In the situations that intracytoplasmic sperm injection (ICSI) has revolutionized the treatment of male infertility, there appeared some needs to evaluate the role of microsurgical single tubular epididymovasostomy (EV). The outcome of microsurgical single tubular EV for obstructive azoospermia patients was retrospectively reviewed in 61 patients who had been followed for more than 18 months postoperatively. The overall patency rate followed surgery was 69% (42/61 patients), and live-birth rate was 31% (19/61 patients). Of these 19 men 13 were able to impregnate their partners; 6 of the 19 live-birth were achieved with the assistance of conventional IVF. Previously known prognostic factors-etiology, preoperative testis biopsy findings and intraoperative presence of sperm or motile sperm- all did not affect the patency and pregnancy rate. The live-birth rate of ICSI has been reported about 20~40%. Our results suggest that microsurgical single tubular EV is the preferential method to treat obstructive azoospermia patients concerning the merits of natural pregnancy and high patency rate. ICSI would be applied to the patients with patent anastomoses who have failed to achieve natural pregnancy. We think that microsurgical single tubular EV in obstructive azoospermia patients should be performed more actively by well-trained urologists in more expanded indications.
Azoospermia ; Biopsy ; Humans ; Infertility, Male ; Male ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Sperm Injections, Intracytoplasmic* ; Spermatozoa ; Testis

Successful percutaneous transluminal angioplasty (PTA) of an internal mammary artery graft was performed in a 40 year old male patient who had recurrent angina soon after bypass surgery. Coronary angiography showed total occlusion of proximal portion of the left anterior descending artery and normal right coronary artery. Angiography of the left internal mammary artery graft revealed a tight stenosis (90% diameter narrowing) in the mammary artery at its insection into the left anterior descending artery.Angiography after the angioplasty demonstrated a widely patent graft (residual stenosis 10%) and translesional pressure gradient was 10 mmHg.
Adult ; Angiography ; Angioplasty* ; Arteries ; Constriction, Pathologic* ; Coronary Angiography ; Coronary Vessels ; Humans ; Insects ; Male ; Mammary Arteries* ; Transplants*

We conducted this cohort analytic study to determine whether women with unexplained elevations of maternal serum hCG at 15-18 weeks' gestation are at increased risk for pregnancy complications and adverse perinatal outcomes. The inclusion criteria were a singleton gestation, a confirmed gestational age, and an hCG level greater than 2.0 multiples of the median (MoM). The exclusion criteria were fetal anomalies, an abnormal karyotype, molar pregnancy, and an MSAFP level greater than 2.5 multiples of the median (MoM). A group of randomly selected women with hCG levels under 2.0 MoM served as controls. Patients with elevated levels of hCG had a significantly higher risk for PIH (17.9% versus 4.5%; P <.05) and preterm delivery (17.9% versus 3.5%; P<, 05) than control. But no significant differences were observed in the incidence of intrauterine growth restriction and low birth weight and in the newborn weight. We suggested that pregnancies with unexplained elevated hCG levels should be regarded as high-risk pregnancies. And these patients require careful monitoring with adequate obstetric management.
Abnormal Karyotype ; Chorionic Gonadotropin* ; Cohort Studies ; Female ; Gestational Age ; Humans* ; Hydatidiform Mole ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome* ; Pregnancy* ; Pregnancy, High-Risk

Percutaneous transluminal angioplasty(PTA) were performed in three patients with atherosclerotic stenosis of subclavian arteries. The arteries were successfully dilated without complications during the procedure. All patients were asymptomatic during follow-up periods ranging from eight months to fifteen months after PTA.
Angioplasty* ; Arteries ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Subclavian Artery*

