CT guided stereotactic biopsies were carried out in 41 patients with tumorous CT findings during past 2 years. In 27 tumorous CT conditions impressed glioma, meningioma, metastatic ca, chondroma, germinoma and craniopharyngioma, 16 cases were disclosed correctly in preoperative cinicalradiological diagnosis comparing with pathological diagnosis confirmed by means of stereotactic biopsy, but other 11 cases, showed the preoperative diagnostic error which pathological diagnosis were infarction, cryptical AVM, abscess, granuloma, and tumors such ad lymphoma, oligodendroglioma, GBM, chordoma. Among 12 granulomatous CT lesions 3 cases showed preoperative diagnostic error, which were, confirmed infarction, multiple sclerosis by pathological diagnosis. The pathological findings of 2 vascular lesions that were impressed as infarction and old hematoma were confirmed as granuloma and GBM. The error of preoperative clinical - CT diagnosis was 39% of total 41 patients. The advantage of preoperative stereotactic biopsy is to confirm the correct histological diagnosis, while it can help the patient and surgeon for the planning of further proper therapy.
Abscess ; Biopsy* ; Chondroma ; Chordoma ; Craniopharyngioma ; Diagnosis ; Diagnostic Errors ; Germinoma ; Glioma ; Granuloma ; Hematoma ; Humans ; Infarction ; Lymphoma ; Meningioma ; Multiple Sclerosis ; Oligodendroglioma

No abstract available.
Animals ; Mice* ; Oocytes*

PURPOSE: To evaluate the usefulness and effectiveness of transurethral coagulation and incision of the ejaculatory duct for hematospermia caused by ejaculatory duct cyst and obstruction. MATERIALS AND METHODS: Twenty-six patients with hematospermia were enrolled. Ejaculatory duct cyst or obstruction was diagnosed by transrectal ultrasound or MRI, revealing seminal vesicle hypertrophy and cystic dilated ejaculatory ducts. One patient had hematospermia associated with infertility. The mean age of the patients and their duration of symptoms were 42.7 years (range, 25-67 years) and 16 months (range, 1-60 months), respectively. All patients underwent transurethral management for treatment of their ejaculatory duct obstruction in the form of incision and coagulation of the ejaculatory duct. We used a 9.5 Fr rigid ureteroscope (Stortz(R), Germany) and a Bugbee electrode. Patients were followed for more than 3 months after the procedure. RESULTS: All patients reported improvement of hematospermia and disappearance of midline cysts, except for one patient. The one case, ureteroscope failed to pass through verumontanum. A ejaculatory duct cyst was found in 18 cases. Calculi were present in the seminal vesicle and ejaculatory ducts in 7 patients and were removed with endoscopic instruments. One infertile patient regained reproductive ability after the procedure. Postoperative complications, such as epididymitis, orchitis, or retrograde ejaculation were not observed. CONCLUSIONS: Transurethral incision and coagulation was a safe and effective treatment option for hematospermia caused by ejaculatory duct obstruction and is considered to be a successful treatment option for infertility secondary to ejaculatory duct obstruction.
Calculi ; Ejaculation ; Ejaculatory Ducts ; Electrodes ; Endoscopy ; Epididymitis ; Hemospermia ; Humans ; Hypertrophy ; Infertility ; Male ; Orchitis ; Postoperative Complications ; Seminal Vesicles ; Ureteroscopes

