45,X/47,XYY mosaicism is a rare sex chromosomal disorder with clinical information limited to 25 cases in the literature. We report an unusual mosaic Turner syndrome case in a 35-year old Korean woman with a phenotypic female, primary amenorrhea, short stature, immature secondary sexual characteristics. Cytogenetic analysis including G- and Q-banding revealed 45,X/47,XYY mosaicism, and SRY gene was demonstrated by polymerase chain reaction(PCR). Prophylactic bilateral gonadectomy was performed because the presence of Y-chromosomal sequences in Turner stigmata may predispose this patient to gonadoblastoma formation.
Adult ; Amenorrhea ; Christianity ; Chromosome Disorders ; Cytogenetic Analysis ; Female ; Genes, sry ; Gonadoblastoma ; Humans ; Mosaicism ; Turner Syndrome*

OBJECTIVE: To evaluate the efficacy of postoperative adjuvant therapy was evaluated in preventing treatment failure occurring after primary treatment with surgery in early invasive cervical cancer patients associated with histopathologic high risk factors such as lymph node metastasis, either macroscopic or microscopic, parametrial extension, lymphovascular permeation and depth of invasion >or=10 mm. METHODS: Postoperative adjuvant concurrent chemoradiotherapy (PCCRT), postoperative adjuvant chemotherapy (PCT) or postoperative adjuvant radiotherapy (PRT) alone was administered to the 80 early invasive cervical cancers with at least one of the high risk factors. Each of 61 patients was received three to six cycles of chemotherapy at about 3-weeks intervals. For squamous cell carcinoma, cisplatin 100 mg/m2 IV, or paraplatin 350 mg/m2 IV was infused followed by 5-FU 1000 mg/m2 IV infusion for 5 days. Twenty three patients were treated with PCCRT, 38 patients were treated with PCT alone. And 19 patients received PRT. RESULTS: The five-year survival rate of patients with macroscopic metastasis was 66.7% and 35.7%, in PCCRT and PRT, respectively. With microscopic lymph node metastasis, the 5-year survival rate was 83.3%, 60.0%, and 70.1% in PCCRT, PCT and PRT, respectively. With parametrial extension, the 5-year survival rate was 58.1% in PCCRT. The five-year survival rate of patients with lymphovascular permeation was 100%, 90.9% and 66.7% in PCCRT, PCT and PRT, respectively. With depth of invasion >or=10 mm, the 5-year survival rate was 100% and 91.3%, in PCCRT and PCT, respectively. CONCLUSION: PCCRT appears to be superior to PRT or PCT alone in early invasive cervical cancer patients with histopathologic high risk factors.
Carboplatin ; Carcinoma, Squamous Cell ; Chemoradiotherapy ; Chemotherapy, Adjuvant ; Cisplatin ; Drug Therapy ; Fluorouracil ; Humans ; Laparotomy* ; Lymph Nodes ; Neoplasm Metastasis ; Radiotherapy, Adjuvant ; Risk Factors* ; Survival Rate ; Treatment Failure ; Uterine Cervical Neoplasms*

No abstract available.
Aneurysm* ; Coronary Aneurysm ; Coronary Vessels* ; Drug-Eluting Stents ; Stents* ; Ultrasonography, Interventional

Direct coronal CT scans of the body have been carried out in 78 cases of the thoracic and abdnominal diseases. The results are as follows: 1. Among total 78 patients, 66 cases were successfully scanned by the direct coronal CT. 2. Direct co ronal CT scan most accurately detected retroperitoneal diseases, especially renal diseases. 3. In comparison with multiplanar reformating (MPR) image, direct coronal CT of the body has three advantages: (a) improved image quality: (b) improved definition of the coronal anatomy : (c) shorter examination time. 4. Direct coronal CT has advantages in evaluation of the mass nature and relationship with other organs. 5. Disadvantages or limitations of the direct coronal CT are as follows: in creased radiation exposure and insufficient positioning for disabled patients. 6. In our experience, direct coronal CT is considered as helpful method for presurgical evaluation and the rapeutic management of various diseases, especially gross tumor of the retroperitoneum.
Humans ; Methods ; Radiation Exposure ; Tomography, X-Ray Computed

