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

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

PURPOSE: To evaluate the clinical usefulness of ultrasonography (US) - guided automated gun biopsy of nonpalpable breast lesions. MATERIALS AND METHODS: In 30 nonpalpable breast lesions over 0.6cm and detected on US, we performed US-guided biopsy using an 18-gauge automated biopsy gun. Two to four specimens were obtained from each lesion. We analyzed the site, size and depth of the lesions, and the length and histopathologic results of the specimens. In four lesions, surgical biopsy and gun biopsy results were compared. RESULTS: In 29 of 30 lesions (96.7%), specimens were adequate for histopathologic diagnosis, and this was as follows: one case of infiltrating ductal carcinoma, 13 of fibrocystic disease, 10 of fibrocystic disease versus fibroadenoma and one of fibroadenoma. There was also one reactive hyperplasia of LN, and one fatty one and two normal tissues, and inthese four lesions, agreement between gun and surgical biopsy results was 100%. The only complication was minor bleeding, which was controlled by compression. CONCLUSION: US-guided automated gun biopsy is a clinically useful and safe procedure for evaluating nonpalpable breast lesions detected on US.
Biopsy* ; Breast* ; Carcinoma, Ductal ; Diagnosis ; Fibroadenoma ; Hemorrhage ; Hyperplasia ; Ultrasonography

Likely to be the most common oral cancer, squamous cell carcinoma(SCC) of the tongue accounts for about 20% of all oral and pharyngeal cancers. SCC of the tongue frequently arises in the lateral border, and if it metastasize, it occurs on submandibular gland and neck lymph nodes. Location of the primary lesions and neck lymph node metastasis affect the prognosis and decrease survival rate of patients with carcinoma of the tongue. The authors experienced the patient with contralateral neck lymph node metastasis of SCC of the tongue. The patient came to our department with chief complaint of elevated lesion on left lateral border of the tongue. The mass was diagnosed as T2N0M0, Stage II invasive SCC of oral tongue. Computed tomography(CT) & magnetic resonance imaging(MRI) which were taken before the operation showed no significant finding of metastasis. Surgical mass removal and preventive neck dissection on the left side were done. While follow up PET/CT, contralateral neck lymph node metastasis(right side, level II) was detected, and re-operation(Rt. side RND) was done. There are few studies concerning the contralateral neck lymph node metastasis related with SCC of the tongue. The purpose of this report is to introduce the uncommon case of contralateral neck lymph node metastasis occurred in the T2-stage of SCC of the tongue treated by surgical resection.
Carcinoma, Squamous Cell ; Follow-Up Studies ; Humans ; Lymph Nodes ; Magnetic Resonance Spectroscopy ; Mouth Neoplasms ; Neck ; Neck Dissection ; Neoplasm Metastasis ; Pharyngeal Neoplasms ; Porphyrins ; Prognosis ; Submandibular Gland ; Survival Rate ; Tongue ; Tongue Neoplasms

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*

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

Panniculitis generally indicates a group of diseases whose hallmark is fibrous thickening and chronic inflammation of subcutaneous fat. Various factors seem to induce a similar pathological histology, and morphological differences can be found among the patients diagnosed with the same disease. Paraneoplastic causes account for 3~10% of the cases of panniculitis. The commonest causes of cancer associated panniculitis are hematological malignancies and mostly lymphomas. In this case, we confirmed acute myeloid leukemia by a blood test and bone marrow examination, and with considering the clinical aspects and pathological findings of the skin lesion, and we finally diagnosed the patient as having panniculitis, which seems to be related with acute myeloid leukemia. The obvious clinical symptoms or pathophysiological features of this rare type of panniculitis are not yet fully known, and so making the differential diagnosis is needed to distinguish this malady from erythema nodosum, erythema induratum and various connective tissue disorders with accompanying erythematous subcutaneous nodules. We diagnosed this very rare and interesting case of paraneoplastic panniculitis that seemed to be generated from acute myeloid leukemia. We report here on this case and we review the relevant literature.
Bone Marrow Examination ; Connective Tissue ; Diagnosis, Differential ; Erythema Induratum ; Erythema Nodosum ; Hematologic Neoplasms ; Hematologic Tests ; Humans ; Inflammation ; Leukemia, Myeloid, Acute ; Lymphoma ; Panniculitis ; Skin ; Subcutaneous Fat