No abstract available.

Juvenile granulosa cell tumor is rare but one of the common congenital testicular neoplasms. Although histological features are typical of its ovarian counterpart, testicular juvenile granulosa cell tumor has a distinctly different clinical presentation. We report a case of juvenile granulosa cell tumor arising in the cryptochid testis of a 4-day-old newborn. A 6 5 5 cm sized multilocular cyst containing thick, mucinous fluid was found in the peritoneal cavity. The external surface of the cyst was smooth and the septae were relatively thin. The cyst consisted of numerous mucin-filled, cystic follicles lined by cells having vacuolated cytoplasm and round to oval dark nuclei without grooves. Cells resembling granulosa cells of an ovarian follicle were also observed in the intervening stroma forming irregular solid nests.
Cryptorchidism* ; Cytoplasm ; Female ; Granulosa Cell Tumor* ; Granulosa Cells* ; Humans ; Infant, Newborn ; Male ; Mucins ; Ovarian Follicle ; Peritoneal Cavity ; Testicular Neoplasms ; Testis

PURPOSE: With our medical school accepting graduate level students, there may be more conflicts between the older students and hospital employees. These issues need to be dealt with in order to improve the quality of education of medical students during clerkship. This study aims to improve the setting of clerkship by analysing how knowledgeable hospital employees are about medical school clerkship. METHODS: Study subjects included 206 hospital employees working at a university hospital in Pusan. Subjects completed a self-reported questionnaires on the hospital employees' knowledge about medical student's clerkship. Means and standard deviations were based on a five point scale, and data were analyzed using statistical methods including chi-square-test, two-sample t-test, ANOVA, and partial correlation. RESULTS: Opinions about the awareness of educational role of the university hospital, necessity of clerkship, influence that clerkship has on doctor's careers, necessity for clerkship students to understand roles of other hospital employees, and degree to which hospital employee explain their roles to clerkship students, were positive, but opinions about the attitudes of clerkship students were neutral, and opinions about attachment to clerkship students, clerkship students' efforts to understand the roles of hospital employees were negative. Opinions about the necessity of clerkship, influence that clerkship had on doctor's careers, clerkship students' efforts to understand roles of hospital employees showed significantly positive correlations with opinions about the attitude of clerkship students, attachment to clerkship students and the degree of explaining hospital employee's roles to clerkship students. CONCLUSION: To increase attentiveness in hospital employees towards medical clerkships, it seems necessary both to educate hospital employees on the clerkship itself and on working together with medical students, and to have clerkship students continue to be taught on the roles of other employees of the hospital.
Busan ; Education ; Humans ; Schools, Medical ; Students, Medical ; Surveys and Questionnaires

The daily pollen counts in the air of Seoul, Korea were measured using a rotorod sampler from June 1990 to July 1992. Two distinct pollen periods were noted: tree pollens such as alder, poplar, willow, oak and pine appeared in the spring from March to May, and weed pollens, such as Artemisia spp., Ambrosia spp. and Hop japanese appeared in the autumn from August to September. Various kinds of grass pollen appeared from June to September. The study indicated that there were two pollen peaks in Seoul composed of tree pollens in spring and weed pollens in autumn.
Air Pollution/*statistics & numerical data ; Allergens/*analysis ; Humans ; Korea ; Plants ; *Pollen/classification ; Seasons

Direction changing positional nystagmus (DCPN) is defined as a nystagmus that changes its direction with different head and body positions. In the past, it was usually thought that DCPN was the sign of central vestibular system lesion. But recently, there have been some reports that DCPN definitely does not localize the site of lesion in the central vestibular pathway, and that it more often indicates a peripheral vestibular site. However, congenital vestibular dys- or hypoplasia was not reported as a cause of DCPN. Recently, we experienced a 17-year-old patient who had a vestibular dys- or hypoplasia and showed a transient geotrophic DCPN with a normal cochlea. We report that congenital vestibular dys- or hypoplasia can be one of the causes of DCPN and present its possible mechanism.
Adolescent ; Cochlea ; Head ; Humans ; Nystagmus, Physiologic*

