PURPOSE: We determined the usefulness of in vitro germ cell culture in nonobstructive azoospermic patients diagnosed with Sertoli cell only syndrome, no sperm in testicular sperm extraction. MATERIALS AND METHODS: This study included 44 patients (45 testicular tissues) with nonobstructive azoospermia who were diagnosed with Sertoli cell only syndrome and were found to have no sperm in testicular sperm extraction between January 2006 and July 2008. Among the 45 testicular tissues, 22 tissues were processed for culture. In the in vitro cultures, the testicular tissues were dissociated and plated on gelatin-coated dishes. Patients were divided into 2 groups according to culture success: group I, culture positive (+; n=10); and group II, culture negative (-; n=12). RESULTS: The mean patient ages were 31.73 and 31.68 years for groups I and II, respectively. The mean testicular sizes were 10.19 and 10.42 cc, respectively; the semen volumes were 2.86 and 3.04 cc, respectively; and the mean FSH, LH, and testosterone levels were 18.86 mIU/ml, 5.99 mIU/ml, and 4.46 ng/ml vs. 21.02 mIU/ml, 6.29 mIU/ml, and 4.32 ng/ml for groups I and II, respectively, with no significant differences between the groups (p>0.05). The culture rate of nonobstructive azoospermic patients diagnosed with Sertoli cell only syndrome was 45.5% (10/22). Round spermatid injection was done in 2 patients with consent of the patients, but implantation failed. Among the 45 tissues, germ cells were found in 8 tissues after pathologic reexamination. CONCLUSIONS: The in vitro culture of germ cells would be useful in the advanced treatment of nonobstructive azoospermic patients.
Azoospermia ; Germ Cells ; Humans ; Semen ; Sertoli Cell-Only Syndrome ; Spermatids ; Spermatozoa ; Testosterone

PURPOSE: Reports of neurologic abnormalities associated with acute diarrhea are increasing recently. It was reported that the incidence of the neurologic abnormalities related to gastroenteritis was higher in rotavirus gastroenteritis than in non-rotavirus gastroenteritis. We investigated the incidence, the manifestations and the prognosis of the neurologic abnormalities associated with rotavirus diarrhea and non-rotavirus diarrhea in Korean children. METHODS: Six hundred forty-nine children who showed acute diarrhea and whose stools were examined for rotavirus were enrolled and categorized into the rotavirus positive group(n=186) and the negative group(n=463). The medical records were reviewed retrospectively for neurologic manifestations, diagnoses and the status of follow-up. RESULTS:The incidence of neurologic abnormalities in all children with diarrhea was 9.4%. Neurologic abnormalities associated with diarrhea were more common in the rotavirus positive group than in the rotavirus negative group(16.1% vs 6.7%, P=0.0002). The neurologic diagnoses of the children ranged from simple febrile convulsion to encephalitis. The rate of patients presenting neurologic abnormalities other than seizures was relatively higher in the rotavirus positive group than in the rotavirus negative group(56.7% vs 25.8%, P=0.01). All children with neurologic abnormalities showed complete recovery. CONCLUSION: The incidence of neurologic abnormalities among patients with diarrhea was about 9%. The neurologic diagnoses in patients who showed neurologic abnormalities were diversed. In rotavirus gastroenterits, the rate of patients presenting neurologic abnormalities other than seizure was higher than in non-rotavirus gastroenteritis. The outcome of the children who showed neurologic abnormalities with diarrhea was excellent.
Child ; Diagnosis ; Diarrhea ; Encephalitis ; Follow-Up Studies ; Gastroenteritis* ; Humans ; Incidence ; Medical Records ; Neurologic Manifestations ; Prognosis ; Retrospective Studies ; Rotavirus* ; Seizures ; Seizures, Febrile

The Jarcho-Levin syndrome is a rare genetic disorder characterized by a short neck, short trunk, and a constricted thorax, and is due to multiple vertebral and rib defects. The small size of the thorax frequently leads to respiratory insufficiency and death in neonates or infants. This syndrome also combines with various kinds of anomalies, especially renal anomalies. We report an infant with Jarcho-Levin syndrome combined with fusion of both kidneys who was referred from a local obstetric clinic for cyanosis and respiratory difficulty.
Abnormalities, Multiple ; Cyanosis ; Heart Defects, Congenital ; Hernia, Diaphragmatic ; Humans ; Infant ; Infant, Newborn ; Kidney ; Neck ; Respiratory Insufficiency ; Ribs ; Thorax

