Pheochromocytoma is a rare endocrine tumor arising from the chromaffin tissue, and it is able to produce and secrete catecholamines. Lymph nodes, liver, lung and bone are the most frequent sites of metastasis. We report here on a case of pheochromocytoma arising from the dura in a patient who was surgically treated for bilateral pheochromocytoma five years previously.
Catecholamines ; Humans ; Liver ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Pheochromocytoma*

Peutz-Jeghers syndrome(PJS) is a relatively rare autosomal-dominant disease characterized by the occurrence of extensive mucocutaneous hyperpigmentation and gastrointestinal polyps. PJS patients are considered to have a high prevalence of intussusception due to polyps. We report the radiological findings in two cases of intussusception due to polyps in patients with PJS, and review the literature.
Humans ; Hyperpigmentation ; Intussusception* ; Peutz-Jeghers Syndrome* ; Polyps ; Prevalence

Background: According to blood management law, serology and nucleic acid testing (NAT) are performed for HIV, HBV, HCV, and others as blood screening tests in Korea. The blood screening tests for HIV, HBV, and HCV have substantially improved transfusion safety. The blood screening results of one blood center were investigated because there is little domestic data available on screening tests. Methods: The blood donation records and screening tests results of a supplying blood center were analyzed retrospectively from January 2011 to December 2020 in Korea. Annual first-time donation numbers, sex, and age distribution of donors were investigated during 10 years. The positivity of ALT, HBsAg, anti-HCV, and anti-HIV antibody testing and the positive cases of HIV, HCV, and HBV NAT were inquired. Results: For 10 years, the blood center has collected 1,896,392 units of blood, and male donation was 1,239,873 units, which was 65.38% of total blood donation. ALT abnormal blood units were 2.06% in 2011, 2.14% in 2013, and 0.81% in 2019. The donor screening test showed HBsAg 0.03%, anti-HCV 0.02%, and anti-HIV 0.06% positivity at 2020. NAT yield cases were three with HIV, two with HCV, and 260 with HBV for 10 years. Conclusion The positivity of serology screening tests of the Hanmaeum blood center showed a decreasing trend, and the transfusion of nucleic acid positive but serologically negative blood could be prevented by performing NAT.

The external auditory canal is composed of skin, subcutaneous tissue and gland. The mass originated from external auditory canal can produce otorrhea and some obstructive symptoms. Ceruminoma is a broad term expressing the tumor arising from the ceruminous gland. The ceruminous gland tumors is assigned to one of four categories(adenoma, pleomorphic adenoma, adenocystic carcinoma & adenocarcinoma) by Wetli's protype. The wide local excision is a treatment of choice for all benign ceruminous gland tumors except the malignant tumors needed combined treatment modalities as surgery and radiotherapy. We report our recent experience of two ceruminous adenomas causing ear canal obstruction & otorrhea.
Adenoma* ; Adenoma, Pleomorphic ; Carcinoma, Adenoid Cystic ; Ear Canal* ; Radiotherapy ; Skin ; Subcutaneous Tissue

BACKGROUND AND OBJECTIVES: The simultaneous binaural bithermal caloric test is performed by stimulating both ear canals with the water of same temperature at the same time. There are some reports that the simultaneous binaural bithermal caloric test appears to be more sensitive than the alternative bithermal caloric test in detecting caloric vestibular abnormalities. However, it is not well known yet what effect simultaneous binaural bithermal caloric test has on the vestibulo-ocular reflex. We attempted to verify the clinical usefulness of the simultaneous binaural bithermal caloric test. MATERIALS AND METHODS: Otoneurologically normal subjects (n=20) and patients who have complaints of dizziness (n=141) were tested. The regular bithermal caloric test was performed, using Life-Tech water irrigator and the water of temperatures 30degreesC and 44degreesC. The simultaneous binaural bithermal test was performed using Brooker-Grams closed loop irrigator with 27degreesC and 44degreesC water. The irrigation time was 40 seconds and nystagmus was detected for more than 120 seconds by electronystagmography. We divided the test response into six types with the reference value of canal paresis (CP) of the regular bithermal caloric test. RESULTS: The distribution of nystagmus type did not show regular pattern in the normal controls. The distribution of type I and II was 77.4% when CP was more than 25% in patients, 50.6% when CP was less than 25% in patients, and 42.5% in the normal group. The maximal velocity of slow component increased in the unilateral canal paresis patients (CP>25%), compared with the normal controls and no unilateral canal paresis patients (Cp<0.05). CONCLUSION: We observed that the simultaneous binaural bithermal caloric test has advantages of being less time-consuming and more comfortable. When the maximal velocity of slow component is more than 22.6 deg/sec with type I or II response, we could predict canal paresis; however, further studies should be made for abnormal response of simultaneous caloric response on the central nervous ststem.
Caloric Tests* ; Dizziness ; Ear Canal ; Electronystagmography ; Humans ; Paresis ; Reference Values ; Reflex, Vestibulo-Ocular ; Water

