Cartilage ; Cleft Lip ; Congenital Abnormalities ; Ear ; Humans ; Palate ; Rhinoplasty ; Transplants ; Young Adult

PURPOSE: To determine effectiveness of Valsalva maneuver and standing position on scrotal color Doppler ultrasound (CDU) for the varicocele diagnosis. MATERIALS AND METHODS: We reviewed the physical examination and CDU finding in 87 patients who visited National Police Hospital from January 2011 to April 2014. Diameters of pampiniform plexus were measured bilaterally during resting and Valsalva maneuver in the supine position and standing position. We calculated the ratio of mean of maximal vein diameter (mMVD) during resting and Valsalva maneuver (resting-Valsalva ratio) and compared in the both position. RESULTS: In the resting and supine position, mMVD of varicocele testis units were 1.8 mm, 2.1 mm, 2.6 mm (grades I, II, III, respectively), and that of normal testis units (NTU) 1.2 mm. During Valsalva maneuver in the supine position, mMVD were 3.0 mm, 3.4 mm, 4.2 mm (grades I, II, III) vs 1.8 mm (NTU) (p=0.007, p<0.001, p<0.001, respectively). Average of resting-Valsalva ratio in the supine position were 0.69, 0.74, 0.74 (grades I, II, III) and 0.67 (NTU). Whereas in the resting and standing position, mMVD were 2.8 mm, 3.3 mm, 3.8 mm (grades I, II, III) and 1.8 mm (NTU) (p=0.002, p<0.001, p<0.001). During Valsalva maneuver in the standing position, mMVD were 5.0 mm, 5.8 mm, 6.6 mm (grades I, II, III) and 2.5 mm (NTU) (p=0.002, p<0.001, p<0.001). And average resting-Valsalva ratio were 0.76, 0.90, 0.71 (grades I, II, III) and 0.26 (NTU), which showed significant differences from all grades (p<0.001, p<0.001, p<0.001). CONCLUSIONS: It is suggested that the standing position and Valsalva maneuver during CDU could improve diagnostic ability for varicocele. Resting-Valsalva ratio in the standing position could be a new diagnostic index for varicocele diagnosis using CDU.
Adult ; Aged ; Humans ; Male ; Middle Aged ; Patient Positioning/*methods ; Physical Examination/methods ; Posture/physiology ; Scrotum/*ultrasonography ; Supine Position/physiology ; Ultrasonography, Doppler, Color/methods ; *Valsalva Maneuver ; Varicocele/*ultrasonography ; Veins/ultrasonography ; Young Adult

PURPOSE: To analyze the differences of semen parameters in Korean young population for three periods from 2002 to 2013. MATERIALS AND METHODS: A total of 516 semen samples were collected from Korean men presenting for infertility, varicoceles or other infectious problems for three periods from 2002 to 2012: January 2002-December 2003, January 2007-December 2008, and January 2012-December 2013. A standard World Health Organization procedure for semen analysis was performed for assessment of semen concentration, volume, motility, morphology, and pH. RESULTS: A total of 160, 162, 194 men constituted the study populations in 2002 to 2003, in 2007 to 2008, and in 2012 to 2013, respectively. The overall sperm parameter results suggested a statistically significant difference between 2002 to 2003 and 2012 to 2013 except pH. However, considering the data from 2007 to 2008, there were no trends in changes in overall semen parameters. Negative correlations were observed in all semen parameters with increasing age in all patients, except for pH. In addition, semen volume, motility, and morphology had higher negative correlation coefficients with age, from 2002 to 2013, serially. CONCLUSIONS: There were no significant changes in the semen parameters of Korean men from 2002 to 2013. In addition, semen volume, motility, and morphology showed higher negative correlation coefficients with age from 2002 to 2013, serially.
Adolescent ; Adult ; Aging/pathology/physiology ; Humans ; Hydrogen-Ion Concentration ; Infertility, Male/*diagnosis ; Male ; Retrospective Studies ; Semen ; Semen Analysis/*methods ; Sperm Count ; Sperm Motility ; Spermatozoa/cytology ; Young Adult

