Spontaneous testicular hemorrhagic necrosis is a rare disease usually associated with testicular torsion. Partially involved and suspicious testis tumor cases are also defined from orchiectomy specimens. Herein, a spontaneous hemorrhagic necrosis, without any testicular torsion, but with involvement of the whole testicle and epididymis, is reported. A 21 year old patient, who presented with a painless left testicular enlargement of several days duration was believed, based on physical examination, ultrasonography and elevation of serum LDH, to have a testicular tumor. Diagnosis was made only after radical orchiectomy and histopathological examination.
Diagnosis ; Epididymis ; Hemorrhage ; Humans ; Male ; Necrosis* ; Orchiectomy ; Physical Examination ; Rare Diseases ; Spermatic Cord Torsion ; Testis* ; Ultrasonography ; Young Adult

Spontaneous rupture of subcapsular liver hematoma in pregnancy is rare but potential life threatening complication of preeclampsia. We experienced a case of spontaneous rupture of subcapsular hematoma of liver that was treated with conservative method. So, we present the case with a brief review of literatures as first report in Korea.
Hematoma* ; Korea ; Liver* ; Pre-Eclampsia ; Pregnancy* ; Rupture, Spontaneous

Myocarditis is defined as the myocardial inflammation caused by various infectious agents (such as virus, rickettsia , bacteria, protozoa, fungus and parasites). The clinical manifestations of myocarditis ranges from the asymptomatic state due to focal inflammation to fulminant fatal congestive heart failure secondary to diffuse myocardial involvement. Clinically, in some cases, it may simulate an acute myocardial infarction. We experienced a case of acute fulminant myocarditis that presented as acute myocardial infarction initially, and then progressed into and recovered from congestive heart failure and multiorgan failure.
Asymptomatic Diseases ; Bacteria ; Estrogens, Conjugated (USP)* ; Fungi ; Heart Failure* ; Inflammation ; Myocardial Infarction ; Myocarditis* ; Rickettsia

We report a case of giant cell tumor of the tendon sheath in a 36-year-old male, who presented an asymptomatic, firm, 1.0 × 0.8 × 0.4cm-sized nodule, involving the volar aspect of the distal phalanx of the right index finger about 1 year ago. Histopathologically, the enucleated lesion showed four lobules surrounded by thin connective tissue, each of which demonstrated the variable cellularity and the polymorphic cell population consisting of foam cells, spindle-shaped fibroblasts, histiocyte-like cells and multinucleated giant cells with heavy hemosiderin deposits near the periphery, in the collagenous stroma. He has done well with no recurrence during one year of follow-up since the operation.
Adult ; Collagen ; Connective Tissue ; Fibroblasts ; Fingers ; Foam Cells ; Follow-Up Studies ; Giant Cell Tumors* ; Giant Cells* ; Hemosiderin ; Humans ; Male ; Recurrence ; Tendons*

BACKGROUND: Fracture-risk assessment tool (FRAX) using just clinical risk factors of osteoporosis has been developed to estimate individual risk of osteoporotic fractures. We developed prediction model of fracture risk using bone mineral density (BMD) as well as clinical risk factors in Korean, and assessed the validity of the final model. METHODS: To develop and validate an osteoporotic FRAX, a total of 768 Korean men and women aged 50 to 90 years were followed for 7 years in a community-based cohort study. BMD as well as clinical risk factors for osteoporotic fracture including age, sex, body mass index, history of fragility fracture, family history of fracture, smoking status, alcohol intake, use of oral glucocorticoid, rheumatoid arthritis, and other causes of secondary osteoporosis were assessed biannually. RESULTS: During the follow-up period, 86 osteoporotic fractures identified (36 in men and 50 in women). The developed prediction models showed high discriminatory power and had goodness of fit. CONCLUSIONS: The developed a Korean specific prediction model for osteoporotic fractures can be easily used as a screening tool to identify individual with high risk of osteoporotic fracture. Further studies for validation are required to confirm the clinical feasibility in general Korean population.
Arthritis, Rheumatoid ; Body Mass Index ; Bone Density* ; Cohort Studies* ; Female ; Follow-Up Studies ; Humans ; Korea ; Male ; Mass Screening ; Osteoporosis ; Osteoporotic Fractures* ; Risk Assessment* ; Risk Factors ; Smoke ; Smoking

