A case of Klinefelter's syndrome was reported and recent related literatures were reviewed. Case report: T. B., a 29 year-old Korean unmarried man, complained of small testes and gynecomastia. The history revealed no significant antecedent episodes which could have related to his problem. He was born when his father was 40 and his mother was 38 years old. He has no brothers nor sisters. He graduated from a university four years ago with poor record. He has been employed as a clerk of a bank Physical examination revealed a well-nourished and developed man: height, 166cm.; symphysis pubis to floor, 97 cm.; span, 168 cm.; breadth of hips, 43 cm.; breadth of shoulders, 42 cm.; hips. 92 cm.; bast, 93 cm.; weight, 67 kg. Body hairs, beard and axillary hairs were rudimentary. Pubic escutcheon was of female type and breasts were also of female type. Fatty tissue was distributed so well around the hips and breasts, that he was of female body constitution. No abnormalities were demonstrated on eyes, chest and abdomen. The penis was 5.7cm. in length. Each testis in the scrotum was palpated as a bean size. Epididymes were almost normal but prostate gland was felt flat and small. Frequency of ejaculations was once a week. (fig. 1) Laboratory examinations: routine blood and urine tests were within normal ranges. A semen sample was devoid of spermatozoa. VDRL was negative. Urinary gonadotropins for 24 hours were elevated. Urinary 17-ketosteroid for 24 hours showed 11.09 mg. The oral mucosal smear revealed that 25 per cent of the cells contained a single chromatin masses (Barr bodies). Testicular biopsies revealed characteristic findings of the syndrome. There were hyalinized seminiferous tubules, occasional tubules which contained only Sertoli ells and an increased number of interstitial cells for the most part appearing in clumps adjacent to the larger seminiferous tubules containing cells. (fig. 2) The recent literatures related to pathogenesis, terminology, sex differentiation, sex chromosome. sex chromatin, signs and symptoms of the syndrome were reviewed.
Abdomen ; Adipose Tissue ; Adult ; Biopsy ; Body Constitution ; Breast ; Chromatin ; Ejaculation ; Fathers ; Female ; Gonadotropins ; Gynecomastia ; Hair ; Hip ; Humans ; Hyalin ; Klinefelter Syndrome* ; Male ; Mothers ; Penis ; Physical Examination ; Prostate ; Reference Values ; Scrotum ; Semen ; Seminiferous Tubules ; Sex Chromatin ; Sex Chromosomes ; Sex Differentiation ; Shoulder ; Siblings ; Single Person ; Spermatozoa ; Testis ; Thorax

No abstract available.
Graves Disease* ; Hypothyroidism*

Norwegian, or crusted scabies, is a fulminant and highly infectious form of scabies in which a large number of Sarcoptes scabiei mites infest the epidermis. This is often seen in the physically or mentally handicapped, immunocompromised, and institutionalized persons. The characteristic skin lesions in this form are gross scaling and hyperkeratotic plaques with erythematous papules, especially on hands, feet, elbow, and subungual area with varying degrees of pruritus. It may be difficult to differentiate Norwegian scabies from tinea unguium when Norwegian scabies involves nail and subungual area. We report a case of tinea unguium hidden by Norwegian scabies with nail involvement in a 71-year-old patient. This is the first report of such a case in Korea.
Aged ; Elbow ; Epidermis ; Foot ; Hand ; Humans ; Institutionalization ; Korea ; Mentally Disabled Persons ; Mites ; Nails ; Onychomycosis ; Pruritus ; Sarcoptes scabiei ; Scabies ; Skin ; Tinea

Endophthalmitis is a rare but catastrophic complication of intraocular surqeries and penetrating injuries. In spite of advances in diagnosis and therapy, the overall prognosis for recovery of useful vision has been regarded as poor. We experienced eight cases of endophthalmitis and performed vitrectomy combined with intravitreal antibiotics. Four(50%) had a final isual acuty of 0.2 or better. Vitrectomy was performed in cases of advanced intraocular inflammation, and intraocular lens was removed for suspected fungal endophthalmitis or to facilitate performance of a vitrectomy. A sample of vitreous, diluted by the irrigating solution, was passed through a disposable membrane filter system and inoculated into the culture media. Modification of therapy after initial broad spectrum antibiotics was based on the culture results and clinical responses. Repetitive intraocular antibiotic injections or reoperation were performed in severe cases.
Anti-Bacterial Agents ; Culture Media ; Diagnosis ; Endophthalmitis* ; Inflammation ; Lenses, Intraocular ; Membranes ; Prognosis ; Reoperation ; Vitrectomy

No abstract available.
Subarachnoid Space* ; Syringomyelia*

Involvement of the conjunctiva with malignant lympoma is very rare. Primary malignant lymphoma of the conjunctiva equally affects men and women over age of 40 years and has a predilection for inferior conjunctival fornices. Most lesions occur unilaterUy, involving right and left sides equally frequently. Periorbital swelling is the most common presenting symptom followed by proptosis, ptosis, pain and poor or blurred vision. Radiation therapy appears to be treatment of choice for malignant lymphoma involving the conjunctiva Surgical treatment alone is less likely to remove all the tumor and should be conjoined with a wide field of radiotherapy. The prognosis of the case depends upon whether or not the disease is generalized. Although in Korea a few cases of secondary involvement of the conjunctiva with generalized malignant lymphoma have been reported, no primary case has yet been reported. The authors reported here a case of primary malignant lymphoma of the conjunctiva in a 48 year-old female patient with a review of the literatures.
Conjunctiva* ; Exophthalmos ; Female ; Humans ; Korea ; Lymphoma* ; Male ; Middle Aged ; Prognosis ; Radiotherapy

