There has been no adequate diagnostic method for the diagnosis of intrascrotal lesions until recent days. Butafter the development of radionuclide testicular scan, early and relatively accurate diagnosis of the testicularlesions are possible. So the authors analyzed the 32 cases of patients who were examined by testicular scan andconfirmed by follow up study or operation, and the results are as follows; 1. These 32 cases consists of 13 casesod epididymitis, 7 cases of testicular torsion, 4 of cryptorchism, 2 of testicular tumor and etc. The over alldiagnostic accuracy is about 69%. 2. In epididymitis, the diagnostic accuracy is 85%(11/13) and the findings ofscan are increased perfusion in radionuclide angiogram and hot activity noted mainly in peripheral portion of thetesticle in static image. 3. In cases o testicular torsion, diagnostic accuracy is 86%(6/7). Acute torsion showsnormal perfusion in angiogram and round cold area instatic image. But in missed torsion, perfusion is increasedand round cold area wit surrounding hyperemia is noted in static image. Radionuclide testicular scan seems to benoninvasive, inexpensive, easily available and simple to perform with low gonadal radiation dose. So it can bevery useful as the first study in patients with acute testicular symptoms.
Cryptorchidism ; Diagnosis ; Epididymitis ; Follow-Up Studies ; Gonads ; Humans ; Hyperemia ; Male ; Methods ; Perfusion ; Spermatic Cord Torsion

Female ; Follow-Up Studies ; Headache ; Humans ; Incidence ; Neck ; Neck Pain ; Shoulder Pain ; Temporomandibular Joint

Clear cell carcinoma of the ovary is a clinicopathologic entity with distinct morphologic characteristics and known to be associated with poor prognosis irrespective of stage and prognostic benefits of chemotherapy have not been evidently demonstrated. This represents 2-3.6% of all ovarian malignancies. From October, 1991 to January, 1998, nine patients with primary clear cell carcinoma of the ovary treated in the deptartment of Gynecology and Obstetrics, University of Ulsan, Asan Medical Center were identified, and clinical and histologic review(including architectural pattern, mitotic activity, nuclear grading) was performed retrospectively. The age of the patients ranged from 30 to 67 year(mean+S.D.; 46.0+11.8) and the mean parity was 1.2 (+1.3). Five(55.6%) of nine patients had elevated level of CA 125. The size of the tumors varied from 3 cm to 20 cm with the mean maximal diameter of 12.1 (+6.3) cm. The FIGO stages of the patients were IC(6 cases, 66.7%), IIC (2 cases, 22.2%) and IV(1 case, 11.1%). All patients except one were treated by total abdominal hysterectomy and bilateral salpingoophorectomy with or without omentectomy and pelvic lymph node dissection. All except two were received postoperative chemotherapy with regimens such as CEC (cyclophosphamide + epirubicin + carboplatin), TC(taxol + carboplatin), CC(cyclophosphamide + carboplatin) or CAP (cyclophosphamide + adriamycin + cisplatin). The mean follow-up duration was 14.6 (+ 8.6) months and 8 patients were free of disease and one patient with stage IV disease died of disease during postoperative chemotherapy(4 months after surgery).
Chungcheongnam-do ; Doxorubicin ; Drug Therapy ; Epirubicin ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Hysterectomy ; Lymph Node Excision ; Obstetrics ; Ovary* ; Parity ; Prognosis ; Retrospective Studies ; Ulsan

Clinical manifestations of hypothyroidism are very various and these degree are related to the severity and duration of the disease. Pericardial effusions, one of the manifestations of hypothy-roidism, were relatively common in the past. However, recently they may not be so frequent representative of hypothyroid subjects. The higher frequency of Hashimotos thyroiditis in Turners syndrome, especially those with an X-isochromosome, compared with the general population is well known. The pathophysiological process of autoimmunity is thought to be linked with the presence of an abnormal X-chromosome. Recently we experienced a case of X-isochromosome Turners syndrome with hypothyroidism and pericardial effusion and report it with reviews of the literatures.
Autoimmunity ; Hypothyroidism* ; Pericardial Effusion* ; Thyroid Gland ; Thyroiditis ; Turner Syndrome*

Von Meyenburg complexes (VMC) have many synonyms such as bile duct hamartomas and biliary hamartoma. These rare benign disorders are considered as congenital diseases caused by malformed differentiation of ductal plate. The diagnosis of VMC by common radiologic modality such as ultrasound and computed tomography was nearly impossible until the emergence of cholangiopancreatography by magnetic resonance imaging (MRCP) and the pathologic examination was the only way to confirm the diagnosis of VMC. But MRCP is now considered as most accurate noninvasive method for diagnosis of VMC. We report a histologically proven case of VMC associated with calculous cholecystitis, cerebral aneurysm and renal cortical cyst. To our knowledge, no comparable case has been reported and this would be the only second reported case of VMC, which was diagnosed by MRCP.
Bile Ducts ; Cholecystitis* ; Diagnosis ; Hamartoma ; Intracranial Aneurysm* ; Magnetic Resonance Imaging ; Ultrasonography

