Appendicular schwannoma is a rare tumor originating from Schwann's cells in the Auerbach plexus. The preoperative diagnosis is difficult because the clinical features are nonspecific, and it is mostly found accidentally via a radiologic image as a tumor, mimicking malignancy. We report a case of an appendicular schwannoma coexisting with an adenocarcinoma in the lung. A laparoscopic appendectomy was done with a clear resection margin, and the immunohistochemical staining showed positive S-100 protein, which confirmed the schwannoma. The patient also underwent a left upper lobectomy of the lung. The patient has been free of recurrence for the 6 months since the operation. The laparoscopic approach could be available for treatment of an appendicular schwannoma, thus avoiding an unnecessary laparotomy.
Adenocarcinoma ; Appendectomy ; Appendix ; Humans ; Laparoscopy ; Laparotomy ; Lung ; Myenteric Plexus ; Neurilemmoma ; Recurrence ; S100 Proteins

BACKGROUND: The aim of this study was to investigate the prevalence, clinical and laboratory findings of hereditary hemolytic anemia (HHA) in Korea from 1997 to 2006 and to develop the appropriate diagnostic approach for HHA. METHODS: By the use of questionnaires, information on the clinical and laboratory findings ofHHA diagnosed from 1997 to 2006 in Korea was collected and analyzed retrospectively. A total of 431 cases were enrolled in this study from 46 departments of 35 hospitals. RESULTS: The overall frequency of HHA did not change through the 10-year period for pediatrics but did show an increasing tendency for internal medicine. The overall male to female sex ratio did not show sex predominance (1.17:1), but a significant male predominance with a ratio of 1.49:1 was seen for pediatrics while a significant female predominance with a ratio of 1:1.97 was seen forinternal medicine. Of the total cases, 74.2% (282/431) were diagnosed before the age of 15 years. The etiologies of HHA were classified as red cell membrane defects, hemoglobinopathies, red cell enzyme deficiencies and unknown causes. There were 382 cases (88.6%) of red cell membrane defects with 376 cases (87.2%) of hereditary spherocytosis and 6 cases (1.4%) of hereditary elliptocytosis, 20 cases (4.6%) of hemoglobinopathies with 18 cases (4.2%) of beta-thalassemia, a case (0.2%) of alpha-thalassemia and a case (0.2%) of Hemoglobin Madrid, 7 cases (1.6%) of red cell enzyme deficiencies with 5 cases (1.2%) of glucose-6- phosphate dehydrogenase (G-6-PD) deficiency, a case (0.2%) of pyruvate kinase (PK) deficiency and a case (0.2%) of enolase deficiency, and 22 cases (5.1%) of unknown causes. The most common chief complaint in pediatric patients was pallor and that in adult patients was jaundice. In the red cell membrane defect group of patients, the level of hemoglobin was significantly higher than in adult patients. The mean corpuscular volume, mean corpuscular hemoglobin, corrected reticulocyte count, total and indirect bilirubin level and lactate dehydrogenase levels in the hemoglobinopathy group of patients were significantly lower than the values in the red cell membrane defect group of patients. The mean concentration of G-6-PD was 0.8+/-0.7U/1012RBC in the G-6-PD deficient patients, PK was 1.7U/1010 RBC in the PK deficient patient, and the level of enolase was 0.04U/g of Hb in the enolase deficient patient. CONCLUSION: The most prevalent cause of HHA in Korea during 1997 to 2006 was hereditary spherocytosis, but HHA by other causes such as hemoglobinopathy and red cell enzyme deficiency gradually increased with the development of molecular diagnostic methods and increasing general interest. However, the etiologies of HHA need to be pursued further in 5.1% of the patients. An systematic standard diagnostic approach is needed in a nationwide prospective study for correct diagnoses and appropriate management of HHA.
Adult ; alpha-Thalassemia ; Anemia, Hemolytic, Congenital* ; beta-Thalassemia ; Bilirubin ; Cell Membrane ; Diagnosis ; Elliptocytosis, Hereditary ; Erythrocyte Indices ; Female ; Hemoglobinopathies ; Humans ; Internal Medicine ; Jaundice ; Korea* ; L-Lactate Dehydrogenase ; Male ; Oxidoreductases ; Pallor ; Pathology, Molecular ; Pediatrics ; Phosphopyruvate Hydratase ; Prevalence ; Pyruvate Kinase ; Reticulocyte Count ; Retrospective Studies* ; Sex Ratio ; Surveys and Questionnaires