In order to investigate electrolyte changes in serum and urine diuretic therapy, we studied 98 patients with hypertension not optimally controlled by previous treatment. After we divied the patients into three gorups in randomized trial, group A were given Amiloride 10mg/day, group B were given Dihydrochlorothiazide 50mg/day, group C were given Amiloride 5mg/day combined with Dihydrochlorothiazide 25mg/day for 7 days. Blood pressure and electrolyte changes in serum and urine after diuretic theraphy for 7 days were as follows. 1) Serum sodium concentrations were not significantly changed in all three groups(P>0.05). 2) Serum potassium concentrations were increased in group A and C (P<0.05), but there were no significant changes in group B(P<0.05). 3) Urinary sodium exceretions were increased in all three groups(P<0.05). 4) Urinary potassium excretion were decreased in group A and C (P<0.05), but there were increased in group B (P<0.05). 5) Blood pressure were decreased in all three groups(P<0.05).
Amiloride ; Blood Pressure ; Diuretics* ; Electrolytes* ; Humans ; Hydrochlorothiazide ; Hypertension* ; Potassium ; Sodium

We studied the intradural variations of spinal nerve rootlets in 100 cases of Korean adults. The results of the study are as follows ; 1. The incidence of intrasegmental variations (abberrant rootlets) is high in cervical segments and decreased toward lumbosacral segments. The incidence is higher in posterior rootlets than anterior, except cervical sesments. 2. The incidence of intersegmental variations is higher in posterior rootlets than anterior, and generally high in cervical and lumbar segments. 3. We divide the intersegmental variations into supernumerary rootlets, dividing rootlets, and anastomosing rootlets, and among them the incidence of anastomosing rootlets is higher. We divide the anastomosing rootlets into parallel anastomosing rootlets, uniting anastomosing rootlets, and rearrangement anastomosing rootlets. 4. The anterior to posterior anastomosing of spinal nerve rootlet is present in 4 of cases studied.
Adult ; Humans ; Incidence ; Spinal Nerves*

The authors dissected and examined a horseshoe kidney from the cadaver of a 54-year-old Korean female. The results were as follows. Other congenital anomalies or complications were not found, and no renal stones showed on plain radiography of the horseshoe kidney. The horseshoe kidney was located in the area between the 12 th thoracic vertebra and the 4th lumbar vertebra, with the superior extremity of the left kidney 10mm more inferior than that of the right. The isthmus connecting the bilateral kidneys was located at the level of the 3rd lumbar vertebra. The size of the kidney was 102mm × 52mm × 44mm (right) and 108mm × 62mm × 34mm (left), and the superoinferior and anteroposterior lengths of isthmus were 22mm and 10mm, respectively. The abdominal aorta and inferior vena cava passed posteriorly to the isthmus, with the inferior mesenteric artery and lumbar splanchnic nerve passing anteriorly. Some grooves were found on the anterior surface of the bilateral kidney. The hilum of the right kidney faced the anteromedial direction and that of the left kidney faced the anterolateral direction. At the hilar plane, the right renal arteries and veins passed anteriorly and posteriorly to the renal pelvis ; the left renal arteries passed posteriorly to the renal pelvis, with the left renal veins passing anteriorly and posteriorly. Three branches of the right renal arteries passed renal hilum, while two branches did not, and two branches of the left renal arteries passed renal hilum, while six branches did not. The two arteries arising from the aortic bifurcation were distributed to the isthmus. The number of renal veins passing the renal hilum were three in the right, and two in the left. The right and left ovarian veins drained to the renal veins. There were 12 minor calyces distributed normally in the right kidney, 13 minor calyces distributed radially in the left kidney, and 3 minor calyces in the isthmus, composed of parenchyme. The left portion of the horseshoe kidney was concluded to have developed poorly, on the basis of incomplete ascension and abnormal rotation during development, the imperfect configuration of the renal shape, and the abnormal distribution of the renal vessels and renal calyces.
Aorta, Abdominal ; Arteries ; Cadaver ; Extremities ; Female ; Fused Kidney* ; Humans ; Kidney ; Kidney Pelvis ; Mesenteric Artery, Inferior ; Middle Aged ; Radiography ; Renal Artery ; Renal Veins ; Spine ; Splanchnic Nerves ; Veins ; Vena Cava, Inferior

Compared with osteosarcoma of bone, primary osteosarcoma of the soft tissue is very rare. Extraskeletal osteosarcoma is also a highly malignant pleomorphic sarcoma composed of cells exhibiting primarily osteoblastic, and to a lesser extent, chondroblastic differentiation. A case of extraskeletal osteosarcoma in the right sole is presented in a 67 year old male. The patient had noticed a progressively enlarging soft tissue mass, during about 14 months. This sarcoma was located in the soft tissues without attachment to the skeleton, as determined by examination of the X-Ray findings. The mass of right plantar portion was simply excised and pathologically confirmed to be an extraskeletal osteosarcoma. The clinical and pathological features of this sarcoma are described, and brief review of the literature is made.

