We experienced two cases of congenital adrenal hyperplasia(CAH), complicated by true precocious puberty with early maturation of the hypothalamic-pituitary-gonadal axis in a boy and a girl. The boy was diagnosed as CAH at 8 years of age, when he showed pseudoprecocity with adrenal rest tumor. The girl was diagnosed at neonate, when she showed ambiguous genitalia and salt-losing symptom. They developed precocious puberty during steroid treatment. Clinically they showed precocity, advanced bone age, and decreased predicted adult height, even though they showed partial gonadotrophin response to luteinizing hormone releasing hormone (LHRH) stimulation test. They were treated with LHRH analogue(leuprolide depot) resulting no further progression of precocity.
Adrenal Hyperplasia, Congenital* ; Adrenal Rest Tumor ; Adult ; Axis, Cervical Vertebra ; Disorders of Sex Development ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Infant, Newborn ; Male ; Puberty, Precocious*

No abstract available.
Atherosclerosis* ; Hyperuricemia* ; Risk Factors*

No abstract available.
Nipples* ; Poroma*

The technique of plssma exchange has been applied to a number of immune disorders in which c4eulating antibodies are present. We observed a patient with bullous pemphigoid and serious side effects of longterm use of steroid therspy. We applied ten times of plasmapheresis to him over six months period. After the plasmapheresis, clinical symptoms have greatly improved and steroid maintenance doses have been decreased. We have not observed any side effect of plasmapheresis such as thrambotopenia or hypogarnrnaglobulinemia during the whole therapeutic period.
Antibodies ; Humans ; Immune System Diseases ; Pemphigoid, Bullous* ; Plasmapheresis*

Rasch was the first to use the term carcinoma erysipelatoides in the dermatologic literature, and it is most frequently associated with breast carcinoma. This inflammatory type of rnetastatic carcinoma of the breast is an uncommon but well known entity. It occurrs almost exclusively in women, tends to appear in the anterior chest wall, and is usually found after recognition of the primary tumor which is usually adenocarcinoma or undifferentiated carcinoma. It has an acute inflammatory process with rapid progress, with many fatalities resulting in a short time. We report a case of carcinoma erysipela,toides originating from a breast carcinoma with characteristic clinical and histopathologic findings.
Adenocarcinoma ; Breast ; Breast Neoplasms ; Carcinoma ; Female ; Humans ; Skin* ; Thoracic Wall

Serum IgE values were determined in 100 patients vith atogic dermatitis in the Department of Dermatology at Severance Hospital, Yonsei University College of Medicine, from Oct. 1, 1978 to Mar. 31, 1980. Mean IgE value of patients is 293. 4 unit/ml which is significantly higher than reference value, and the following results were obtained. 1. The mean IgE value in adults with atopic dermatitis, 339.8 unit/ml, 30 cases: more tian 16 years old) was significantly higher than in children(251. 4 unit /ml, 70 cases). 2. Male patierts showed higher IgE va,lue (mean 324. 5 unit/ml, 62 cases,' than female patients (242.7 unit/ml, 38 cases). 3. No close correlation was demonstrated between IgE values and eosiniphils in blood. 4. Patients with parasitic infesta,tion (5 cases) showed relatively increased IgE values (mean; 116. 2 unit/ml;. 5. Patients wifh bronchial asthma (2 cases) showed high IgE values exceeding 1000 unit/ml, 6. IgE. values roughly correlated with severity of the dermatitis. Four cases with high IgE values exceeding 1000 unit/ml were included in the clinically severe group.
Adult ; Asthma ; Dermatitis ; Dermatitis, Atopic* ; Dermatology ; Female ; Humans ; Immunoglobulin E* ; Male ; Reference Values

BACKGROUND: Follicular thyroid carcinoma (FTC) is the second most common thyroid malignancy and its differential diagnosis includes follicular adenoma (FA) and adenomatous goiter (AG). Several ancillary markers have been suggested to aid in the diagnosis of FTC, but the successful use of these methods still needs to be validated. METHODS: In the present study, we verified the immunoexpression of HMGA2, CEACAM6, survivin, and SFN/14-3-3 delta in lesions including 41 AGs, 72 FAs, and 79 FTCs. We evaluated their diagnostic usefulness, combined with galectin 3, Hector Battifora mesothelial 1 (HBME1), cytokeratin 19, and cyclin D1, in diagnosing FTC. RESULTS: The expressions of HBME1 (65.8%) and HMGA2 (55.7%) were significantly higher in FTCs than in FAs and AGs (p<.001 and p=.005, respectively). HBME1 was the only marker that was more frequently expressed in FTCs than in FAs (p=.021) and it was more frequently expressed in follicular neoplasms than in AGs (p<.001). Among the novel markers, the combination of HMGA2 and HBME1 showed the highest sensitivity (72.2%) and specificity (76.1%) for diagnosing FTC. CEACAM6, survivin, and SFN/14-3-3 delta were barely expressed in most cases. CONCLUSIONS: Our present results show that only HMGA2 can be beneficial in differentiating FTC using the novel markers.
Adenocarcinoma, Follicular* ; Adenoma ; Cyclin D1 ; Diagnosis ; Diagnosis, Differential ; Galectin 3 ; Goiter ; Keratin-19 ; Sensitivity and Specificity ; Thyroid Gland

