Klinefelter's syndrome is found very often among patients whose chief complaint is sterility or genital deformity. In order to discover the clinical manifestations of Klinefelter's syndrome as well as the proper treatment for it, we made some clinical observations. A total of 19 cases were found to have 47, XXY, a typical chromosomal pattern of Klinefelter's syndrome. Observation was made on the 16 cases whose clinical observation was possible. The patients' average age was 26, and their chief complaints were sterility, small testis, gynecomastia, impotence, and cryptorchidism. The testicular volume was under 5ml for all 16 cases. Nine patients who married were sterile and 6 were gynecomastia. The results of semen analysis showed azoospermia in all cases. The biopsy for the patient with cryptorchidism revealed hyalinized seminiferous tubules, thickened basement membrane, and hyperplasia of the interstitial cells. On the hormonal study, plasma FSH was 28.8-80.4 mIU/ ml (N:1-15 mIU /ml) and plasma LH was 18.1-152 mIU/ml (N:1-15 mIU/ml). The plasma testosterone was 0.7-3.8 ng/ml (N:3-10 ng/ml). Treatment was hormonal therapy with testosterone. For two patients who showed gynecomastia, mastectomy was performed. Orchiectomy was performed for one patient with cryptorchidism.
Azoospermia ; Basement Membrane ; Biopsy ; Congenital Abnormalities ; Cryptorchidism ; Erectile Dysfunction ; Gynecomastia ; Humans ; Hyalin ; Hyperplasia ; Infertility ; Klinefelter Syndrome* ; Male ; Mastectomy ; Orchiectomy ; Plasma ; Semen Analysis ; Seminiferous Tubules ; Testis ; Testosterone

BACKGROUND: It has been well known that absolute and interpeak latencies of brainstem auditory evoked potentials (BAEP) are usually prolonged in diabetics. However, Its etiology is still controversial. We tried to identify whether the cause is structural or metabolic in origin by performing BAEP and brain MRI in the diabetic patients. METHODS: BAEP were performed in both the diabetic patients (DM) group (16 males and 15 females) and the normal control group (25 males and 33 female). A brain MRI was performed in the DM group on those who showed abnormal BAEP and com-pared the results of BAEP of the DM group with those of the control group. RESULTS: 7 patients (22.6%) showed abnor-mal BAEP (male; 6, female; 1, unilateral; 4, bilateral; 3) when abnormal BAEP was defined as being larger than two and a half standard deviations of the control group BAEP results. Two males of the DM group who showed abnormal structural lesions of the pons in their brain MRI were not included in the statistical analysis. The remaining 14 diabetic male patients (mean age: 58.7 +/-9.1 years, mean disease duration: 6.1 +/-4.7 years, mean hemoglobin (Hb) A1C: 7.7 +/- 2.0%) and 15 diabetic female patients (mean age: 60.6 +/-10.8 years, mean disease duration: 5.4 +/-5.1 years, mean HgA1C: 7.8 +/-2.1%) were stastistically analyzed. Interpeak latencies of I-III, III-V, and I-V were found to be signifi-cantly prolonged in the DM group. The prolongation of interpeak latencies of I-III and I-V were found to be signifi-cantly correlated with the disease duration only in the diabetic female patients, but not with age and HbA1c. CONCLUSIONS: These findings suggest that both metabolic derangement and structural lesion contribute to prolonging the central conduction time on BAEP pathway in diabetics.
Brain ; Brain Stem* ; Diabetes Mellitus ; Evoked Potentials, Auditory, Brain Stem* ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Pons

In order to evaluate antitumor rnechanisms of interleukin (IL)-12/IL-2 that has been shown significant tumor suppressive activity on established primary and metastatic Renca tumor, we studied chemokine gene expression induced by direct action of IL- 12/IL-2 or cytokine cascade. IL-12/IL-2 induced gene expression of interferon gamma (IFN-r) and granulocyte monocyte-colony stimulating factor (GM-CSF) in splenocytes, and it induced gene expression of monokine induced by IFN-r (Mig), interferon inducible protein 10 (IP- 10), SDF-1, macrophage inflammatory protein (MIP)-1a, MIP-1B, MIP-2, monocyte chemotactic protein (MCP)-1, and Rantes in tumor mass. However IL-12/IL-2 could not induce these chemokines in tumor mass of GKO mice and Renca cell in vitro. IL- 12 also did not increased chemokine gene expression in Renca cell in vitro, but IFN-r induced gene expression of Mig, IP-10, MCP-1 in Renca cell in vitro. In the chemotaxis assay, culture supernatant of Renca cell stimulated with IFN-r increased splenocyte migration in vitro. All these data suggest IL-12/IL-2 can induce IFN-r-chemokine cascade in tumor mass, and Mig, IP-10, MCP-1 produced from tumor cell may play an important role for initial immune cell migration into tumor mass.
Animals ; Cell Movement ; Chemokine CCL5 ; Chemokine CXCL10 ; Chemokines ; Chemotaxis ; Gene Expression* ; Granulocytes ; Interferons ; Interleukins ; Macrophages ; Mice ; Monocytes

