PURPOSE: Because cryptorchid testes are known to undergo histopathologic changes affecting development, maturation, and tertility, early surgical correction is usually recommended. However there are differing opinions concerning whether retractile testes are affected by similar changes and also whether there is a need for surgical treatment. We aimed to assess the histopathologic changes in retractile testis by studying the changes in testes artificially placed back in the abdomen after they have descended to scrotum in experimental rat models. MATERIALS AND METHODS: Male Sprague-Dawley rats were divided into 3 groups; a control group(controls), prepubertal ascent group (P) in which testis were placed back intraabdominally by bilateral inguinal canal obstruction at 6 weeks, a neonatal group(N) in which intraabdminal testis was induced by bilateral inguinal canal obstruction at birth. The relative weight of the testis, morphology of the seminiferous tubules including Leydig cells, tubular degeneration phase(TDP), spermatogonia per tubules(S/T), and Sertoli cell index (SCI) of these three groups were analyzed and compared. RESULTS: The relative weight of testis was significantly decreased in the group of N(0.0016+/-0.001) and P(0.0015+/-0.0002) compared to controls(0.0037+/-0.0002) (p<0.05). The S/T value was also decreased in P(2.05+/-18.2) and N(73.2+/-32.4) when compared to controls (360.2+/-21.3). Similar changes were observed in SCI of both P(64.5+/-6.4) and N (91.2+/-14.2) when compared to controls (227.9+/-31.1). Only minority of N and P showed higher TDP values. However, although statistically insignificant, TDP was increased in both P and N when compared to controls. The Leydig cells in N and P showed cellular distortion and hypertrophy. CONCLUSIONS: This study demonstrate that prepubertal ascent, similar to that of innate cryptorchid testis, also can induce histopathologic changes such as changes in testicular seminiferous tubule, decrease in the S/T value and decrease in SCI value. Our findings supports that hypothesis that retractile testis may cause histological damage thus surgical correction may also be warranted similar to in case of genuine cryptorchism.
Abdomen* ; Animals ; Cryptorchidism ; Humans ; Hypertrophy ; Inguinal Canal ; Leydig Cells ; Male ; Models, Animal ; Models, Theoretical ; Parturition ; Rats* ; Rats, Sprague-Dawley ; Scrotum ; Seminiferous Tubules ; Spermatogonia ; Testis*

OBJECTIVE: To describe normal postoperative MR findings and MR findings of postoperative discitis in patients who underwent operation due to herniated intervertebral disc. MATERIALS AND METHODS: We retrospectively reviewed normal postoperative MR findings and MR findings of discitis in 30 patients(21-61yrs.) (13 cases dignosed as discitis and 17 cases as normal) who previonsly underwent laminectomy and discectomy, or bony fusion. We analyzed signal intensity of end plate and disc, end plate destruction, and enhancement of end plate and disc on T1- and T2-weighted images(WI) of 1.5T MRI. RESULTS: Among 14 out of 17 patients with no evidence of discitis, 7 patients showed high signal of the posterior portion of disc on T1- and T2-WI and 11 patients revealed enhancement at the same sites. In all 13 patients suspected of having discitis, end plate and disc showed low signal on T1-WI, high signal on T2-WI, heterogeneous enhancement, and irregular destruction of end plate. Meanwhile, 3 cases with no evidence of postoperative discitis clinically who underwent bony fusion showed similiar findings to those of the above 13 patients, except for homogeneous enhancement of end plate and vertebral body. CONCLUSION: The MR findings of postoperative discitis were low signal on T1-WI, high signal on T2-WI, and heterogeneous enhancement of and plate and disc, and destruction of end plate.
Discitis* ; Diskectomy ; Humans ; Intervertebral Disc* ; Laminectomy ; Magnetic Resonance Imaging ; Retrospective Studies

Glassy cell carcinoma is an unusual neoplasm of the uterine cervix with highly aggressive clinical behavior. On cervico-vaginal smear examination, the tumor has well confused of atypical repair cell of the endocervix. Recently, we have experienced two cases of glassy cell carcinoma of the uterine cervix, diagnosed on cervico-vaginal smears and confirmed on following histologic sections. The cervico-vaginal smears revealed abundant clusters with well defined boarders. The cell clusters were composed of large tumor cells. The tumor cells had distinct granular cytoplasm and eosinophilic macronucleoli. Characteristic cytologic features of this tumor were discussed in view of differential diagnosis.
Adenocarcinoma ; Breast ; Cervix Uteri ; Cytoplasm ; Diagnosis, Differential ; Eosinophils ; Female ; Hydronephrosis*

