Macrodactyly is a rare congenital malformation characterized by an increase in the size of all the elements or structures of a digit or digits. The phalanges, tendons, vessels, subcutaneous fat, finger nails, and skin are all enlarged, but the metacarpals are not affected. The condition is most frequently found in the index and long fingers, and its etiology remains unexplained. Macrodactylism associated with neurofibroma of the median nerve in the left middle finger, in a 13 year old girl, is presented with a review of the literature, and diagnosis was confirmed by pathological examination. Chief complaints were enlargement of the left middle finger and a soft tissue mass in the left palm since birth. There was no change in motor and sensory function of the hand. X-ray showed enlargement of phalanges and a diffusely enlarged soft tissue shadow in the middle finger. We performed epiphysiodesis of the proximal, middle and distal phalanges of the left middle finger with exploration of the left median nerve to the wrist joint. An enlarged fibromatous median nerve, left side, was found with very large abundant fat lobules around it.
Diagnosis ; Female ; Fingers ; Hand ; Humans ; Median Nerve ; Metacarpal Bones ; Neurofibroma ; Parturition ; Sensation ; Skin ; Subcutaneous Fat ; Tendons ; Wrist Joint

OBJECTIVE: Rebamipide is a propionic acid derivative that has an action of the inhibition of superoxide production and removal of hydroxyl radical with the sperm incubation and cryopreservation. In the present study, to investigate whether rebamipide is useful to treat male infertility and sterility, the author observed the antioxidative effects in patient with male infertility and also examined its absorption and distribution in rat genital organ. METHODS: To measure the distribution of rebamipide in reproductive organ in the rat, carbon indicated rebamipide, 14C-OPC-12759, was orally administered to 10 Spraque-Dawley rats and its organ concentration in serum, liver, kidney, stomach, duodenum, colon, urinary bladder, seminal vesicle, epididymis and testicle were measured each time after 0.5, 1, 2, 4, 8 and 24 hours by using HPLC fluorescent method. The concentrations in semen were measured by HPLC fluorescent method in a sample of 50 infertile males who took 900 mg of rebamipide daily for 3 months. To measure the antioxidative effect and fertility rate for 3 months, each month before and after the treatment, sperm motility, vitality, the oxygen free radical formation, level of peroxidation, fetilizing capacity of semen sample which were obtained from infertile male patients by masturbation after at least 48 hours abstinence were analyzed by computer assisted semen analyzer, eosin-nigrosin stain, chemiluminescence, thiobarbituric acid method and hypo-osmotic swelling test. Simultaneously in a sample that wanted baby, both pregnancy and delivery were researched. RESULTS: The 14C-OPC-12759 concentration in the body of white rats was highest in gastrointestinal organ like stomach, smal intestine and duodenum and followed by genital organ like seminal vesicle, testis and epididymis. The rebamipide concentration in semen of infertile males was 220.77+/-327.84 ng/mL (SD) which showed a large deviation but it was higher than serum which was 126+/-76 ng/mL (SD). In the infertile males, after the treatment with rebamipide, the level of seminal reactive oxygen species (ROS) and lipid peroxidation have significantly decreased in duration of the treatment (p<0.05) and sperm vitality and fertilizing capacity except sperm motility significantly improved on post treatment of 2~3 months (p<0.05). Out of the 41 cases who hoped for pregnancy, 15 cases (36.6%) became pregnant and 12 cases had childbrith, 2 cases had miscarriage and one case is ongoing. The side effect was observed in 1 case (2%) which experienced diarrhea but it was lost spontaneously. CONCLUSIONS: We conclude from this study that rebamipide showed relatively high tendancy of absorption and excretion in the genital organ. In infertile males who had elevated ROS in semen, by specifically inhibiting the cell damage from the antioxidation, a way to preserve sperm motility, vitality and fertilizing capacity was confirmed.
Abortion, Spontaneous ; Absorption* ; Animals ; Birth Rate ; Carbon ; Chromatography, High Pressure Liquid ; Colon ; Cryopreservation ; Diarrhea ; Diethylpropion ; Duodenum ; Epididymis ; Female ; Genitalia ; Hope ; Humans ; Hydroxyl Radical ; Infertility ; Infertility, Male ; Intestines ; Kidney ; Lipid Peroxidation ; Liver ; Luminescence ; Male ; Masturbation ; Oxygen ; Pregnancy ; Rats ; Reactive Oxygen Species ; Semen ; Seminal Vesicles ; Sperm Motility ; Spermatozoa ; Stomach ; Superoxides ; Testis ; Urinary Bladder

