The authors have experienced a case of mixed gonadal dysgenesis who had a testis on the left side and a streak gonad on the right side with a karyotype of 45,XO/46,XY mosaicism. Bilateral gonadectomy and feminizing genitoplasty were performed for this neonate.
Gonadal Dysgenesis, Mixed* ; Gonads ; Humans ; Infant, Newborn* ; Karyotype ; Mosaicism ; Testis

Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most useful diagnostic tool in biliary and pancreatic disease. However, ERCP cannot be performed successfully in all patients. Cannulation failure is the most common cause of failure of ERCP. Mechanical pathologies, such as peri-Vater diverticulum, cancer of the papilla of Vater, and impacted stone were the common causes of cannulation failure. We experienced two cases of carcinoma of the papilla of Vater in whom cholangiography and insertion of the nasobiliary tube were performed througth an artificial choledoehoduodenal fistula made by a needle type diathermy knife, beacuse cannulation to the duct was failed due to the tumor.
Catheterization ; Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Diathermy ; Diverticulum ; Fistula* ; Humans ; Needles ; Pancreatic Diseases ; Pathology

No abstract available.
Female ; Mammaplasty*

To evaluate the influence of intraoperative irradiation on the healing of jejunal anastomosis, an experimentalstudy was undertaken using a total of 150 rats. The bursting pressure of the normal jejunum was obtained in groupI. Group II was subjected to resection and anastomosis, and group III was irradiated on the anastomosed jejunumwith a single dose of 1,000 rads. Healing process was evaluated by measuring bursting pressure of the anastomosedjejunum on each postoperative day from 2nd to 14th, and on 21 th day. Bursting pressure was tested by inflatingthe loop of gut with water, and bursting sites were observed. The resuls obtained are summarized as follows; 1.The bursting pressure of the anastomosed jejunum retained normal strength by the 7th postoperative day in thenonirradiated group, whereas by the 11th postoperative day in the irradiated group. 2. Irradiation caused delay inthe healing of anastomosis of the jejunum until the 10th postoperative day; but after then, there was nosignificant difference in bursting pressure between both groups. 3. In the jejunal segments with normal strength,bursting occurred exclusively at the non-anastomotic site in both groups; Bursting started along the mesentericborder in the non-irradiated group, whereas rupture usually occurred on the antimesenteric border in theirradiated group. in the jejunal segments with subnormal strength, bursting usually started on the mesentericborder of the anastomotic site in both groups. The results indicate that intraoperative irradiation with a singledose of 1,000 rads causes no harmful effect on the healing of anastomosis of the jejunum in rats. Therefore, thisstudy suggests the possibility of more effective clinical application of intraoperative irradiation.
Animals ; Intestine, Small ; Jejunum ; Rats ; Rupture ; Water

The localizations and morphological characteristics of gonadotropes in the adenohypophy-sis of Korean native goat were investigated with double immunohistochemistry. The gonadotropes were present in the pars distalis and pars tuberalis, but not in the pars intermedta. Gonadotropes occupied about 49.0% of the cells in the pars distalis in females, and about 40.8% in males. Three types of gonadotropes ; FSH immunoreactive cells[FSH cells], LH immunoreac-tive cells[LH cells], and FSH and LH immunoreactive cells[FSH/LH cell], were identified according to their immunoreactivities for FSH and LH antisera. The possessional perce-ntages of FSH cells, LH cells and FSH/LH cells were 1.1%, 40.6%, 58.3% in females and 1.8%, 30.0%, 68.8% in males, respectively. FSH/LH cells were large and oval or round in shape. These cells were distributed throughout the pars distalis, but were more abundant on the dorsal part adjacent to the hypophyseal cavity and along the lateral and ventral peripheral regions. LH cells were smaller than other gonadotropes and were observed throughout the pars distalis, but predominant in the central region. FSH cells were large and oval in shape. These cells were intercalated between FSH/LH cells.
Female ; Goats* ; Gonadotrophs ; Humans ; Immune Sera ; Immunohistochemistry ; Male

