In male reproducible health, fertility and IVF (in-vitro fertilization), semen analysis has been most important. Semen analysis can be divided into concentration, motional and morphological analysis of sperm. The existing method which was developed earlier to analyze semen concentrated on the sperm motility analysis. To provide more useful and precise solutions for clinical problems such as infertility, semen analysis must include sperm morphological analysis. But the traditional tools for semen analysis are subjective, imprecise, inaccurate, difficult to standardize, and difficult to reproduce. Therefore, with the help of development of microcomputers and image processing techniques, we developed a new sperm morphology analyzer to overcome these problems. In this study the agreement on percent normal morphology was studied between different observers and a computerized sperm morphology analyzer on a slide-by-slide basis using strict criteria. Slides from 30 different patients from the SNUH andrology laboratory were selected randomly. Microscopic fields and sperm cells were chosen randomly and percent normal morphology was recorded. The ability of sperm morphology analyzer to repeat the same reading for normal and abnormal cells was studied. The results showed that there was no significant bias between two experienced observers. The limits of agreement were 4.1%~-3.8%. The Pearson correlation coefficient between readers was 0.79. Between the manual and sperm morphology analyzer, the same findings were reported. In this experiments the slides were stained by two different methods, PAP and Diff-Quik staining methods. The limits of agreement were 7.2%~-5.7% and 6.0%~-6.3%, respectively. The Pearson correlation coefficients ware 0.76 and 0.91, respectively. The limits of agreement was tighter below 20% normal forms. In the experiments of repeatability, 52 cells stained by PAP and Diff-Quik staining methods were analyzed three times in succession. Estimating pairwise agreement, the kappa statistic for the pairs were 0.76, 0.81, 0.86, and 0.75, 0.88, 0.88 respectively. In this study it was shown that there was good agreement between manual and computerized assessment of normal and abnormal cells. The repeatability and agreement per slide of computerized sperm morphology analyzer was excellent. The computer's ability to classify normal morphology per slide is promising. Based on results obtained, this system can be of clinical value both in andrology laboratories and IVF units.
Andrology ; Bias (Epidemiology) ; Fertility ; Humans ; Infertility ; Male ; Microcomputers ; Semen ; Semen Analysis ; Sperm Motility ; Spermatozoa*

One of the complication during or after subclavian vein cannulation is intravascular catheter or wire embolization. Although some studies have reported safety of retaining foreign body embolization, and even death. The intravascular foreign body can be removed surgically or non-surgically. With improvement in instrument technology and technique, percutaneous retrieval of intravascular foreign bodies has become a relatively common procedure. Commonly used methods to remove intravascular foreign bodies are loop snare and basket technique. Sometimes biopy forcep can be used. We have experienced 2 cases of non-surgical removal of intravascular foreign bodies. One of the foreign bodies was 7cm wire fragment in right atrium(RA), the other was a 50cm guide wire. We used the standard loop snare technique for removal of 7cm wire fragment in RA and stone removal basket and 3.0mm ACS PTCA balloon to remove the 50cm short guide wire.
Catheterization ; Catheters ; Foreign Bodies* ; SNARE Proteins ; Subclavian Vein ; Surgical Instruments

The diagnosis of soft tissue osteochondroma should be considered when a well-defined osseous mass is located in the soft tissues. The differential diagnosis includes myositis ossificans, tumoral calcinosis, synovial chondromatosis, and soft tissue osteosarcoma, true osteochondroma which arises from bone. One case of soft tissue osteochondroma in the knee, a lesion of uncertain pathogenesis is reported.
Calcinosis ; Chondromatosis, Synovial ; Diagnosis ; Diagnosis, Differential ; Knee ; Myositis Ossificans ; Osteochondroma* ; Osteosarcoma