From May, 1978 through Oct., 1979 the effect of Coenzyme Q10 was evaluated on 10 patients with chronic heart failure. The subjects selected for this study consisted of 7 patients with cardiomyopathy and 3 patients with valvular heart disease admitted to Severance Hospital, Yonsei University College of Medicine, All these patients had symptoms and signs of congestive heart failure which was stable for at least one month before starting Coenzyme Q10. Coenzyme Q10 was administered 30mg daily for eight weeks, one hour before meal and in combination with digitalis and/or diuretics. The drug effects were determined by measuring the cardio-thoracic ratio by chest X-ray, the sum of 'S' wave in V1 and 'R' wave in V5 in electrocardiogram, and PEP/LVET (pre-ejection period/left ventricular ejection time) by simultaneous tracings of carotid pulse and phonocardiogram every two weeks during medication. The cardio-thoracic ratio was improved in 4 of 10 cases, the sum of RV+SV5 was decreased in all 5 cases who showed voltages above 40mm before medication, and PEP/LVET ratio was decresed in 4 of 10 cases. The difference of average values before and after medication were not statistically significant(p<0.05) in all 3 parameters when examined by t-test. During treatment, there was improvement, if any, from two weeks after medication and no significant side effects were noted throughout the study period.
Cardiomyopathies ; Digitalis ; Diuretics ; Electrocardiography ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Heart Valve Diseases ; Humans ; Meals ; Thorax

From May, 1978 through Oct., 1979 the effect of Coenzyme Q10 was evaluated on 10 patients with chronic heart failure. The subjects selected for this study consisted of 7 patients with cardiomyopathy and 3 patients with valvular heart disease admitted to Severance Hospital, Yonsei University College of Medicine, All these patients had symptoms and signs of congestive heart failure which was stable for at least one month before starting Coenzyme Q10. Coenzyme Q10 was administered 30mg daily for eight weeks, one hour before meal and in combination with digitalis and/or diuretics. The drug effects were determined by measuring the cardio-thoracic ratio by chest X-ray, the sum of 'S' wave in V1 and 'R' wave in V5 in electrocardiogram, and PEP/LVET (pre-ejection period/left ventricular ejection time) by simultaneous tracings of carotid pulse and phonocardiogram every two weeks during medication. The cardio-thoracic ratio was improved in 4 of 10 cases, the sum of RV+SV5 was decreased in all 5 cases who showed voltages above 40mm before medication, and PEP/LVET ratio was decresed in 4 of 10 cases. The difference of average values before and after medication were not statistically significant(p<0.05) in all 3 parameters when examined by t-test. During treatment, there was improvement, if any, from two weeks after medication and no significant side effects were noted throughout the study period.
Cardiomyopathies ; Digitalis ; Diuretics ; Electrocardiography ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Heart Valve Diseases ; Humans ; Meals ; Thorax

PURPOSE: We assessed the usefulness of magnetic resonance angiography(MRA) and its techniques for differential diagnosis of hemorrhagic causes in patients with non-traumatic intracranial hemorrhagic disease. MATERIALS AND METHODS: We retrospectively reviewed 74 patients with non-traumatic intracranial hemorrhagic diseases, which were confirmed by radiological examinations(36 cases) and operations(38 cases). We compared the usefulness of magnetic resonance imaging(MRI) alone from MRI with MRA in evaluation of hemorrhagic causes. MRA was obtained by Time-of-Flight(TOF) and Phase Contrast(PC) technique. We investigated the usefulness of TOF and PC technique. RESULTS: MRI with MRA for detection of hemorrhagic causes(89%, 66 cases) was better than MRI only (64%, 47 cases). PC was better than TOF for evaluation of arteriovenous malformation and aneurysm due to subtraction of background noise(hemorrhage). CONCLUSION: MRI with MRA in more useful than MRI alone for evaluation of non-traumatic intracranial hemorrhagic causes.
Aneurysm ; Angiography* ; Arteriovenous Malformations ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies

