This is a case report of virilizing adrenal cortical adenoma in 22 month old male patient who was diagnosed by clinical features, endocrinological studies, radiologic studies and pathologic findings. During surgery, a 40gm well-encapsulated tumor was removed from the right adrenal gland. Histologic examination revealed no capsulr invasion and a diagnosis of adrenocortical adenoma was made. He is in well condition without the clinical or laboratory evidence of recurrence at 2 years of follow up.
Adrenal Glands ; Adrenocortical Adenoma* ; Diagnosis ; Follow-Up Studies ; Humans ; Infant ; Male ; Recurrence

We describe an ovarian mucinous cystadenocarcinoma with a sarcoma-like mural nodule. In the literature, rare cases of ovarian mucinous tumors have been described which contain foci of undifferentiated carcinoma, sarcoma, and sarcoma-like nodules. The distinction between these lesions is important because of poorer prognosis of true sarcoma and anaplastic carcinoma than sarcoma-like mural nodules. This case shows different results of immunohistochemical stain for anaplastic carcinoma.

Agnogenic myeloid metaplasia (AMM) is a myeloproliferative disorder characterized by leukoerythroblastosis, tear-drop erythrocytes, extramedullary hematopoiesis with hepatosplenomegaly, and varying degrees of myelofibrosis. The mean age at presentation is about 60 years, and pediatric cases are rare. We experienced a case of AMM in a 9 months old female who was presented with pallor, huge splenomegaly and intermittent fever. Peripheral blood showed leukoerythroblastosis poikilocytosis, and tear drop cells. Bone marrow was difficult to aspirate, and biopsy specimen showed increased reticulin with decreased cellularity, which was compatible with myelofibrosis. We presented a case of AMM with brief review of the literatures.
Biopsy ; Bone Marrow ; Erythrocytes ; Female ; Fever ; Hematopoiesis, Extramedullary ; Humans ; Infant ; Myeloproliferative Disorders ; Pallor ; Primary Myelofibrosis* ; Reticulin ; Splenomegaly

Schizophrenia is a devastating mental illness that can lead to deterioration in the social and occupational functioning of affected individuals with a major cost to society. A wide range of studies suggest a genetic component to the inheritance of schizophrenia. The molecular genetic studies on schizophrenia have been actively performed since late 1980s. In linkage studies, no loci were replicated across studies and there were no loci surpassing genome-wide significance. Candidate gene association studies showed generally inconsistent results and there were no enrichment of smaller P-values. In the GWAS era, the community has coalesced into large international consortia. The largest schizophrenia GWAS to date is 50,000 samples and efforts are ongoing to accumulate 50,000 cases and 50,000 controls as part of 'PGC2' collaboration. With the limitation of GWAS results, several alternatives are being explored. In genotyping, the concepts of allelic spectrum including from common polygenic to rare penetrant variation are emerging. Phenotypes include all phenomena beyond DNA. The developments in transcriptomic & proteomic approach and intensive research on endophenotype will bring crucial insights into the nature of schizophrenia in the future. But there still remains our task about research on many factors including environment that influence gene expression (epigenetics), age, and gender.
Cooperative Behavior ; DNA ; Endophenotypes ; Epigenomics ; Gene Expression ; Genetic Association Studies ; Molecular Biology ; Phenotype ; Schizophrenia ; Wills

No abstract available.
Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating*

