Duplication of the urethra within a single penile shaft is a rare anomaly. These can be divided into those that are in the sagittal plane, which is most common, and those that occur side by side. In some cases, the accessory channel is complete, having a separate bladder opening and no communication with the more normal ventral urethra. In other cases, the accessory urethra is incomplete, either ending blindly or communicating with the urethra distal to the bladder neck. We report on a 20-year-old male with incomplete double urethra.
Humans ; Male ; Neck ; Urethra* ; Urinary Bladder ; Young Adult

Vasectomy has become a popular method for male sterilization in Korea and this, in turn, has been followed by an increase in the number of patients requesting vasectomy reversal. Recently, many authors have reported a high success rate of vasovasostomy using microsurgical techniques. However, a significant discrepancy persist between the patency and pregnancy rate despite improvements in surgical techniques. A total of 200 patients undergoing vasovasostomy from May 1983 to April 1990 were reviewed. Of these 200 patients, only 130 patients (98 patients by two-layer, 32 patients by modified two-layer technique) could be followed up and analyzed as to pregnancy rate related to age, vasal obstructive interval, gross appearance and sperm quality of the vas fluid, operative method, and presence or absence of sperm granuloma. Success rates were 90.3% for patency and 65.4% for pregnancy. With regard to factors influencing to operation, it seemed that the results were better when there was a shorter vasal obstructive interval, watery vas fluid, presence of normal morphologic sperm quality, presence of sperm granuloma, and when the operation was done using the two-layer technique. However, no statistically significant difference was found, except between the bilateral presence and absence of sperm granuloma at the vasectomy site. Thus it is suggested that the most important single factor influencing the success rate of vasovasostomy is a meticulous and skillful operative technique itself, althought other factors may affect the outcome. More effort and research are needed to find the factors affecting the success rate of vasovasostomy.
Granuloma ; Humans ; Infertility* ; Korea ; Pregnancy Rate ; Pregnancy* ; Spermatozoa ; Sterilization, Reproductive ; Vasectomy ; Vasovasostomy*

We performed erotic stimulation that in 63 patients with erectile dysfunction in order to investigate erectile responses to visual sexual stimulation in patients with psychogenic and organic impotence and to elucidate valuable parameters for differential diagnosis between psychogenic and organic impotence. After the test using polygraph system and erotic film, subjective sexual drive in each patient was evaluated as grade I (poor), grade II (moderate), grade III (good). Following parameters were statistically analyzed : degree of maximal rigidity, degree of maximal tumescence, T -up phase (time taking place from the beginning of the erection to maximal level). The T-max phase (time taking place for the plateau phase of maximal erection). The results obtained were summarized as follows. Regardless of sexual drive of each patient, psychogenic impotence group showed better maximal rigidity and shorter T-up phase of rigidity than organic impotence group (p<0.05}. Of patients with psychogenic impotence, good sexual drive group showed better maximal rigidity and maximal tumescence than poor sexual drive group (p<0.06). Psychogenic impotence group showing good sexual drive revealed much better maximal rigidity and shorter T-up phase of rigidity than organic impotence group with same degree of sexual drive (p<0.05). These results indicate erotic stimulation test is highly valuable method for differential diagnosis between psychogenic and organic impotence, especially when the patient shows sexual drive in moderate or good degree. And it is suggested that maximal rigidigity and T-up phase of erection parameters in erotic stimulation test provide high validity for the differention.
Diagnosis, Differential ; Erectile Dysfunction* ; Humans ; Male

Respiratory syncytial virus is the most common cause of lower respiratory infection (bronchiolitis and pneumonia) of infancy and early childhood. We analyzed clinical and radiological features of 76 patients with lower respiratory infections by respiratory syncytial virus, which were diagnosed by indirect immunofluorescent test or culture of nasal aspirate in Hep-2 cell monolayer, during the period of January-December, 1991. There were peaks of incidences in March-May and November-December, accounting for 87% of eases. Sixty-two cases (82%) were under 1 year of age. Fifty cases(66%) had underlying diseases. Major radiographical findings were overaeration (83%), parahilar peribronchial infiltrates(67%), segmental or subsegmental atelectasis(32%), and segmental or lobar consolidation(16%). In 15 cases(20%), overaeration was the only radiological findings. There was no evidence of pleural effusion or hilar lymph node enlargement in all cases. By considerig clinical features(symptoms, age. Underlying diseases, epidemic seasons) in addition to the radiological findings, radiologists would be familiar with lower respiratory infection by respiratory syncytial virus. Air space consolidation, which is generally though to represent bacterial pneumonia, is also observed not infrequently in respiratory syncytial virus infections.
Child* ; Humans ; Incidence ; Infant* ; Lymph Nodes ; Pleural Effusion ; Pneumonia, Bacterial ; Respiratory Syncytial Virus Infections ; Respiratory Syncytial Viruses* ; Respiratory Tract Infections

