Subchondral bony cyst, large solitary or multiple cysts in acetabular dome usually exacerbate progression to degenerative osteoarthritis in the hip joint. But it can be treated through arthroscopic intervention. We report two cases that treated by arthroscopic curettage and bone graft for subchondral bony cysts in early osteoarthritis of the hip joint, and it may delay progression to moderate osteoarthritis.
Acetabulum ; Bone Cysts ; Curettage ; Hip Joint* ; Osteoarthritis* ; Transplants*

The effectiveness of progestogens in advanced and recurrent endometrial carcinoma has been widely accepted. But the use of progestogens in young women with early stage of endometrial carcinoma (Stage Ia) is controversial. Some authors reported that progestogens alone therapy improved or cured the endometrial pathology in young patients with early stage of endometrial carcinoma. The response to the progestogens has known to be better in cases of early stage, well-differentiated histologic type and narrow depth of invasion. We used the high-dose megestrol acetate (Megace(R)) as the primary treatment in four young women with early stage of endometrial carcinoma (Stage Ia) for the purpose of saving the fertility. We made the patients to have 320~400 mg of Megace(R) per day for 3 months, and then repeated the endometrial curettage for the purpose of finding changes of endometrial pathology. Three cases revealed no response to the Megace(R), so they were operated later. One case showed the resolution of endometrial pathology and delivered a baby following therapy. There have been no evidences of clinical recurrence in all cases. Even though the therapeutic efficacy is limited, high-dose therapy with megestrol acetate can be used as primary therapy in young women with early stage of endometrial carcinoma.
Curettage ; Endometrial Neoplasms* ; Female ; Fertility ; Humans ; Megestrol Acetate* ; Megestrol* ; Pathology ; Progestins ; Recurrence ; Treatment Outcome*

OBJECTIVE: The objective of this study was to examine the effect on development of mouse preimplantation embryos in culture media with different composition of energy sources in vitro culture. METHODS: Two hundred and seventy one two-cell embryos were cultured in four different culture system for 96 hours. Group I (n=61) was cultured in DMEM-G (DMEM with glutamine) only, groupII (n=64) was cultured in DMEM-GGP (DMEM with glutamine, glucose and pyruvate) only, group III (n=72) was cultured for 48 hours in DMEM-G and then transferred to DMEM-GGP and group IV (n=74) was cultured for 48 hours in DMEM-GGP and then transferred to DMEM-G. Development of embryos in each group was observed every 24 hours. RESULTS: After 24 hours, the rate of development > or = 3-cell was significantly higher in groupII (87.5%) and IV (86.5%) compared with group I (59.0%) and III (62.5%). After 48 hours, the rate of development into > or = morula stage was significantly higher in GroupII (79.7%) and IV (86.5%) compared with group I (34.4%) and III (37.5%). After 72 hours, the rate of development into blastocyst was significantly higher in group IV (74.3%) compared with group I (49.2%) and III (45.8%). After 96 hours, the rate of development into > or = expanded blastocyst was significantly higher in group IV (70.3%) compared with group I (32.8%),II (53.1%), and group III (40.3%). CONCLUSION: Mouse preimplantation embryos development was the most effective in culture system with DMEM-GGP for 48 hours and then transferred to DMEM-G.
Animals ; Blastocyst* ; Culture Media* ; Embryonic Structures ; Glucose ; Glutamine ; Mice* ; Morula ; Pyruvic Acid

One hundred patients who underwent bilateral subtotal thyroidectomy for Graves' disease between January 1980 and September 1984 have been evaluated. The observation period ranged from 5 to 9 years, the average being 6.2 years. Postoperative thyroid function was evaluated with T3, T4 and TSH and compared with their clinical manifestations. Eighty-two patients became euthyroid, 14 patients had recurrence and 4 patients developed hypothyroidism. The thyroid hormone level of euthyroid patients were in an unstable state up to 5 years after the operation. Sixteen variables which might influence the postoperative recurrence and hypothyroidism were analyzed but no statistically significant factors were determined, although recurrences were found frequently in patients over 30 years, the patients with lower infiltration of lymphocytes and absent of fibrosis of thyroid tissue. The results obtained in the present study suggest that mean 6.0 gm of remnant thyroid is suitable for maintaining euthyroidism postoperatively in a majority of patients. In addition, patients should be followed closely for many years and should undergo hormonal determination periodically because recurrence and hypothyroidism can occur at 5 years or more after the operation.
Adolescent ; Adult ; Chi-Square Distribution ; Female ; Follow-Up Studies ; Graves' Disease/physiopathology/*surgery ; Human ; Logistic Models ; Male ; Middle Age ; Prognosis ; Support, Non-U.S. Gov't ; Thyroid Gland/*physiopathology ; *Thyroidectomy/methods

