Additional two cases of Klinefelter's syndrome with a literatural review was presented Two cases were revealed characteristics of Klinefelter's syndrome such as small testes, hyalinization of seminiferous tubules, azoospermia, increased FSH, normal 17-ketogteroid and positive sex chromatin. One case was associated with left inguinal crytorchidism.
Azoospermia ; Hyalin ; Klinefelter Syndrome* ; Seminiferous Tubules ; Sex Chromatin ; Testis

No abstract available.
Child* ; Humans ; Liver Cirrhosis* ; Liver*

No abstract available.

No abstract available.
Urinary Bladder*

This is to describe a neonatal hepatitis with pericellular hepatic fibrosis and Mallory bodies in a sero-positive infant for IgM anti-CMV. A necropsy of the liver revealed severe heaptocellular swelling with many intracytoplasmic hyaline bodies, pronounced fibrosis of a creeping type, bile stasis with ductular proliferation, and the lack of parenchymal regeneration. These microscopical changes of the liver resembled those of Indian Childhood Cirrhosis (ICC). In the present case the patient's serum IgM anti-CMV is the only clue for the etiological diagnosis.
Infant ; Child ; Male ; Female ; Infant, Newborn ; Humans

No abstract available.
Immunosuppression* ; Prognosis* ; Transplantation*

Avascular osteonecrosis has frequently occured in patients who have undergone transplantation of a kidney and generally has been considered to be a complication of the use of corticosteroids. But there are controversies regarding their dosage and duration of use in its influence on prevalence of avascular osteonecrosis. We analyzed the cases of our patients who underwent transplantation of a kidney and who we were able to follow up more than 8 months. l. Of a total of 300 patients, osteonecrosis developed in 24 joints of 12 patients. 2. Osteonecrosis was more frequently found in group of patients who were administered with larger doses of steroid. 3. Rejections of the transplanted kidney occured more frequently in those groups with osteonecrosis. 4. Most of rejections occured within 3 months after renal transplantation. 5. It took 4–26 months (average 12.3 months) the osteonecrosis could be found. 6. There were no differences in blood concentration of calcium phosphate and creatinine between osteonecrosis and non-osteonecrosis group. 7. Replacement arthroplasties were done in 10 joints without significant complication.
Adrenal Cortex Hormones ; Arthroplasty, Replacement ; Calcium ; Creatinine ; Follow-Up Studies ; Humans ; Joints ; Kidney ; Kidney Transplantation ; Osteonecrosis ; Prednisolone ; Prevalence

Authors reviewed clinical records of 92 patients with tetanus from January 1974 to December 1983 at Severance Hospital and the following results wre obtained. 1) There were about 2.2 times more cases of neonatal tetanus than that of nonneonatal. The admitted cases of tetanus decreased in 1980's compared to those of 1970's. 2) The male versus female ratio was 3 : 1 not only in nonneonatal but also in neonatal teanus. 3) There was a tendency of higher mortality when the site of injury was on the central part of the body than on the distal. 4) Most cases of tetanus developed after the injury with bactrial contamination as expected, but a few cases are due to only trivial injury such as acupuncture or injection without overt contamination. 5) There was a close relationship between the incubation period and mortality in neonatal tetaus but no such definite relationship in nonneonatal tetaus. 6) The duraton of admission was about 3 weeks and the majority of deaths occureed in less than one week of admission. 7) There was no statistically significant difference in mortality between the group who used tetanus antitoxin from animal and that who used human tetanus immuneglobulin.
Acupuncture ; Animals ; Female ; Humans ; Male ; Mortality ; Tetanus Antitoxin ; Tetanus*

In this study, we evaluated the safety and efficacy of mycophenolate mofetil(MMF) for the prevention of acute rejection episodes when given in combination with cyclosporine and corticosteroids during the first 6 postoperative months in living donor kidney transplantation. One hundred patients were enrolled; 50 patients received dual immunosuppression (cyclosporine+corticosteroids: control group) and another 50 patients received triple regimen including MMF 2 g/day(cyclosporine+corticosteroids+MMF: study group) through randomization. In the protocol, first-line treatment for acute rejection was a high-dose steroid pulse therapy. Steroid resistant acute rejection was to be treated with polyclonal antilymphocyte agents(ATG). There was no demographic difference between study and control groups. There were 7(14%) acute rejection episodes in the study group and 16(32%) in the control group with statistical significance. Two cases of premature withdrawal were developed in the study group(one severe abdominal pain and another profound leukopenia). The incidence of opportunistic infection was 7(14%) in the study group and 6(12%) in the control group within 6 months post transplantation. There was no statistical differences in serum creatinine level between study and control group at 6 months after transplantation(1.28+/-0.33 mg/dl vs. 1.24+/-0.51 mg/dl). The addition of MMF to a dual immunosuppressive regimen with cyclosporine and corticosteroids seems to lower the incidence and severity of acute rejection in living donor kidney transplantation during the early post-transplantation period. The graft function of the MMF group is comparable with that of the control group. The most common adverse effect of MMF was abdominal pain and diarrhea but almostly resolved with symptomatic treatment. If the frequency of acute rejection during the first 6 months is one of the main determinants of long-term graft survival, it might be expected that MMF could lead to an improved graft survival in combination with cyclosporine and corticosteroids.
Abdominal Pain ; Adrenal Cortex Hormones ; Allografts* ; Creatinine ; Cyclosporine ; Diarrhea ; Graft Survival ; Humans ; Immunosuppression ; Incidence ; Kidney Transplantation ; Living Donors* ; Opportunistic Infections ; Prospective Studies* ; Random Allocation ; Transplants

A microemulsion cyclosporine(Me-CsA) was developed and became available with more predictable whole blood CsA concentration and minimal inter- and intra-personal variability in daily dosage of CsA. We prospectively performed this study to assess 1) the ability of Me-CsA maintaining the adequate predefined therapeutic level and 2)long-term safety and tolerability of Me-CsA in kidney transplant recipients. A total of 123 renal transplant patients were enrolled on the Me-CsA group, who have been on Me-CsA as an initial main immunosuppressant since their transplantation. This group of patients were compared to 200 renal transplant patients on conventional cyclosporine(Con-CsA) as a historical control group(Con-CsA group). There were no differences in the methods of operation, induction immunosuppression, the strategies of maintenance immunosuppression and anti-rejection therapy between these two groups. The clinical status and laboratory values were monitored at 1,3,6,9, and 12 months after the kidney transplantation. There were no statistical differences in acute rejection episodes, serum creatinine level, and graft failure and survival rate between Con-CsA and Me-CsA groups. In this study, we could demonstrate the significant fluctuation of the mean values of daily dosage and whole blood trough level and their standard deviations of cyclosporine in Con-CsA group compare to those of Me-CsA group. We also could demonstrate early stabilization of CsA blood trough level in patients using Me-CsA. These results mean that Me-CsA has less interpersonal variations than Con-CsA. In conclusion, Me-CsA has more predictable pharmacodynamic characteristics than Con-CsA and comparable tolerability and safety to Con-CsA with no additional side effects.
Allografts* ; Creatinine ; Cyclosporine* ; Follow-Up Studies* ; Humans ; Immunosuppression ; Kidney ; Kidney Transplantation ; Prospective Studies ; Survival Rate ; Transplantation ; Transplants