Postpubertal mumps may result in ochitis and permanent testicular atrophy may develop following infection. This present study was initiated to evaluate the preventive effect of interferon-alpha2B on infertilty after mumps orchitis. There were 21 patients with mumps orchitis between May 1990 and June 1997. Patients were randomly distributed into 2 groups: group 1 patients (n=13) maintained therapy with interferon-alpha2B (3x10(6) IU per day) and group 2 were managed by conservatively. All of the patients were evaluated with testis size measurement, mumps virus titer, hormone level, and if possible semen analysis. For group 1 patients symptoms disappeared within 2 to 3 days and the volume of testis returned to normal within 11 days and testis atrophy was not observed in all patients in follow up. But asthenospermia was continued in 4 patients (unilateral 2, bilateral 2). For group 2 patients symptoms disappeared within 5 to 6 days and the volume of testis returned to normal within 10 days and testis atrophy was observed in 3 patients (unilateral 2, bilateral 1) in floow up. Asthenospermia was continued in 4 patients (unilateral 2, bilateral 2). Sperm count and morphology were recovered all the recover in group 1, 4 patients had persistent reduced sperm count and morphology in group 2, respectively. These observations suggest that systemic interferon-alpha2B treatment is highly effective in preventing infertility as well as testicular atrophy after mumps orchitis.
Atrophy ; Follow-Up Studies ; Humans ; Infertility* ; Male ; Mumps virus ; Mumps* ; Orchitis* ; Semen Analysis ; Sperm Count ; Testis

The author has examined the effect of cortical spreading depression(CSD) on the changes in extracellular concetration of aspartate and glutamate in the neocortex of anesthetized rats using microdialysis and high performance liquid chromatography(HPLC). The rats were prepared by halothane anesthesia and artificial ventilation. Rats were placed in a stereotaxic frame, and craniotomies were performed over the frontal and parietal cortexes on one side. The CSD was elicited by local application of KCI-soaked small pellets to the frontal cortex. The CSD was monitored by the changes of direct current(DC) potential in the parietal cortex. The microdialysis probe was implanted in the anterior part of the parietal cortex. Amino acids were analyzed by HPLC and fluorescence detection. Baseline concentration of the aspartate was 34.9+/-15.9nM and that of glutamate was 189.8+/-29.1nM(mean standard deviation). The perfusate for analysis was obtained 30 minutes after the beginning of the 300mM KCl induced CSD. Aspartate was found to increase to 146+/-55% baseline, glutamate up to 173+/-30% baseline(mean standard deviation). The increment of glutamate was statistically significant(p<0.05). Then 2M KCI-doaked pellets were applied for more frequent CSD amd the samples were collected. Aspartate increased up to 258+/-97% baseline, glutamate up to 174+/-57% baseline(mean standard deviation), The increment of glutamate and aspartate accompanying 2M KCI induced CSD were also statistically significant(p<0.05). These data suggest that the excitatory amino acids were released during the CSD and this may explain the various aspects of CSD that could contribute to the secondary neuronal damage in the compromised nerve cell.
Amino Acids ; Anesthesia ; Animals ; Aspartic Acid* ; Cerebral Cortex* ; Chromatography, High Pressure Liquid ; Cortical Spreading Depression* ; Craniotomy ; Excitatory Amino Acids ; Fluorescence ; Glutamic Acid* ; Halothane ; Microdialysis ; Neocortex ; Neurons ; Rabeprazole ; Rats* ; Ventilation