The cardiac pacemaker has been implanted for patients with debilitating low cardiac output associated heart block. Modern technology has provided advanced, controllable and simple cardiac pacemakers throughout the world. The patient with a cardiac pacemaker implanted could give anestheaiolgists many associated problems during the operation and anesthesia. During anesthesia an anesthesiologist should be able to manage the problems which might occur because of a cardiac pacemaker by varicus origins. Authors have experienced a case of open reduction for malunioned femur fracture with a cardiac pacemaker implanted.
Anesthesia ; Cardiac Output, Low ; Femur ; Heart Block ; Humans

The cardiac pacemaker has been implanted for patients with debilitating low cardiac output associated heart block. Modern technology has provided advanced, controllable and simple cardiac pacemakers throughout the world. The patient with a cardiac pacemaker implanted could give anestheaiolgists many associated problems during the operation and anesthesia. During anesthesia an anesthesiologist should be able to manage the problems which might occur because of a cardiac pacemaker by varicus origins. Authors have experienced a case of open reduction for malunioned femur fracture with a cardiac pacemaker implanted.
Anesthesia ; Cardiac Output, Low ; Femur ; Heart Block ; Humans

PURPOSE: We investigated the clinical characteristics and relationship between chromosome and its phenotypic expression in patients with 45 XO/46XY mosaicism or 45 XO with SRY gene. MATERIALS AND METHODS: 11 patients with 45XO/46XY chromosomal abnormality and 4 patients with 45XO with SRY positive reaction admitted from 1990 to 1996 were evaluated. Patients were grouped according to chromosome and gonadal expression. Group A consisted of patients with 45XO/46XY chromosome and unilateral streak gonad, group B patients with 45XO chromosome, SRY positive reaction and unilateral streak gonad and group C patients with 45XO/46XY chromosome and bilateral streak gonads. RESULTS: Of the total 15 patients, the number of patients in group A, B, and C were 8, 4, and 3, respectively. SRY gene was positive in all group A and B patients but only one patient was positive in group C. Of the 8 patients in group A, 5 patients had a high XY mosaicism ratio compared to XO whereas an equal ratio was observed in the remaining 3 patients. Of the 4 male penotype patients only 1 patient had a high XY mosaicism ratio compared to XO while 3 patients displayed an equal ratio. There was no difference in associated anomaly and the degree of severity of ambiguity according to the mosaicism ratio in all patients. CONCLUSIONS: There was no definite correlation between the mosaicism ratio and phenotypic expression. Presence of SRY gene in 45XO patients may suggest MGD(mixed gonadal dysgenesis) and therefore, the evaluation SRY gene could be useful in the diagnosis of 45XO patients with ambiguous genitalia.
Chromosome Aberrations ; Diagnosis ; Disorders of Sex Development ; Genes, sry* ; Gonadal Dysgenesis, Mixed ; Gonads ; Humans ; Male ; Mosaicism*

PURPOSE: Although retractile testes are frequently found in the pediatric population, there are controversies in the management of retractile testes. We investigated the necessity of treatment for retractile testes by analyzing their histologic findings. MATERIALS AND METHODS: Sixty-one testicular biopsies were performed during orchiopexy from 36 boys(range: 1.3-12.9 years, mean: 5.4 years) with retractile testes(11 unilateral, 50 bilateral) and 115 testicular biopsies from 83 cryptorchid patients(range: 0.6-15.0 years, mean: 3.7 years, 51 unilateral, 64 bilateral). Parameters for both Sertoli cell and germ cell were determined in each group. RESULTS: The average tubular degeneration phase(TDP) V-VII were 0.23+/-0.18 for retractile testes and 0.22+/-0.17 for cryptorchid testes and were not statistically different. Both the average sertoli cell index(SCI) and mean spermatogonia per tubules(S/T) value were statistically different between retractile and cryptrochid testes with values of 26.81+/-6.75, 23.04+/-5.85(p<0.01) and 2.96+/-1.33, 0.61+/-0.87(p<0.01), respectively. CONCLUSIONS: Although S/T value of retractile testes was higher than that of cryptorchid testes, Sertoli cell degenerative patterns were similar. These findings might indicate that retractile testis needs treatment like cryptorchid testis does. However, further investigation is warranted to elucidate whether these changes are normal variations since changes are observed in both Sertoli & germ cells in normal boys as they are aging.
Aging ; Biopsy ; Germ Cells ; Orchiopexy ; Pathology ; Spermatogonia ; Testis*

