Down syndrome is a chromosome related desease that shows mental retardation, growth retardation and many other signs such as defects in the face, hands and skin. Down syndrome is very uncommon in dizygotic twins, especially in twins with different sex. This twin's chromosomal analysis shows both twins with trisomy 21, but the parents' chromosomal analysis is normal. A 30 year old infertile woman who became pregnant via ICSI(intracytoplasmic sperm injection) has shown dizygotic twins with different sex to have Down syndrome and therefore it is being reported along with simple documents.
Down Syndrome ; Female ; Hand ; Humans ; Intellectual Disability ; Skin ; Sperm Injections, Intracytoplasmic ; Spermatozoa ; Twins, Dizygotic

Paraovarian cysts arise in the mesosalpinx, between the ovarian hilum and the fallopian tube. Clinical significance of paraovarian tumors is considerably less frequent than ovarian tumors, and malignant paraovarian lesions are exceedingly rare. Paraovarian carcinomas or borderline malignancy mostly occur in young women. Abdominal enlargement and pelvic pain are the usual complaints. Usually they have a capsule, are unilateral and are connected to the broad ligament. Little is known about the biological behavior of the paraovarian borderline malignancies, since these lesions are so rare. The appropriate therapy for this unusual lesion have not been fully defined. We had experienced a case of papillary serous adenocarcinoma of borderline malignancy and report this case with a brief review of literature.
Adenocarcinoma ; Broad Ligament ; Fallopian Tubes ; Female ; Humans ; Pelvic Pain

Survival rate after renal transplantation has increased by using intense immunosuppressive agents and sophisticated operative techniques were introduced but incidences of malignancy is increasing after transplantation. Renal transplanted patients undergo variable malignancy but the acute T-cell lymphoma originating in the face is relative rare. Cyclosporin A is an immunosuppressive agent with selective inhibitory effects on T lymphocytes. It is currently available to use in organ and bone marrow transplantation recipients. We report a case of acute arising T-cell lymphoma on forehead of a 56-years-old male patient. This patient received renal allograft about 15 years ago. And then for recent 3 years, he takes Cyclosporin A 15mg/day due to allograft rejection. Its pathologic finding was diffuse large T-cell type and exhibited homogenecity of the tumor. He has been followed 3 months and no relapse occurred. We report this case with a brief review of literatures.
Allografts ; Bone Marrow Transplantation ; Cyclosporine ; Forehead ; Humans ; Immunosuppressive Agents ; Incidence ; Kidney Transplantation ; Kidney* ; Lymphoma, T-Cell* ; Male ; Recurrence ; Survival Rate ; T-Lymphocytes*

PURPOSE: In treatment of facial bone fracture, occurred in children, we generally use wires, miniplate, absorbable plate or their combination. These foreign bodies can be palpable, and sometimes may cause infections, and need reoperation for removing. When bone fragments are multiple, small or thin, they are hard to handle and make accurate reduction of all fragments. In these cases, a biodegradable tissue adhesive, Histoacryl(R) (n-butyl-2-cyanoacrylate), can be used as fixation technique for small, multiple, and thin fracture fragments. METHODS: 3 years old and 6 years old children, who has comminuted fracture on frontal sinus, we used Histoacryl(R) for fixation of multiple bone fragments. After approaching by coronal incision, we pulled out all bone fragments and reconstructed bone fragments by Histoacryl(R) and fixed those on frontal sinus by absorbable plates. RESULTS: Photographs and 3-dimensional CT obtained preoperatively and postoperatively. And we compared them each other in terms of accuracy of reconstructed bony contour. We could reconstruct almost all bone fragments easily along 3-dimensional structure and get excellent aesthetic results. There was no complication such as infection. CONCLUSION: In treatment of comminuted facial bone fracture, occurred in children, Histoacryl(R) is an excellent method for accurate reconstruction in small and thin bone fragments which cannot be fixed by wire, miniplate or absorbable plate without complication.
Child ; Enbucrilate ; Facial Bones ; Foreign Bodies ; Fractures, Comminuted ; Frontal Sinus ; Humans ; Reoperation ; Tissue Adhesives

