No abstract available.
Chloroform*

46, XX male is a rare sex cluomasomal constitution characterized by the development of bilateral testis in persons who lack a Y chomosome. The majority of affected persons have normal external genitalia and usually seek medical advice due to infertility, hypogonadism and/or gynecomastia in adulthood. Although Y chromosomsl sequences can be detected in the majority of male subjects with 46, XX karyotype, several studies have shown thst approximately 10 % of patients lack Y chromosomal material including the SRY ( sex-determining region of Y-chromosome) gene. Several hypothesis have been proposed to explain the etiology of this constitution. 1. Translocation of the testis-determining factor (TDF) fiom the Y to the X chromosome or autosome. 2. Acquisition of Y chromosome function by a mutant autosomal or X-linked gene. 3. Undetected mosaicism with Y-bearing cell line 4. Loss of Y chmmosome hom the XXY Klinefelter zygote. We experienced a case of 46, XX male who was 30 years old. We report a case with review of the literature.
Adult ; Cell Line ; Constitution and Bylaws ; Genes, X-Linked ; Genitalia ; Gynecomastia ; Humans ; Hypogonadism ; Infertility ; Karyotype ; Male* ; Mosaicism ; Sex-Determining Region Y Protein ; Testis ; X Chromosome ; Y Chromosome ; Zygote

OBJECTIVES: To evaluate the relation between diagnostic clinical parameters and the depth of trophoblastic invasion in tubal pregnancy and decide the most predictable parameter. Methods: Total 50 patients who were confirmed as tubal pregnancy pathologically, from Jan. to Dec. 1997, were included in this study. Menstrual missed periods was calculated by clinical history, volume of gestational mass was calculated as sphere, beta-hCG was titered with preoperative blood sample. All surgical specimens were examined pathologically and divided into two groups such as intraluminal and extraluminal, defined as intact tubal musculature and trophoblastic invasion beyond musculature, n=22 and n=28, respectively. Statistical analysis was performed among three parameters and between each parameter and the depth of trophoblastic invasion. Statistical analysis included were Student's t-test, Chi square, linear regression, and linear correlation analysis using SPSS statistical package and statistical significance was determined as p<0.05. RESULTS: There was a correlation between volume of gestational mass and beta-hCG(p<0.05), but not between beta-hCG and missed period or volume of gestational mass and missed period. beta-hCG level was 1843.7+/-1524.7 mIU/ml(Mean+/-SD) in intraluminal and 12144.3+/-10561.6 mIU/ml(Mean+/-SD) in extraluminal. There was a predictive correlation between beta-hCG and the depth of trophoblastic invasion(p<0.05), and cut off level 3,500 mIU/ml showed the highest sensitivity, specificity, positive predictive value, negative predictive value, 0.79, 0.86, 0.88, 0.76, respectively. Two parameters(volume of gestational mass and missed period) had no ability to predict whether intraluminal or extraluminal. CONCLUSION: We suggest that successful medical treatment of tubal pregnancy depend on lesional intactness of vasculature for drug delivery. In patient selection for medical treatment, it should be important to predict intraluminal type because of intact vasculature. Of clinical parameters, beta-hCG is single most predictive parameter, cut off level of 3,500 mIU/ml was the most reasonable level in this study.
Female ; Humans ; Linear Models ; Patient Selection ; Pregnancy ; Pregnancy, Tubal* ; Sensitivity and Specificity ; Trophoblasts*

Elastofibroma is a rare disease which presents as a slowly-growing, solid, ill-defined fibroelastic mass occuring almost exclusively in elderly women and arising mainly from the connective tissue between the lower part of the scapula and chest wall. Of the 270 cases of elastofibroma which have been reported, 170 cases had developed in Japanese patients. Despite the fact that there have been only two case reports in Korea, there might be a higher prevalence of elastofibroma in Korea than expected because of geographical similarity. We experienced a case of elastofibroma occurring in a 56-year-old man. To our knowledge, this is the first case report of elastofibroma in Korean dermatologic of literature.
Aged ; Asian Continental Ancestry Group ; Connective Tissue ; Female ; Humans ; Korea ; Middle Aged ; Prevalence ; Rare Diseases ; Scapula ; Thoracic Wall

A Statistical observations were done on 587 pediatric patients who were diagnosed as having congenital heart disease by cardiac catheterization angiography and operation at Dong San Hospital Keimyung University, during the period of January 1982 to june 1987. The results were as follows 1) Out of 587 patients, 317 cases were male and 276 cases were female. There were female preponderance in atrial septal defect and patent ductus arteriosus, whille in male tetralogy of Fallot, pulmonary stenosis, and ventricular septal defect. 2) The incidence of congenital heart disease were as folliws;ventricular septal defect 35.7% tetralogy of Fallot 17.5%, patient ductus arteriousus 13.9%, arterial septal defect 7.5% and pulmonary stenosis 2.9%. 3) Most of the patients were visited hospital for the first time between the age of 2 and 10 years. 4) Assosiated anomalies of major congenital heart disease were as follows:the most commonly associated anomaly in ventricular septal defect were pulmonary stenosis and patent ductus arteriosus. Pulmonary stenosis was frequently associated with atrial septal defect. Right sided aortic arch and pentalogy were assosiated with tetralogy of Fallot. The mitral regurgitation was associated with patent ductus arteriosus mostly. 5) The overall surgical mortality was 6.8%. The mortality was high in tetralogy of Fallot(16.1%), transposition of great vessels(28.5%).
Angiography ; Aorta, Thoracic ; Cardiac Catheterization ; Cardiac Catheters ; Ductus Arteriosus, Patent ; Female ; Heart Defects, Congenital* ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Incidence ; Male ; Mitral Valve Insufficiency ; Mortality ; Pulmonary Valve Stenosis ; Statistics as Topic* ; Tetralogy of Fallot

