PURPOSE: To assess the ability of scrotal Doppler ultrasonography to confirm the diagnosis of clinical varicoceles and detect subclinical varicoceles. MATERIALS AND METHOD: Sixty patients with clinically evident varicocele were examined by scrotal doppler ultrasonography(gray scale: 60 patients, spectral Doppler: 35 patients, color Doppler: 22 patients). A control group of 21 patients with no suspected scrotal pathology also were studied. The age range of the varicocele group was 12-49 years. The normal group consisted of 21 subjects aged 19-23 years. Ultrasonographic measurement of scrotal vein diameter of patients before and during Valsalva maneuver, and scrotal vein blood flow reversal with Valsalva maneuver was compared with the findings of varicocele by physical examination. RESULTS: Significant differences were found in scrotal vein diameter before and during Valsalva maneuver between normal and varicocele testicular units. Cut-off points were selected in an arbitrary fashion on the basis of scattergram. Using this cut-off points and blood flow reversal, we found that 12(23%) of 53 patients with a clinically palpable left unilateral varicocele had an ultrasonographically positive subclinical right varicocele. 8(38%) of 21 patients without a clinical varicocele had a positive scrotal ultrasound. CONCLUSIONS: We suggest that scrotal doppler ultrasonography is a reliable means of confirming the clinical varicocele and screening the subclinical varicoceles.
Diagnosis ; Humans ; Mass Screening ; Pathology ; Physical Examination ; Ultrasonography ; Ultrasonography, Doppler* ; Valsalva Maneuver ; Varicocele* ; Veins

Castlernan disease is a rare lymphoproliferative disorder of uncertain cause, which most commonly involves mediastinum and rarely affects retroperitoneal, axillary or cervical lymph nodes. Authors present CT the and MRI findings of a cases of Castleman disease involving cervical lymph nodes. On CT and MR. There were multiple lymph nodes enlargement with homogeneous enhancement along the bilateral internal jugular and spinal accessory lymph node chain.
Giant Lymph Node Hyperplasia* ; Lymph Nodes ; Lymphoproliferative Disorders ; Magnetic Resonance Imaging* ; Mediastinum ; Neck*

Castlernan disease is a rare lymphoproliferative disorder of uncertain cause, which most commonly involves mediastinum and rarely affects retroperitoneal, axillary or cervical lymph nodes. Authors present CT the and MRI findings of a cases of Castleman disease involving cervical lymph nodes. On CT and MR. There were multiple lymph nodes enlargement with homogeneous enhancement along the bilateral internal jugular and spinal accessory lymph node chain.
Giant Lymph Node Hyperplasia* ; Lymph Nodes ; Lymphoproliferative Disorders ; Magnetic Resonance Imaging* ; Mediastinum ; Neck*

BACKGROUND: Controversy exists as to whether or not inhalation anesthetics and intravenous anesthetics impair arterial oxygenation (PaO2) during one lung ventilation (OLV). Accordingly, we examined the effect of enflurane and propofol on PaO2 and pulmonary vascular resistance (PVR) during OLV. METHODS: Forty patients, who had prolonged periods of OLV anesthesia with minimal trauma to the nonventilated lung were studied in a cross over design. Patients were randomized to four groups; Group 1 received 1 MAC of enflurane and oxygen from induction until the first 20 min after complete lung collapse, then were switched to propofol 100 g/kg/min (P100). In group 2, the order of the anesthetics was reversed. Group 3, Group 4 received the same order of the anesthetics as Group 1, Group 2, respectively but received propofol 200 g/kg/min (P200). RESULTS: During OLV, the PaO2 values were lower than those with two lung ventilation (TLV), there were no significant differences among each groups and between propofol and enflurane in PaO2, but in the selected patients (n=10, PaO2<120 mmHg during OLV), PaO2 in propofol group was higher than that of enflurane group (p<0.05). Conversion from TLV to OLV caused a significant increase in PVR, but there were no difference in PVR between propofol and enflurane group. CONCLUSIONS: These results suggest that the usual clinical dose of propofol affords no advantage over 1 MAC of enflurane anesthesia except low PaO2 patients during OLV. Propofol might be of value in risk patients of hypoxemia during thoracic surgery when OLV is planned.
Anesthesia ; Anesthetics ; Anesthetics, Inhalation ; Anesthetics, Intravenous ; Anoxia ; Cross-Over Studies ; Enflurane* ; Humans ; Lung ; One-Lung Ventilation* ; Oxygen* ; Propofol* ; Pulmonary Atelectasis ; Thoracic Surgery ; Vascular Resistance ; Ventilation

Agnogenic myeloid metaplasia (AMM) is a myeloproliferative disorder characterized by leukoerythroblastosis, tear-drop erythrocytes, extramedullary hematopoiesis with hepatosplenomegaly, and varying degrees of myelofibrosis. The mean age at presentation is about 60 years, and pediatric cases are rare. We experienced a case of AMM in a 9 months old female who was presented with pallor, huge splenomegaly and intermittent fever. Peripheral blood showed leukoerythroblastosis poikilocytosis, and tear drop cells. Bone marrow was difficult to aspirate, and biopsy specimen showed increased reticulin with decreased cellularity, which was compatible with myelofibrosis. We presented a case of AMM with brief review of the literatures.
Biopsy ; Bone Marrow ; Erythrocytes ; Female ; Fever ; Hematopoiesis, Extramedullary ; Humans ; Infant ; Myeloproliferative Disorders ; Pallor ; Primary Myelofibrosis* ; Reticulin ; Splenomegaly