Six hundred fifty-one metacarpal bones of Koreans were studied for variations in articular and non-articular surface and the number, position and direction of the diaphyseal nutrient foramina. The facets for articulation of the metacarpal bone with one another showed very frequent variations from the standard text-book description. The number and the sites of entry of the diaphyseal nutrient foramina also showed considerable variations. These findings show no apparent racial difference in variations of metacarpal bones between a Korean and an Indian.
Metacarpal Bones*

OBJECTIVES: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease involving the upper and lower motor neuron of the brain and spinal cord, leading ultimately to death due to respiratory failure in most cases. The etiology of ALS is currently unknown, but several studies show that lead exposure might be one of the potential environmental causes of ALS. In this perspective, we introduce a case involving an ALS patient exposed to lead while maintaining mechanical equipment in a waste treatment plant. METHODS: The patient was interviewed and his medical records were investigated to confirm the final diagnosis of ALS. The results of his health examination and working environment measurement were reviewed in order to evaluate the relation of his work with ALS. We also performed an analysis of lead concentration from samples taken from his workplace when we visited the plant to survey the work environment. RESULTS: Based on the patient's clinical information, work environment, relatively high level of blood lead concentration, and several studies proposing the occupational relationship between lead and ALS, his ALS may possibly have been caused by lead exposure at his workplace. CONCLUSIONS: Given the recent situation where the causal association between lead exposure and ALS is still unclear, this case report could be used as a basis to support the relevance of lead exposure with ALS, and to help improve the health and work environment of other workers who are likely to be exposed to lead.
Amyotrophic Lateral Sclerosis ; Brain ; Humans ; Medical Records ; Motor Neurons ; Neurodegenerative Diseases ; Occupational Exposure ; Plants ; Respiratory Insufficiency ; Spinal Cord

Dandy-Walker syndrome is congenital malformation characterized by cystic enlargement of the fourth ventricle and agenesis or hypogenesis of the cerebellar vermis. The major clinical symptoms of the disease are hydrocephalus, weakening of physical strenth and athletic abilities, macrocephaly, cerebellar disorders like ataxia, nystagmus and irritability, vomiting from IICP. The syndrome usually occurs in early infancy and is barely diagnosed in adult. A fifty six aged female patient whose chief complaints were dizziness with right nystagmus and right hearing disturbance visited our outpatient clinic and showed ninety three/fifty six dB in right pure tone audiometry. So we prescribed PO medication on the assumption that she had right sudden sensoryneural hearing loss with vertigo, however left nystagmus was seen in her physical examination after discharge. We present this case that she was diagnosed as Dandy-Walker syndrome in brain MRI after all.
Adult ; Ambulatory Care Facilities ; Ataxia ; Audiometry ; Brain ; Cerebellar Diseases ; Dandy-Walker Syndrome* ; Dizziness ; Female ; Fourth Ventricle ; Hearing ; Hearing Loss ; Humans ; Hydrocephalus ; Macrocephaly ; Magnetic Resonance Imaging ; Physical Examination ; Sports ; Vertigo ; Vestibular Neuronitis* ; Vomiting

