No abstract available.
46, XX Disorders of Sex Development* ; Female* ; Humans

Rapid identification of Mycobacterium spp. isolated from patients is important with increased isolation of mycobacteria other than tubercle bacilli (MOTT). DNA-DNA hybridization with streptavidin-peroxidase and tetramethylbenzidine (TMB) color reaction method was recognized as a useful tool for identification of various species of mycobacteria. In this study, optimum condition of the test was determined. The optimal concentrations of tetramethylbenzidine dihydrochloride and hydrogen peroxide for streptavidin-horseradish peroxidase were 0.3-0.6 ug/ ml and 0.16 mM, respectively. The TMB stock solution was stable when prepared in methanol and the dilution of TBM stock solution in 10 mM sodium citrate-10 mM EDTA solution (pH 5.0) gave highest peroxidase-TMB activity. The suitable composition of hybridization solution consisted of 2 x SSC, 10% dextran sulfate, 50 ug/ml salmon DNA, 5 x Denhardt's solution, and 50% formamide. The 5-minute heating at 100C of test DNA prior to photobiotin labeling significantly increased the reaction. In conclusion, DNA-DNA hybridization method with streptavidin-peroxidase and TMB color reaction method may be useful for rapid identification of Mycobacterium spp. isolated from patients.
Dextran Sulfate ; DNA ; Edetic Acid ; Heating ; Hot Temperature ; Humans ; Hydrogen Peroxide ; Methanol ; Mycobacterium* ; Peroxidase ; Salmon ; Sodium

Transsexuals are those who have appropriate chromosomal, hormonal and anatomical characteristics corresponding to their sexual phenotype but feel strongly with respect to their sexual identity, that they belong to the opposite sex. For this reason, they wish to be reassigned to their psychological sex by means of endocrinological and surgical treatment. Although its etiology is unknown, the majority of modern psychiatrists and behavioral scientists agree that the transsexualism is a disease entity belonging to gender identity disorder or gender dysphoria but not to be confused with the transversite, honosexualism or psychiatric problem. Three kinds of hermaphroditism have been defined according to the histology of the gonad : female pseudohermaphroditism, male pseudohermaphroditism and true hermaphroditism. It is very difficult, if not possible to assign sex especially in neonate and young children. Once sex assignment has been decided and accepted by the patient, surgical intervention should be undertaken as soon as possible. For adults there are many kinds of operative techniques. We have operated 28 cases of transexualism patients by using the penile and scrotal skin flap. This technique is superb for improving sexual appearance and function, and finally for a good opportunity for social activity. We report the results of surgery.
46, XX Disorders of Sex Development ; 46, XY Disorders of Sex Development ; Adult ; Child ; Disorders of Sex Development ; Female* ; Gender Identity ; Gonads ; Humans ; Infant, Newborn ; Male* ; Ovotesticular Disorders of Sex Development ; Phenotype ; Psychiatry ; Skin* ; Transsexualism*

Despite a recent trend toward increased screening and public awareness for colorectal cancer, 30% of patients present with incurable disease. This study was designed to identify objective criteria that might help surgeons decide which patients with incurable colorectal cancer will benefit from palliative resection. Among 33 patients considered incurable colorectal cancer, twenty one patients underwent palliative resection and twelve patients had bypass surgery. Incidence of postoperative complication after palliative resection was 61.9%(13 cases), and after bypass surgery was 58.3%(7 cases). Among patients treated by palliative resection, one patient required reoperation for postoperative bleeding. The operative mortality after palliative resection was 19%(4 cases), and after bypass surgery was 25%(3 cases). The median survival was 11.4 months for patients treated by palliative resection, and was 9.7 months for patients treated by bypass surgery. These results show that palliative resection can be done safely and effectively in patients with incurable colorectal cancer. We believe this approach improved the quality of the remaining life in these patients.
Colorectal Neoplasms* ; Hemorrhage ; Humans ; Incidence ; Mass Screening ; Mortality ; Postoperative Complications ; Reoperation

Familial juvenile polyposis is a rare intestinal polyposis characterized by the occurrence of multiple juvenile polyps in the gastrointestinal tract. We report a case of familial juvenile polyposis in a 17-year-old man with a review of the literature. This patient underwent total colectomy due to a 6 years history of rectal bleeding. Grossly, the colon showed 36 variable sized pedunculated polyps, measuring 2.5cm x 2cm from the largest size and 0.2cm x 0.2cm to the smallest size. Histologically, the polyps consisted of cystically dilated glands, lined by normal colonic epithelial cells, scattered in loose, edematous stroma containing inflammatory cell infiltration. There were no areas of tubular adenoma or malignancy in any of the polyp.
Adenoma ; Adolescent ; Colectomy ; Colon ; Epithelial Cells ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Intestinal Polyposis ; Polyps

