No abstract available.
Adrenocorticotropic Hormone*

PURPOSE: To determine the efficacy of CarnitilR (acetylcarnitine, Hanmi, Korea) therapy in idiopathic oligoasthenospermic men. MATERIALS AND METHODS: Forty-four subfertile men with abnormal semen parameters were treated between March, 2003 and March, 2004 with 3 g of CarnitilR daily for 3 months. Changes in semen parameters were evaluated 3 months after this therapy. RESULTS: The mean age was 34.2 years and the mean follow-up duration was 3.7 months. In asthenospemic patients (n=28), semen analysis before and after CarnitilR treatment showed an increase in volume (2.64+/-1.65 ml vs. 3.10+/-1.60 ml), motility (35.1+/-17.7% vs. 45.9+/-20.4%) and viability (51.4+/-20.3% vs. 59.3+/-13.6%) respectively. In oligoasthenospermic patients (n=16), semen analysis before and after CarnitilR treatment showed an increase in sperm count (10.7+/-54.4 million/ml vs. 38.4+/-32.5 million/ml) respectively. CONCLUSIONS: These results suggested that in idiopathic oligoasthenospermic men the empirical medical therapy with acetylcarnitine may be considered as primary treatment.
Acetylcarnitine* ; Carnitine ; Follow-Up Studies ; Humans ; Infertility, Male ; Male ; Semen ; Semen Analysis ; Sperm Count

Periprosthetic humeral fractures in patients with total shoulder arthroplasty are rare and difficult to treat. With the significant increase in the number of older patients who have undergone total shoulder arthroplasty in recent years, an increase in the number of periprosthetic shoulder fractures can be estimated. The decisions of treatment have to be taken individually, depending on the stability of the prosthesis, fracture location, and bone quality. On the other hand, there are limited data for treatment guidance and outcomes. This paper reviews the risk factors, classification, treatment, and outcomes of periprosthetic humeral fractures.

Spontaneous coronary artery dissection is a rarely identified entity whose exact incidence, etiology, pathogenesis, medium-term evolution and optimal treatment have not yet been firmly estabilished. The cause of spontaneous disection remains unclear but theories of etiology include a medial eosinophilic angiitis, pregnancy induced degeneration of collagen and rupture of the vasovasoum. Most paients die suddenly, but a clinical spectrum is seen including and unstable angina, myocardial infarction and cardiogenic shock. We experienced 4 cases with spontaneous coronary artery dissection found angiographically which caused myocardial infarction and unstable angina. Our patients were treated medically.
Angina, Unstable ; Collagen ; Coronary Vessels ; Eosinophils ; Humans ; Incidence ; Myocardial Infarction ; Myocardial Ischemia* ; Pregnancy ; Rupture ; Shock, Cardiogenic ; Vasculitis

PMMA(polymethyl Methacrylate) introcular lens(IOL) has been designed for making surface hydrophobic. Hydrophilic IOL has advantages such as less damage of corneal endothelium and less attachment of inflammatory cells on the IOL surface especially in case of uveitis or diabetes mellitus. Therefore, hydrophilic IOL is regarded as a biocompatible IOL. In this study, we made PMMAs hydrophilic using hydrolysis (described in The Effect of Hydrophilic Treatment of PMMA using Hydrolysis on Light Transmission and Cell Attachment in Vitro (I)). The number of PMMA treated in each condition was twelve and each PMMA has been implanted into rat peritoneal space. These PMMAs were examined with inverted light microscope and scanning electron microscope 3 days and 7-14 days after implantation. The number of cell attachment on pMMA-1 or PMMA-2 was about 1/5 of that on PMMA-0 and the difference was statistically significant (p<0.05). There was no statistically significant difference of cell attachment between PMMA-1 and PMMA-2. The cells on PMMA-0 showed prominent cytoplasmic processes, while those on PMMA-1 or PMMA-2 showed little processes. The majority of the surface PMMA-0 was covered with membrane light sheet. Therefore, it was found that treatment of PMMA with Isopropranol and NaOH was useful in making PMMA dydrophilic and decreasing the cell attachment on PMMA in vivo.
Animals ; Cataract ; Cytoplasm ; Diabetes Mellitus ; Endothelium, Corneal ; Hydrolysis* ; Membranes ; Polymethyl Methacrylate* ; Rats ; Uveitis

