PURPOSE: To identify a possible relation between erectile capacity and serum testosterone concentrations in men with normal testicles and erectile dysfunction. PATIENTS AND METHODS: We studied 206 patients with erectile dysfunction who had no anatomic defect in their sex organs and no vascular risk factors or history of operation or trauma. The protocol included assay of serum testosterone in the morning and duplex ultrasonography after pharmacologic induction of erection using prostaglandin E1. The subjects were assigned to three groups according to their serum testosterone concentration: low (<300 ng/dL), normal (300-700 ng/dL), and high (>700 ng/dL). Some clinical factors, the result of duplex flow study, and pharmacologic erection test findings were compared. RESULTS: The residual spontaneous erectile rigidity of the three groups was 43.5% in the low, 46.5% in the normal, and 37.6% in the high group (p>0.05). The mean penile rigidities after injection of PGE1 in the low, normal, and high testosterone groups were 73.8%, 78.1%, and 81.9%, respectively (p>0.05). The differences in peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index (RI), which are indicators of penile hemodynamics, did not reach statistical significance between these groups. However, the average age of the low-testosterone group was significantly greater than the averages of the other two groups (p<0.05). CONCLUSIONS: There was no significant relation between serum testosterone concentration and erectile capacity in patients with erectile dysfunction who had normal testicles. Our data imply a serum testosterone threshold for penile erection which is much lower than the normal laboratory range.
Alprostadil ; Erectile Dysfunction ; Hemodynamics ; Humans ; Male ; Penile Erection ; Risk Factors ; Testis ; Testosterone* ; Ultrasonography

No abstract available.
Femur*

Segmental non-familial colonic polyposis was first reported by Chiang et al. in 1992. It is characterized by segmental distributlion of colonic polyposis usually confined to the descending colon, absence of family history of polyposis, large bowel malignancy, inflammatory bowel disease, or other pre-malignant colonic conditions. We experienced a nineteen-year-old male, who suffered from 2 years watery diarrhea about five to ten times a day, intermittent hematochezia, and weight loss of 12 kg in a year. He had no family history of colonic polyps, colon cancer, or inflammatory bowel disease. Colon study showed variable sized multiple colonic polyps on the rectum and sigmoid colon. Colonoscopy showed that 0.5 to 1.5 cm sized multiple polyps were scattered from the 6cm site to the 30cm site above the anal verge and the intervening mucosa between polyps was edematous. Colonoscopic biopsy revealed hyperplastic, adenomatous, and mixed hyperplastic and adenomatous polyps, After partial colectomy, we discovered 169 polyps from the resected specimen. After operation, diarrhea and abdominal pain had disappeared. We experienced a case of segmental non-familial polyposis and report it with review of the literatures related to it.
Abdominal Pain ; Adenomatous Polyps ; Biopsy ; Colectomy ; Colon* ; Colon, Descending ; Colon, Sigmoid ; Colonic Neoplasms ; Colonic Polyps ; Colonoscopy ; Diarrhea ; Gastrointestinal Hemorrhage ; Humans ; Inflammatory Bowel Diseases ; Male ; Mucous Membrane ; Polyps ; Rectum ; Weight Loss

PURPOSE: Microcystic adnexal carcinoma is a rare malignant appendage tumor, first described by Goldstein et al in 1982. Here, we present our experience in treatment of a case on the lower lip. METHODS: A 52-year-old female with an asymptomatic nodule on the chin, previously misdiagnosed as trichoadenoma by needle aspiration biopsy, was treated by wide excision combined with multiple circumferential frozen biopsies. RESULTS: Pathological examination revealed typical features of microcystic adnexal carcinoma, such as basaloid and squamous cells forming nests and cord-like patterns, horn cysts, and minimal cytologic atypia. The patient has been followed up for 6 months. No sign of recurrence is noted to date. CONCLUSION: Differentiation from other benign adnexal neoplasms is important for its appropriate treatment. Differentiation can be difficult histologically because it is difficult to acquire an adequate biopsy due to its invasiveness, and clinically due to its asymptomatic and slow growing features. Complete excision is the key treatment, but it may not always be the best solution considering the huge defect that may result and the low incidence of metastasis & deaths owing to the tumor. We add this case to the approximately 300 cases reported worldwide with a review of literature.
Animals ; Biopsy ; Biopsy, Needle ; Chin ; Female ; Horns ; Humans ; Incidence ; Middle Aged ; Needles ; Neoplasm Metastasis ; Recurrence