BACKGROUND: Serious organ shortage necessitates ABO incompatible (ABOi) kidney transplantation (KT). Recent reports utilizing rituximab instead of splenectomy and tacrolimus (FK)-based triple immunosuppressants showed excellent graft outcome. METHODS AND RESULTS: Thirteen cases of ABOi living donor KT have been performed since Feb. 2007 in our center. Donor and recipient blood group was B to O (n=5), A1 to O (2), AB to B (2), AB to A1 (1), A1 to B (2) and B to A1 (1). Rituximab was given at 4 weeks before transplantation. Plasmapheresis (PP) was initiated at 7~14 days before transplantation with concurrent immunosuppressants. The number of pretransplant PP was 5.7+/-1.4. Posttransplant PP was also performed in 6 patients with higher initial titer of ABO antibody (IgG > or =256; n=2), rapidly rising antibody titer during the critical period of 2 weeks posttransplantation (n=2), or increase in serum creatinine during the critical period while awaiting pathology report of graft biopsy (n=2). Mean number of posttransplant PP in these 6 patients was 2.2+/-1.3. Median IgG anti-ABO antibody titer before precondition, at transplantation, at 2 weeks and at 6 months was 64 (8~512), 2 (1~8), 2 (1~16) and 6 (1~16), respectively. IgM titer at corresponding time point was 16 (2~128). 1 (1~1), 1 (1~2) and 1.5 (1~4), respectively. Median follow up was 8 (5~27) months. No patient or graft was lost. No patient developed acute humoral rejection. Graft function remained stable with latest serum creatinine 1.2+/-0.3 mg/dl. CONCLUSIONS: ABOi living donor KT without splenectomy can be safely performed with the use of current preconditioning and immunosuppressive regimen, and is therefore a valuable option for expanding donor pool and should be actively performed in Korea.
Antibodies, Monoclonal, Murine-Derived ; Biopsy ; Creatinine ; Critical Period (Psychology) ; Follow-Up Studies ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Immunosuppressive Agents ; Kidney ; Kidney Transplantation ; Living Donors ; Plasmapheresis ; Rituximab ; Rejection (Psychology) ; Splenectomy ; Tacrolimus ; Tissue Donors ; Transplants

PURPOSE: We hypothesized that phototherapy, if the total serum bilirubin (TSB) is > or = 14mg/dl, would decrease not only in frequency and duration, but complications due to phototherapy, such as weight loss, rash, temperature instability, feeding intolerance, and diarrhea, would decrease when compared to phototherapy TSB > or = 10mg/dl after 48 hours of life in healthy term newborns without hemolysis. METHODS: Forty healthy newborns born by cesarean section in Hanyang University Kuri Hospital from February, 1996 and March, 1996 were enrolled and randomly divided into two groups according to different guidelines of phototherapy after 48 hours of age; study group, phototherapy TSB > or = 14mg/dl and control group, phototherapy TSB > or = 10mg/dl. TSB and body weight were measured every 24 hours from 48 hours of life to 144 hours of life. Exclusion criteria included a positive Coombs test and any pathologic conditions. RESULTS: Eventually, 17 cases were enrolled to the study group and 16 cases to the controls. Ninety-four percent of all newborns were TSB > or = 7mg/dl and 82% TSB > or = 10mg/dl. Among the newborns who reached TSB > or = 10mg/dl, 44% of them were at 48 hours of life. Phototherapy was given in the study group less frequently and shorter than in the controls (6% vs. 82%, P<0.001; 22 hours vs. 70 +/- 49 hours, P=unaccountable). TSB (mean +/- SD, mg/dl) at 120 and 144 hours of life among the newborns who reached TSB > or = 10mg/dl were significant higher in the study group compared to the controls (11.4 +/- 1.4 vs 10.1 +/- 1.7 P=0.046; 11.2 +/- 0.7 vs 8.5 +/- 2.8, P=0.028, respectivelyy). There were no significant differences in complications of phototherapy in two groups. CONCLUSION: Phototherapy if TSB > or = 14mg/dl after 48 hours of life in healty term newborns without hemolysis decreased frequency and duration of phototherapy without any risk of kernicterus compared to phototherapy if if was at TSB > or = 10mg/dl.h
Bilirubin ; Body Weight ; Cesarean Section ; Coombs Test ; Diarrhea ; Exanthema ; Female ; Hemolysis ; Humans ; Infant, Newborn ; Infant, Newborn* ; Jaundice ; Jaundice, Neonatal* ; Kernicterus ; Phototherapy* ; Pregnancy ; Weight Loss

