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*

No abstract available.
Female ; Ovary* ; Teratoma*

Microsatellites are short nucleotide repeat sequences present throughout the human genome. Alterations of microsatellites, comprising extra or missing copies of these se quences, have been termed microsatellite instability(MSI, genetic instability, replication errors, RER(+) phenotype). To date, at least four genes involved in DNA mismatch repair, hMSH2, hMLH1, hPMS1 and hPMS2, are thought to account for the observation of microsatellite instability in tumor from Hereditary nonpolyposis colorectal cancer (HNPCC) patients. The genetic defect responsible for the MIN+ phenotype in sporadic colorectal cancer, however, has yet to be clearly delineated. The purpose of this study was to determine the presence of MSI in sporadic cancer and to correlate its occurrence with clinicopathological parameters, we have studied six microsatellite loci by use of polymerase chain reaction amplification and denaturing polyacrylamide gel electrophoresis. We found that 20%(9 of 46 cases) sporadic colorectal cancers showed RER at two or several loci(RER+). Microsatellite instability was associated with location of the tumor in the proximal colon 66%(6 of 9 cases) and with poorly differentiated tumor phenotype 56%(5 of 9 cases). In order to better understand the role of somatic alterations within hMSH2 in the process of colorectal tumorigenesis, we examined the most conserved regions(codon 598~789) of this gene in nine patients with MIN spotadic colorectal cancer. 6 patient of RER(+) colorectal ca. patients had a polymorphism which was a T to C base change in the intron sequence at -6 position of the splice acceptor site at the 5'end of exon 13. This particular sequence variation is a polymorphism rather than a mutation which increase cancer susceptability. These data suggest that the genetic instability is detect ed in some colorectal cancers and play an important role in the pathogenesis of sporadic colorectal cancer.
Carcinogenesis ; Colon ; Colorectal Neoplasms* ; Colorectal Neoplasms, Hereditary Nonpolyposis ; DNA Mismatch Repair ; Electrophoresis, Polyacrylamide Gel ; Exons ; Genome, Human ; Humans ; Introns ; Microsatellite Instability* ; Microsatellite Repeats* ; Phenotype ; Polymerase Chain Reaction ; RNA Splice Sites

PURPOSE: The purpose of this study was to determine the following:the safety of fine needle aspiration biopsy in immunocompromized children with radiographic features of Pneumocystis car/nil pneumonia, its diagnostic rate in those groups and the appropriate radiographic stage for fine needle aspiration biopsy to prove the etiologic agent. METHODS AND MATERIALS: We retrospectively reviewed the patient records of 16 children with immune compromizing diseases who had undergone fine needle aspiration biopsy of the lung. They showed the infectious sign of the lung along with the radiographic pattern of diffuse pulmonary disease, suggesting Pneumocystis carlnil pneumonia. All patients had underlying lymphoreticular malignancies including 14 acute lymphocytic leukemia and 2 non Hodgkin's lymphoma. According to the radiographic pattern of biopsy site, parenchymal disease was categorized as fine reticulonodular density(n=4), ground-glass opacity(n=9) and compact consolidation(n=3). We assessed the diagnostic rate of Pneumocystis carinii pneumonia and complications in each of the three groups. RESULTS: A diagnosis of Pneumocystis carinii pneumonia was established by fine needle aspiration biopsy in 9 patients(56%) including 2 of 4 patients with fine reticulonodular density, 4 of 9 patients with ground-glass opacity, and all 3 patients with compact consolidation. Four patients(25%) developed pneumothorax, and three of them required tube insertion. There was no patient who developed hemoptysis. CONCLUSION: Fine needle aspiration biopsy is a safe and easy method that can yield Pneumocystis carinii organism at a relatively high rate in immunocompromized children with diffuse pulmonary lesions suopicions of Pneumocystis carinii pneumonia. We recommend performing fine needle aspiration biopsy regardlesss of radiographic patterns when Pneumocystis carinii pneumonia is suggested.
Biopsy* ; Biopsy, Fine-Needle* ; Child* ; Diagnosis ; Hemoptysis ; Humans ; Lung Diseases ; Lung* ; Lymphoma, Non-Hodgkin ; Pneumocystis ; Pneumocystis carinii ; Pneumonia* ; Pneumonia, Pneumocystis ; Pneumothorax ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Retrospective Studies

