• Archives of Plastic Surgery
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• v.49 no.3
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• pp.453-456
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• 2022

When the scrotal sac is entirely debrided following a Fournier gangrene, testes exposure poses unique challenges for the reconstructive surgeon. Despite the anterolateral thigh (ALT) flap is considered a workhorse in such context, aesthetic results are often suboptimal because of the lack of natural ptosis and patchwork appearance. We describe the use of a super-thin pedicled ALT flap for total scrotal reconstruction, modified according to a peculiar flap design and inset technique. A 42-year-old man was referred to our department for delayed total scrotal reconstruction 8 months after a Fournier gangrene extensive debridement. A super-thin pedicled ALT flap from the right thigh was designed: in the central portion of the ALT, a lateral skin paddle extension was marked to guarantee adequate posterior anchorage during insetting and ptosis of the scrotal sac. This particular flap arrangement has inspired the name "sombrero" as the shape is akin to the famous hat. No secondary refinements were needed, and the patient showed satisfying aesthetic and functional results at 12 months' follow-up. The ALT flap design "sombrero" modification proposed in this article can improve scrotum cosmesis and patient satisfaction in a single-stage single-flap procedure.

• Journal of Genetic Medicine
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• v.19 no.2
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• pp.115-119
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• 2022

The 46,XX testicular disorder of sex development (DSD) is a rare condition in which 46,XX individuals develop testicular differentiation and virilization. Translocation of the sex-determining region Y (SRY) onto the X chromosome is the main cause of 46,XX testicular DSD, whereas dysregulation between pro-testis and pro-ovarian genes can induce SRY-negative 46,XX testicular DSD. Nuclear receptor subfamily 5 group A member 1 (NR5A1), a nuclear receptor transcription factor, plays an essential role in gonadal development in XY and XX embryos. Herein, we report the first Korean case of SRY-negative 46,XX testicular DSD with a heterozygous NR5A1 p.Arg92Trp variant. The patient presented with a small penis, bifid scrotum, and bilateral undescended testes. Whole exome sequencing revealed a heterozygous missense variant (c.274C>T) of NR5A1. Our case highlights that NR5A1 gene variants need to be considered important causative factors of SRY-negative non-syndromic 46,XX testicular DSD.

• Clinical Pain
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• v.18 no.1
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• pp.36-39
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• 2019

Chronic postoperative inguinal pain (CPIP) is a major complication after inguinal herniorrhaphy. We report the treatment of CPIP using ultrasonography-combined with nerve stimulator for injection of the genitofemoral nerve (GFN). A 59-year-old man underwent laparoscopic herniorrhaphy and presented with numbness from the inguinal region to the scrotum after operation. In the pain clinic, ultrasonography-guided GFN block and pharmacological treatments had little effect. Six month after operation, patient was referred to the Department of Physical Medicine and Rehabilitation, and ultrasonography-combined with nerve stimulator for GFN injection underwent to enhance the accuracy of neural approach. The induction of scrotal contraction and paresthesia on the GFN distribution was monitored by nerve stimulator and local anesthetic was injected. After the block, pain relief lasted for 6 months without analgesic use. Ultrasonography-combined with nerve stimulator is an effective approach to treat CPIP as it enhances precise localization and injection of small peripheral nerve like GFN.

• Clinical and Experimental Reproductive Medicine
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• v.2 no.1
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• pp.19-38
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• 1975

A total of 185 vasovasostomies were carried out for 11 years. Various factors which are of importance in fluencing the successful vasovasostomies are analysed and presented as follows: In recent years, demand of reanastomosis of the vas deferens increased considerably. An average age of the subjects is 39, and that of their wives, 33 in this series. An average interval between vasectomy and vasovasostomy is 4 years. An average number of living chidren is 2.6 at the time of vasectomy. and 2.1 at the time of time of vasovasostomy. Merchant and public official are the most commonly encounterd occupation in the present series. Coital frequencies are 2.2/week after vasovasostomy. The most common reasons for requesting the vasovasostomy are remarriage and deaths of children, especially son. Success rate is considerably higher among younger group than that of the older. Success rate is somewhat higher among groups of shorter interval between the operations (vasectomy and vasovasostomy) than that of longer interval group. Success rate is higher among bilateral vasovasostomy group than that of any others. Success rate is higher in solid splint group and no splint group than hollow splint group. The closed dressing technique of the end of splint on the scrotum is found to be reasonably effective in preventing infection. Ordinary end-to-end anastomosis and folded side-to-side anastomosis techniques are proved to be the most ideal form of modified operation for the successful vasovasostomies. The most common causes of failure are infection, injuries of blood supply, avascular necrosis due to extensive mobilization, inadequate approximation of both vasal end, hematoma, changes of epididymal environment, and early ambulation in this series. Overall success rate of the author's series is found the 81 per cent, and impregnation rate is 35 per cent. Overall results reported by other workers are that success rate regarding appearance of sperm in the semen after operation is 64 per cent, and that of impregnation after vasovasostomy is 33 per cent. The results of semen assessment performed on same cases prior to vasectomy and following vasovasostomy showed that post-vasovasostomy sperm count scarcely reached three-quaters of pre-vasectomy count.

