The dysplastic nevus is a rare form of melanocytic nevus in Korean people. During the past 5 years the authors experienced 5 cases in the St. Mary's Hospital and Kang Nam St. Mary's Hospital. The criteria and the histologic findings of dysplastic nevi are debated in the western literature. Clinically, all cases were greater than 5 mm in size with ill defined irregular borders and irregularly distributed pigmentation. Histopathologically, all cases showed numerous discrete individual nests of melanocytes located in the dermoepidermal junction and the papillary dermis and were characterized by extension of dermoepidermal component of the nevus at the "shoulder" beyond the dermal component of the nevus. There was no cytologic atypia of nevus cells in all cases. Our cases lacked personal or family history of malignant melanoma. Therefore, we believe our cases are nonfamilial, sporadic and benign nevi with no prognostic significance. A brief review of the literature and a discussion on the term "dysplastic" and clinicopathologic correlation are made.

Wilm's tumor, which is the most mommon renal tumor in childhood, has rarely been reported in adult. Diagnosis of Wilm's tumor in an adult is more apt to be accidental and is almost never suspected in the adult until discovered at operation or necropsy. Recently, we experienced a caseof Wilm's tumor in 20-year-old female patient with chief complaints of right flank pain and he maturia for two months. Renal angiogram revealed a huge renal mass replacing the upper portion of the right kidney. Nephrectomy was done under the impression of renal tumor. Grossly, the tumor was rather soft and relatively well circumscribed, measuring 13 x 8.3 cm in dimension with adhesion to renal capsule and perirenal adipose tissue. The cut surfaces revealed grayish brown in color with areas of multifocal necrosis and hemorrhage. Histologically, the tumor was composed of mainly ovoid or polygonal shaped undifferentiated blastemal cells with large areas of necrosis.
Child ; Adult ; Male ; Female ; Humans

Trisomy 9p syndrome was first described by Rethore, et al in 1970 and about 150 cases have been reported. Trisomy 9p has been reported as either partial or complete. The term "duplication 9p syndrome" instead of "trisomy 9p syndrome" is used since most of the reported patients had only partial duplication rather than the whole arm duplication of 9p. Duplication of 9p syndrome is characterized by growth and developmental retardation, microbrachycephaly, deep and wide set eyes with down-slanting palpebral fissures, "globular" nose, down-turned corners of the mouth, prominent apparently low-set ears, and short fingers and toes with small nails. A 10- month-old male was referred to our department of pediatrics because of hypotonia and delayed development. Karyotype revealed 46, XY, dup(9)(p12p24) by GTC-Banding. We report a case of a duplication 9p syndrome diagnosed by GTC-banding.
Arm ; Ear ; Fingers ; Growth and Development ; Humans ; Karyotype ; Male ; Mouth ; Muscle Hypotonia ; Nose ; Pediatrics ; Toes ; Trisomy*

It hae been well established that, specifi alterations in members of the ras gene family, H-ras, K-ras and N-ras, can convert them into active oncogenes. These alterations are either point mutations occurirg in either codon 12, 13 or 61, or alternatively, a 5- to 50-fold amplification of the wfld-type gene. Activated ras oncogenes have been found in a significant proportion of all turnors, but the incidence varies considerably with the tumor type : it is frequent (20~40%) in colarectal eancer and acute myeloid leukemia, but absent or preaent rarely in breast and atomach cancer. But the role of c-K-ras point mutatio in the development of cancers in the female genital tract has not been extensively studied. Polymerase chain reaction followed by gel electrophoresis was performed respectively using wild-type normal and specific point mutation primers{GGT->GAT, GGT->AGT, GGT->TGT and GGT->GTT) to detect, point, mutation of codon 12 of c-K-ras oncogene. The c-K-ras oncogene point mutation was confirmed by Southern blot hybridization using synthetic oligonucleatide probe. 3'-end Iabelled with digoxigenin -dUTP. With this method, the frequency of point mutation on codon 12 of c-K-ras oncogene was examined the tissues in 37 casea of ovarian cancer, 7 cases of endometrial cancer, 36 cases of the gestational trophoblastic tumor, 60 cases of cervical cancer. The relationship between the presence of a c-K-ras point mutation and clinicopathological characteristics of the female genital tract cancers were also analysed. The results were as follows; 1. The incidence of four point mutations on codon 12 of c-K-ras oncogene in 37 ovarian cancers was 45.9% (17/37) and distribution were 43.2% (16/37), 2.7% (1/37) and 0% (0/37) in GGT-->GAT, GGT-->AGT, GGT-->TGT, and GGT-->GTT, respectively. According to histological type, in ovarian cancers, The point mutation of K-ras oncogene waspositive in 45 % (10/22) of serous cystadenocarcinomas. The incidence of four point mutations on codon 12 among 37 patients with ovarian cancer according to histological type was 45.5 % (10/22) with serous cystadenocarcinoma, 57.1% (4/7) of mucinous cystadenocarcinoma. Comparing the positive rate of point mutations of K-ras oncogen among 37 patients with ovarian cancer with the clinical stage, point mutation was detected in 28.5% (2/7) of patients with stage I, 40.0% (2/5) with stage II, and 52.0% (13/25) with stage III/IV. There was no statistically significant increasement of point mutations with the advance of the clinical stage of ovarian cancer. Comparing the positive rate of point mutations of K-ras oncogen among 37 patients with ovarian cancer according to the histologic grade point mutation was detected in 50.0 % (2/4) 0f patients with grade I, 451.7 % (5/12) with grade II and 47.6 % (10/21) with grade III. 2. The incidence of point mutations of K-ras oncogen among 33 patients with ovarian cancer who were performed pelvic lymph node dissection was 57.1 % (12/21) of the patients with pelvic lymph node metastases and 16.7% (2/12) of the patients without pelvic lymph node metastases. There was statistically significant difference between the positive rate of c-K-ras point mutations and the pelvic lymph nodal status(P<0.05). 3. In 7 cases of endometrial cancer, positive rate of K-ras point was 42.8 % (3/7). Point mutations were also detected in 2 cases from 4 choriocarcinomas, but, the point mutation was only detected in 1 case from 60 cervical carcinomas. From these results, we may suggest that the point mutation on codon 12 c-K-ras oncogene are considered to be one of the important genetic change in the tumor formation and progression of ovarian of c-K-ras oncogene seems to be the one stop in the multistep process of tumor formation in ovarian cancer. Furthermore, the point mutation of c-k-ras gene could occur more frequently in the patients of ovarian cancer with pelvic lymph node metastases than in those without pelvic metastases, suggesting the orle in tumor progression. And we concluded that point mutation on codon 12 is comparable frequent in uterine endometrial carcinomas and have significance as an event that contributes to progrssion of endometrial cancers and choriocarcinoma, but cervical carcinoma do not appear to have c-K-ras point mutation in general. More studies will be necessary, but the detection of c-k-ras point mutation as the possibility of biological tumor marker to predict clinical outcome may be utilized in female malignancies.
Blotting, Southern ; Breast ; Choriocarcinoma ; Codon ; Cystadenocarcinoma, Mucinous ; Cystadenocarcinoma, Serous ; Digoxigenin ; Electrophoresis ; Endometrial Neoplasms ; Female* ; Genes, ras ; Humans ; Incidence ; Leukemia, Myeloid, Acute ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Oncogenes* ; Ovarian Neoplasms ; Point Mutation* ; Polymerase Chain Reaction ; Pregnancy ; Trophoblastic Neoplasms ; Biomarkers, Tumor ; Uterine Cervical Neoplasms