Avascular osteonecrosis has frequently occured in patients who have undergone transplantation of a kidney and generally has been considered to be a complication of the use of corticosteroids. But there are controversies regarding their dosage and duration of use in its influence on prevalence of avascular osteonecrosis. We analyzed the cases of our patients who underwent transplantation of a kidney and who we were able to follow up more than 8 months. l. Of a total of 300 patients, osteonecrosis developed in 24 joints of 12 patients. 2. Osteonecrosis was more frequently found in group of patients who were administered with larger doses of steroid. 3. Rejections of the transplanted kidney occured more frequently in those groups with osteonecrosis. 4. Most of rejections occured within 3 months after renal transplantation. 5. It took 4–26 months (average 12.3 months) the osteonecrosis could be found. 6. There were no differences in blood concentration of calcium phosphate and creatinine between osteonecrosis and non-osteonecrosis group. 7. Replacement arthroplasties were done in 10 joints without significant complication.
Adrenal Cortex Hormones ; Arthroplasty, Replacement ; Calcium ; Creatinine ; Follow-Up Studies ; Humans ; Joints ; Kidney ; Kidney Transplantation ; Osteonecrosis ; Prednisolone ; Prevalence

OBJECTIVE:The purpose of this study is to evaluate the CT findings of the carcinoma of the ampulla of Vater and to differentiate from other periampullary carcinoma including the carcinoma of the distal common bile duct and pancreas head. MATERIALS AND METHODS: We retrospectively reviewed the CT findings of 13 cases of the carcinoma of the ampulla of Vater, 20 cases of the carcinoma of the distal common bile duct and 20 cases of the carcinoma of the pancreas head confirmed by pathology. Five millimeter consecutive settings of CT scan were performed in all cases on ampulla level with supine position. The CT findings were retrospectively evaluated in view of common bile duct dilatation, pattern of termination of bile duct, pancreatic duct dilatation, protruding mass in duodenal lumen, and regional lymph node metastasis. RESULTS: All case of the carcinoma of the ampulla of Vater(13/13) and distal common bile duct(20/20) showed common bile duct dilatation with abrupt termination. Among the 10 cases of the carcinoma of the pancreas head with common bile duct dilatation, five cases each had is abrupt termination(5/20) and gradual stenosis of bile duct(5/20). Five cases of the carcinoma of the ampulla of Vater(5/13) and four cases of the carcinoma of distal common bile duct(4/20) showed pancreatic duct dilatation and all cases of the carcinoma of pancreas head show pancreatic duct dialtation(20/20). Twenty cases of the carcinoma of the ampulla of Vater showed protruding mass in the medial wall of the second portion of the duodenum(12/13) but only one case of the carcinoma of the distal common bile duct(I/20) and five cases of the carcinoma of the pancreas head (5/20) had protruding mass in the duodenal lumen. Only one case of the carcinoma of the ampulla of Vater showed(1/13) regional lymph node metastasis but three cases of the carcinoma of the distal common bile duct(3/20) and 18 cases of the carcinoma of the pancreas head(18/20) showed regional lymph node metastasis. CONCLUSION: Common bile duct dilatation with abrupt termination, protruding mass in the duodenal lumen and rare lymph node metastasis in CT may suggest the carcinoma of the ampulla of Vater.
Ampulla of Vater* ; Bile ; Bile Ducts ; Common Bile Duct ; Constriction, Pathologic ; Dilatation ; Head ; Lymph Nodes ; Neoplasm Metastasis ; Pancreas ; Pancreatic Ducts ; Pathology ; Retrospective Studies ; Supine Position ; Tomography, X-Ray Computed