Ureteroscopic removal of the stone is now popular for the management of the lower ureteral stone. A clinical study was performed on our 75 patients with lower ureteral stone treated with ureteroscopy. Of the 75 stone manipulations 62 (83%) were immediately successful and the final success rate including spontaneous delivery of stone or fragment after the procedure was 87 percents (65 cases). Of 57 smaller calculi than 1 cm (radiographic largest diameter) 50 (88%) were removed successfully. Mean duration of postoperative hospitalization was 5.6 days. There were no interrelations between the success rate and anesthetic methods. Significant complications during or after procedure were not identified. We conclude that ureteroscopic removal of stones under direct vision can be done safely and be the first choice of procedure for the lower ureteral stones.
Calculi ; Clinical Study ; Hospitalization ; Humans ; Ureter* ; Ureteroscopy

An in vitro pharmacologic study was conducted to investigate the effect of phentolamine on norepinephrine induced contraction of human corpus cavernosum. The isometric muscle tension of corpus cavernosum from 4 potent volunteers were recorded after stimulation with various concentrations of norepinephrine and phentolamine. The results are summarized as follows. Contractile response of corpus cavernosum was observed to begin in the concentration of 10(-6) M and to reach maximal level in the concentration of 10(-4)M norepinephrine. Compared to it, contractile activity of corpus cavernosum to norepinephrine was observed to be gradually decreased in response to pretreatment with phentolamine from 10(-6)M to 10(-4)M. These indicate that norepinephrine causes a dose dependent contraction of corpus cavernosum and phentolamine had a relaxant effect on norepinephrine-induced contraction of corpus cavernosum in dose dependent manner.
Humans ; Muscle Tonus ; Norepinephrine* ; Phentolamine* ; Volunteers

Purpose of the present study was to find the optimal ovulation induction medicine for the maturation and development of immature oocytes and culture media for 2-cell embryos in the mouse model. ICR female mouse aged 6 to 8 weeks, were stimulated with 5 IU PMSG injection. At 47 to 50 hour post-PMSG injection, ovaries were dissected out and oocytes-cumulus complexes were punctured. The oocyte-cumulus complexes were cultured in media containing various ovulation induction medicine, CC, HMG and Metrodin for 18 hours. Female ICR mice were stimulated with 5 IU PMSG and 48 hours later were injected 5 IU of hCG, then female and male mice were mated. At 48 hour post-hCG injection, oviducts were dissected out and 2-cell embryos were flushed. The 2-cell embryos were cultured in various media, Ham's F-10 media of milli-Q water (3degrees), Ham's F-10 media of HPLC (high performance liquid chromatography, Baxter) water, Medicult media, HTF (human tubal fluid) media for 96hours. The results were as follows. 1. When the oocytes-cumulus complexes were cultured in 10(-9)microgram/ml~ 10(-8)microgram/ml of CC, those were suppressed in meiotic maturation (28.2~ 33.7%). Whereas the oocytes-cumulus complexes were cultured in 10(-7)microgram/ml~10(-4)microgram/ml, these were not effected in meiotic maturation (54.5~72.7%). 2. When the oocytes-cumulus complexes were cultured in 10(-4)microgram/ml~ 10(-1)microgram/ml of Metrodin, those were suppressed in meiotic maturation (35.7~ 41.5%). Meanwhile the oocytes-cumulus complexes were cultured in 10(-7)microgram/ml~10(-5)microgram/ml, those were not effected in meiotic maturation (54.2~ 70.3%). 3. When the oocytes-cumulus complexes were cultured in 10(-5)microgram/ml~ 10(-4)microgram/ml of HMG, those were suppressed in meiotic maturation (48.2~ 50.4%). As being cultured in 10(-7)microgram/ml~10(-6)microgram/ml, increased in meiotic maturation (75.8~80.7%). 4. When the 2-cell embryos were cultured in Ham's F-10 media of milli-Q wats. ( 3degrees), Ham's F-10 media of HPLC (high performance liquid chromatograpy, Banter) water, Medicult media, HTF (human tubal fluid) media, developmental rates to blastocyst and hatching for 96 hour were 50.0%, 45.2%, 71.5% and 95.6%, respectively.
Animals ; Blastocyst ; Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Culture Media ; Embryonic Structures* ; Female ; Humans ; Male ; Mice* ; Mice, Inbred ICR ; Oocytes* ; Ovary ; Oviducts ; Ovulation Induction* ; Ovulation* ; Urofollitropin ; Water