PURPOSE: To estimate the influences of pain and urinary symptoms on quality of life and determine the item that has the most predicting ability for quality of life in young men with chronic prostatitis-like symptoms. MATERIALS AND METHODS: Chronic prostatitis-like symptoms were measured by the National Institutes of Health-Chronic Prostatitis Symptom Index. of 28,841 men aged 20 years dwelling in the community, 16,321 men(a response rate 56.6%) completed self-administered questionnaires. A total of 1,057men who complained symptoms suggestive of chronic prostatitis were included in the study. The influences of pain and urinary symptoms on quality of life were determined by the logistic regression analysis. The receiver operating characteristic(ROC) curve was used to provide the predicting ability of each item quality of life. RESULTS: In multivariate analysis, pain and urinary symptoms were associated with an increased likelihood of impaired quality of life, and pain contributed more than urinary symptoms. Among items of pain and urinary symptoms, pain severity had the most predicting ability for impact, overall quality of life and quality of life impact domain. The areas under the ROC curves for impact, overall quality of life and quality of life impact domain were 71.3%, 69.3% and 67.0%, respectively. CONCLUSIONS: Urinary symptoms as well as pain may be associated with an increased likelihood of impaired quality of life in young men with chronic prostatitis-like symptoms. In addition, our findings suggest that pain severity is the most influencing factor for quality of life in this population.
Academies and Institutes ; Humans ; Logistic Models ; Male ; Multivariate Analysis ; Prostatitis ; Quality of Life* ; Surveys and Questionnaires ; ROC Curve

PURPOSE: Although subintimal angioplasty (SIA) has been advocated to treat chronic lower extremity arterial occlusions, numerous reports have described differences in its results. We evaluated the effect of SIA in a group of patients with severe lower extremity arterial occlusive disease. METHOD: During a 5-month period, 6 limbs in 4 patients with arterial occlusions (mean length, 17.7 cm; range, 9 to 27 cm) were treated with SIA. Three limbs had gangrene, and all patients had resting pain. There were two external iliac-superficial femoral, two superficial femoral-popliteal and two femoral-popliteal-tibial artery lesions. With fluoroscopic guidance, via an antegrade common femoral artery puncture, a subintimal dissection plane was created across the occlusion with standard hydrophilic guidewire and catheter. The arterial lumen was reentered distal to the occlusion, and the recanalized segment was balloon (3 to 6 mm) dilated. RESULT: SIA was technically successful in all 6 limbs (100%). Pain was completely resolved and all areas of gangrene were healed. The mean increase in ankle-brachial index after SIA was 0.51 (range, 0.25 to 0.71). There was no significant complication related with SIA and all arteries were patent during 3.6-months mean follow-up period. CONCLUSION: SIA for long occlusions of the crural arteries is safe and effective and can be an excellent alternative to reconstructive surgery in elderly and frail patients.
Aged ; Angioplasty* ; Ankle Brachial Index ; Arterial Occlusive Diseases ; Arteries ; Catheters ; Extremities ; Femoral Artery ; Follow-Up Studies ; Gangrene ; Humans ; Lower Extremity* ; Punctures

The author has performed an experimental study in order to investigate the effect of nimodipine on the production of CSF in 12 cats. The cats were divided into 2 groups, one for nimodipine intravenous infusion and the other for its vehicle infusion group. Using ventriculo-cisternal perfusion method, nimodipine and its vehicle were examined for their effects on CSF formation rate respectively. Baseline CSF formation rate was 22.5+/-2.9 microliter/min(S.E.) and it gradually reduced to 17.0+/-3.4 microliter/min(S.E.) after final infusion of nimodipine at 60 microgram/kg/min. Vehicle infusion revealed no significant change in CSF formation rate. Although the nimodipine insuion revealed declining tendency in CSF formation rate along with increment of nimodipine concentration, it was not statistically different from that of vehicle infusion group. Systolic blood pressure was significantly reduced after nimodipine infusion(133+/-31.8mmHg at baseline, 93.9+/-19.1mmHg at the end of the experiment) on oneway ANOVA test and it was significantly different from that in vehicle infusion group(p<0.01).
Animals ; Blood Pressure ; Cats ; Infusions, Intravenous ; Nimodipine* ; Perfusion

AIMTo help clarifying the possibility of connective-tissue diseases in men with penile or testicular prostheses.

METHODSEight patients underwent inflatable penile prostheses and 15, testicular prostheses consented to the study. Their medical records were reviewed and a follow-up interview and physical and serological examinations were performed.

