PURPOSE: A histological study was undertaken to characterized the vanished testes in boys who had impalpable cryptorchidism and found to have nubbin remnant during last 9-years period. METHODS: Of 108 impalpable cryptorchid boys, 42(44 nubbins, 38.9%) were found to have vanished testes at exploration. RESULTS: Thirty nine(88.6%) were located on the left side and the other 5(11.4%) were on the right side. The age range was 6 months to 14 years(mean;52.2 months). All 44 nubbin remnants were excised and examined microscopically. Grossly it was characterized by several centimeters of spermatic cord with small fibrotic tissue at distal end. Microscopically fibrous tissues were identified in all 44 specimens(100%), vasa deferens in 36(81. 8%), epididymis in 19(43.2%), calcifications in 18(40.9%), hemosiderin deposits in 6(13. 6%), germ cells in 5(11.4%), seminiferous tubules in 7(15.9%), tunicae albuginea in 7(15.9%) and hyalinizations in 3(6.8%). CONCLUSIONS: The finding of scattered foci of calcifications, hemosiderin deposits and the presence of relatively normal spermatic cord and epididymis, supports the concept of in utero torsion of the testis as the etiology of vanished testis. The 11.4% incidence of viable germ cells warrants exploration and removal of remnant tissue in boys with a impalpable cryptorchidism.
Cryptorchidism ; Epididymis ; Germ Cells ; Hemosiderin ; Hyalin ; Incidence ; Male ; Seminiferous Tubules ; Spermatic Cord ; Testis*

No abstract available.
Lung Diseases, Interstitial*

OBJECTIVE: The surgical treatment of symptomatic degenerative disc disease remains one of the most controversial topics among spine surgeons. Recently, advances in many endoscopic surgical techniques have resulted in lowered morbidity, expense, and suffering associated with their open surgery counterparts. The purpose of this study is to evaluate the efficacy of laparoscopic anterior lumbosacral interbody fusion in our patients with symptomatic degenerative disc disease. PATIENTS AND METHODS: We performed laparoscopic anterior interbody fusion for degenerative disc disease at L5-S1 in 26 patients who were unresponsive to conservative treatments for 1 year, from Oct. 1996 to Dec. 1997. This technique consists of a four-puncture laparoscopic approach with a 10mm trocar at the umbilicus for laparoscope, two 5mm trocars at left and right flanks for dissection, and a 15mm trocar at suprapubic area for working port. We performed complete discectomy and stabilized the spine with carbon interbody fusion cages filled with allograft bone. RESULTS: Laparoscopic fusion at L5-S1 was successful in 22 of 26 patients and the remaining four patients were successfully converted to minilaparotomy. The operation time averaged 150 minutes, hospitalization 4.1 days and average blood loss was 90cc. The mean follow-up period was 16.8 months. Radiographic fusion was achieved in 23 of 26 patients(88.5%) and clinical results showed excellent in 11/26, good in 11/26, fair in 3/26, poor in 1/26 according to Macnab's criteria. There were four complications; retroplacement of cages(1), transient dry ejaculation (1), transient urinary bladder dysfunction(1) and malposition of cages(1). CONCLUSION: Laparoscopic fusion at L5-S1 in degenerative disc disease seems to be safe, with satisfactory clinical results. Main advantage are early recovery and short hospitalization time compared with conventional technique.
Allografts ; Carbon ; Diskectomy ; Ejaculation ; Follow-Up Studies ; Hospitalization ; Humans ; Laparoscopes ; Laparotomy ; Male ; Spine* ; Surgical Instruments ; Umbilicus ; Urinary Bladder

