OBJECT: In order to estimate the frequency and risk factors for adenomyosis. METHOD: The clinical records of 1127 women undergoing hysterectomy were retrieved in the Department of Obstetrics and Gynecology, Incheon Christian Hospital, during 7 years, from Jan. 1st 1991 to Dec. 31st 1997. RESULT: The following results were obtained. 1. Adenomyosis was found in 206 of 1127 patients(18.3%). 2. The highest incidence was 41-50 years of age group, an incidence of 55% and mean age group was 46.9 years. 3. Adenomyosis was more frequently observed in parous woman than non-parous woman, such as 8.3% and 91.7%, respectively. 4. Grossly, the size of uterus was enlarged more than 10 weeks gestational size in adenomyosis, an incidence of 62.4%. 5. Pelvic pain, dysmenorrhea and metrorrhagia were common symptom of adenomyosis, an incidence of 26.7%, 25.2% and 19.4%, respectively. 6. Myoma was the most combined disease in adenomyosis, showing the incidence of 53.4%. 7. Combined pelvic endometriosis was not observed in this study. 8. Endometrial findings of adenomyosis showed proliferative phase of normal endometrial cycle in the highest incidence, giving 72.3% of all cases. 9. Preoperative diagnostic accurracy of adenomyosis was 8.2%. CONCLUSION: This results show that deeply understanding of the common symptom and epidemiology of adenomyosis improve the preoperative diagnostic accuracy.
Adenomyosis* ; Dysmenorrhea ; Endometriosis ; Epidemiology ; Female ; Gynecology ; Humans ; Hysterectomy* ; Incheon ; Incidence ; Menstrual Cycle ; Metrorrhagia ; Myoma ; Obstetrics ; Pelvic Pain ; Risk Factors ; Uterus

The authors have experienced a case of histiocytosis-X. A 7-year-old male patient had three tender masses, one on the right parietal region, another on the left parietal region, the other on the left occipital region and revealed exophthalmus on his left side. Plain skull films showed multiple punched out skull defects and on lumbar spine films, collapse of body of second lumbar vertebra was detected. Among the masses, the largest right parietal one was excised totally. The final diagnosis revealed histiocytosis-X on pathologic basis and he was given subsequent chemotheraphy.
Child ; Diagnosis ; Histiocytosis, Langerhans-Cell* ; Humans ; Male ; Rabeprazole ; Skull ; Spine

PURPOSE: To assess the clinical course of submacular hemorrhage (SMH) due to various chorioretinal diseases with or without pneumatic displacement and the factors related with the final visual outcome. METHODS: The authors of the present study retrospectively reviewed the charts of 12 eyes (group 1) which underwent pneumatic displacement for SMH and the charts of 14 eyes (group 2) which did not receive pneumatic displacement. Best-corrected visual acuity (BCVA) at baseline was compared with the BCVA at 1, 3, and 6 months and on the final visit. Association between final BCVA and other clinical features was analyzed including age, baseline BCVA, duration of symptoms, and size of SMH. RESULTS: In group 1, log MAR BCVA was 1.22 +/- 0.66 at baseline and there was a significant BCVA improvement of 0.77 +/- 0.57 at 6 months compared with baseline (p = 0.045). On the final visit, 6 eyes (50%) had gained 2 Snellen lines or more. In group 2, BCVA was significantly improved from 1.29 +/- 0.70 at baseline to 1.06 +/- 0.84 at 1 month (p = 0.045). Ten eyes (71.4%) had gained 2 Snellen lines or more on the final visit. In group 1, there were no factors correlated with final BCVA (p > 0.05), while the final BCVA was significantly correlated with age and baseline BCVA in group 2. CONCLUSIONS: Clinicians may expect conservative treatment to lead to significant improvement of BCVA in patients with SMH due to various chorioretinal diseases who did not undergo any procedures to displace the hemorrhage.
Displacement (Psychology) ; Eye ; Hemorrhage ; Humans ; Retrospective Studies ; Visual Acuity