Acute interstitial pneumonia is a fulminant disease of unknown etiology that usually occurs in a previously healthy person and produces the histologic findings of the organizing phase of diffuse alveolar damage. We experienced an autopsy case of acute interstitial pneumonia of unknown etiology. The patient was a 48 year old man who had been healthy and had not been exposed to organic dusts or other toxic materials. The chief complaints represented were dyspnea and a dry cough for several weeks before hospitalization, and the chest radiographs showed bilateral interstitial infiltrates. Patchy consolidation of air space was also identified and ground-glass attenuation similar to those described in ARDS was detected on high-resolution computed tomography. Steroid pulse therapy, mechanical ventilation, and antibiotics for superimposed bacterial infection were performed, but the symptoms did not improve and the patient died of generalized respiratory insufficiency and severe hypoxemia 2 1/2 months after hospitalization. At autopsy the macroscopic and microscopic findings were confined mainly to the lungs. On the whole, both lungs were firm in consistency and the external surface showed a cobblestone appearance. The cut surface showed almost complete replacement of the normal lung parenchyma with gray to yellow fibrous tissue with a little residual functional area remaining. The pathology of both open lung biopsy and autopsy tissue showed marked hyperplasia of type II pneumocytes, hyaline membrane formation, thickening of the alveolar wall due to extensive fibroblast proliferation, and relatively abundant young collagen deposition in the interstitium. An immunohistochemical stain for cytokeratin revealed epithelial hyperplasia and showed that the alveolar spaces were markedly shrunken by fibrous tissue.
Anoxia ; Anti-Bacterial Agents ; Autopsy* ; Bacterial Infections ; Biopsy ; Collagen ; Cough ; Dust ; Dyspnea ; Fibroblasts ; Hospitalization ; Humans ; Hyalin ; Hyperplasia ; Keratins ; Lung ; Lung Diseases, Interstitial* ; Membranes ; Middle Aged ; Pathology ; Pneumocytes ; Pulmonary Fibrosis ; Radiography, Thoracic ; Respiration, Artificial ; Respiratory Insufficiency

Purpose: To determine whether travoprost 0.003% has a similar intraocular pressure (IOP) reduction effect to that of travoprost 0.004% while reducing side effects. Methods: This was a prospective study from January 2018 to December 2018 that included 102 patients diagnosed with open angle glaucoma who switched from travoprost 0.004% to travoprost 0.003%. We investigated the changes in IOP, conjunctival hyperemia, corneal erosion, and eyelid pigmentation before and at 3 months after switching to travoprost 0.003%. Additionally, a questionnaire survey of these patients was conducted to determine possible side effects, including hyperemia, stinging, pruritus, irritation, blurred vision, dryness, and foreign body sensation. Results: IOP readings before and after switching to travoprost 0.003% were 12.95 ± 4.25 and 12.94 ± 3.89 mmHg, respectively, showing no significant change (p = 0.974). No changes were observed in corneal erosion or eyelid pigmentation; however, conjunctival hyperemia was reduced significantly from 1.60 ± 0.88 to 1.36 ± 0.84 (p = 0.001). No significant changes in hyperemia, stinging, pruritus, irritation, or foreign body sensation were reported; however, a significant improvement was noted for blurred vision and dryness (p = 0.008, p = 0.007, respectively). Conclusions We were able to show the effectiveness and safety of travoprost 0.003% as being as effective as travoprost 0.004% in reducing IOP and injections while improving blurred vision and dryness.

Purpose: We compared the effectiveness of narrow-band imaging (NBI) cystoscopy and white light cystoscopy (WLC) for detection of intravesical recurrence of bladder cancer. Materials and Methods: We studied the positive predictive value (PPV) in the recurrent suspicious lesions in patients with nonmuscle invasive bladder cancer (NMIBC) for the 13 months of the follow-up from July 2016 to June 2017 with WLC and another 13 months from July 2017 to July 2018 with NBI, respectively. We also studied the second transurethral resection of bladder tumor (TURBT) free survival (STFS) and cancer-specific recurrence-free survival (CSRFS) with WLC and NBI in the 12 months of short-term follow-up. Results: The total number of first TURBT patients in the follow-up was 164. Eighty patients were excluded. Among the 84 patients with NMIBC, WLC group was 43, NBI group was 41. Thirty-six patients had more than second TURBT. In 48 cases of patients with more than second TURBT, PPV of WLC and NBI was 81.8% and 61.5%, respectively. There was no statistically significance of PPV between the 2 groups (p=0.124). There were no pathological differences between the results about 1 year of follow-up patients with one of WLC or NBI (p=0.288). STFS was statistically significantly shorter in NBI (p=0.002), but there were no statistically significant difference in CSRFS. Conclusions NBI had made the bladder lesions detected early but had a low PPV for cancer recurrence within the bladder and there is no survival benefit.

Purpose: To determine whether travoprost 0.003% has a similar intraocular pressure (IOP) reduction effect to that of travoprost 0.004% while reducing side effects. Methods: This was a prospective study from January 2018 to December 2018 that included 102 patients diagnosed with open angle glaucoma who switched from travoprost 0.004% to travoprost 0.003%. We investigated the changes in IOP, conjunctival hyperemia, corneal erosion, and eyelid pigmentation before and at 3 months after switching to travoprost 0.003%. Additionally, a questionnaire survey of these patients was conducted to determine possible side effects, including hyperemia, stinging, pruritus, irritation, blurred vision, dryness, and foreign body sensation. Results: IOP readings before and after switching to travoprost 0.003% were 12.95 ± 4.25 and 12.94 ± 3.89 mmHg, respectively, showing no significant change (p = 0.974). No changes were observed in corneal erosion or eyelid pigmentation; however, conjunctival hyperemia was reduced significantly from 1.60 ± 0.88 to 1.36 ± 0.84 (p = 0.001). No significant changes in hyperemia, stinging, pruritus, irritation, or foreign body sensation were reported; however, a significant improvement was noted for blurred vision and dryness (p = 0.008, p = 0.007, respectively). Conclusions We were able to show the effectiveness and safety of travoprost 0.003% as being as effective as travoprost 0.004% in reducing IOP and injections while improving blurred vision and dryness.