OBJECTIVE: The effects on spermatogenesis by expression of vascular endothelial growth factor (VEGF) and endothelin-1 (ET-1) were investigated. MATERIALS AND METHODS: Testicular specimens were obtained from 40 infertile males due to primary testicular failure and from 10 fertile males with other urologic problems. The specimens of infertile males were devided into 4 groups according to histologic findings; Sertoli cell only syndrome (A), maturation arrest (B), hypospermatogenesis (C) and sloughing and disorganization (D). VEGF and ET-1 expression were detected with immunohistochemical stain. RESULTS: VEGF expression on Leydig cell was detected in all cases. But, VEGF expression rates on germ cell were significantly higher in infertile group B, C, D compared to that of the control group (p<0.05). ET-1 expression rates on Leydig cell was significantly lower in all infertile group compared to that of the control group (p<0.05). But, ET-1 expression rates on Sertoli cell was significantly higher in all infertile group compared to that of the control group (p>0.05). In germ cell of infertile group, LH, FSH and prolactin were significantly decreased, and estradiol is increased in positive stain group on ET-1 immunohistochemical stain (p<0.05). VEGF and ET-1 expression were not correlated mean seminiferous tubule diameter (p>0.05). CONCLUSIONS: Abnormal spermatogenesis would be reflected in VEGF expression in germ cell.
Endothelin-1* ; Estradiol ; Germ Cells ; Humans ; Male ; Oligospermia ; Prolactin ; Seminiferous Tubules ; Sertoli Cell-Only Syndrome ; Spermatogenesis ; Testis* ; Vascular Endothelial Growth Factor A

BACKGROUND: It is known that 20% of childhood epilepsy is refractory to anticonvulsants therapy, Recently, a few new anticonvulsants has been introduced. One of these, gabapentin is known to effective in such refractory cases. This study has been done to estimate the effectiveness of gabapentin in refractory childhood as well as adult epilepsies. SUBJECTS AND METHODS: 43 patients(male 25, female 18) has been selected among refractory epilepsies during the period of March, 1981 to Feb, 1996 diagnosed and treated at pediatric neurologic clinic School of Medicine, Yonsei University Those were already treated with various anticonvulsants and gabapentin was added to previous medication, and effectiveness of seizure frequency and the degree has been investigated over more than 3 month period as well as the side effect. RESULTS: 30 patients out of 43, showed seizure free or decreased frequency of seizure, those patients whose the seizure frequency was decreased over 50% was 11 cases, partial seizure 10 cases, generalized seizure 1 cases. 15 case out of 43 showed no changes or increased frequencies of seizure in 4 out of 27 in partial epilepsies, 1 out of 16 in generalized seizure, and 6 cases out of 43 manifested side effects such as behaviour change, abdominal pain and headache. CONCLUSION: Gabapentin was effective by add on therapy in refractory epilepsies and reducing the frequency of seizure over 50% was 25.6%. Most of these patients was partial seizure. We concluded that gabapentin as add on therapy is effective at least in 1/4 cases of refractory partial seizures.
Abdominal Pain ; Adult ; Anticonvulsants ; Epilepsies, Partial ; Epilepsy ; Female ; Headache ; Humans ; Seizures*

OBJECTIVE: Rebamipide is a propionic acid derivative that has an action of the inhibition of superoxide production and removal of hydroxyl radical with the sperm incubation and cryopreservation. In the present study, to investigate whether rebamipide is useful to treat male infertility and sterility, the author observed the antioxidative effects in patient with male infertility and also examined its absorption and distribution in rat genital organ. METHODS: To measure the distribution of rebamipide in reproductive organ in the rat, carbon indicated rebamipide, 14C-OPC-12759, was orally administered to 10 Spraque-Dawley rats and its organ concentration in serum, liver, kidney, stomach, duodenum, colon, urinary bladder, seminal vesicle, epididymis and testicle were measured each time after 0.5, 1, 2, 4, 8 and 24 hours by using HPLC fluorescent method. The concentrations in semen were measured by HPLC fluorescent method in a sample of 50 infertile males who took 900 mg of rebamipide daily for 3 months. To measure the antioxidative effect and fertility rate for 3 months, each month before and after the treatment, sperm motility, vitality, the oxygen free radical formation, level of peroxidation, fetilizing capacity of semen sample which were obtained from infertile male patients by masturbation after at least 48 hours abstinence were analyzed by computer assisted semen analyzer, eosin-nigrosin stain, chemiluminescence, thiobarbituric acid method and hypo-osmotic swelling test. Simultaneously in a sample that wanted baby, both pregnancy and delivery were researched. RESULTS: The 14C-OPC-12759 concentration in the body of white rats was highest in gastrointestinal organ like stomach, smal intestine and duodenum and followed by genital organ like seminal vesicle, testis and epididymis. The rebamipide concentration in semen of infertile males was 220.77+/-327.84 ng/mL (SD) which showed a large deviation but it was higher than serum which was 126+/-76 ng/mL (SD). In the infertile males, after the treatment with rebamipide, the level of seminal reactive oxygen species (ROS) and lipid peroxidation have significantly decreased in duration of the treatment (p<0.05) and sperm vitality and fertilizing capacity except sperm motility significantly improved on post treatment of 2~3 months (p<0.05). Out of the 41 cases who hoped for pregnancy, 15 cases (36.6%) became pregnant and 12 cases had childbrith, 2 cases had miscarriage and one case is ongoing. The side effect was observed in 1 case (2%) which experienced diarrhea but it was lost spontaneously. CONCLUSIONS: We conclude from this study that rebamipide showed relatively high tendancy of absorption and excretion in the genital organ. In infertile males who had elevated ROS in semen, by specifically inhibiting the cell damage from the antioxidation, a way to preserve sperm motility, vitality and fertilizing capacity was confirmed.
Abortion, Spontaneous ; Absorption* ; Animals ; Birth Rate ; Carbon ; Chromatography, High Pressure Liquid ; Colon ; Cryopreservation ; Diarrhea ; Diethylpropion ; Duodenum ; Epididymis ; Female ; Genitalia ; Hope ; Humans ; Hydroxyl Radical ; Infertility ; Infertility, Male ; Intestines ; Kidney ; Lipid Peroxidation ; Liver ; Luminescence ; Male ; Masturbation ; Oxygen ; Pregnancy ; Rats ; Reactive Oxygen Species ; Semen ; Seminal Vesicles ; Sperm Motility ; Spermatozoa ; Stomach ; Superoxides ; Testis ; Urinary Bladder