Tubular apocrine adenoma is a well-circumscribed intradermal benign tumor with tubular structures showing apocrine differentiation. Most of those cases occur on the scalp in middle aged women. Histologically, tubular structure with apparent apocrine decapitation secretion, cystic dilatation of tubule, and connection with epidermis are the characteristic features of tubular apocrine adenoma. We presented a case of tubular apocrine adenoma that had recurred after incomplete excision. It showed apocrine decapitation secretion histologically and both eccrine and apocrine differentiation on immunohistochemical study.
Adenoma* ; Decapitation ; Dilatation ; Epidermis ; Female ; Humans ; Middle Aged ; Scalp

No abstract available.
Nipples*

As the breast is a symbol of feminity, so nipple areolar complex is a crucial aesthetic unit of the breast. Symmertrical and appropriate nipple areolar complex completes the breast reconstruction. Throughout the history of breast reconstruction, various methods of nipple areolar reconstruction have been developed. Composite graft and several local flap methods have been used for reconstruction of nipples. Skin grafts from contralateral areolar or inguinal area and tattooing methods have been introduced for areolar reconstruction. Among 85 patients of breast reconstruction during recent three years, we experienced only 14 cases of nipple areolar reconstruction. This fact is partly from conservative attitude of Korean women to breast reconstruction and also from the long time-period needed to accomplish an acceptable breast mound. For nipple reconstrction, we performed eight H-shape local flaps, three fish tail shape local flaps, and three composite grafts. For reconstruction of areola, full thickness skin graft was used in 13 cases(10 from inguinal area, 3 from contralateral areola) and tattooing was used in a case. We experienced necrosis of reconstruction nipple in two cases(one in fish tail shape local flap cases and one in composite graft cases). There was no other remarkable complication. Among the three methods of nipple reconstruction. H-shape local flap method was a reliable one which provides stable nipple projection as well as simplicity. In most cases areola was successefully reconstructed with full thickness skin graft and if the size of contralateral areola is large enough to share, contralateral areolar sharing seems to be the best choice. In conclusion, the combination of a H-shape local flap and a full thickness skin graft from the inguinal area provides a satisfactory projection of the nipple and pigmentation of the nipple and pigmentation of the areola comparable to the other side.
Breast ; Female ; Humans ; Mammaplasty ; Necrosis ; Nipples* ; Pigmentation ; Skin ; Tattooing ; Transplants

Cicatrix ; Humans ; Maxilla ; Maxillary Sinus ; Osteotomy ; Skeleton ; Visual Fields

PURPOSE: To evaluate the ultrasonographic and CT findings of hepatosplenic tuberculosis MATERIALS AND METHODS: We retrospectively reviewed the ultrasonographic and CT findings of confirmed hepatosplenic tuberculosis in 12patients. Six were men and six were women ; their average age was 41, and most were in their twenties. Lesions ofthe liver and spleen, as well as associated findings such as abdominal tuberculosis and other organ involvement oftuberculosis were analyzed. RESULTS: There were three cases of hepatic tuberculosis, seven of splenictuberculosis, and two of hepatosplenic involvement of tuberculosis. On the basis of the ultrasonographic and CTfindings, hepatosplenic tuberculosis was classified as one of two patterns : miliary or micronodular, ormacronodular. The micronodular type was more common (9/12 cases) being characterized by innumerable micronodules,and with easy coalescence in the liver and spleen in five of the nine cases. The macronodular type of low densitymass was noted in the other three patients. Splenomegaly was noted in 12 cases and hepatomegaly in ten. Pulmonarytuberculosis-including the miliary type(n=5)-was noted in eight patients. Associated abdominal tuberculosis suchas lymphadenopathy with central low density and peripheral rim enhancement (n=6), tuberculous peritonitis(n=3),highly attenuated ascites(n=6), adrenal tuberculosis(n=1), renal tuberculosis(n=1), ovarian abscess(n=1), psoasabscess(n=1), and systemic tuberculosis such as central nervous system tuberculoma(n=2), cervicallymphadenopathy(n=4) and tuberculous spondylitis(n=1) were noted. CONCLUSION: Ultrasonography and CT werevaluable in the detection and diagnosis of hepatosplenic tuberculosis
Central Nervous System ; Diagnosis ; Female ; Hepatomegaly ; Humans ; Liver ; Lymphatic Diseases ; Male ; Retrospective Studies ; Spleen ; Splenomegaly ; Tuberculosis* ; Tuberculosis, Gastrointestinal ; Tuberculosis, Hepatic ; Ultrasonography