We investigated a unilocular mammary cyst occurring in a two and a half year old male baby. The cyst was lined by simple columnar epithelium and filled with a milky secretory material. These histologic features were consistent with galactocele. The child had enlarged left breast since birth, but it seemed to be noncontributory as the child had neither endocrine abnormalities nor perinatal disorders. Galactocele is an uncommon breast lesion usually occuring in females following lactation. It is rarely a cause of breast enlargement.
Child ; Male ; Female ; Humans ; Cysts

No abstract available.
Leiomyosarcoma* ; Uterus*

Two cases of skull metastasis from thyroid carcinoma are presented. The one case shows multiple involvement inthe skull base with sphenoid sinus, frontal bone, and rib. The other case is solitary extensive involvement to theright parietal bone. The follicular caroinoma of the thyroid shows a strong tendency toward vascualr invasion and dissemination through blood stream to the lungs, bones, liver, brain, and other distant sites. The sternum, thevetebrae, and the pelvis are the most common sites in bone metastasis of thyroid carcinoma, followed by the femur,shoulder girdle, skull, and rib. Metastatic caroinoma to the skull base, including sphenoid sinus s extremelyrare. Authors experienced recently 2 cases of metastatic carcinoma of the thyroid to the skull and report withreview of literature.
Brain ; Frontal Bone ; Liver ; Lung ; Neoplasm Metastasis ; Parietal Bone ; Pelvis ; Ribs ; Rivers ; Skull Base ; Skull ; Sphenoid Sinus ; Sternum ; Thyroid Gland ; Thyroid Neoplasms

Background: The highly lipid soluble opioid, fentanyl, has a rapid onset and short duration of action. The present study was designed to examine the analgesic efficacy and side effects of the combination of fentanyl with morphine in patients using intravenous PCA. Methods: Patients were randomly assigned to receive one of three PCA regimens: M4 group (40 mg morphine+90 mg ketorolac+1.5 mg dorperidol), M2F2 group (20 mg morphine+200 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol), or M2F4 group (20 mg morphine+400 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol). All patients were given initial loading dose of 0.1 mg/kg morphine plus 1 mg droperidol at the end of surgery. Pain score, side effects, and overall satisfaction were assessed at 30 min, 1 hr, 8 hr, 24 hr, and 48 hr postoperatively. Results: The pain score was significantly higher in the M2F2 group than in the M4 group and M2F4 group during 1 hr and 8 hr postoperatively. The total opioid consumption was significantly greater in the M2F4 group than in the M4 group. Patient satisfaction was better in the M2F4 than other two groups. There were no differences in the overall incidence of side effects among three groups. Conclusions: The present results suggest that the combination of fentanyl with morphine for intravenous patient-controlled analgesia is a useful method, and the double dose of fentanyl in comparison with the equipotent morphine dose is recommended in the early postoperative period.
Analgesia, Patient-Controlled* ; Droperidol ; Fentanyl* ; Humans ; Incidence ; Morphine* ; Passive Cutaneous Anaphylaxis ; Patient Satisfaction ; Postoperative Period