Adenoid cystic carcinoma is an uncommon adenocarcinoma type which affects mainly the salivary gland and respiratory system. In the female reproductive tract it occurs more commonly in Bartholin's gland and than in uterine cervix. Almost patients are postmenopausal women. The main presenting complaint is vaginal spotting having an abnormal pap smear. It has been diagnostically confused with adenoid basal carcinoma which has a somewhat different clinical course and pathology. The treatment should be individualized to the patients by local recurrence or distant metastasis. It shows relatively unfavorable survival. Recently we experienced a case of adenoid cystic carcinoma arising in the cervix after menopause, so we report this case with a brief review of literature.
Adenocarcinoma ; Adenoids* ; Carcinoma, Adenoid Cystic* ; Cervix Uteri* ; Female ; Humans ; Menopause ; Metrorrhagia ; Neoplasm Metastasis ; Pathology ; Recurrence ; Respiratory System ; Salivary Glands

Purpose: Choosing the appropriate antibiotic is important for treatment of complicated appendicitis. However, increasing multidrug resistant bacteria have been a serious problem for successful treatment. This study was designed to identify bacteria isolated from patients with complicated appendicitis and reveal their susceptibilities for antibiotics and their relationship with patient clinical course. Methods: This study included patients diagnosed with complicated appendicitis and examined the bacterial cultures and antimicrobial susceptibilities of the isolates. Data were retrospectively collected from medical records of Kangbuk Samsung Hospital from January 2008 to February 2018. Results: The common bacterial species cultured in complicated appendicitis were as follows: Escherichia coli (n=113, 48.9%), Streptococcus spp. (n=29, 12.6%), Pseudomonas spp. (n=23, 10.0%), Bacteriodes spp. (n=22, 9.5%), Klebsiella (n=11, 4.8%), and Enterococcus spp. (n=8, 3.5%). In antibiotics susceptibility testing, the positive rate of extended-spectrum beta lactamase (ESBL) was 9.1% (21 of 231). The resistance rate to carbapenem was 1.7% (4 of 231), while that to vancomycin was 0.4% (1 of 231). E. coli was 16.8% ESBL positive (19 of 113) and had 22.1% and 19.5% resistance rates to cefotaxime and ceftazidime, respectively. Inappropriate empirical antibiotic treatment (IEAT) occurred in 55 cases (31.8%) and was significantly related with organ/space surgical site infection (SSI) (7 of 55, P=0.005). Conclusion The rate of antibiotic resistance organisms was high in community-acquired complicated appendicitis in Koreans. Additionally, IEAT in complicated appendicitis may lead to increased rates of SSI. Routine intraoperative culture in patients with complicated appendicitis may be an effective strategy for appropriate antibiotic regimen.

The epiopathogenesis of craniosynostosis remains obscure. According to the studies involved, the conditions observed at birth are very different. In case that a deformity is obvious or the risk of brain compression is possible, strip craniectomy, frontal bone advancement and cranial vault remodeling methods are used. These direct reshaping or remodeling methods are time consuming and require greater use of physical resources and still are not uniformly successful in making skull shape to normal. Distraction of the cranial bone has been studied to solve this problem. This study subsequently included 30 white rabbits aged about 25 weeks. The rabbits were divided in three groups. In group I, a 0.25mm distraction was done every other day after 3 day latency period. In group II, there was a 7 day latency period with the same rate of distraction as in group I. There was a 3 day latency period with a 0.5mm distraction every other day in group III. The contralateral side underwent a sham operation as a control group. During distraction and after consolidation periods, histologic and ultrastructural studies were carried out. And a serial radiologic study was done. As a result, group I and group II showed successful distraction osteogenesis, and we demonstrated the biological and mechanical factor associated with distraction osteogenesis. In group I, despite the short latency period, there was successful bone regeneration. Group III, it also showed successful ossification. During the distraction period, there was a remarkable increase of TGF-beta1 in both groups, especially in periosteum osteoid and newly developed connective tissue. In conclusion, we have demonstrated a useful model of distraction osteogenesis in rabbit skulls, and attempted to evaluate associated biological and mechanical factors.
Bone Regeneration ; Brain ; Congenital Abnormalities ; Connective Tissue ; Craniosynostoses ; Frontal Bone ; Latency Period (Psychology) ; Osteogenesis, Distraction ; Parturition ; Periosteum ; Rabbits ; Skull* ; Transforming Growth Factor beta1