Background: This study investigates the influence factors of medical service variations using medical charge and the length of stay (LOS) for urinary incontinence surgery and uterine polypectomy. Methods: The National Health Insurance claims data and Medical Resource Report by the Health Insurance Review & Assessment Service in 2016 were used. Frequency analysis, one-way analysis of variance, and Bonferroni post-hoc tests were executed for each surgery. A multilevel analysis was executed to assess the factors to the medical charge and LOS for each surgery in patient, doctor, and hospital level. Results: Fifty-two point eight percent of urinary incontinence surgery and 87.1% of uterine polypectomy were distributed in general and tertiary hospitals. Among three levels, the patient level variation was 61.5% or 77.2% in medical charge and 93.9% or 96.3% in LOS, respectively. The doctor level variation was 29.6% or 22.6% in medical charge and 0.6% or 0.0% in LOS, respectively. The institution level variation was 8.9% or 0.2% in medical charge and 5.5% or 3.7% in LOS, respectively. Number of other disease and organizational type were main factors that affected the charge and LOS for urinary incontinence surgery and uterine polypectomy. Conclusion Medical service variations of the urinary incontinence surgery and uterine polypectomy were the largest for the patient level, followed by doctor level for the medical charge, and the institution level for the LOS.

No abstract available.
Ultrasonics*

Microphallus species occur primarily as intestinal parasites of birds and mammals, and metacercariae of a new species belonging to this genus have been discovered from the crab, Macrophthalmus dilatatus, in the Republic of Korea. The metacercaria of this fluke was round with 2 thick walls, and the excysted one had mature genital organs. The adult flukes recovered from experimentally infected chicks had numerous intrauterine eggs, well-developed pars prostatica, widely bifurcating ceca, and prominent uterine bulge. After observing internal structures, it was concluded that this species is different from any other known Microphallus spp. Based on the morphology of metacercariae and adult flukes, we describe this specimen as a new species, Microphallus koreana n. sp.
Animals ; Brachyura/*parasitology ; Chickens ; Rats ; Trematoda/*anatomy & histology/*classification/isolation & purification ; Trematode Infections/parasitology/transmission

Persistent hiccups are described as a recurring troublesome series of involuntary inspirations accompanied by glottic closure, lasting longer than a month. Recently, baclofen, the most effective treatment for intractable hiccups was found to be a useful drug for the management of chronic hiccups, and that substituting gabapentin for baclofen can be effective. Moreover, gabapentin was used successfully in combination with baclofen. We report here on three patients with persistent hiccups, where gabapentin was used successfully as an "add-on" with baclofen.
Baclofen* ; Hiccup* ; Humans

Hydranencephaly is a condition that is characterized by an absent brain mantle along with the subadjacent white matter, with replacement of the cerebral hemispheres by a thin-walled membranous sac containing CSF. During brain sonograpy in a neonate with hydranencephaly, we have found a brain-in-brain appearance as an unusual sonographic artifact. We report here on this interesting sonographic artifact in a neonate with hydranencephaly, and this artifact was due to multipath reflection artifact of the ultrasound beam/wave, and we explain the underlying physics.
Artifacts ; Brain ; Cerebrum ; European Continental Ancestry Group ; Humans ; Hydranencephaly ; Infant, Newborn

We experienced a case of aldosterone and cortisol secreting adrenal adenoma associated with pregnancy in a 23 year old female patient.The patient complained of severe thoraco-lumbar pain, weight gain, sweating, anxiety, and mild abdominal discomfort. On physical findings, hypertension, tachycardia, facial plethora, moon face, buffalo hump and truncal obesity were found.
Adenoma ; Aldosterone ; Anxiety ; Buffaloes ; Female ; Humans ; Hydrocortisone ; Hypertension ; Moon ; Obesity ; Pregnancy ; Sweat ; Sweating ; Tachycardia ; Weight Gain