The Effects of Radiofrequency Energy on Human Articular Cartilage: The Effect of Power Setting and Mode of Treatment on Chondrocyte Viability / 대한정형외과학회잡지

PURPOSE: The objective of this study was to investigate the effects of radiofrequency energy on human chondrocyte viability, and to correlate confocal laser microscopy fluorescence to sulfate uptake and to the histological integrity of articular cartilage. MATERIALS AND METHODS: The chondroplasty procedure for chondromalacic articular cartilage was performed using a 3.0-mm ArthroWand (Arthroscopic Electrosurgery System, ArthroCare Corporation) on fresh human articular cartilage. Radiofrequency energy was applied to the cartilage surface through the probe at a velocity of 10-mm per second in contact and non-contact mode. Three power settings were used. The treated cartilage was analyzed for chondrocyte viability by confocal laser microscopy and (35)S uptake. RESULTS: Confocal laser microscopy demonstrated partial-thickness chondrocyte death irrespective of treatment method. No mode of treatment or radiofrequency energy power setting resulted in full-thickness chondrocyte death. The depth of cartilage ablation was increased in the treated areas in contact mode in proportion to the power level and the time of treatment. No statistically significant difference in radiolabeled sulfate uptake of the specimens was observed with respect to the treatment modes and power settings. CONCLUSION: The extent of chondrocyte death by radiofrequency energy was not as significant as reported previously when the probe was moved at the speed of 10 mm/sec. Radiofrequency energy may be useful to treat chondromalacic cartilage in a contact mode using a proper energy level and delivery time.

The Significance of the Femoral Tunnel Position in PCL Reconstruction Using the Bone-Patellar tendon - Bone Graft

PURPOSE: We compared the clinical and radiological RESULTS of two patient-groups who had had PCL reconstruction for grade III PCL injury using the autogenous bone-patellar tendon-bone graft at the isometric point and at the anatomical point of femoral condyle. MATERIALS AND METHODS: Of 31 patients who were involved in this study, 20 patients had consecutive isometric PCL reconstructions between June 1993 and May 1995(group 1), And 11 patients had anatomi- cal PCL reconstructions between 1995 and 1997(group 2). We evaluated the clinical results using the Lysholm knee scoring system and measured the posterior translation of the tibial condyle on the posterior stress lateral radiographs. RESULT: The average posterior translation at the final follow-up was 7mm in group 1 and 5.9mm in group 2. The Lysholm knee score was 89 points in group 1, and 92 point in group 2. However, there wasn't any statistically significant difference in clinieal and radiological results between the two groups. SUMMARY: The clinical and radiological results can be influenced by several factors inherent to arthro-scopically assisted PCL reconstruction. Although it seems that initial knee kinematics can be improved by more distal PCL graft placement, there may be little effect to the final clinical and radiological results according to the femoral tunnel positions.

Surfactant replacement therapy in neonates with respiratory distress syndrome: A collective evaluation of trials from 16 hospitals

Surfactant replacement therapy in neonates with respiratory distress syndrome (RDS) has been introduced in our country since May 1990. The purpose of this study was to assess the effect and short-term outcome of surfactant replacement for neonatal RDS using collective data of uncontrolled trials from different hospitals in Korea. For the period May 1990 to Dec. 1991, a total of 68 RDS neonates were treated with a reconstituted bovine surfactant (Surfactant-TA) at 17 hospitals. Data on 60 neonates were collected from 16 hospitals and were analyzed in this study. In order to examine the factors that might influence the mortality, we performed a stepwise discriminant analysis. RDS was diagnosed according to accepted clinical and radiographic criteria at each hospital. The mean gestational age of 60 neonates was 31+/-3 weeks (1 SD, range, 24~40 wk) and the mean birth weight was 1549+/-566 grams (range, 590~3300 gm). Surfactant treatment resulted in a significant improvement in ventilatory requirement during the subsequent clinical course. However, there were large variations in the instillation procedure (single vs repeated instillations), dose of surfactant, and respirator settings after surfactant treatment. The neonatal mortality was 40% in this group. When the effect of surfactant treatment was compared between survival and death group, the magnitude of improvement was significantly less in death group than that in survival group. Factors affecting the neonatal mortality include a poor response to surfactant, sepsis and/or DIC, decreasing gestational age and weight, acidosis before treatment and air-leaks. We conclude that treatment with Surfactant-TA has an impact on the clinical course of RDS. To optimize the effects of surfactant therapy, the following refinement will be needed: better initial stabilization with respect to blood pressure, blood gases and pH, instillation techniquse including pre-and post-surfactant ventilation, weaning guidelines, dose, dose schedule, as well as timing of treatment, management of infection, and prevention of severe birth asphyxia.

