Although the definition of male pseudohermaphroditism remains controversial, male pseudohermaphrodites will be defined as chromatin-negative individuals who have testis with the failure of normal development of the normal male. Also included are those individuals who may have more than one cell line, but at least one cell line, containing a Y chromosome and no cell line having two X chromosomes. Gonadal histologic findings may be either testicular or streak, but not ovarian. Male pseudohermaphroditism can result as a consequence of 1) absent M(llerian regression, 2) Inadequate synthesis of testosterone, 3) inadequate synthesis of dihydrotestosterone and 4) androgen receptor deficiency. We have seen 5 cases of male pseudohermaphroditism with manifestations of penoscrotal or perineal hypospadias, pubertal virilization, cryptorchism or atrophied testes, and feminization. Four cases had been reared as male and one case as female. All revealed chromatin-negative pattern in buccal smear and testes. After the plausible discussion, two cases were decided to be reared as female and three were as male.
46, XY Disorders of Sex Development* ; Androgen-Insensitivity Syndrome ; Cell Line ; Cryptorchidism ; Dihydrotestosterone ; Female ; Feminization ; Gonads ; Humans ; Hypospadias ; Male* ; Testis ; Testosterone ; Virilism ; X Chromosome ; Y Chromosome

The Ilizarov fixator allows significantly more axial motion at the fracture site than the conventional monofixators. But the transfixing wires have inevitable problems of soft tissue impalement. Therefore the Rancho mounting technique, replacing the transfixing wires with half pins, has become a common place. But the increment of the axial stiffness secondary to replacing transfixing wires with half pins has not been defined clearly yet. The authors measured the axial stiffness of the Ilizarov fixator and two different configurations of the Rancho frame. The group I frame was the Ilizarov fixator composed of four rings and two transfixing wires on each ring. The group II frame was the Rancho frame and it was constructed same as the Ilizarov frame but a transfixing wire was replaced with a half pin from two central rings respectively. The group III frame was another type of Rancho frame which was constructed same as the second group but the remaining transfixing wire was replaced with a half pin from the two central rings respectively. The axial stiffness of the Group I , II and Group III frames were 71.54+/-7.21N/mm, 89.65+/-6.42N/mm, 101.01+/-7.92N/mm respectively. The axial stiffness difference between the Group I frame and the Group II frame was statistically significant(p<0.01). Also the difference between the Group I frame and the Group III frame was statistically significant(p<0.01). This study shows that the replacement of two transfixing wires with two stainless half pins resulted in significant increment of the axial stiffness of the Ilizarov frame.

Pedunculated lipofibroma is a rare disorder characterized by ectopic deposits of mature adipose tissue in the dermis. It is a dorne shaped or sessile papule which occurs at any site and develops later in life. We, herein, report two cases of pedunculated lipofibroma which have developed on the chin of a 64-year-old man and the buttock of a 47-year-old woman.
Adipose Tissue ; Buttocks ; Chin ; Dermis ; Female ; Humans ; Middle Aged

Helicobacter pylori, loss of basement membrane, atrophy, type III intestinal metaplasia, adenomatous polyposis coli (APC) gene mutations and altered p53 function were believed as a factor to develop the gastric adenocarcinomas. To investigate the incidence and prevalence of Helicobacter pylori, intestinal metaplasia and atrophy, 120 gastrectomy specimens collected from patients with gastric adenocarcinoma (100 cases) and non-neoplastic conditions (20 cases) were studied. Intestinal metaplasia can be classified as type I (complete), type II (incomplete, sulfomucin-negative) and type III (incomplete, sulfomucin-positive) by Filipe and Jass. The incidence of intestinal metaplasia of gastric adenocarcinoma was 96% compared with the incidence of 75% in non-neoplastic conditions. The type I and type II were more common than type III and were present in both non-neoplastic conditions (75%) and adenocarcinoma (74%). In contrast, type III intestinal metaplasia was seen in only 20% of intestinal metaplasia-positive cases, all of which (22 of 22) were from patients with adenocarcinoma. The high specificity of type III intestinal metaplasia might be acceptable for screening purposes, but its sensitivity of 22% for gastric adenocarcinoma is low. Helicobacter pylori were detected in 96% of adenocarcinoma cases and 100% of non-neoplastic cases. Atrophy was detected in 50% of non-neoplastic cases and in 57% of adenocarcinoma cases. The data thus confirms a significant relation between incomplete sulfomucin-secreting intestinal metaplasia (type III) and gastric carcinoma, especially intestinal type (p<0.01). Thus, the type III intestinal metaplasia should be considered a risk factor and its presence in a biopsy specimen should prompt close surveillance.
Adenocarcinoma ; Adenomatous Polyposis Coli ; Atrophy ; Basement Membrane ; Biopsy ; Gastrectomy ; Helicobacter pylori ; Humans ; Incidence ; Mass Screening ; Metaplasia* ; Prevalence ; Risk Factors ; Sensitivity and Specificity

No abstract available.
Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Head* ; Hemiarthroplasty* ; Necrosis*

