PURPOSE: To determine the efficacy of CarnitilR (acetylcarnitine, Hanmi, Korea) therapy in idiopathic oligoasthenospermic men. MATERIALS AND METHODS: Forty-four subfertile men with abnormal semen parameters were treated between March, 2003 and March, 2004 with 3 g of CarnitilR daily for 3 months. Changes in semen parameters were evaluated 3 months after this therapy. RESULTS: The mean age was 34.2 years and the mean follow-up duration was 3.7 months. In asthenospemic patients (n=28), semen analysis before and after CarnitilR treatment showed an increase in volume (2.64+/-1.65 ml vs. 3.10+/-1.60 ml), motility (35.1+/-17.7% vs. 45.9+/-20.4%) and viability (51.4+/-20.3% vs. 59.3+/-13.6%) respectively. In oligoasthenospermic patients (n=16), semen analysis before and after CarnitilR treatment showed an increase in sperm count (10.7+/-54.4 million/ml vs. 38.4+/-32.5 million/ml) respectively. CONCLUSIONS: These results suggested that in idiopathic oligoasthenospermic men the empirical medical therapy with acetylcarnitine may be considered as primary treatment.
Acetylcarnitine* ; Carnitine ; Follow-Up Studies ; Humans ; Infertility, Male ; Male ; Semen ; Semen Analysis ; Sperm Count

We report an extremely rare case in which two tuberculids, papulonecrotic tuberculid and erythema nodosum, occurred together. A 16-year-old girl had two types of clinically distinct lesions; asymptomatic necrotic papules on the upper and lower extremities and painful subcutaneous nodules on the legs. A Mantoux test showed a strong positive reaction. Histopathologic findings of the necrotic papule and subcutaneous nodule were consistent with papulonecrotic tuberculid and erythema nodosum, respectively. There was no extracutaneous focus of tuberculosis. Polymerase chain reaction for tuberculous bacilli in the papulonecrotic tuberculid lesion revealed a negative result. Antituberculous therapy brought a rapid clinical improvement of both lesions.
Adolescent ; Erythema Nodosum* ; Erythema* ; Female ; Humans ; Leg ; Lower Extremity ; Polymerase Chain Reaction ; Tuberculosis ; Tuberculosis, Cutaneous*

Chronic eosinophilic pneumonia is a rare diasease characterized by chronic infiltration of the lung with ~eosinophils, usually associated with peripheral eosinophilia. In 65% of cases, the chest rad Ogroaph shows typiical nonsegmental air-space consolidation confined to the outer third of the lung and in 25)/0 of case "photographic negative of pulmonary edema". Typical lung manifestations with 'peripheral eosinophiliSa' tahrcharacteristic of chronic eosinophilic pneumonia. In the remaining cases, radiographic findings are nonspecific and require lung biopsy for confirmation. We repot a case of chronic eosinophilic pneumonia in which chest radiograph and CT scans revealed bilateral patchy or diffuse opacity with nodules scattered throughout the lungs.
Biopsy ; Eosinophilia ; Eosinophils* ; Lung ; Pulmonary Eosinophilia* ; Radiography, Thoracic ; Thorax ; Tomography, X-Ray Computed

A 25-year-old woman presented with effort-induced chest pain. Physical examination revealed different blood pressures, 180/100 mmHg in right arm and 100/60 mmHg in left arm. Resting electrocardiogram was normal, but down-slope depression of ST segment more than 3 mm in V3-6, II, III, aVF developed at the stage 1 of treadmill exercise test. Stress Thallium-201 scan showed severe ischemia in the anteroseptal and lateral wall of left ventricle. Diagnostic coronary angiogram showed critical stenosis in the ostium of left main coronary artery. The left subclavian artery was occluded totally with well-developed collateral circulation. The patient underwent ostioplasty of left coronary ostium using pericardial patch, and her symptom improved after surgery. Follow-up coronary angiogram one year after surgery showed patent coronary artery ostium with good flow and myocardial perfusion improved on follow-up Thallium-201 SPECT. She has no major cardiac events during 7-year clinical follow-up.
Adult ; Arm ; Chest Pain ; Collateral Circulation ; Constriction, Pathologic ; Coronary Vessels* ; Depression ; Electrocardiography ; Exercise Test ; Female ; Follow-Up Studies* ; Heart Ventricles ; Humans ; Ischemia ; Perfusion ; Physical Examination ; Subclavian Artery ; Takayasu Arteritis* ; Tomography, Emission-Computed, Single-Photon

