A 16-year old male patient visited the hospital complaining of inguinal pain and internal snapping of right hip joint. In physical examination, the patient was presumed to be diagnosed femoroacetabular impingement (FAI) and acetabular labral tear. In radiologic evaluation, FAI and acetabular labral tear were identified and bony tumor associated with internal snapping was found on the posteromedial portion of the femoral neck. Despite of conservative treatment, there was no symptomatic improvement. So arthroscopic labral repair, osteoplasty and resection of bony tumor were performed. The tumor was pathologically diagnosed as osteochondroma through biopsy and all symptoms improved after surgery. There was no recurrence, complication or abnormal finding during 1 year follow up. Osteochondroma located at posteromedial portion of femoral neck can be a cause of internal snapping hip and although technical demands are challenging, arthroscopic resection can be a good treatment option.
Acetabulum ; Arthroscopy ; Biopsy ; Femoracetabular Impingement ; Femur Neck ; Follow-Up Studies ; Hip ; Hip Joint* ; Humans ; Male ; Osteochondroma* ; Physical Examination ; Recurrence

Leydig cell tumors of the testis is only 1 to 3% of all testicular tumors. Although they are usually clinically benign, about 1O% of the reported cases has been associated with a malignant course. Malignant testicular leydig cell tumors occur exclusively in adult. Early metastasis is usually seen and there is no proved sensitivity to radiation or chemotherapeutic regimens in patients with disseminated tumor with poor prognosis. A-70-year-old man was admitted to Korea University Haewha Hospital with rapid growing, nontender testicular mass. On physical examination, right testicular hard mass measuring 9 x 6 x 5cm in size showed negative transilumination test. Under the impression of testicular tumor, radical orchiectomy was performed. Histologic and electron-microscopic features revealed malignant leydig cell tumor and the literatures are reviewed.
Adult* ; Humans ; Korea ; Leydig Cell Tumor* ; Neoplasm Metastasis ; Orchiectomy ; Physical Examination ; Prognosis ; Testicular Neoplasms ; Testis*

Rhabdomyosarcoma of the kidney is a highly malignant and very rare tumor. Only a few cases were reported previously. A 54-years-old male was admitted to the Korea University, Haewha hospital with gross, painless hematuria and palpable mass in RUQ of abdomen. Herein, we are presenting a case of renal rhabdomyosarcoma with the review of literatures.
Abdomen ; Hematuria ; Humans ; Kidney ; Korea ; Male ; Rhabdomyosarcoma*

Angiokeratoma of the vulva is a relatively rare, benign condition that usually presents as single or a few isolated papules mainly on the labia majora. It is histologically identical to angiokeratoma of the scrotum. A 50-year-old woman presented with a one year history of nonpruritic lesions on the vulva. Her skin lesions used to bleed vith subtle trauma. Several dark purplish papules, ranging in diameter from 3 to 5mm, were noticed on both labia majora. A biopsy confirmed the diagnosis of angiokeratoma. A simple electrodesiccation of all lesions was performed under local anesthesia. The patient has remained asymptomatic nd without recurrence for the follow-up period of 10 months without any recurrence.
Anesthesia, Local ; Angiokeratoma* ; Biopsy ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Recurrence ; Scrotum ; Skin ; Vulva*

BACKGROUND: 'Dong-A Syphilis' enzyme immunoassay(EIA) kit for detecting antibodies against T. pallidum was recently introduced. The performance of 'Dong-A Syphilis' in precision, sensitivity and specificity was evaluated to know the adequacy in substituting for VDRL as a primary screening test. METHODS: Intra and inter-run precision were evaluated by positive and negative controls and 4 other concentrations which were made by mixing positive controls with negative controls. Sensitivity and specificity were evaluated using 120 samples positive in both VDRL and FTA-ABS and using 487 samples negative in VDRL, respectively. Positive rates of EIA and VDRL among 342 persons who visited health promotion center in Asan Medical Center were compared. RESLUTS: Intra-run precision was between 2.2% and 5.5%, and inter-run precision between 9.9% and 15.6%. Sensitivity and specificity were 99.2% and 99.7%, respectively. EIA showed higher positive rate (5.8%) than VDRL (3.5%). 11 samples (3.2%) were reactive only in both EIA and FTA-ABS. CONCLUSION: The performance of 'Dong-A syphilis' EIA was so good in precision, sensitivity and specificty that the EIA kit could substitute for VDRL as a primary screening test for syphilis. EIA screening for syphilis would be more appropriate for a person to promote his own health in that it could detect untreated past infection.
Antibodies ; Chungcheongnam-do ; Health Promotion ; Humans ; Immunoenzyme Techniques ; Mass Screening ; Sensitivity and Specificity ; Syphilis

