A relatively rare and puzzling tumor of the testicular tunic is reported. The tumor, so called a fibrous pseudotumor of testicular tunics, in presented because of the clinical dilemma this rare entity causes urologists and pathologists. This report demonstrates the necessity for familiarity with testicular pseudotumors in order to avoid an unnecessary orchiectomy.
Orchiectomy ; Recognition (Psychology)

Traumatic dislocation of the testis occurs when a normally distended testis assumes, as a result of trauma, a non-scrotal position by passing along fascial plane and through normal anatomic aperture. Less than 50 cases of true traumatic dislocation have been reported. The etiology, classification and treatment of testicular luxation are reviewed briefly. If efforts at closed reduction are unsuccessful, management requires surgical exploration and orchiopexy. The prognosis for recovered or fertility potential after this repair of dislocation of the testis is good. We report the case that one testis has traumatic dislocation with a ruptured vas deferens and the other has a primary spermatogenic defect.
Classification ; Dislocations* ; Fertility ; Orchiopexy ; Prognosis ; Testis* ; Vas Deferens

No Abstract Available.
Posterior Cruciate Ligament*

BACKGROUND: Recently, UVB irradiation was found to activate AP-1, which is known to be a major enhancer factor of the collagenase gene. However, tbe effect of UVA irradiation on the activity of AP 1 in derrnal fibroblasts is unclear. Although all trans-retinoic acid(tRA) has been known to prevent. the AP 1 and collagenase stimulatory effect of UVB irradiation, the effect of tRA and ursolic acid(UsA) on the enhancement of AP-1 activity hy UVA irradiation is unknown. OBJECTIVE: In this stuc y, the effect of UVA irradiation on the AP-1 activity in cultured human dermal fibroblasts was studied. The effect. of tRA and UsA on the enhancement of AP-1 activity by UVA irradiation was also investigated. METHODS: Confluent human dermal fibroblasts were irradiated with 15J/cm of UVA. Drugs were administered and kept in a culture rnedia for 12 hrs before or immediately after UVA irra diation. Nuclear protein extracts were isolated 12 hrs after UVA irradiation and were subjected to gel retardation assay ising oligolabeled DNA probe for AP l binding site. RESULTS: 1. The activity of AP-1 was increased by UVA irradiation and prominent activation was detected at 6 and 12 hrs postirradiation. 2. Compared to the UVA irradiated group, tRA and the high concentration(10(-5)M) of UsA administered before or al ter UVA irradiation inhibited the increase of AP-1 activity. CONCLUSION: These res ilts suggest that UVA irradiation enhance the AP-1 activity, which is known to be a major er hancer factor of the collagenase gene, and tRA and UsA downregulate the 1JVA induced AP-l activity enhancement.
Binding Sites ; Collagenases ; DNA ; Electrophoretic Mobility Shift Assay ; Fibroblasts* ; Humans* ; Nuclear Proteins ; Transcription Factor AP-1* ; Tretinoin*

Diagnosis* ; Electric Impedance* ; Humans ; Obesity* ; Pediatric Obesity

BACKGROUND: Osteopenia or osteoporosis is one of the most frequently encountered complications in patients receiving various immunosuppressants after kidney transplantation. The few available preventive strategies for these complications tend to result in various outcomes. In this study, we evaluated the effect of intermittent etidronate therapy for the prevention of bone loss after kidney transplantation. METHODS: Fifty patients who received kidney transplantation for various reasons were recruited and followed for one year. Thirty-eight of these patients commenced etidronate treatment 7 days after operation, the other 12 were followed without etidronate therapy. The treatment consisted of 400mg of etidronate administered orally for 14 days, then repeated four-times every three months. Blood chemistry, iPTH and aluminium levels were tested periodically in all patients. Also checked were bone mineral density of the lumbar spine(L2-4) and femur at baseline, 6 and 12 months after kidney transplantation, as well as D-L spine lateral x-ray at baseline and 12 months. Serum osteocalcin and urine deoxypyridinoline were measured at baseline, 7 days and then every 3 months. RESULTS: Both the etidronate-treated and control groups showed significant decreases in bone mineral densities of the lumbar spine, femur neck and total femur at 6 and 12 months after kidney transplantation(p<0.005). Bone loss was significantly lower in the etidronate-treated group than the control at 12 months after kidney transplantation; lumbar spine(-3.54% vs. -9.51%, p<0.0005), femur neck (-5.41% vs. -8.91%, p<0.0005), total femur (-7.59% vs. -9.07%, p<0.005). Osteocalcin was decreased and deoxypyridinoline increased in both groups. No significant differences in the level or pattern of osteocalcin and deoxypyridinoline were observed in either group. New radiologic compression fractures were found in two patients of the treated group who exhibited severe osteoporosis at baseline during follow-up. CONCLUSIONS: The intermittent administration of etidronate seems to be effective in preventing rapid bone loss after kidney transplantation. Furthermore, this method is safe and convenient for administration and follow-up. Further studies will be required to elucidate the most effective treatment course for the prevention of fractures after kidney transplantation, especially in patients with established severe osteoporosis.
Bone Density ; Bone Diseases, Metabolic ; Chemistry ; Etidronic Acid* ; Femur ; Femur Neck ; Follow-Up Studies ; Fractures, Compression ; Humans ; Immunosuppressive Agents ; Kidney Transplantation* ; Kidney* ; Osteocalcin ; Osteoporosis ; Spine