• Journal of the Korea Fashion and Costume Design Association
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• v.18 no.1
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• pp.169-181
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• 2016

This study analyzed the characteristics and patterns of men's drawers panties to get basic data for their design. For this, drawers panties in 7 different brands (4: domestic brands, 3: imported brands) in terms of a front-center shape were collected, and the shape of men's drawers panties, characteristics of the materials, dimensions & type of patterns by the part and front-center patterns were analyzed. The study results found the followings: First, in terms of the shape of men's drawers panties, the front-center part were designed to rest the penis and scrotum in a natural and comfortable manner without a pee slit. They were seamless on the sides except for one product with side seams. Second, the drawer panties were made of elastic polyurethane materials. Specifically, domestic brand items used warm, elastic and durable nylon, polyester and rayon and polyurethanes while imported brands were mostly made of absorbent and sanitary polyurethanes. Third, regarding a size of drawer panties by part, imported brands were large in waist circumference. In terms of waist breadth at the front center, there was difference depending on an oval type. In addition, the front length at the front center differed by product, revealing difference in three-dimensional effect at the front center. The side length also differed greatly by product, which means that there might be a great difference in wear comfort. Fourth, in terms of the patterns of men's drawers panties, there was difference in side seams, center back seam and front-center patterns. Among a total of 7 products, only one product had side seams, and center back seams were found in two products only. Fifth, in terms of front-center patterns, the drawer panties can be divided into three types, creating three-dimensional effect not to give any pressure on the crotch: i) the cutting line only at the bottom of the front center part where the penis is rested, ii) puff created at the front center by adding a transverse line to the center line, iii) cutting transverse line to separate the penis from the testicles.

• Journal of Veterinary Clinics
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• v.26 no.4
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• pp.331-335
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• 2009

This paper was performed to investigate the propensity of the diameter of maximum distended urethra from urethra to os penis in mature male dogs of 25 male dogs of different breeds. The measured sites of urethras were divided into 7 regions, i.e. prostate, membrane, isthmus, perineum, scrotum, prescrotum and os penis. By using the inflated balloon catheter filled with contrast medium, the maximum diameter of the distended urethras of each region was recorded and compared among regions. The mean diameter of the lumen from the prostatic urethra to the os penis urethra was gradually narrowed except for the isthmus portion, with a sense of resistance for retraction being noted at the level of ischiatic arch in 22 dogs. Proposed results from this should be utilized as a predictor of a treatment plan for the removal of urethroliths using an urohydropropulsion.

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.175-180
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• 1992

Giant lymph node hyperplasia(Castleman's disease) is a rare disease, which represents a peculiar form of lymph node hyperplasia. Generally, it has been considered as benign and localized disease but recently, revealed malignant transformation in some cases of multicenteric form. It usually occurs on the mediastinum and occasionaly neck, lung, axilla, mesentery, broad ligament, retroperitoneum or soft tissue of extremities. Histopathologically, it is divided into hyaline vascular or plasma cell type and the former is characterized with prominent vascular proliferation and hyalinization in the central portion and tight concenteric layering of lymphocytes at the periphery of the fillicles(mantle zone) and the latter is characterized by a diffuse plasma cell proliferation in the interfollicular area. From the point of view of clinical presentation, it has been divided into solitary form, which presents as a localized mass located most commonly in the mediastinum, and multicenteric form, which occurs multiple location and has systemic manifestation arid transformation into malignancy. Herein we report a case of Giant lymph node hyperplasia occuring in the left spermatic cord in a 58-year old male with brief review of literatures.

• Journal of the Optical Society of Korea
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• v.19 no.1
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• pp.69-73
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• 2015

The mesothelium is an essential lining for maintaining the normal homeostasis of the closed body cavity and a central component of pathophysiologic processes. The mesothelium has been known as the end target for asbestos which induces asbestos-related lung diseases. Malignant mesothelioma (MM) is a rare and fatal neoplasm predominantly due to asbestos exposure. Adaptation of an advanced and reliable technology is necessary for early detection of MM because it is difficult to diagnose this disease in its early stages. Optical coherence tomography (OCT) provides cross-sectional images of micro-tissue structures with a resolution of $2-10{\mu}m$ that can image the mesothelium with a thickness of ${\sim}100{\mu}m$ and, therefore, enable investigation of early development of MM. The mesothelium is typically located at the pleura and tunica vaginalis of the scrotum. In this study, we developed animal window models in the above two anatomical sites to visualize mesothelial layers within the mesothelium. OCT images at the two locations were also acquired.

• Progress in Medical Physics
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• v.19 no.3
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• pp.172-177
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• 2008

As a part of estimating quantitative radiation treatment doses, we produced a mathematical phantom based on the standard Korean male. Then, with the prostate as the source organ, we calculated the absorbed dose in the prostate and surrounding organs forecasted to occur during brachytherapy for prostate cancer. To simulate the procedure, we selected $^{25}I$ and $^{103}Pd$ useful in brachytherapy of the prostate as the radionucleids and made an assumption that 1 Ci of initial radioactivity is administered. As a result, we found that the prostate, as the source organ, indicated 101 Gy/Ci and 7.24 Gy/Ci, respectively, in case of $^{125}I$ and $^{103}Pd$. With the exception of the prostate, organs with high absorbed doses were found to be in the order of the penis and scrotum, sigmoid colon, testicles and the urinary bladder, which are relatively close to the prostate.

• Journal of Veterinary Clinics
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• v.26 no.2
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• pp.185-188
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• 2009

A six-month-old Boston terrier presented with an extruded penis caudally, incompletely formed preputial sheath, bifid scrotum, retained testicle and deformity of the os penis. On physical examination, the urethral orifice was located on the surface of the perineum and a fibrous band was observed running from the grans to the urethral orifice on the perineum. The dog also had urethritis that was infected by ascending bacteria entering through the contaminated urethral orifice. Corrective surgery was undertaken to excise the external genitalia and retained testicle. The prepuce, penis and retained testicles were successfully excised. After the urethral orifice was cleaned periodically and antibiotics were administrated, recurrent urethritis disappeared. Using this therapeutic regime it is not necessary to reconstruct the anomaly located urethral orifice, if the location of urethral orifice is not the cause of recurrent urethritis and urinary incontinence.