BACKGROUND AND OBJECTIVES: Cigarette smoking and alcohol consumption are well known risk factors of laryngeal squamous cell carcinoma. Recently, attention has been focused on other risk factors such as human papillomavirus (HPV). The presence of HPV genome in the tumor has been reported to correlate with poor patient outcome. The integration of viral genome into the host DNA is believed to be helped by alcohol and cigarette smoking. This study attempted to evaluate the incidence of HPV in laryngeal cancer with regard to its stage and recurrence. MATERIALS AND METHODS: The authors examined the incidence of HPV in 61 cases of laryngeal cancers (34 supraglottic cancers, 26 glottic cancers, 1 subglottic cancer). The histologic type of tumor in all cases was squamous cell carcinoma. There were 8 patients in the stage 1, 26 patients in the stage 2, 14 patients in the stage 3 and stage 4. Recurrence of the disease during follow-up periods occurred in 12 patients (19.6%). Polymerase chain reaction (PCR) was performed using the consensus primers for HPV on the formalin-fixed, paraffin-embedded archival tissue. For cases with amplified products corresponding to the HPV genome, a dot blot hybridization was performed for typing the different HPV types. RESULTS: The HPV genome was identified in 5 cases (8%) of laryngeal squamous cell carcinomas by using PCR. In recurrent laryngeal cancer group, detection rate of HPV DNA was significantly greater than in the non-recurrent group (p<0.05). The dot blot hybridization showed only one case to be the HPV type 31. The other cases (4 cases) could not be typed using the dot blot hybridization. CONCLUSION: We can only say that the possible role of HPV in the carcinogenesis of larynx cancer is not yet resolved.
Alcohol Drinking ; Carcinogenesis ; Carcinoma, Squamous Cell ; Consensus ; DNA ; Follow-Up Studies ; Genome ; Genome, Viral ; Humans* ; Incidence ; Laryngeal Neoplasms* ; Papillomavirus Infections* ; Polymerase Chain Reaction ; Recurrence ; Risk Factors ; Smoking

PURPOSE: We wanted to determine the clinical characteristics and prognosis according to the VEGF expression in stage II cervical carcinoma patients treated with definitive radiotherapy. MATERIALS AND METHODS: We enrolled 31 patients who were diagnosed with cervical cancer from 1995 to 2003 at Samsung Medical Center and their paraffin block tissue samples were available for study. The median age of the patients was 65 years. The mean tumor size was 4.1 cm (range: 1.2~8.2 cm). Seven patients (22.6%) were suspected of having pelvic lymph node metastasis. An external beam irradiation dose of 45-56.4 Gy was administered to the whole pelvis with a 15 MV linear accelerator, and an additional 24 Gy was given to point A by HDR intracavitary brachytherapy. VEGF staining was defined as positive when more than 10% of the tumor cells were stained. The median follow-up duration was 58 months. RESULTS: A positive VEGF expression was observed in 21 patients (67.7%). There was no significant correlation between the VEGF expression and pelvic lymph node metastasis, tumor size and the response of radiotherapy. During follow-up, 7 patients had recurrence. The complete response rate was not significant between the VEGF (-) and VEGF (+) tumors. However, the VEGF (+) tumors showed a significantly higher recurrence rate in comparison with the VEGF (-) tumors (p=0.040). The three year disease-free survival rates were 100% and 66.7%, respectively, for patients with VEGF (-) or VEGF (+) tumor (p=0.047). CONCLUSION: The VEGF expression was a significant factor for recurrence and disease-free survival. However, the significance of the VEGF expression is still controversial because of the various definitions of VEGF expression and the mismatches of the clinical data in the previous studies.
Brachytherapy ; Cervix Uteri* ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin ; Particle Accelerators ; Pelvis ; Prognosis ; Radiotherapy* ; Recurrence ; Uterine Cervical Neoplasms ; Vascular Endothelial Growth Factor A*