No abstract available.
Adrenocortical Carcinoma*

Asian Continental Ancestry Group ; Child ; Diagnosis ; Female ; Fever ; Fever of Unknown Origin ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Neck ; Rare Diseases ; Young Adult

Bladder cancer is generally manifested with gross hematuria and this is the most common urinary tract neoplasm in Korea, but it is very rare to find it combined with a contracted bladder. A case of contracted bladder was suspected as being recurred urinary tuberculosis; because of her past history, the urine analysis and cystoscopic findings seemed to resemble the chronic inflammation associated with urinary tuberculosis, and the transurethral biopsy reported only chronic inflammation. Yet the final histopathologic report after cystectomy and urinary diversion revealed that there was no tuberculosis, but rather, there was bladder transitional cell carcinoma (TCC). Therefore, any contracted bladder found in an older age patient is considered to be a urinary TCC until proven otherwise. To the best of our knowledge, this is the first case of bladder TCC combined with contracted bladder.
Biopsy ; Carcinoma, Transitional Cell* ; Cystectomy ; Hematuria ; Humans ; Inflammation ; Korea ; Tuberculosis ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urinary Diversion ; Urologic Neoplasms

PURPOSE: This study was carried out to clarify the histological characteristics of the interface of the corneal stroma and Descemet's membrane of the human eye. METHODS: Nighteen donor eyes without corneal pathology were examined by scanning and transmission electron microscopy. The Descemet's membrane including the corneal endothelium was cheked for scanning electron microscopy. The junctional characteristics of the posterior corneal stroma and Descemet's membrane was examined by transmission electron microscopy. RESULTS: The scanning electron microscopy showed that collagen sheet faced each other at the right angle near the Descemet's membrane and penetrated the Descemet's membrane with the irregular arrangement. The transmission electron microscopy showed that the electron-dense collagen filaments extended to the posterior stroma from Descemet's membrane. The arrangement of electron-dense collagen filaments paralleled with the arrangement of the collagen fibrils of the posterior stroma. CONCLUSIONS: The interface of the corneal stroma and Descemet's membrane was composed of two-typed extracellular materials without the intercellular specificatons.
Collagen ; Corneal Stroma* ; Descemet Membrane* ; Endothelium, Corneal ; Humans ; Microscopy, Electron ; Microscopy, Electron, Scanning ; Microscopy, Electron, Transmission ; Pathology ; Tissue Donors

BACKGROUND: We compared elderly and adult patients and tried to find a way to make an early diagnosis and proper management for elderly patients with altered mental status in the emergency department(ED). METHODS: During one year, two groups -123 elderly patients over 65 years and 127 adult patients from 20 to 64 years who visited ED in National Police Hospital(NPH)-were selected. Sex, age, arrival time after symptom onset, means of transportation, underlying diseases, causative disease, time of notification to other departments, and pattern of discharge of two groups were analyzed. RESULTS: The average age of the elderly and the adults were 76.43+/-9.51 and 42.12+/-15.0(yrs), respectively. As for the means of transportation, 84% of the elderly used a 911 ambulance service, and 11% used other emergency services. The average times from symptom onset to arrival for two groups were 124 minutes and 69 minutes, respectively. 86.99% of the elderly and 68.38% of the adults had underlying diseases. As for final diagnosis, cerebrovascular disease for the elderly and cardiovascular disease for the adults were the main causes. When patients left the hospital, rate of transfer to other hospital was higher in the elderly(60.2%), and rate of discharge was higher in the adults(15.8%). CONCLUSION: The elderly patients had more intracranial causes and needed longer time for diagnosis than the adult patients. In the case of the patients with intracranial cause who needed an emergency care, they were usually diagnosed at the secondary medical facility and then transferred to the other hospitals for proper treatment causing bad effect on the prognosis of the treatment due to time delay.
Adult ; Aged ; Ambulances ; Cardiovascular Diseases ; Early Diagnosis ; Emergencies ; Emergency Medical Services ; Humans ; Police ; Prognosis ; Transportation