RESULTSIn patients with penile prostheses, there was no abnormal antinuclear antibody (ANA) or IgM elevation. The serum levels of the rheumatoid factor (RF), C4, IgA and IgG were abnormal in one patient, and the levels of erythrocyte sedimentation rate (ESR) and C3, abnormal in two. Four had elevated IgE. In patients with testicular prostheses, there was no abnormal RF, ANA or IgM. The serum levels of ESR and IgA were abnormal in two, and three had abnormal C4, ten abnormal C3, and eleven decreased IgG. All had increased IgE. Men with penile prostheses had higher serum levels of IgG and IgM than those with testicular prostheses (P=0.001, P=0.016, respectively). The rates of abnormal values of IgE and IgG were higher in men with testicular prostheses than in men with penile prostheses (P=0.008, P=0.009, respectively). Physical examination was normal in all patients and nobody had documented symptoms pertinent to connective-tissue diseases.

CONCLUSIONOur findings suggest that the risk of connective-tissue diseases is not higher in patients wearing prostheses as the ANA is negative and there is no apparent manifestation suggestive of connective-tissue diseases.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Blood Sedimentation ; Complement C3 ; metabolism ; Complement C4 ; metabolism ; Connective Tissue Diseases ; epidemiology ; etiology ; immunology ; Humans ; Immunoglobulin A ; blood ; Immunoglobulin E ; blood ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Male ; Middle Aged ; Penile Prosthesis ; adverse effects ; Pilot Projects ; Risk Factors ; Silicon ; adverse effects ; immunology

PURPOSE: A catheter-associated urinary tract infection, which frequently occurs in patients with an indwelling Foley catheter, can cause serious morbidity or mortality. Recently, antibiotic coated Foley catheters, to prevent catheter-associated urinary tract infections, have become commercially available. This study investigated the long-term effects of the use of antibiotic-coated Foley catheters on biofilm formations. MATERIALS AND METHODS: Silicone Foley or antibiotic-coated Foley catheters were indwelled in 72 patients with a neurogenic bladder. Each catheter was removed 1, 3, 5, 7, 14 and 28 days after insertion. The cell densities of the biofilm bacteria were evaluated by counting the number of colonies on plate cultures. The biofilm formations on the catheters were evaluated by scanning electron microscopy. The inner surface morphology of the catheter was imaged by field emission scanning electron microscopy (Philips-XL20SFEG), at 10kV, following gold sputtering for electrical conductance. Six catheters were studied in each group, and the means calculated for comparisons. RESULTS: Thick bacterial biofilms were observed on both the antibiotic- coated and silicone Foley catheters 7 days after insertion. There were no significant differences in the cell densities of the biofilm bacteria between the two types of catheter during days 7-28 after insertion (p<0.05). Two to three species of bacteria were isolated from the catheters in each patient; the most common species were Pseudomonas, Klebsiella, Serratia, Proteus species and Escherichia coli. CONCLUSIONS: The antibiotic-coated Foley catheters showed no preventive effects on the biofilm formations after 7 days of indwelling compared with the silicone Foley catheters. Our data suggest that the routine use of antibiotic-coated Foley catheters to prevent catheter-associated infection in patients with a neurogenic bladder is not reasonable. The emergence of resistance associated with antibiotic-coated catheters should be evaluated.
Anti-Bacterial Agents ; Bacteria ; Biofilms* ; Catheter-Related Infections ; Catheters* ; Cell Count ; Escherichia coli ; Humans ; Klebsiella ; Microscopy, Electron, Scanning ; Mortality ; Proteus ; Pseudomonas ; Serratia ; Silicones ; Urinary Bladder, Neurogenic ; Urinary Tract Infections

