Although cystic teratoma is the most common benign tumor of the ovary, the association of sebaceous gland tumor with cystic teratoma is rare. We have recently experienced a case of sebaceous gland tumor, arising in the cystic teratoma of the ovary in a 78-year-old Korean woman. Histologically, the tumor was characterized by an organoid lobular architectures of the sebaceous glands which are exculsively composed of germinative and mature sebaceous cells. Although it is difficult to come to a valid conclusion due to the presence of atypical mitosis and necrosis, this tumor was regarded as benign from the viewpoint of preserved organoid structures, and absence of capsular invasion or metastasis.
Female ; Humans

No abstract available.
Actinomycosis*

OBJECTIVE : The purpose of this study was to identify the current trends of the incidence of hyperbilirubinemia and the results of the auditory evoked potential and to evaluate the correlation with early and late evidence of bilirubin-induced brain injury. METHODS : We reviewed the medical records of all neonates who were admitted to the Holy family hospital of CUMC exclusively for management of neonatal jaundice from January, 2002 to December, 2006. The gestational age, the age at peak bilirubin level, the peak bilirubin level, feeding method and brainstem auditory-evoked potential (AEP) were reviewed. RESULTS : We investigated 121 term and 101 preterm infants treated for management of neonatal jaundice. The mean peak bilirubin values of term and preterm infants were 22.7+/-0.5 and 13.7+/-0.3 mg/dL. The mean age at peak bilirubin level of term and preterm infants were 7.5+/-0.5 and 4.7+/-0.2 days. All were breastfed (46.3% vs. 30.7%) or fed a combination of breast and bottle feedings (53.7% vs. 44.5%) in term and preterm infants. Comparison of peak bilirubin levels and age at peak bilirubin level in the serum of term and preterm group with AEP results showed no significant relationship. Trend in peak serum indirect bilirubin level in term infants were significantly increased in the recent 3 years. Trend in AEP abnormality showed no significant changes during the study periods. Only two preterm infant showed abnormal AEP at follow up study. CONCLUSION : Recently, increased frequency of breast-feeding, shortened hospital stays, and inconsistent follow-up after hospital discharge may cause the increased incidence of severe hyperbilirubinemia in healthy preterm and term newborn infants. But it is not clear such early onset hyperbilirubinemia may cause acute bilirubin encephalopathy or permanent brain injury.
Bilirubin ; Bottle Feeding ; Brain Injuries ; Brain Stem ; Breast ; Evoked Potentials, Auditory* ; Evoked Potentials, Auditory, Brain Stem ; Feeding Methods ; Follow-Up Studies ; Gestational Age ; Humans ; Hyperbilirubinemia* ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Jaundice, Neonatal ; Kernicterus ; Length of Stay ; Medical Records

No abstract available.
Adenoids* ; Biopsy, Fine-Needle* ; Breast* ; Carcinoma, Adenoid Cystic* ; Diagnosis*

An adenomyoepithelioma (AME) is an uncommon neoplasm characterized by proliferation of both epithelial and myoepithelial cells in the salivary gland, skin, lung and breast. AMEs can recur, progress to malignancy and metastasize. A 68-year-old woman presented a large mass occupying her whole right breast. The mass had grown slowly for about 20 years and the preoperative biopsy of the mass was chondroid syringoma. The mass was completely resected and the postoperative biopsy revealed malignant AME with a negative resection margin. The patient didn't receive any adjuvant therapy and has been free of recurrence or metastasis up to now. We report herein a case of a malignant AME that was diagnosed in the largest breast mass reported to date. This mass grew slowly and without metastasis. Clinicians should consider this rare disease entity in the differential diagnosis of a breast mass and remember the importance of complete excision of this tumor.
Adenoma, Pleomorphic ; Adenomyoepithelioma ; Aged ; Amphotericin B ; Biopsy ; Breast ; Diagnosis, Differential ; Female ; Humans ; Lung ; Neoplasm Metastasis ; Rare Diseases ; Recurrence ; Salivary Glands ; Skin