During 1964 to 1967, a survey of 30,534 persons for filariasis was made on all over the country with the following results: Among 24,816 draftees from all over the country in the army recruitment camp 155(0.63 %) were found infected with Brugia malayi. Cheju Do showed the highest microfilaria rate(3.5 %), North Kyongsang Do(1.4 %) the next and South Cholla Do(1.2 %) the third. Blood films from 2,308 inhabitants were examined and 407(17.6 %) showed microfilaria in Cheju Do. 30(3.1 %) out of 974 inhabitants in North Kyongsang Do were found to be infected. The microfilaria rates were 2.0 per cent for 400 inhabitants of Chindo island in South Cholla Do. However, no positive case of microfilaria was found in the inhabitants of Kokumdo among 1,820 persons examined in South Cholla Do and of Namhae island(among 165 persons examined) in South Kyongsang Do. The mean microfilarial density per 20 cu. mm of blood was 52.6 in the inhabitants of Cheju Do, 12.2 in North Kyongsang Do and 27.3 in Chindo island(South Cholla Do). Any distinct relationship between the incidence of positive cases of microfilariae and age or sex of the cases was not observed in Cheju Do. However, in Norh Kyongsang Do and South Cholla Do the microfilaria rate of the male group is higher than the one of the female group of the inhabitants. From the above survey results it turned out that filariasis was found throughout Southern Korea except Kyonggi Do and South Kyongsang Do. A total 30,534 persons examined, 601(2.0 %) were found to be infected by Brugia malayi. Therefore, it seems that there are some endemic foci of malayian filariasis in three main areas such as North Kyongsang Do, South Cholla Do and Cheju Do.
parsitology-helminth-nematoda-Brugia malayi ; filariasis ; epidemiology ; Army

Three-dimensional solid model has not been widely used in surgical prediction of orthognathic surgery because freque from occlusal restorations or prosthesis limited the usefulness of simulated surgery involving occlusion. We prepared three-dimensional(3D) solid model from CT data and integrated the 3D solid model with dental cast using a face-bow transfer technique combined with skeletal reference measurement and confirmation with cephalometric radiographs. With this simple and easy method, it was possible to predict bony interference between the proximal and distal segment of the mandible so that we can prevent condylar displacement after sagittal split ramus osteotomy of the mandible with prominent asymmetry. The method error was within 2mm and it seemed to be useful in preoperative planning for maxillofacial surgery with maxillo-mandibular occlusal change
Mandible* ; Orthognathic Surgery* ; Osteotomy, Sagittal Split Ramus ; Prostheses and Implants ; Surgery, Oral

A new method of urinary diversion via Skinner`s modification of Koch continent ileal reservoir was tried. With this method continence with storage of urine under low pressure is well maintained so that no external applicances are necessary. Ileorenal reflux is also prevented with this nipple forming technique. From May l986 to September l986, 4 patients underwent urinary diversion that included creation of a modified Koch pouch by Skinner. Previous urinary diversion was by ureterocutaneous diversion in 1 patient. A total of 3 patients underwent radical cystectomies for bladder cancer In 1 patient, simultaneous urethrectomy was done because of carcinoma in situ in the urethra. There were no operative mortalities. All patients are continent and without reflux to the upper urinary tract. The volume capacity of pouch is more than 400ml. The pouch is emptied by self-catheterization every 4 to 6 hours during the day and once at night. Postoperative follow-up presently is short and it is impossible to check late complications. Although preliminary, this clinical trial suggests that the quality of life for patients can be improved markedly by the modified Koch continent ileal reservoir.
Carcinoma in Situ ; Colonic Pouches* ; Cystectomy ; Follow-Up Studies ; Humans ; Mortality ; Nipples ; Quality of Life ; Urethra ; Urinary Bladder Neoplasms ; Urinary Diversion ; Urinary Tract

A retrospective review was undertaken of 5 pediatric cases of posterior urethral valve with vesicoureteral reflux. The clinical data were summarized as follows : 1. At the time of diagnosis, patient age was recorded as 2 months, 3, 4, 13, and 14 years. Three cases presented with high fever, one with urinary dribbling and one with acute epididymitis. 2. Voiding cystourethrogram was abnormal in all cases, showing thickened, trabeculated bladder wall, dilatation of posterior urethra and vesicoureteral reflux. Vesicoureteral reflux was bilateral in 3 cases, unilateral in 2 cases and its degree was grade R-V/V in 8 renal units, grade E/V in one renal unit. 3. Initially transurethral valve ablation was performed in all cases, of which 2 had concomitant antireflux surgery and 3 had delayed ureteral reconstruction between one and 11 months after valve ablation. 4. Follow up duration was between 13 and 53months. In 4 cases, reflux disappeared and the pyelographic appearance markedly improved as regards pelvocalyceal and ureteral dilatation with improvement of general status at followup. But, in one case that had demonstrated bilateral high grade vesicoureteral reflux with sever ureteral dilatation and poor renal function, voiding symptom and radiologic appearance improved but left vesicoureteral reflux persisted by 13 months after reconstructive surgery.
Diagnosis ; Dilatation ; Epididymitis ; Fever ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Ureter ; Urethra ; Urinary Bladder ; Vesico-Ureteral Reflux*

