OBJECTIVE: To preliminarily evaluate technical feasibility of a dual-echo ultrashort echo time (UTE) subtraction MR imaging by using concurrent dephasing and excitation (CODE) sequence for visualization of iron-oxide enhancement in focal inflammatory pulmonary lesions. MATERIALS AND METHODS: A UTE pulmonary MR imaging before and after the injection of clinically usable superparamagnetic iron-oxide nanoparticles, ferumoxytol, was conducted using CODE sequence with dual echo times of 0.14 ms for the first echo and 4.15 ms for the second echo on 3T scanner in two rabbits concurrently having granulomatous lung disease and lung cancer in separate lobes. A mean ratio of standardized signal intensity (SI) was calculated for comparison of granulomatous lesion and cancer at first echo, second echo, and subtracted images. Lesions were pathologically evaluated with Prussian blue and immunohistochemistry staining. RESULTS: Post-contrast subtracted CODE images visualized exclusive enhancement of iron oxide in granulomatous disease, but not in the cancer (mean ratio of SI, 2.15 ± 0.68 for granulomatous lesion versus 1.00 ± 0.07 for cancer; p value = 0.002). Prussian blue and corresponding anti-rabbit macrophage IgG-staining suggested an intracellular uptake of iron-oxide nanoparticles in macrophages of granulomatous lesions. CONCLUSION: Dual-echo UTE subtraction MR imaging using CODE sequence depicts an exclusive positive enhancement of iron-oxide nanoparticle in rabbits in focal granulomatous inflammatory lesions.
Ferrosoferric Oxide ; Granuloma ; Immunohistochemistry ; Iron ; Lung Diseases ; Lung Neoplasms ; Macrophages ; Magnetic Resonance Imaging ; Nanoparticles ; Rabbits

Hyperprolactinemia due to a pituitary adenoma is a rare cause of erectile dysfunction (ED). The prevalence of clinically apparent prolactinomas is reported to be from 6–10 to 50 per 100,000. A few reports have been published of prolactinoma presenting with ED. Here, we report a rare case of a young man who presented with ED as a chief complaint and who was diagnosed with a huge prolactinoma, and we discuss a related fertility issue.
Erectile Dysfunction ; Fertility ; Hyperprolactinemia ; Male ; Pituitary Neoplasms ; Prevalence ; Prolactinoma

Obstructive azoospermia caused by acute epididymitis is usually permanent, and microsurgical vasoepididymostomy is the only reconstructive treatment option. There have been no reports of delayed recovery of sperm count after over 1 year in a patient with obstructive azoospermia related to history of acute epididymitis. We present a young male patient who had azoospermia and a history of acute epididymitis who experienced delayed recovery, with complete restoration of sperm production and the ability to conceive naturally.
Azoospermia ; Epididymitis ; Humans ; Infertility ; Male ; Sperm Count ; Spermatozoa

OBJECTIVE: We investigated the clinical characteristics of men with testosterone replacement therapy (TRT)-induced hypogonadism and its effect on assisted reproductive technology (ART) in infertile couples.METHODS: This study examined the records of 20 consecutive male patients diagnosed with azoospermia or severe oligozoospermia (<5×10⁶/mL) who visited a single infertility center from January 2008 to July 2018. All patients were treated at a primary clinic for erectile dysfunction or androgen deficiency symptoms combined with low serum testosterone. All men received a phosphodiesterase 5 inhibitor and TRT with testosterone undecanoate (Nebido®) or testosterone enanthate (Jenasteron®). Patients older than 50 years or with a chronic medical disease such as diabetes were excluded.RESULTS: The mean age of patients was 37 years and the mean duration of infertility was 16.3±11.6 months. At the initial presentation, eight patients had azoospermia, nine had cryptozoospermia, and three had severe oligozoospermia. Serum follicle-stimulating hormone levels were below 1.0 mIU/mL in most patients. Three ongoing ART programs with female factor infertility were cancelled due to male spermatogenic dysfunction; two of these men had normal semen parameters in the previous cycle. After withholding TRT, serum hormone levels and sperm concentrations returned to normal range after a median duration of 8 months.CONCLUSION: TRT with high-dose testosterone can cause spermatogenic dysfunction due to suppression of the hypothalamic-pituitary-testicular axis, with adverse effects on infertility treatment programs. TRT is therefore contraindicated for infertile couples attempting to conceive, and the patient's desire for fertility must be considered before initiation of TRT in a hypogonadal man.
Azoospermia ; Cyclic Nucleotide Phosphodiesterases, Type 5 ; Erectile Dysfunction ; Family Characteristics ; Female ; Fertility ; Follicle Stimulating Hormone ; Humans ; Hypogonadism ; Infertility ; Infertility, Male ; Male ; Oligospermia ; Reference Values ; Reproductive Techniques, Assisted ; Semen ; Spermatozoa ; Testosterone