PURPOSE: Microdeletions on the Y chromosome have been associated with infertile in men. The deletions cluster in three regions, named azoospermia factor (AZF): AZFa, AZFb and AZFc. It has been suggested that deletions in AZFa result in Type I Sertoli cell-only (SCO) infertility (no spermatogonia present), deletions in AZFb in spermatogenic arrest, and deletions in AZFc Type II SCO (some spermatogonia present with limited spermatogenesis). The purpose of this study was to determine the prevalence of Y chromosome microdeletions and to correlate of the pathologic presentation with specific deletions in infertile Korean men. MATERIALS AND METHODS: We analyzed 115 non-obstructive azoospermic (NOA), 30 obstructive azoospermic (OA), 30 severe oligospermic (sperm concentration <5 x 10(6)/ml) patients and 50 fathered men. We tested leukocyte DNA by PCR for the presence of STS markers, AZFa (sY84, 85, 86), AZFb (sY129, 134, 135, 143, RBM1) and AZFc (DAZ, sY242). The PCR results were confirmed by Southern hybridization and were investigated by SSCP analysis for DAZ gene muations. RESULTS: None of 30 OA and 50 fertile men had microdeletions, but 15 (13.0%) of the 115 NOA and 4 (13.3%) severely oligospermic patients had one or more microdeletions. Deletions involving only the AZFc region were found in 9 men (3 severe oligospermia, 4 spermatogenic arrest, 1 Type I SCO and 1 Type II SCO). Deletions involving only the AZFb were found in 4 (1 severe oligospermia and 3 spermatogenic arrest), and deletions involving only AZFa were found in 1 (Type I SCO). Also, deletions involving the AZFb and AZFc were found in 5 (2 severe oligospermia and 3 Type I SCO). CONCLUSIONS: The prevalence of Y chromosome microdeletion was 13.0% and 13.3% in NOA and severely oligo spermia patients. The earlier reported association with particular types of infertility was not confirmed. The region of the deletions does not correlate with severity of spermatogenic failure or the presence of visible sperm. Deletions involving more proximal regions of the Y chromosome (AZFa) seemed to be rare.
Azoospermia ; DNA ; Fathers ; Humans ; Infertility ; Leukocytes ; Male ; Oligospermia ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Prevalence ; Spermatogonia ; Spermatozoa ; Y Chromosome*

Bronchial asthma is a disease characterized by the condition of airway hyper-responsiveness, which serves to produce narrowing of the airway secondary to airway inflammation and/or various spasm-inducing stimulus. Nonspecific bronchoprovocation testing is an important method implemented for the purpose of diagnosing asthma; this test measures the actual degree of airway hyper-responsiveness and utilizes direct and indirect bronchoprovocation testing. Direct bronchoprovocation testing using methacholine or histamine may have superior sensitivity as these substances directly stimulate the airway smooth muscle cells. On the other hand, this method also engenders the specific disadvantage of relatively low specificity. Indirect bronchoprovocation testing using mannitol, exercise, hypertonic saline, adenosine and hyperventilation serves to produce reactions in the airway smooth muscle cells by liberating mediators with stimulation of airway inflammatory cells. Therefore, this method has the advantage of high specificity and also demonstrates relatively low sensitivity. Direct and indirect testing both call for very precise descriptions of very specific measurement conditions. In addition, it has become evident that challenge testing utilizing each of the various bronchoconstrictor stimuli requires distinct and specific protocols. It is therefore important that the clinician understand the mechanism by which the most commonly used bronchoprovocation testing works. It is important that the clinician understand the mechanism of action in the testing, whether direct stimuli (methacholine) or indirect stimuli (mannitol, exercise) is implemented, when the testing is performed and the results interpreted.
Adenosine ; Asthma ; Bronchial Provocation Tests ; Hand ; Histamine ; Hyperventilation ; Inflammation ; Mannitol ; Methacholine Chloride ; Methods ; Myocytes, Smooth Muscle ; Respiratory Hypersensitivity ; Sensitivity and Specificity