No abstract available.
Joints*

Objectives: ：The purpose of this study is to investigate the characteristics of the perception of the somatic symptoms and the cognitive emotion regulation strategies in patients with posttraumatic stress disorder (PTSD). Methods: ：A total of 48 patients meeting DSM-5 criteria for PTSD and 48 normal controls were recruited for participation in this study. We evaluated subjects using Clinician-Administered PTSD Scale (CAPS), Somato-Sensory Amplification Scale (SSAS), Hamilton Anxiety Scale (HAM-A) and Cognitive Emotion Regulation Questionnaire (CERQ). We analyzed data using an independent t-test and Pearson’s correlation analysis. Results: ：In terms of SSAS, PTSD patients presented higher average SSAS scores than normal controls but the result is not statistically significant. In PTSD patients, the severity of PTSD is significantly correlated with CERQrumination and CERQ-catastrophizing. The SSAS scores of PTSD patients show the significant positive correla-tion with PTSD hyperarousal symptoms, CERQ-catastrophizing and CERQ-blaming others. Conclusions ：These results reveal that patients with PTSD have maladaptive cognitive emotion regulation strategies such as rumination and catastrophizing. Somato-sensory amplification seems to be related with PTSD hyperarousal, CERQ-catastrophizing and CERQ-blaming others. Therefore, reducing somato-sensory amplifica-tion, rumination and catastrophizing can be helpful to reduce PTSD symptoms and somatic symptoms in PTSD patients.

BACKGROUND: To predict the therapeutic efficacy of osteoporosis, one or two years is needed to evaluate the therapeutic effect by the measurement of bone mineral density(BMD), whereas three to six months is sufficient with bone markers. Using this information, we can change therapeutic plan or modulate drug dosage if necessary. This approach would provide appropriate therapy for osteoporosis. The purpose of this study is to evaluate the association between the percentage change of BMD which was measured by peripheral quantitative computed tomography(pQCT), and bone markers after 1 year of hormone replacement therapy(HRT) in healthy postmenopausal women. METHODS: Bone mineral density of nondominant distal forearm in 89 postmenopausal women was measured by pQCT. We measured serum alkaline phosphatase(ALP) and intact osteocalcin(iOC, Novocalcin) as bone formation markers, urinary deoxypyridinoline(dPyr, PyriLinks-D(TM)) as bone resorption marker by using enzyme immunoassay. After 1 year of HRT, 54 subjects dropped out and 33 subjects were reevaluated. RESULTS: After 1 year of HRT, the drop-out rate was 61%. There was no significant difference in age, age of menopause, years since menopause, initial BMD, initial bone markers between remained and drop out groups. But osteocalcin level was significantly high in remained group(p=0.02). ALP(-27.6 %), iOC(-29.9%), dPyr(-25.2%) were significantly decreased after 1 year of HRT(p<0.001). Trabecular BMD was increased by 2.4%(p=0.003), but the percentage change of total and cortical BMD was not significant(p>0.05). The levels of BMD and bone markers between before and after was significantly correlated, demonstrating the homogeneity of response to HRT. The percentage change of trabecular BMD was negatively correhted with the percentage change of dPyr after HRT(r=-0.45, p=0.01). The variance of the percentage change of dPyr contributed to the percentage change of trabecular BMD by 20%. There was no correlation between the percentage change of total BMD or cortical BMD and the change of ALP, iOC, or dPyr after HRT. CONCLUSIONS: After 1 year of HRT in postmenopausal women, all biochemical bone markers were decreased significantly, whereas only trabecular BMD measured by pQCT was increased significantly. This result suggests that bone markers was more sensitive than BMD to monitor the therapeutic efficacy of HRT. The percentage change of trabecular BMD was correlated with the change of dPyr after HRT only. dPyr might be the most sensitive marker among bone markers tested. Therefore, we can predict the change of BMD after HRT through monitoring the levels of dPyr.
Bone Density* ; Bone Resorption ; Female ; Forearm ; Hormone Replacement Therapy* ; Humans ; Immunoenzyme Techniques ; Menopause ; Osteocalcin ; Osteogenesis ; Osteoporosis