OBJECTIVES: A number of investigators have examined the possible pathophysiological mechanisms in patients who died from asthma, but the reasons for the increased incidence of death in patients with asthma are largely unknown. To elucidate the risk factors and possible causes of fatal asthma, we reviewed the clinical data of patients with potentially fatal asthma(PFA). METHODS: We retrospectively studied the clinical and laboratory profiles of 35 PFA patients(43 episodes) who had been admitted at the Kyungpook University Hospital and Taegu Fatima Hospital in recent 5 years(1989. 7-1994. 6). Our criteria of PFA were defined as either respiratory arrest or an arterial carbon dioxide tension(PaCO2) greater than 50 mmHg or an altered state of consciousness, due to acute asthma. RESULTS: 1) Twenty four patients with PFA were female and 11 male. At the time of PFA episode, age distribution was between 16-65 year (42% between 36-49). 2) Seasonal distribution was 13 episodes between March and May, 13 June and August, 6 September and November, 11 December and February. 3) Previous hospitalization history due to asthmatic attack was noted in 81 percent, and 75 percent were relatively compliant to their therapy. 5) At visiting emergency room, 81 percent satisfied the criteria of PFA, whereas 19 percent during hospitalizatoin. 77 percent required mechanical ventilation, and 52 percent of them within 30 minutes after visiting. 6) Initial arterial blood gas analysis at emergency room showed marked hypercapnia(75 +/- 29 mmHg), hypoxemia(50 +/- mmHg) and acidosis(pH 7.14 +/- 0.15). Serum potassium levels were within normal ranges in 75 percent. 7) All, except one, showed no significant cardiac arrthymias. 8) Possible precipitating factors leading to PFA were respiratory tract infection in 31 episodes, ingestion of NSAIDs in 2, emotional upsets in 2, irritant air pollutions in 2, withdrawal of anti-asthma drugs in 1, and unknown causes in 5. 9) Nine of 16 patients were atopic, and majority of them showed positive reaction to Dermatophagoides antigen. CONCLUSIONS: These results may suggest that PFA is mainly due to airway obstruction, and upper respiratory infection is an important precipitating factor leading to PFA. It is necessary to establish an appropriate plan for preventing PFA and related deaths.
Age Distribution ; Air Pollution ; Airway Obstruction ; Anti-Inflammatory Agents, Non-Steroidal ; Asthma* ; Blood Gas Analysis ; Carbon Dioxide ; Consciousness ; Daegu ; Eating ; Emergency Service, Hospital ; Female ; Gyeongsangbuk-do ; Hospitalization ; Humans ; Incidence ; Male ; Potassium ; Precipitating Factors ; Pyroglyphidae ; Reference Values ; Research Personnel ; Respiration, Artificial ; Respiratory Tract Infections ; Retrospective Studies* ; Risk Factors ; Seasons

BACKGROUND/AIMS: Portal hypertension in cirrhosis is associated with a hyperdynamic circulation, which is characterized by hypervolemia, high cardiac output, arterial hypotension and low peripheral vascular resistance. These circulatory abnormalities are thought to be secondary to a splanchnic arteriolar vasodilation related to the increase in portal pressure. Studies assessing regional hemodynamics in patients of cirrhosis with ascites have shown vasoconstriction in the renal circulation and in peripheral vascular territory. This study was designed to assess the cerebral vascular resistance in cirrhotic patients with ascites. METHODS: The resistive index in the middle cerebral artery and in a renal interlobar artery were measured by Doppler ultrasonography in 12 cirrhotic subjects without ascites, 23 cirrhotic subjects with ascites, and 8 healthy subjects. The arterial blood pressure and plasma renin and norepinephrine concentration, which reflect the activity of the renin-ngiotensin and sympathetic nervous systems respectively, were also measured. RESULTS: The resistive index in the middle cerebral artery were significantly higher in cirrhotic patients with ascites (0.58 +/- 0.04, mean +/- standard deviation) than in cirrhotic patients without ascites (0.53 +/- 0.02, p<0.01) and in control subjects (0.50 +/- 0.05, p<0.01). The resistive index in the middle cerebral artery showed direct correlation with renal resistive index (r = 0.52, p<0.01), plasma renin activity (r = 0.44, p<0.01) and norepinephrine (r = 0.33, p<0.05). The resistive index in the middle cerebral artery showed an inverse correlation with mean arterial pressure (r = -.59, p<0.01). CONCLUSION: The results suggest that in patients of cirrhosis with ascites, independent of the amount of ascites, there is a cerebral vasoconstriction which is related with the arterial hypotension and the overactivity of vasoconstrictor systems.
Arterial Pressure ; Arteries ; Ascites* ; Cardiac Output, High ; Fibrosis ; Hemodynamics ; Humans ; Hypertension, Portal ; Hypotension ; Liver Cirrhosis* ; Liver* ; Middle Cerebral Artery ; Norepinephrine ; Plasma ; Portal Pressure ; Renal Circulation ; Renin ; Sympathetic Nervous System ; Ultrasonography, Doppler ; Vascular Resistance ; Vasoconstriction ; Vasodilation

Juvenile idiopathic arthritis (JIA) can develop extra-articular manifestations, including growth retardation, osteopenia and chronic uveitis. However, pleuropulmonary involvement is rare. Approximately 40% of patients with JIA have abnormal pulmonary function tests without pulmonary symptoms, with the commonest abnormality in carbon monoxide diffusing capacity, but clinically evident pulmonary parenchymal disease in JIA is extremely uncommon. We describe a 15-year-old male with JIA who presented with dyspnea due to interstitial lung disease.
Adolescent ; Arthritis ; Arthritis, Juvenile Rheumatoid* ; Bone Diseases, Metabolic ; Carbon Monoxide ; Dyspnea ; Humans ; Lung Diseases ; Lung Diseases, Interstitial ; Lung* ; Male ; Respiratory Function Tests ; Uveitis