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

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

No abstract available.
Heart Atria* ; Histiocytoma, Malignant Fibrous*

No abstract available.
Agglutination* ; Diagnosis* ; Female ; Immunoenzyme Techniques* ; Latex* ; Pregnancy ; Pregnancy, Ectopic*

BACKGROUND/AIMS: Ultrasonography is the easiest, fastest procedure for the diagnosis of choledocholithiasis, but the diagnostic failure are mostly because of the intrapancreatic level of this condition and the absence of bile duct dillatation. Endoscopic ultrasonography is a promising procedure for the diagnosis of extrahepatic cholestasis due to noninvasiveness and accuracy in the digestive gas interposition. The aim of this study was to prospectively compare the diagnostic accuracy of endoscopie ultrasonography with abdominal ultrasonography and endoscopic retrograde cholangiography in 66 patients with suspected choledocholithiasis. METHODS: All of the patients had abdominal ultrasonography, endoscopic ultrasonography ~and endoscopie retrograde cholangiography within 72 hours and final diagnosis was determined by endoseopic retrograde cholangiography with sphincterotomy. RESULTS: (l) Choledocholithiasis was confirmed in 45 patients: Thirteen patients had nondilated common bile ducts and 20 patients had stones with diamerer < 1 cm. (2) Endoscopic ultrasonography was more sensitive(95.5%) than abdominal ultrasonography (44.4%: P<0.0001) and similar to endoscopic retrograde cholangiography (97.8%). Specificity was same as 100% in 3 diagnostic tools. (3) Endoscopic ultrasonography was superior to abdommal ultrasonography for the diagnosis of choledocholithiasis with nondilated common bile duct(100% vs 15.3%, P<0.0001) and with less than 1cm sized small stone(100% vs 10.0%, P<0.0001). Endoscopic ultrasonography results did not depend on stone diameter or common bile duct dilatation. CONCLUSIONS: Endoscopic ultrasonography could be an accurate and safe diagnostic tool for the diagnosis of choledocholithiasis and could be promising especially in the cases with difficult cannulation of bile duct and gal1 stone pancreatitis.
Bile ; Bile Ducts ; Biliary Tract* ; Catheterization ; Cholangiography ; Choledocholithiasis* ; Cholestasis, Extrahepatic ; Common Bile Duct ; Diagnosis ; Dilatation ; Endosonography* ; Humans ; Pancreas* ; Pancreatitis ; Prospective Studies ; Sensitivity and Specificity ; Ultrasonography

Lumbar spinal stenosis (LSS) is a common spinal disease in the elderly. The cardinal symptom of LSS is neurogenic claudication, but not all patients present with such typical symptom. The clinical symptoms are often confused with symptoms of peripheral neuropathy, musculo-skeletal disease and other medical conditions in elderly patients. In particular, LSS presenting with rapid progression of leg weakness must be distinguished from other combined diseases. We report a case of rapid progressive leg weakness in a patient with LSS and iatrogenic adrenal insufficiency that was induced by obscure health supplement.
Adrenal Insufficiency ; Aged ; Constriction, Pathologic ; Humans ; Leg ; Peripheral Nervous System Diseases ; Spinal Diseases ; Spinal Stenosis

We investigated the usage of basic fibroblast growth factor administration to promote the survival of the dopaminergic neurons and behavioral efficacy of fetal mesencephalic grafts in rat parkinsonian models induced by 6-hydroxydopamine. The authors made partial lesioned rat parkinsonian models in which there was destruction of the dopaminergic nigrostriatal pathway & sparing of the mesolimbic pathway. A basic firoblastic growth factor was given continuously by using osmotic minipump into the lateral ventricle of the rat parkinsonian model for 2 weeks. Twelve weeks after grafts, all of the fetal mesencephalic grafts with basic fibroblast growth factor showed enhancement of the survival of dopaminergic neurons as well as activity of tyrosine hydroxylase in the caudate-putamen. Also, they accelerated the recovery in the grafted animals in test of apomorphine-induced rotational behavior when compare with that of the fetal mesencephalic grafts alone. The levels of tyrosine hydroxylase activity in the caudate-putamen were significantly enhanced in the fetal mesencephalic grafts with basic fibroblast growth factor and basic fibroblast growth factor alone compared with the control group. Those rats with fetal mesencephalic grafts with/without basic fibroblast growth factor or basic fibroblast growth factor alone showed the recovery in tests of apomorphine-induced rotational behaviors. Our study suggests that the basic fibroblast growth factor may be a neurotrophic factor for dopaminergic neurons, or may act indirectly by inducing the release of a dopaminergic trophic factor from other sources.
Animals ; Apomorphine ; Dopamine ; Dopaminergic Neurons ; Fibroblast Growth Factor 2 ; Lateral Ventricles ; Models, Animal* ; Oxidopamine ; Parkinson Disease ; Rats* ; Transplants* ; Tyrosine 3-Monooxygenase