The authors studied 54 patients (55 cases) of femoral shaft fractures treated by compression plate fixation and IM nailing from August 1986 to December 1991. The purpose of this study is to analyse comparatively the radiological and clinical results between the compression plate fixation and IM nailing in femoral shaft fracture of adult. The obtained results were as follows: 1. Among the 54 patients, the ratio of male and female was 44: 10, and the highest in cidence of age was between 3rd and 4th decades. 2. The main cause of injury was traffic accident in 38 cases. 3. The most common fracture type was B1-② in ten cases by AO-ASIF classification. 4. The mean duration of union was 13 weeks in compression plate fixation by the Koostra's criteria and the average 23 weeks in IM nailing by the Bjorens criteria. 5. The clinical result according to Margerl et al, was good in 25 cases (80.6%) with compression plate fixation and good in 20 cases (83.3%) with intramedullary fixation. 6. Complications of compression plate fixation were metal failure in 2 cases and deep wound infection in 1 case, and 1 case of femur neck fracture during operation and 1 case of metal failure in intramedullary fixation.
Accidents, Traffic ; Adult ; Classification ; Female ; Femoral Neck Fractures ; Fracture Fixation, Intramedullary ; Humans ; Male ; Wound Infection

No abstract available.
Fertilization in Vitro* ; Humans ; Twins* ; Umbilical Cord*

To evaluate the detection of HPV DNA according to subtype of lesions of uterine cervix and its clinical applicability, in situ hybridization (ISH) and immunohistochemistry for HPV were performed in 189 cases of uterine cervical lesion, including 23 cases of low grade squamous intraepithelial lesion (SIL), 115 cases of high grade SIL and 51 cases of invasive carcinoma. Positive immunostaining, brown precipitate, was mainly noted in the nucleus of koilocytes in the superficial and intermediate layer. Positivity of immunostaining was 21.7% in low grade SIL, 13.0% in high grade SIL and 9.8% in invasive carcinoma. Positive reaction in ISH, red precipitate, was noted in the nucleus of not only koilocytes but also non-koilocytes in the superficial and intermediate layer, and dot precipitate was rarely identified in the nest of squamous cell carcinoma. Based on HPV subtype, 6/11 was 21.7% in low grade SIL, 16/18 was 32.2% and 39.2% in high grade SIL and invasive carcinoma, respectively. With regard to their associated HPV types, low grade SILs were heterogeneous and high grade SILs and invasive carcinomas were related with the high oncogenic risk group only. The correlation of HPV subtypes with panHPV was 91.3% in low grade SIL, 91.3% in high grade SIL and 98.0% in invasive carcinoma. These results suggest that detection of HPV infection by ISH may be a more useful method than immunohistochemistry and application of the HPV subtype probe with the panHPV probe could improve the sensitivity of ISH.
Carcinoma, Squamous Cell ; Cervix Uteri* ; DNA ; Female ; Humans* ; Immunohistochemistry* ; In Situ Hybridization*

PURPOSE: Refractory status epilepticus refers to patients who do not respond properly to adequate first-line drug treatment such as diazepam, phenytoin, phenobaribital, lorazepam and show longer than 60 minute seizure. This study was designed to determine the efficacy and safety of midazolam given as a continuous infusion in the treatment of status epilepticus in children. METHODS: Midazolam was infused to twelve children with seizures, for whom two time repeated doses of 0.3mg/kg of diazepam, 20mg/kg of phenobarbital, and 20mg/kg of phenytoin failed to bring the episode under control. All patients received a bolus of midazolam(0.15mg/kg) followed by a continuous infusion at 1microgram/kg/min. The dose was increased every 15 min until the episode of seizure was brought under control. Time required to control seizures, infusion rate, and side-effects were monitored. RESULTS: The mean age of the patient population was 6.06 yrs(range 2 months to 16 yrs; 6 females and 6 males). In 11 patients, seizures were controlled in a mean time of 60.1 min(range 15-180 min). The mean infusion rate was 8.5microgram/kg/min(range 1-20). The total treatment duration was 17.6 days(range 1-54 days). One patient who was confirmed to have cortical dysplasia failed to respond. Two of the patients showed respiratory depression and bradycardia. CONCLUSION: Midazolam is an effective and safe drug to control refractory seizures in children with status epilepticus.
Bradycardia ; Child* ; Diazepam ; Female ; Humans ; Lorazepam ; Malformations of Cortical Development ; Midazolam* ; Phenobarbital ; Phenytoin ; Respiratory Insufficiency ; Seizures ; Status Epilepticus*

Open carpal tunnel release has been the standard method of sumical treatment of carpal tunnel syndrome. Recently endoscopic carpal tunnel release has been introduced and is heing used by many authors. The advantages of this new technique are less postoperative pain, rapid restoration of power and rapid return-to-work. However many considerate authors, in spite of these advantages. insist that the inevitahle risk of neurovascular injury during the endoscopic procedure should not he underestimated. The purpose of our study is to compare the clinical results of endoscopic carpal tunnel release with those of open release. 20 open carpal tunnel releases in 16 patients and 15 endoscopic carpal tunnel reieases (single-portal technique) in 11 patients were performed hy the first author. Preoperative conditions of both groups are not different. Authors compared the clinical results between the two groups with some parameters. The overall clinical results were not different significantly hetween two groups. Rapid return-to-work(36 days in endoscopic group versus 60 days in open group) and less postoperative scar and pillar pain in endoscopic group were demonstrated. However, the major complication of one median nerve injury in endoscopic group seemed to overweigh these some benefits. We suggest that the standard operative technique for carpal tunnel syndrome should be open carpal tunnel release and more considerations should be takcn in choosing endoscopic method because of its inherent risk.
Carpal Tunnel Syndrome ; Cicatrix ; Humans ; Median Nerve ; Pain, Postoperative ; Return to Work