Gynecomastia is a proliferation of the glandular component of the male breast. Gynecomastia is the most common variant condition of the male breast and results from the effect of an altered estrogen-androgen balance on breast tissue or from the increased sensitivity of breast tissue to a normal estrogen level. We experienced a case of macrogynecomastia in a 16-year-old boy who had a normal male phenotype and was treated by reduction mammoplasty with breast tissue removal, which was effective and produced good cosmetic and psychologic results.
Adolescent ; Breast ; Estrogens ; Female ; Gynecomastia ; Humans ; Male ; Mammaplasty* ; Phenotype

PURPOSE: To assess the effect of gestational age and illness severity, and the effect of antenatal exposure to magnesium sulfate, glucocorticoids, and antibiotics, on the timing of the first stool in preterm infants. METHODS: Medical records of all preterm infants admitted to the neonatal ward at Kangnam Sacred Heart Hospital between March 1998 and August 1998 were reviewed. We studied the time of the first stool in 55 infants. RESULTS: The median age of the infant at the time of first stool was 18 hours, and 90% of the infants passed stool by 50 hours. Both the gestational age and the illness severity, as measured by the score for neonatal acute physiology(SNAP), correlated significantly with the timing of the first stool(r=0.47 and P<0.001 for SNAP; r=0.29 and P<0.05 for gestational age). An analysis of covariance showed that the relationship between SNAP and the timing of the first stool was significant even after adjustment for gestational age(P<0.01), but the relationship between the gestational age and the timing of the first stool was not significant after adjustment for SNAP (P=0.14). Antenatal exposure to magnesium sulfate for tocolysis, glucocorticoids for enhancing fetal lung maturity, and antibiotics, had no effect on the timing of the first stool. CONCLUSION: Delayed passage of first stool is a function of illness severity, not of gestational immaturity. Antenatal exposure to magnisium sulfate, dexamethasone, and antibiotics, does not affect the timing of first stool in premature infants.
Anti-Bacterial Agents ; Dexamethasone ; Gestational Age ; Glucocorticoids ; Heart ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Lung ; Magnesium Sulfate ; Medical Records ; Tocolysis

PURPOSE: To assess the effect of gestational age and illness severity, and the effect of antenatal exposure to magnesium sulfate, glucocorticoids, and antibiotics, on the timing of the first stool in preterm infants. METHODS: Medical records of all preterm infants admitted to the neonatal ward at Kangnam Sacred Heart Hospital between March 1998 and August 1998 were reviewed. We studied the time of the first stool in 55 infants. RESULTS: The median age of the infant at the time of first stool was 18 hours, and 90% of the infants passed stool by 50 hours. Both the gestational age and the illness severity, as measured by the score for neonatal acute physiology(SNAP), correlated significantly with the timing of the first stool(r=0.47 and P<0.001 for SNAP; r=0.29 and P<0.05 for gestational age). An analysis of covariance showed that the relationship between SNAP and the timing of the first stool was significant even after adjustment for gestational age(P<0.01), but the relationship between the gestational age and the timing of the first stool was not significant after adjustment for SNAP (P=0.14). Antenatal exposure to magnesium sulfate for tocolysis, glucocorticoids for enhancing fetal lung maturity, and antibiotics, had no effect on the timing of the first stool. CONCLUSION: Delayed passage of first stool is a function of illness severity, not of gestational immaturity. Antenatal exposure to magnisium sulfate, dexamethasone, and antibiotics, does not affect the timing of first stool in premature infants.
Anti-Bacterial Agents ; Dexamethasone ; Gestational Age ; Glucocorticoids ; Heart ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Lung ; Magnesium Sulfate ; Medical Records ; Tocolysis

The authors studied clinical features, thymus histology, acetylcholine receptor antibody titers and the responses to multiple modalities of treatment in a consecutive series of 151 patients to know the characteristics of myasthenia gravis in Korea and to clarify the selection of theraputic regimens. The MG subjects were enrolled in Seoul National University Hospital Myasthenia Gravis Registry and followed for at least over 12 months from 1986 to 1991. The overall clinical features were nearly the same as other previous reports in other country except that pure ocular MG group showed younger age of onset and no significant sexual difference. When we classified 151 MG subjects by several criteria. The most valid grouping variables were whether the thymoma was present or not and whether the symptoms were generalized or not. However there was no difference of clinical features when they were divided by age of onset. Therefore we thought that it may be reasonable to classify the MG subjects by a few variables listed above for it will be helpful for comparing therapeutic modalities, estimating the prognosis, and understanding the basic pathomechanisms underlying each subgroups.
Acetylcholine ; Age of Onset ; Follow-Up Studies* ; Humans ; Korea ; Myasthenia Gravis* ; Prognosis ; Seoul ; Thymoma ; Thymus Gland