PURPOSE: To evaluate the preoperative ocular motility disorder and to study the relationship between motility disorder and morphologic change in blowout fracture. METHODS: The ocular motility disorders of 38 patients who had inferior wall orbital fracture were evaluated and classified using Hess test and quantified using field of biocular single vision (FBSV). The type and location of fracture and the morphologic changes of inferior rectus muscle was classified using computed tomography. RESULTS: In Hess test, up gaze disorder was found in 12 patients, down gaze disorder in 1, up and down gaze disorder in 21, and asymmetric disorder in 4. In up and down gaze disorder group, the FBSV score was significantly low (p<0.05) and the rate of entrapment or deviation of inferior rectus muscle was significantly high (p<0.05) in comparison with up gaze disorder group. CONCLUSIONS: The ocuar motility disorder induced by inferior wall orbital fracture could be evaluated using Hess test. The ocular motility disorder was more influenced by entrapment or deviation of inferior rectus muscle rather than the type or location of the fracture. Preoperative assessment of the ocular motility disorder could play an important role in evaluating the disorder of inferior rectus muscle and its treatment.
Humans ; Ocular Motility Disorders ; Orbital Fractures

PURPOSE: To evaluate the incidence, cause and clinical feature of the amblyopia in congenital ptosis. METHODS: A retrospective review of 61 consecutive patients with congenital ptosis who had preoperative records on refractive error and strabismus was perfomed. The presence of amblyopia, strabismus, anisometropia, and severity of ptosis were recorded. RESULTS: Eleven out of 61 patients (18.0%) had amblyopia, 6 patients (9.8%) had strabismus, and 18 patients (29.5%) had anisometropia. Among 11 amblyopic patients 10 patients (90.9%) had unilateral ptosis and amblyopia in that ptotic eye. Eight of 11 patients (72.7%) had astigmatism of more than 1.5 diopters in ptotic eye only. There was no statistically significant relationship between the severity of ptosis and the incidence of amblyopia (P>0.05). CONCLUSIONS: The high incidence of anisometropia, strabismus, and astigmatism was found in congenital ptosis with amblyopia. This warrants compulsive examination of refractive error and strabismus to prevent amblyopia in congenital ptosis.
Amblyopia* ; Anisometropia ; Astigmatism ; Humans ; Incidence ; Refractive Errors ; Retrospective Studies ; Strabismus

The aim of this study was to investigate the susceptibility of mutans streptococci (S. mutans and S. sobrinus) and Streptococcus anginosus, for seven antibiotics, penicillin G, amoxicillin, ciprofloxacin, cefuroxime, erythromycin, bacitracin, and vancomycin. The minimum inhibitory concentration (MIC) of seven antibiotics against 3 species (type strains) of mutans streptococci and S. anginosus, 10 strains (wild type) of S. mutans, 7 strains (wild type) of S. sobrinus, and 11 strains (wild type) of S. anginosus, were measured by broth dilution method. All of the type strains of mutans streptococci and S. anginosus had the same susceptibility for penicillin G, amoxicillin, cefuroxime and bacitracin. Type strain of S. anginosus was sensitive in ciprofloxacin, but those of mutans streptococci were not. All of the clinical isolates of mutans streptococci and S. anginosus had the same susceptibility for the seven antibiotics. Our data reveal that mutans streptococci and S. anginosus have similar antibiotic-resistant character. In addition, these results may offer the basic data to verify the antibiotic-resistant mechanism of mutans streptococci and S. anginosus.
Amoxicillin ; Anti-Bacterial Agents ; Bacitracin ; Cefuroxime ; Ciprofloxacin ; Dental Plaque* ; Erythromycin ; Microbial Sensitivity Tests ; Penicillin G ; Penicillins ; Streptococcus anginosus* ; Streptococcus* ; Vancomycin

