Kyphoscoliosis is a disease manifested as lateral curvature of spine and accompanying rotation of the vertebrae, resulting in distortion of rib cage. A curve greater than 40 degrees in considerd to be severe and most likely to be associated with physiologic derangements in cardiac and pulmonary function. Restrictive lung disease and pulmonary hypertension progressing to cor pulmonale are the major causes of mortality in patients with kyphoscoliosis. However, pregnancy itself increases cardiac output and circulating blood volume, and decreases total lung capacity due to enlarged uterus. So tidal volume is increased in pregnant women to compensate. But in kyphoscoliosis patients pulmonary fucntion is already impaired and cardiovascular reserve is minimal. So there is increasing tendency in actue cor pulmonale. Recently we experienced a case of cesarean section in patient with kyphoscoliosis, and observed severe hemodynamic changes especially in pulmonary capillary wedge pressure and cardiac output. And we investigated 7 cases of cesarean section of patients with kyposcoliosis.
Anesthesia* ; Blood Volume ; Cardiac Output ; Cesarean Section* ; Female ; Hemodynamics* ; Humans ; Hypertension, Pulmonary ; Lung Diseases ; Mortality ; Pregnancy ; Pregnant Women ; Pulmonary Heart Disease ; Pulmonary Wedge Pressure ; Ribs ; Spine ; Tidal Volume ; Total Lung Capacity ; Uterus

Chromosomally derived sterility has long been recognized. A review of the literature of somatic chromosome investigations in infertile males has shown that 13.7% of azoospermic males and 4.6% of oligozoospermic males have an abnormal karyotype. In the first group, sex chromosome abnormalities predominate (mainly 47,XXY), whereas in the latter, autosome anomalies (i.e. Robertsonian and reciprocal translocations) are the most frequent. A similar review on meiotic studies revealed that meiotic chromosome anomalies can explain male infertility in 4.3-40.4% of patients. Recently, fluorescent in-situ hybridization studies on spermatozoa from infertile men were published; it was suggested that both X-Y pairing and pairing of the autosomes were impaired, resulting in spermatogenic disruption. It is estimated that there are 2,000 genes that regulate spermatogenesis, most of these being present on the autosomes, but there are approximately 30 genes on the Y chromosome. In general, autosomal genes that regulate spermatogenesis are concerned with regulation of metabolic processes in other cells in the body as well as in the cells of spermatogenesis, whereas Y genes are not essential for vital functions related to reproduction. To be able to provide proper counseling for those couples whose male infertility can now be treated by intracytoplasmic sperm injection, it is suggested that clinical investigations should include mitotic and meiotic studies, an analysis of the chromosome content of individual spermatozoa and a DNA analysis of blood and spermatozoa to detect partially deleted Y chromosome material. We have experienced a case of azoospermia associated with inversion of chromosome 1. So we report this case with a brief review of literatures.
Abnormal Karyotype ; Azoospermia* ; Chromosomes, Human, Pair 1* ; Counseling ; DNA ; Family Characteristics ; Humans ; Infertility ; Infertility, Male ; Male ; Metabolism ; Reproduction ; Sex Chromosome Aberrations ; Sperm Injections, Intracytoplasmic ; Spermatogenesis ; Spermatozoa ; Y Chromosome

We report the case of a 32-year-old female who developed polymyositis associated with scrub typhus. She exhibited the eschar with high titer of anti-Rickettsia(R)-tsutsugamushi antibody, severe muscle weakness, markedly elevated serum levels of muscle enzymes, EMG changes, and infiltration of macrophages in a muscle biopsy specimen. Initiation of appropriate antibiotic therapy resulted in complete healing of scrub typhus and disappearance of symptoms and signs of polymyositis within 1 month after high dose steroid therapy. We suggest that scrub typhus also be included within the causes of idiopathic inflammatory polymyositis.
Adult ; Biopsy ; Female ; Humans ; Macrophages ; Muscle Weakness ; Polymyositis* ; Scrub Typhus*

Pelvic pain syndrome or pelvic congestion syndrome, with no apparent organic cause, is a common gynecologicaldisorder. Ovarian varix, one of the causes of this syndrome, presents a difficult diagnostic and therapeuticproblem, though surgical ligation of the ovarian vein is an effective method of treatment. Although ovarian veinembolization has been recently developed as a useful alternative, no previous reports have described thisprocedure in Korea. We report a case of pelvic pain syndrome successully treated by ovarian vein embolization.
Estrogens, Conjugated (USP) ; Korea ; Ligation ; Pelvic Pain* ; Varicose Veins ; Veins*