No abstract available.
Cystadenoma, Mucinous* ; Mucins* ; Pancreas*

This review-article is aimed at shedding a light upon the nature of age-associated changes in the human skeletal system. When the anatomical, physiological and biochemical consequences of bone aging are considered together with the hardening, drying and the diminished repair capabilities of the elderly, it can be seen that fractures assume greater importance as a clinical problem in the geriatric population. Older people start out with a deficit of cortical bone, making them more fracture prone and once fractures occur, the necessary treatments (immobilization, use of casts, etc.) accelerate the rate of bone loss. In addition, aged individuals stand a higher risk for complications of the hospital and enforced bed rest that may ensue. The problems resulting from bone loss in the elderly may be partially alleviated by providing adequate health service support which should include consideration of the following points : 1. Age, sex and general health status ; 2. Habits and inclinations towards physical activities ; 3. Nutritional and endocrine background ; 4. Presence of any specific bone diseases, including osteoporosis, osteoarthritis, osteomalacia and ankylosis ; 5. Psychosocial adaptability and other behavioral elements.
Aged ; Aging ; Ankylosis ; Bed Rest ; Biology* ; Bone Diseases ; Health Services ; Humans* ; Motor Activity ; Osteoarthritis ; Osteomalacia ; Osteoporosis

BACKGROUND: Tufted angioma is an uncommon slowly progressive vascular tumor found typically in infants and young children with characteristic histologic findings, so called "cannonball" appearance. OBJECTIVE: The purpose of this study was aimed to investigate the clinical and histopathological characteristics of tufted angioma and the response to intralesional steroid. METHODS: Clinical information of 10 patients with tufted angioma diagnosed in Severance hospital and Pundang CHA hospital from 1983 to 1999 was obtained from the medical records and clinical follow-ups. We re-evaluated 10 biopsy specimens obtained from them with routine H&E staining. RESULTS: Five male and five female patients were included. In 9 patients the lesion appeared before 2 months of age. Four had a lesion at birth. The thigh was the most common site. The clinical symptoms were diverse, but characteristically tenderness was present in most cases. In all the patients the lesions had a tendency to spread progressively. Microscopically, numerous, distinct, variably sized, tightly packed capillary and endothelial cellular lobules were scattered in the dermis. There were characteristic semilunar spaces adjacent to the capillary tufts. Six patients received intralesional triamcinolone. This treatment was found to be effective in 5 patients who experienced remarkable improvement. The improved cases had similar histologic findings which were composed of cellular mass more than lumen formation. We classified our specimens into two categories, one with more cellular mass and the other with more lumen formation in relative proportion. The former was different from the latter in that it had more solid appearance and more definite margin. And we realized that it was useful to divide into these two categories since its response to treatment could be different. CONCLUSIONS: Tufted angioma is a relatively uncommon disease with characteristic histopathologic findings. It seems not to regress spontaneously. So early treatment is required to pre-vent further spreading up to the extent. We treated 6 patients with intralesional injection of triamcinolone and 5 patients experienced marked improvement which had more cellular mass more than lumen formation histopathologically.
Biopsy ; Capillaries ; Child ; Dermis ; Female ; Follow-Up Studies ; Hemangioma ; Humans ; Infant ; Injections, Intralesional ; Male ; Medical Records ; Parturition ; Thigh ; Triamcinolone

The study presents the application of STR polymorphisms to male identification in the cases of a serial rapist in Korea. Since October 2000 a rapist from Cheongju city (a town located in central district) committed at least 36 rapes. DNA profiles obtained from semen stains, buccal cells and tongue tissue left at the scenes of crime and vaginal swabs of victims gave information that one and the same man had committed all the rapes. The Y-chromosome haplotype (12 loci) obtained was used for the identification process of rapist in mixed genotypes including victim's alleles. The crime scene data were referred from investigating police authorities described the relationship of victim to the offender, victim's age, time and place of sexual assault and rape locations. The behavioural analysis of crime scenes showed more similarities than differences for related crimes. These components were usually assessed in terms of proximity in time and space. Certain crime scene aspects of a serial rapist help identify components of offender spatial behaviour. As a result of this work, future research on the geography of rape and behavioural aspects of rapist will be directed towards those aspects of offences, which have been identified as relevant to the distance between an offender's base, and the site where he approached his victim.
Alleles ; Chungcheongbuk-do ; Coloring Agents ; Crime* ; Criminals ; DNA ; Genotype ; Geography ; Haplotypes ; Humans ; Korea ; Male* ; Police ; Rape ; Semen ; Tongue

