BACKGROUND: The differentiation of syphilids from other skin decreases is frequently difficult due to considerable variations of clinical and histologic pattern. The most common histologic changes in secondary syphilis are swelling & proliferation of endothelial cells and the presence of a perivascular infiltrate containing plasmia cells. But often, these findings are absert or inconspicuous. OBJECTIVE: We examined the histopathologic findings of secondary syphilis in relation to the clinical types of the skin lesion. MEHTODS: 36 biopsy specimens from twenty-nine serologically and clinically confirmed cases of secondary syphilis (15 macules, 8 papules, 2 condylomata latas and 11 papulosquamous lesions) were examined. RESULTS: The histopath,ologic findings of secondary syphilis showed comparative differences according to the clinical types of the skin lesion. The plasms cell infltrates were absent or sparse in 14 csses(39%) and the plasma cell infiltration was significantly correhted with the age of skin lesions(p=0.02197). Vascular changes were seen in 32 cases (89%), but the incidence of endothelial proliferation was less(25%). CONCLUSION: This study demonstrates the histopathologic findirigs of secondary syphilis in accordance to the clinical morphology of the eruption and thus, help to differentiate syphilids from other skin diseases.
Biopsy ; Endothelial Cells ; Incidence ; Plasma Cells ; Skin ; Skin Diseases ; Syphilis ; Syphilis, Cutaneous*

BACKGROUND: Surgical endarterectomy had been known to be the standard treatment modality in management of carotid stenosis. However, endarterectomy had several limitations in high-risk patients, particulary with coronary artery disease. Carotid angioplasty and stenting has been suggested to be a safer and more cost-effective alternative to carotid endarterectomy in the management of symptomatic carotid artery disease. The purpose of this study is to evaluate the feasibility and safety of elective carotid artery stent implantation in patients with carotid artery stenosis. METHOD: We treated 19 patients with symptomatic and asymptomatic stenosis of >60% in 19 carotid arteries with balloon angioplasty followed by elective stent implantation. Of all carotid stenting procedures, 18 stents were implanted in obstructing atherosclerotic plaques and in one for Takayasu's arteritis. Of all patients, 10 patients were symptomatic with a history of stroke or transient ischemic attacks which were ipsilateral to the treated carotid artery. 12 patients represented a high-risk subset with myocardial infarction, previous coronary artery bypass graft and coronary artery stenosis. 6 months follow up angiogram was done in 7 patients, a patient(Takayasu's arteritis) showed restenosis. Result: Angiographic and procedural success rate were 100%, and there were no acute or subacute stent thrombosis. Immediately after initial carotid stenting, the mean(+/-SD) stenosis was reduced from 74.9+/-13.6% to 10.2+/-8.7% and the minimal luminal diameter was increased from 1.4+/-0.8mm to 5.3+/-1.0mm corresponding to an acute gain of 3.9mm. There were no major or minor stokes during follow-up. CONCLUSION: Percutaneous carotid angioplasty with stenting is a safe and feasible procedure. It is associated with high immediate success rates and relatively low complications in the management of carotid artery stenosis. Carotid stenting seems to be a reasonable alternatives to medical management for the treatment of carotid stenosis in patients deemed to be poor candidates for standard carotid endarterectomy.
Angioplasty ; Angioplasty, Balloon ; Carotid Arteries* ; Carotid Artery Diseases ; Carotid Stenosis* ; Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Stenosis ; Endarterectomy ; Endarterectomy, Carotid ; Follow-Up Studies ; Humans ; Ischemic Attack, Transient ; Myocardial Infarction ; Phenobarbital ; Plaque, Atherosclerotic ; Stents* ; Stroke ; Takayasu Arteritis ; Thrombosis ; Transplants

This study was carried to determine the possibility of finding motile spermatozoa and fertilization, pregnancy rate after testicular sperm extraction(TESE) with ICSI in obstructive and non-obstructive azoospermic patients. In 154 cases(132 patients), obstructive azoospermia was 77 cases and non-obstructive azoospermia was 77 cases. In obstructive azoospermia, patients generally showed normal spermatogenesis and included vas agenesis(n=8), multiple vas obstruction(n=7), epididymal obstruction (n=54). Total of 982 retrieved oocytes were obtained and 84.4% were injected. The fertilization rates with 2 PN and cleavage rate were 72.5% and 62.3%, .respectively. 30 pregnancies(38.9%) were achieved and the ongoing pregnancies were 22 cases (28.6%). In non-obstructive azoospermia, patients showed hypospermatogenesis(n=49), maturation arrest(n=4), Sertoli cell only syndrome (n=24). The various stages of spermatogenic cell could be retrieved by TESE and could be reached normal fertilization and embryo development with ICSI. Total of 1072 retrieved oocytes obtained and 80.2% were injected. The fertilization rates with 2 PN and cleavage rate were 52.8% and 68.9%, respectively. 22 pregnancies(30.1%) were achieved and the ongoing pregnancies were 19 cases(26.0%). Conclusively, the combination of TESE with ICSI using testicular spermatozoa can achieve normal fertilization and pregnancy rate and effective method in obstructive and non-obstructive azoospermic patients.
Azoospermia ; Embryonic Development ; Female ; Fertilization* ; Humans ; Oocytes ; Pregnancy Rate* ; Pregnancy* ; Sertoli Cell-Only Syndrome ; Sperm Injections, Intracytoplasmic ; Spermatogenesis ; Spermatozoa*