BACKGROUND AND OBJECTIVES: It has been recently reported that coronary artery disease (CAD) is more correlated with postprandial triglyceride (TG) levels than fasting TG levels. We performed this study to compare the patients with CAD to age- and sex-matched controls in regard to postprandial TG levels and to know the effects of fenofibrate on postprandial TG levels. MATERIALS AND METHOD: Serum TG, total cholesterol (C), HDL-C and LDL-C were measured before, and 2, 4, 6, 8, and 24 hours after a high-fat meal in 22 patients (mean: 60 yr) with CAD and 12 normal subjects (mean: 54 yr). The same parameters were also serially measured after the high-fat meal plus fibrate in 10 patients with CAD (mean: 59 yr). RESULTS: he patients group without fibrate showed that more prolonged and exaggerated hypertriglyceridemia following the meal than normal subjects, especially 4 to 8 hours after the meal and that lower HDL-C throughout the test duration. These changes were also persisted when hyperlipidemic patients were excluded out of the patients group. The patients with fibrate did not show such a significant elevation of TG levels 4 to 8hours after the meal compared when normal subjects. The time to reach the peak TG levels after the meal was 4, 6, and 4 hours after the meal in normal subjects, patients with CAD, and fibrate group, respectively. CONCLUSION: Coronary artery disease is clearly related with postprandial hypertriglyceridemia than fasting TG levels and postprandial hypertriglyceridemia can be somewhat prevented by fibrate.
Cholesterol ; Coronary Artery Disease* ; Coronary Vessels* ; Fasting ; Fenofibrate ; Humans ; Hypertriglyceridemia* ; Meals* ; Triglycerides

BACKGROUND AND OBJECTIVES: MLH1 and MSH2, which are DNA mismatched repair genes, used to be studied in HNPCC (hereditary nonpolyposis colon cancer). Now, the defects in MLH1 and MSH2 are known to be related with malignant transformations of other tumor. Mismatched repair proteins are widely dispersed in the adnexal structures. According to studies, if mismatched repair proteins were stained, as melanocytic nevi progresses into melanocytic dysplastic nevi and cutaneous malignant melanoma, positive immunoreactivity decreases. The purpose of the study is to find out the appearance pattern of DNA mismatched repair proteins, and MLH1 and MSH2 known to be associated with microsatellite instability and carcinogenesis. MATERIALS AND METHODS: Of 19 patients who had been diagnosed with malignant melanoma by pathological study in Asan medical center between June, 1989 and January, 2002, 11 patients had mucosal malignant melanoma while 8 patients had malignant melanoma on the skin. There were 9 males and 10 females, with the average age of 55 (32-77). We investigated the nuclear positivity of MLH1 and MSH2 by immunochemical staining of paraffin tissue method. RESULTS: The nuclear positivity of MLH1 and MSH2 were 27.3% (3/11) and 36.8% (7/11), respectively, indicating that there were no significant differences. Three cases of 4 metastatic mucosal malignant melanoma cases showed negative MLH1 response and MSH2 had 2 positive and 2 negative responses. Biopsy after metastasis represented negative conversion of nuclear activity in MLH1 in only on case, and this indicated a loss of activity as the disease progressed. Four except one of the metastatic cutaneous malignant melanoma cases showed negative staining of MLH1 and MSH2. CONCLUSION: We found decreased nuclear activity in MLH1 and MSH2 in the cutaneous malignant melanoma and mucosal malignant melanoma. This information can be applied for diagnosis or follow-up methods of malignancy in the future.
Biopsy ; Carcinogenesis ; Chungcheongnam-do ; Colon ; Diagnosis ; DNA ; DNA Repair ; Dysplastic Nevus Syndrome ; Female ; Follow-Up Studies ; Humans ; Male ; Melanoma* ; Microsatellite Instability ; Microsatellite Repeats ; Negative Staining ; Neoplasm Metastasis ; Nevus, Pigmented ; Paraffin ; Skin

Primary adrenal lymphoma is a very rare extranodal lymphoma; its clinical features consist of a high incidence of bilateral adrenal involvement and diffuse large B-cell lymphoma. We report a patient with primary bilateral adrenal diffuse large B-cell lyphoma who achieved complete remission with R-CHOP (rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy. A 52-yr-old man presented with fever and progressive fatigue for 3 months. Computed tomography (CT) scans of the abdomen and pelvis demonstrated large bilateral adrenal masses, and a needle biopsy of the left adrenal mass revealed diffuse large B-cell lymphoma. After 6 cycles of R-CHOP chemotherapy, CT scans showed no residual disease. To our knowledge, this is the second report to date of a patient with primary bilateral adrenal diffuse large B-cell lymphoma who achieved complete remission using R-CHOP chemotherapy.
Adrenal Gland Neoplasms/*drug therapy/pathology/radiography ; Antibodies, Monoclonal/*therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Cyclophosphamide/therapeutic use ; Doxorubicin/therapeutic use ; Drug Therapy, Combination ; Humans ; Lymphoma, Large B-Cell, Diffuse/*drug therapy/pathology/radiography ; Male ; Middle Aged ; Positron-Emission Tomography ; Prednisone/therapeutic use ; Tomography, X-Ray Computed ; Vincristine/therapeutic use