OBJETIVE: To assess the effects of progesterone and acetyl-L-carnitine used after treated with IsolateR gradient before semen cryopreservation-thawing on sperm parameters and membrane integrity. MATERIALS AND METHODS: From April 2001 to July 2001, ten normal male partner of couples who were visited in vitro fertilization (IVF) clinics. the semens were treated with IsolateR gradient before cryopreservation, spermatozoa was incubated with progesterone (1, 5 and 10 micrometer), acetyl-L-carnitine (2.5, 5 and 10 micrometer), or both (progesterone, 1 micrometer; and acetyl-L-carnitine, 5 micrometer) for 30 min. RESULTS: There were no differences in sperm parameters and vital stain among isolate only treated group, progesterone (1, 5 and 10 micrometer), acetyl-L-carnitine (2.5, 5 and 10 micrometer) and both (progesterone, 1 micrometer; and acetyl-L-carnitine, 5 micrometer). But, in high concentration of acetyl-L-carnitine (10 micrometer) treated group, sperm parameters and vital stain were decreased. The statistical method was used ANOVA (Kruskal-Wallis test) and p value was <0.01. CONCLUSIONS: Neither progesterone nor acetyl-L-carnitine show to be protective effect on the cryodamage assessed by sperm parameters and vital stain (eosin-Y stain) in normal sperm. High concentration of acetyl-L-carnitine (10 micrometer), however, was harmful effect on cryoprevention.
Acetylcarnitine* ; Cryopreservation ; Family Characteristics ; Fertilization in Vitro ; Humans ; Male ; Membranes* ; Progesterone ; Semen ; Spermatozoa*

OBJECTIVE: The clinical features and prognosis of intraductal papillary mucinous tumor (IPMT) of the pancreas are diverse. We reviewed the clinicopathologic features and surgical results of patients who were treated for IMPT. METHODS: WE retrospectively reviewed seven cases that were surgically resected and pathologically diagnosed. RESULTS: The mean patient age was 63.7 years and there were 6 (85.7%) symptomatic patients. The diagnostic accuracy of abdominal CT was 57.1% (n=4) and the was 71.4% (n=5). (Ed note: the last part made no sense. Put in the correct terms.) The final diagnosis was benign IPMT in 4 cases (57.1%), malignancy in 3 cases (42.9%, and borderline malignancy, carcinoma in situ and invasive carcinoma in one case each, respectively). Three cases each of pylorus preserving panreaticoduodectomy (42.9%) and distal pancreatectomy were performed (42.(%), respectively, and 1 pancreatic wedge resection (14.3%) was performed for 1 case. Three patients (42.9%) were found to have associated malignancies. The median follow-up duration was 10 months (range: 3-25). Four patients are still alive and 3 patients have died, but only one patient died of systemic metastasis. CONCLUSION: The clinicopathological features, treatment, and prognosis of IPMT are still unclear, but the significant possibility of malignancy and associated malignancies should always kept in mind and further study is required
Carcinoma in Situ ; Diagnosis ; Follow-Up Studies ; Humans ; Mucins* ; Neoplasm Metastasis ; Pancreas* ; Pancreatectomy ; Pancreatic Neoplasms ; Prognosis ; Pylorus ; Retrospective Studies ; Tomography, X-Ray Computed

Sodium glucose cotransporter 2 (SGLT2) inhibitor has been recently reported of diabetic ketoacidosis due to accumulation of ketone bodies in patients with severe dehydration caused from such like diarrhea even though the patient had normal glucose level. This is a case of ketoacidosis in normal glucose level as production of ketone bodies is stimulated in liver with increased secretion of glucagon by stimulation of α cells in pancreas due to increase of lipolysis caused from reducing insulin and by SGLT2 inhibitor among patients who are under concurrent insulin and SGLT2 inhibitor. Thus, insulin dosage reduction requires caution in order to control blood glucose level on combined treatment of SGLT2 inhibitor in a patient who is administering insulin because the patient may be caused ketoacidosis in normal blood glucose level.
Blood Glucose ; Dehydration ; Diabetic Ketoacidosis* ; Diarrhea ; Glucagon ; Glucose* ; Humans ; Insulin* ; Ketone Bodies ; Ketosis ; Lipolysis ; Liver ; Pancreas ; Sodium*