This study was undertaken to investigate the characterization and distribution patterns of MHC class II positive dendritic cells[DCs] and ED2 positive tissue macrophages throughout the estrous cycle and during pregnancy in the rat ovary. The immunohistochemical characterization of the cells was carried out using the monoclonal antibodies OX6 and ED2 in cryostat-cut sections. DCs were distributed in the theca cell layer of the growing and mature follicles,stroma and corpus luteum. Tissue macrophages were distributed in the theca externa of the growing and mature follicles, stroma and corpus luteum but they were smaller in number than DCs. None of DC and tissue macrophage was found in the ovum, granulosa layer and follicular cavity of the ovarian follicle. However, DCs and tissue macrophages were present in the granulosa layer and follicular cavity in the atretic follicles. Degenerating corpus luteum contained a vast number of OX6 positive cells. On the contrary, fewer tissue macrophages were founcl in the degenerating corpus luteum. More macrophages tended to be observed in the former follicular cavity and theca lutein cell layer than in the granulosa lutein cell layer of the corpus luteum. In stroma,DCs and tissue macrophages were more frequently found around the blood vessels than in the other region, however, DCs were relatively greater in number than tissue macrophages. There was no estrous cycle and pregnancy dependent variation in the numbers and distribution patterns of DCs and tissue macrophages. In conclusion, the rat ovary contains rich networks of MHC class II positive dendritic cells and ED2 positive tissue macrophages. These findings suggest the existence of a well-developed system of immunological surveillance in the rat ovary. The results of this study have potentially important implications for the understanding not only of the ovarian immune system and the pathogenesis of various ovarian diseases but also of various physiologic functions of the ovary.
Animals ; Antibodies, Monoclonal ; Blood Vessels ; Corpus Luteum ; Dendritic Cells* ; Estrous Cycle ; Female ; Immune System ; Immunologic Surveillance ; Luteal Cells ; Macrophages* ; Ovarian Diseases ; Ovarian Follicle ; Ovary* ; Ovum ; Pregnancy ; Rats* ; Theca Cells

Future cell-based therapies such as tissue engineering will benefit from a source of autogenous pluripotent stem cells. There are embryonic stem cells (ESC) and autologous adult stem cells, two general types of stem cells potentilally useful for these applications. But practical use of ESC is limited due to potential problems of cell regulation and ethical considerations. To get bone marrow stem cells is relatively burden to patients because of pain, anesthesia requirement. The ideal stem cells are required of such as the following advantages: easy to obtain, minimal patient discomfort and a capability of yielding enough cell numbers. Adipose autologus tissue taken from intraoral fatty pad or abdomen may represent such a source. Our study designed to demonstrate the ability of human adipose tissue-derived stromal cells (hATSC) from human abdominal adipose tissue diffentiating into osteocyte and adipocyte under culture in vitro conditions. As a result of experiment, we identified stromal cell derived adipose tissue has the multilineage potentiality under appropriate culture conditions. And the adipose stromal cells expressed several mesenchymal stem cell related antigen (CD29, CD44) reactions. Secondary, we compared the culture results of a group of hATSC stimulated with TGF-beta1, bFGF with a hATSC group without growth factors to confirm whether cytokines have a important role of the proliferation in osteogenic differentiation. The role of cytokines such as TGF-beta1, bFGF increased hATSC's osteogenic differentiation especially when TGF-beta1 and bFGF were used together. These results suggest that adipose stromal cells with growth factors could be efficiently available for cell-based bone regeneration.
Abdomen ; Abdominal Fat ; Adipocytes ; Adipose Tissue ; Adult Stem Cells ; Anesthesia ; Bone Marrow ; Bone Regeneration ; Cell Count ; Cytokines ; Embryonic Stem Cells ; Humans ; Intercellular Signaling Peptides and Proteins* ; Mesenchymal Stromal Cells ; Osteocytes ; Pluripotent Stem Cells ; Stem Cells ; Stromal Cells* ; Tissue Engineering ; Transforming Growth Factor beta1

Von Recklinghausen`s neurofibromatosis is an unusual disorder with a wide variety Of manifestations. The initial findings may at times involve the female genitalia. When the phallus is affected, the urologist has an opportunity for the establishment of an accurate diagnosis as well as for cosmetic correction. We report a case of neurofibromatosis with an involvement of clitoris in 1l-year-old girl.
Clitoris ; Diagnosis ; Female ; Genitalia, Female ; Humans ; Neurofibromatoses* ; Neurofibromatosis 1

We report a case of male infertility secondary to pituitary apoplexy, which occurred as a sequela of korean hemorrhagic fever. A 32 years old male patient with past history of korean hemorrhagic fever was studied because of infertility and erectile impotence. The size of his testicles were about 8ml in Rt. and Lt. Semen analysis, endocrinologic studies, and brain MRI demonstrated hypogonadotrophic hypogonadism due to panhypopituitarism. The patient was treated with HCG (2,000 IU) administered intramuscularly three times per week for 6 months. After the treatment, improvement of male secondary sex characteristics such as hair growth and testicle size was noted. Promotion of sexual potency and improvement of semen quality were also noted. Following the treatment, his wife conceived after 6 months.
Adult ; Brain ; Erectile Dysfunction ; Hair ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Hypogonadism ; Infertility ; Infertility, Male* ; Magnetic Resonance Imaging ; Male ; Male* ; Pituitary Apoplexy* ; Semen Analysis ; Sex Characteristics ; Spouses ; Testis

The authors report an unusual case of a primary chondroid chordoma arising from the base of the petrous temporal bone. A 43-year-old female presented with left sided facial weakness and left sided jugular foramen syndrome. The CT findings of a tumor arising from the base of left petrous temporal bone and it involved left cerebello-pontine angle, and extended through left jugular foramen to parapharyngeal space. The clinical and histopathologic differences between classical(typical) chordoma and its variant are highlighted. The rarity of primary chordomas at this site is stressed.
Adult ; Chordoma* ; Female ; Humans ; Temporal Bone*