OBJECTIVES: The cerebrovascular diseases including stroke have become prevalent in Korea, ranking first as the cause of death in the aged. The quality of life (QOL) in stroke patients has been studied with growing interest since every aspect of life after stroke is influenced by the sequelae of this illness. This study aimed at 1) describing QOL of stroke patients and 2) identifying predictors of two month QOL after the event in stroke survivors. METHOD: WHO QOL scale was used to evaluate two month QOL after the stroke in 69 ischemic stroke patients. Data on age at the stroke event, sex, education level, brain MRI (magnetic resonance imaging) findings, symptoms of depression and anxiety, and neurologic disabilities were collected. Analyses were performed to explore the predictors of two month QOL. RESULTS: Stroke survivors with higher number and volume of frontal cortex lesions had lower two month QOL. Also, patients with more severe subcortical gray matter lesions had significantly lower two month QOL. Stroke patients with depression at the event had lower two month QOL than patients without depression. CONCLUSION: Lesions in frontal cortex and subcortical gray matter hyperintensities on MRI T2 images and depression in acute phase were of paramount importance in predicting two month QOL. Accurate and prompt neurologic and psychiatric interventions are required to improve QOL after stroke.
Anxiety ; Brain ; Cause of Death ; Depression ; Education ; Frontal Lobe ; Humans ; Korea ; Magnetic Resonance Imaging ; Quality of Life* ; Stroke* ; Survivors

PURPOSE: This study evaluated the usefulness of ultrasonography for a diagnosis of acetabular labral tear in femoroacetabular impingement (FAI). MATERIALS AND METHODS: From March 2010 to October 2011, an ultrasonographic examination was performed in 58 patients(58 hips: 26 men and 32 women) with acetabular labral tear. The sensitivity and positive predictive value of ultrasonography were evaluated for 58 cases with acetabular labral tear confirmed by hip arthroscopy. RESULTS: The sensitivity and positive predictive value for an acetabular labral tear using ultrasonography was 89.6% and 100%, respectively. The concordance rate of an acetabular labral tear between arthroscopy and ultrasonography was 84.6%. CONCLUSION: Hip ultrasonography can make a significant contribution to a pathologic diagnosis and isa useful diagnostic tool for acetabular labral tears.
Arthroscopy ; Femoracetabular Impingement ; Hip ; Humans ; Male

BACKGROUND: Infection with human papilloma virus (HPV) is the main cause of cervical cancer, and HPV genotyping is of increasing importance for determining clinical course and management of the disease based on the HPV genotypes. Here, we established a novel matrix-assisted laser desorption/ ionization time of flight mass spectrometry (MALDI-TOF MS) assay, termed restriction fragment mass polymorphism (RFMP) that is suitable for genotyping multiple HPV in an accurate and high-throughput manner. We evaluated the performance of the RFMP assay in HPV genotyping by comparing the results with those of direct or clonal sequencing and hybrid capture (HC) assays. METHODS: The study population consisted of 50 patients with histologically confirmed cervical lesions and a positive test for HPV DNA. HPV genotyping was performed with RFMP, sequencing, and HC assays. The assigned genotypes and risk groups were compared among the methods. RESULTS: Concordance rates in the genotype level between RFMP vs sequencing, sequencing vs HC, and HC vs RFMP were 98% (49/50), 88% (44/50), and 88% (44/50), respectivley. Especially, RFMP and sequencing were 100% concordant when assigned high-risk group was considered identical in 1 case of mixed genotypes identified only in RFMP. The observed discrepancy between HC and the other two methods is due to the assignment of six cases of low, intermediate, or unassigned risk genotypes as high-risk group in HC method. CONCLUSIONS: RFMP, sequencing, and HC assays were highly concordant with each other in HPV genotyping. Compared to sequencing assay, RFMP assay is found to be advantageous in detecting mixed genotype infections. The accuracy and amenability to high-throughput analysis should make the RFMP assay suitable for reliable screening of HPV genotypes in clinical laboratories.
Female ; Genotype ; Humans ; Nucleic Acid Hybridization/methods ; Papillomaviridae/classification/genetics/*isolation & purification ; Papillomavirus Infections/*diagnosis ; Polymorphism, Restriction Fragment Length ; Sequence Analysis, DNA/methods ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization/*methods ; Uterine Cervical Neoplasms/*diagnosis