BACKGROUND AND OBJECTIVES: High dorsal deflection of the nasal septum around cartilage or the perpendicular plate is technically difficult to correct. The objective of this study was to assess whether correction of high septal deviation during septoplasty is necessary to improve nasal airflow. PATIENTS AND SURGICAL METHOD: Twenty-one patients with high septal deviation around the septal cartilage or the perpendicular plate were included in this study. In order to improve nasal obstruction, septoturbinoplasty was performed, but high septal deviation was not corrected. Subjective and objective improvements were evaluated using the visual analogue scale and acoustic rhinometry 1 month before and 3 months after surgery. RESULTS: After correction of nasal septum deviation except high septal deviation and reduction of turbinate mucosal volume, postoperative nasal volume and minimum cross-sectional area were significantly increased. Subjective symptom scales for nasal obstruction, rhinorrhea, sneezing, and posterior nasal drip were considerably improved after limited septoturbinoplasty in patients who still had high dorsal deflection of the nasal septum. CONCLUSION: Our findings suggest that limited septoturbinoplasty without excessive resection of high dorsal deflection of the nasal septum can improve nasal airflow and reduce subjective symptoms, including nasal obstruction.
Cartilage ; Humans ; Methods ; Nasal Obstruction* ; Nasal Septum ; Rhinometry, Acoustic ; Sneezing ; Turbinates ; Weights and Measures

Purpose: The GenesWell™ breast cancer test (BCT) is a recently developed multigene assay that predicts the risk of distant recurrence in patients with hormone receptor-positive (HR+) and human epidermal growth factor-2 negative (HER2−) early breast cancer (BC). The ability of this assay to predict the response to neoadjuvant chemotherapy (NACT) has not been established to date. Methods: Biopsy specimens from HR+/HER2− BC patients with axillary lymph node (LN) metastasis who underwent NACT were analyzed using the BCT score. The modified BCT score was developed and patients classified into high-and low-response groups. A total of 88 patients were available for the BCT score among the 108 eligible patients. The median followup duration was 35.9 (7.8–128.5) months. Results: Among them, 61 (65.1%) had cN1 and 53 (60.2%) had cT1 or cT2 disease. The BCT score was low in 25 (28.4%) patients and high in 63 (71.6%). Among the 50 patients with pathologic complete response or partial response, 41 (82.0%) were in the high BCT score group and 9 (18.0%) were in the low BCT score group. Among the 38 patients with stable or progressive disease, 22 (57.9%) were in the high BCT score group and 16 (42.1%) were in the low BCT score group (p = 0.025). Ki-67 before NACT was a significant factor for predicting tumor response (p = 0.006; 3.81 [1.50–10.16]). The BCT score showed a significant response to NACT (p = 0.016; 4.18 [1.34–14.28]). Distant metastasis-free survival was significantly different between the high- and low-response groups (p = 0.004). Conclusion We demonstrated that the BCT score predicts NACT responsiveness in HR+/ HER2− BC with LN metastasis and might help determine whether NACT should be performed. Further studies are required to validate these results.