Temporary Opening of the Testis-blood Barrier by Triolein Fat Emulsion / 대한비뇨기과학회지

PURPOSE: Although the purpose of the blood-testis barrier (BTB) is to protect germ cells from harmful influences, it also impedes the delivery of chemotherapeutic agents to the testis. This study was undertaken to determine whether a triolein emulsion could transiently alter the permeability of the BTB in cats. MATERIALS AND METHODS: An emulsion of 0.05ml triolein in 20ml of saline or just 20ml of normal saline, as the control, were infused into the testicular arteries in 18 and 15 cats, respectively (embolic and control group). Pre- and post-contrast magnetic resonance images (MRIs) were obtained 30 minutes and 2 hours after embolization. Qualitative and quantitative analyses of the MRIs were performed via the presence and degree of contrast enhancement and the contrast enhancement ratios (CERs), respectively. An electron microscopy (EM) study was subsequently performed, using a lanthanum tracer, to correlate with the MRI results. RESULTS: Contrast enhancement of the testis was observed in both groups and at both time points, but was more prominent in the embolic group. The CERs in the embolic group were significantly higher than those in the control group (p=0.0001). In each group, the CERs at 2 hours were significantly lower than those at 30 minutes (p=0.006). In the EM study, the entry of lanthanum was markedly increased at 30 mins, but recovered at 2 hours after embolization compared to the control. CONCLUSIONS: Intra-arterial infusion of triolein emulsion transiently increased the permeability of the BTB. This result may be useful in future studies for a chemotherapy delivery system to the testis.

Primary Angiitis of the Central Nervous System in Children

Primary angiitis of the CNS(PACNS), also known as isolated angiitis of the CNS, is an idiopathic vasculitis confined to the CNS and it primarily occurrs to middle aged adults. Neurologic manifestations include headache, focal seizure, and progressive, behavioral or multifocal neurologic impairments. A 20-month-old boy was presented with recurrent right-sided hemiplegia and loss of consciousness. Brain MRI revealed focal T2 hyperintensely enhanced lesions involving left lentiform nucleus and caudate nucleus with no mass effects. Cerebral angiogram disclosed multifocal stenosis in both middle cerebral arteries and left posterior cerebral artery. The child was treated with prednisone alone since he was diagnosed as IACNS. He was asymptomatic with a normal neurologic examination and continued on prednisone therapy. Therefore, it is concluded that children who have frequent or severe headache or focal neurologic deficits should be carefully evaluated and those meeting criteria of IACNS should be treated aggressively.

CT Findings of the Chronic Sinonasal Inflammatory Disease

PURPOSE: Recently, paranasal sinus(PNS) CT has increasingly been used because of the wide applications of a functional endoscopic sinonasal surgery(FESS) as one of the therapeutic modalities of the chronic sinonasal inflammatory disease. MATERIALS AND METHODS: We retrospectively analyzed PNS CT findings in 76 patients with chronic sinonasal inflammatory disease who had undergone the PNS CT from April 1991 to July 1992. RESULTS: There were 5 sinonasal patterns of inflammation ;4 cases of infundibular type(5.3%), 14 cases of ostiomeatal unit(OMU) type(18%), one case of sphenoethmoidal(SER) type(1%), 56 cases of sinonasal polyposis type(74%), and one case of sporadic type(1%). The mucosal abnormality was seen in 74 OMU cases, 71 maxillary sinus cases, 69 ethmoidal sinus cases, 55 frontal sinus cases, 49 SER, and 46 sphenoidal sinus cases. The normal bony variant included ethmoid bulla(25 cases, 335), concha bullosa (20 cases 25%), Hailer cells(10 cases, 13%), paradoxical curvature of middle turbinate (4 cases, 5%), lateral deviation of uncinate process(3 cases, 4%), and deviation of nasal septurn(31 cases, 41%). CONCLUSION: The PNS CT is an excelleht imaging method providing detailed informations about the mucosal abnormality, pathological pattern, the anatomical structure and landmark, and bony variants prior to an operation.

Minocycline Hydrochloride Sclerotherapy of Renal Cysts

PURPOSE: To report the effectiveness of Minocin sclerotherapy in the treatment of renal cysts. MATERIALS AND METHODS: We performed minocin sclerotherapy to 19 patients with 21 renal cysts composed of 17 cases of solitary renal cyst and three cases of multiple renal cyst and one case of polycystic kidney comfirmed by ultrasound and CT. After aspiration of cyst fluid, if the amount was less than 50ml, 500mg of minocin was mixed with 3ml of normal saline,if more than 50ml, 1000mg of minocin mixed with 5ml of normal saline were injected, and each case was followed-up over 3 months by ultrasound. RESULTS: Of all 21 renal cysts, 14 cases were followed-up three months after minocin sclerotherapy. In 12 of 14 cases, the size of the cysts decreased by 10% or collapsed completely. Of the remaining two cases, one collapsed after 6 months while the other recurred after 6months. Three cases were followed up after 20 months and only one of them recurred. 19 of all 21 cases(91%) were cured, and two of 21 cases(9%) were recurred. Pain was the only complaint. and four of 10'cases needed analgesics. CONCLUSION: Sclerotherapy with minocin has low recurrence-rate and low complication, and relatively early high cure-rate.

A comparison of high resolution CT scan of temporal bone and operative findings in middle ear cholesteatoma

To evaluate the value of HRCT imaging in middle ear cholesteatoma, we prospectively analysed the CT images in 28 surgically proven cases with cholesteatomas regarding main site of lesion, ossicular change, facial nerve exposure and fistula formation . The most common main site of lesion was the epitympanum (92.8%). The results of sensitivity, positive predictability, and accuracy by CT imagings were as follows: for ossicular involvement, 94.1%, 88.8%, and 86.2% in malleus, 96.0%, 88.8%, and 85.7% in incus, 81.2%, 81.2%, and 78.5% in stapes; for facial verve exposure, 66.6%, 57.1%, and 81.2%; for fistula formation, 100%, 75.0%, and 96.4%, respectively. In conclusion, the temporal bone HRCT imaging is an accurate preoperative method in detecting main lesion site, ossicular involvement, fistula formation. Because of the low sensitivity and positive predictability in detecting facial nerve exposure, it is necessary to correlate the HRCT images with the clinical status.