A Case of Malignant Melanoma of the Iris

A case of 68 years old(Korean) male patient who has had a malignant melanoma of the iris in his left eye with sudden decreased visual acuity of duration of one month is reported. The left eye was enucleated and prepared for histopathological examination, Histopathological examination revealed a malignant melanoma, amelanotic epithelioid type, without extraocular metastasis, involving the iris of "Left eye".

An Effect of Anti-Testicular Rabbit Serum on Rat Testis / 대한비뇨기과학회지

Evidence of the antigenicity of testis and semen was first presented at the end of the last century. Landsteiner (1899), Metchnikoff (1900), and Metalnikoff (1900) demonstrated the induction of a spermotoxic antibody in animals sensitized with testicular homogenate or semen; this antibody was capable of immobilizing sperm cells. The earliest manifestation of homologous type of antisperm sensitization (Kennedy, 1924) was the immobilization of spermatozoa, and in some cases atrophy of germinal epithelium, following repeated injection of testicular homogenate or epidydimal sperm. Ryoo and Kim (1982) reported that spermatogenesis was adversely affected with degeneration and sloughing of germinal cells of the seminiferous tubules in the mice which were immunized with testis homogenate plus complete Freund's adjuvant. The purpose of this study was to observe the effect of antitesticular rabbit serum produced against rat testis on spermatogenesis in rat. The results were as follows: 1.Theseminiferous tubules showed mild to moderate impairment of spermatogenesis such as degeneration and exfoliation of germinal epithelium in all experimental groups. Intraluminal spermatozoa of seminiferous tubules were decreased in number. Interspaces of seminiferous tubules were wider than normal and were infiltrated with mononuclear cells with some hemorrhage. 2. Intraluminal spermatozoa of the epididymides were markedly decreased in number but immature sperm cells were observed much more often than in normal control group.

The Effect of Antiepididymal Rabbit Serum on Rat Epididymis / 대한비뇨기과학회지

Evidence of antigenicity of testis and semen has been presented since Landsteiner (1899), Metchinikoff (1900) and Metalnikoff (1900) first demonstrated the induction of a spermatoxic antibody in animals sensitized with testicular homogenates or semen. Interest in the field of male accessory sex gland began longtime ago, when the first cross-reaction between extracts of prostate, seminal plasma were demonstrated. Saline extracts of prostatic secretion from bulls, tested by double agar diffusion technique showed four antigens common to serum proteins and spermatozoa. The seminal vesicle have been found to have three to five antigens, also with common reactivity to spermatozoa. Attempts have been made to induce cross-immunologic damage in the testes by repeated immunization of mice with epididymal extracts (free of sperm) plus adjuvant and it was claimed that spermatogenesis was adversely effected and fertility of females was markedify reduced following mating with immunized male (Shethye and Rao, 1968; Kim and Kim, 1982). Rabit antiserum produced against the tissue protein of rat epididymis and seminal vesicle was capable of immobilizing and agfflutinating the sperm of both animals and the rabbit antiserum against complex antigen of epididymal tissue protein and seminal vesicle tissue protein of rat was most potent on sperm immobilization and agglutination of both animals (Cha and Kim, 1975). The purpose of this study is to observe the effect of rabbit anti-rat epididymal serum on epididymis and spermatogenesis in rat. The results were as follow; 1. The intraluminalspermatozoa of epididymis were decreased in number but immature sperm cells were much more noted than normal control group. The interspaces of epididymal ducts were widened and infiltrated with mononuclear cells and congestion in some places. There was no definite degenerative changes on epididymal epithelium. 2. Spermatogenesis was mildly to moderately impaired in the experimental group whereasit was unaffected in the control group. Degeneration and exfoliation were found in the germinal cells of seminiferous tubules. Intraluminal Spermatozoa of seminiferous tubules were decreased in number.