Family discord and social maladjustment is frequently noticed within the family of schizophrenics. Several decades ago this family dysfunction itself had been considered as a cause of schizophrenia. According to the concept of the "schizophrenogenic mother", schizophrenia results from an inadequate mother-child relationship. Although this concept is not the case today, the parental fostering attitudes to schizophrenic patients and their family environment have been thought to be one of the important factors in recurrence and prognosis of schizophrenia. The purpose of this study was to evaluate the perceived parental fostering altitudes in schizophrenic patients. The author selected 52 schizophrenic patients diagnosed with the criteria of DSM-III -L 52 patient's siblings and 69 controls which consisted of randomly selected college students and laymen. The subjects were asked to fill out "The Parental fostering Attitude Scale" consisted of 43 items with a S-point rating score. In the parental fostering attitude scale, 8 subscales of affection, hostility, control, anxious emotion, consistent limitation, active participation, rational guidance and achievement were evaluated. The results were as follows. first of all, The perceived maternal attitudes was not significantly different between schizophrenic patients and the control poop except the achievement subscale. No significant differences of perceived paternal attitudes were found between the patient group and the control group. In short, the hypothesis of fromm-Leichmann that mothers of schizophrenic patient are aloof rejecting, overprotective and overtly hostile, is not consistent with our results. Secondly, perceived parental attitudes did not show any significant differences among groups by the educational level of the subjects. Thirdly, fathers in all groups were perceived as less affective, more hostile, not overprotective and controlling, not limiting consistently and guiding rationally on children's behavior, and less supportive on achievement than mothers. The paternal fostering attitudes were more problematic and further elaboration is needed.
Altitude ; Diagnostic and Statistical Manual of Mental Disorders ; Fathers ; Foster Home Care* ; Hostility ; Humans ; Mother-Child Relations ; Mothers ; Parents* ; Prognosis ; Recurrence ; Schizophrenia ; Siblings

Thymectomy is considered as one of the important therapy for patients with myasthenia gravis(MG) for reducing the symptoms and hasting the time of remission. However, the efficacy of thymectomy in previous studies were not in concordant with each others. This study was designed to assess the effects of thymectomy in 84 MG patients. The patients were divided into two groups according to their medications before thymectomy : the patients who had been treated with anticholinesterase(ACE group) and the others who had been treated with both anticholinesterase and steroid(steroid group). The outcomes of thymectomy were divided into two group : ""success"" and ""failure"". The ""success"" outcomes included the patients with remission or improvements and the ""failure"" outcomes included the patients with improvement by immunosuppressive agents, unimprovement, and death. To find factors which might influence on the prognosis after thymectomy, the following variables were considered for statistics; The onset age of MG, gender, myasthenic crisis before operation, the clinical symptoms at the time of operation, and the pathologic findings of thymus. The results were as follows. Sixty-six patients were included in ACE group and 18 in steroid group. The success were occurred in 37 patients among ACE group(56%) and in 8 patients among steroid group(44.4%). In ACE group, the success more frequently occurred in the patients with thymic follicular hyperplasia(79.3%) than in those with thymoma(36%), and normal or atrophic thymus(41.7%). The Patients who had mild clinical symptoms at the operation also showed higher success rate. However, gender, the age of onset, and the presence of myasthenic cirsis before the operation did not influences on the results of the operation. In steroid group, the success rate was higher in the patients with shorter duration of steroid treatment before thymectomy(< 6 month) and follicular hyperplasia. In addition, the immunosuppressive treatments also gave symptomatic improvements in most patients with failure outcomes after thymectomy. In conclusion, thymectomy demonstrated beneficial effects in about half of MG patients. Follicular hyperplasia and mild symptoms at the operation were considered to be factors for predicting better results after thymectomy. Our findings also suggest that the longstanding steroid treatment before thymectomy may negatively affect on the successful thymectomy, especially on remission.
Age of Onset ; Humans ; Hyperplasia ; Immunosuppressive Agents ; Myasthenia Gravis* ; Prognosis ; Thymectomy* ; Thymus Gland