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*

Core decompression is still widely used in avascular necrosis of the femoral head but the results are unpredictable and the indications are not settled yet. The reparative process of the decompressed femoral head is poorly understood. Seven cases in 5 patients were undertaken THRA following failed decompression and these were studied for the radiological and pathological changes of the core tracts. The lesions of failed cases were involved more than 1/3 of femoral head on MRI and all cases were stage II A or B. The extent of the necrotic area in MRI was enlarged with crack, sclerosis and sometimes gas collection. Depression of the subchondral plates were also observed. Capillary ingrowth or neovascularization was not found at all and there were only fibrosis, inflammatory response and foreign body reactions.
Capillaries ; Decompression* ; Depression ; Fibrosis ; Foreign Bodies ; Head* ; Humans ; Magnetic Resonance Imaging ; Necrosis* ; Sclerosis

PURPOSE: The detection of epileptogenic lesion plays an important role in the management of patients with partial epilepsy. Although the development of MRI improved the examination of cerebral hemispheres greatly, many patients with neocortical temporal lobe epilepsy (TLE) or extratemporal lobe epilepsy (extra-TLE) still show no lesion in conventional two-dimensional (2D) images. To increase the yield of MRI in those patients, we performed three-dimensional (3D) surface-projection rendering (SPR) of the cerebral hemispheres. METHODS: Conventional 2D MRI (T1, T2, FLAIR, thin slice SPGR) and 3D SPR were performed in 24 patients with neocortical TLE and extra-TLE, and 20 normal subjects. Sulcogyral patterns were evaluated blindly to clinical information. The locations of the epileptogenic zone, ictal onset zone (IOZ) and irritative zone (IRZ) were determined by intracranial EEG monitoring and epilepsy surgery. RESULTS: The 2D MRI identified epileptogenic lesions in five of the 10 neocortical TLE (50%) and five of the 14 extra-TLE (35.7%). 3D SPR revealed abnormal sulcogyral patterns in 9 of the 10 neocortical TLE (90%) and 9 of the 14 extra-TLE (64.3%). Cortical deformation zones with sulcogyral anomalies included the whole area of IOZ in 10 (55.5%) and IRZ in 6 (33.3%), overlapped with IOZ in 7 (38.9%) and IRZ in 11 (61.1%), were connected to IOZ in 1 (5.6%) and IRZ in 1 (5.6%). CONCLUSION: 3D SPR of volumetric MRI data can detect epileptogenic structural lesions of neocortical epilepsy that are not visible in the conventional 2D images.
Brain* ; Cerebrum ; Electroencephalography ; Epilepsies, Partial ; Epilepsy* ; Epilepsy, Temporal Lobe ; Humans ; Magnetic Resonance Imaging*