No abstract available.
Humans ; Methacholine Chloride* ; Rhinitis*

PURPOSE: To determine the usefulness of MR imaging for differentiation between infectious and non-infectiousbursitis. MATERIALS AND METHODS: MR images of 16 patients (18 lesions) in whom bursitis around the hip had beendiagnosed were analyzed for homogeneity of the bursa, the presence of septation, the enhancement pattern, andassociated findings. Clinical data (symptoms and signs, laboratory data, aspiration of the bursa, and surgicalfindings) were available for correlation. The location of bursitis was trochanteric (n=9), ischiogluteal (n=5),iliopsoas (n=3), or ischiotrochanteric (n=1). RESULTS: Etiologies included infection in seven cases (3 pyogenic; 4tuberculous) and noninfecti-on in 11 (6 inflammation; 3 hemorrhage; 2 metabolic disease). In seven patients withinfectious bursitis, T1-weighted enhanced image revealed thick rim enhancement of the bursa (n=7) association withchanges in bone marrow signal intensity (n=2), bone erosion (n=2), and cellulitis (n=1). Of 11 cases ofnoninfectious bursitis, three demonstrated typical signal characte-ristics of hematoma within the distended bursa.In six of seven patients who underwent contrast-enh ancement, thick and thin peripheral enhancement of the bursawas noted. Bone erosion was found in one case of tuberculous bursitis and two of metab-olic disease. Internalseptation (n=4) and internal debris (n=3) were found in both infected and noninfected patients. CONCLUSION: MRimaging plays an important role in the diagnosis of bursitis around the hip. MR findings of thick rim enhancement,associated cellulitis, and changes in bone marrow signal intensity are suggestive of infectious bursitis.
Bone Marrow ; Bursitis* ; Cellulitis ; Diagnosis ; Femur ; Hematoma ; Hemorrhage ; Hip* ; Humans ; Inflammation ; Magnetic Resonance Imaging

PURPOSE: To determine the usefulness of carbon dioxide(CO2) indirect portography during TIPS procedure. MATERIALS AND METHODS: We evalvated eight patients who had undergone TIPS due to variceal hemorrhage or ascites caused by portal hypertension. All patients but one with complete situs inversus underwent wedged right hepatic venography for visualization of the portal vein using CO2. For CO2 indirect portal venography, 50cc of CO2 was injected by hand without prior injection of a small amount of CO2. In three patients a 5-F angiographic catheter was wedged into the right hepatic vein, and in the other five a 9-F sheath from a Ring 's transjugular access set was adjunctively wedged into the right hepatic vein over the 5-F catheter. The time required for portal vein puncture was defined as the time between the indirect portal venography procedure and the first procedure after successful portal vein puncture. RESULTS: All patients successfully underwent TIPS without any immediate complication. The portal vein was visualized by CO2 in 7 of 8 patients (87.5 %). Two of three patients who underwent indirect portography with only a 5-F catheter wedging demonstrated opacification of the right portal vein; in the remaining patient the portal venous system was not visualized. Of the five patients who underwent indirect portography with an adjunctive 9-F sheath wedged in the right hepatic vein, four showed opacification from the peripheral to the main portal vein, and in the other, the only right peripheral portal vein was opacified. The mean time for portal vein puncture was 20.5 minutes. CONCLUSION: For visualization of the portal venous system during TIPS procedure, the use of CO2 indirect portography is feasible.
Ascites ; Carbon ; Carbon Dioxide ; Catheters ; Hand ; Hemorrhage ; Hepatic Veins ; Humans ; Hypertension, Portal ; Phlebography ; Portal Vein ; Portasystemic Shunt, Surgical ; Portography* ; Punctures ; Situs Inversus