OBJECTIVE: To compare the efficacy and side effects of single-dose and multiple-dose systemic methotrexate (MTX) regimen for ectopic pregnancies. METHODS: Between January 1999 and December 2002, 192 of 947 cases of ectopic pregnancies were treated with systemic methotrexate therapy at the Department of Obstetrics and Gynecology, Bundang CHA Hospital. The patients were treated with either of the two regimens: a) Single dose regimen: 50 mg/m2 of intramuscular MTX without leucovorin rescue (87 cases) b) Multiple dose regimen: two to five doses of 1 mg/kg of IM MTX with leucovorin rescue (105 cases) Baseline characteristics, regimen used and the number of doses administered, treatment outcome, presence and severity of side effects were analyzed. Serum beta-hCG value at initiation of treatment and the presence of cardiac activity were controlled for with multivariate logistic regression. RESULTS: The mean age of the patients was 30.2 years (range 20-41) and gestational age at diagnosis was 45.8 days (range 28-70). Initial level of serum beta-hCG ranges from 1650 to 114332 mIU/ml (mean 3670.4). Non-tubal ectopic pregnancy occupied 23.4% of the study group. The multiple dose regimen was more commonly used. There were no significant differences in initial beta-hCG values, gestational age and presence of cardiac activity between single-dose arm and multiple-dose arm, between treatment success group and failure group. The overall success rate of MTX management for an ectopic pregnancy was 85.9% (165 of 192) with 79.3% and 91.4% for single and multiple dose regimen arms respectively. Side effects occurred in 22.9% (44 of 192) of the study group but no treatment was needed in most cases. CONCLUSION: Systemic methotrexate therapy is an effective and safe treatment modality for some selected ectopic pregnancies. Neither regimen showed definite superiority over the other. Further comparative studies with long-term follow-up are needed to evaluate reproductive outcome and to reduce side effects.
Arm ; Diagnosis ; Female ; Follow-Up Studies ; Gestational Age ; Gynecology ; Humans ; Leucovorin ; Logistic Models ; Methotrexate* ; Obstetrics ; Pregnancy ; Pregnancy, Ectopic* ; Treatment Outcome

OBJECTIVE: To evaluate of the perinatal outcome of twin gestations complicated by a single anomalous fetus. METHODS: The study included all patients with twin gestations diagnosed with a major fetal anomaly in one fetus in the second trimester during 1997-2000. Twins with anomalies in both fetuses and minor anomalies were excluded. From a total of 717 twin deliveries, there were 24 twin pregnancies with single anomalous fetus observed in Department of Obstetrics and Gynecology, CHA Hospital. Outcomes assessed included gestational age at diagnosis and delivery, antenatal complications, type of anomalies and perinatal mortality rate. RESULTS: The incidence of single anomalous fetus with twin pregnancies was 3.3% in the study population. There were 24 twin pregnancies with one anomalous fetus, and their median gestational age at delivery was 35+3 weeks (range 27-39). The incidence of preterm delivery was 54.2% (13/24) and growth restriction and respiratory distress syndrome of the normal sibling were 12.5% (8/24) and 8.3% (2/24), respectively. Eight cases (33.3%) of preterm deliveries, 3 cases (12.5%) of severe preeclampsia were noted and 2 cases (8.3%) of the pregnancies were complicated with both conditions. Regarding the type of anomalies, chromosomal anomalies and central nervous system (CNS) anomalies were the most common with 5 cases (20.8%) each. Perinatal outcomes of the normal twin and the anomalous twin were compared. There were 2 cases (8.3%) of neonatal death in the normal twin compared with 9 cases (37.5%) of intrauterine death, 9 cases (37.5%) of neonatal death in the abnormal twin. CONCLUSION: Our study shows that the presence of a major anomaly in one fetus in a twin gestation significantly increased the risk of preterm delivery and risk of intrauterine fetal death and neonatal death rate in anomalous fetus. This information may provide useful information for counseling patients about their options when faced in dilemma.
Central Nervous System ; Counseling ; Diagnosis ; Female ; Fetal Death ; Fetus* ; Gestational Age ; Gynecology ; Humans ; Incidence ; Mortality ; Obstetrics ; Perinatal Mortality ; Pre-Eclampsia ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy, Twin ; Siblings