No abstract available.
Hemolytic-Uremic Syndrome* ; Mycoplasma Infections* ; Mycoplasma*

Tsutsugamushi disease, an infectious disease by Rickettsia(R.) tsntsugamushi, is characterized by eschar, fever and rash. Eschar caused by chigger bite, is pre sent on 47 94% of patients with documented R. tsutsugamushi. We recently noticed one case of R. tsutsugamushi infection. Patient had fever, heaclache, lymphadenopathy, erythematous maculopapules and eschar. The R. tsu tsugamushi was isolated from serum of the patient. Histopathologic findings of eschar show epidermal ulceration overlying a zone of coagulative necrosis of upper dermis and necrotizing vasculitis. E]ectron microscopic findings of endothelial cells of capillary show rickettsia with cell division.
Capillaries ; Cell Division ; Communicable Diseases ; Dermis ; Endothelial Cells ; Exanthema ; Fever ; Humans ; Lymphatic Diseases ; Necrosis ; Rickettsia ; Scrub Typhus* ; Trombiculidae ; Ulcer ; Vasculitis

PURPOSE: We analysed the role of modified Gianturco self-expandable stents in the treatment of tracheobronchial stenosis in 13 patients. MATERIALS AND METHODS: We inserted modified Gianturco self-expandable stents under the fluoroscopic and bronchoscopic guidance. There were stenosis in the trachea(n--2), the right main bronchus(n=2), and the left main bronchus(n=9). The causes of the stenosis were endobronchial tuberculosis(n=10), intubation granuloma (n=l), restenosis after surgical reconstruction(n=2). RESULTS: Dyspnea or wheezing was improved within 1 or 2 days following the procedure. There were 32% and 22% respective increase in average FEV1 and FVC. Lung perfusion scan showed 9.6% increase of perfusion in the involved lung. No complications related to the procedure were encountered. During follow-up period of up to 31 months, 2 patients showed tracheal or bronchial restenosis, at 3 and 6 months, retrospectively. There was a distal migration of the stents in one case. CONCLUSION: During the follow up period after stent insertion, improvement of the obstructive changes and dyspnea persisted in 10 out of 13 patients. The modified Gianturco self-expandable metallic stents may be a good choice for the treatment of tracheobronchial stenosis, either as a primary treatment, or when the reconstruction failed.
Constriction, Pathologic* ; Dyspnea ; Follow-Up Studies ; Granuloma ; Humans ; Intubation ; Lung ; Perfusion ; Respiratory Sounds ; Retrospective Studies ; Stents*

Acromioclavicular joint dislocations are frequently seen with industrial accident, sports activity and traffic accident. Various operative treatment modalities have been suggested. The purpose of this study is to compare the clinical results of two operative methods in young patients with acromioclavicular dislocation. The authors analyzed the clinical and radiological results of 30 patients with acromioclavicular dislocation, in whom 15 patients were treated by acromioclavicular reduction & fixation with K-wire(Phemister procedure) and 15 patients by acromioclavicular reduction & coracoclavicular fixation by cancellous screw with coracoclavicular ligament repair(Bosworth procedure) from March 1989 to September 1993 at Ansan Hospital, Korea University. They were followed up more than 12 months. The results obtained were as follows: 1. The difference of coracoclavicular distance compared with normal side after operation was 2.6mm in Phemister operations and 1.6 mm in Bosworth operations. And these differences were not changed at follow up significantly. 2. The complications were two K-wire migrations, one superficial infection, and one recurred gross deformity after pin removal in Phemister operations and two mild upward migrations of screw after Bosworth operations. 3. We obtained similar good results after Phemister and Bosworth operations. But less complications were visible, and anatomical reduction and early ROM exercise were possible after Bosworth operations.
Accidents, Occupational ; Accidents, Traffic ; Acromioclavicular Joint ; Congenital Abnormalities ; Dislocations ; Follow-Up Studies ; Gyeonggi-do ; Humans ; Korea ; Ligaments ; Methods ; Sports