PURPOSE: While acute urinary retention(AUR) secondary to bladder outlet obstruction in the male occurs commonly and rarely causes difficulty with diagnosis and treatment but AUR in female is an uncommon findings. This study was performed to evaluate AUR in possible causes by urodynamic study and analyzed the results of treatment. MATERIAL AND METHODS: We have retrospectively tried to evaluate the possible causes of AUR in 41 female patients. Urine analysis, urine culture, urodynamic study and selectively cystoscopy were performed in 41patients. We analysed the urodynamic feature respectively and classified into areflexia type, hyperreflexia type, detrusor hyperreflexia with impaired contractility(DHIC) type and normal finding. RESULTS: The mean age of patients was 57.9 years. Major causes of AUR were CNS lesion(13 cases, 31.7%), diabetes mellitus(6 cases, 15.3%) and spinal lesion(4 cases, 10.2%). Urethral catheterization was employed as initial treatment in 32 cases(78.0%). Catheter was removed after mean 5.2 days and selective urodynamic study was done in 36 cases. Urodynamically, there were hyperreflexia type 16 cases(44.4%), areflexic type 9 cases(25%), DHIC type 6 case(16.7%), normal finding 5 cases(13.9%). The treatments of areflexic type included intermittent catheterization(IC) in 4 cases (44.4%), urethral catheterization in 3 cases (33.3%), medical therapy in 2 cases(22.2%). The treatments of hyperreflexia type included IC in 4 cases(25%), urethral catheterization in 1 case(6.3%) and medical therapy in 11 cases(68.8%). The treatments of DHIC type included IC in 2 cases(5.5%), urethral catheterization in 1 case(2.8%), medical therapy in 2 cases(5.5%) and ileal conduit in 1 case(2.8%). CONCLUSIONS: Causes of female AUR were commonly considered the functional urinary retention and rarely organic urinary retention, but there were various causes. Our study indicated the need to consider the gender and urodynamic finding on the evaluation and treatment of AUR.
Catheters ; Cystoscopy ; Diagnosis ; Female ; Humans ; Male ; Reflex, Abnormal ; Retrospective Studies ; Urinary Bladder Neck Obstruction ; Urinary Catheterization ; Urinary Catheters ; Urinary Diversion ; Urinary Retention* ; Urodynamics

Microscopic polyangiitis is a primary systemic vasculitis which involve small arterioles and capillaries. Clinical manifestations show generalized weakness, fever, myalgia, weight loss. oliguria, proteinuria, skin rash, neuromuscular symtoms, and pulmonary, gastrointestinal symtoms. Prednisolone and cyclophosphamide therapy is effectve, more than 80% of patients with microscopic polyangiitis survive for longer than 5years. However, about 50% of patients will have at least one relapse in the 4-5years after initial treatment. There is a very strong correlation between the presence of ANCA(especially p-type) and microscopic polyangiitis. We herein report a case of microscopic polyandiitis with the review of literature. A 65 years-old woman admitted to our hospital due to general weakness, fever, generalized edema, and dyspnea. Laboratory result showed high serum creatinine and CRP, moderate proteinuria, and microscopic hematuria. P-ANCA was 1:1280 positive in indirect immunofluorescence method, and kidney biopsy showed focal segmental necrotizing glomerulonephritis, crescent formation, fibrin clots, PMN and lymphocytes infiltrations in small arterioles and capillries. Immunofluorescence study was negative. Her clinical feature, laboratory findings, and the kidney biopsy result were compatible with microscopic polyangiitis. The patient had been treated with prednisolone and cyclophosphamide. P-ANCA titration was decreased 1:320 at the 19th day of treatment and was negative about 2months later.
Aged ; Antibodies, Antineutrophil Cytoplasmic ; Arterioles ; Biopsy ; Capillaries ; Creatinine ; Cyclophosphamide ; Dyspnea ; Edema ; Exanthema ; Female ; Fever ; Fibrin ; Fluorescent Antibody Technique ; Fluorescent Antibody Technique, Indirect ; Glomerulonephritis ; Hematuria ; Humans ; Kidney ; Lymphocytes ; Microscopic Polyangiitis* ; Myalgia ; Oliguria ; Prednisolone ; Proteinuria ; Recurrence ; Systemic Vasculitis ; Weight Loss