BACKGROUND/AIMS: Spontaneous HBeAg seroconversion occurs frequently in the immune reactive phase in HBeAg-positive chronic hepatitis B (CHB). Therefore, observation for 3-6 months before commencing antiviral therapy is recommended in patients with alanine aminotransferase (ALT) levels that exceed twice the upper limit of normal (ULN). However, HBeAg seroconversion occurs infrequently in patients infected with hepatitis B virus (HBV) genotype C. The aim of the present study was to determine whether the waiting policy is necessary in endemic areas of HBV genotype C infection. METHODS: Ninety patients with HBeAg-positive CHB were followed prospectively without administering antiviral therapy for 6 months. Antiviral therapy was initiated promptly at any time if there was any evidence of biochemical (i.e., acute exacerbation of HBV infection or aggravation of jaundice) or symptomatic deterioration. After 6 months of observation, antiviral therapy was initiated according to the patient's ALT and HBV DNA levels. RESULTS: Only one patient (1.1%) achieved spontaneous HBeAg seroconversion. Biochemical and symptomatic deterioration occurred before 6 months in 17 patients (18.9%) and 5 patients, respectively. High ALT and HBV DNA levels were both independent risk factors for biochemical deterioration. Of 15 patients with HBV DNA > or =5.1x107 IU/mL and ALT > or =5xULN, biochemical deterioration occurred in 7 (46.7%), including 1 patient receiving liver transplantation due to liver failure. CONCLUSIONS: Spontaneous HBeAg seroconversion in patients with HBeAg-positive CHB is rare within 6 months. Biochemical deterioration was common and may lead to liver failure. Immediate antiviral therapy should be considered, especially in patients with high ALT and HBV DNA levels in endemic areas of genotype C infection.
Adult ; Alanine Transaminase/blood ; Antiviral Agents/*therapeutic use ; DNA, Viral/blood ; Female ; Follow-Up Studies ; Genotype ; Guanine/analogs & derivatives/therapeutic use ; Hepatitis B e Antigens/*blood ; Hepatitis B virus/*genetics ; Hepatitis B, Chronic/*drug therapy ; Humans ; Male ; Middle Aged ; Prospective Studies ; Risk Factors

BACKGROUND: YMDD motif mutants of the hepatitis B virus (HBV) emerged in some chronic hepatitis B patients after prolonged lamivudine treatment. Recently a novel genotyping assay, the restriction fragment mass polymorphism (RFMP) method, was introduced for the detection of YMDD mutations. We compared the performance of the RFMP method with that of sequencing method in chronic hepatitis B patients who had suffered the HBV DNA breakthrough after lamivudine treatment. METHODS: Enrolled in this study were 18 chronic hepatitis B patients who experienced the DNA breakthrough after a period during which HBV DNA was undetectable by Hybrid capture II HBV DNA test (Digene Inc., Gaithersburg, MD, USA). Both sequencing and RFMP methods were used to detect YMDD variants in three phases such as before treatment, before breakthrough and after breakthrough. RESULTS: YMDD mutants were detected in 13 samples (72.2%) by both methods after DNA breakthrough. Among them were two samples with a mixed HBV population detected by RFMP. Before breakthrough, the mutants were detected in three samples (16.7%) by sequencing and four (22.2%) by RFMP, showing discrepant results for two samples. The concordance rate between both methods was 92.6%. CONCLUSIONS: Both sequencing and RFMP methods were highly concordant except in a few cases, so it is suggested that both methods are appropriate in detecting YMDD mutants.
DNA ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Lamivudine