BACKGROUND: This study was performed to evaluate our experience on laparoscopic appendectomy. METHODS: Retrospective analysis was performed on 2,856 patients who had been operated by laparoscopic appendectomy under diagnosis of acute appendicitis at the Sung-Ae Hospital and Kwang-Myoung Sung-Ae Hospital from October 1991 to July 1998. RESULTS: Among 2,856 patients who had undergone laparoscopic appendectomy,2,379 patients (83.3%) were operated due to simple acute appendicitis, 275 patients (9.6%) due to perforated appendicitis. Operation time was 44.6 minutes for simple acute appendicitis and 60.3 minutes for perforated appendicitis. In perforated appendicitis, intra-peritoneal irrigation and drain insertion was performed. The length of hospital stay in patient with simple acute appendicitis was 3.7 days (5.82 days in conventional appendectomy) and patients with perfotrated appendicitis was 6.1 days (9.91 days in conventional appen-dectomy). Complications such as wound infection, intra-abdomen abscess, trocar site bleeding, subcutaneous emphysema developed in 43 (1.5%) patients (79/1,947, 4.5% in conventional appendectomy). In 202 (7.1%) patients, appendix was normal, but another diseases were detected, including acute pelvic inflammation, ovarian cyst, mesenteric lymphadenitis, enteritis, diverticulitis in order. CONCLUSION: Overall complication rate was lower in laparoscopic appendectomy compared with conventional appendectomy and the length of hospitalization of laparoscopic appendectomy was shorter. When the acute appendicitis is suspected, especially in the reproductive women, the laparoscopic approach would be better diagnostic and therapeutic value than conventional method. Therefore laparoscopic appendectomy would be replaced with conventional appendectomy.
Abscess ; Appendectomy* ; Appendicitis ; Appendix ; Diagnosis ; Diverticulitis ; Enteritis ; Female ; Hemorrhage ; Hospitalization ; Humans ; Inflammation ; Length of Stay ; Mesenteric Lymphadenitis ; Ovarian Cysts ; Retrospective Studies ; Subcutaneous Emphysema ; Surgical Instruments ; Wound Infection

Digital subtraction angiography(DSA) was made in 72 patients at department of radiology, Seoul National University hospital from February 1982 to January 1983 with our system, SRM-II, developed by cooperation of department of medical engineering, Seoul National University Hospital. The results were as follows; 1. In the total 72 cases, vascular disease was 28 cases in which aortic disease including Takayasu's aortitis was 18 cases. Others were vascular tumors in 32 cases and various conditions such as renal donor and artificial arteriovenous shunt. 2. Extent of the lesion was well delineated especially in aortic disease in cluding 8 cases of Takayasu's aortitis, 6 cases of aortic aneurysm and 2 cases of Behcet's syndrome. 3. DSA can be done to outpatient without admission because of its simplicity and non-invasiveness. DSA is useful especially in the evaluation and follow-up of vascular disease and the diagnostic value is expected to grow continuously according to the renewal of system.
Angiography, Digital Subtraction* ; Aortic Aneurysm ; Aortic Diseases ; Aortitis ; Behcet Syndrome ; Follow-Up Studies ; Humans ; Outpatients ; Seoul ; Tissue Donors ; Vascular Diseases

Inhaled nitric oxide (iNO) is recognized as a potent and selective pulmonary vasodilator that does not decrease systemic vascular tone. The therapeutic application of iNO in human was first described in 1991. Subsequent reports showed that iNO therapy was effective to improve oxygenation in infants with persistent pulmonary hypertension of the newborn (PPHN). Owing to its selective pulmonary vasodilator effects, iNO therapy is an important treatment for term newborns with hypoxemic respiratory failure due to PPHN. The Food and Drug Administration of the United States of America first approved iNO in 1999 for use as a medical gas to treat hypoxic respiratory failure associated with clinical or echocardiographic evidence of pulmonary hypertension in term and late preterm neonates. Thereafter, iNO therapy is clinically applied to treat PPHN in term and late preterm neonates without consensus. In this review, we focused on the clinical practice of iNO therapy in PPHN. Based on published studies, we discuss iNO initiation and withdrawal methods, respiratory support devices that complement iNO therapy, and the patient and gas monitoring during iNO therapy.
Americas ; Complement System Proteins ; Consensus ; Echocardiography ; Female ; Humans ; Hypertension, Pulmonary* ; Infant ; Infant, Newborn* ; Nitric Oxide* ; Oxygen ; Persistent Fetal Circulation Syndrome ; Respiratory Insufficiency ; United States ; United States Food and Drug Administration