New Aspects of Renal Tuberculosis / 대한비뇨기과학회지

In urinary tuberculosis, during recent years, there has been remarkable progress in treatment new aspects have been reported, which raise problems in diagnosis. There is an increase of silent forms, forms with rapid destructive development even under treatment and forms masked by association with other disease. We made a clinical study on 9 cases of renal tuberculosis which showed atypical symptoms, radiologic findings, cystoscopic findings and laboratory findings.

New Aspects of Renal Tuberculosis / 대한비뇨기과학회지

In urinary tuberculosis, during recent years, there has been remarkable progress in treatment new aspects have been reported, which raise problems in diagnosis. There is an increase of silent forms, forms with rapid destructive development even under treatment and forms masked by association with other disease. We made a clinical study on 9 cases of renal tuberculosis which showed atypical symptoms, radiologic findings, cystoscopic findings and laboratory findings.

A Clinical Observation on 8 cases with Primary Non-Transitional Cell Carcinoma of Bladder / 대한비뇨기과학회지

Eight patients with primary non-transitional cell carcinoma of the bladder during the period from January 1978 to December 1982 were reviewed, and following results ware obtained. 1. Primary non-transitional bladder carcinomas were 8 cases (11%) of 52 bladder carcinomas. 2. The age distribution was from 28 years to 72 years. Male to female ratio was 5 to 3. 3. Hematuria was presented in all cases, dysuria in 2 cases, frequency in 2 cases, lower abdominal pain in 2 cases. 4. Histopathological findings showed squamous cell carcinoma in 3 cases, adenocarcinoma in 3 cases, undifferentiated carcinoma in 1 cases, carcinosarcoma in 1 cases. According to 2Iewett classification, the degree of invasion was stage C in 5 cases, stage B2 in 1 case, stage B1 in 1 case and stage A in 1 case. 5. Five cases arised on lateral wall, 3 cases on dome, 1 case on posterior wall and 1 case on trigone. Four cases were nodular in type. 2 cases were papillary and 2 cases were smooth surface round pedunculated mass. Five cases were single and 3 cases were multiple. 6. 1) In stage C of adenocarcinoma, partial cystectomy was made in 1 case, radical cystectomy with ureteroileocutaneostomy in 1 case, partial cystectomy with postoperative irradiation in 1 case. In former two case, tumor metastasized to periaortic lymphnodes and lumber vertebrae after 6 months post-operatively. 2) Partial cystectomy was performed in 1 case of carcinosarcoma in stage A, tumor recurrence or metastasis did not occur after 1 year post-operatively. 3) In 2 cases of squamous cell carcinoma of stage C, preoperative irradiation with total cystectomy and ureterocutaneostomy was made in 1 case, total cystectomy with ureterocutaneostomy in 1 case and partial cystectomy with 5-FU instillation into the bladder was performed in 1 case of stage B2. In all cases, we couldn't follow up post-operatively. 4) In stage B1 of undifferentiated carcinoma, radical cystectomy with ureteroileocutaneostomy was performed. This case also couldn't be followed up.

Effect of the Vasectomy on the Fine Structure of the Sperm-Acrosome in Rats / 대한비뇨기과학회지

Vasectomy has been increased as a popular method of birth control because it is simpler than other methods for men. But the vasectomy results in several problems such as relation to effect changes on the structure and function of the reproductive organ. The fate of non-ejaculated spermatozoa is postulated by some authors that those are disappeared by a progress of dissolution and reabsorption in the epididymis, and we have attempted to prove the true state of sperm-acrosome on the fine structure in vasectomized rats. The results were as follows: 1. Apical segments of the acrosome were swollen similar to the shape of club in many spermatozoa. 2. Discontinuities of the outer and inner acrosomal membranes were occasionally noted and there were complete losses of acrosomes in the certain places. 3. There was no evidence of significant changes in the nuclear structure, nor dilatation of the subacrosomal space. 4. Vasectomy might effect destructive changes in the acrosomes of the non-ejaculated spermatozoa in situ.

