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

OBJECTIVE: Brain-derived neurotrophic factor (BDNF) is a neurotrophin that is widely expressed in the mammalian brain and acts to regulate neuronal survival and influence cognitive processes. The present study measured serum BDNF levels to investigate the associations of the BDNF Val66Met and 5-hydroxytryptamine transporter linked promoter region (5-HTTLPR) polymorphisms with cognitive function in elderly Korean individuals. METHODS: Over 60 years, a total of 834 subjects were recruited for the present study. The subjects were classified into groups based on the degree of cognitive impairment (age-associated cognitive decline, mild cognitive impairment, and Alzheimer's disease) and compared with normal controls in terms of a neuropsychological assessment and a clinical evaluation. RESULTS: Of the initial 834 study participants, 165 (59 controls and 106 subjects with cognitive impairments) completed the study. There was a significant increase in serum BDNF levels in subjects with cognitive impairments relative to the control group and the BDNF Val66Met polymorphism was significantly associated with cognitive function but not serum BDNF levels. The 5-HTTLPR polymorphism did not have any associations with cognitive impairment or serum BDNF levels. CONCLUSION: The present findings suggest that BDNF may play a role in the pathophysiology of cognitive impairment and the BDNF Val66Met polymorphism may be an important factor in the susceptibility to these age-related deficits.
Aged* ; Brain ; Brain-Derived Neurotrophic Factor* ; Cognition ; Dementia ; Humans ; Mild Cognitive Impairment ; Neurons ; Polymorphism, Genetic ; Promoter Regions, Genetic ; Serotonin

BACKGROUND: In 1951, Ardran reported that metastatic bone lesions could be detectable on plain radiography with 30% to 50% of decalcification. Authors performed experimental study for minimum level of decalcification to detect the osteolytic bone metastasis of long bone with recent technique of radiographs. METHODS: One pair of fibula and humerus from two cadavers was cut into specimen 1 inch in length. Distal half of specimen was dipped into hydrochloride (HCl) with 15 min interval. All 16 specimens were checked by film-type radiography (FR), computed radiography (CR), digital radiography (DR). To exclude inter-observer's variance, 3 radiologists evaluated images. Calcium amount before and after decalcification was measured and expressed in percentage of decalcification. RESULTS: Osteolytic changes were detectable with 11% to 16% of decalcification for fibula and 3% to 8% for humerus on plain radiography with FR, CR, and DR. CONCLUSIONS: Our study showed that minimum of 3% and maximum of 16% of decalcification is necessary when osteolytic metastatic bone lesions of long bone could be detected on plain radiography.
Cadaver ; Calcium ; Decalcification Technique ; Fibula ; Humerus ; Neoplasm Metastasis* ; Osteolysis ; Radiographic Image Enhancement ; Radiography*

An important challenge in Parkinson’s disease (PD) based neuroscience and neuroimaging is mapping the neuronal connectivity of the basal ganglia to understand how the disease affects brain circuitry. However, a majority of diffusion tractography studies have shown difficulties in revealing connections between distant anatomic brain regions and visualizing basal ganglia connectome. In this current study, we investigated the differences in basal ganglia connectivity between 6-OHDA induced ex-vivo PD mouse model and normal ex-vivo mouse model by using diffusion tensor imaging tractography from diffusion-weighted images obtained with a high resolution 9.4 T MR scanner. Connectivity pattern of the basal ganglia were compared between five 6-OHDA and five control ex-vivo mouse brains using results of probabilistic tractography generated with PROBTRACKX. When compared with control mouse, 6-OHDA mouse showed significant enhancements to motor territory-related subthalamopallidal and pallido-subthalamic connectivity. Multi-fiber tractography combined with diffusion MRI data has the potential to help recognize the abnormalities found in connectivity of psychiatric and neurologic disease models.

Educational evironment and condition strongly influence the quality of graduate medical education. However, in Korea educational environment of in-hospital graduate medical education and training has not been explored in details. To evaluate current situation, we investigated 1,859 graduate trainees(residents) by self-administered questionnaire from May to July in 1996. Major findings of the survey were as follows; 1. Major providers of education were senior trainees(46.7%), compared with other sources of training such as self-study(22.9%) and staff trainers(14.5%). 2. At hospitals with less than or equal to 500 beds, formal educational programs for training were more poorly developed than hospitals with more than 500 beds. Among them, weakness in programs of case conference, staff lecture and training in affiliated hospitals was more remarkable. 3. At small hospitals with less than or equal to 500 beds, satisfaction level of trainees on their training were lower than that of trained at hospitals with more than 500beds. Research, conference, discussion with senior residents, and outpatient care were more dissatisfactory in particular. 4. Significant barriers to ideal training were work overload(57.2%) and shortage of educational programs(19.0%). Most of trainees are not satisfied with environment and condition of their training programs. To improve the quality of graduate medical education which is closely related with health care quality in the near future, general environment of education such as work load and educational programs has to be reoriented.
Ambulatory Care ; Education ; Education, Medical, Graduate* ; Korea ; Quality of Health Care ; Surveys and Questionnaires