BACKGROUND: Kallmann's syndrome is related to the defect in migration of olfactory neuron and GnRH neuron from the olfactory placode to the brain and it represents hypogonadism with anosmia or hyposmia. There are 3 modes of transmission in Kallmann's syndrome: X-linked, autosomal recessive and autosomal dominant. X-linked form is the most common. KAL gene is responsible for the X-linked form of Kallmann's syndrome and it had been localized to Xp22.3. The intron-exon organization had been determined and KAL gene mutation had also been identified in familial Kallmann's syndrome and it is very rare and shows heterogeneity. Furthermore, in the sporadic cases, KAL gene mutation is more rare. METHODS: In order to investigate the KAL gene mutation and the regulation of the gene expression in Kallmann's syndrome, we examined genomic DNA of 35 patients with sporadic Kallmann's syndrome. In the exon 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 of KAL gene and 1, 2, 3 of GnRH receptor gene, the mutations were analyzed by PCR-based DNA sequencing. RESULTS: In our study, the mutation of KAL gene and GnRH receptor gene was not identified in the studied exons that were known as preferable sites of the mutation. CONCLUSION: The mutation of KAL gene and GnRH receptor gene is rare, and it might be needed to investigate mutations in other genes or in other part of the KAL gene such as intron or promoter region.
Brain ; DNA ; Emigration and Immigration ; Exons ; Gene Expression ; Gonadotropin-Releasing Hormone* ; Humans ; Hypogonadism ; Introns ; Kallmann Syndrome* ; Neurons ; Olfaction Disorders ; Population Characteristics ; Promoter Regions, Genetic ; Receptors, LHRH* ; Sequence Analysis, DNA

Objective: We aimed to develop a deep neural network for segmenting lung parenchyma with extensive pathological conditions on non-contrast chest computed tomography (CT) images. Materials and Methods: Thin-section non-contrast chest CT images from 203 patients (115 males, 88 females; age range, 31–89 years) between January 2017 and May 2017 were included in the study, of which 150 cases had extensive lung parenchymal disease involving more than 40% of the parenchymal area. Parenchymal diseases included interstitial lung disease (ILD), emphysema, nontuberculous mycobacterial lung disease, tuberculous destroyed lung, pneumonia, lung cancer, and other diseases. Five experienced radiologists manually drew the margin of the lungs, slice by slice, on CT images. The dataset used to develop the network consisted of 157 cases for training, 20 cases for development, and 26 cases for internal validation. Two-dimensional (2D) U-Net and three-dimensional (3D) U-Net models were used for the task. The network was trained to segment the lung parenchyma as a whole and segment the right and left lung separately. The University Hospitals of Geneva ILD dataset, which contained high-resolution CT images of ILD, was used for external validation. Results: The Dice similarity coefficients for internal validation were 99.6 ± 0.3% (2D U-Net whole lung model), 99.5 ± 0.3% (2D U-Net separate lung model), 99.4 ± 0.5% (3D U-Net whole lung model), and 99.4 ± 0.5% (3D U-Net separate lung model).The Dice similarity coefficients for the external validation dataset were 98.4 ± 1.0% (2D U-Net whole lung model) and 98.4 ± 1.0% (2D U-Net separate lung model). In 31 cases, where the extent of ILD was larger than 75% of the lung parenchymal area, the Dice similarity coefficients were 97.9 ± 1.3% (2D U-Net whole lung model) and 98.0 ± 1.2% (2D U-Net separate lung model). Conclusion The deep neural network achieved excellent performance in automatically delineating the boundaries of lung parenchyma with extensive pathological conditions on non-contrast chest CT images.