PURPOSE: We aimed to determine the quantity and quality of research output of selected Asian countries in the field of total knee arthroplasty (TKA) in the last 10 years. MATERIALS AND METHODS: Top 15 Asian countries were selected according to their gross domestic product. The Science Citation Index Expanded database was used to search for the literature published between 2004 and 2013 using "Total Knee Arthroplasty". The numbers of articles, journals and citations and the contribution of each country were analyzed. The articles were classified according to the type of study and the relative proportion of each type was analyzed. RESULTS: Asian surgeons have increasingly contributed to orthopedic literature on TKA for the past 10 years, but the dominant contribution came from only a few countries. The total number of articles published by Asian countries increased by 261%, with Japan producing most of the studies and China showing the maximum growth rate. The majority of studies were published in low impact factor journals. Korea published the highest proportion of articles in high impact factor journals. Clinical papers were most frequent. CONCLUSIONS: Our identification of research productivity pertaining to TKA among Asian countries gives a unique insight into the level of academic research in the field of TKA in these countries. There is a need to improve the quality of research to enhance the publishing power in high impact journals as well as the need for more basic research and epidemiological studies considering the unique differences among Asian patients undergoing TKA.
Arthroplasty ; Asia ; Asian Continental Ancestry Group ; Bibliometrics ; China ; Efficiency ; Gross Domestic Product ; Humans ; Japan ; Knee ; Korea ; Orthopedics

BACKGROUND: In recent years, lung cancer has been one of most common cause of death in Korea. Despite many physician's high degree of pessimism about the gains made in treatments progressive improvement in the survival of lung cancer by treatment has occurred, particulary in the early stages of the disease. However, a lot of patients refuse treatment or give up in the fight against the disease. This study was done to evaluate factors ifluencing the compliance to therapy and to lead in the establishment of special programs to enhance compliance in patients with lung cancer. METHODS: The medical records of 903 patients, whose ECOG(Eastern Cooperative Oncology Group) performance status was 3 or less and whose medical record was relatively satisfactory, among 1141 patients diagnosed with lung cancer between January 1989 and December 1996 were reviewed retrospectively. Compliance was classified into three groups based on the degree of compliance with physicians practice guideline : (a) complaints ; (b) patients who initially complied but gave up of themselves midway during the course of treatment ; (c) noncompliants who refused the treatment. RESULTS: The overall compliance rats was 63.9%, which was progressively increased from 57.3-61.3% in 1989 and 1990 to 64.2-67.5% in 1995 and 1996. Age, education level and occupation of patients bore statistically significant relationship with the compliance but sell marital status and smoking history did not. The compliance was significantly higher in patients without symptoms than with, and was also significantly higher in patients with good performance status. The compliance was significantly high in patients with NSCLC(non-small cell lung cancer) compared to SCLC(small cell lung cancer), but after exclusion of stage l and ll, among NSCLC, which had higher compliance to surgery there was no significant difference of compliance by histology. The compliance was significantly lower in advanced stage. CONCLUSION: To enhance the compliance, special care including education programs about therapy including complicantion and prognosis are necessary, especially for educationally and economically disadvantaged patients.
Animals ; Cause of Death ; Compliance* ; Education ; Humans ; Korea ; Lung Neoplasms* ; Lung* ; Marital Status ; Medical Records ; Occupations ; Prognosis ; Rats ; Retrospective Studies ; Smoke ; Smoking ; Vulnerable Populations

Infantile hepatic hemangioendothelioma is a rare disorder. It is a benign entity and usually resolves spontaneously. Most patients present in infancy and early childhood. Because of its natural course and symptom onset, most cases are discovered during childhood. We experienced a rare case of infantile hepatic hemangioendothelioma in an adult.
Adult ; Hemangioendothelioma ; Humans ; Liver