Diffuse plane xanthoma is a group of plane xanthomas that appear as yellow-brown flat patches or slightly elevated plaques with a wide-spread distribution. Cutaneous xanthomas may occur either hyperlipoproteinemic or normolipoproteinemic states. Diffuse plane xanthoma with normolipoproteinemia is often associated with multiple myeloma, other reticulo-endothelial malignancies and monoclonal gammopathy of unknown significance(MGUS). We report a case of diffuse plane xanthoma associated with monoclonal gammopathy of unknown significance(MGUS) and normolipoproteinemia.
Multiple Myeloma ; Paraproteinemias* ; Xanthomatosis*

OBJECTIVE: Few studies have examined the relationship between the risk of cancer and exposure to pesticides in Korea or in other East Asian that have until recently used chlorophenoxy herbicides. The aim of this study was to evaluate the relationship between the exposure to pesticides and cancer incidence. METHODS: We conducted a prospective cohort study with a follow-up period of 13 years (1985-1998). The subjects included 2,687 male and 3,589 female Kangwha Island residents, Koreans aged fifty-five or more as of March 1985, who received a personal health interview and completed a health examination survey. A Cox proportional hazards models were used to estimate relative risks (RR). RESULTS: At baseline, the mean age of the study participants in 1985 was 66.4 for males and 67.1 for females. During the 13 years follow-up, a total of 300 incidents of cancer in males and 146 in females developed. In males, the total cancer incidence in the highest group was RR, 1.4 (95% CI=1.0-1.9), p for trend=0.041, for digestive organ cancer incidence in the highest group, RR, 1.5 (95% CI=1.0-2.3), p for trend=0.057, for stomach cancer incidence in the highest group, RR, 1.6 (95% CI=0.9-2.8), p for trend=0.094, for gallbladder cancer incidence in the highest group, RR, 9.1 (95% CI=1.1-77.0), p for trend=0.014 were elevated according to the higher frequency of pesticide use per year. In particular, the risk of gallbladder cancer was very high. Although not significant, the risk of liver cancer was higher than in the non-exposed group (in the highest group, RR, 2.0 (95% CI=0.7-5.9)). In females, although not significant, breast cancer incidence in the highest exposure group was higher than in the non-exposed group (in the highest group, RR, 4.7 (95% CI=0.8-27.9)). CONCLUSIONS: This study demonstrates that Korean farmers who use pesticides, particularly males, have a significantly higher total cancer incidence, particularly from digestive organ cancers such as, stomach, gallbladder, and liver cancer. In particular, the risk of gallbladder cancer was very high.
Asian Continental Ancestry Group ; Breast Neoplasms ; Cohort Studies* ; Female ; Follow-Up Studies ; Gallbladder ; Gallbladder Neoplasms ; Herbicides ; Humans ; Incidence* ; Korea ; Liver Neoplasms ; Male ; Pesticides* ; Proportional Hazards Models ; Prospective Studies ; Stomach ; Stomach Neoplasms

BACKGROUND: The purpose of this study is to report a modified transtibial technique to approach the center of anatomical femoral footprint in anterior cruciate ligament (ACL) reconstruction and to investigate the accurate femoral tunnel position with 3-dimensional computed tomography (3D-CT) and radiography after reconstruction. METHODS: From December 2010 to October 2011, we evaluated 98 patients who underwent primary ACL reconstruction using a modified transtibial technique to approach the center of anatomical femoral footprint in single bundle ACL reconstruction with hamstring autograft. Their femoral tunnel positions were investigated with 3D-CT and radiography postoperatively. Femoral tunnel angle was measured on the postoperative anteroposterior (AP) radiograph and the center of the femoral tunnel aperture on the lateral femoral condyle was assessed with 3D-CT according to the quadrant method by two orthopedic surgeons. RESULTS: According to the quadrant method with 3D-CT, the femoral tunnel was measured at a mean of 32.94% +/- 5.16% from the proximal condylar surface (parallel to the Blumensaat line) and 41.89% +/- 5.58% from the notch roof (perpendicular to the Blumensaat line) with good interobserver (intraclass correlation coefficients [ICC], 0.766 and 0.793, respectively) and intraobserver reliability (ICC, 0.875 and 0.893, respectively). According to the radiographic measurement on the AP view, the femoral tunnel angles averaged 50.43degrees +/- 7.04degrees (ICC, 0.783 and 0.911, respectively). CONCLUSIONS: Our modified transtibial technique is anticipated to provide more anatomical placement of the femoral tunnel during ACL reconstruction than the former traditional transtibial techniques.
Adolescent ; Adult ; Anterior Cruciate Ligament Reconstruction/*methods ; Female ; Femur/*radiography/surgery ; Humans ; Imaging, Three-Dimensional/*methods ; Male ; Middle Aged ; Surgery, Computer-Assisted/*methods ; Tibia/radiography/surgery ; Tomography, X-Ray Computed/*methods