No abstract available.
Aspergillosis*

With the recent increase of coronary artery disease in Korea, coronary arteriography israpidly gaining importance as a diagnostic procedure in the management of ischemic heart disease in this country. In order to delineate normal angiographic anatomy of the coronary arteries in Korean adults, the author reviewed 63 normal or near normal coronary angiograms out of 113 consecutive cases done at the cardiac laboratory of Yonsei University Severance Hospital from February, 1976 through September, 1982 and obtained the following results. 1) The diameter of the main stems of the left and the right coronary arteries measured 2.7-6.3mm(mean, 4.0mm) and 2.1-6.0mm(mean, 3.6mm) respectively, and the length of the left main stem measured 0-23mm(mean, 9.3mm). 2) The conus branch was visualized to originate from the proximal right coronary artery in 50 cases(79.4%), and in the other 13(20.6%) in whom the conus branch was not visualized, it was assumed to have a separate ostium directly from the aortic root. 3) The sinus node artery originated from the right coronary artery in 35 cases(55.5%) and from the left circumflex 20(31.7%). The remaining 8 cases(12.7%) appeared to have dual blood supply. 4) The artery to the A-V node arose from the proximal part of the posterior descending artery as a branch of the right coronary artery in 59 cases(93.7%) and of the left circumflex in only 4(6.3%), and the pattern of the A-V node blood supply coincided with the dominancy(crossing the crux of the heart and giving rise to the posterior descending artery) of the right or the left circumflex arteries. 5) In 33 cases(52.4%), both of the arteries to the SA and the AV nodes arose from the right coronary, and in 19(30.2%), the SA node artery came from the right, whereas the AV node artery originated from the left circumflex. 6) The number of ramifications(furcation) of the main left coronary artery was two in 53 cases(83.1%), three in 9(14.3%), and four in 1(1.6%). 7) The number of diagnoal branches of the left anterior descending artery was one in 34 cases(54%), two in 28(44.4%) and 3 in 1(1.6%).
Adult* ; Angiography ; Arteries ; Atrioventricular Node ; Conus Snail ; Coronary Angiography* ; Coronary Artery Disease ; Coronary Vessels* ; Heart ; Humans ; Korea ; Myocardial Ischemia

PURPOSE: The purpose of this study was to evaluate the utility of the CT cholangiography by using helical CT with multiplanar reformation in patients with extrahepatic biliary obstruction. MATERIALS AND METHODS: Helical CT was performed in 36 patients of extrahepatic biliary obstruction confirmed by operation or invasive cholangiography(percutaneous transhepatic cholangiography or endoscopic retrograde cholagiopancreatography). The cause of obstructions were 18 benign diseases(11 common bile duct stones, four choledochal cysts, three pancreatitis) and 18 malignant diseases(seven common bile duct carcinomas, seven pancreatic head carcinomas, three ampullary carcinomas, one periampullary duodenal carcinoma). After helical scanning through the extrahepatic bile duct, retrospective reconstruction of the helical data was performed. And then, CT cholagiogram was obtained with multiplanar reformation. We evaluated the technical success rate and the accuracy in determinating the level and the cause of the obstruction. We compared findings of the CT cholangiogram with that of operation or invasive cholangiography. RESULTS: In 100%(36/36) of cases, CT cholangiography could be obtained successfully. The accuracy of the CT cholangiography in determinating the level of the obstruction was 100%(11 cases of suprapancreatic duct, 13 cases of intrapancreatic duct, 13 cases of infrapancreatic duct and ampulla), and the accuracy in determinating the cause of the obstruction was 91.7%(all cases of 18 benign diseases, and 15 cases of 18 malignant diseases). CONCLUSION: In evaluating the obstruction of extrahepatic bile ducts, the CT cholangiography by using helical CT with multiplanar reformation is an useful noninvasive method in determinating the level.and the cause of biliary obstruction and therefore could replace t~e invasive cholangiography.
Bile Ducts, Extrahepatic ; Cholangiography* ; Choledochal Cyst ; Common Bile Duct ; Head ; Humans ; Retrospective Studies ; Tomography, Spiral Computed*