OBJECTIVES: To examine the in vitro interactions of blastocyst attachment using type I collagen. MATERIALS AND METHODS: ICR mice were used and follicular growth was stimulated by pregnant mare serum gonadotropin and human chorionic gonadotropin. On day 4 of pregnancy, the uteri were removed and blastocysts were flushed. Mixtures of 1mL sterile water, 0.5mL DMEM, 2mL type collagen solution and 0.5mL 0.1M NaOH were prepared and transferred to an incubator where the collagen solution polymerized. Blastocysts were transferred to dishes previously coated with type I collagen. CMRL 1066 was used as the basic culture medium. It was supplemented with 1mM glutamine and 1mM sodium pyruvate plus 50 IU/ml penicillin and 50 mg/ml streptomycin. During the first 4 days the culture medium was supplemented with 20% fetal calf serum and thereafter with 20% heat inactivated human cord serum. All blastocysts were initially cultured for 2 days without media change. After 2 days, fresh medium was renewed daily. The stages of embryo growth were examined and recorded everyday under a dissecting microscope and classified according to the standard in vivo criteria set forth by Witschi. RESULTS: By 48h, nearly all blastocysts had attached to the surface of collagen pad. Following adhesion to the collagen pad, the blastocysts maintained their 3-dimensional integrity in contrast to control. The embryos in collagen pad were not flattening and kept polarity and spherical shape during culture. The polar trophoblast invaded the type I collagen downward unlike the horizontal growth in control. In the developmental stage of mouse blastocyst, there were significant differences between control and type I collagen group during day 4 and 5 culture. CONCLUSION: Blastocyst development was better in type I collagen group than control. Therefore, in vitro culture study using type I collagen could provide improved model for the establishment of blastocyst implantation study.
Animals ; Blastocyst ; Chorionic Gonadotropin ; Collagen ; Collagen Type I* ; Embryo Implantation ; Embryonic Structures* ; Female ; Glutamine ; Gonadotropins ; Hot Temperature ; Humans ; Incubators ; Mice* ; Mice, Inbred ICR ; Penicillins ; Polymers ; Pregnancy ; Pyruvic Acid ; Sodium ; Streptomycin ; Trophoblasts ; Uterus ; Water

OBJECTIVES: To investigate the effect of granulocyte colony stimulating factor (G-CSF) and granulocyte macrophage colony stimulating factor (GM-CSF) on expression of matrix metalloproteinase-2, 9 (MMP-2, 9) mRNA in mouse embryos. Materials and METHOD: From October 1997 to December 1998, morula stage mouse embryos were cultured for 48 hours with G-CSF and GM-CSF at concentrations of 0.1 pg/ml, 1 pg/ml, 10 pg/ml, 100 pg/ml, 1 ng/ml and 10 ng/ml, respectively. Embryos not treated with G-CSF or GM-CSF were served as control. Reverse transcription-polymerase chain reaction (RT-PCR) has been used to examine the expression of MMP-2, 9 mRNA in developed blastocysts. Following reverse transcription, strategically designed nested primers, optimized for specificity, were used for amplification from the cDNA equivalent of a single embryo. The products were then verified by restriction enzyme digestion and sequence analysis. Results were analyzed with Kolmogorov-Smirnov test and analysis of variance (ANOVA). The statistical significance was defined as p< 0.05. RESULTS: The relative quantities (relative volume x intensity) of MMP-2 mRNA expressed in embryos of all G-CSF treatment groups were significantly increased than in the control, especially in 10, 100 pg/ml and 1 ng/ml treatment groups. The relative quantities of MMP-2 mRNA in all GM-CSF treatment groups were also significantly increased than in the control, especially in 100 pg/ml treatment group. The relative quantities of MMP-9 mRNA of all GM-CSF treatment groups except 10 ng/ml group were significantly increased than in the control, especially 10, 100 pg/ml and 1 ng/ml treatment group. However, the relative quantity of MMP-9 mRNA was significantly increased in only 10 ng/ml G-CSF treatment group than in the control and other treatment groups. CONCLUSION: This study suggests that G-CSF and GM-CSF may increase the m-RNA expression of MMP-2 or 9 in mouse blastocysts with the concentration-specific manner.
Animals ; Blastocyst ; Colony-Stimulating Factors* ; Digestion ; DNA, Complementary ; Embryonic Structures* ; Granulocyte Colony-Stimulating Factor ; Granulocyte-Macrophage Colony-Stimulating Factor* ; Granulocytes* ; Matrix Metalloproteinase 2* ; Mice* ; Morula ; Reverse Transcription ; RNA, Messenger ; Sensitivity and Specificity ; Sequence Analysis