PURPOSE: Pretransplant peripheral vascular examination in renal transplant recipient is not common even though the uremic status is a risk factor of developing atherosclerosis. Since that kind of atherosclerotic stenosis is inadequate for renal artery anastomosis, surgeons should perform certain procedures in that area. Until now, we have no written report about the results of renal transplant recipient who have been done endarterectomy at anastomosing iliac artery. The aim of this paper is to review the results of renal allograft recepient whose anastomosed iliac artery is endarterectomized at the time of transplantation. METHODS: Among 161 living donor renal allografts which were performed between January 1993 through June 1998, 21 allografts needed recipient iliac artery endarterectomy before vascular anastomosis. Their graft survivals, serial changes of blood pressure, serum creatinine level, and ultrasonic measure of renal arterial diameter and peak systolic velocity with their wave patterns were compared between endarterectomy group and non-endarterectomy group (control group). Mean age of endarterectomy group was older than control group (45.4 vs 32.9). Endarterectomy was done at internal iliac artery in 18 patients and both common and external iliac arteries in 3 patients. RESULTS: One and 3 year graft survivals showed higher in endarterectomy group than control group (90.9% vs 82.3%). Uncontrolled hypertension of endarterectomy group was 6.3%, 11.5%, 27.3% in 12, 24, 36 months and that of control group was 18.9%, 23.6%, 25.1%, but there was no statistical significance between groups. Serial changes of serum creatinine level of endarterectomy group was maintained low until the end of 3 years compare to control group (1.2 0.9 mg/ml vs 1.9 1.1). There was no difference between groups in peak systolic velocity and wave pattern proximal and distal to the anastomotic site of renal artery, and also no difference in measured arterial diameter and resistance index. CONCLUSION: Endarterectomy of recipient iliac artery before transplant renal vascular anastomosis show no adverse effect on recipient blood pressure, renal allograft function, graft survival and renal artery restenosis at least up to 3 years after graft.
Allografts* ; Atherosclerosis ; Blood Pressure ; Constriction, Pathologic ; Creatinine ; Endarterectomy* ; Graft Survival ; Humans ; Hypertension ; Iliac Artery ; Living Donors ; Renal Artery ; Risk Factors ; Transplantation ; Transplants ; Ultrasonics

STUDY DESIGN: A prospective study. OBJECTIVES: To report the results of new designed dual growing rods system for progressive pediatric spinal deformity. SUMMARY OF LITERATURE REVIEW: The current expandable spinal implant system appears effective in controlling progressive pediatric spinal deformity, allowing for spinal growth. However, there was no report concerning the growing rod in Korea. MATERIALS AND METHODS: Between 2010 and 2011, seven pediatric patients, who had a minimum of 1year follow-up, had undergone surgery for spinal deformity correction with a dual growing rods technique. We analyzed the demographic and radiologic data, including height, weight, age at surgery, diagnosis, number of lengthening, Cobb's angle of the major curve, thoracic kyphosis angle, lumbar lordosis angle, T1-S1 length, instrumented segment length, and complications, from the preoperative period to the last follow up period. RESULTS: Four male and three female patients with 5 neuromuscular scoliosis, 1 idiopathic juvenile osteoporosis and 1 spondyloepiphyseal dysplasia had underwent corrective surgery with dual growing rods. The mean age at the initial surgery was 11.6 years (7-13.8). The mean follow-up duration was 19.3 months (12-24), and the mean lengthening procedure time was 2.8 (2-4) for every patient. Cobb's angle of scoliosis curve was corrected from preoperative 80.2degrees(55-136) to 37.6degrees (15-81) on the last follow-up. Thoracic kyphosis angle and lumbar lordosis angle were changed from preoperative 48.7degrees(12-101) and 38.3degrees(9-72) to 44.5degrees(12-75) and 18.8degrees(1-46) on the last follow-up, respectively. Growth length during the follow-up period was measured as instrumented segment is 46 mm (33-59) and T1-S1 segment is 82 mm (66-98). Complications, such as breakage of rod in 3 cases and soft tissue infection in 1 case, occurred during the follow-up period. CONCLUSIONS: New designed dual growing rods system for pediatric patients with progressive spinal deformity is an effective and relatively safe method because of adequate correction and acceptable rate of complications.
Animals ; Congenital Abnormalities ; Female ; Follow-Up Studies ; Humans ; Kyphosis ; Lordosis ; Male ; Osteochondrodysplasias ; Osteoporosis ; Preoperative Period ; Prospective Studies ; Scoliosis ; Soft Tissue Infections

