Thanatophoric dysplasia is the most common lethal congenital chondrodysplasia with characteristic features of narrow thorax, short rib, severe platyspondyly, short bowed limbs and skull deformity, etc. It is not a hereditary disorder and there is usually no family history of dysplasia. We experienced a case of thanatophoric dysplasia at 38 weeks of gestation with antenatal sonographic and abdominal radiographic findings of small thorax, short bowed extremities with surrounding thickened soft tissues and marked platyspondyly. Soon atter delivery, the baby died and post-mortem radiographs showed the characteristic findings of thanatophoric dysplasia.
Congenital Abnormalities ; Extremities ; Humans ; Pregnancy ; Ribs ; Skull ; Thanatophoric Dysplasia* ; Thorax ; Ultrasonography

Lipoma is one of the unusual benign breast neoplasms and usually manifests at fatty breast of women at the age of 40 to 60. We experienced a case of large breast lipoma nearly replacing the whole left breast parenchymal tissue with mammographic finding of well-defined radiolucent mass, sonographic finding of hyperechoic mass with disorganized echopattern and computerized tomographic finding of very low attenuation mass, characteristic to adipose tissue, in a young woman of her dense breast.
Adipose Tissue ; Breast Neoplasms ; Breast* ; Female ; Humans ; Lipoma* ; Ultrasonography

Male Breast cancer is an uncommon disease with an incidence of I per cent of all breast cancers. Male breast cancer usually appears as a small mass with well-defined contour which is eccentrically located in relation to the nipple on mammogram. We report a case of breast cancer in a 51-year-old man with mammographic appearance of large hyperdense mass with nipple inversion and axillary lymphadenopathy, gray-scale sonographic finding of homogeneous solid mass and mu Itiple tumor vessels with in the mass on color Doppler ultrasound.
Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Humans ; Incidence ; Lymphatic Diseases ; Male ; Male* ; Middle Aged ; Nipples ; Ultrasonography

Urinary protein per se causes renal tubular injury and stimulates immunologic reaction. The extent of proximal tubular injury can be estimated by measuring the amount of 24 hours urinary beta2-microglobulin (U beta2-MG). The aim of this study was whether U beta2-MG level could predict the response to the initial steroid treatment for the patients with minimal change nephrotic syndrome (MCNS). We analyzed 58 adult patients (33 M, 25 F), aged 33+/-15 years (range 16-76), with biopsy-proven MCNS treated with 40 to 60mg of oral prednisolone daily up to 16 weeks. The responsiveness (44 cases) inculded complete and partial remission or steroid resistance (14 cases). No difference was found between the steroid responsive and resistant group with regard to age, BUN, serum creatinine, albumin, cholesterol, and urinary protein. The levels of U beta2- MG (microgram/g creatinine) were 250808+/-478917 and 1648+/-2386 in resistan ia Kwang-Yul Chang, et al.:Prediction of Steroid Responsiveness in Adult Minimal Change Nephrotic. Syndrome Using Urinary beta2-Microglobulint group and responsive group, respectively (P<0.05). The cut off value was 400microgram/ g creatinine with 78% of sensitivity and 48% of specificity. The likelihood ratio for the resistance was 2.5 to 2.8 with the U beta2-MG levels over 400 ug/g creatinine and was 0.2 to 0.3 below that value. Multivariate analysis confirmed that higher U beta2- MG level was associated with a lower likelihood of steroid responsiveness, independent of age, sex, creatinine, serum protein, and urinary protein. This study showed that the pretreatment U beta2- MG level may be used to identify subgroup of patients with MCNS who are more likely to be responsive to initial steroid treatment.
Adult* ; Cholesterol ; Creatinine ; Humans ; Multivariate Analysis ; Nephrosis, Lipoid* ; Prednisolone ; Sensitivity and Specificity