The authors report a rare case of right distal posterior inferior cerebellar artery(PICA) aneurysm arising from just distal to its vermian brance. A 36-year-old female patient presented with a sudden onset of headache, nausea, dizziness and ataxia without any other neurologic deficit. On brain computerized tomographic(CT) scan and magnetic resonance imaging(MRI), a well-defined round mass was detected just behind the fourth ventricle. On transfemoral vertebral angiogram(TFVAG), it was confirmed as a saccular aneurysm arising from the vermian brance of the right PICA. The aneurysm was initially directly clipped through bilateral suboccipital approach. Postoperative follow up angiogram after two weeks revealed a more enlarged aneurysm and an incompletely clipped neck. After making sufficient exposure of the aneurysm, the neck was reclipped and the sac removed. Postoperative results were uneventful.
Adult ; Aneurysm* ; Arteries* ; Ataxia ; Brain ; Dizziness ; Female ; Follow-Up Studies ; Fourth Ventricle ; Headache ; Humans ; Nausea ; Neck ; Neurologic Manifestations ; Pica

Mesenteric fibromatosis is a rare nonmetastasizing fi brous tumor, characterized by fibroblastic proliferation without evidence of inflammatory response or definite neoplasia. It appears at any age, but mainly in the second to fifth decades as incidence of two to four desmoid tu mor cases per 1 million people per annum. It is pseudoen capsulated and locally invasive and has a tendency to recur, but metastases are rare. It is more frequent with Gardner's syndrome(adenomatosis coli) in which 50% of them will appear as mesenteric fibromatosis. Trauma, especially that of previous surgery, has been associated with the subsequent development of desmoid tumor. The treatment of choice is a wide margin resection of the tumor. we experienced a case of mesenteric fibromatosis without Gardner's syndrome 2 years after appendectomy in a 31-year old man and recurred at 21 months after resection and report with a review of literatures. 6
Adult ; Appendectomy* ; Fibroblasts ; Fibroma* ; Fibromatosis, Aggressive ; Gardner Syndrome ; Humans ; Incidence ; Neoplasm Metastasis

Gastrointestinal bleeding from the biliary tree, called hemobilia, is an uncommon event. It may clinically present as hematemesis or melena. Ruptured cystic artery pseudoaneurysm is a rare cause of hemobilia, with 2 cases reported in Korea. We present this unusual condition in a 65-year-old man whose chief complaint was abdominal pain. His final diagnosis was ruptured cystic artery pseudoaneurysm, and he was successfully treated by transcatheter arterial embolization and laparoscopic cholecystectomy.
Abdominal Pain ; Aged ; Aneurysm, False* ; Arteries* ; Biliary Tract ; Cholecystectomy, Laparoscopic ; Diagnosis ; Hematemesis ; Hemobilia* ; Hemorrhage ; Humans ; Korea ; Melena

Left ventricular-right atrial communications, known as Gerbode-type defects, are rare intracardiac defects that can be either congenital or acquired. Acquired forms arises from endocarditis, trauma, mitral or aortic valve replacement and myocardial infarction. In this case, a forty-seven year-old man with resting dyspnea and fever was diagnosed to have infected congenital bicuspid aortic valve resulting in severe acute aortic regurgitation and he also was diagnosed to have a Gerbode-type defect which were demonstrated by the color doppler method and realtime three-dimensional echocardiography. The causasive organism was Streptococcus mitis. After sufficient antibiotics therapy, aortic valve replacement was performed and the atrioventricular portion of the membranous septum was closed directly with mattress suture. We also review the anatomical features and hemodynamic consequences of such a defect.
Anti-Bacterial Agents ; Aortic Valve ; Aortic Valve Insufficiency ; Bicuspid ; Dyspnea ; Echocardiography* ; Echocardiography, Three-Dimensional ; Endocarditis* ; Fever ; Hemodynamics ; Myocardial Infarction ; Streptococcus mitis ; Sutures