An experiment was made to detect the presence of Trichomonas vaginalis in 120 patients with lower urinary tract infection and 480 male soldiers without any noticeable symptoms. Microscopic examination and cultivation of sediment of centrifuged specimen of urine and of prostatic secretion obtained by prostatic massage was performed. Clinical observation was performed. Clinical observation was also made on 26 cases of Trichomoniasis in the lower urinary tract of males. The results were summarized as follows: 1. T. vaginalis was demonstrated in 7.5% of the lower urinary tract infected group (Group A) and 3.33% of control group (Group B). 2. Motile trichomonads were found in 57.1% through microscopic examination and additionally 42.9% by cultivation. 3. The sites of infection were urethra in 68%, prostate in 40% and bladder and epididymis in 4%. 4. The frequent subjective symptoms were itching sensation in the urethra (16%), perineal discomfort (12%), dysuria (12%) and urethral discharge (8%). 5. Higher level than the normal limit of leukocyte count through microscopic examination was observed in 48% in urine and 24% in prostatic secretion of the patients with Trichomoniasis. 6. Other pathologic bacteriae were demonstrated in 40% in urine and 20% in prostatic secretion by Gram stain. The most frequently mixed bacteriae were Gram positive cocci. 7. Nitrimedazine 250mg was administered orally twice a day for 7 days in 10 cases of Trichomoniasis in the urethra without mixed bacterial infection. The result was effective in 9 cases.
Bacteria ; Bacterial Infections ; Dysuria ; Epididymis ; Gram-Positive Cocci ; Humans ; Leukocyte Count ; Male* ; Massage ; Military Personnel ; Prostate ; Pruritus ; Sensation ; Trichomonas vaginalis ; Urethra ; Urinary Bladder ; Urinary Tract Infections ; Urinary Tract*

The changes in the germinal epithelium of 27 azoospermic patients were studied by light and electron microscope. And a brief clinical observation was also made. The results obtained were as follows, 1) The two thirds of 27 cases were in the age group of 26 to 35. Fifteen cases (55.6%) were in the 2nd to 5th year of their marriages. The tendency of decreasing in tuberculous disease, gonorrhea and mumps was observed in their past history. The average volume of seminal fluid was 2.4ml in amount 2) Light microscopically, spermatogenic arrest was found in 22 cases, and followed by germinal tell aplasia in 3 and hypospermatogenesis in 2. Fifteen of 22 cases of spermatogenic arrest were relatively advanced. Two of 3 cases of germinal cell aplaeia were found in the older age group of 35 to 40, and both of two cases of hypospermatogenesis in the younger age group of 21 to 25. 3) On electron microscopic observation in the hypospermatogenesis, increase in number and mild vacuolar dilatation of endoplasmic reticulum and increase in number of lysosomes in the spermatocytes, and deformities and swelling of acrosomes and vacuolization of nucleoplasm in the spermatocytes, but no significant changes were seen in the spermatogonia and the Sertoli cells. 4) In the spermatogenic arrest, severe degenerative changes such as condensation of chromatin, occurrence of electron dense round bodies, and inapparent cell organells were observed in the spermatocytes. Mild to moderate degenerative changes such as increase in number and dilatation of endoplasmic reticulum, deformities, swelling or atrophy. and decrease in number of cristae of mitochondria were seen in the spermstogonia and the Sertoli cells 5) In the germinal cell aplasia, progressive and degenerative changes such as marked increase in number. vacuolar dilatation, and irregular arrangement of endoplasmic reticulum. marked deformities. swelling, vacuolization, and loss of cristae of mitochondria, and increase in number of lysosomes were noticed.
Acrosome ; Atrophy ; Chromatin ; Congenital Abnormalities ; Dilatation ; Endoplasmic Reticulum ; Epithelium* ; Gonorrhea ; Humans ; Infertility, Male ; Lysosomes ; Male ; Marriage ; Mitochondria ; Mumps ; Oligospermia ; Sertoli Cell-Only Syndrome ; Sertoli Cells ; Spermatocytes ; Spermatogonia