PURPOSE: This study was made to evaluate the clinical characteristics of testicular microlithiasis which shows small diffuse hyperechoic nonshadowing foci throughout both testes on sonography. MATERIALS AND METHODS: Between July 1995 and May 1997, we had seen 15 Patients with dilateral diffuse microlithiasis of the testes on the sonography. Medical records were reviewed with respect to age at presentation, associated diseases, and sonographic and pathologic characteristics. RESULTS: The age of the patients ranged from 8 to 69 years. The testicular microlithiasis was coincidental to the presence of erectile dysfunction(n=5), epididymitis(n=5), varicocele(n=4), epididymal cyst(n=2), infertility(n=1), testicular teratoma(n=1) and diabetes mellitus(n=1). There were considerable variations in the numbers of echogenic foci on each sonography that examined the entire half of the scrotum(from 15 to more than 60 foci). The histological examinations were done in two patients and sbowed the lumina of seminiferous tubules filled with concentrically lamellated calcified concretions. CONCLUSIONS: The testicular microlithiasis showed a wide range of age at presentation and associated with diabetes mellitus and a variety of urological problems including erectile dysfunction, epididymitis, varicoce18, epididymal cyst, infertility and testicular teratoma. The clinical relevance remains unclear at this time. Further additional cases as well as a long-term follow-up would be necessary to assess the association between testicular microlithiasis and these coincidental conditions.
Diabetes Mellitus ; Epididymitis ; Erectile Dysfunction ; Humans ; Infertility ; Male ; Medical Records ; Seminiferous Tubules ; Spermatocele ; Teratoma ; Testis ; Ultrasonography

BACKGROUND: Adult with congenital heart disease represents a new category of specialized cardiovascular interest that requires the cooperation of a number of medical and surgical disciplines, and also requires the interactions among traditional departmental jurisdiction. Uninterrupted, long-term continuity care is essential if the concerns inherent in this new and increasing patient population are to be addressed. The purpose of this study was to analyze the clinical characteristics of congenital heart disease in adolescents and adults. METHODS: Between October 1994 and July 1996, retrospective follow-up records and registry chart of 229 consecutive patients with congenital heart disease for over 16 years in GUCH (grown-up congenital heart) clinic were reviewed by a physician and a nurse specialist. RESULTS: There were 126 female and 103 male GUCH patients with the mean age of 34+/-14.6 years old. Among the 229 patients, there were 179 natural survivors, those without cardiac repair, and 50 postoperative survivors. Congenital heart defects were 167 shunt legions, 17 obstructive and valvular legions, 14 tetralogy of Fallot, 15 complex congenital heart anomalies and 16 others. Among the 179 natural survivors; 122 (68%) required heart surgery or continuous medical surveillance, and among the 50 surgically repaired survivors; 37 (74%) required reoperation for residual heart defects, constant medical treatment or consultation from other medical divisions. The reasons for the hospital vistis were:cardiac operation or cardiac diagnosis in 128 (56%) patients, symptomatic heart conditions in 43 (19%), routine heart examinations since childhood in 31 (14%) and others in 27 (11%). Also, the patient compliances were higher in the GUCH clinic than the traditional departmental jurisdiction (p<0.001). CONCLUSIONS: To achieve continuing care for the patients with congenital heart disease in adolescents and adults, it is important to develope a specialized clinic addressing the specific needs of the congenital heart disease in adolescents and adults.
Adolescent* ; Adult* ; Diagnosis ; Female ; Follow-Up Studies ; Heart ; Heart Defects, Congenital* ; Humans ; Male ; Reoperation ; Retrospective Studies ; Specialization ; Survivors ; Tetralogy of Fallot ; Thoracic Surgery