A Histopathological Observation on 48 cases of Benign Prostatic Hypertrophy / 대한비뇨기과학회지

The histopathological observation was made on 48 cases of benign prostatic hypertrophy which had been admitted to the Department of Urology, Chung-Ang University Hospital from January, 1971 to December, 1981. The results were as follows: 1. Histopathologically the fibromyoadenomatous type was 22 cases (45.8%) and the fibroadenomatous type 17 cases (35.4%), the fibromuscular type 9 cases (16.7%), muscular type 1 case (2.1%). There was no special difference between each histopathological type in age distribution. 2. Mean size of removed prostatic tissue was 81.1cm3 in fibroadenomatous type, 71.8cm3 in fibromyoadenomatous type, 25.0cm3 in muscular type, 20.0cm3 in fibromuscular type. The type of which weight was more than 50 gm was fibromyoadenomatous type. 3. Additional lesion such as inflammation, infarction or cancer was notedin I6 cases (31.9%). Inflammatory Change were present in 4 cases of fibromyoadenomatous hyperplasia and in 3 cases of fibroadenomatous hyperplasia. Infarction was seen in 2 cases of fibromyoadenomatous hyperplasia and in 1 case of fibromuscular hyperplasia. Latent cancer was found in 2 cases of fibromyoadenomatous hyperplasia and in 2 cases of fibroadenomatous hyperplasia. Inflammatory changes and latent cancer were present only in adenomatous hyperplasia and infarction in fibromuscular hyperplasia.

Effect of the Vasectomy and Seminal Vesiculectomy on the Fine Structure of the Sperm-Acrosome / 대한비뇨기과학회지

It is generally conceded that vasectomy is one of the most reliable methods of birth control because the technique is relatively simple, and the complete obstruction of the pathway for spermatozoa. However, a lot of unexpected effects were found after vasectomy. The possibility that it may effect changes in the function and structure of the testis and epididymis, as it were the formation of the sperm granuloma and antisperm antibody has been an important consideration in the controversy. The fate of non-ejaculated spermatozoa is postulated by some authors that those are disappeared by a progress of dissolution and reabsorption in the epididymis, or by formation of the sperm granuloma. According to Choi and Kim`s report about the effects of the seminal vesiculectomy on the structure and function of the testis and epididymis in rats. The distribution ratio of the sperm granuloma formation was higher in group of vasectomy and seminal vesiculectomy than that of vasectomy only, which indicated that the seminal vesicle produces a certain substance which enhance the sperm to be dissolved and reabsorbed in the epididymis. Therefore, we have attempted to prove the true state of sperm-acrosome on the fine structure after vasectomy and seminal vesiculectomy. The results were as follows: 1. The acrosomal membrane appeared quite intact on the electron microscopic study. 2. The architecture of the nucleus remained unchanged. 3. There was no evidence of nuclear membrane discontinuities, nor widening of the subacrosomal space. 4. Seminal vesicle seems to have some destructive activity on the sperm-acrosome after vasectomy.

The Effect of Homologous Epididymal Extracts on Spermatogenesis in Mouse / 대한비뇨기과학회지

A number of tissues have been studied in the past with respect to their organ-specific antigens. In many instances it has been possible to produce autoantibodies against characteristic components. The testis, epididymis, and seminal plasma have been largely explored from this angle. Interest in the field of accessory glands began many years ago, when the first cross-reactions between extracts of prostate, seminal vesicles and seminal plasma were demonstrated. As a consequence, the possibility that some seminal plasma antigens might be present in the accessory glands before being secreted into the genital tract opened up a new approach to possible autoimmunologic damage of these glands and of seminal spermatozoa as well. The purpose of this study is made to observe the effect of homologous epididymal extracts on the spermatogenesis in mouse. Isoimmunization with extracts of mouse epididymis, administered with complete Freund`s adjuvant, has been performed in this study.The results were as follows: 1. The histological observations revealed that spermatogenesis was adversely affected by the immunization with homologous epididymal extract added with an equal amount of complete Freund's adjuvant for 6 weeks. It was observed that spermatogenesis was remarkably impaired in the experimental group whereas it was unaffected in the control group of male mouse. The results further indicated that the degeneration and exfoliation were found in the germinal cell of seminiferous tubules and in the epithelium of the epididymal ducts besides intercanalicular infiltration of m0nonuclear round cells. 2. The cross-reactions between extracts of epididymis and testicular tissues were demonstrated in mouse. 3. The immunological examination such as immune diffusion test and sperm agglutination test showed negative reaction on all of the experimental animals in this study. Therefore. the immunological change in this experiments seems to be caused by cell mediated immunity.