A clinical evaluation of the chemotherapy (INH, PAS and SM) on the 16 patients with renal tuberculosis for the period of 9 months to 4 years was performed. The results obtained were summarized as follows; 1) Of the 16 cases with renal tuberculosis, minimal lesion was found in only one case. moderately advanced in 6, and far advanced in 9. 2) In the case of the minimal lesion, no tubercle bacilli were detected by microscopic examination .after the triple therapy for 3 months. It was suggested that the minimal lesion would require at 1eaet 6 months to be cured by the chemotherapy. 3) Five of the 6 cases with the moderately advanced lesion were cured (83%), and at least 12 months were required for the moderately advanced lesion to be cured. 4) In the 9 cases of the far advanced lesion, only one case was cured, two were on the healing process, three were exacerbated even after the therapy for 6 months, and the remaining three were progressed to those with non-visualizing kidneys 9 to 12 months after the therapy. 5) Five of the 6 exacerbated far advanced lesions were associated with ureteral strictures, and thus the ureteral stricture may be an important factor in determining the prognosis of the renal tuberculosis. For the far advanced lesions progressed to the non-visualizing kidneys in spite of the chemo-therapy, surgical interventions are likely to be more favorable.
Constriction, Pathologic ; Drug Therapy* ; Humans ; Kidney ; Prognosis ; Tuberculosis, Renal* ; Ureter

Vasectomy is one of the accepted simple procedure as a contraceptive method. However, there have been no reliable reports on the rate of sperm disappearance from the ejaculate following vasectomy. Rieser found the 14 of the 21 patients with follow-up semen studies required an average of 8 weeks to be azoospermic, and Freund and Davis described that sperm free semen was noted after 6 to 10 ejaculations following bilateral vasectomy. In order to determine the exact end point in terms of the frequency of ejaculations after vasectomy to be sperm free in the ejaculate, a clinical observation was made on the 50 vasectomized patients for the last 3 years. Bilateral vasectomy was performed through a midline incision in the scrotal raphe under local anesthesia (2% procaine). Each semen specimen was collected by coitus using condom. The results obtained were as follows; l) The fourth decade was the most prevalent age group to have had vasectomy(44 cases). The mean number of children was 3. 3 (male 2.2, female 1.1). The 25 patients (38.5%) had two sons and a daughter, and there were no patients without a son. 2) The postoperative first specimen was obtained in all of the 50 cases, the second in 35, the third in 27. the fourth in 20, the fifth in 15, the sixth in 10, the seventh in 3, and the eighth in only one. 3) The meat volume of the semen was not varied with the frequency of ejaculations. The average number of the spermatozoa on the first ejaculate following vasectomy was 43 millions, 23 millions on the second, 16 millions on the third, and 2 millions on the fourth. 4) On the rate of sperm free in the ejaculates in terms of the number of the ejaculations, 7.4 per cent became azoospermic on the third, 20 per cent on the fourth, 33 per cent on the fifth, 60 per cent on the sixth, and 67 per cent on the seventh ejaculation.
Anesthesia, Local ; Child ; Coitus ; Condoms ; Contraception ; Ejaculation ; Female ; Follow-Up Studies ; Humans ; Male ; Meat ; Nuclear Family ; Semen ; Spermatozoa* ; Vasectomy*

The Klinefelter's syndrome is characterized by azoospermia, gynecomastia, a variable degree of eunuchoidism elevated urinary gonadotropins, atrophic testis and hyalinization of the seminiferous tubules in which Leydig cells were preserved. Reviewing some world literatures, we have reported a case of Klinefelter's syndrome associated with right inguinal hernia in 22 year-old Korean male.
Azoospermia ; Eunuchism ; Gonadotropins ; Gynecomastia ; Hernia, Inguinal ; Humans ; Hyalin ; Klinefelter Syndrome* ; Leydig Cells ; Male ; Seminiferous Tubules ; Testis ; Young Adult