No abstract available.
Pulmonary Embolism*

BACKGROUND: Previous studies have reported that obesity increases heart rate variability. Body mass index (BMI) has been reported to affect blood pressure variability (BPV) over 24 hours. However, the diurnal variation in the effect of BMI on BPV has not been evaluated. This study aimed to clarify the diurnal variation in the effect of BMI on BPV. METHODS: A total of 2,044 patients were consecutively enrolled in this study, and the data were analyzed retrospectively. All patients underwent 24-hour ambulatory blood pressure monitoring. We divided patients into two groups according to BMI (non-obese group: n = 1,145, BMI < 25; obese group: n = 899, BMI > or = 25). We compared BPV during daytime and nighttime between the non-obese and obese groups. We also evaluated the impact of BMI on BPV by multivariate regression analysis. RESULTS: On univariate regression analysis, there was no significant difference in BPV during daytime (systolic BP [SBP] variability: 20.7 vs. 21.7, p = 0.511; diastolic BP [DBP] variability: 16.8 vs. 17.5, p = 0.539). However, both SBP variability (13.8 vs. 17.6, p = 0.009) and DBP variability (11.7 vs. 14.3, p = 0.042) during nighttime were affected significantly by BMI. After adjusting other compounding variables (age > 60 years, current smoking habit, hypertension, diabetes mellitus, and use of calcium channel blockers and renin-angiotensin-aldosterone system blockers), multivariate analysis showed that BMI was an independent factor associated with increase in BPV during the night (SBP variability: p = 0.039; DBP variability: p = 0.034). CONCLUSIONS: Obesity increased BPV during nighttime.
Blood Pressure Monitoring, Ambulatory ; Blood Pressure* ; Body Mass Index ; Calcium Channel Blockers ; Diabetes Mellitus ; Heart Rate ; Humans ; Hypertension ; Multivariate Analysis ; Obesity* ; Renin-Angiotensin System ; Retrospective Studies ; Smoke ; Smoking

Endovascular procedures have been proposed as minimally invasive alternative treatments, allowing safe and effective aortic aneurysm repair. Despite the potential benefits, endovascular stent grafting may elicit an unexpected systemic inflammatory response, called postimplantation syndrome (PIS). The main features of PIS include fever, elevated C-reactive protein levels, leukocytosis and/or coagulation disturbances, perigraft air on abdominal computed tomography, and no evidence of infection. The main management of PIS is supportive care. Antibiotics have no clinical benefit. We report a case of PIS after endovascular aortic aneurysm repair in an elderly patient.
Aged* ; Anti-Bacterial Agents ; Aortic Aneurysm* ; Blood Vessel Prosthesis ; C-Reactive Protein ; Endovascular Procedures ; Fever ; Humans ; Leukocytosis

BACKGROUND AND PURPOSE: Triflusal(TR), 2-acetoxy-4-trifluoromethyl banzoic acid, is a platelet aggregation inhibitor structurally related to aspirin, proven to possess both in vitro and in vivo platelet antiaggregatoy activity. The aim of this study was to evaluate the effect of TR with different dosages on platelet function using platelet aggregation, adenosine triphosphate (ATP) secretion, and thromboxane generation after TR administration. METHODS: Twenty healthy volunteers (age 25-41years, 15 males 5 females) were randomly divided into two groups of ten subjects who were receiving one of two regimens (TR 300mg/day; TR 900mg/day) for seven days. Platelet functions including platelet aggregation by impedance methods using whole blood with ADP (5, 10uM) and collagen (1,2uM), ATP secretion and thromboxane B2 generation were determined. RESULTS: The inhibitory effect of platelet aggregation was observed in both groups. The degree of inhibitory effect was depended on the dosage of TR and the types of aggregating agent. Thromboxane B2 concentrations were significantly decreased by TR ingestion in both groups (p<0.01), but there was no differences in ATP secretion. CONCLUSIONS: This study show that TR exerts a remarkable platelet antiaggregation effect and inhibition of thromboxane synthesis in whole blood. In addition, the fact that TR does not affect ATP secretion means selective blocking of the platelet cyclooxygenase pathway.
Adenosine Diphosphate ; Adenosine Triphosphate ; Aspirin ; Blood Platelets* ; Collagen ; Eating ; Electric Impedance ; Healthy Volunteers ; Humans* ; Male ; Platelet Aggregation* ; Prostaglandin-Endoperoxide Synthases ; Thromboxane B2

