Herein, polyorchidism possessing of more than the usual number of testicles, which was found in two patients, is reported. Both patients had three testes, and one presented with painful swelling of the right scrotum caused by torsion of the testis and the other revealed a non-palpable testis in the right hemiscrotum. Both patients were managed surgically with orchiopexy and an orchiectomy, respectively, followed by the insertion of an artificial testis.
Humans ; Orchiectomy ; Orchiopexy ; Scrotum ; Testis ; Urogenital Abnormalities

Interest in the prevalence of patent foramen ovale(PFO) and its relation to embolic stroke has increased with the sophistication of methods for noninvasive cardiac assessment. The effect of foramen ovale closure on the risk for subsequent strokes is promised. A 22-year old woman was presented with sudden onset of cerebral infarct. She had a patent formen ovale, and right to left shunt during the Valsalva maneuver, which was diagnosed by transesophageal contrast echocardiography. Transcatheter closure of PFO was performed with Rashkind PDA umbrella under the guidance of transesophageal echocardiography. Transcatheter closure of PFO can be accomplised with little morbidity and may reduce the risk of embolic episode.
Echocardiography ; Echocardiography, Transesophageal* ; Female ; Foramen Ovale ; Foramen Ovale, Patent* ; Humans ; Prevalence ; Stroke* ; Valsalva Maneuver ; Young Adult

Two cases of abnormalities of the left ventricular wall(left ventricular aneurysm or diverticulum) are presented. A saccular deformity of the left ventricle may be and aneurysm or a diverticulum. In one case, the defect seems to be subcalvular aneurysm(or fibrous diverticulum) or aneurysm of the membranous ventricular septum; this lesion seems to be a natural consequence of spontaneous closure of a defect of the membranous septum. The other case, it seems that the defect is ventricular aneurysm with syndrome of myocardial infarction and normal coronary arteries, or double or accessory chambered left ventricle. The thromboembolic phenomenon was noted on a left frontoparietal lobe of brain. Both cases have the diagnosis supported by cardiac catheterization and angiography. The clinical, angiographic and pathologic characteristic of diverticulum and aneurysm of the heart are reviewed, and an attempt is made to clarify the concept of aneurysm and diverticulum of the heart.
Aneurysm* ; Angiography ; Brain ; Cardiac Catheterization ; Cardiac Catheters ; Congenital Abnormalities ; Coronary Vessels ; Diagnosis ; Diverticulum* ; Heart ; Heart Ventricles* ; Myocardial Infarction ; Ventricular Septum

PURPOSE: Intractable diarrhea during infancy is one of the major causes of infant mortality. But, its etiology, clinical courses, or methods of treatment are not well known. Therefore, we conducted a clinical approach to intractable diarrhea during infancy. METHODS: We have retrospectively evaluated clinical characteristics, laboratory findings, methods of treatment, days required for recovery, in 23 infants who were admitted with intractable diarrhea, from January 1993 to December 1996. RESULTS: The onset age was 18.4 +/- 17.8 days and the duration of diarrhea was 28.8 +/- 16.5 days. All patients were fed artificial milk before the onset of diarrhea. The possible causes of diarrhea were infection (60.8%), change of milk, milk concentration (17.4%), or an unknown origin (21.8%). Laboratory findings on admission showed hemoglobin 9.5 +/- 2.2g/dL, serum albumin 2.9 +/- 0.7g/dL. E. coli was cultured in urine in 1 case. Stool rotavirus antibody was positive in 1 case. Nineteen patients (82.6%) required total parenteral nutrition for 18.3 +/- 13.6 days and antibiotics were administered to 20 patients (86.9%). Twenty-two patients (95.7%) were fed special element formula milk. All but one who died of necrotizing enterocolitis, recovered. Special element fomula milk was used for 92.6 +/- 20.5 days after discharge, and there were no cases of recurrence. CONCLUSION: We considered appropriate oral element fomulas, total parenteral nutrition and the proper treatment of infection as important factors in future outcome of intractable diarrhea during infancy. We thought the short-term administration of special formula milk can be substituted for normal milk or a weaning diet. However, encouraging breast feeding may perhaps be a more effective way of preventing this problem.
Age of Onset ; Anti-Bacterial Agents ; Breast Feeding ; Diarrhea* ; Diet ; Enterocolitis, Necrotizing ; Humans ; Infant ; Infant Mortality ; Milk ; Parenteral Nutrition, Total ; Recurrence ; Retrospective Studies ; Rotavirus ; Serum Albumin ; Weaning