OBJECTIVE: To evaluate the role of C-reactive protein and fetal fibronectin for patients with preterm labor and intact mxmbranes. STUDY DESIGN: The study group was comprised of sixty patients who presented to the Taegu Fatima Hospital between 24-36 gestational weeks who had a diagnosis of preterm labor. The study group underwent assay of C-reactive protein in the matemal serum, and fetal fibronectin from the external os and posterior fomix of the vagina by means of polyester fiber swabs. The study group was categorized to four groups according to the results of CRP and fetal fibronectin, that is 28 cases of CRP(-)/fetal fibronectin(-); group I, 12 cases of CRP(+)/fetal fibronectin (-); groupII, 9 cases of CRP(-)/fetal fibronectin(+); groupIII, 11 cases of CRP(+)/fetal fibronectin(+): grouplV, and the controls were 12 women without preterm labor. Outcome measures were occurrence of preterm delivery, the admission-to-delivery interval, matemal age and parity, fetal body weight, 1min/5min Apgar score, perinatal morbidity and mortality etc. Statistical analyses were performed by means of ANOVA test and Dunnett's t-test. RESULTS: The prevalence of study group were group I 46.7%, group II 20%, group III 15% and group IV 18.3%. There were no significant difference of matemal age, parity and gestational weeks at admission between study group and control group, but in all study group the admission to delivery interval was significantly shorter than that of control group. Analysis indicated also no significant difference of maternal hemoglobin between study group and conuol group but white blood cell count of group II and IV were significantly higher than that of control group. In perinatal outcomes, the mean birth weight and 1 minute Apgar score of study group except group I were significantly lower than those of control group but 5minutes Apgar score was lower only in group IV compared with control group. Perinatal morbidity and mortality of study group were higher than those of control group except group I. This study group was designed to compare the diagnostic performance of cervical fibronectin and of the serum CRP levels. The sensitivity and specificity of fetal fibronectin as a test to predict of preterm labor were 80% and 90%, which were slightly higher than those of CRP(70%, 78%). CONCLUSION: Both positive cervicovaginal fetal fibronectin and positive C-reactive protein in women with preterm uterine contraction can help identify the pregnancies at risk and to select proper management protocol.
Apgar Score ; Birth Weight ; C-Reactive Protein ; Daegu ; Diagnosis ; Female ; Fetal Weight ; Fibronectins ; Humans ; Leukocyte Count ; Membranes* ; Mortality ; Obstetric Labor, Premature* ; Outcome Assessment (Health Care) ; Parity ; Polyesters ; Pregnancy ; Prevalence ; Sensitivity and Specificity ; Uterine Contraction ; Vagina

No abstract available.
Hemangioma* ; Ligation*

Wilms' tumor is one of the most common primary malignant tumors of the kidney during infancy and childhood and is known to be originated from the primitive cells of metanephric blastema. It presents difficulties when encountered in deciding the presence of anaplasia or in differentiating it from other renal tumors of childhood with different biologic behavior because of its diverse histologic patterns and varying degrees of differentiation. Evaluation of clinical and histopathologic features in terms of prognostication was done of 32 cases of Wilms' tumor which were surgically resected and diagnosed in the period from January 1979 through June 1992. Immunohistochemical reaction for cytokeratin, vimentin, actin and desmin was also analysed on all cases of Wilms' tumor in conjunction with clear cell sarcoma of the kidney(CCSK), malignant rhabdoid tumor of the kidney(MRTK) and congenital mesoblastic nephroma(CMN) to assess the validity of immunohistochemistry in differentiating Wilms' tumor from these renal tumors. Twenty four(75%) cases were diagnosed before the age of 5 and 40.7% were under 2 years old. Mixed type was most common(62.5%), followed by epithelial, blastemal and stromal predominant type in descending order of frequency. Anaplasia was observed in 3 cases(9.4%), two of which were epithelial predominant type and one blastemal predominant type. Treatment modality and presence of anaplasia were significantly correlated with 5 year survival rate of patients. Immunohistochemical stain revealed that all epithelial component of Wilms' tumor were positive for cytokeratin and 56.3% of Wilms' tumor had blastemal component which were positive for both cytokeratin and vimentin. Twenty cases(62.5%) of Wilms' tumor had blastemal component which were positive for cytokeratin with a proportion of more than 5% of reactive cells. Stromal component of Wilms' tumor generally did not show differentiation into the specialized type of tissue and all revealed positive reactions for vimentin among which some revealed positive reactions for actin. Only 3 out of 6 cases with rhabdomyoblastic differentiation were positive for desmin. CCSK, MRTK and CMN which have different biologic behavior and treatment modality compared to Wilm's tumor showed positivity only for vimentin and/or actin. In summary, treatment modality and presence of anaplasia are significantly correlated with patients' survival and the immunohistochemical stain for cytokeratin is very helpful in confirming the presence of blastemal component and useful in the differential diagnosis of Wilms' tumor from other kinds of pediatric renal tumors.
Child ; Male ; Female ; Humans ; Diagnosis, Differential

In this paper, the title was described incorrectly.