BACKGROUND AND OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) is one of the critical life events that can affect physical, emotional, and functional aspects of quality of life. Canalith repositioning procedure (CRP) provides rapid and long lasting relief of symptoms in most patients with BPPV. However, some patients express nonspecific symptoms such as anxiety or discomfort after treatment, The purpose of this study was to assess the residual symptoms after CRP in patients with BPPV using Dizziness Handicap Inventory (DHI) in a questionnaire format and to evaluate the therapeutic efficacy of CRP according to accompanying the DizzyFIX device. MATERIALS AND METHODS: We performed a prospective investigation in 135 consecutive patients with confirmed posterior semicircular canal BPPV. CRP was performed until nystagmus and vertigo disappeared. Patients were divided into three group using the DizzyFIX (group A), not using the DizzyFIX (group B) and closed observation (group C) after treatment. Then patients were asked to complete the questionnaire for Korean form DHI before treatment, 1, 2, 3, 4, and 8 week after treatment. RESULTS: There was a significant improvement in DHI scores when comparing the pre CRP and post CRP three groups (p<0.05), although emotional items showed incomplete improvement at 1 week. But at 2 week after treatment, there were statistically significant differences between group A and other groups in DHI scores specially in emotional items. CONCLUSION: Even after successful CRP, DHI scores indicated incomplete recovery and residual subjective symptoms may remain. For these patients additional follow up and management are necessary and using of the DizzyFIX will be helpful to reduce the incidence of residual dizziness especially emotional aspect.
Anxiety ; Dizziness ; Follow-Up Studies ; Humans ; Incidence ; Prospective Studies ; Quality of Life ; Surveys and Questionnaires ; Semicircular Canals ; Vertigo

We aimed to compare the CT findings of nontuberculous mycobacterial pulmonary diseases caused by Mycobacterium avium-intracellulare complex (MAC) and Mycobacterium abscessus. Two chest radiologists analyzed retrospectively the thin-section CT findings of 51 patients with MAC and 36 with M. abscessus infection in terms of patterns and forms of lung lesions. No significant difference was found between MAC and M. abscessus infection in the presence of small nodules, tree-in-bud pattern, and bronchiectasis. However, lobar volume decrease (p=0.001), nodule (p=0.018), airspace consolidation (p=0.047) and thin-walled cavity (p=0.009) were more frequently observed in MAC infection. The upper lobe cavitary form was more frequent in the MAC (19 of 51 patients, 37%) group than M. abscessus (5 of 36, 14%) (p=0.029), whereas the nodular bronchiectatic form was more frequent in the M. abscessus group ([29 of 36, 81%] vs. [27 of 51, 53%] in MAC) (p=0.012). In conclusion, there is considerable overlap in common CT findings of MAC and M. abscessus pulmonary infection; however, lobar volume loss, nodule, airspace consolidation, and thin-walled cavity are more frequently seen in MAC than M. abscessus infection.
Adult ; Aged ; Aged, 80 and over ; Anatomy, Cross-Sectional/methods ; Diagnosis, Differential ; Female ; Humans ; Lung Diseases/*microbiology/*radiography ; Male ; Middle Aged ; Mycobacterium Infections, Atypical/microbiology/radiography ; Mycobacterium avium-intracellulare Infection/microbiology/*radiography ; Research Support, Non-U.S. Gov't ; Retrospective Studies ; Tomography, Spiral Computed/*methods ; Tuberculosis, Pulmonary/radiography