BACKGROUND: This study was designed to examine whether iNOS pathway is pathologically altered in experimental diabetic nephropathy and whether therapy with ACE inhibitor (imidapril: I) or angiotensin II type 1 receptor (AT1) blocker (L-158, 809: L) ameliorates these changes. METHODS: Male SD rats were injected with diluent (control: C) or streptozotocin. Diabetic (D) rats were then randomized to receive vehicle, I (2 mg/ kg/d) or L (1 mg/kg/d) by gavage. At the end of the 12-week treatment, rats underwent either a 4 hour placebo or an intraperitoneal LPS (2 mg/kg) challenge. Inducible NOS mRNA and protein were measured by RT-PCR and Western blot in isolated glomeruli. RESULTS: Systolic blood pressure and urinary protein excretion increased significantly in D rats compared with C. The basal expression of iNOS mRNA was increased in D rats compared with that of C, whereas there was no significant difference in the level of protein. Upon LPS stimulation, the iNOS mRNA and protein expression was significantly elevated in D rats. In D rats, this up-regulation of LPS-stimulated iNOS expression was equally ameliorated by both I and L in mRNA and protein levels. CONCLUSION: LPS-stimulated glomerular iNOS expression was enhanced in diabetic nephropathy, and the activation of angiotensin II may play a role in this enhancement.
Angiotensin II* ; Angiotensins* ; Animals ; Blood Pressure ; Blotting, Western ; Diabetic Nephropathies ; Humans ; Male ; Nitric Oxide Synthase Type II* ; Rats* ; Receptor, Angiotensin, Type 1 ; RNA, Messenger ; Streptozocin ; Up-Regulation

Pyrazinamide (PZA) is an anti-tuberculosis drug and an essential component of the standard four-drug regimen for tuberculosis. Here, we report a case of immediate angioedema secondary to PZA administration intended for pulmonary tuberculosis treatment. A previously healthy 48-year-old woman was diagnosed with pulmonary tuberculosis and tuberculous lymphadenitis. Thirty minutes after taking the first dose of isoniazid, rifampicin, pyrazinamide, and ethambutol, the patient developed facial edema, generalized rash, and dizziness. An oral provocation test was performed on the four drugs, and 1,000 mg pyrazinamide showed a positive result characterized by 50 minutes of urticaria, angioedema, and hypotension. As the prevalence of tuberculosis increases, prescriptions for anti-tuberculosis drugs may increase as well. Clinicians should be aware of the possibility of immediate hypersensitivity as well as delayed hypersensitivity to anti-tuberculosis drugs.
Angioedema* ; Dizziness ; Drug Hypersensitivity ; Edema ; Ethambutol ; Exanthema ; Female ; Humans ; Hypersensitivity, Delayed ; Hypersensitivity, Immediate ; Hypotension ; Isoniazid ; Middle Aged ; Prescriptions ; Prevalence ; Pyrazinamide ; Rifampin ; Tuberculosis ; Tuberculosis, Lymph Node ; Tuberculosis, Pulmonary ; Urticaria*

BACKGROUND: Primary malignant lymphoma of the lung is a very rare neoplasm. Although the prognosis of lymphoma is favorable, the clinical features, prognostic factors and management have not been clearly defined. MATERIAL AND METHOD: We retrospectively reviewed the records of 8 patients we managed between 1994 and 2006. They all had malignant lymphoma on the pathologic examination of the lung with no evidence of mediastinal adenopathy and extrathoracic disease, and no past history of lymphoma. RESULT: The study group consisted of 3 males and 5 female patients with a mean age of 53.9 years. Three patients were asymtomatic and 5 patients were seen with pulmonary or systemic symptoms. The diagnostic methods were 3 CT needle aspiration biopsies, 1 bronchoscopic biopsy and 4 surgical methods (wedge resection, lobectomy). There were 3 patients with MALT lymphoma, two with diffuse large B-cell lymphoma, two with small lymphocytic lymphom, and one with follicular lymphoma. The 8 patients were treated with a variety of modalities, including surgery, chemotherapy, radiotherapy and combination therapy. The 8 patients have survived for a median follow-up of 38 months. CONCLUSION: Although this entity of lymphoma appears to have a good prognosis, further clinical experience and long-term follow-up are needed to identify its clinical features, prognostic factors and management.
Biopsy ; Biopsy, Needle ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Lung* ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Follicular ; Male ; Needles ; Pathology ; Prognosis ; Radiotherapy ; Retrospective Studies