No abstract available.
Age Factors* ; Hematoma, Subdural, Chronic*

No abstract available.
Aneurysm* ; Arteries*

No abstract available.
Angiomyolipoma* ; Lymph Nodes*

Duplex ultrasonography (USG) is an accepted method to assess noninvasively arterial inflow to the penis. Optimal pharmacological agents as well as timing of the scan and stimulation during the scan continue to be debated. Between August 1994 and May 1996, 24 normal males (control group) and 45 impotent patients (impotence group) underwent penile doppler sonography, and their records were reviewed. Scans were performed at 1, 3, 5, 10, 15, 20 and 30 minutes after intracavernous injection of PGE1 (10 pg) in all subjects. Any subject not having a full erection at 15 minutes performed private self-stimulation for at least 5 minutes before the 30 minute scan. If we define normal arterial inflow as a peak systolic velocity (PSV) of 30 cm. per second or greater in the best artery, 46% of control group and 55% of impotence group achieved this velocity until 5 minutes. One (4%) of control group and three (6%) of impotence group achieved maximum velocity at 1 or 3 minutes but continually PSV of 30 cm. per second or greater after 5 minutes, so any subject may not have had an incorrect diagnosis. When we calculated maximum velocity in the best artery in relation to percentage tumescence, maximum velocity were recorded most often at 10% tumescence (46% of control group and 51% of impotence group). If we define normal arterial inflow as PSV of 30 cm. per second or greater in best artery, the cumulative percentage of patients who achieved this velocity at 1, 3, 5, 10, 15, 20 and 30 minutes were 4, 34, 46, 88, 96, 96 and 100% in control group and 6, 28, 55, 90, 92, 94 and 96% in impotence group. In conclusion, we support delaying the initial scan until 5 minutes, performing the additional scans until 30 minutes and self-stimulation when necessary. We believe all efforts should be made to have studies performed in the setting of least anxiety to the patient.
Alprostadil* ; Anxiety ; Arteries ; Diagnosis ; Erectile Dysfunction ; Humans ; Male ; Penis ; Ultrasonography*

Ticlopidine is a powerful inhibitor of platelet aggregation which is induced by adenosine diphosphate. Ticlopidine has been shown to be effective in reducing combined stroke, myocardial infarction, reocclusion of coronary stent. The principal side effects of ticlopidine are severe neutropenia, rash and gastrointestinal upset. Recently, we experienced two cases of severe neutropenia associated with ticlopidine. One was administered ticlopidine to prevent subacute thrombosis after intracoronary stent implantation in unstable angina pectoris. Thirty days of therapy, her absolute neutrophil count (ANC) had dropped to 14/mm3 . The other patient was presented with recurrent episodes of cerebral infarction, for which he had undergone right carotid angiogram. The carotid angiogram demonstrated tight stenosis of right internal carotid artery. Carotid artery stenting was performed at right internal carotid artery without any complications. Twenty seven days of ticlopidine therapy, his ANC had dropped to 111/mm3. The ticlopidine was stopped, and they were given granulocyte-colony stim-ulating factor 250 microgram/day subcutaneous injection until their ANC was up to 1000/mm3. They were discharged with normal neutrophil count and no other complications.
Adenosine Diphosphate ; Angina, Unstable ; Carotid Arteries ; Carotid Artery, Internal ; Cerebral Infarction ; Constriction, Pathologic ; Exanthema ; Granulocyte Colony-Stimulating Factor ; Humans ; Injections, Subcutaneous ; Myocardial Infarction ; Neutropenia* ; Neutrophils ; Platelet Aggregation ; Stents ; Stroke ; Thrombosis ; Ticlopidine*

OBJECTIVE: The laparoscopic appendectomy was developed as an alternative procedure to be used in acute appendicitis. Some surgeons dispute the advantages of laparoscopic procedures for acute appendicitis. Specifically, there are many controversies associated with perforated appendicitis. We reviewed the results of appendectomies to assess the feasibility of a laparoscopic appendectomy in acute appendicitis that included perforated appendicitis. METHODS: Three hundred thirty-nine consecutive patients with laparoscopic appendectomies, which include 27 patients with perforated appendicitis, were analysed. This study considered the lengths of the operation and the hospital stay. Differences in complications between non-perforated and perforated appendicitis were also evaluated. RESULTS: A total of 388 patients underwent appendectomies, 339 patients with laparoscopy and 49 patients with conventional open appendectomies, from April 1994 to June 1996. The mean duration of laparoscopic appendectomies was 48.9 minutes. This was slightly longer than that of open appendec tomies (44.9 minutes) in the same hospital. The duration of hospital stay was on the average of 4.9 days. Six patients (1.8%) were converted to conventional surgery because of difficult mobilization in 4 patients and uncontrollable bleeding in the remaining two. The surgeries on patients who were converted to conventional surgery were performed by rotating residents without staff supervision. Minor complications developed in eight patients (2.4%). In comparing the results between non-perforated and perforated appendicitis, durations of operation (47.3 vs. 78.3 minutes) and the hospital stay (4.6 vs. 8.6 days) were longer in perforated appendicitis. However, the complication rate (2.6 vs. 0%) was unexpectedly found to be lower in perforated appendicitis. CONCLUSIONS: The laparoscopic appendectomy is a safe, feasible procedure for acute appendicitis. It is an excellent procedure for perforated appendicitis and has minor complications compared to an open appendectomy with its large incision that is followed by a high rate of wound infection and/or post operative adhesion. There aree various reports on prospective randomized studies evaluating the benefits of a laparoscopic appendectomy compared to a conventional open appendectomy. The reports by laparo scopic surgeons in various centers are different with regard to operative time, postoperative recovery, morbidity, and postoperative complications. For complicated appendicitis, most surgeons are not in agree ment with the laparoscopic approach. We obtained excellent results with laparoscopic appendectomies in perforated appendicitis which included periappendiceal abscesses.
Abscess ; Appendectomy* ; Appendicitis ; Dissent and Disputes ; Hemorrhage ; Humans ; Laparoscopy ; Length of Stay ; Operative Time ; Organization and Administration ; Postoperative Complications ; Prospective Studies ; Wound Infection