No abstract available.
Heart Septal Defects, Atrial*

SUMMARY: Some of the information concerning sexual function in the male diabetes has been focused upon the problems of endocrine or semen parameters. However, the characteristics of acrosome reaction and spermatozoa concentration at the epididymis and vas deferens have scarcely been studied, and the causes of the infertility has not been critically identified. So, we designed to inspect the spermatozoa concentration and the characteristics of acrosome reaction at epididymis and was deferens of diabetic Wistar rat induced by streptozotocin (STZ, 70 mg/kg, ip). Experimental animal was sacrificed at 3 days and 14 days after the STZ injection. In the diabetes-induced rat, the levels of insulin and glucose had a pattern of inverse proportion. The spermatozoa concentrations in caput and corpus epididymis were significantly decreased in all diabetic condition. In cauda epididymis, however, there was significant decrease in sperm concentration at 14 days onward. In diabetic rat, the spontaneous reaction rate of spermatozoa of cauda and was deferens were significantly higher than the control group. The ARIC (acrosome reaction to ionophore challenge) value of caudal sperm was 28.7 at control, 22.1 at 3 days, and 8.3 at 14 days. In the present study the spermatozoa concentration was decreased and the spontaneous reaction rate was increased by diabetes. In ARIC-test, it is revealed that the fertility of spermatozoa of 14 days group was lower than control or 3 days group. Diabetes mellitus may be provoke the decreased fertilization rate and subsequent infertility.
Acrosome Reaction* ; Acrosome* ; Animals ; Diabetes Mellitus ; Epididymis ; Fertility ; Fertilization ; Glucose ; Humans ; Infertility ; Insulin ; Male ; Rats* ; Semen ; Spermatozoa* ; Streptozocin ; Vas Deferens

It is well known that the clinical test for responsibility of accurate fertilization capacity in male partners is very important to diagnose and treat the infertility. However, it has been reported that the traditional semen analysis cannot accurately predict fertilization and pregnancy potential. The present study was performed to evaluate the acrosomal reaction to ionophore challenge (ARIC) test as a prognostic indicator for fertilization of sperm and oocyte in an in vitro fertilization and embryo transfer (IVF-ET) program. From March 1996 to Februry 1997, 30 couples undergoing IVF program were allocated to this study group. All female partners in the study group were 35 years old or less and their serum level of basal follicle stimulating hormone (FSH) and estradiol (E2) were normal. All the male partners have normal parameters of semen analysis. The ARIC tests were performed on the day of ovum pick up and in vitro insemination in all the male partners. The controlled ovarian hyperstimulation (COH) using luteal long protocol of gonadotropin releasing hormone (GnRH) agonist was used in all couples for IVF-ET. The acrosomal reaction with 10microliter of 10% DMSO was induced spontaneously in 10.1+/-9.8%, and acrosomal reaction with calcium ionophore A 23187 was induced in 27.4+/-18.1%, and the ARIC value was 17.4+/-16.2%. There were no significant correlation between the ARIC value and the fertilization rate (r2=0.044, p=0.268). There were also no significant correlation between the ARIC value and the percentage of the grade I, II embryos (r2=0.046, p=0.261). On the basis of above results, it was suggested that ARIC test might not be a useful prognostic indicator for fertilization in IVF-ET in male partners with normal parameters of conventional semen analysis. We guessed that IVF-ET could be performed to the patients primarily without universal appilcation of ARIC test to all male partenrs, and if fertilization failure occurs, the microassisted fertilization (MAF) such as intracytoplsmic sperm injection (ICSI) might be used as an alternative mode of treatment with acceptable success rate.
Acrosome Reaction* ; Acrosome* ; Adult ; Calcimycin ; Calcium ; Dimethyl Sulfoxide ; Embryo Transfer ; Embryonic Structures ; Estradiol ; Family Characteristics ; Female ; Fertilization ; Fertilization in Vitro* ; Follicle Stimulating Hormone ; Gonadotropin-Releasing Hormone ; Humans ; Infertility ; Insemination ; Male ; Oocytes ; Ovum ; Pregnancy ; Semen Analysis ; Spermatozoa