An analysis of echocardiograms was made in 50 patients with pericardial effusion of various origins, diagnosed by clinical and M-mode echocardiographic examinations. In these cases the estimated volume of pericardial effusion ranged between 40 ml and 999 ml. The width of echo-free space behind the left ventricular wall which reflect the amount of effusion showed a significant positive correlation with the systolic excursion and the diastolic mean velocity of both right and left ventricular epicardial surfaces. The echocardiographic patterns of so-called pseudo-mitral valve prolapse and a notch on the right ventricular epicardial surface during systole were found more frequently in patients with large pericardial effusion. Thus, in pericardial effusion, and echocardiographic examination is useful for the visualization of the abnormal motions of cardiac structures as well as for its diagnosis.
Diagnosis ; Echocardiography* ; Humans ; Pericardial Effusion* ; Prolapse ; Systole

The cardiac dimensions and functions were studied by analyzing simultaneously recorded M-mode echocardiograms and phonocardiograms in 24 cases of essential hypertension with no evidence of heart faliure, and also in 20 healthy adults for comparison. Thirteen hypertensives out of 24 had findings consistent with left ventricular hypertrophy on either routine chest roentgenograms or electrocardiograms or both(group II) and the remaining 11 had no such findings(group I). The posterior wall and septal thickness, and isovolumic relaxation time were significantly was increased even in the group I as well as in the group II. The isovolumic relaxation time was correlated well with the septal thickness in both groups. In contrast, a significant increase in left atrial and left ventricular systolic dimensions was noted only in the group II, and so was a significant reduction in the fractional shortening and mean velocity of circumferential fiber shortening. These findings suggest that the echocardiographic examination is useful in patients with essestial hypertension for the early dagnosis of the increased thickness of the posterior wall and the septum, and the abnormality during early diastolic relaxation of the left ventricle, prior to the appearance of the ventricular hypertrophy on the routine chest films amd/or electrocardiograms, and also that echocardiograms enable early detection of the systolic dysfunction of the hypertrophied left ventricle in the absence of apparent failure.
Adult ; Echocardiography* ; Electrocardiography ; Heart ; Heart Ventricles ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular ; Relaxation ; Thorax

BACKGROUND: The growth of elderly population increased the need for oral health care. Elderly patients with poor teeth alignment needs more attention with orthodontic treatment METHODS: Elderly patients visiting department of orthodontics, Kangdong Sacred Heart Hospital between 2000-2004 were treated with fixed appliances in one or both dental arches. Treatment plans were different from than that of younger patients and included uncommon and strategic removals of teeth and prosthesis. RESULTS: There was decrease in orthodontic treatment forces with increasing age, and the observation made from this study was favorable in the patients' as well as in the orthodontist's, point of view. It was possible to move the remaining teeth considerably, and the retention was made with various fixed appliances. CONCLUSIONS: Orthodontic treatment is not limited by patient age. However, it is wise not to extend treatment goals too far beyond the patients' objective needs
Aged* ; Dental Arch ; Heart ; Humans ; Oral Health ; Orthodontics ; Prostheses and Implants ; Tooth