PURPOSE: The purpose of this study was to evaluate the frequency, location, and appearance of increasedattenuation of the liver adjacent to a mass during arterial-phase spiral CT in patients with hemangioma. Thecharacteristics of the mass associated with these findings were also evaluated. MATERIALS AND METHODS: Usingspiral CT, 153 lesions in 114 hepatic hemangioma patients were retrospectively reviewed. We evaluated thefrequency, location, and appearance of increased hepatic attenuation adjacent to the hemangioma, and determinedwhether lesion size varied according to whether or not there was increased hepatic attenuation. RESULTS: Areas ofincreased hepatic attenuation adjacent to the hemangioma were identified in 10.5% of cas-es(16/153) and seen inmasses which showed a homogeneously hyperdense (11/16, 69%) or peripherally hy-perdense pattern (5/16, 31%). Thelocation of increased hepatic attenuation was commonly the peripheral por-tion (9/16, 56%), and increased hepaticattenuation was frequently wedge shaped of the mass (11/16, 69%). Lesion size did not vary according to whether ornot there was increased hepatic attenuation. CONCLUSION: Increased hepatic attenuation adjacent to a hemangiomais not rare, and is usually located periph-eral to the mass. It is common in a mass showing a homogeneouslyhyperdense pattern.
Hemangioma* ; Humans ; Liver* ; Retrospective Studies ; Tomography, Spiral Computed

OBJECTIVE: This study was designed to describe the radiological findings of extensively drug-resistant (XDR) pulmonary tuberculosis (TB) and to compare the observed findings with findings of drug-sensitive (DS) and non-XDR multidrug-resistant (MDR) TB in non-AIDS patients. MATERIALS AND METHODS: From September 1994 to December 2007, 53 MDR TB patients (M:F = 32:21; mean age, 38 years) and 15 XDR TB non-AIDS patients (M:F = 8:7; mean age, 36 years) were enrolled in the study. All of the MDR TB patients had received no treatment or less than one month of anti-TB treatment. In addition, all XDR TB patients received either no anti-TB treatment or only first-line anti-TB drugs. In addition, 141 consecutive DS TB patients (M:F = 79:62; mean age, 51 years) were also enrolled in the study for comparison. Chest radiograph, CT and demographic findings were reviewed and were compared among the three patient groups. RESULTS: For patients with XDR TB, the most frequent radiographic abnormalities were nodules (15 of 15 patients, 100%), reticulo-nodular densities (11 of 15, 73%), consolidation (9 of 15, 60%) and cavities (7 of 15, 47%) that were located mainly in the upper and middle lung zones. As seen on radiographs, significant differences were found for the frequency of nodules and ground-glass opacity lesions (all p < 0.001) (more frequent in DS TB patients than in MDR and XDR TB patients). For the use of CT, significant differences (more frequent in MDR and XDR TB patients) were found for the frequency of multiple cavities, nodules and bronchial dilatation (p = 0.001 or p < 0.001). Patients with MDR TB and XDR TB were younger as compared to patients with DS TB (p < 0.001). Imaging findings were not different between patients with MDR TB and XDR TB. CONCLUSION: By observation of multiple cavities, nodules and bronchial dilatation as depicted on CT in young patients with acid-fast bacilli (AFB) positive sputum, the presence of MDR TB or XDR TB rather than DS TB can be suggested. There is no significant difference in imaging findings between patients with XDR TB and MDR TB.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Drug Resistance, Bacterial ; Drug Resistance, Multiple, Bacterial ; Female ; Humans ; Image Processing, Computer-Assisted/methods ; Lung/drug effects/radiography ; Male ; Middle Aged ; Observer Variation ; Retrospective Studies ; Tomography, X-Ray Computed/methods ; Tuberculosis, Multidrug-Resistant/*radiography ; Tuberculosis, Pulmonary/*drug therapy/*radiography ; Young Adult

To determine overall detection rates of lung cancer by low-dose CT (LDCT) screening and to compare histopathologic and imaging differences of detected cancers between high- and low-risk groups, this study included 6,406 asymptomatic Korean adults with >or=45 yr of age who underwent LDCT for lung cancer screening. All were classified into high- (>or=20 pack-year smoking; 3,353) and low-risk (3,053; <20 pack-yr smoking and non-smokers) groups. We compared CT findings of detected cancers and detection rates between high- and low-risk. At initial CT, 35% (2,255 of 6,406) had at least one or more non-calcified nodule. Lung cancer detection rates were 0.36% (23 of 6,406). Twenty-one non-small cell lung cancers appeared as solid (n=14) or ground-glass opacity (GGO) (n=7) nodules. Cancer likelihood was higher in GGO nodules than in solid nodules (p<0.01). Fifteen of 23 cancers occurred in high-risk group and 8 in low-risk group (p=0.215). Therefore, LDCT screening help detect early stage of lung cancer in asymptomatic Korean population with detection rate of 0.36% on a population basis and may be useful for discovering early lung cancer in low-risk group as well as in high-risk group.
Adenocarcinoma/diagnosis ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung/diagnosis ; Carcinoma, Squamous Cell/diagnosis ; Comparative Study ; Female ; Humans ; Korea ; Lung Neoplasms/*diagnosis ; Male ; Mass Screening/*methods ; Middle Aged ; Risk Factors ; Tomography, X-Ray Computed/*methods

