to investigate the effects of unilateral testicular torsion on the contralateral testicular histology. All rats were divided into eight experimental group (5 animals each), one of which was used for experimental control (sham operation). We have examined contralateral testes to determine the effect of therapeutic orchiectomy or detorsion after active physical 720' torsion (six hrs., twelve hrs., twenty four hrs.) through hemi-scrotal incision, and the effect of torsion only for two weeks. The contralateral testes demonstrated significant decreased weights variously and smaller seminiferous tubular diameter in both the orchiectomy and detorsion groups compared to the torsion only group, and there was marked contralateral testicular alterations in the torsion only group compared to the control group. These studies indicate that testicular torsion will cause contralateral testicular damage, and these contralateral alterations may be caused by generalized perineal inflammatory responses rather than immunologic phenomenon.
Animals ; Humans ; Male ; Orchiectomy ; Rats* ; Spermatic Cord Torsion* ; Testis* ; Weights and Measures

No abstract available.
Meconium* ; Prospective Studies* ; Statistics as Topic*

The physeal injuries in children occur result of trauma, infection, metabolic or ischemic disease, and these conditions cause significant problems, such as growth disturbance, deformity and premature closure of physis. The authors experienced 7 cases of children who had angular deformity of knee and limb shortenings, but no history of obvious causes of physeal injury. All of these cases had severe osteoporosis and underlying disease, which were osteogenesis imperfecta, fibrous dyplasia and long term steroid therapy. The purpose of this study are evaluation of pathomechanism of physeal injuries in severe osteoporotic children. Patients were range of age from 4 to 9 years and had common clinical features, which were angular deformities of knee, limb shortening. Also they had common radiographic findings, that were severe porosis, metaphyseal sclerosis and in some cases, pop corn like calcification around physis. At this, we supposed that chronic mechanical stress in osteoporotic bone make physis be damaged due to loss of capillary circulation and this event appear to result from collapse of bone plate, through which epiphyseal vessel penetrate. In conclusion, the children with severe osteoporosis should be observed carefully about physeal injuries, which pathomechanism are perhaps deprivation of capillary circulation through bone plate. Therefore, We should try to protect bone plate by being conscious of its existence.
Bone Plates ; Capillaries ; Child ; Congenital Abnormalities ; Extremities ; Humans ; Knee ; Osteogenesis Imperfecta ; Osteoporosis* ; Sclerosis ; Stress, Mechanical ; Zea mays