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*

A clinica1 observation was made on the 14 inpatient cases of ureteral obstruction which were not originated from calculi or tuberculous nature in the Department of Urology, Korea University College of Medicine during the period of 1 year from Sep. 1973 to Aug. 1974, and following results were obtained: 1. As to the origin of the obstruction, 4 cases of ureteral fibrosis, 2 cases of aberrant vessel, and one congenital ureteral stricture, one ureteral tumor, one ureterocele, one periureteral fibrosis, and one case of ureteral ligation during the radical total hysterectomy. 2. As to the location of the ureteral stricture, the upper ureter in 9 cases. middle ureter in o2e case and lower ureter in 4 cases. 3. The surgical treatment employed were nephrectomy in 6 cases, pyeloplasty in 5, ureteroneocystostomy in 1, ureteral dilation in 1 and transurethral resection in 1 case.
Calculi ; Constriction, Pathologic ; Fibrosis ; Humans ; Hysterectomy ; Inpatients ; Korea ; Ligation ; Nephrectomy ; Ureter* ; Ureteral Obstruction* ; Ureterocele ; Urology

Idiopathic gingival fibromatosis is associated with other abnorma ities of which the most striking is hypertrichosis of variable degree. Gorlin and Pindborg described this condition as a distinct syndrome termed idiopathic gingival fibromatosis and hypertrichosis. We report a case of idiopathic gingival fibromatosis and hypertrichosis occuring in 34-year-old woman with enlarged gingival tissue, hypertrichosis, and enlargenment of the breasts, ears and nose. Laboratory tests including hormonal and chromosomal studies were all within normal limits. Histologically, the gingival hyperplastic tissue showed thick bundle of collagen fibers with few fibroblasts or capillaries and little or no inflammatory infiltrate.
Adult ; Breast ; Capillaries ; Collagen ; Ear ; Female ; Fibroblasts ; Fibromatosis, Gingival* ; Humans ; Hypertrichosis* ; Nose ; Strikes, Employee

Idiopathic gingival fibromatosis is associated with other abnorma ities of which the most striking is hypertrichosis of variable degree. Gorlin and Pindborg described this condition as a distinct syndrome termed idiopathic gingival fibromatosis and hypertrichosis. We report a case of idiopathic gingival fibromatosis and hypertrichosis occuring in 34-year-old woman with enlarged gingival tissue, hypertrichosis, and enlargenment of the breasts, ears and nose. Laboratory tests including hormonal and chromosomal studies were all within normal limits. Histologically, the gingival hyperplastic tissue showed thick bundle of collagen fibers with few fibroblasts or capillaries and little or no inflammatory infiltrate.
Adult ; Breast ; Capillaries ; Collagen ; Ear ; Female ; Fibroblasts ; Fibromatosis, Gingival* ; Humans ; Hypertrichosis* ; Nose ; Strikes, Employee

No abstract available.
Hepatitis, Chronic* ; Interferon-alpha* ; Killer Cells, Natural* ; Prednisolone*

No abstract available.
Arthroplasty* ; Hip*

BACKGROUND: The aim of study was to determine the influence of pH-adjusted lidocaine of epidural anesthesia on the maternal and fetal blood lidocaine concentration. METHODS: Thirty parturients having epidural anesthesia for cesarean section were assigned to two group. Plain group (n=15) received 18 ml of 1.8% lidocaine (2% lidocaine plus 1ml saline per 10 ml lidocaine) with added 1:200,000 epinephrine. Patients in the alkalinized group (n=15) were given 18 ml of 1.8% lidocaine (2% lidocaine plus 1ml sodium bicarbonate per 10 ml lidocaine) with added 1:200,000 epinephrine. The level of analgesia was assessed 5 min after injection and then reassessed every 1min in the middle line. Maternal and umbilical venous blood were obtained at birth and the concentrations of lidocaine in these samples were determined by Immunofluorescence assay. Apar score was also assessed. RESULTS: The peak level of sensory blockade were similiar (T5) but The time to peak level was significantly more rapid in alkalinized group than plain group. The plasma lidocaine levels in the maternal venous blood and umbilical venous blood were similar in both groups. The ratios of umbilical vein to maternal vein concentration of lidocaine were 0.76+/-0.36 in alkalinized group and 0.62+/-0.21 in plain group. CONCLUSIONS: We conclude that alkalinization of lidocaine in epidural anesthesia results in a faster onset of sensory block and more rapid time to peak level but no adverse effects on Apgar score. Alkalinization of lidocaine is therefore recommended when epidural anesthesia is planned for Cesarean section.
Analgesia ; Anesthesia, Epidural* ; Anesthetics ; Apgar Score ; Cesarean Section* ; Epinephrine ; Female ; Fetal Blood ; Fetus* ; Fluorescent Antibody Technique ; Humans ; Lidocaine* ; Mothers* ; Parturition ; Plasma ; Pregnancy ; Sodium Bicarbonate ; Umbilical Veins ; Veins