OBJECTIVE: We aimed to review the patterns of lung abnormalities of pulmonary cryptococcosis on CT images, position emission tomography (PET) findings of the disease, and the response of lung abnormalities to the therapies in non-AIDS patients. MATERIALS AND METHODS: We evaluated the initial CT (n = 23) and 18F-fluorodeoxyglucose (FDG) PET (n = 10), and follow-up (n = 23) imaging findings of pulmonary cryptococcosis in 23 non-AIDS patients. Lung lesions were classified into five patterns at CT: single nodular, multiple clustered nodular, multiple scattered nodular, mass-like, and bronchopneumonic patterns. The CT pattern analyses, PET findings, and therapeutic responses were recorded. RESULTS: A clustered nodular pattern was the most prevalent and was observed in 10 (43%) patients. This pattern was followed by solitary pulmonary nodular (n = 4, 17%), scattered nodular (n = 3, 13%), bronchopneumonic (n = 2, 9%), and single mass (n = 1, 4%) patterns. On PET scans, six (60%) of 10 patients showed higher FDG uptake and four (40%) demonstrated lower FDG uptake than the mediastinal blood pool. With specific treatment of the disease, a complete clearance of lung abnormalities was noted in 15 patients, whereas a partial response was noted in seven patients. In one patient where treatment was not performed, the disease showed progression. CONCLUSION: Pulmonary cryptococcosis most commonly appears as clustered nodules and is a slowly progressive and slowly resolving pulmonary infection. In two-thirds of patients, lung lesions show high FDG uptake, thus simulating a possible malignant condition.
Adult ; Aged ; Contrast Media/diagnostic use ; Cryptococcosis/*radiography/*radionuclide imaging/therapy ; Disease Progression ; Female ; Fluorodeoxyglucose F18/diagnostic use ; Follow-Up Studies ; Humans ; Lung Diseases, Fungal/*radiography/*radionuclide imaging/therapy ; Male ; Middle Aged ; Positron-Emission Tomography/*methods ; Radiopharmaceuticals/diagnostic use ; Retrospective Studies ; Tomography, Spiral Computed/*methods

BACKGROUND/AIMS: A hepatectomy for liver metastases from colorectal cancer has recently received general acceptance as a safe, potentially curative treatment modality due to its low surgical mortality and significant improvement of survival rates after resection. However, criteria for the selection of patients and treatment modalities remains controversial. The aim of study was to determine the prognostic factors. in patients who had undergone a hepatic resection for metastatic colorectal cancer. METHODS: Twenty-four patients who had underdone initial hepatic resection for liver metastases from colorectal cancer between 1992 and 2002 were analyzed with regard to clinical and pathological parameters. The survival rate was calculated using the Kaplan-Meier method and Cox regression hazard model. The mean follow up period was 37 months. RESULTS: The overall 5-year survival rate was 29.3%, with a mean survival of 39 months. There were 10 (41.3%) and 14 (58.7%) cases of synchronous and metachronous metastasis, respectively. The 5-year survival rate was shown to be significantly lower in patients with more than 4 metastases (p=0.01), bilobar metastasis (p=0.02) and vascular invasion (p=0.01). The number of hepatic metastases (p= 0.02) has been demonstrated as an independent factor for the 5-year survival. CONCLUSION: Patients with multiple, bilobar hepatic metastases and vascular invasion demonstrated a poor survival rate. Therefore, in patients with poor prognostic factors, curative surgical resection, accompanied by a multimodality treatment, is necessary for an improved survival.
Colorectal Neoplasms* ; Follow-Up Studies ; Hepatectomy ; Humans ; Liver ; Mortality ; Neoplasm Metastasis ; Proportional Hazards Models ; Survival Rate*