BACKGROUND: Squamous cell carcinoma of the supraglottic larynx have a propensity to metastasize earlier to the regional lymph nodes compared to their glottic counterpart owing to their unique embryological origin and abundant lymphatic tissues. However, reliable biological markers for predicting lymph node metastasis with its associated poor outcome is lacking. OBJECTIVES: As a search for biologic markers related to nodal metastasis in supraglottic cancer, the authors have performed immunohistochemical staining of various gene products and tissue factors. The results were analysed to see if these markers influenced the metastatic capability of supraglottic cancers. MATERIALS AND METHODS: Twenty-nine cases of supraglottic cancers were subdivided into node negative group(group I, N=13) and node positive group(group II, N=16). Tumor angiogenesis was assessed by counting the peritumoral microvessels in which the endothelial cells are selectively stained by von Willebrand factor. PCNA-proliferation index(PI) was obtained, and the positivity of nm23 protein, a metastasis suppressor gene product and p53 protein, a tumor suppressor gene product were assessed. RESULTS: The mean vessel counts per high power fields(X 200) were 16.6 and 27.3 for node negative and node positive groups respectively(p=0.001). The mean PCNA-PI was 8.1 in node negative group and 18.4 in the node positive group(p=0.001). The expression of nm23 was 30.8% in the node negative group and 50.0% in the node positive group. p53 expression rate was higher in the node positive group; 50.0% compared to the node negative group; 38.5%, however there was no statistical significance. CONCLUSION: We conclude that the number of new vessels and PCNA-proliferation index, but not the nm23 and p53 expression rate, may be related to the lymph node metastasis in squamous cell carcinoma of the supraglottic larynx.
Biomarkers ; Carcinoma, Squamous Cell ; Cell Proliferation* ; Endothelial Cells ; Genes, Tumor Suppressor ; Larynx ; Lymph Nodes* ; Lymphoid Tissue ; Microvessels ; Neoplasm Metastasis* ; Proliferating Cell Nuclear Antigen ; Thromboplastin ; von Willebrand Factor

Renal cell carcinoma takes up 85 per cent of primary malignant renal tumors. It frequently metastasizes to the adrenal gland, lung, bone, liver and nephrectomy site but rarely to the head and neck area. When metastasizes to head and neck area, it involves the gingiva, tongue, palate, parotid gland, uvula, mandible, and lip. When tumors are found in the salivary gland consisting of clear cells, it is impartant to carry out differential diagnosis of various primary tumors with clear cell and metastatic renal cell carcinoma. Patients' medical history, review of system, and pathologic findings would be helpful factors in the differential diagnosis. In this paper, we report on a case of renal cell carcinoma which had metastasized to the psubmandibular gland after a radical nephrectomy.
Adrenal Glands ; Carcinoma, Renal Cell* ; Diagnosis, Differential ; Gingiva ; Head ; Lip ; Liver ; Lung ; Mandible ; Neck ; Nephrectomy ; Palate ; Parotid Gland ; Salivary Glands ; Submandibular Gland* ; Tongue ; Uvula

BACKGROUND: Since the morning fluoride level of 10 uM is recommended for adults patients being treated for osteoporosis so far, measurement of serum fluoride level is important to detect abnormally high levels or to detect levels below the therapeutic windows. Aims of this study are to determine the normal range of serum ionic fluoride levels in Korean female adults (from 5th to 7th decade), and to evaluate the in vivo fluoride pharmacokinetics of monofluorophosphate in Korean adults. METHODS: Serum level of fluoride was measured from blood samples of 72 female subjects (age 43-69years) using an ion selective electrode. For pharrnacokinetics of monofluorophosphate-calcium (MFP-Ca), 6 subjects (age 27~45 years) were included to be withdrawn the blood hourly for the first S hours and the blood was withdrawn at 24 hours after a single dose of MFP-Ca. RESULTS: Mean level of serum fluoride was 1.64+-0.12uM in 5th, 6th, 7th decades adults, and there was no difference of serum fluoride levels among age groups. Peak serum fluoride level exhibited 5.02+-0.67pM, and returned to basal level on 24 hours after a single dose of MFP-Ca. CONCLUSION: This study shows that mean serutn fluoride of Korean female adults (from 5th to 7th decade) is not different from that of other reports, and a single dose of MFP-Ca does not cause serum fluoride levels above the recommended therapeutic windows of 5-10uM for 24 hours.
Adult* ; Electrodes ; Female ; Fluorides* ; Humans ; Osteoporosis ; Pharmacokinetics ; Reference Values

The presence of a bystander who can implement cardiopulmonary resuscitation would appear to increase chances of survival. However, there have been many reported complications associated with bystander CPR. Gastric rupture is a rare complication following cardiopulmonary resuscitation. An incidence of 0.1% has been reported in the literature. The majority of reported cases have been associated with inappropriate airway management or esophageal intubation. Gastric rupture can occur during chest compressions when the stomach is overinflated due to difficult airway management or esophageal intubation. Here we present the case of a patient with sudden cardiac arrest who experienced gastric rupture and pneumoperitoneum after bystander cardiopulmonary resuscitation.
Airway Management ; Cardiopulmonary Resuscitation ; Death, Sudden, Cardiac ; Humans ; Incidence ; Intubation ; Pneumoperitoneum ; Stomach ; Stomach Rupture ; Thorax