PURPOSE: Intractable diarrhea during infancy is one of the major causes of infant mortality. But, its etiology, clinical courses, or methods of treatment are not well known. Therefore, we conducted a clinical approach to intractable diarrhea during infancy. METHODS: We have retrospectively evaluated clinical characteristics, laboratory findings, methods of treatment, days required for recovery, in 23 infants who were admitted with intractable diarrhea, from January 1993 to December 1996. RESULTS: The onset age was 18.4 +/- 17.8 days and the duration of diarrhea was 28.8 +/- 16.5 days. All patients were fed artificial milk before the onset of diarrhea. The possible causes of diarrhea were infection (60.8%), change of milk, milk concentration (17.4%), or an unknown origin (21.8%). Laboratory findings on admission showed hemoglobin 9.5 +/- 2.2g/dL, serum albumin 2.9 +/- 0.7g/dL. E. coli was cultured in urine in 1 case. Stool rotavirus antibody was positive in 1 case. Nineteen patients (82.6%) required total parenteral nutrition for 18.3 +/- 13.6 days and antibiotics were administered to 20 patients (86.9%). Twenty-two patients (95.7%) were fed special element formula milk. All but one who died of necrotizing enterocolitis, recovered. Special element fomula milk was used for 92.6 +/- 20.5 days after discharge, and there were no cases of recurrence. CONCLUSION: We considered appropriate oral element fomulas, total parenteral nutrition and the proper treatment of infection as important factors in future outcome of intractable diarrhea during infancy. We thought the short-term administration of special formula milk can be substituted for normal milk or a weaning diet. However, encouraging breast feeding may perhaps be a more effective way of preventing this problem.
Age of Onset ; Anti-Bacterial Agents ; Breast Feeding ; Diarrhea* ; Diet ; Enterocolitis, Necrotizing ; Humans ; Infant ; Infant Mortality ; Milk ; Parenteral Nutrition, Total ; Recurrence ; Retrospective Studies ; Rotavirus ; Serum Albumin ; Weaning

Posterior reversible encephalopathy syndrome (PRES) is a transient condition characterized by altered mental status, seizure, headache, and visual disturbance with typical neuro-imaging findings in the bilateral parieto-occipital regions. Clinicians should be aware of this syndrome because delayed diagnosis and treatment result in irreversible neurologic deficits. We present the case of a 77-year-old male diagnosed with PRES in the setting of postoperative critical illness caused by small-bowel strangulation.
Aged ; Critical Illness* ; Delayed Diagnosis ; Headache ; Humans ; Intensive Care Units ; Male ; Neurologic Manifestations ; Posterior Leukoencephalopathy Syndrome* ; Postoperative Period ; Seizures

To evaluate the predictability of visual outcome in vaculopathy patients after treatment, we compared the difference between the pre-treatment visual acuity measured by hand-held laser interferometer and the posttreatment corrected visual acuity using Han`s visual acuity chart. Disease distribution was as follows; BRVO(18 cases), CRVO(11 cases), CSCR(9 cases), posterior uveitis(4 cases). The mean up period was 3.45 months. Among 42 cases, 28 eyes showed positive disparity and 13 eyes showed negative disparity. The range of disparity was from -0.2 to +0.3(mean 0.113). The post-treatment visual acuity was predictable within 2 lines in 38 eyes(90%) We concluded that the hand-held laser interferometer is one of the reliable methods to predict the post-treatment visual acuity in maculopathy patients.
Humans ; Visual Acuity*