We report a case of B-cell lymphoma primarily involving the skin in a 12-year-old boy. The histopathologic findings were compatible with those of small lymphocytic type of non-Hodgkin's lymphoma. A cutaneous lesion was the sole manifestation of his disease without any other organ involvement. Immunophenotypic studies and immunoglobulin gene rearrangement with Southern blot analysis determined its lineages and monoclonality with result of B-cell lineage neoplasm, i. d. CD20⁺, C1323⁺, CD35⁻ and rearranged band on JH probe. We treated him with surgical excision and CVP regimen of chemotherapy (cyclophosphamide, vincristine, prednisolone). There is no recurrence or metastasis during the last six months.
B-Lymphocytes ; Blotting, Southern ; Child ; Drug Therapy ; Genes, Immunoglobulin ; Humans ; Immunophenotyping ; Lymphoma, B-Cell* ; Lymphoma, Non-Hodgkin ; Male ; Neoplasm Metastasis ; Recurrence ; Skin ; Vincristine

Hydrocephalus is one of the major complications following spontaneous subarachnoid hemorrhage(SAH) as a result of intracranial aneurysm rupture. But the diagnosis and treatment of hydrocephalus is not often a straightforward task because of diagnostic uncertainties. From 1991 to 1995, twenty patients who developed hydrocephalus and received ventriculoperitoneal shunt operations(VP shunt) among total of one hundred ninetynine patients with ruptured intracerebral aneurysms were retrospectively studied. We investigated to obtain possible prognostic factors regarding to VP shunt operations among several parameters: such as age, sex, radiological findings, clinical findings, and their actual influence on the result of VP shunt operations. Of the twenty patients, thirteen patients(75%) showed clinical improvements after shunt operations. Cortical effacement on brain CT, gait disturbance, memory disturbance, and increased ventriculocranial volume ratio(>5%) were appeared to be significant prognostic factors for good results after VP shunt operations.
Aneurysm ; Brain ; Diagnosis ; Gait ; Humans ; Hydrocephalus* ; Intracranial Aneurysm ; Memory ; Retrospective Studies ; Rupture ; Subarachnoid Hemorrhage* ; Ventriculoperitoneal Shunt

Fibrous capsular contracture has been considered as a major side effect of breast silicone implant. The etiology of fibrous capsular contracture has not been fully determined. In the present study, we tried to determine the indirect effect of immune system in fibroblast function which plays a major role in fibrous capsular contracture. For preparation of conditional medium of lymphocytes, mouse (ICR) splenocytes were cultured for one day. Two kinds of conditioned medium, silicone conditioned medium (SCM) and silicone free normal conditioned medium (NCM), were prepared from splenocyte cell suspension cultured on silicone gel coated surface and naked surface, respectively. Mouse fibroblasts (NIH 3T3) were cultured in usual culture dish. Conditioned medium of 25% concentration was added. On day 2 after innoculation, cell number, thymidine incorporation and proline uptake of fibroblasts were measured. The results were as follow; 1) There was no difference of fibroblast number by cultivation in SCM of splenocytes compared with that in fresh medium(FM). 2)There was significant increase of DNA synthesis of fibroblasts in SCM compared with that in FM (p < 0.001). 3) There was significant increase of collagen synthesis of fibroblasts in SCM compared with that in FM (p < 0.01) and in NCM (p <0.001). 4) The functional activities of DNA and collagen synthesis mediated by same number of fibroblast were calculated to be significantly increased in SCM compared with that in NCM and in FM (p < 0.001). In conclusion, fibroblasts cultured in SCM had a higher potential to synthesize macromolecules such as collagen and DNA. We can postulate that SCM may contain certain amount of unknown growth stimulant of fibroblasts, which is produced by silicone gel sensitized murine splenocytes.
Animals ; Breast ; Cell Count ; Collagen ; Contracture ; Culture Media, Conditioned* ; DNA ; Fibroblasts* ; Immune System ; Lymphocytes* ; Mice ; Proline ; Silicone Gels ; Thymidine