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*

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: 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

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 AND METHODS: The presence of aneuploidy or high proliferative activity in cytologic specimens is considered as complementary for the diagnosis of malignancy. To evaluate the diagnostic usefulness of DNA ploidy and cell cycle analysis in lung cancer, we compared the diagnostic yielding rates of DNA ploidy test by brushing specimens using flow cytometry with bronchoscopic forceps biopsy and brushing cytology. RESULTS: Of the seventy-six cases, 55 cases proved to have malignant diseases(squamous cell cancer: 27, adenocarcinorna: 7, large cell cancer: 1, undifferentiated: 4 and small cell cancer: 16). The incidence of aneuploidy in lung cancer..patients was 32.y %(18/55), as opposed to no cases in benign disease. And the proportion of high proliferative activity(S+GEM>22%) in lung cancer patients was 42.9% (15/35), but none in benign diseases. In (iffy-six of 75 cases(74.7%), cytology of brushing specimens and DNA analysis(either aneuploidy or high proliferative activity vs. diploidy and low proliferative activity) were in concordance. The sensitivity with only brushing cytology was 41.8%(23/55), but with the addition of DNA analysis, it was increased to 56.4%(31/55), without decreasing the specificity(100%). And there was a case whose clue for malignancy was absent except aneuploidy, and he was confirmed to have squamous cell cancer following open thoracotomy There were no differences in the frequency of aneuploidy or high proliferative activity between histologic subtypes of bronchogenic malignancy. CONCLUSIONS: The diagnostic detection rate of lung cancer was improved with the addition of DNA ploidy and cell cycle analysis, and the presence of aneuploidy or high proliferative activity was a relatively specific indicator of malignant disease. It would be useful to test DNA ploidy and cell cycle analysis with brushing specimen for the diagnosis of bronchogenic malignancy particularly in patients whose biopsy specimen could not be obtainable.
Aneuploidy ; Biopsy ; Cell Cycle ; Diagnosis ; Diploidy ; DNA* ; Flow Cytometry ; Humans ; Incidence ; Lung Neoplasms* ; Lung* ; Neoplasms, Squamous Cell ; Ploidies* ; Surgical Instruments ; Thoracotomy

OBJECTIVES : The present study aimed to compare anxiety sensitivity among anxiety disorder groups, and to examine the relationships between lower-order factors of anxiety sensitivity and each anxiety disorder. METHODS : Three hundred and twenty four normal control subjects and 212 patients with anxiety disorders were enrolled in this study. All subjects completed a psychometric assessment package including the Korean Anxiety Sensitivity Index-Revised (ASI-R) test. Statistical analysis of the two groups was performed using the Mann-Whitney U test, and comparison of anxiety sensitivity amongthe anxiety-disorder groups (panic disorder-PD, general anxiety disorder-GAD, social phobia- SP, obsessive-compulsive disorder-OCD) was investigated using Kruskal-Wallis test. RESULTS : All anxiety disorder groups showed higher total scores of the ASI-R than did the normal control group (Z=-13.724, p<.001), and the mean total score of the ASI-R in the panic disorder group was the highest among the anxiety disorder groups. The mean score of each lower-order factor of the ASI-R in each anxiety disorder group was higher than that of the normal control group and there were statistically significant differences in fear of cardiovascular symptoms (PD,GAD>SP,OCD), fear of respiratory symptoms (PD>GAD, SP,OCD), and fear of publicly observable anxiety reactions (SP>PD,OCD) among the anxiety disorder groups. CONCLUSION : These results suggest that anxiety sensitivity reflects vulnerability to anxiety disorders, and that lower-order factors of the ASI-R may help in the differential diagnosis of anxiety disorders.
Anxiety ; Anxiety Disorders ; Diagnosis, Differential ; Humans ; Panic Disorder ; Psychometrics

OBJECTIVES : The present study aimed to compare anxiety sensitivity among anxiety disorder groups, and to examine the relationships between lower-order factors of anxiety sensitivity and each anxiety disorder. METHODS : Three hundred and twenty four normal control subjects and 212 patients with anxiety disorders were enrolled in this study. All subjects completed a psychometric assessment package including the Korean Anxiety Sensitivity Index-Revised (ASI-R) test. Statistical analysis of the two groups was performed using the Mann-Whitney U test, and comparison of anxiety sensitivity amongthe anxiety-disorder groups (panic disorder-PD, general anxiety disorder-GAD, social phobia- SP, obsessive-compulsive disorder-OCD) was investigated using Kruskal-Wallis test. RESULTS : All anxiety disorder groups showed higher total scores of the ASI-R than did the normal control group (Z=-13.724, p<.001), and the mean total score of the ASI-R in the panic disorder group was the highest among the anxiety disorder groups. The mean score of each lower-order factor of the ASI-R in each anxiety disorder group was higher than that of the normal control group and there were statistically significant differences in fear of cardiovascular symptoms (PD,GAD>SP,OCD), fear of respiratory symptoms (PD>GAD, SP,OCD), and fear of publicly observable anxiety reactions (SP>PD,OCD) among the anxiety disorder groups. CONCLUSION : These results suggest that anxiety sensitivity reflects vulnerability to anxiety disorders, and that lower-order factors of the ASI-R may help in the differential diagnosis of anxiety disorders.
Anxiety ; Anxiety Disorders ; Diagnosis, Differential ; Humans ; Panic Disorder ; Psychometrics