Human assisted reproductive technology programs have been being developed marvelously during this decade. However, implantation rates following embryo replacement remain low, regardless of increased fertilization rates by ICSI. One proposed possibility limiting the successful implantation is an impaired hatching caused by suboptimal culture conditions. As to improve the hatching potential of blastocysts, assisted hatching by an artificial alteration of zona pellucida(ZP) have been done in many laboratories using the various methods. We tried to investigate whether the supplementation of proteases into culture media has any effect on development, zona structure, and/or hatching of mouse embryos. Supplementation of either pronase E(PE) or proteinase K(PK) in culture media did not affect development up to blastocyst but significantly increased hatching rate. And we observed the alteration of ultrastructure and casein binding properties of ZP in mouse embryos. Also we investigated the effects of protease on development of human embryos and pregnancy rates in human ART program. From July 1994 to December 1996, 792 cycles(for study I) and 1095 cycles(for study II) undergoing the IVF-ET program in MizMedi Hospital were randomly selected for BAH. The concentrations of proteases used in this study were 1microgram/ml PE, 0.1microgram/ml PK and 1microgram/mlPE+0.1microgram/ml PK in HTF with 0.5% human serum albumin(HSA), and in vitro fertilized embryos were cultured for 24 hours. We analyzed the efficiency and stability of biochemical assisted hatching(BAH) according to the clinical profiles of patients and fertilization methods. After cultured in HTF with proteases for 24 hours of human embryos, the thinning in zona pellucida of embryos was observed but its development was not disturbed. Also, clinical pregnancy rates were higher in the PE, PK and PE+PK groups than the control group without proteases(36.0%(32/89), 35.3%(36/102), 35.1%(39/111) vs. 25.5%(125/490), p<0.05). The live birth rate in the PE, PK and PE+PK groups were increased than control, and the abortion rate were not different. They were showed a effect and safety of proteases treatment in human embryos. We selected PE as BAH for study II because of slightly better embryonic morphology and pregnancy rate. In patients over 35 years old, clinical pregnancy rates of the BAH group was higher than that of the control group(31.4%(58/185) vs. 22.2%(51/230); p<0.05). And in the cases with few oocytes retrieval, or less than 3 cycles of IVF-ET, clinical pregnancy rates of the BAH group was significantly higher than that of the control group(36.8%(86/234) vs. 27.2%(93/342), p<0.05; 36.8%(148/402) vs. 29.9%(168/562), p<0.05). In BAH groups, the clinical pregnancy rate was similar between conventional IVF and ICSI group. From above results, it is suggested that improved hatching by protease treatment is due to physiological alteration of ZP structure, giving rise to the similar hatching process to that in vivo. We suggest that BAH using protease is a simple, safe and economic technique compared to the other known assisted hatching techniques in human ART program.
Abortion, Induced ; Adult ; Animals ; Blastocyst ; Caseins ; Culture Media ; Embryonic Structures* ; Female ; Fertilization ; Herpes Zoster ; Humans* ; Live Birth ; Mice ; Oocytes ; Peptide Hydrolases ; Pregnancy Rate ; Pronase ; Reproductive Techniques, Assisted ; Sperm Injections, Intracytoplasmic ; Zona Pellucida

We sought to describe the incidence rate of the urologic disease in the Korean military by reviewing diagnoses made in active duty soldiers from 2008 to 2013. A total of 72,248 first visits were generated in the Defense Medical Statistics Information System (DMSIS) with its gradually increasing trend over 6 years. A sharp increase of first visit was observed after implementation of the regular health check-up for all conscripted soldiers since 2013. Urolithiasis, prostatitis, epididymoorchitis, urethritis, and varicocele were prevalent. Prostatitis was the highest diagnosis made in the outpatient service, while varicocele was ranked the highest in the inpatient service. The incidence rates of urologic disease varied from 12.3 to 34.2 cases per 1,000 person-years. The urologic disease in conscripted men showed different distribution when we separated the population into conscripted and professional soldiers. Epididymoorchitis was the highest disease followed by urolithiasis, dysuresia, and balanoposthitis in 2013. This study underscores that the urologic disease has spent significant amount of health care resources in the Korean military. This calls for further study to find any significant difference and contributing factors of the urologic disease in the military and the civilian population.
Delivery of Health Care ; Diagnosis ; Epidemiology ; Humans ; Incidence ; Information Systems ; Inpatients ; Male ; Medical Records* ; Military Personnel* ; Outpatients ; Prostatitis ; Urethritis ; Urolithiasis ; Urologic Diseases* ; Urology ; Varicocele