PURPOSE: Ethane 1,2-Dimethane sulfonate (EDS), an alkylating agent, has been widely used to create the testosterone withdrawal rat model. The present study was carried out to test the effect of EDS administration on the expression of steroidogenesis-related genes in the rat testis and on epididymal sperm counts. MATERIALS AND METHODS: Adult male Sprague-Dawley rats (300~350 g B.W.) were injected with a single dose of EDS (75 mg/kg, i.p.) and sacrificed on days 0, 7, 14, 21, 28, 35, 42, and 49. Tissue weights (testis, epididymis and seminal vesicle) were measured, and serum LH levels were determined by specific radioimmunoassay. The transcriptional activities of LH receptor (LH-R), 3beta-hydroxysteroid dehydrogenase (3beta-HSD), and steroidogenic acute regulatory protein (StAR) were evaluated by semi-quantitative RT-PCR. RESULTS: Weights of the reproductive and accessory organs declined progressively after the EDS treatment (weeks 1~3). After this, the decrease stopped, with a gradual return towards normal. Full recovery was observed in testis and seminal vesicle evaluations on weeks 5 and 6, respectively. Only 70% recovery was found in epididymis during weeks 5~7. A more dramatic drop was observed in caput epididymal sperm count, and the maximum recovery was 40% on week 7. Serum LH level increased significantly on week 2 after EDS treatment, then gradually decreased during weeks 3~5. The transcripts for the steroidogenesis-related genes in testis declined sharply during weeks 1~2, then returned to normal on week 4. CONCLUSIONS: Our results demonstrate that EDS might directly induce severe damage, such as tissue destruction and decreased sperm counts, in epididymis compared to those in testis and seminal vesicles. Changes in the activities of testicular steroidogenesis-related genes caused by abrupt death and repopulation of Leydig cells in EDS-treated rats were in good correlation with other parameters shown in this and previouslypublished data. Taken together, the EDS injection model might be useful to understand not only the mechanism of differentiation of testicular somatic and germ cells but also the function of the epididymis in the aging process.
Adult* ; Aging ; Animals ; Epididymis ; Ethane* ; Germ Cells ; Humans ; Leydig Cells ; Male ; Models, Animal ; Oxidoreductases ; Radioimmunoassay ; Rats* ; Rats, Sprague-Dawley ; Receptors, LH ; Seminal Vesicles ; Sperm Count* ; Spermatozoa* ; Testis ; Testosterone ; Weights and Measures

Milrinone is a positive inotropic/vasodilator agent in both preclinical and clinical studies. Milrinone has been shown previously to inhibit specific type III PDE isolated from different sources. To investigate the effect and the mechanism of milrinone on the corpus cavernosum, we have studied on the human and rabbit corpus cavernosum using organ bath and measured the levels of cAMP and cGMP after treatment of milrinone and papaverine. Our results show that milrinone relaxes human and rabbit corpus cavernosal tissue in a dose- dependent manner. And significant increases in cAMP content were evident with milrinone. These indicate that the accumulation of cAMP resulting from the inhibition of type III PDE plays an important role in milrinone on rabbit corpus cavernosum. And these may reflect the impotence of cAMP dependent second messenger systems for the relaxation of penile smooth muscle. These results suggest a possible potential for milrinone in the treatment of impotence.
Baths ; Erectile Dysfunction ; Humans* ; Male ; Milrinone* ; Muscle, Smooth ; Papaverine ; Relaxation ; Second Messenger Systems