The management of malignant left colon obstruction remains a difficult problem. Conventional surgical treatment is muti-staged and each stage carries its own morbidity and mortality. The purpose of this study is to identify the feasibility and safety of one stage operation in patients presenting with acute obstruction of the left colon. From January 1991 to June 1996, 29 patients received one stage resection for acutely obstructed carcinoma of the left colon at Soonchunhyang University Chunan Hospital. Subtotal colectomies were performed in 9 patients(31.0%), left hemicolectomies in 6(20.7%), low anterior resection in 6(20.7%), sigmoid colectomy in 4(13.8%), anterior resection in 4 patients(13.8%). Subtotal colectomy was performed in patients with massively distended colon of dubious viability and to contain ischemic lesions at proximal colon. Total operative mortality was 6.9%: 5% in the immediate resection with anastomosis group, 11.1% in subtotal colectomy group. Complications included wound infection(4), fecal incontinence(2), intestinal obstruction(2), anastomotic leakage(1), upper G-I bleeding(1), postoperative bleeding(1), pulmonary complication(1). Our results suggest that resection and primary anastomosis can be performed with acceptable morbidity and mortality in patients with acute malignant obstruction of the left colon.
Chungcheongnam-do ; Colectomy ; Colon* ; Colon, Sigmoid ; Humans ; Mortality ; Wounds and Injuries

BACKGROUND AND OBJECTIVES:Electrocochleography is the only proven investigation and diagnostic tool to demonstrate the endolymphatic hydrops at this time. We designed this study to assess the characteristics of transtympanic electrocochleographic findings and to estimate the clinical value of the test results in the patients with Meniere's disease. MATERIALS AND METHOD:Electrocochleographic duration and amplitude were measured in a clinically defined definite Meniere's disease group and the results were compared with those from a normal hearing control group. RESULTS:The summating potential (SP)/action potential (AP) amplitude ratio was significantly different among study groups with 0.40+/-.10 in the bilateral Meniere's group, 0.34+/-.08 in the unilateral Meneire's group and 0.22+/-.08 in the normal group (p<0.01). The elevated SP/AP ratio in the patients with such a relatively long duration of Meniere's disease in this study was mainly due to the decreased AP amplitude rather than the enhanced SP amplitude. CONCLUSION:Measuring electrocochleography and demonstrating the elevated SP/AP ratio could be quite valuable to diagnose the patients with Meniere's disease. The recognition of decreased AP amplitude might be helpful to understand the cochlear pathologic status in the patients with Meniere's disease.
Audiometry, Evoked Response* ; Endolymphatic Hydrops ; Hearing ; Humans ; Meniere Disease*

Mature cystic teratomas of the ovary (MCT) are usually observed in women of reproductive age with the most dreadful complication being malignant transformation which occurs in approximately 1% to 3% of MCTs. In this case report, we present a patient with squamous cell carcinoma which developed from a MCT during pregnancy. The patient was treated conservatively without adjuvant chemotherapy and was followed without evidence of disease for more than 60 months using conventional tools as well as positron emission tomography-computed tomography following the initial surgery. We report this case along with the review of literature.
Carcinoma, Squamous Cell ; Chemotherapy, Adjuvant ; Dermoid Cyst ; Electrons ; Female ; Humans ; Ovary ; Pregnancy ; Teratoma

Palatal myoclonus, a kind of objective tinntius, is an uncommon disorder which shows rhythmic involuntary movement of the muscles of soft palate. Because of inadequate response of the muscles involved in palatal myoclonus to medical therapy, injection of botulinum toxin has been considered. We report a case of palatal myoclonus which had not responded to medical therapy. Injection of botulinum toxin into the muscle under the electromyographic guidance showed complete recovery of tinnitus and no more rhythmic movements of the muscles. Electromyography findings before and after botulinum toxin injection were also demonstrated.
Botulinum Toxins ; Dyskinesias ; Electromyography ; Muscles ; Myoclonus* ; Palate, Soft ; Tinnitus*

BACKGROUND: The presence of axillary lymph node metastases (ALNM) and tumor size are two most important prognostic factors in breast cancer. An axillary lymph node dissection (ALND) is usually performed in infiltrating breast cancer for the information of therapeutic decision and prediction of prognosis. However this procedure results in lymphedema of the affected upper extremity, increased axillary drainage, sensory abnormality, and pain. If the axillary lymph node status could be predicted accurately prior to an ALND, selected patients with a low probability of ALNM could be spared the procedure. The purpose of this study was to determine the association between the incidence of ALNM and 14 clinico-pathologic factors by using univariate and multivariate analysis and to investigate the possibility of using those factors as predictors for ALNM. METHODS: We reviewed data from 253 patients with breast cancer who had undergone at least a level I/II axillary dissection between 1991 and 1998. The association between the incidence of ALNM and 14 clinico-pathologic factors (age, menstruation, tumor size, palpability of tumor, tumor site, pathologic type, nuclear grade, estrogen receptor status, progesteron receptor status, p53, c-erbB-2, Ki67, Cd34, and Cathepsin D) were analyzed by using univariate and, when significant, multivariate analysis. RESULTS: Approximately 38.7% of the 253 patients with breast cancer had ALNM. Univariate analysis showed that ALNM were associated with tumor size (P<0.01), pathologic type (P<0.001), palpability (P<0.01), and nuclear grade (P<0.01). However, independent predictors of ALNM in the multivariate analysis were tumor size and pathologic type. Among the patients with smaller than 1.0 cm in the tumor size and DCIS in the pathologic type, the ALNM was not founded. CONCLUSIONS: We conclude that the characteristics of primary breast cancer can help assess the risk for ALNM. Selected patients, who are assessed to be minimal risk, might be spared a routine ALND, if the treatment decision would not be influenced by the lymph node status.
Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Cathepsins ; Drainage ; Estrogens ; Female ; Humans ; Incidence ; Lymph Node Excision ; Lymph Nodes* ; Lymphedema ; Menstruation ; Multivariate Analysis ; Neoplasm Metastasis* ; Prognosis ; Upper Extremity