OBJECTIVE: The objective of the study was to estimate socioeconomic burden of polycystic ovary syndrome (PCOS) during the reproductive life span using current definitions and prevalence or incidence data. METHODS: Questionnaires were given to 8,588 reproductive women reviewed at Ewha Womans University Mokdong hospital. The PCOS affected approximately 10.4% of reproductive-aged women (11 million women in Korea, prevalence rate according to 1990 National Institutes of Health PCOS diagnosis criteria). We tied general societal cost data for the different health consequences to reproductive-age PCOS costs, using prevalence data. RESULTS: We estimated the mean annual cost of the initial evaluation to be 76 hundred million won, that of hormonally treating menstrual dysfunction, providing infertility care, diagnosis/treatment of endometrial hyperplasia, GDM, type 2 DM, and hypertension to be 280 billion won. The total annual socioeconomic cost of evaluating and providing care to reproductive-aged PCOS women in Korea is 350 billion won. CONCLUSION: Because the cost of the diagnostic evaluation accounted for a relatively minor part of the total socioeconomic costs, more widespread screening for PCOS appears be a cost-effective strategy, leading to earlier diagnosis and intervention and possibly the amelioration and prevention of serious sequelae.
Endometrial Hyperplasia ; Female ; Humans ; Hypertension ; Incidence ; Infertility ; Korea ; Mass Screening ; National Institutes of Health (U.S.) ; Polycystic Ovary Syndrome ; Prevalence ; Surveys and Questionnaire

Authors analysed and present chest X-ray findings of serologically proven leptospirosis from Seoul NationalUniversity Hospital, either admitted or referred for serological verification, during recent 2 years. Radiologicalfindings were correlated with the lung specimen finding of experimentally induced leptospirosis in guinea pig. Theresults are as follows: 1. 24 cases(56%) showed positive X-ray findings. 2. Predominent radiological patterns ofinvolved lung were tiny dot, small nodule, rosette density in 11 cases, massive confluent consolidation in 4cases, and diffuse ill-defined veilly increased density in 9 cases. 3. Distribution of pulmonary lesions werebilateral (100%), non-lobar, non-segmental(95%), and there were conspicuous tendency of peripheral lungpredominence. 4. Extrapulmonary manifestation, such as pleural effusion or cardiomegaly was rare. 5. Pulmonarylesions resolved completely usually 5 to 10 days after their appearance. 6. From the gross and microscopicfindings of serially sacrified guinea pig's lung and a case of autopsy, authors conlcuded that fine dot-likedensity in chest X-ray was due to petechial hemorrhage in intraalveolar space at initial stage, growing up toressette density or confluent consolidation as the petechia extends to surrounding lung forming purpura andcoalescent hemorrhage.
Animals ; Autopsy ; Cardiomegaly ; Guinea ; Guinea Pigs ; Hemorrhage ; Leptospirosis ; Lung ; Pleural Effusion ; Purpura ; Seoul ; Thorax

A case of myxopapillary ependymoma of the lateral ventricle is reported. The patient was a 30 year old woman who had headache for 9 months' duration & visual disturbance of left eye for 2 months' duration. Brain CT and MRI scan revealed solid mass at trigonal area of left lateral ventricle with cystic component. And cerebral angiogram revealed faint punctate mottled staining. Total removal of the tumor was done via transcortical transventricular approach without further neurologic deficit. The tumor was diagnosed as myxopapillary ependymoma with H & E staining, immunohistochemical staining for gliofibrillary acidic protein and electron microscopic examination, Postoperative radiotherapy was performed on primary area & whole brain field with the dose of 5500 rads.
Adult ; Brain ; Ependymoma* ; Female ; Headache ; Humans ; Lateral Ventricles* ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Radiotherapy