No abstract available.
Fetus* ; Heart Rate* ; Heart*

Choanal atresia is the congenital failure of one or both posterior nasal apertures to communicate with the nasopharynx. Coexisting congenital anomalies are 20% to 50% of patients. Bilateral choanal atresia almost always presents respiratory distress, sucking difficulty and cyanosis relieved by crying in the newborn. Bilateral choanal atresia in newborns and infants carries significant morbidity and mortality, therefore, prompt correction is required. Athelia is the absence of the nipple-areola complex. It is a rare entity that can be either congenital or acquired. Congenital athelia is always associated with amastia and a syndrome. We report a case of choanal atresia associated athelia, in term baby.
Choanal Atresia* ; Crying ; Cyanosis ; Humans ; Infant ; Infant, Newborn* ; Mortality ; Nasopharynx

Eosinophilic granulomatosis with polyangiitis (EGPA), previously called Churg-Strauss syndrome, is an anti-neutrophil cytoplasmic antibody associated vasculitis, accompanied by asthma, hypereosinophilia, nonfixed pulmonary infiltrates, and sinusitis. Peripheral neuropathy is common in patients with EGPA; however, a few cases of EGPA with central nervous system (CNS) involvement have been reported. A 45-year-old female referred for right side weakness and posterior neck pain was diagnosed as EGPA with subarachnoid hemorrhage and mononeuritis multiplex. She was effectively treated with a high dose glucocorticoid, cyclophosphamide, and intravenous immunoglobulin. EGPA with CNS involvement is uncommon and causes significant morbidity and mortality. Therefore more rapid and accurate diagnostic evaluation may be required. EGPA should be considered in patients with neurological symptoms and hypereosinophilia.
Antibodies, Antineutrophil Cytoplasmic ; Asthma ; Central Nervous System ; Churg-Strauss Syndrome ; Cyclophosphamide ; Eosinophils* ; Female ; Humans ; Immunoglobulins ; Middle Aged ; Mononeuropathies* ; Mortality ; Neck Pain ; Peripheral Nervous System Diseases ; Sinusitis ; Subarachnoid Hemorrhage* ; Vasculitis

The hydromyelia is one kind of four types of syringomyelia, chronic progressive and degenerative disorder, which develops pathological cavity or syrinx within spinal cord. It is rare and comprises dilated spinal syrinx. Its clinical manifestations include muscle weakness without pain in arm and hand, dissociated segmental dysesthesia, and loss of pain and temperature sensation. It is also frequently associated with hydrocephalus. We report a case of hydromyelia with erythematous depressed patch on low back in term neonate.
Arm ; Hand ; Humans ; Hydrocephalus ; Infant, Newborn* ; Muscle Weakness ; Paresthesia ; Sensation ; Spinal Cord ; Syringomyelia

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. A 77-year-old man was referred for the evaluation of general weakness and leukocytosis. Computed tomography showed a 9.5×6.5-cm cavitary lesion with an air-fluid level near the stomach, which was thought to be a perigastric abscess. Upper endoscopy revealed a fistula on the greater curvature at the mid body of the stomach. The margin of the fistula opening was clearly demarcated, and yellow turbid fluid oozing from the fistula was seen. Laparoscopic wedge resection was performed at the perforated area of the stomach. Immunohistochemistry revealed CD117 expression. A diagnosis of intermediate-risk GIST was made. No recurrence was identified within 18 months after the operation. The final diagnosis was perforated gastric GIST communicating with the gastric lumen and presenting as an intra-abdominal abscess.
Abdominal Abscess ; Abscess* ; Aged ; Diagnosis ; Endoscopy ; Fistula ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Humans ; Immunohistochemistry ; Laparoscopy ; Leukocytosis ; Recurrence ; Stomach*