OBJECTIVE: The object of this study was to compare the diagnostic accuracy of a sonographic morphologic scoting system, the serum CA-125 assay, and a combination of both in patients undergoing laparotomy for a clinically diagnosed adnexal mass. METHODS: In 129 consecutive patients, the morphology of the mass was evaluated and scored by the morphologic scoring system of Sassones using transabdominal or transvaginal sonography and blood samples were obtained for CA-125 assay before planning surgery, RESULTS: The sensitivity of the sonographic morphologic scoring system was 90.6%, the specificity 84.5%, the positive predictive value 65.9%, and the negative predictive value 96.5%, compared with 68.8, 77.3, 50.0, and 88.2% for CA-125 and 96.9, 66.0, 48.4, and 98.5% for the two tests combined, respectively. Only one case of serous borderline ovarian tumor was missed when the two tests were combined. The sensitivity and mean value of the serum CA-125 increased with the stage of ovarian cancer. CONCLUSION: The combination of sonographic findings with a serum CA-125 assay was more sensitive, but less specific, than sonography or the serum CA-125 assay alone in predicting the malignancy of an adnexal mass. The serum CA-125 level generally reflected the stage of the disease. We think that it is reasonable to check the serum CA-125 only in cases of ovarian malignancy diagnosed by sonography.
Diagnosis* ; Humans ; Laparotomy ; Ovarian Neoplasms* ; Sensitivity and Specificity ; Ultrasonography*

PURPOSE: Our purpose in this study is to evaluate the effectiveness of bronchial and nonbronchial systemic arteries for the control of hemoptysis. MATERIALS AND METHODS: Seventy patients with massive or recurrent hemoptysis underwent percutaneous transcatheter embolotherapy between 1991 and 1993. Retrospectively we reviewed 77 cases of bronchial artery embotization and 32 cases of nonbronchial systemic artery embolization in the 70 patients. RESULTS: Immdiate control of hemoptysis was achieved in 33 of 39 patients with massive hemoptysis(84.6%) and 20 of 24 patients with recurrent hemopt ysis(83.3%). In 32 cases, nonbronchial systemic arteries contributed significantly to areas of pathologic pulmonary tissue and frequently were the major arterial supply. CONCLUSION: Bronchial artery embolization is an effective and life saving procedure in non-surgical candidates. Recognition and occlusion of nonbronchial systemic arteries that feed to hypervascular pulmonary lesions is essential for successful percutaneous embolotherapy of hemoptysis.
Arteries ; Bronchial Arteries ; Embolization, Therapeutic ; Hemoptysis* ; Humans ; Retrospective Studies

BACKGROUND: It has been well known that absolute and interpeak latencies of brainstem auditory evoked potentials (BAEP) are usually prolonged in diabetics. However, Its etiology is still controversial. We tried to identify whether the cause is structural or metabolic in origin by performing BAEP and brain MRI in the diabetic patients. METHODS: BAEP were performed in both the diabetic patients (DM) group (16 males and 15 females) and the normal control group (25 males and 33 female). A brain MRI was performed in the DM group on those who showed abnormal BAEP and com-pared the results of BAEP of the DM group with those of the control group. RESULTS: 7 patients (22.6%) showed abnor-mal BAEP (male; 6, female; 1, unilateral; 4, bilateral; 3) when abnormal BAEP was defined as being larger than two and a half standard deviations of the control group BAEP results. Two males of the DM group who showed abnormal structural lesions of the pons in their brain MRI were not included in the statistical analysis. The remaining 14 diabetic male patients (mean age: 58.7 +/-9.1 years, mean disease duration: 6.1 +/-4.7 years, mean hemoglobin (Hb) A1C: 7.7 +/- 2.0%) and 15 diabetic female patients (mean age: 60.6 +/-10.8 years, mean disease duration: 5.4 +/-5.1 years, mean HgA1C: 7.8 +/-2.1%) were stastistically analyzed. Interpeak latencies of I-III, III-V, and I-V were found to be signifi-cantly prolonged in the DM group. The prolongation of interpeak latencies of I-III and I-V were found to be signifi-cantly correlated with the disease duration only in the diabetic female patients, but not with age and HbA1c. CONCLUSIONS: These findings suggest that both metabolic derangement and structural lesion contribute to prolonging the central conduction time on BAEP pathway in diabetics.
Brain ; Brain Stem* ; Diabetes Mellitus ; Evoked Potentials, Auditory, Brain Stem* ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Pons