PURPOSE: Ethane 1,2-Dimethane sulfonate (EDS), an alkylating agent, has been widely used to create the testosterone withdrawal rat model. The present study was carried out to test the effect of EDS administration on the expression of steroidogenesis-related genes in the rat testis and on epididymal sperm counts. MATERIALS AND METHODS: Adult male Sprague-Dawley rats (300~350 g B.W.) were injected with a single dose of EDS (75 mg/kg, i.p.) and sacrificed on days 0, 7, 14, 21, 28, 35, 42, and 49. Tissue weights (testis, epididymis and seminal vesicle) were measured, and serum LH levels were determined by specific radioimmunoassay. The transcriptional activities of LH receptor (LH-R), 3beta-hydroxysteroid dehydrogenase (3beta-HSD), and steroidogenic acute regulatory protein (StAR) were evaluated by semi-quantitative RT-PCR. RESULTS: Weights of the reproductive and accessory organs declined progressively after the EDS treatment (weeks 1~3). After this, the decrease stopped, with a gradual return towards normal. Full recovery was observed in testis and seminal vesicle evaluations on weeks 5 and 6, respectively. Only 70% recovery was found in epididymis during weeks 5~7. A more dramatic drop was observed in caput epididymal sperm count, and the maximum recovery was 40% on week 7. Serum LH level increased significantly on week 2 after EDS treatment, then gradually decreased during weeks 3~5. The transcripts for the steroidogenesis-related genes in testis declined sharply during weeks 1~2, then returned to normal on week 4. CONCLUSIONS: Our results demonstrate that EDS might directly induce severe damage, such as tissue destruction and decreased sperm counts, in epididymis compared to those in testis and seminal vesicles. Changes in the activities of testicular steroidogenesis-related genes caused by abrupt death and repopulation of Leydig cells in EDS-treated rats were in good correlation with other parameters shown in this and previouslypublished data. Taken together, the EDS injection model might be useful to understand not only the mechanism of differentiation of testicular somatic and germ cells but also the function of the epididymis in the aging process.
Adult* ; Aging ; Animals ; Epididymis ; Ethane* ; Germ Cells ; Humans ; Leydig Cells ; Male ; Models, Animal ; Oxidoreductases ; Radioimmunoassay ; Rats* ; Rats, Sprague-Dawley ; Receptors, LH ; Seminal Vesicles ; Sperm Count* ; Spermatozoa* ; Testis ; Testosterone ; Weights and Measures

The purpose of this study was to evaluate the surface roughness of Ni-Cr-Be alloy(Verabond ~, Aalba Dent Inc. USA) according to electrolyte concentration and etching time. Total of 150 metal specimens (12x 10 X 1.5mm) composed of 5 polisded specimens, 5 sandblasted specimens, 140 etched specimens were prepared. Etched groups were divided into 28 groups by the HC1O4 con= centrations(10, 30, 50, 70%) and etching times(15, 30, 60, 120, 180, 240, 300 seconds). The mean surface roughness(Ra) and the etching depth were measured with Optical 3-dimensional surface roughness measuring machine(Accura 1500M, Intek Engineering Co., Korea) and observed under SEM. The results obtaind were as follows 1. Surface roughness(Ra) and etching depth were affected by the order of etching time, electrolyte concentration, and their interaction (NO.05) . 2. Surface roughness(Ra) and etching depth were increased with etching time in 10%, 30% electrolyte concentrations, but they had no significant difference with etching time in 70%(P<0.05). 3. Surface roughness(Ra) and etching depth decreased in the order of 30, 10, 50, 70% electrolyte concentrations from 120 seconds etching time(p<0.05). 4. The remarkable morphologic changes in etched surface were observed along the grain boundaries in 15, 30 seconds of 10%, 30% concentrations and the morphologic changes could be denoted in the grains themselves as well as along the boundaries with the lapse of time. Even though the noticeable morphologic changes also took place in etched surface with 50% concentration, the degree of changes were less than that of changes with 10%, 30%. However, there were little morphologic changes with 70% concentration regardless of etching time. 5. Surface roughness(Ra) of sandblasting group with 50um A1203 had no significant difference with 30%-30 seconds etched group(p<0.05).
Alloys* ; Edible Grain

