An autopsy case of male pseudohermaphrodite associated with Bochdalek diaphragmatic hernia is reported. This newborn infant showed a large clitoris and hypospadic urethra which was the only opening in the perineum except for the anus. There were urethrovaginal fistula and uterus didelphys. The adrenals were slightly larger than normal, but microscopically did not show any features of cortical hyperplasia. Well formed testes were found and were histologically unremarkable. In addition, Bochdalek type of diaphragmatic hernia was present, associated with severe left lung hypoplasia and massively herniated abdominal organs into the chest cavity, shifting the mediastinum considerably and eventually led to death in a few minutes after birth. The pathogenesis of genital anomaly and diaphragmatic hernia is briefly discussed and it is suggested that this type of genital abnormality might be due to defect of testicular M llerian inhibitor factor and can be categorized as incomplete male pseudohermaphroditism.
Infant ; Male ; Female ; Infant, Newborn ; Humans

PURPOSE: This study was conducted to determine the factors which affect the resilience and quality of life for cancer patients with radiotheraphy. METHODS: Collecting data was conducted by self-administered questionnaire that 205 cancer patients with radiation therapy in one university hospital participated from 15th to 31st May 2015. The data analyzed by SPSS v18 and AMOS v18. RESULTS: This research found that the side-effect of treatments, social support, self esteem, depression, uncertainty and resilience are verified to be the variables having not only direct but indirect influence on the quality of life of patients receiving radiotheraphy. The side-effect of treatments was found to have direct influence on the quality of life of patients receiving was, and social support was found to have indirect influence on resilience through uncertainty and self esteem, and resilience was found to have direct influence on the quality of life. for cancer patients. CONCLUSION: It's necessary to come up with the approaches to develop the realistic practice guideline in order to raise the quality of life of patients receiving radiotheraphy, and to lower social support, self esteem, uncertainty in order to have higher resilience.
Depression ; Humans ; Quality of Life* ; Radiotherapy* ; Self Concept ; Uncertainty

OBJECTIVE: To analyse the sites of medical information by popular search engines and its appropriateness as guidance to medical information. METHOD: The search phrase "carpal tunnel syndrome" (CTS) and "stroke" were entered into four commonly used Korean web search engines. 24 and 21 web-sites from search engines were gathered, respectively. These web sites then were evaluated for authorship, content, and an informational value score was assigned to each. RESULTS: According to authorship in CTS, 16.6 percent of the sites were commercial sites and 20.8 percent were authored by oriental medical doctors with 37.5 and 16.6 percent by general physicians and physiatrists, respectively. With stroke, 9.5 percent was commercial and each 71.4, 19.0, 0 percent was authored by oriental medical doctors, physician, physiatrist respectively. Each 75, 28.6 percent of the sites offered conventional information. The mean informational value of web sites was 51.1, 41.1 points. CONCLUSION: The information about CTS on the internet is of limited quality, inconsistent contentional value, despite of relatively high informational value. With stroke, information was offered by mainly oriental medical doctors, and was not so valuable. The public and medical communities need to recognize these limitations so that the quality of medical information on the internet can be improved.
Authorship ; Carpal Tunnel Syndrome* ; Internet* ; Search Engine ; Stroke*

Reduced nasal breathing can influence the growth and development of facial structures. It may have many causes, and enlarged adenoid is the most frequent one. To investigate the effects of adenoids to jaw growth, we must first understand the normal growth of adenoids and jaws, and the relationship between size of adenoids and the values for the jaw variables. The purpose of this study is to present a more objective standard of nasopharyngeal size and jaw dimension at each bone age, by using Cervical Vertebrae Maturation Index(CVMI) of Hassel, from normal occlusion children aged 6 to 17. The results of this study suggests as follows: 1. At same bone age, female's chronologic age was about 2 year older than male. 2. There was a growth peak of nasopharyngeal(NP) height and depth between CVMI 1 to 2 in male, but in female NP height and depth gradually increase through CVMI 1 to 6. 3. Relative airway of nasopharynx increases the most between CVMI 1 to 2 period in both gender. 4. Among adenoid measurements, Ad2-related variables and upper pharynx, and among dentofacial measurements intercanine width in both arch, maxillary intermolar width and palatal depth had high correlation coefficient with adenoid percentage.
Adenoids* ; Cervical Vertebrae ; Child* ; Child, Preschool ; Female ; Growth and Development ; Humans ; Jaw* ; Male ; Nasopharynx ; Pharynx ; Respiration