BACKGROUND: Acquired idiopathic sideroblastic anemia (AISA) is a heterogeneous condition. Most instances, involving only the erythroid line, are benign disease with a longer survival and a low propensity for evolution into acute leukemia. A subset of patients have severe clinical course and evidence of other cell line involvement at presentation, may develop the emergence of blast cells and evolution into acute leukemia. In an attempt to identify the natural history and the risk factors for the development of acute leukemia, the clinical, hematological and outcome data were studied in the patients with AISA. METHODS: We reviewed retrospectively the medical records of 15 patients of AISA treated at the Catholic University of Taegu-Hyosung and Kyungpook National University Hospital from March 1989 to December 1995. RESULTS: The median age at diagnosis was 41 years and the male to female ratio was 8 : 7. On bone marrow examination, erythroid abnormalities were prominent in all cases, 5 patients also showed involvement of the granulocytic and/or megakaryocytic cell lines (AISA with myelodysplastic features, AISA-M). The median follow-up duration was 32 months. Transfusion dependence occurred in 11 of 16 cases. Progression towards refractory anemia with excess of blasts or acute leukemia (M2) was observed in two patients with AISA-M after follow-up period of 16 months and 24 months, respectively. Infections and hemorrhages were causes of death in 3 patients with AISA-M but not in patients with dyserythropoiesis only (AISA-erythroid, AISA-E). CONCLUSIONS: Most patients with AISA have a relatively benign course with prolonged survival after the onset of anemia. Patients with features of dysgranulopoiesis and/or dysmegakaryopoiesis in addition to dyserythropoiesis at presentation were increased risk of transformation to refractory anemia with excess of blasts or acute leukemia and shorter surtival. But further study of larger numbers of patients and longer follow-up may be warranted.
Anemia ; Anemia, Refractory, with Excess of Blasts ; Anemia, Sideroblastic* ; Bone Marrow Examination ; Cause of Death ; Cell Line ; Diagnosis ; Female ; Follow-Up Studies ; Gyeongsangbuk-do ; Hemorrhage ; Humans ; Leukemia ; Male ; Medical Records ; Natural History ; Retrospective Studies ; Risk Factors

PURPOSE: The aim of this study was to characterize the clinical presentation and outcome of a series of patients with Brunner's gland adenoma. METHODS: Between 1996 and 2007, 15 patients who underwent surgical resection and 9 patients who underwent endoscopic polypectomy for pathologically confirmed Brunner's gland adenoma were identified. We reviewed the clinico-pathological features of these patients. RESULTS: The mean age of the total patients was 56 years and the male to female ratio was 1.4 to 1. There were no significant differences in age, gender and the polyp size between the surgical resection group and the endoscopic polypectomy group. Among the 15 patients of the surgery group, all 15 patients (100%) were symptomatic (p=0.031). The hospital stay in the endoscopic polypectomy group was significantly shorter than that in the surgery group (p=0.001). CONCLUSION: Brunner's gland adenoma is a rare duodenal tumor that occurs in middle age people and the patients with this tumor present with either gastrointestinal hemorrhage, obstructive symptoms or other incidental findings. Surgical or endoscopic excision for treating this tumor is uncomplicated, and the long-term outcome is favorable.
Adenoma ; Duodenum ; Female ; Gastrointestinal Hemorrhage ; Humans ; Incidental Findings ; Length of Stay ; Male ; Middle Aged ; Polyps

BACKGROUND: Stem cell transplantation with high dose chemoradiotherapy has made it possible to cure a significant proportion of patients with hematopoietic malignancies. RBC purging is an essential step prior to transplantation in ABO mismatched setting. The purpose of this study is to develop a new simple method for RBC depletion from harvested stem cells. METHODS: Ten cord bloods were collected during deliveries at Kyungpook National University Hospital, Taegu, Korea at August, 1998. All nucleated cells were collected after the compression of bags with 6% hydroxyethyl starch and cord blood for 4 hours. The cell viability of mononucleated cell (MNC) was calculated after 24~72 hours. RESLUTS: The collected mean volume of cord blood was 37.1 +/- 6.7 ml. The WBC count was 10,852 +/- 1,137/microL. The 3.90 +/- 0.62x108 TNC and 1.82 +/- 0.36x108 MNC were obtained per collection. TNC efficiency was 83.8 +/- 7.01% and MNC efficiency was 90.9 +/- 9.23% by compression method with 6% hydroxyethyl starch. RBC contamination was negligible. The cell viabilities of mononuclear cell were kept in a range of 99~100% after 24~72 hours. CONCLUSION: Because compression method with 6% hydroxyethyl starch progresses in closed system is simple & easy, has high erythrocyte depletion efficacy, and can maintain high viability of stem cells, it can be used for RBC purging in ABO mismatched stem cell transplantation.
Cell Survival ; Chemoradiotherapy ; Daegu ; Erythrocytes* ; Fetal Blood* ; Gyeongsangbuk-do ; Hematologic Neoplasms ; Humans* ; Korea ; Starch* ; Stem Cell Transplantation ; Stem Cells ; Umbilical Cord*