PURPOSE: To investigate the various ictal perfusion patterns and find the relationships between clinical factors and different perfusion patterns. MATERIALS AND METHODS: lnterictal and ictal SPECT and SPECT subtraction were performed in 61 patients with partial epilepsy. Bath positive images showing ictal hypoperfusion and negative images revealing ictal hypoperfusion were obtained by SPECT subtraction. The ictal perfusion patterns of subtracted SPECT were classified into focal hypoperfusion, hypoperfusion-plus, combined hypoperfusion-hypoperfusion, and focal hypoperfusion only. RESULTS: The concordance rates with epileptic focus were 91.8% in combined analysis of ictal hypoperfusion and hypoperfusion images of subtracted SPECT, 85.2% in hypoperfusion images only of subtracted SPECT, and 68.9% in conventional ictal SPECT analysis. Ictal hypoperfusion occurred less frequently in temporal lobe epilepsy (TLE) than extratemporal lobe epilepsy. Mesial temporal hypoperfusion alone was seen only in mesial TLE while lateral temporal hypoperfusion alone was observed only in neocortical TLE. Hippocampal sclerosis had much lower incidence of ictal hypoperfusion than any other pathology. Some patients showed ictal hypoperfusion at epileptic focus with ictal hypoperfusion in the neighboring brain regions where ictal discharges propagated. CONCLUSION: Hypoperfusion as well as hypoperfusion in ictal SPECT should be considered for localizing epileptic focus. Although the mechanisrn of ictal hypopertusion could be an intra-ictal early exhaustion of seizure focus or a steal phenomenon by the propagation of ictal discharges to adjacent brain areas, further study is needed to elucidate it.
Baths ; Brain ; Epilepsies, Partial* ; Epilepsy ; Epilepsy, Temporal Lobe ; Humans ; Incidence ; Pathology ; Perfusion* ; Sclerosis ; Seizures ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: To evaluate the clinical efficacy and durability of transurethral microwave thermotherapy (TUMT) in the treatment of benign prostatic hyperplasia, the useful clinical factors were retrospectively investigated. MATERIALS AND METHODS: Between September 1997 and July 2003, 113 patients with symptomatic benign prostatic hyperplasia were treated with TUMT (Prostatron with Prostasoft 2.5). 64 patients were followed up at 3, 6 and 12 months after treatment. Treatment outcomes were evaluated by the International Prostate Symptom Score (IPSS), quality of life (QoL) score and by urodynamic investigation. The patients were divided into responders and non-responders on the basis of their response evaluation criteria. RESULTS: The mean IPSS, QoL score, peak flow rate, mean flow rate and post-voiding residual volume were significantly improved after TUMT (p<0.05). The pretreatment QoL score of the responders was significantly lower than that of the non-responders (p<0.05), and peak and average flow rates of the responders were significantly higher than those of the non-responders (p<0.05). Lower prostate-specific antigen (PSA), lower residual volume and higher energy had trends toward a good prognosis (0.05 Humans ; Prognosis ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia* ; Quality of Life ; Residual Volume ; Retrospective Studies ; Transurethral Resection of Prostate* ; Urodynamics

To verify the effect of subgingival calculus on the periodontal tissues in periodontitis and the effectiveness of supragingival scaling to remove the calculus, 30 teeth from healthy group (Probing pocket depth:PPD< or =mm: HP group), 15 teeth from moderate group (4< or =PD<7mm: MP group), 30 teeth from advanced group (PPD>7mm: AP group) were selected and supragingival scaling was performed before extraction of all experimental teeth. After careful extraction, the teeth were cleaned with saline and disclosed with toluidine blue and carefully examined the relationship and distance between the calculus attached on the root surface and periodontal tissues. As a result, it was; 1. The calculus was not discovered on the root surface of teeth in HP group, but was in MP and AP group, mostly on interproximal surface and furca area. The shape of the attached calculus was ovoid, trepazoid and polygonal and the calculus was distributed randomly over the root surface. 2. PPD was more than the distance between the gingival margin to the level of attached connective tissue in AP group rather than in HP and MP group. 3. The length of calculus was 2.7mm+/-.44mm in HP group and 4.1+/-.89in AP group. 4. The distance between the apical margin of calculus and the level of attached connective tissue was 2.4+/-.33mm in MP group and 3.4+/-.89mm in AP group. 5. The length of subgingival calculus was tended to increase in relation to the probing pocket depth. Therefore, it can be concluded, the calculus in periodontal pocket can not be removed completely with supragingival scaling. As the terminal part of calculus was far away with limited distance from the periodontal tissue, it can be said that the calculus was not a direct factor in destroying the periodontal tissue. In this study, the extent of the plaque was not verified but the location of calculus can be used in clinical practice for complete removal of calculus when the distance relation bewteen calculus and plaque will be known.
Calculi* ; Connective Tissue ; Dental Scaling ; Periodontal Pocket ; Periodontitis* ; Tolonium Chloride ; Tooth