Objective: : Anterior cervical spine surgery (ACSS) is a common surgical procedure used to treat cervical spinal degenerative diseases. One of the complications associated with ACSS is prevertebral soft tissue swelling (PSTS), which can result in airway obstruction, dysphagia, and other adverse outcomes. This study aims to investigate the correlation between various cervical sagittal parameters and PSTS following single-level ACSS, as well as to identify independent risk factors for PSTS. Methods: : A retrospective study conducted at a single institution. The study population included all patients who underwent single-level ACSS between January 2014 and December 2022. Patients with a history of cervical spine surgery or trauma were excluded from the study. The presence and severity of PSTS was assessed by reviewing pre- and postoperative imaging studies. The potential risk factors for PSTS that were examined include patient age, sex, body mass index, tobacco use, comorbidities, serum albumin levels, operative time, implant type, implanted level, and various cervical spine sagittal parameters. Multivariate linear regression analysis was performed to identify the independent risk factors for PSTS. Results: : A total of 62 consecutive patients who underwent single-level ACSS over a 8-year period at a single institution were enrolled in this study. Only preoperative segmental angle showed positive correlation with PSTS among various cervical spine sagittal parameters (r=0.36, p=0.005). Artificial disc replacement showed a negative correlation with PSTS (β=-0.38, p=0.002), whereas the use of demineralized bone matrix (DBM) had a positive impact on PSTS (β=0.33, p=0.009). We found that male sex, lower preoperative serum albumin, and implantation of upper cervical level (above C5) were independent predictors for PSTS after single-level ACSS (β=1.21; 95% confidence interval [CI], 0.27 to 2.15; p=0.012; β=-1.63; 95% CI, -2.91 to -0.34; p=0.014; β=1.44; 95% CI, 0.38 to 2.49; p=0.008, respectively). Conclusion : Our study identified male sex, lower preoperative serum albumin levels, and upper cervical level involvement as independent risk factors for PSTS after single-level ACSS. These findings can help clinicians monitor high-risk patients and take preventive measures to reduce complications. Further research with larger sample sizes and prospective designs is needed to validate these findings.

BACKGROUND: We developed a Pseudomonas aeruginosa outer membrane protein(OMP) vaccine, CFC-101, and the prophylactic efficacy of which has been demonstrated in animal models. In order to evaluate the safety and immunogenicity of the P. aeruginosa vaccine, we carried out a phase I/IIa clinical trial in healthy male volunteers. METHODS: Groups of eight volunteers, including two placebo subjects, were vaccinated intramuscularly with three doses of 0.25, 0.5 or 1.0 mg of the vaccine at one week intervals. Signs of systemic and local reactions observed after vaccination were recorded for each vaccinee for 5 days. Physical examinations were performed on days 0, 1, 7, 8, 14, 15, 21, and 42, and clinical laboratory tests were done on days 0, 3, and 21. Blood samples for assay of serum antibody levels were obtained up to 42 days after the first vaccination. RESULTS: The vaccine was generally well tolerated by all vaccinees, showing no significant side effects. In the three dosage groups, all vaccinees, except one receiving the 0.25 mg dose, showed significant elevation in serum IgG antibody titers against the vaccine proteins, indicating 100% seroconversion in 0.5 and 1.0 mg groups. The human antibodies induced by the vaccine were specific for P. aeruginosa OMPs, as confirmed by western blot analysis and immunoprecipitation assays. The capacity of the human antisera to enhance opsonophagocytic killing activity by polymorphonuclear leukocytes and to confer protection against P. aeruginosa infections indicates that the antibodies elicited by the vaccine have protective efficacy. CONCLUSION: We conclude that the P. aeruginosa OMP vaccine is safe and effective for human use and its optimal dose to be 0.5 or 1.0 mg.
Antibodies ; Blotting, Western ; Homicide ; Humans ; Immune Sera ; Immunoglobulin G ; Immunoprecipitation ; Male ; Membrane Proteins* ; Membranes* ; Models, Animal ; Neutrophils ; Physical Examination ; Pseudomonas aeruginosa* ; Pseudomonas* ; Vaccination ; Volunteers

OBJECTIVES: The purpose of the study was to assess the risk factors assumed to be related to the high frequency hearing loss in the noise-exposed male workers. METHODS: 712 occupationally noise-exposed male workers were included in this cross sectional study. The subjects filled out a questionnaire on the history of noise exposure, hearing protection, otologic diseases, tobacco smoking, and were tested on height, weight, hematocrit, serum total cholesterol level, fasting plasma glucose level and arterial blood pressure level. Pure tone audiometry and otoscopy were conducted and the subjects were allocated into two groups according to whether they had 4000 Hi hearing loss or not. RESULTS: The multiple logistic regression analysis showed that military noise exposure, poor wearing status of the hearing protection devices, increased age, long noise exposure duration, mean arterial pressure less than 80mmHg, high fasting plasma sugar are the factors significantly related to high frequency hearing loss (P<0.05). On the contrary, there was no significant relationship between noise intensity, body mass index, serum total cholesterol level, smoking and high frequency hearing loss. Low hematocrit was shown to be a significant factor with a p-value less than 0.1. CONCLUSIONS: High frequency hearing loss in the noise-exposed male workers is related to military noise exposure, use of hearing protection devices, age, noise exposure length, fasting glucose level and mean arterial pressure, in this order. Appropriate use of the hearing protection devices has a great impact on the prevention of the noise-induced hearing loss.
Arterial Pressure ; Audiometry ; Blood Glucose ; Body Mass Index ; Cholesterol ; Ear Diseases ; Fasting ; Glucose ; Hearing Loss* ; Hearing Loss, Noise-Induced ; Hearing* ; Hematocrit ; Humans ; Logistic Models ; Male* ; Military Personnel ; Noise ; Occupations ; Otoscopy ; Plasma ; Questionnaires ; Risk Factors ; Smoke ; Smoking