OBJECTIVE: To investigate whether frozen-thawed testicular sperm obtained from men with azoospermia could serve as an efficacious sperm source for intracytoplasmic sperm injection (ICSI) by comparing to the results of ICSI using fresh testicular sperm. METHODS: From January 1997 to March 1999, 41 patients with azoospermia who underwent ICSIs using fresh and/or frozen-thawed testicular sperm were included in the study. In 23 patients of 41, fresh testicular sperm was left after ICSI and therefore remaining testicular sperm was frozen and frozen testicular sperm was used in next ICSI cycles. The results of ICSI were compared in frozen-thawed testicular sperm (frozen-thawed group, 30 cycles) versus fresh testicular sperm (fresh group, 39 cycles). RESULTS: The number of fertilized oocytes, grade I/II embryos, fertilization rate, clinical pregnancy rate were comparable in the frozen-thawed and fresh groups. There were also no differences in the miscarriage rate and multiple pregnancy rate between the two groups. In patient group with obstructive azoospermia, there were no significant differences in the number of fertilized oocytes, grade I/II embryos, fertilization rate, clinical pregnancy rate between the two groups. In patient group with non-obstructive azoospermia, all parameters of results of ICSI were comparable in both groups. In each non-obstructive azoospermic patient group with mixed motile/immotile sperm and patient group with only immotile sperm, there were also no significant differences in the number of fertilized oocytes, grade I/II embryos, fertilization rate, clinical pregnancy rate between the frozen-thawed and fresh groups. CONCLUSION: Our data demonstrate that using frozen-thawed and fresh testicular sperm gives rise to comparable results after ICSI irrespective of the status of sperm in patients with obstructive or non-obstructive azoospermia.
Abortion, Spontaneous ; Azoospermia* ; Embryonic Structures ; Female ; Fertilization ; Humans ; Male ; Oocytes ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple ; Sperm Injections, Intracytoplasmic* ; Spermatozoa*

The University of California, San Francisco, announced in 2011 Cancer of the Prostate Risk Assessment Postsurgical (CAPRA-S) score which included pathologic data, but there were no results for comparing preoperative predictors with the CAPRA-S score. We evaluated the validation of the CAPRA-S score in our institution and compare the result with the preoperative progression predictor, CAPRA score. Data of 130 patients were reviewed who underwent radical prostatectomy for localized prostate cancer from 2008 to 2013. Performance of CAPRA-S score in predicting progression free probabilities was assessed through Kaplan Meier analysis and Cox proportional hazards regression test. Additionally, prediction probability was compared with preoperative CAPRA score by logistic regression analysis. Comparing CAPRA score, the CAPRA-S score showed improved prediction ability for 5 yr progression free survival (concordance index 0.80, P = 0.04). After risk group stratification, 3 group model of CAPRA-S was superior than 3 group model of CAPRA for 3-yr progression free survival and 5-yr progression free survival (concordance index 0.74 vs. 0.70, 0.77 vs. 0.71, P < 0.001). Finally the CAPRA-S score was the more ideal predictor concerned with adjuvant therapy than the CAPRA score through decision curve analysis. The CPARA-S score is a useful predictor for disease progression after radical prostatectomy.
Combined Modality Therapy ; Decision Making ; Disease Progression ; Disease-Free Survival ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Middle Aged ; Neoplasm Staging ; Postoperative Period ; Proportional Hazards Models ; Prostate-Specific Antigen/analysis ; Prostatectomy ; Prostatic Neoplasms/mortality/*pathology/therapy ; Retrospective Studies