PURPOSE: Several studies have shown that finasteride limits hematuria in patients with benign prostatic hyperplasia(BPH). However, there are few reports addressing dutasteride therapy. We evaluated the effect of dutasteride on intraoperative blood loss and on microvessel density(MVD) in patients with BPH. MATERIALS AND METHODS: We studied 39 patients with BPH who underwent transurethral resection of the prostate(TURP). Group I included 22 patients who received dutasteride 0.5mg daily for 2 weeks preoperatively, and group II included 17 patients who did not. Blood loss was evaluated by comparing preoperative and postoperative hemoglobin. Sections from the prostatic suburothelium and hyperplastic prostate were individually stained for CD 34. MVD was calculated by counting the number of positively stained blood vessels in 5 random high power fields. There were no significant differences between the groups in terms of age, total prostatic volume, resected prostatic weight, or prostate-specific antigen (PSA). RESULTS: The mean MVD in the suburethral portion in dutasteride-treated patients was significantly lower than that seen in untreated patients(14.47 versus 22.19 vessels per high power field, p=0.026). In nodular hyperplasia, there was no significant difference in MVD between the two group(14.72 versus 15.24 vessels per high power field, p=0.801). CONCLUSIONS: Short term pretreatment with dutasteride decreases suburethral prostatic MVD in patients with BPH and may help reduce blood loss during TURP, particularly in huge BPH, which sometimes bleeds excessively during operation.
Azasteroids ; Blood Vessels ; Finasteride ; Hematuria ; Hemoglobins ; Humans ; Hyperplasia ; Microvessels ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Transurethral Resection of Prostate ; Dutasteride

A primary signet ring cell carcinoma (PSRCC) of the urinary bladder is a rare variant of a mucin-producing adenocarcinoma. The prognosis of a PSRCC is poor, as silent progression in a linitis platica fashion leads to delayed diagnosis. Herein, the case of a PSRCC of the bladder, which extended to the prostate, which was treated with a cystoprostatectomy, is reported.
Adenocarcinoma ; Carcinoma, Signet Ring Cell* ; Delayed Diagnosis ; Prognosis ; Prostate* ; Urinary Bladder*

BACKGROUND AND OBJECTIVES: Diagnosis by Related Groups (DRG), a system forcibly implemented in all medical institutions from July 2013, was applied to tonsillectomy and adenoidectomy in the field of Otorhinolaryngology. We analyzed the changes in medical costs and evaluated the efficiency of the DRG system by analyzing the data collected before and after the DRG implementation. SUBJECTS AND METHOD: We analyzed the total number of cases, total medical costs and per charge for tonsillectomy and adenoidectomy using the data from the Korean National Health Insurance from 2011 to 2014. We compared the number and cost of tonsillectomy and adenoidectomy by hospital type, region, and patient age. RESULTS: The total number of tonsillectomy and adenoidectomy after the application of DRG systems in July 2013 in all medical institutions was reduced, but the total costs showed a tendancy to increase, resulting in an increase per charge of case. The number of tonsillectomy and adenoidectomy was decreased in general and specialized hospitals, but the costs were increased after DRG systems. CONCLUSION: Medical costs per charge of case related to tonsillectomy and adenoidectomy was higher in the DRG system than in the 'fee for service' system. Increased medical costs, considered to be the most likely cause of patient copayments, are recognized in the DRG system. The results showed that saving effect of medical costs was not significant in the DRG system; it may appear to relieve patient burden in the short term, but the financial state of national health insurance is worsening.
Adenoidectomy ; Diagnosis* ; Diagnosis-Related Groups ; Humans ; Insurance, Health* ; Methods ; National Health Programs ; Otolaryngology ; Tonsillectomy*

Varicella, more commonly known as chickenpox, is caused by the varicella-zoster virus. It is a common benign childhood illness. In adults, Varicella is uncommon but is more severely associated with complications including pneumonia, hepatitis, disseminated intravascular coagulation, encephalitis and myocarditis. A serious and life-threatening complication is the development of varicella-zoster virus pneumonia (VZVP). Although VZVP is well described in immunocompromised hosts, it is rarely seen in immunocompetent adults. The VZVP in healthy adults is more prevalent in cigarette smokers and during pregnancy. However, reports of VZVP in healthy adults are scarce in Korea. The authors report here a case of VZVP in an immunocompetent adult and present a literature review.
Adult ; Chickenpox ; Disseminated Intravascular Coagulation ; Encephalitis ; Hepatitis ; Herpesvirus 3, Human ; Humans ; Immunocompetence ; Immunocompromised Host ; Korea ; Myocarditis ; Pneumonia ; Pregnancy ; Tobacco Products

Bronchial carcinosarcoma is a very rare malignant tumor that is composed of carcinomatous and sarcomatous elements. We describe the first case in which digital tomosynthesis was useful for the evaluation of airway obstruction by bronchial carcinosarcoma that was overlooked on initial chest radiography.
Airway Obstruction* ; Carcinosarcoma* ; Radiography ; Thorax

OBJECTIVES: The purpose of this study was to investigate the abnormality of cerebrovascular reactivity in patients with dementia of Alzheimer's type by the acetazolamide brain SPECT, which has been used in the assessment of cerebrovascular diseases. METHODS: Eighteen patients with dementia of Alzheimer's type, as diagnosed by the criteria of DSM-IV and NINCDS-ADRDA, and ten normal comparison subjects were recruited. They were rated by Mini-Mental Status Examination, Mattis Ddementia Rating Scale, and Hamilton Depression Rating Scale. Acetazolamide brain SPECT scans of dementia patients and comparison subjects were analyzed by 3-dimensional volume of interest method. RESULTS: The results were as follows. There were significant differences in the values of cerebrovascular reactivity between the two groups. The cerebrovascular reactivity of dementia patients was significantly decreased in the right frontal lobes, and increased in left temporal lobe, compared to comparison subjects(p<0.05). CONCLUSION: These results imply the possible role of the abnormality of cerebrovascular reactivity in the pathophysiology of dementia of Alzheimer's type.
Acetazolamide ; Brain* ; Dementia* ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Frontal Lobe ; Humans ; Temporal Lobe ; Tomography, Emission-Computed, Single-Photon*