Irreparable obstructive azoospermic patients can be treated successfully with microsurgical epididymal sperm aspiration(MESA) o. testicular sperm extraction (TESE) by intracytoplasmic sperm injection(ICSI). Obstructive azoospermic patients generally have normal spermatogenesis. The aim of this study was to see if any spermatozoa could be retrieved from non-obstructive azoospermia and to assess the efficacy of ICSI with TESE in germinal failure. 42 non-obstructive azoospermic patients revealed no spermatozoa at all in their ejaculates, even after centrifuge. The histology of 42 patients revealed 15 Sertoli cell only Syndrome, 4 maturation arrest and 23 severe hypospermatogenesis. All patients underwent extensive multiple testicular biopsy for sperm retrieval. These patients were scheduled for ICSI using testicular spermatozoa. In 25 out of 42 non-obstructive azoospermic patients, spermatozoa were recovered from multiple testicular biopsy specimen and 11 ongoing pregnancies were achieved. There are usually some tiny foci of spermatogenesis which allow TESE with ICSI in non-obstructive azoospermia. Also these patients may have sufficient sperm in the testes for ICSI, despite extremely high FSH level and small testes.
Azoospermia* ; Biopsy ; Humans ; Male ; Oligospermia ; Pregnancy ; Sertoli Cell-Only Syndrome ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval ; Spermatogenesis ; Spermatozoa ; Testis

Acute malperfusion syndrome is a serious complication of acute aortic dissection. A 76-year-old female patient was admitted with acute type B aortic dissection and developed renal malperfusion during medical therapy. We are reporting a clinically successful result from the thoracic endovascular aortic repair used for malperfusion syndrome that occurred by acute type B aortic dissection.
Aged ; Aorta ; Female ; Humans ; Stents ; Transplants

No abstract available.
Meningioma* ; Radiosurgery*

OBJECTIVES: The purpose of our study was to estimate skin structure and conductivity distribution in a cross section of local tissue using non-invasive measurement of impedance data. The present study was designed to evaluate the efficiency of skin depth information through computer simulations. The multilayer tissue model was composed of epidermis, dermis tissues, and subcutaneous. METHODS: In this study, electrical characteristics of skin models were used for conductivity of 0.13 S/m, 0.26 S/m, 0.52 S/m, permittivity of 94,000 F/m, and a frequency of 200 Hz. The effect of the new method was assessed by computer simulations using three-electrode methods. A non-invasive electrical impedance method has been developed for analysis using computer simulation and a skin electrical model with low frequency range. Using the three-electrode method differences through the potentials between measurement electrodes and reference electrodes can be easily detected. The Cole electrical impedance model, which is better suited for skin was used in this study. RESULTS: In this study, experiments using three-electrode methods were described by computer simulation based on a simple model. This electrical impedance model was fitted and developed in comparison with our model for measurement of skin impedance. CONCLUSIONS: The proposed electrical model for skin is suitable for use in interpretation of changes in impedance characterization of the skin. Using the computer simulation method, information on skin impedance depth can be more accurately developed and predicted.
Computer Simulation ; Dermis ; Electric Impedance ; Electrodes ; Epidermis ; Skin

OBJECTIVES: Congenital muscular torticollis, a common disorder that refers to the shortening of the sternocleidomastoid in infants, is sensitive to correction through physical therapy when treated early. If physical therapy is unsuccessful, surgery is required. In this study, we developed a support vector regression model for congenital muscular torticollis to investigate the prognosis of the physical therapy treatent in infants. METHODS: Fifty-nine infants with congenital muscular torticollis received physical therapy until the degree of neck tilt was less than 5degrees. After treatment, the mass diameter was reevaluated. Based on the data, a support vector regression model was applied to predict the prognoses. RESULTS: 10-, 20-, and 50-fold cross-tabulation analyses for the proposed model were conducted based on support vector regression and conventional multi-regression method based on least squares. The proposed methodbased on support vector regression was robust and enabled the effective analysis of even a small amount of data containing outliers. CONCLUSIONS: The developed support vector regression model is an effective prognostic tool for infants with congenital muscular torticollis who receive physical therapy.
Humans ; Infant ; Least-Squares Analysis ; Neck ; Prognosis ; Torticollis

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by the presence of IgG autoantibody against platelet, low platelet count, and bleeding disorders. Anecdotal experience of renal transplantation adopting the use of 2 weeks of steroids treatment, perioperative intravenous immunoglobulin, and simultaneous splenectomy in a patient with ITP was reported recently. However, advantage of these procedures is not yet confirmed. Recently, we performed a case of uneventful renal transplantation in a patient with ITP without immunoglobulin treatment and no splenectomy. Although platelet counts have been under normal limit after transplantation, the anti-platelet antibody converted to negative postoperatively and the graft function has been stable until now. Our case report raised the question about the use of perioperative immunoglobulin and splenectomy in these particular patient groups waiting for renal transplantation.
Blood Platelets ; Hemorrhage ; Humans ; Immunoglobulin G ; Immunoglobulins ; Kidney Transplantation* ; Kidney* ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy ; Steroids ; Transplants

Subamniotic hematoms are rare placental pathological lesions resulting from the rupture of chorionic vessels near the cord insertion. Most subamniotic hematomas are found after birth and result from excessive traction on the umbilical cord at delivery. The development of these lesions has been rarely reported in utero. A case of a subamniotic hematoma was diagnosed by ultrasound at 7(+5) weeks of gestation. We describe the ultrasound features of a subamniotic hematoma and the differential diagnosis.
Chorion ; Diagnosis, Differential ; Hematoma* ; Parturition ; Placenta ; Pregnancy ; Prenatal Diagnosis* ; Rupture ; Traction ; Ultrasonography ; Umbilical Cord