Although the definition of male pseudohermaphroditism remains controversial, male pseudohermaphrodites will be defined as chromatin-negative individuals who have testis with the failure of normal development of the normal male. Also included are those individuals who may have more than one cell line, but at least one cell line, containing a Y chromosome and no cell line having two X chromosomes. Gonadal histologic findings may be either testicular or streak, but not ovarian. Male pseudohermaphroditism can result as a consequence of 1) absent M(llerian regression, 2) Inadequate synthesis of testosterone, 3) inadequate synthesis of dihydrotestosterone and 4) androgen receptor deficiency. We have seen 5 cases of male pseudohermaphroditism with manifestations of penoscrotal or perineal hypospadias, pubertal virilization, cryptorchism or atrophied testes, and feminization. Four cases had been reared as male and one case as female. All revealed chromatin-negative pattern in buccal smear and testes. After the plausible discussion, two cases were decided to be reared as female and three were as male.
46, XY Disorders of Sex Development* ; Androgen-Insensitivity Syndrome ; Cell Line ; Cryptorchidism ; Dihydrotestosterone ; Female ; Feminization ; Gonads ; Humans ; Hypospadias ; Male* ; Testis ; Testosterone ; Virilism ; X Chromosome ; Y Chromosome

No abstract available.
Graves Disease* ; Humans ; Thyroid Gland*

BACKGROUND: Endocrine pancreas tumor is a rare disease which incidence is less than 2% of all pancreatic tumors. But it comprises various types of tumor and usually secretes several hormones from one type of tumor although the patient with this tumor complains of sole symptom associated with only one hormone. The mechanism and clinical significance of multiple hormone secretion in the endocrine pancreas tumom are not yet clearly defined. METHODS: We analyzed retrospectively the clinicopathologic features of 20 cases which were operated at Seoul National University Hospital during the period between February 1989 and May 1998. RESULTS: The most common tumor was insulinoma (13 cases) and the second most common tumor was nonfunctioning tumor (6 cases). There was one case of somatostatinoma. Most of the patients with insulinoma complained of neuroglycopenic symptoms. There were 9 cases (45.0%) in which the tumors secreted more than two kinds of hormones, 7 cases in insulinoma, 2 cases in nonfunctioning tumors. Whether the tumor secreted multiple hormones was detected by the method of immunohistochemical staining. Though the tumors secreted more than two kinds of hormones, the patients with the tumors complained of symptoms which were associated with the cell type most strongly stained by immunohistochemical method. Whether or not the tumors secreted multiple hormones was not associated with the pathologic features such as tumor size, histologic patterns of the tumor, status of tumor cell differentiation and malignancy. CONCLUSION: From this results, we suggest that endocrine tumors of the pancreas secreted multiple hormones not by the mechanism of dedifferentiation from already differentiated endocrine cells but by the mechanism of neogenesis of multipotent islet stem cells. Since the relationship between the function of multiple hormone secretion in the endocrine pancreas tumors and islet stem cell would be significant, further study should be needed to find out the function of stem cells and application of stem cells to clinical use.
Cell Differentiation ; Endocrine Cells ; Humans ; Incidence ; Insulinoma ; Islets of Langerhans ; Pancreas* ; Rare Diseases ; Retrospective Studies ; Seoul ; Somatostatinoma ; Stem Cells

No abstract available in English.
Acromioclavicular Joint ; Dislocations ; Methods