Clonidine, an a2-adrenergic agonist, has sedative and analgesic properties and reduces the inhalation anesthetic requirement and modifies the hemodynamic responses to surgery. But occasionally, severe bradycardia and hypotensian during inhalation anesthesia develops following oral clonidine premedication. To predict intraoperative hemodynamic changes during enflurane anesthesia, author evaluated noninvasive autonomic tests consisted of respiratory sinus arrhythmia (RSA), Valsalva's maneuver (VSV), R-R interval difference in head up tilt (HTR) and diastolic blood pressure difference in head up tilt (HTP) in fifty-one patients (ASA physical status I~II ) scheduled for elective surgery. Patients were received 5 ug/kg of oral clonidine at 90 min before operation. Anesthesia was maintained with enflurane, oxygen (2 liter/min) and nitrous oxide (2 liter /min). The enflurane concentration was controlled to maintain blood pressure within +/-20% of preinduction value. After anesthesia, patients were allocated to two groups according to above and below 0.5 MAC (0.84 vo1%) enflurane concentration. Each preoperative autonomic test results revealed significant correlation with heart rate (HR), mean arterial pressure (MAP), and enflurane concentration (EC), respectively (p<0.05). Values of RSA, HTR, HTP, MAP and HH wm 81+/-14.4 ms, 76+/-43.5 ms, -6+/-5.2 mmHg, 76+6.4 mmHg and 63+/-5.5 beats/min, respectively in below 0.5 MAC enflurane concentration group and were significantly different from values of RSA; 16933.7 ms, HTR; 175+/-41.7 ms, HTP; 6+/-3.1 mmHg, MAP; 90+/-11.0 mmHg and HR; 76+/-7.6 beats/min in above 0.5 MAC enflurane concen- tration group (p<0.05). In conclusion, the simple noninvasive autonomic tests are recommended in prediction of intra-operative hemodynamic changes during enflurane anesthesia when oral clonidine premedication is indicated.
Anesthesia* ; Anesthesia, Inhalation ; Arrhythmia, Sinus ; Arterial Pressure ; Blood Pressure ; Bradycardia ; Clonidine* ; Enflurane* ; Head ; Heart Rate ; Hemodynamics* ; Humans ; Inhalation ; Nitrous Oxide ; Oxygen ; Premedication ; Valsalva Maneuver

Clonidine, an a2-adrenergic agonist, has sedative and analgesic properties and reduces the inhalation anesthetic requirement and modifies the hemodynamic responses to surgery. But occasionally, severe bradycardia and hypotensian during inhalation anesthesia develops following oral clonidine premedication. To predict intraoperative hemodynamic changes during enflurane anesthesia, author evaluated noninvasive autonomic tests consisted of respiratory sinus arrhythmia (RSA), Valsalva's maneuver (VSV), R-R interval difference in head up tilt (HTR) and diastolic blood pressure difference in head up tilt (HTP) in fifty-one patients (ASA physical status I~II ) scheduled for elective surgery. Patients were received 5 ug/kg of oral clonidine at 90 min before operation. Anesthesia was maintained with enflurane, oxygen (2 liter/min) and nitrous oxide (2 liter /min). The enflurane concentration was controlled to maintain blood pressure within +/-20% of preinduction value. After anesthesia, patients were allocated to two groups according to above and below 0.5 MAC (0.84 vo1%) enflurane concentration. Each preoperative autonomic test results revealed significant correlation with heart rate (HR), mean arterial pressure (MAP), and enflurane concentration (EC), respectively (p<0.05). Values of RSA, HTR, HTP, MAP and HH wm 81+/-14.4 ms, 76+/-43.5 ms, -6+/-5.2 mmHg, 76+6.4 mmHg and 63+/-5.5 beats/min, respectively in below 0.5 MAC enflurane concentration group and were significantly different from values of RSA; 16933.7 ms, HTR; 175+/-41.7 ms, HTP; 6+/-3.1 mmHg, MAP; 90+/-11.0 mmHg and HR; 76+/-7.6 beats/min in above 0.5 MAC enflurane concen- tration group (p<0.05). In conclusion, the simple noninvasive autonomic tests are recommended in prediction of intra-operative hemodynamic changes during enflurane anesthesia when oral clonidine premedication is indicated.
Anesthesia* ; Anesthesia, Inhalation ; Arrhythmia, Sinus ; Arterial Pressure ; Blood Pressure ; Bradycardia ; Clonidine* ; Enflurane* ; Head ; Heart Rate ; Hemodynamics* ; Humans ; Inhalation ; Nitrous Oxide ; Oxygen ; Premedication ; Valsalva Maneuver