STATEMENT OF PROBLEM: The current trend in prosthodontics is the adoption of a conservative approach to preparing dental prostheses by minimizing the amount of sound tooth structure removal during preparation. PURPOSE: The major disadvantage of the adhesion bridge is the inherently poor resistance to dislodgement that its use in areas subjected to high occlusal load is limited. The purpose of this study was to compare the dislodgement resistance of Bio-pin(R), conventional 3-unit and adhesion bridges. MATERIAL AND METHODS: The experimental groups were classified as follows: .Group I : 3-unit bridge cemented using Super-Bond. C&B .Group II : Adhesion bridge cemented using Super-Bond. C&B .Group III : Bio-pin(R) design adhesion bridge without incorporation of Bio-pin(R) (cemented using Super-Bond. C&B) .Group IV-1: Bio-pin(R) retained adhesion bridge incorporating a single Bio-pin(R) (cemented using Super-Bond. C&B) .Group IV-2: Bio-pin(R) retained adhesion bridge incorporating a single Bio-pin(R) (cemented using Panavia. F) .Group V : Bio-pin(R) retained adhesion bridge incorporating two Bio-pins. (cemented using Super-Bond. C&B) RESULTS: The results of this study were as follows: 1. Significant differences in dislodgement resistance of the restorations were found between Group I, Group II and Group III (p<0.05). No significant differences in dislodgement resistance of the restorations were observed between Group I, GroupIV-1 and GroupV. However, there were significant differences in dislodgement resistance between GroupII and the other groups (p<0.05). 2. No significant differences in dislodgement resistance of the restorations were observed between GroupIV-1 and GroupIV-2, both of which utilized a single Bio-pin(R). However, significant differences were observed when GroupIII was compared to either GroupIV-1 or GroupV (p<0.05). 3. No significant differences in dislodgement resistance relative to the type of dental cements used were found. CONCLUSION: From the above results, it is concluded that the dislodgement resistance of Biopin. bridge restorations utilizing a single Bio-pin(R) is similar to that of a conventional 3-unit bridge. The results also suggest that Bio-pin(R) bridge restorations using a single Bio-pin(R) are a viable alternative to the conventional 3-unit bridge when minimal removal of sound tooth structure and fulfillment of both function and esthetic aspects are considered.
Dental Cements ; Dental Prosthesis ; Prostheses and Implants* ; Prosthodontics ; Tooth

We experienced two cases of convulsive seizure, accompanied with tachycardia and hypertension following spinal anesthesia for inguinal herniorrhaphy and skin graft. Spinal anesthesia was performed with teracaine, 10% dextrose solution and epinephrine. Tranexamic acid was used instead of 10% dextrose solution inadvertently. About 2 hours after spinal anesthesia, the patients developed spastic rigidity at the upper extremities and chest wall that progressed to episthotonus and seizure preceded by tachycardia and hypertension. About 40 hours after vigorous symptomatic treatment using mechanical ventilator, oxygen, short acting barbiturate, antihypertensive drugs and anticonvulsants, the patients had recovered completely with clear mental state. And they didn't show any other neurologic deficits except amnesia.
Amnesia ; Anesthesia, Spinal ; Anticonvulsants ; Antihypertensive Agents ; Epinephrine ; Glucose ; Herniorrhaphy ; Humans ; Hypertension ; Muscle Spasticity ; Neurologic Manifestations ; Oxygen ; Seizures* ; Skin ; Subarachnoid Space* ; Tachycardia ; Thoracic Wall ; Tranexamic Acid* ; Transplants ; Upper Extremity ; Ventilators, Mechanical

A 17-year-old male was presented withfpruritic grouped erythematous papules on the face, chest, upper back, both axillae, and genital area. The histologic picture of a benign papilloma and spongiosis around the acrosyringium were prominent findings. The term acrosyringeal epidermal nevus is proposed for this histological picture, and some explanations for its pathogenesis are suggested.
Adolescent ; Axilla ; Humans ; Male ; Nevus* ; Papilloma ; Thorax

No abstract available.
Churg-Strauss Syndrome* ; Humans ; Vasculitis*