BACKGROUND AND OBJECTIVES: We investigated the relationship between the degree of enophthalmos and the volume of herniated orbital tissue measured from computed tomography scan in the isolated blowout fractures of orbital wall. SUBJECTS AND METHOD: In this retrospective study, 100 patients with isolated blowout fractures were evaluated. We classified them into 4 groups according to the site of fracture (medial and inferior) and the presence of symptoms like diplopia and limitation of ocular motility, which needs an operation. The volume of orbit and herniated orbital tissue has been measured by computed tomography scans using three-dimensional reconstruction technique, and the degree of enophthalmos was evaluated with Hertel's ophthalmometer. We compared the volume from which we got from the computed tomography scan, the degree of enophthalmos and the presence of symptoms to figure out the mutual relation between the groups. RESULTS: In the case of medial blowout fracture group, the volume of herniated orbital tissues increased significantly with the presence of symptoms and was in proportion to the extent of enophthalmos (p<0.05). The volume expansion of orbit associated with 2 mm of enophthalmos as calculated by the regression curve was 3.1 ml or 12.8 % in the no-symptoms groups. Finally, in the case of inferior blowout fracture group, there was no evidence of mutual relation. CONCLUSION: These results suggest that surgical intervention is required even though there isn't any symptom for medial blowout fractures, especially when the orbit volume is more than 12.8%. In cases of inferior blowout fractures, a close follow-up is needed even though the extent of fracture is small.
Diplopia ; Enophthalmos ; Follow-Up Studies ; Humans ; Orbit ; Retrospective Studies

Synovial sarcoma comprises approximately 10% of soft tissue sarcomas. Primary pulmonary synovial sarcoma is a rare tumor. It makes up only 0.5% of all primary lung malignancies. It typically presents in adolescents and young adults. The usual progress of the tumor is unknown. We report the rapid progress of a primary pulmonary sarcoma that developed in a 67-year-old woman. In this case, metastatic sarcoma was excluded by positron emission tomography-computed tomography. Synovial sarcoma was histologically confirmed by a biopsy from the lung tissue. The patient had two masses located at the upper lobe of the lung. The patient refused all medical treatment and left our hospital. Two months later, she was readmitted and diagnosed with multiple metastases in the other lung and pancreas. She expired due to syndrome of inappropriate antidiuretic hormone secretion and superior vena cava syndrome four days after admission.
Adolescent ; Aged ; Biopsy ; Electrons ; Female* ; Humans ; Lung* ; Neoplasm Metastasis ; Pancreas ; Sarcoma ; Sarcoma, Synovial* ; Superior Vena Cava Syndrome ; Young Adult

PURPOSE: To obtain basic information for studies of female sexual dysfunction, we investigated the sexual activities and attitudes of young Korean women. MATERIALS AND METHODS: We conducted a questionnaire survey via the Internet. From July 2004 to August 2004, we sent e-mail to 43,000 women who registered with an internet research company. The recipients of the e-mail were asked to join our study if they had stable sexual activities more than once a month for the most recent 6 months. RESULTS: A total of 508 subjects completed the questionnaire, a response rate of 24.7%. Among 423 questionnaires analyzed, 176 women were single and 247 were married. The mean frequency of coitus per month was 5.5 3.9. About 40% of the women had experienced masturbation, and 112 women (26.5%) had masturbated regularly, even though they had stable sexual activities with their partner(s). Among the 423 subjects, 349 had no plan to have a baby; however, only 287 subjects (67.8%) had used a contraceptive method(s). Among those who used contraceptive methods, 183 subjects (63.8%) used methods with low success rates, such as menstrual timing or extra-vaginal ejaculation. Most of the women answered that they have a positive attitude toward sex (3.4 0.8 point on a 5 point scale) and their sex life has great importance in their life. CONCLUSIONS: Via an Internet survey, we investigated the sexual life and attitudes of young Korean women. An Internet survey requires less manpower, a shorter study period, and less research funds than classical survey methods such as mail or interview surveys. The study results obtained will be useful as basic data for studies of female sexual function in Korean women.
Coitus ; Contraception ; Surveys and Questionnaires ; Ejaculation ; Electronic Mail ; Female ; Financial Management ; Humans ; Internet* ; Male ; Masturbation ; Postal Service ; Sexual Behavior