Injury of diaphragm mainly occur in penetrating, crush and blunt injuries to the lower chest or upper abdomen, and it is most often secondary to automobile accidents. Diaphragmatic rupture is most frequent in blunt chest trauma and the rate is below 1% of them. Traumatic rupture of the diaphragm is responsible for the herniation of abdominal viscera. Physical finding and radiographic sign of diaphragmatic hernia is nonspecific and misreading. Therefore, the diagnosis of traumatic rupture of diaphragm may be difficult during the early period after the injury, especially when clinical features are dominated by associated injuries. Emergency surgical management is necessary when it is complicated with serious complication. We experienced the case of traumatic diaphragmatic hernia detected after the operation of femur fracture. The patient was injured by motor vehicle accident 6 days before the operation of the femur fracture. There was no specific symptom and sign and the manifestation of the diaphragmatic hernia. in radiographic studies until operation of the femur fracture was done. Diaphragmatic hernia was confirmed by chest X-ray and arterial blood gas analysis after operation of the femur fracture. The repair of the diaphragmatic hernia was directly performed after the diagnosis. The prognosis was favorable, and she was discharged to ward from intensive care unit after 1 day of operation. We must consider the possibility of traumatic diaphragmatic hernia in the patient who have the history of blunt chest or abdominal trauma.
Abdomen ; Analgesia, Patient-Controlled* ; Automobiles ; Blood Gas Analysis ; Diagnosis ; Diaphragm ; Emergencies ; Femur* ; Hernia, Diaphragmatic ; Hernia, Diaphragmatic, Traumatic* ; Humans ; Intensive Care Units ; Morphine* ; Motor Vehicles ; Prognosis ; Rupture ; Thorax ; Viscera ; Wounds, Nonpenetrating

One of the goals of anesthesia is complete, comfortable and rapid recovery without sequelae from anesthesia. We compared the recovery pattern between anesthesia with propofol and thiopental/isoflurane. The fifty patients undergoing emergency appendectomy were allocated randomly to receive one of the anesthesia with propofol or thiopental/isoflurane. All of the patients were also given fentanyl, atracurium in equivocal dosage per weight and 50% N2O. Group 1(patient No; 25) was received anesthesia with fentanyl, atracurium, N2O and continuous injection of 6~12 mg/kg/hour of propofol. Group 2(patient No; 25) was received anesthesia with thiopental, fentanyl, atracurium, N2O and 1~2 MAC(minimal alveolar concentration) of isoflurane. We studied the duration of return of self respiration from discontinuation of anesthetics and recovery pattern in time sequence. The results were as following; The group 1 compared with group 2 at early recovery phase. 1) The duration of return of self respiration from discontinuation of anesthetics retured more rapid. 2) Emergence time was more rapid. 3) Postoperative sequelae(nausea, vomiting, sedation, drowsiness, memory dysfunction, pain) rate was less severe. But at recovery phase after 24 hours, there were no significant difference in postoperative sequelae and recovery condition in both groups. Therefore, we concluded that propofol is better than thiopental/isoflurane for anesthesia of emergency appendectomy in view of early recovery pattern.
Anesthesia* ; Anesthetics ; Appendectomy ; Atracurium ; Emergencies ; Fentanyl ; Humans ; Isoflurane ; Memory ; Propofol* ; Respiration ; Sleep Stages ; Thiopental ; Vomiting

Tracheal tumors are uncommon comprising less than 0.1% of all malignancies. Metastatic tracheal tumors, especially form the extrathoracic sites, are exceedingly rare. Ovarian cancer tends to metastasize to the serous cavities and the lymph nodes. One large autopsy study reported tracheal involvement in 1% of patients who had died from ovarian cancer. Other studies have not mentioned tracheal involvement at all. Since the main symptoms of cough, hemoptysis, or wheezing are nonspecific, patients may be initially treated for other conditions including asthma or bronchitis. Here we describe a metastatic tracheal tumor from an overain carcinoma that was initally treated for bronchial asthma.
Asthma ; Autopsy ; Bronchitis ; Cough ; Hemoptysis ; Humans ; Lymph Nodes ; Ovarian Neoplasms ; Respiratory Sounds