In recent years there has been an increase in the number of outpatient surgical procedures performed using local anesthesia with intravenous sedation. However, many patients are reluctant to undergo surgery because of their concerns about pain and pain-awareness during the operation. We performed a study to evaluate the effectiveness and safety of midazolam during outpatient surgical procedures. Between March 1997 and December 1998, 50 patients were anesthetized with bolus intravenous injection of 0.1mg/kg of midazolam, followed by local anesthesia. The blood pressure, pulse and oximeter values were monitored. There was no significant change of arterial oxygen saturation. Midazolam induced antegrade amnesia in most cases. All patients except three (94%) said they would willingly choose this anesthetic technique again. Major complications were not noted. We concluded that midazolam is a good sedative agent in providing favorable antegrade amnesia, as well as reduced anxiety and fear of pain during surgical procedures. This suggests that midazolam may be used routinely in outpatient surgical procedures. Monitoring of oxygen saturation, however is essential in preventing severe hypoxia during procedures.
Amnesia ; Anesthesia, Local* ; Anoxia ; Anxiety ; Blood Pressure ; Humans ; Injections, Intravenous ; Methods ; Midazolam* ; Outpatients ; Oxygen

Supracondylar fractures of the humerus is the most common elbow fractures in children. Many papers has been published about the treatment of the supracondylar fractures of the humerus in children and prevention of both Volkmann's ischemic contractures and nerve injuries associated with these fractures, however, unfortunately it is still one of the most difficult fractures to manage. After successful reduction, the late complications of loss of elbow motion, the change in carrying angle, myositis ossificans, and progressive ulnar nerve palsy still lie ahead. For the period of 5 years from January 1975 to December 1979, 110 patients who had been treated for supracondylar fractures of the humerus at Severance Hospital, Yonsei University Coilege of Medicine were studied and analyzed retrospectively and the results are summerized as follows: 1. The age of the patients varied from 1 to 26 years, the majority (80.0%) being between 4 to 11 years and the fractures were on the left side in 71.8% and males comprized 75.5%. 2. The extension type comprized 94.5%. 3. Most common complications were cubitus varus deformities. 4. Percutaneous pinning and open reduction and internal fixation elicited rare cubitus varus diformities. 5. Limitation of motion was most frequent camplication after open reduction and internal fixation. 6. All cases which showed cubitus varus deformities were initially medially displaced fractures. 7. Four median nerve injuries were associated with posterolateral displacement and one radial nerve injury was associated with posteromedial displacement. 8. Finally, with prompt and adequate treatment, there were no Volkmanns ischemic contractures seen in this study.
Child ; Congenital Abnormalities ; Elbow ; Humans ; Humerus ; Ischemic Contracture ; Male ; Median Nerve ; Myositis Ossificans ; Radial Nerve ; Retrospective Studies ; Ulnar Neuropathies

Congenital scoliosis is a structural deformity due to congenital anomaly of the spine. After Winter's report in 1973, congenital scoliosis is said to be progressive in 75% of cases, and 50% are rapidly progressive, serious and demand treatment. And thus, most of them need more aggressive and early treatment compared with idiopathic scoliosis. The prognosis depends on the type, angle and flexibility of the curvature, and the age of patient. The authors reviewed the results of operative treatment for the congenital scoliosis that had been treated from Jan. 1984 to Dec. 1993 at the orthopedic department of Yonsei University College of Medicine, and the results as follows. 1. The age distribution of the patients was from 2 years to 14 years, and the mean was 8.4 years. Five male patients and two female patients were operated. 2. The involved spinal segments of the primary curve were 2 cases of thoracolumbar, 3 cases of lumbar. There were two cases of double major curves. 3. According to MacEwen's classification, the types of vertebral anomaly were 4 cases of hemivertebra, 2 cases of miscellaneous and one case of wedge vertebra. 4. The levels of apical vertebra were each 1 case of T3, T9, Ll, L2, L4 respectively and each 2 cases of T12, L3 respectively. 5. The methods of operation included 1 case of resection of rib, 4 cases of posterior fusion, 1 case of combined anterior and posterior hemiepiphysiodesis and fusion, and 1 case of hemivertebra excision with spine fusion. 6. The curvature of spine on admission ranged form 10 degrees to 63 degrees, and the mean angle was 35.5 degrees. And, we followed up postoperatively from 1 year to 10 years, and the mean follow up period was 32 months. The final correction angles were from
Age Distribution ; Classification ; Congenital Abnormalities ; Female ; Follow-Up Studies ; Humans ; Male ; Orthopedics ; Pliability ; Prognosis ; Pseudarthrosis ; Ribs ; Scoliosis ; Spine

Adenomatoid tumor is an uncommon neoplasm found mainly near or in the epididymis in the male and the fallopian tubes and ovary in the female. We observed a case of adenomatoid tumor of the epididymis, which was found incidentally 20 years ago by patient self examination. A rubbery, non-tender, 2 X 1-cm mass was found in the tail portion of the right epididymis. Scrotal ultrasonography showed a 2.1 X 1.1 X 1.2-cm hypoechoic solitary mass. Mass excisional biopsy with partial epididymectomy was done under local anesthesia. Pathologic examination showed an adenomatoid tumor.
Adenomatoid Tumor* ; Anesthesia, Local ; Biopsy ; Epididymis* ; Fallopian Tubes ; Female ; Humans ; Male ; Ovary ; Self-Examination ; Ultrasonography