PURPOSE: A relationship between thyroid disease and primary breast cancer remains controversial. Several studies have demonstrated there is an increased risk of breast cancer in patients with thyroid dysfunction and thyroid cancer. The purpose of this study was to evaluate the incidence, relationship and clinical characteristics of thyroid nodules and cancer in patients with breast cancer. METHODS: Two hundred sixty one women with primary breast cancer had an ultrasonogram of the thyroid prospectively performed at the Department of General Surgery of the Soonchunhyang University Hospital from April 1995 to December 1999. The thyroid nodules were identified by high- resolution ultrasonography before all patients had undergone breast cancer surgery. RESULTS: Among the 261 patients with breast cancer, thyroid nodules were found in 57 (21.8%). The most prevalent age group of the 57 thyroid nodules was the 5th decade. Twenty- one out of 57 patients with thyroid nodules had undergone thyroid surgery and 14 benign nodules and 7 thyroid cancers (5 papillary carcinoma & 2 follicular carcinoma) were discovered. The incidence of thyroid cancer in the patients with breast cancer was 2.7%. CONCLUSION: Although the factors associated with thyroid nodules and cancer in the patients with breast cancer were not demonstrated, these results were suggested that there may be a relationship between them. Therefore, ultrasonography of the thyroid in patients with breast cancer priorto breast cancer surgery operations is recommended.
Breast Neoplasms* ; Breast* ; Carcinoma, Papillary ; Female ; Humans ; Incidence* ; Prospective Studies ; Thyroid Diseases ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule* ; Ultrasonography

PURPOSE: A relationship between thyroid disease and primary breast cancer remains controversial. Several studies have demonstrated there is an increased risk of breast cancer in patients with thyroid dysfunction and thyroid cancer. The purpose of this study was to evaluate the incidence, relationship and clinical characteristics of thyroid nodules and cancer in patients with breast cancer. METHODS: Two hundred sixty one women with primary breast cancer had an ultrasonogram of the thyroid prospectively performed at the Department of General Surgery of the Soonchunhyang University Hospital from April 1995 to December 1999. The thyroid nodules were identified by high- resolution ultrasonography before all patients had undergone breast cancer surgery. RESULTS: Among the 261 patients with breast cancer, thyroid nodules were found in 57 (21.8%). The most prevalent age group of the 57 thyroid nodules was the 5th decade. Twenty- one out of 57 patients with thyroid nodules had undergone thyroid surgery and 14 benign nodules and 7 thyroid cancers (5 papillary carcinoma & 2 follicular carcinoma) were discovered. The incidence of thyroid cancer in the patients with breast cancer was 2.7%. CONCLUSION: Although the factors associated with thyroid nodules and cancer in the patients with breast cancer were not demonstrated, these results were suggested that there may be a relationship between them. Therefore, ultrasonography of the thyroid in patients with breast cancer priorto breast cancer surgery operations is recommended.
Breast Neoplasms* ; Breast* ; Carcinoma, Papillary ; Female ; Humans ; Incidence* ; Prospective Studies ; Thyroid Diseases ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule* ; Ultrasonography

Chemical pneumonitis is caused by the inhalation of noxious chemical substances and is a cause of occupational lung disease. Nitric acid, which is a one of the common air pollutants and a potential oxidant for refining and cleansing of metals, has a chance for occupational and environmental exposure. A 52-year-old man visited our hospital due to coughing and dyspnea after the inhalation of nitric acid fumes at his workplace. He had conditions of tachypnea (respiratory rate 26 /min) and hypoxemia (PaO2 42.6 mmHg, SaO2 80.2% in room air) in our emergency department. The chest radiographs showed diffuse interstitial infiltrates and ground glass opacity in both lungs. The patient made improvements in clinical symptoms and chest radiography after being given a supply of oxygen, antibiotics, and bronchodilator therapy without systemic glucocorticoid therapy. On his follow up visit after 4 weeks, he showed no symptoms and sequelae, and the pulmonary function test showed a normal pulmonary function.
Air Pollutants ; Anoxia ; Anti-Bacterial Agents ; Cough ; Dyspnea ; Emergency Service, Hospital ; Environmental Exposure ; Follow-Up Studies ; Glass ; Humans ; Inhalation* ; Lung ; Lung Diseases ; Metals ; Middle Aged ; Nitric Acid* ; Oxygen ; Pneumonia* ; Radiography ; Radiography, Thoracic ; Respiratory Function Tests ; Tachypnea ; Thorax

The typical radiographic findings of bronchiolitis obliterans organizing pneumonia (BOOP) are known to be patchy air-space consolidation that is often subpleural, and with or without ground-glass opacities. However, there are scant radiologic reports about the micronodular pattern of BOOP. We report here on a case of BOOP that manifested as diffusely scattered ill-defined centrilobular micronodules on HRCT.
Bronchiolitis Obliterans* ; Bronchiolitis* ; Cryptogenic Organizing Pneumonia*