In order to evaluate the role of anti-endothelial cell antibody (AECA) in acute rejection in renal transplantation, serum AECA IgG titers were measured in 68 healthy controls, 111 chronic hemodialysis (HD) patients and 58 first renal transplant recipients. The AECA titer in hemodialysis patients was higher than in healthy controls (13.9+/-5.0 vs. 4.8+/-2.3 U/mL, p<0.01). In transplant recipients, AECA titers were not affected by dialysis mode (HD vs. CAPD vs. non-dialysis ; 9.6+/-7.6 vs. 7.9+/-3.9 vs. 11.9+/-3.1 U/mL, p>0.05). After renal transplantation, AECA titer was decreased significantly (vs. 4.7+/-3.6 U/mL, p<0.01). The serum AECA IgG titers increased significantly in recipients with acute rejection (6.9+/-3.1 vs. 13.5+/-9.9 U/mL, p<0.01), but decreased to 5.6+/-3.0 U/mL (p<0.01) after formal rejection therapy. In the recipients with acute rejection (n=27), the pre-renal transplant AECA titer was higher than in that without acute rejection (14.0+/-8.6 vs. 7.7+/-3.8 U/mL, p<0.01). The results of this study lead us to conclude that pre- and post-renal transplant AECA titer might be a useful predictor for acute rejection and useful for monitoring acute rejection in renal transplant recipients.
Adult ; Aged ; Autoantibodies/analysis* ; Biological Markers/analysis ; Comparative Study ; Enzyme-Linked Immunosorbent Assay ; Female ; Graft Rejection/immunology* ; Human ; Kidney Transplantation/immunology* ; Kidney Transplantation/adverse effects ; Male ; Middle Age ; Probability ; Prognosis ; Reference Values ; Renal Dialysis ; Sensitivity and Specificity ; Statistics, Nonparametric ; Transplantation Immunology/physiology

OBJECTIVE: Hemorrhagic fever with renal syndrome(HFRS) is characterized by acute renal failure and increased vascular permeability. Hypoalbumi-nemia is frequently observed in the acute stage of HFRS, but its pathogenesis is not well known. In this study, we investigated intestinal loss of plasma protein in patients with HFRS. METHODS: First, we evaluated the incidence of proteinuria and measured the amount of urine protein in 20 patients during clinical course of HFRS. Second, GI loss of plasma protein was evaluated using Tc-human serum albumin(Tc-HSA) scan and fecal clearance of a l-antitrypsin(Cz). RESULTS: Seventeen(85%) of 20 patients demonstrated hypoalbuminemia(serum albumin level <3.5 g/dL) during admission and its lowest level was 3.0 +/- 0.3g/dL. Urine protein during admission was 1.9 +/- 1.3g/day and most of them showed negative con- version within 7days(7 6days). Tc-HSA scan revealed 65% positivity(13/20) in the acute stage and increased CAJ was observed 13 out of 20 patients (65%). In these patients, CAf in the recovery stage was significantly decreased compared to that in the acute stage(9.2 +/- 4.2ml/day vs 40.5>24.lml/day, p< 0.01). The mean serum albumin level in the patients with increased CAp was lower than that in the patients with normal CAy(2.80.1g/dL vs 3.4+0.2 g/dL, p<0.01). In the patients who had increased CA J', hypotensive episodes were more frequent, number of patients who needed hemodialysis was more, and thrombocytopenia was severer compared with the patients with normal CAp. But there was no difference in the amount of proteinuria between two groups. CONCLUSION: Our study suggests that intestinal loss of plasma protein is in part associated with hypoalbuminemia occurred in the acute stage of HFRS.
Acute Kidney Injury ; Capillary Permeability ; Fever ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Hypoalbuminemia* ; Incidence ; Plasma* ; Proteinuria ; Renal Dialysis ; Serum Albumin ; Thrombocytopenia

PURPOSE: Recombinant human growth hormone is an effective therapy for short-statured children born small for their gestational age (SGA). This single-arm, multicenter, phase III clinical study of such children was designed to assess the efficacy and safety of treating them with recombinant human-growth-hormone (Eutropin(TM) Inj.) for 6 months. METHODS: Between 2005 and 2007, 30 treatment naive, prepubertal, short-statured SGA-born children were recruited as participants. Eutropin(TM) Inj. was administered for 6 months with a subcutaneous dose of 0.48 mg/kg/wk. The primary endpoint was the change in height velocity from the baseline to month 6. Various parameters were checked to obtain secondary outcome measures and to meet safety criteria. RESULTS: Height velocity significantly increased from 5.36 +/- 1.59 cm/yr at baseline to 10.66 +/- 2.03 cm/yr at month 6 (P < 0.0001). Secondary outcome measures (height velocity at month 3, height SDS for chronological age (CA), weight SDS for CA, bone maturation, and IGF-I and IGFBP-3 levels) were also significantly increased. Eutropin(TM) Inj. was well tolerated and safe over 6 months of treatment. CONCLUSION: The clinical efficacy and safety of Eutropin(TM) Inj. was demonstrated for the 6 month treatment of prepubertal children with short stature due to SGA. Further long-term study is needed.
Child ; Gestational Age ; Human Growth Hormone ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Outcome Assessment (Health Care)

The serum levels of sICAM-1 were significantly higher in febrile & hypotensive (789+/-241ng/ml) stage than in diuretic stage (514+/-151ng/ml) and convalescence stage (410+/-88ng/ml) (P<0.01). Also the serum levels of sICAM-1 in oliguric (628+/-220ng/ml) stage higher than that of convalescence stage (P<0.01). The serum level of sICAM-1 was significantly high in convalescence stage of patients with HFRS compared to control (306+/-75ng/ml) (P<0.01). sICAM-1 levels correlated with platelet count (R=-0.35, P<0.05) in all stage of HFRS. Our results suggest that the enhanced immune activation is a common feature in early stage of HFRS.
Convalescence ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Intercellular Adhesion Molecule-1* ; Platelet Count