OBJECTIVES: Carbon nanotubes are an important new class of technological materials that have numerous novel and useful properties. Multi-walled carbon nanotubes (MWCNTs), which is a nanomaterial, is now in mass production because of its excellent mechanical and electrical properties. Although MWCNTs appear to have great industrial and medical potential, there is little information regarding their toxicological effects on researchers and workers who could be exposed to them by inhalation during the handling of MWCNTs. METHODS: The generation of an untangled MWCNT aerosol with a consistent concentration without using surfactants that was designed to be tested in in vivo inhalation toxicity testing was attempted. To do this, MWCNTs were dispersed in deionized water without the addition of any surfactant. To facilitate the dispersion of MWCNTs in deionized water, the water was heated to 40degrees C, 60degrees C, and 80degrees C depending on the sample with ultrasonic sonication. Then the dispersed MWCNTs were atomized to generate the MWCNT aerosol. After aerosolization of the MWCNTs, the shapes of the NTs were examined by transmission electron microscopy. RESULTS: The aerosolized MWCNTs exhibited an untangled shape and the MWCNT generation rate was about 50 mg/m3. CONCLUSION: Our method provided sufficient concentration and dispersion of MWNCTs to be used for inhalation toxicity testing.
Carbon ; Electrons ; Handling (Psychology) ; Hot Temperature ; Inhalation ; Nanostructures ; Nanotubes, Carbon ; Sonication ; Surface-Active Agents ; Toxicity Tests ; Ultrasonics ; Water

BACKGROUND AND PURPOSE: Many literatures indicate that executive dysfunction exists in mild cognitive impairment (MCI) as well as Alzheimer’s disease (AD). However, there are few studies that found how early the deficits of the executive function (EF) exist in MCI. The present study investigated the presence of executive dysfunctions in the earliest stage of MCI, and the sub-domains of EF which are disproportionately impaired earlier than others. METHODS: The participants were 41 normal elderly (NE), 86 with amnestic multi-domain MCI, and 41 with mild AD. The MCI group was further sub-divided into two groups: Early MCI (EMCI, n=45) and late MCI (n=41), based on the Clinical Dementia Rating-Sum of Boxes. All participants were given neuropsychological tests to assess the sub-domains of EF, such as verbal fluency, psychomotor speed, inhibitory control, and mental set-shifting. RESULTS: Impairment of semantic fluency was observed in EMCI, with gradual worsening as cases approached mild AD. Phonemic fluency and psychomotor speed were also impaired at the early stage of MCI relative to the NE, but maintained at the same level up to mild AD. EMCI exhibited the same degree of performance with NE for inhibitory control and mental set-shifting; however, they progressively worsened from EMCI to mild AD. CONCLUSIONS: These results suggest that impairments of EF exist even in the earliest stage of the MCI, with a disproportionate decline in the sub-domains of EF.
Aged ; Alzheimer Disease* ; Dementia ; Executive Function* ; Humans ; Mild Cognitive Impairment* ; Neuropsychological Tests ; Semantics

We describe a group of 3 cases of invasive meningococcal disease that occurred in a military training camp in April 2011. All three patients were hospitalized. Ultimately, two patients recovered and one died. One patient had meningitis, one patient had septicemia and meningitis, and the other had no definite septicemia or meningitis. Neisseria meningitidis serogroup W-135 was detected in the serum and cerebrospinal fluid (CSF) of all patients by real-time polymerase chain reaction. In the one case of mortality, two strains were isolated from the patient's blood and CSF. Using multilocus sequence typing analysis, these strains were identified as a novel sequence type, ST-8912. Special attention is required for the meningococcal disease in military camp because the military personnels are in high risk of contact transmission.
DNA, Bacterial/blood/cerebrospinal fluid ; Electrophoresis, Gel, Pulsed-Field ; Humans ; Male ; Meningitis/complications/*diagnosis/microbiology ; Military Personnel ; Multilocus Sequence Typing ; Neisseria meningitidis, Serogroup W-135/genetics/*isolation & purification ; Real-Time Polymerase Chain Reaction ; Sepsis/complications/*diagnosis/microbiology ; Young Adult