BACKGROUND: Purified major allergens of house dust mite are essential for evaluation of the allergic mechanism in molecular basis and development of new modalities of immunemodulation. OBJECTIVE: In this study, we aimed to purif group 1 and group 2 allergens from Dermatophagoides pteronyssinus (Dp). In addition, cDNAs corresponding to Der pI and II in Korean Dp were isolated and recombinant Der p1 and Der pII were synthesized. MATERIALS AND and METHOD: Der pI allergen was purified by ammonium sulfate precipitation, anion -exchange column chromatography, and gel filtrat,ion chromatography. Der pII allergen was purified by anion exchange chromatography, gel filtration chromatography, and a preparative isoelectric focusing method. RESULTS: Eight hundred ug of Der pI and 50 ug of Der pII were obtained from 100 g of culture medium and 1 g of mite bodies, respectively. The purities of these allergens were confirmed by SDS PAGE and the strong reactivity to the patient sera was identified. In order to produce a recombinant allergens, poly(A) RNA from house dust mites were isolated and used for cDNA synthesis by RT PCR. The cDNA was inserted into prokaryotic expression vector and the vectors were transformed into E. coli. A little amount of recombinant Der pI protein was produced due to the low solubility, and 1.2 mg of recombinant Der pII was produced from 1 L of E. coli culture medium. The antigenicity of Der pI was relatively weak, however, Der pII showed a strong antigenicity. Amino acid sequence of the amplified cDNA deduced from DNA sequences of Der pII showed 6 different variants. The variation of amino acid sequences suggests the possibility of high incidence of mutation of Der pII protein. CONCLUSION: A simplified method for the purification of Der pI and Der pII was developed. Recombinant allergens will be useful for the diagnosis and treatment of allergy with lower costs.
Allergens* ; Amino Acid Sequence ; Ammonium Sulfate ; Base Sequence ; Chromatography ; Chromatography, Gel ; Dermatophagoides pteronyssinus* ; Diagnosis ; DNA, Complementary ; Electrophoresis, Polyacrylamide Gel ; Humans ; Hypersensitivity ; Incidence ; Isoelectric Focusing ; Mites ; Polymerase Chain Reaction ; Pyroglyphidae* ; RNA, Messenger ; Solubility

BACKGROUND: Recently elderly people have increased in Korea and increased demands of medical service. This study was carried out to identify diseases and health service utilization patterns of geriatric inpatients to provide better understanding and basis planning to meet the needs of expanding geriatric population. METHOD: We use data of `Patient Survey in Korea` in 1999 and analyzed characteristics of disease structure and utilization patterns of health care service of 54,013 cases of discharged patients aged 65 years or more. RESULT: The proportion of the elderly in total discharged patients is 14.7%. Male to female ratio is 1:1.3 and most common age group was between 65 and 69 years old. 84.2% of elderly patients were admitted at secondary or tertiary health care facilities. The most common disease in geriatric inpatients is malig- nancy in male and vascular disease in female. The average duration of hospitalization is 14.2 days. They stay longer than the nation wide average hospital length and stay longest when they are admitted by mental and behavioral disorders. CONCLUSION: Geriatric patients are admitted mostly with chronic degenerative diseases such as neoplasm and vascular disease. Elders prefer to be admitted to tertiary hospitals and oriental hospitals. They stay more in hospital.
Aged ; Delivery of Health Care ; Female ; Health Services* ; Hospitalization ; Humans ; Inpatients* ; Korea ; Male ; Tertiary Care Centers ; Vascular Diseases

Angiokeratoma circumscriptum is present at birth or early childhood and is an uncommon dermatosis characterized by papules and small nodules that may coalesce to form plaques. Histopathologically, there are varying degrees of hyperkeratosis, papillomatosis, and irregular acanthosis. In the papillary dermis, greatly dilated capillaries are observed, The acanthotic epidermis encircles the vascular spaces(blood cysts) where, occasionally, organized thrombi may be found. The use of pulsed-dye lasers to treat cutaneous vascular lesions is based on the theory of selective photothermolysis. We report a case of an angiokeratoma circumscriptum in an 48-year-old woman for whom the flashlamp pulsed tunable dye laser proved to be a highly successful means of treatment.
Angiokeratoma* ; Capillaries ; Dermis ; Epidermis ; Female ; Humans ; Lasers, Dye* ; Middle Aged ; Papilloma ; Parturition ; Skin Diseases