In order to study the change in bacterial population, the effect of immunity on bacteriuria, and the antibody response in urinary tract infections. Escherichia coli 06(06) was inoculated in bladder and kidney of rabbits non-immunized and immunized with 0 antigen of 06 and enterobacterial common. antigen(CA) of Kunin derived from culture supernatant of Salmonella typhimurium. The results obtained are as follow: 1. Rabbits immunized with O6 antigen and CA showed high antibody titers in sera, and tires were usually higher in rabbits immunized with 06 antigen than those with CA. 2. Bacterial counts reached highest number at the first day of observation in urine of rabbits inoculated in bladder, and after 3 days in rabbits inoculated in kidney. Numbers of bacteria decreased gradually after the highest: peak of bacterial counts, but still remained at considerable numbers after 13~l6 days of inoculation. There were no significant differences in bacterial counts between immunized and non-immunized rabbits. 3. Among non-immunized rabbits, antibody titer began to rise from 4th to 7th days of inoculation in bladder, and from 4th day of inoculation :in kidney. Titers were very low in groups inoculated in bladder, and significantly high in rabbits inoculated in kidney. Antibody titers were usually high when large size of inoculum was used 4. Antibody titers decreased ;gradually and slightly when 06- or CA-immunized rabbits were inoculated with 06. 5. Rabbits inoculated 06 into kidney showed considerable increase in antibody titers from 4 to l0days after inoculation in CA. immunized rabbits, while gradual decrease from the beginning of inoculation in those inoculated in bladder. 6. There were no significant changes other than chronic inflammation in kidneys of rabbits inoculated with 06 in kidney of immunized and non-immunized rabbits when observed after about two weeks of inoculation, No significant difference by the size of inoculum was also observed.
Antibody Formation ; Bacteria ; Bacterial Load ; Bacteriuria ; Escherichia coli ; Inflammation ; Kidney ; Rabbits ; Salmonella typhimurium ; Urinary Bladder ; Urinary Tract Infections* ; Urinary Tract*

The mongrel dogs, anesthetized with pentobarbital sodium, were used as experimental animals. The effects of a single intravenous injection of ethyl adrianol. 0.5 mg per kg of body weight, on cardiovascular response and urinary flow were compared with those of epinephrine, 0.05 mg per kg of body weight and norepinephrine, 0.05 mg per kg of body weight. 1) The pressor effect induced with 0.5 mg of ethyl adrianol per kg of body weight was similar to that with equipressor doses, 0.05 mg, kg of epinephrine or norepinephrine. 2) The duration of the pressor action of ethyladrianol lasted at least one hour but only about 15minutes with equipressor dose of epinephrine or norepinephrine. 3) Ethyladrienol was responsible for the increase of the urinary volume, which phenomenon is assumed to be related of the renal-function and the durability of the reaction. 4) Ethyladrianol is considered to be one of the ideal drugs for the treatment of hypotensive shock.
Animals ; Body Weight ; Dogs* ; Epinephrine ; Etilefrine* ; Injections, Intravenous ; Norepinephrine ; Pentobarbital ; Shock

In order to grasp the real status of male sterility of the Koreans, clinical observation, semen analysis, and testicular biopsy were conducted on 257 cases. the study was performed in the Department of Urology, Kyungpook National University School of Medicine during the period from April 1963 to March 1968 for5 years. 1) The 257 cases complained of sterility occupied 4.3% of the total number of outpatients, 5927. visited during the observation period. 2) The age range of the cases applied was from 55, maximum, to 21. minimum, with the category of 26 to 35 occupying 2/3 of the whole. 3) The majority of the cases were in the 2nd to 5th year of their marriages 10.8%. 4) Cities were found to produce more of such cases than the country. and no specific relationship was revealed to be connected with patient's occupations. 5) Tuberculous diseases weremore prevalent in the past histories of those involved, and gonorrhea and mumps showed a decreasing tendency. 6) 141 cases (55.2%) produced 2 to 4ml of semen amount and 40 cases, less than 1.0ml. 7) 90 cases (35.O%) were found have azoospermia and 122 cases (47.7%) had more than 50 X 10(6) sperms, 8) 106 cases (63.5%) had higher than 60% of active sperm while 16 cases showed to have less than 20%. 9) Findings of testicular biopsies were conducted on 35 cases with azoospermia of oligospermia: Germinal cell aplasia-17 cases (48.6%); spermatogenic arrest-10 cases (28.6%); hypospermatogenesis-6 cases (17.1%); normal-2 cases.
Azoospermia ; Biopsy ; Gonorrhea ; Gyeongsangbuk-do ; Hand Strength ; Humans ; Infertility ; Infertility, Male* ; Male ; Male* ; Marriage ; Mumps ; Occupations ; Oligospermia ; Outpatients ; Semen ; Semen Analysis ; Spermatozoa ; Urology