Citrobacter freundii is frequently isolated in antimicrobial-resistant nosocomial infections. Many strains of Citrobacter freundii are capable of producing an inducible broad-spectrum beta-lactamase. We report a case of an abdominal aortic aneurysm infected with Citrobacter freundii. A 55-year-old woman presented with acute lower back pain. Contrast enhanced computed tomography revealed a saccular aneurysm of the infrarenal abdominal aorta, with impending rupture. She underwent emergency surgery, during which a segment of aneurysmal aorta and infected tissue were completely removed and an in situ graft was placed for vascular reconstruction. The anastomotic site and inserted graft were wrapped with greater omentum. Citrobacter freundii was isolated by tissue culture from the resected aneurysmal wall.
Aneurysm ; Aorta ; Aorta, Abdominal ; Aortic Aneurysm, Abdominal ; beta-Lactamases ; Citrobacter ; Citrobacter freundii ; Cross Infection ; Emergencies ; Female ; Humans ; Low Back Pain ; Middle Aged ; Omentum ; Rupture ; Transplants

Dimethylacetamide is widely used in the production of plastics, resins, synthetic fibers, and gums and in purification and crystallization processes. Inhalation of the vapor or skin absorption of the liquid of dimethylacetamide(DMAC) can cause liver damage. Toxic hepatitis possibly attributable to DMAC exposure occurred in seven works among 178 employees who had worked on a new spandex-fiber production line. A large amount of DMAC is used as a spinning solvent for synthetic fibers in the factory. The patients were aged 23-47 years old and composed of five males and two females. They were involved in the process of polymerization(1 patient), spinning(1), take-up(4) and packaging(1). The mean duration of exposure was 10 weeks. They experienced fatigue, dizziness and jaundice. The patients showed elavated total bilirubin, alanine aminotransferase(ALT), and aspartate aminotransferase(AST) levels. The serologic test for viral hepatitis A, B and C were negative, as were the abdominal ultrasonographic scans. Based on the presumptive diagnosis of DMAC-induced toxic hepatitis, they were removed from the workplaces. One or two months after removal from the work, the transaminase levels returned to normal. The patients had no history of significant alcohol use, blood transfusion, recent medication, and drug abuse. As a result, authors could not find any attributable cause of toxic hepatitis but the toxicity by DMAC exposure.
Alanine ; Aspartic Acid ; Bilirubin ; Blood Transfusion ; Crystallization ; Diagnosis ; Dizziness ; Drug-Induced Liver Injury* ; Fatigue ; Female ; Gingiva ; Hepatitis A ; Humans ; Inhalation ; Jaundice ; Liver ; Male ; Plastics ; Resins, Synthetic ; Serologic Tests ; Skin Absorption ; Substance-Related Disorders

PURPOSE: Among various modalities of treatment in hepatic metastasis of colorectal cancer, hepatic resection has been proven to be the most effective treatment. This analysis was intended to determine important prognostic parameters and to understand clinically significant factors during hepatic resection and follow-up period in patients with hepatic metastasis from colorectal cancer. MATERIALS AND METHODS: Among 1,022 colorectal cancer patients treated at Asan Medical Center from July 1989 to December 1995, 99 patients were found to have liver metastasis at the time of first diagnosis or during follow-up period. These 99 patients were the subject of analysis in this retrospective clinical study. Surgical resection with curative intent was done in 35 patients and chemotherapy in 46 patients. Eighteen patients were with no treatment or misssed during follow-up. Survival rate was analysed according to clinicopathological parameters: sex, age, location of primary tumor, preoperative serum CEA level, TNM staging of primary tumor, number of hepatic metastasis, distribution, synchronous or metachronous lesions, diesase free interval, mode of treatment, type of resection, tumor free resection margin. RESULTS: Overall survival of the patients with hepatic metastasis was significantly related with numbers of metastasis (<4 vs. >4), distribution (unilobar vs. bilobar), synchronous or metachronous lesions, disease free interval ( < 12 vs. > 12 months), mode of treatment (hepatic resection vs. chemotherapy vs, no treatment, p<0.01. A multivariate analysis showed a significant association of survival with mode of treatment (p<0.01). Survival of patients with hepatic resection was significantly related with resection margin (positive vs. < 1 cm vs. > 1 cm), TNM staging of primary tumor (II vs. III), number of hepatic metastasis (p<0.01), disease free interval (p<0.05). A multivariate analysis showed a significant correlation with survival for tumor free resection margin (p<0.01). CONCLUSION: An aggressive approach of hepatic resection in the colorectal liver metastasis will improve survival, if the lesion pennits. In patients with hepatic resection, tumor free resection margin was the most important prognostic parameter by the uniand multivariate analysis. Therefore, every effort should be made to ensure that the clear margin be kept at least more than 1 cm during hepatic resection.
Chungcheongnam-do ; Colorectal Neoplasms* ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Liver ; Multivariate Analysis ; Neoplasm Metastasis* ; Neoplasm Staging ; Retrospective Studies* ; Survival Rate