The Effect of Vasectomy on the Absorptive Function of the Cauda Epididymis in Rats / 대한비뇨기과학회지

It has been shown that spermatogenesis continues after vasectomy, but the fate of sperms which seem to be continuously produced is still uncertain. Some authors postulated that non-ejaculated spermatozoa after vasectomy disappear by a progress of dissolution and reabsorption in the epididymis. According to Ryoo and Kim's observation of sperm-acrosome by electron microscope after vasectomy in rats, vasectomy might effect destructive changes in the acrosome of the non-ejaculated spermatozoa. Choi and Kim reported that the seminal vesicle might produce a certain substance which enhance the spermatozoa to be dissolved and reabsorbed in the epididymis after vasectomy. To observe the effects of vasectomy on the absorptive function of the epididymis in vasectomized rats, we measured the time for the disappearance of 0.01cc indigo carmine which was injected into the cauda epididymis. The results are as follows: 1. The mean absorptive time in the normal group was 371+/-75.7 min. 2. The mean absorptive time in the vasectomized group was 257.4+/-28.6 min. 3. The absorptive activity in the epididymis of vasectomized rats was significantly more rapid than in the epididymis of the normal rats.

The Effect of Homologous Testicular Tissue Protein on Spermatogenesis of Mouse / 대한비뇨기과학회지

It has become increasingly evident within the last few decades that immunologic factors are involved in some aspects of the reproductive process and hence in the physiology and pathology of genital tract. Clear-cut demonstration of the antigenic power of the spermatozoa or of whole semen in heterogeneous inoculation was first presented toward the end of last century. Around 1952, real progress widening the conception of spermatogenesis was made when a selective destruction of germinal cell! was obtained in guinea pig by auto- or homologous sensitization with a single dose of homogenate prepared from testicular tissue to which Freund`s complete adjuvant was added. The testis lesions were accompanied by development of humoral antibodies and cellular immunity. The purpose of this study is to observe the effect of homologous sensitization with homogenated testicular tissue on the spermatogenesis and immune response in mice, dividing into three groups; the first group is to give a complex of testicular extracts and Freund`s complete adjuvant (10 mice), the second group is to give a Freund's complete adjuvant alone (5 mice), the third group is normal control group (5 mice). The results were as follows: 1. The histopathologic observations revealed that spermatogenesis was more or less adversely affected exception case in group I whereas it unaffected in group II and III. The impairment of spermatogenesis was, diminished number of spermatozoa, degenerated and exfoliated germinal cells in seminiferous tubules and epididymides. 2. Diffusion test and sperm agglutination test for antibody were negative in group I as well as group II and III, which suggested that the histopathologic changes might be caused by cell mediated immune response rather than humoral antibody.

Effects of Seminal Vesiculectomy on Structure and Function of Testes and Epididymides in Vasectomized Rats / 대한비뇨기과학회지