PURPOSE: This research was performed to investigate the relationship between CD44 and cancer cell invasion depth, histologic differentiation, tumor size and lymph node metastasis in the gastric carcinoma. MATERIALS AND METHODS: In 20 cases of early gastric cancer and 40 cases of advanced gastric cancer, the immunohistochemical staining for CD44v3 and CD44v5 was performed. RESULTS: 1. In all 60 cases, the positive rates for CD44v3 and CD44v5 were 18.3% and 71.7% respectively. 2. CD44v5 was expressed in 45% of early gastric cancer and 85% of advanced gastric cancer. 3. Larger tumor exhibited higher positive rates for CD44v5. 4. There were 28 cases of lymph node metastases out of 43 cases of CD44v5-positive primary gastric carcinoma (65.1%), and were 4 cases of lymph node metastases out of 17 CD44v5-negative cases (23.5%). 5. The 5 year survival rate was low in CD44v5- positive cases (p-value=0.039). CONCLUSION: The tumors that exhibit deep invasion and have large size and lymph node metastases tend to have more frequent expression of CD44v3 and CD44v5. In especially CD44v5. We found a good correlation between he expression of CD44v5 and the established prognostic factors. Actually we can use the CD44v5 rather than CD44v3 as a prognostic factor in advanced gastric cancer.
Lymph Nodes ; Neoplasm Metastasis ; Stomach Neoplasms* ; Survival Rate

Adrenal cortical tumor is a rare disease both in adults and children. Most of these tumors are malignant and functional, especially in children, producing endocrine syndrome such as virilization, Cushing's syndrome, hyperaldosteronism or feminization. Recently, we experienced a case of adrenal cortical tumor in a 26 month-old boy who showed features of virilization. This case was diagnosed with typical hormonal findings and abdominal CT and confirmed by pathologic examinations. He was successfully treated with right adrenalectomy. We report a case of virilizing adrenal cortical tumor and review the literature.
Adrenalectomy ; Adult ; Child* ; Child, Preschool ; Cushing Syndrome ; Feminization ; Humans ; Hyperaldosteronism ; Male ; Rare Diseases ; Tomography, X-Ray Computed ; Virilism

The perineal defect in female genitalia results from multiple etiologies, including obstetric injury, sexual assaults, and perineal trauma. Untreated defects may lead to significant physical, functional, and esthetic complaints. Numerous reconstruction methods are used for a perineal defect, but various complications, such as fecal impaction, fecal incontinence, and wound disruption, are introduced. We report a case of a 40-yr-old woman with a cloaca-like perineal defect, who was treated with reconstructive surgery of the perineal defect and recovered with a good anatomical and functional outcome.
Fecal Impaction ; Fecal Incontinence ; Female ; Genitalia, Female ; Humans

Depression is a common mental illness with a high lifetime prevalence rate in the general population. However, the pathophysiology of depression is still poorly understood. Recent studies showed that environmental factors can affect gene expression by modifying epigenetic factors. Early life stress (ELS) is likely a risk factor of lifetime vulnerability to stress and development of depression. ELS or stressful lifetime can induce changes in gene expression through epigenetic mechanism, such as DNA methylation or histone modification. In this article, recent researches on the epigenetic mechanisms of depression will be discussed.
Depression* ; DNA Methylation ; Epigenomics* ; Gene Expression ; Histones ; Prevalence ; Risk Factors ; Stress, Psychological

Leiomyosarcoma of the intestine is an uncommon malignant tumor of the small and large bowels. It may metastasize mostly to the peritoneum, omentum and liver. We describe a case of a liver metastasis from ileal leiomyosarcoma which was treated by right hepatic lobectomy. Ultrasonography revealed multiple cysts in both lobes of liver and pelvic mass. Computerized tomography of the abdomen revealed that lobulated, marginated, low density mass was noted in ileal loop, and multiple, well-defined, low density masses were identified in both lobes of the liver. The patient underwent exploratory laparotomy and removal of the ileal leiomyosarcoma. One month later, the patient underwent a right hepatic lobectomy and removal of a cystic mass on the liver dome of the left lobe. The patient recovered and was discharged by postoperative day 24.
Abdomen ; Humans ; Intestines ; Laparotomy ; Leiomyosarcoma* ; Liver* ; Neoplasm Metastasis* ; Omentum ; Peritoneum ; Ultrasonography