Chronic hepatitis B viral infection causes membranous nephropathy and membranoproliferative glomerulonephritis. Patients with positive serum HBsAg with membranous nephropathy or membranoproliferative are considered as hepatitis B virus associated glomerulonephritis(HBV-GN) in epidemic areas of hepatitis B viral infection. To elucidate the clinical difference between hepatitis B virus-associated membranous nephropathy and membranoproliferative glomerulonephritis, and idiopathic membranous nephropathy and membranoproliferative glomerulonephritis, the authors conducted a clinical study including 71 cases of patients with renal biopsy proven diagnoses. Among the patients with hepatitis B virus antigenemia, the pathologic diagnoses were 7 membranous nephropathy(HBV-MN), 13 membranoproliferative glomerulonephritis(HBV-MPGN) but patients with mixed pattern of both membranous nephropathy and membranoproliferative glomerulonephritis were excluded. For the patients with idiopathic glomerulonephritis, 35 of membranous nephropahty(MN) and 16 cases of membranoproliferative glomerulonephritis (MPGN) were enrolled in this study. The patients of HBV-GN groups had more than 80% of HBe antigenemia. The nephrotic range proteinuria presented more frequently in HBV-MN(86%) than in MN group(54%). The cases of HBV-MPGN group(4 cases, 31%) showed nephrotic range proteinuria less frequently than those with MPGN(69%, p< 0.05) and significant discrepancy existed in HBV- MN vs HBV-MPGN and HBV-MPGN vs MPGN. The cases with decreased serum C3 level below normal were over 50% of HBV-GN and MPGN group except MN group. Serum levels of SGOT and SGPT were significantly elevated in HBV-MN and HBV- MPGN groups than those of MN and MPGN groups, respectively(p<0.05). The number of cases with increased SGOT, SGPT and gamma-GTP were 4(57%), 2 (29%) and 1(16%) in HBV-MN and 15(83%), 12(67%) and 9(75%) cases in HBV-MPGN group, in respectively. The cases developed progressive renal functional impairment during follow-up period of at least one year were 3 of 5(60%) in HBV-MN, 2 of 8 (25%) in MPGN and 3 of 9(33%) in HBV-MPGN groups which were significantly more than 2 of 22 cases(9%) in MN group(respectively p<0.05, not in HBV-MPGN vs MN). The renal functional impairment rate defined by the ratio of patients with their serum creatinine elevated above 2mg/dL over 3 months in each group was more rapidly increased in HBV-MPGN and HBV-MN than the idiopathic groups by Kaplan-Meier statistic analysis. We suggest that the patients with HBV-associated glomerulonephropathy seem to have worse prognosis in terms of renal functional impairment than those with idiopathic types of glomerulonephropathy with same pathology.
Alanine Transaminase ; Aspartate Aminotransferases ; Biopsy ; Creatinine ; Diagnosis ; Follow-Up Studies ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative* ; Glomerulonephritis, Membranous* ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Pathology ; Prognosis ; Proteinuria

Premature ovarian failure is a condition causing amenorrhea, hypoestrogenism, and elevated gonadotropins in women younger than 40 years. A karyotype should be performed as part of basic laboratory evaluation for all patients with premature ovarian failure and prodromal premature ovarian failure. Gonadal dysgenesis represents a wide spectrum of clinical phenotypes, gonadal structures that include the presence of at least one streak gonad, and a variety of X chromosome abnormalities and mosaicism. Development of a malignancy in a dysgenetic gonad is of major concern. The presence of a fragment of the Y chromosome is thought to be a key to the oncogenic potential of these gonads. Malignant potential is clearly not linked to the testicular determining factor itself (SRY). Failure to display SRY or a closely related sequence does not rule out the presence of the segment of the Y chromosome postulated to be associated with the development of malignancies. Pregnancy in premature ovarian failure with chromosomal abnormality is rare. Furthermore, the incidence of pregnancy in patient with Y chromosome is very rare. We have experienced a case of premature ovarian failure with chromosomal abnormality involving Y chromosome fragment. She has got pregnant spontaneously and gave birth to male baby but he was found to have the same karyotype as his mother. So we report this case with a brief review of literatures.
Amenorrhea ; Chromosome Aberrations ; Female ; Gonadal Dysgenesis ; Gonadotropins ; Gonads ; Humans ; Incidence ; Karyotype ; Male ; Mosaicism ; Mothers ; Parturition ; Phenotype ; Pregnancy* ; Primary Ovarian Insufficiency* ; X Chromosome ; Y Chromosome*