PURPOSE: The purpose of our study is to evaluate characteristic features of 4th ventricular tumors in CT and MRI. MATERIALS AND METHODS: Pathologically proved 9 patients with 4th ventricular tumor were examined by CT and/or MRI. 4th ventricular tumors were epedymoma(4 cases), medulloblastoma(2 cases), choroid plexus papilIoma(2 cases), and oligodendroglioma(1 case). Included in our study were only those mass lesions that were located at surgery predominently within 4th ventricle with or without ventricular expansion. RESULTS: The origin of 4th ventricular tumor was the roof (epedymoma 3 cases, medulloblastoma 2 cases), the floor (epedymoma 1 case), and the undetermined(remaining 3 cases). On MRI, all tumors were hypointense exept ependymoma(3 cases) showing isointensity on T1WI. All tumors were hyperintense on PDWI and T2WI. On Gd-DTPA enhanced T1WI, strong enhancement was seen in all but epedymoma(1 case) which showed mild enhancement. On CT, as compared with MR images, various density on precontrast and postcontrast images were seen. Calcification was seen in choroid plexus papilloma(1 case) and oligodendroglioma(1 case). Hydrocephalus is seen in all cases exept ependymoma(2 cases) and oligodendroglioma(1 case). Hemorrhage within tumor was present only in epedymoma(2 cases). Cystic change or necrosis of tumor was seen in ependymomma(3 cases), choroid plexus papilloma(1 case), and oligodendroglioma(1 case). Peritumoral edema was seen in medulloblastoma(1 case). Extension through the foramen Luschka and the Magendie was seen in ependymoma(2 cases), choroid plexus papilloma(2 cases), and medulloblastoma(1 case). Seeding along the CSF pathway was seen only in ependymoma(2 cases). CONCLUSION: The results of our study may suggest that specific diagnosis of 4th ventricular tumor can be suggested preoperatively by analysing the origin in 4th ventricle, difference of CT density or MRI signal inten. sity, presence of extension or seeding through cerebrospinal fluid of the lesion.
Cerebrospinal Fluid ; Choroid Plexus ; Diagnosis ; Edema ; Gadolinium DTPA ; Hemorrhage ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging* ; Medulloblastoma ; Necrosis

In literatures, most of the studies of severe hyponatremia during or following its treatment has been concentrated with special references to the rate of correction and its neurologic outcomes. But, there is relatively few ones analyzing the diverse clinical manifestations of neurologic symptorns or complications during the course of treating severe hyponatremia. We experienced a catastrophic course related to hyponatremia in a 51 year woman with severe rheumatoid arthritis, who underwent knee joint replacement, and this case revealed the initial transient neurologic recovery for 3 days by the initial rapid correction of hyponatremia, then followed by delayed deterioration of osmotic demyelination syndrome leading to locked-in syndrome. Reported cases with similar clinical course (biphasic course) in the world lituratures were reviewed with special interests in the initial maximum rate of correction of hyponatremia and radiologic findings. This review suggests that clinicians treating the patients with severe symptomatic hyponatremia should be aware of the possibility of delayed neurologic sequelae despite the recovery of neurologic status as well as the degree of hyponatremia in the early treatment course of hyponatremia.
Arthritis, Rheumatoid ; Demyelinating Diseases* ; Female ; Humans ; Hyponatremia ; Knee Joint ; Quadriplegia

A 45-year-old female patient visited the hospital complaining of severe sudden headache and posterior neck pain. The patient did not have any traumatic history or abnormal neurologic finding. The patient had sudden quadriplegia and sensory loss. Cervical spine MRI scan was taken, and the compatible findings to acute epidural hematoma were shown. The emergency operation was performed. After the operation, the patient recovered all motor and senses. As there was CSF leakage in the postoperative wound, this was confirmed by cervical spinal computed tomography (CT). Then lumbar drainage was thus performed. The opening pressure upon lumbar puncture was not measured as it was very low. As a result of continous CSF leakage, dural repair was performed. After the operation, the patient had been discharged without neurologic deficits. In this case, it is sensible to suspect intracranial hypotension as a possible cause of spinal EDH.
Drainage ; Emergencies ; Female ; Headache ; Hematoma ; Hematoma, Epidural, Spinal* ; Humans ; Intracranial Hypotension* ; Magnetic Resonance Imaging ; Middle Aged ; Neck Pain ; Neurologic Manifestations ; Quadriplegia ; Spinal Puncture ; Spine