BACKGROUND: It is known that depression and anxiety tendency causes physical or social dysfunction. Nowadays, the air travel is increasing as the life condition has been improved so the health of pilots who are in charge of passengers become a very important issue. However, few studies have been done on this issue, especially the relationship between depression & anxiety and medical diseases among them. This study was performed to know the factors affection pilots' sick leave and the correlation between depression & anxiety and sick leave. METHODS: Self administered questionaires were obtained from 123 pilots of one of the airline companies at Seoul from 1st April to 30th may 2003. Depression tendency was measured based upon BDI, the level of anxiety was measured by the standardised STAI and obesity was diagnosed if a BMI is over 25 kg/m2. The data on the subjects' age, position, airlines and the days of sick leave were obtained from personal record. RESULTS: All the study subjects were male with the average age of 40.23+/-7.48 (ranging from 30 to 60). The average age for those who had sick leave was 34.58+/-3.50 and that for those who had not was 40.48+/-7.55 and these two average ages showed difference with statistical significance (P value <0.001), and the odd ratio of sick leave about age was 0.796 (95% CI: 0.645-0.938). Whether a pilot had sick leave or not, however, was not statistically related to the level of BDI, STAI, flying duty, flying route, and body mass index (P value >0.05). CONCLUSION: This study shows that the average age of sick leave group was lower than that of non-sick leave group (P<0.001). The level of depression and anxiety were not related to the sick leave. The reasons for this seems to be the fact that pilots are healthier than general population and also they pay more attention to their own health. The younger pilots tended to have more days of sick leave, which might be explain that the older pilots were more cautious about the disadvantages of having sick leave but, the younger pilots tend to have strong individualistic personalities.
Anxiety* ; Body Mass Index ; Depression* ; Diptera ; Humans ; Male ; Obesity ; Seoul ; Sick Leave*

PURPOSE: Since 1997, the quantification of organic acids in urine has become possible in Korea. This helped to diagnose a great variety of inborn errors of metabolism. However, we still don't know the normal value of organic acids in amniotic fluid, therefore it is impossible for doctors to make a correct diagnosis of inborn errors of metabolism in prenatal care. We tried to confirm the normal value of organic acid in amniotic fluid. METHODS: From Jan. 1998 to Dec. 2001, we carried out amniocentesis and were able to obtain 43 samples of amniotic fluid from between 16 and 20 weeks of gestation, and quantified 82 organic acids to come up with a normal value. Organic acid concentrations were quantified with gas chromatography, and the individual acids were identified with mass spectrometry. To isolate organic acids from amniotic fluid, we used a solvent extraction method with ethylacetate. Derivatization was done with MSTFA(N-methy-N-trimethylsilylfluoroacetamide). RESULTS: The results of this study showed that when organic acid concentrations in amniotic fluid were compared with those in urine, TCA cycle intermediates(lactate, pyruvate, malate, 2-ketoglutarate, citrate etc) and ketone body(3-hydroxybutyric acid, acetoacetate etc) were found at significantly higher levels. CONCLUSION: Because TCA cycle intermediate in amniotic fluid is found at high concentrations, we could expect that diagnosis of mitochondria disorder is difficult. Organic acids other than TCA cycle intermediates were undetectable in amniotic fluid. Therefore, prenatal diagnosis of organic acidemias is possible. In our study, the prenatal diagnosis of methylmalonic acidemia could be made by using the measurement of methylmalonic acid in the amniotic fluid taken at high risk pregnancy with a family history of methylmalonic acidemia.
Amniocentesis ; Amniotic Fluid* ; Chromatography, Gas ; Citric Acid ; Diagnosis ; Female ; Humans ; Korea ; Mass Spectrometry ; Metabolism, Inborn Errors ; Methylmalonic Acid ; Mitochondria ; Pregnancy ; Pregnancy, High-Risk ; Prenatal Care ; Prenatal Diagnosis* ; Pyruvic Acid ; Reference Values

A wedge-shaped anterior hairline extension is a very rare skin manifestation usually associated with congenital anomalies including a Tessier number 10 cleft. Other associated conditions are the Tessier number 9 cleft, the Fraser syndrome, and the Manitoba oculotrichoanal syndrome (MOTA syndrome). The Tessier number 10 cleft features include a coloboma of the middle third of the upper eyelid, and an eyebrow divided into two portions. The medial eyebrow portion may be absent and the lateral portion is angulated vertically, joining the hairline of the scalp. This creates a wedge-shaped anterior hairline extension. Herein we report on a case of a wedge-shaped anterior hairline extension associated with the Tessier number 10 cleft.
Abnormalities, Multiple ; Anal Canal ; Coloboma ; Eyebrows ; Eyelids ; Fraser Syndrome ; Hypertelorism ; Manitoba ; Scalp ; Skin Manifestations