Ascites is a rare complication of multiple myeloma. When it develops, it is usually associated with extensive liver infiltration with plasma cells, infectious peritonitis or myelomatous peritoneal infiltration. Ascites caused by peritoneal infiltration is even less frequent than others. The majority of previously reported cases were characterized by an IgA paraprotein and lack of skeletal lesions. This rare extramedullary complication of myeloma has been unresponsive to therapy and rapidly fatal. Therefore, it is important to recognize myeloma as a cause of ascites and the presence of ascites heralds a poor prognosis of myeloma. We recently experienced a case of myeloma with ascites and reviewed the relevant literature of human myeloma presenting with the triad of ascites, relative or absolute sparing of the skeleton, and an IgA paraprotein. A 76-year-old man was presented with ascites early in the course of myeloma. He had no evidence of intra-abdominal plasmacytoma and skeletal lesions. Myelomatous ascites was demonstrated by the monoclonal immunoglobulin of IgA type in ascitic fluid. He was treated by plasmapheresis due to hyperviscosity syndrome and VAD combination chemotherapy. He was discharged with the improved clinical condition.
Aged ; Ascites* ; Ascitic Fluid ; Drug Therapy, Combination ; Humans ; Immunoglobulin A ; Immunoglobulins ; Liver ; Multiple Myeloma* ; Paraproteins ; Peritonitis ; Plasma Cells ; Plasmacytoma ; Plasmapheresis ; Prognosis ; Skeleton

Medulloblasoma is a common intracranial neoplasm of childhood. Multiple clinical and therapeutic factors have been described to predict the outcome of patients with medulloblastoma. There were several studies about the usefulness of the DNA ploidy, the presence of mutation of p53 gene, and PCNA as predictors of the prognosis in the various type of intracranial tumors. The current study investigates the relationship between DNA ploidy, PCNA, mutation of p53 and the clinical course of the medulloblastoma patients. We analyzed the extent of resection, p53 mutation, PCNA, age, sex, and tumor stage as the prognostic indicator in 13 children with medulloblastoma. The patient' age and sex were not related to survival(p>0.1). The extent of resection was related to the patients' survival(p=0.03). The DNA ploidy was marginally related to the patients outcome(p=0.1) and this probably is due to the small number of our patients. There were no correlations between tumor stage, PCNA, p53 and patients' survival. The current study suggests that the prognosis is mainly influenced by the extent of the tumor resection in medulloblastoma patients. The DNA ploidy is weakly correlated with the outcome of the patients. Neither the mutation of p53 gene nor the PCNA were correlate with patients' survival.
Brain Neoplasms ; Child ; DNA* ; Genes, p53 ; Humans ; Medulloblastoma* ; Ploidies* ; Prognosis ; Proliferating Cell Nuclear Antigen*

The purpose of this study was to invstigate the effect of acetazolamide and fluphenazine on the formation of CSF. Studis were performed in 12 cats those were divided into 2 groups;A-F group included animals received initial acetazolamide infusion and additional infusion of fluphenazine to the initial infusion and the F-A group for vice versa. The rate of CSF formation was measured at 3cm above zero outflow pressure by force transducer which connected to personal computer. After obtaining steady value of CSF formation rate, the drugs were infused intravenously according to the protocol. Base line CSF formation rate, 18.87+/-6.52 microliter/min. is reduced to 6.67+/-2.45 microliter/min after acetazolamide infusion and further reduced to 3.48+/-4.06 microliter/min after additional fluphenazine. In fluphenazine group, the base line CSF formation rate, 16.34+/-4.58 microliter/min is reduced to 9.63+/-4.58 microliter/min after initial infusion of fluphenazine and further to 6.45+/-3.64 microliter/min. after additional infusion of acetazolamide. Mean reduction of CSF formation after initial intravenous infusion of acetazolamide and fluphenazine were 59% and 37% respectively. Although statistically insignificant, the CSF formation reduction in A-F group revealed more even and profound value comparing with that of F-A group. These date suggest that in addition to the effect of acetazolamide to reduce the formation of CSF, some other mechanism may exist in CSF formation that major tranquilizer exert the effect on CSF formation.
Acetazolamide* ; Animals ; Cats ; Fluphenazine ; Infusions, Intravenous ; Microcomputers ; Transducers