Vasectomy has become increasingly popular as a method of male fertility control in humans because it is simpler than other methods for a woman. In spite of numerous studies on the effects of vasectomy on reproductive organs and their functions over varying periods of time, a lot of problems remained such as histological and functional changes of the reproductive organs. Recently the vasovasostomy has been developed under the requiring of succeeding an offspring or other problems, but it has not proved to be consistently i reliable in reversing previously performed vasectomies. Results in most of the investigations indicate that sperm is present in the ejaculate of 95 per cent of the operated cases. However, pregnancy occurs in only 40 per cent of the partners. It also has been demonstrated that antisperm antibodies occur in the serum of approximately half of the patients who have undergone vasectomy, and the immunologic consequences of vasectomy have been investigated extensively in a variety of laboratory animals and in man, but opinions vary as to whether such antibodies may be responsible for infertility after vasectomy. A second, also less information about phenomenon is formation of antisperm antibodies. Some have postulated that sperm granuloma formation is a mechanism for sensitization of the host to his own sperm, but other have concluded that sperm granuloma formation does not necessarily result in humoral sperm autosensitization. In an attempt to observe the effects of seminal vesiculectomy on structure and function of the testes and epididymides in vasectomized rats, this study was performed. The results as follows: 1. Spermatogenesis in the testicular tissue seems to be much inhibited in vasectomized rats after seminal vesiculectomy. 2. Absorptive activity of the rat epididymides may be accounted to be decreased after seminal vesiculectomy. 3. Sperm granuloma occurred around the epididymides of 90 per cent in the vasectomized rat after seminal vesiculectomy: Large one was measured by 2.5 x 1.5cm., but 50 per cent in the vasectomized rat with large one measured by 1.5 x 0.6cm. in size.

One Case of the Prader-Willi Syndrome / 대한비뇨기과학회지

Prader-Willi syndrome is characterized by such as infantile hypotonia, mental retardation hyperphagia with obesity and hypogonadism. We experienced one case of so called Prader-Willi syndrome associated with hypogonadotrophic hypogonadism, hypomentia, hyperphagia with obesity and cryptochism. Testicular biopsy revealed predominant Sertoli cells, decreased spermatogonia and edematous stromal tissue.

Comparative Examination on Bladder Washings and Urine for the Diagnosis of Bladder Cancer in Cytology / 대한비뇨기과학회지

For making a diagnosis of bladder Ca. the comparative study was performed on 12 cases with bladder washings and urine in cytology by the routine papanicolaou stins, and all of those were con firmed by cystoscopic examination. Results are as follows: 1. Bladder washing Cytology showed better results than urine cytology in 8 of 12 patients. 2. Of those cases, the significant cases were 83% on bladder washing cytology and 25% on urine of bladder cancer. 3. Neoplastic cells were found in 10 cases of the bladder washings, instead of 4 cases of bladder urine.

Comparative Examination on Bladder Washings and Urine for the Diagnosis of Bladder Cancer in Cytology / 대한비뇨기과학회지

For making a diagnosis of bladder Ca. the comparative study was performed on 12 cases with bladder washings and urine in cytology by the routine papanicolaou stins, and all of those were con firmed by cystoscopic examination. Results are as follows: 1. Bladder washing Cytology showed better results than urine cytology in 8 of 12 patients. 2. Of those cases, the significant cases were 83% on bladder washing cytology and 25% on urine of bladder cancer. 3. Neoplastic cells were found in 10 cases of the bladder washings, instead of 4 cases of bladder urine.

Epidemiologic Study on Urolithiasis in Korea / 대한비뇨기과학회지

A clinical and epidemiologic study was performed on urolithiasis in Korea. The subjected cases are all of the patients whom visited to Department of Urology, College of Medicine, Chung Ang University Hospital for 3 years. The emphasis of this study laid on regional distribution of urolithiasis or climate and attitude of working activity, so on. The following results were obtained: 1. The urolithiasis were found to be 216 cases (4.0%) in the all of the out-patients(5382 cases) for 3 years(1976-1979) 2. Age distribution was between 6 and 82 years old, shows the highest incidence in 2l to 50 years old(81.9%). 3. In 216 cases of out-patients, 159 cases were male and 57 cases in female with ratio of 2.8:1. 4. Specific location of the stones showed 75% in ureter, 18.5% in kidney, 5.5% in bladder, and other are 2 cases of urethra and prostatic stone. 5. The ureteral stone was located most frequently in the lower 1/3 of the ureter with 69.5% all ureteral stones. 6. The seasonal distribution of urolithiasis in Korea was found 33.8% in the summer season which is around July. 7. Urinary calculi in this study were much more likely to found individuals who have sedentary occupation of 30.5% of all cases 8. The highest incidence of urolithiasis in Korea indicated the province of Jeon Buk (14.3%), next place is the province of Kyung Buk and Kyung Hee, like this order.