Recently there are many sophisticated diagnostic tools for subclinical varicocele, but its clinical significance is debatable. Using Doppler stethoscope, we evaluated the presence of subclinical varicocele and its possible impact on male infertility. Retrograde flow. through the internal spermatic vein on Doppler stethoscope was detected in 34 cases(27.9 %) on left side, 9 cases (7.4%) on right side and 5 cases(4.1%) on both sides. Comparing both testicular volumes, there was no significant difference between the cases with subclinical varicocele and normal finding on Doppler stethoscope. Semen analysis was done in 83 cases except the cases with their children. Among these cases, 3 had abnormal semen quality, in which only one case with decreased sperm count revealed high grade subclinical varicocele. This case taken high ligation of internal spermatic vein. but the semen quality was not recovered during follow-up period up to 7 months. These results suggest that the incidence of subclinical varicocele by Doppler stethoscope is relatively high and its effect on male fertility may not be significant. Therefore it may be assumed that the subclinical varicocele does not need to be detected and treated actively.
Child ; Diagnosis* ; Fertility ; Follow-Up Studies ; Humans ; Incidence ; Infertility, Male ; Ligation ; Male ; Semen Analysis ; Sperm Count ; Stethoscopes* ; Varicocele* ; Veins

In 1883 Fournier, a French venereologist, described 5 patients with unexplained fulminating gangrene of the male genitalia. Fournier emphasized 3 characteristics 1) the abrupt onset in a young, healthy male subjects, 2) the rapid progression to gangrene and 3) the absence of a discernible cause. As currently used by many authors, Fournier's gangrene describes a widely destructive, gangrenous process of the genitalia, with little regard for Fournier's original tenets of patient's age or definable etiology. Early identification and prompt initiation of medical and surgical therapy is imperative. We report two cases of Fournier's gangrene with brief review of the literatures.
Fournier Gangrene* ; Gangrene ; Genitalia ; Genitalia, Male ; Humans ; Male

Fibroepithelial polyp of the ureter is a extremely rare benign tumor which is mesodermal origin. It should be suspected preoperatively in cases with a long history of loin pain or hematuria, or both, in a younger patient with the radiologic finding of long ureteric filling defect. Unfortunately. in the majority of cases reviewed. the diagnosis was not made preoperatively but the diagnostic confirmation was made intraoperatively or postoperatively. Herein, we report a case of fibroepithelial polyp or the ureter which was diagnosed preoperatively with ureteroscope. The management was local segmental excision and end-to-end anastomosis of the ureter.
Diagnosis ; Hematuria ; Humans ; Mesoderm ; Polyps* ; Ureter* ; Ureteroscopes ; Ureteroscopy

Fibroepithelial polyp of the ureter is a extremely rare benign tumor which is mesodermal origin. It should be suspected preoperatively in cases with a long history of loin pain or hematuria, or both, in a younger patient with the radiologic finding of long ureteric filling defect. Unfortunately. in the majority of cases reviewed. the diagnosis was not made preoperatively but the diagnostic confirmation was made intraoperatively or postoperatively. Herein, we report a case of fibroepithelial polyp or the ureter which was diagnosed preoperatively with ureteroscope. The management was local segmental excision and end-to-end anastomosis of the ureter.
Diagnosis ; Hematuria ; Humans ; Mesoderm ; Polyps* ; Ureter* ; Ureteroscopes ; Ureteroscopy

BACKGROUND AND OBJECTIVES: Carotid artery stenting (CAS) is emerging as a reasonable alternative to carotid endarterectomy, and especially for those patients with comorbidities. However, this endovascular approach has acute complications related to distal embolization. Therefore, the use of protection devices is expected to reduce the risk of embolic strokes during this procedure and to deliver more favorable outcomes. We report here on our early experiences with balloon occlusion and filter type distal protection devices that were used for CAS. SUBJECTS AND METHODS: CAS was performed on 92 lesions of 73 patients (age:61.0 +/-1 2.7 years, males:71.2%). Of these patients, 16 patients with 17 carotid lesions underwent CAS using distal protection devices. A balloon occlusion type protection device, PercuSurge GuardWire system, was used for 8 lesions and a filter type, FilterWire EX system, was used for 9 lesions. Procedural and early clinical outcomes including complications were compared between the two groups of patients who underwent CAS with the distal protection (group I) and without the distal protection (group II). RESULTS: Carotid angioplasty and stenting was performed successfully in all the patients. Successful deployment of the protection devices was possible in all 17 carotid lesions. Among the 75 carotid lesions treated without protection device, there were two fatal strokes, one non-fatal major stroke, one minor stroke and five transient ischemic attacks (TIA), whereas one TIA and one non-neurologic death occurred among the 17 lesions treated with the protection device (p=ns). CONCLUSION: CAS with use of the distal protection device can be performed successfully and safely. Despite the limited experience with the protection devices, our results suggest the use of distal protection device for carotid intervention may reduce acute complications related to distal embolization during the procedure.
Angioplasty ; Balloon Occlusion ; Carotid Arteries* ; Carotid Stenosis ; Comorbidity ; Endarterectomy, Carotid ; Humans ; Ischemic Attack, Transient ; Protective Devices ; Stents* ; Stroke

Stenosis of extracranial vertebral artery (VA) is not an infrequent lesion, and it can pose a significant clinical problem. However, the standard treatment for a significant VA stenosis has still not been established. Here in this study, we report our experiences of VA stenting in 25 patients (age 56.2 +/-15.2 years, male 76%). The patients had comorbidities as follows: DM (36%), hypertension (64%), Takayasu's (12%) and Behcet's diseases (4%). There were combined involvement of other vessels such as the coronary artery (72%), carotid artery (36%), subclavian artery (32%) and the contralateral vertebral artery (24%). Indications for stenting were prior stroke or symptoms related to vertebrobasilar ischemia in 11 patients, and an asymptomatic but angiographically significant stenosis (> 70% stenosis) in 14 patients. Twenty-three balloon-expandable stents and two self-expandable stents were deployed. A drug-eluting coronary stent and distal balloon protection device were each used in one case. A technically successful procedure was achieved in all patients. The baseline reference diameter was 4.7 +/-1.3 mm, minimal luminal diameter (MLD) 1.0 +/-0.6 mm (diameter stenosis 77.8 +/-12.5%) and lesion length 6.4 +/-3.9 mm. After stenting and adjuvant dilation, the MLD was increased to 4.5 +/-0.9 mm (diameter stenosis 3.1 +/-17.9%). There were no procedure-related complications. During the further follow-up period of 25 (3-49) months, no stroke or death occurred. Restenosis was observed in 4 (30.8%) of 13 eligible patients. In conclusion, VA stenting is feasible with a high degree of technical success, and this treatment is associated with a relatively low incidence of procedure-related complications. However, a relative high rate of in-stent restenosis remains as a problem to be resolved.
Adult ; Aged ; Angiography ; *Angioplasty, Balloon ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; *Stents ; Treatment Outcome ; Vertebrobasilar Insufficiency/diagnosis/*therapy