Leiomyomatosis peritonealis disseminata is a rare benign condition characterised by the occurrence of multiple leimyomas scatterred throughout the peritoneal cavity, giving the clinical impression of a wide spread malignant tumor. The histopathology of leiomyomatosis peritonealis disseminata is that of a benign leiomyoma, probably originating from the multipotent subcoelomic mesenchymal cells. Three cases with malignant transformation were described among previous reported fifty cases. Many of the early reports described the disorder in premenopausal women, and now the histogenesis is considered to be a metaplastic change by abnormal tissue response to the relatively or absolutely elevated female sex hormone. We report a case of leiomyomatosis peritonealis disseminata, which was diagnosed by multiple scattered submucosal and subseroal leimyomas of stomach, small bowel and colon, combined with advanced gastric cancer in a 58 years old man, Multiple submucosal tumors of the stomach combined with advanced gastric cancer were demonstrated by fibergastroscopy, upper gastrointestinal barium study and abdominal ultrasonography. During radical subtotal gastrectomy multiple submucosal and subserosal tumors of stomach, and subserosal tumors of small bowel and colon were observed and these tumors were confirmed as leiomyoma without malignant potential.
Barium ; Colon ; Female ; Gastrectomy ; Humans ; Leiomyoma ; Leiomyomatosis ; Middle Aged ; Peritoneal Cavity ; Stomach ; Stomach Neoplasms* ; Ultrasonography

PURPOSE: To evaluate the MR imaging findings and gadolinium enhancing patterns of Kienboeck's disease. MATERIALS AND METHODS: Thirteen patients with Kienb ck's disease were included in this study. T1 and T2 or T2*weighted images(WI) were taken in all patients and gadolinium enhancement was performed in six patients. We compared MR signal intensity of lunates with that of normal bone marrow. MR imaging findings and stages accordingto Lichtman's classification were correlateds and we evaluated the enhancing patterns of the lunates and synovia. RESULTS: Stage II was found in five patients, stage III in seven, and stage IV in one. T1WIs showed low or focaliso signal intensity in all patients. T2WI showed low signal intensity in three patients and focal iso or focal high signal intensity in ten. There were no significant correlations between the signal intensity of lunates and stages. Synovial enhancement was detected in five patients. In four, the areas of focal iso or high signal intensity on T2WI were the enhanced areas of lunates. CONCLUSION: Kienb ck's disease showed low signal intensityon T1WI in all patients and variable signal intensity on T2WI. There was no significant correlation between MRsignal intensity and Lichtman's stage. Synovia and the areas of focal iso or high signal intensity on T2WI were frequently enhanced.
Bone Marrow ; Classification ; Gadolinium ; Humans ; Magnetic Resonance Imaging* ; Necrosis ; Osteonecrosis* ; Synovial Fluid

PURPOSE: To evaluate the diagnostic accuracy and clinical utility of percutaneous needle biopsy of the bony lesions. MATERIALS AND METHODS: Among 100 consecutive patients who underwent percutaneous needle biopsy of bony lesions, 96 patients who were diagnosed ultimately by surgery, or by clinical and radiological follow-up over 6 months were reviewed in this study. Biopsy sites were in the long bones in 51, axial bones in 45. Twelve biopsies were performed under CT guidance and the remainder were guided under fluoroscopy. The categories for the suspected diagnosis included 25 primary malignant tumors, 21 benign tumors, 31 metastases, 13 infections, and 6 miscellaneous lesions. RESULTS: Of the 96 biopsies, 86(89.6%) were adequate for the diagnosis out of which 81 were ultimately confirmed as true-positive or true-negative with the overall diagnostic accuracy rate of 94.2%. Diagnostic accuracy according to the suspected diagnosis was 91.3% in primary malignant tumors, 90.3% in metastases, and 100% in infections, benign tumors, and miscellaneous lesions. Respective diagnostic yield was 90.3% in metastases, 84.6% in infections, 84% in primary malignant tumors, 71.4% in benign tumors, and 100% in miscellaneous lesions. Both diagnostic accuracy and diagnostic yield differed little with the lesion location. No complication was observed in our series. CONCLUSION: Percutaneous needle biopsy of bony lesion is a safe procedure, offering high diagnostic accuracy and high clinical utility.
Biopsy ; Biopsy, Needle* ; Diagnosis ; Fluoroscopy ; Follow-Up Studies ; Humans ; Needles* ; Neoplasm Metastasis