OBJECTIVE: To investigate whether patterns of dysphagia were associated with the location of the brain lesion and clinical factors in subacute stroke patients. METHOD: One hundred and seventy-eight first-ever subacute stroke patients who underwent videofluoroscopic swallowing study (VFSS) from January 2006 to April 2012 were enrolled in the present study. Swallowing-related parameters were assessed by VFSS. The location of brain lesions were classified into the cortical, subcortical, and brain stem. The degree of cognitive impairment and the independency of activities of daily living were assessed by the Korean version of mini-mental status examination and Korean version of modified Barthel index (K-MBI). Aphasia and hemineglect were assessed by Korean version of Western aphasia battery and line bisection test. These data were collected via retrospective chart review. RESULTS: A reduced laryngeal elevation and prolonged pharyngeal delay time were associated with brain stem lesion. Other swallowing parameters were not associated with lesion topology. Pyriform sinus residue was associated with the presence of aphasia and low K-MBI scores. Prolonged pharyngeal delay time was associated with the patient's age, type of stroke and brain stem lesion. CONCLUSION: Pyriform sinus residue was associated with clinical factors such as aphasia and K-MBI scores rather than with the location of brain lesion. However, reduced laryngeal elevation and prolonged pharyngeal delay time were predominant in brain stem lesions.
Activities of Daily Living ; Aphasia ; Brain Stem ; Brain* ; Deglutition Disorders ; Deglutition* ; Humans ; Pyriform Sinus ; Retrospective Studies ; Stroke*

PURPOSE: To identify the inter-fractional shift pattern and to assess an adequate treatment margin in the radiotherapy of a liver tumor using mega-voltage computed tomography (MVCT) of a tomotherapy unit. MATERIALS AND METHODS: Twenty-six patients were treated for liver tumors by tomotherapy from April 2006 to August 2007. The MVCT images of each patient were analyzed from the 1st to the 10th fraction for the assessment of the daily liver shift by four groups based on Couinard's proposal. Daily setup errors were corrected by bony landmarks as a prerequisite. Subsequently, the anterior-, posterior-, right-, and left shifts of the liver edges were measured by maximum linear discrepancies between the kilo-voltage computed tomography (KVCT) image and MVCT image. All data were set in the 2-dimensional right angle coordinate system of the transverse section of each patient's body. RESULTS: The liver boundary shift had different patterns for each group. In group II (segment 2, 3, and 4), the anterior mean shift was 2.80+/-1.73 mm outwards, while the left mean shift was 2.23+/-1.37 mm inwards. In group IV (segment 7 and 8), the anterior-, posterior-, right-, and left mean shifts were 0.15+/-3.93 mm inwards, 3.15+/-6.58 mm inwards, 0.60+/-3.58 mm inwards, and 4.50+/-5.35 mm inwards, respectively. The reduced volume in group II after MVCT reassessment might be a consequence of stomach toxicity. CONCLUSION: Inter-fractional liver shifts of each group based on Couinard's proposal were somewhat systematic despite certain variations observed in each patient. The geometrical deformation of the liver by respiratory movement can cause shrinkage in the left margins of liver. We recommend a more sophisticated approach in free-breathing mode when irradiating the left lobe of liver in order to avoid stomach toxicity.