OBJECTIVE: Patients undergoing intracranial operations often suffer from post-operative epidural hematoma (EDH). The incidence and risk factors for with the occurrence of EDH after intracranial operations are not well described previously. The objective of this study was to identify the risk factors and the incidence of post-operative EDH adjacent and regional to the craniotomy. METHODS: This was a retrospective study of 23 (2.4%) patients, between January 2005 and December 2011, who underwent epidural hematoma evacuation after primary intracranial during this period, 941 intracranial operations were performed. The control group (46 patients) and hematoma group (23 patients) were categorized on the basis of having undergone the same pre-operative diagnosis and treatment within 3 months of their operations. The ages of the hematoma and control group were individually matched to similar ages within 10 years of each other to minimize bias of age. RESULTS: Univariate analysis showed that the significant pre-operative and intra-operative factors associated with post-operative EDH were a pre-operative Glasgow Coma Scale (GCS) scored <8 (crude odds ratio 8.295), prothrombin ratio >1.0 (p=0.014), prothrombin time (PT) >11.3 sec (p=0.008), intra-operative blood loss >650 mL (p=0.003) and craniotomy size >7,420 mm2 (p=0.023). In multivariate analysis, intra-operative blood loss exceeding 650 mL (median of total patients) placed a patient at significantly increased risk for post-operative EDH. CONCLUSION: Recognizing the limitations of the study, large intra-operative blood loss, wide craniotomy area, prolonged PT and a pre-operative GCS <8 are presented implicated with an increased risk of post-operative EDH after intracranial surgery.
Bias (Epidemiology) ; Craniotomy ; Glasgow Coma Scale ; Hematoma ; Hematoma, Epidural, Cranial ; Humans ; Incidence ; Multivariate Analysis ; Odds Ratio ; Prothrombin ; Prothrombin Time ; Retrospective Studies ; Risk Factors

PURPOSE: Adequate image post-processing software, essential for functional magnetic resonance imaging (fMRI)of cerebral cortex activation, is not readily available; this study aimed to evaluate the usefulness of a homemade post-processing system for fMRI and to investigate the physiologic and anatomic sources of activation signals infMRI. MATERIALS AND METHODS: Twenty nine fMRIs of motor and visual cortices activated by hand movement and photic stimulation were performed using the GRE technique (TR/TE/flip angle : 80/60/40 degrees, 64x128 matrix) in 10 normal volunteers. By using post-processing software, final functional maps were subsequently obtained. In order to investigate physiologic and anatomic sources of activation signals, fMRIs of motor cortices were repeated with different echo times, flip angles and presaturation of adjacent sections. Activation signals were compared tocortical veins on MR venograms. RESULTS: All fMRIs were successfully performed and those activation signals were detected in regions well known as motor and visual cortices. Mean percentage changes of signal intensities (PCSIs)of activation signals at echo times of 15, 30, and 60 msec were 2.9%, 3.5%, and 12.5%, respectively (p < 0.01).Mean PCSIs of activation signals with 40 degreesnd 10 degreeslip angles were 11.1% and 6.6% (p < 0.01), and those of activation signals without and with presaturation of the adjacent sections were 8.9% and 5.2% (p < 0.01). The shape and location of activation signals corresponded well with those of cortical veins. CONCLUSION: The imagepost-processing system developed in this study is a useful method for fMRI of cerebral cortex activation. Both BOLD (blood oxygen level-dependent) and inflow effects contribute to the physiologic source of activation signals, and the cortical veins draining activated cortex are the main anatomic source of activation signals.
Cerebral Cortex* ; Hand ; Humans* ; Magnetic Resonance Imaging ; Oxygen ; Veins