A hypoplastic empty scrotum is a critical factor in the success of implantation of artificial testis. A hypoplastic scrotum increases the postoperative complication, such as wound dehiscence and prosthesis extrusion. Any technique cannot overcome this problem satisfactorily. Furthermore previous operative scars and inflammatory disease as epididymo-orchitis have often added to the difficulties. Enlarging the scrotum by gradual distention of a tissue expander implanted in the contracted scrotum has been successful in overcoming this problem. We report a case of successful artificial testes implantation after gradually enlarging scrotum by tissue expander in a 6 year old boy, who was diagnosed anorchidism with scrotal hypoplasia.
Child ; Cicatrix ; Humans ; Male ; Postoperative Complications ; Prostheses and Implants ; Scrotum ; Testis* ; Tissue Expansion Devices* ; Wounds and Injuries

Epidermolysis bullosa dystrophica is a rare skin disease characterized by milia, nail dystrophy, andblistering of the skin and mucous membranes in response to minimal trauma. A forty years old man had typical skinlesions on the extremities, and the presence of distal phalangeal wedge deformity with soft tissue webbing wasnoted. multiple segmental strictures and ulceration involved the cervical and distal esophagus. Esophageal balloondilatation was therefore performed and dysphagia was relieved. The authors describe a case involving multipleesophageal strictures and musculoskeletal lesion, with clinically and radiologically documented epidermolysisbullosa dystrophica.
Congenital Abnormalities ; Constriction, Pathologic* ; Deglutition Disorders ; Epidermolysis Bullosa Dystrophica* ; Epidermolysis Bullosa* ; Esophagus ; Extremities ; Mucous Membrane ; Skin ; Skin Diseases ; Ulcer

A retrospective study of 135 injured cervical spine patients who admitted to Soonchunhyang University Hospital between Jan 1, 1989 and May 31, 1994 was conducted. The major results were as follows: 1) The incidence was highest in fourth decade and average age was 39 years old. The ratio of male to female was 3.5:1. 2) Traffic accident(67%) was the most common cause of cervical spine injury, and passenger car accident(55%) was the most frequent cause among them. 3) In 111 patients, 141 cases of radiographic abnormalities were found and vertebral body fracture(57%) was the most common lesion among them. SCIWORA(spinal cord injury without radiographic abnormality) patients were seven. High cervical spine(C1-2) injury was 36 cases (26%) and lower cervical spine(C3-7) injury was 105 cases(74%). The most common involved level of injured vertebrae was C2(23%) followed by C5(22%), C6(20%). The anterior dislocation of body was more common than the posterior one, and C5-6 dislocation was the most common among them. The compressive flexion(40%) and distractive flexion(29%) injuries were more common among types of the lower cervical injuries. 4) The associated injuries were head injury, long bone fracture, chest injury, visceral injury and mutiple contusion & laceration, and head injury was the most common among them. 5) According to Franekel's grade, the rates of neurologic improvement were 23%, 47% and 14% in total cases, operated and non-operated patients respectively. There was statistical significance in the difference between the improvement of Frankel's grade of operated and those of non-operated patients(p<0.02). 6) In 101 patients(75%) conservative treatment was performed. Of 34 patients(25%) were operated, 23 patients were performed anterior approach and 11 were done posterior approach. 7) The common complications were respiratory disorder, bed sore, and urinary tract infection, in order of frequency and the rate of complication was 33%. 8) Mortality rate during hospitalization was 5%, and the common causes were pneumonia and septicemia.
Adult ; Contusions ; Craniocerebral Trauma ; Dislocations ; Female ; Fractures, Bone ; Hospitalization ; Humans ; Incidence ; Lacerations ; Male ; Mortality ; Pneumonia ; Pressure Ulcer ; Retrospective Studies ; Sepsis ; Spine* ; Thoracic Injuries ; Urinary Tract Infections