BACKGROUND: Cardiac patients undergoing open heart surgery usually require ventilatory support that involves ICU admission in the postoperative period. We tried to find out determinants of postoperative ventilatory support time. METHODS: We reviewed the medical records of 56 open heart surgery patients retrospectively in terms of their disease, preoperative physical status, age, post-bypass arterial oxygen tension/inspired oxygen fraction (PaO2/FIO2) ratio, number of inotropics used and searched the relationship between each factor and postoperative intubation time. RESULTS: None of the factors except the number of inotropics used had an significant influence on the postoperative intubation time. CONCLUSION: In open heart surgical patients their disease, preoperative physical status, age, postbypass PaO2/FIO2 ratio do not affect postoperative intubation time rather than number of inotropics used does.
Heart* ; Humans ; Intubation* ; Medical Records ; Oxygen ; Postoperative Period ; Retrospective Studies ; Thoracic Surgery*

Angiosarcoma is a very rare malignant tumor of endothelial cell origin. We experienced a case of angiosarcoma presented with massive pleural effusion, which was considered as a metastasis from right kidney. A 44-year-old male patient was admitted due to dyspnea for one month. He had a history of transient hematuria 3 months before admission, which disappeared spontaneously Chest roentgenography showed total haziness in left hemithorax with multiple nodular shadows in right lung. Abdominal ultrasonogram showed a single heterogeneous hyperechoic mass, measuring about 7.3×7.1×6.5cm in size in the upper and mid-pole of the right kidney, involving. renal sinus. Computed tomography of the chest revealed highly enhanced multiple pulmonary and subpleural nodules with loculated pleurisy. In bronchoscopic finding, a fungating, hypervascular tumor mass was noticed at the orifice of anterior basal segment of left lower lung after removal of tenaceous mucus Pleural and bronchoscopic biopsies showed findings of angiosarcoma confirmed by immunochemical stains with factor VIII related antigen(+), laminin(+) and vimentin(+), and by characteristic electronmicroscopic findings. Massive pleural effusion was controlled with several times of pleurodesis in both pleural spaces.
Adult ; Biopsy ; Coloring Agents ; Dyspnea ; Endothelial Cells ; Factor VIII ; Hemangiosarcoma* ; Hematuria ; Humans ; Kidney ; Lung ; Male ; Mucus ; Neoplasm Metastasis ; Pleural Effusion* ; Pleurisy ; Pleurodesis ; Radiography ; Thorax ; Ultrasonography

PURPOSE: To evaluate the effect of adding exogenous extracellular matrix (ECM) proteins on the reattachment of retinal pigment epithelium (RPE) to the damaged surface of Bruch's membrane (BM). METHODS: Porcine BM explants were divided into six groups: BMs with an intact basal lamina (bl-BM) and five damaged BMs (d-BM: bare & four ECM-coated). The d-BM was coated with ECM proteins (either fibronectin, laminin, collagen IV, or all). Primary RPE sheets were plated and cultured for each group of BM explants. The attached live cells were counted and examined with a scanning electron microscope after three days, as well as at 1, 2 and 4 weeks. RESULTS: The RPE reattachment rate was highest in bl-BM and lowest in uncoated d-BM. ECM-coated groups showed a lower reattachment rate than bl-BM, but when compared with the uncoated group, the reattachment rate was significantly increased (p<0.05). ECM-exposure time did not influence the reattachment rate of any of the groups. RPE cells plated on bl-BMs and ECM-coated d-BMs attached and proliferated well and achieved confluence over time. Even though most cells were flat and large in shape, some cells revealed a good morphology with microvilli on their surface. On the other hand, only some of the RPE sheets plated on the uncoated d-BM attached loosely and most cells remained round and clumped. CONCLUSIONS: These results show that the addition of ECM proteins may increase the ability of RPE cells to reattach to the damaged BM surface, which would likely create a good morphology.
Basement Membrane ; Bruch Membrane ; Collagen ; Epithelial Cells* ; Extracellular Matrix Proteins* ; Extracellular Matrix* ; Fibronectins ; Hand ; Laminin ; Microvilli ; Retinal Pigment Epithelium ; Retinaldehyde*