OBJECTIVE: Pfirrmann disc grade is a useful scoring tool for evaluating disc degeneration, but normal values according to aging process has not been elucidated. This study was conducted to identify the prevalence and pattern of whole spine disc degeneration according to ages and gender differences. METHODS: Total 653 patients (336 male and 317 female patients, 48.1±58.7 years old) who took whole spine magnetic resonance images were enrolled in this study. There were 19 cases in their 2nd decades and 74 cases in 3rd decades, 141 cases in 4th decades, 129 cases in 5th decades, 139 cases in 6th decades, and 93 cases in 7th decades, 58 cases in over 8th decades. Pfirrmann disc grades were measured according to sex and ages by 2 neurosurgeons that were blind to this study. RESULTS: All spinal disc degeneration grades were correlated with ageing. The Pfirrmann disc grades of degeneration in all spine levels showed the statistically significant difference according to the ages (p < 0.001). The common Pfirrmann disc grades according to the ages were grade 3 among 2nd to 5th decades, and grade 4 was more common than 6th decades. The lower cervical level (C2–3 to C4–5) and lumbar level (L1–2 to L5–S1) were happened relatively early severe disc degeneration compared to other levels. The intersexual differences were increased after 6th decades. CONCLUSION: Disc degeneration is natural course after one’s 2nd decades. And its incidence and grade were increased with age, and more affected by sexual difference after 6th decades.
Aging ; Female ; Humans ; Incidence ; Intervertebral Disc Degeneration* ; Male ; Neurosurgeons ; Prevalence ; Reference Values ; Spine*

The author analyzed 60 cases of urethrography of patients with posterior urethral injury, from 1971 to 1980 at the Department of Urology, Busan National University Hospital, and according to the radiographic findings, presents a new classification of posterior urethra1 injury; type I, type II, type III and type IV. Type II and IV were most common (70%). The most common pattern of pelvic fractures was bilateral fracture of pubic rami, accounting for 27 cases of total. Therapeutic goals of posterior urethral injury are to prevent late complications such as stricture, impotence and incontinence. In the past we used urethral Foley catheter indwelling, primary realignment and primary reanstomosis for posterior urethral injury. Following primary realignment, the incidence of stricture was 18 cases (86%), impotence 9 cases (43%) and incontinence 3 Cases (14%) out of 21 cases. In Foley catheter indwelling the incidence of stricture was 67%, impotence 33% and incontinence 8% out of 12 cases. Now we adopt cystostomy alone with or without delayed pull-through (Badenoch) urethroplasty for posterior urethral injury. After cystostomy alone, the incidence of stricture is 2 cases (22%), impotence 2 cases (22%) and incontinence 1 case (11%) out of 9 cases. In cystostomy with delayed urethroplasty the incidence of stricture is 1 case (25%), impotence 2 cases (50%) and no incontinence out of 4 cases.
Busan ; Catheters ; Classification* ; Constriction, Pathologic ; Cystostomy ; Erectile Dysfunction ; Humans ; Incidence ; Male* ; Urology

No abstract available.
Pylorus*

No abstract available.
Female ; Ovary*

PURPOSE: To evaluate the specific findings of infiltrating ductal carcinoma from the ductal carcinoma in situ (DCIS) and to differentiate from the atypical ductal hyperplasia(ADH). MATERIALS AND METHODS: Fifty breast lesions in 48 patients including thirty-six breasts of 36 patients with infiltrating ductal carcinoma, fourteen breasts of 12 patients with DCIS, and nine breasts of 7 patients with ADH were examined with FLASH technique using Gd-DTPA. We evaluated the maximal amount, the speed, and the pattern of enhancement after intravenous injection of Gd-DTPA(0.16mmol/kg body weight). Also we evaluated the diagnostic accuracy in the patients with breast cancer. RESULTS: The maximal amount of enhancement were 1,161.84 +/- 394.44 NU in infiltrating ductal carcinoma, 982.11 +/- 458.35 NU in DCIS, and 1,035.94 +/- 305.20 NU in ADH. The speed of enhancement was 827.33 +/- 384.20 NU within the first 1 minute with a sudden increase in signal intensity after injection and a much slighter in- crease thereafter in infiltrating ductal carcinoma. DCIS showed in creasing signal intensity within the first 2 minutes(749.70 +/- 487.36 NU), and ADH showed significant increased enhancement(765.40 +/- 313.61 NU) at 3 minutes after injection of Gd-DTPA. The patterns of enhancement were focal with irregular margins in infiltrating ductal carcinoma and irregular peripheral enhancement in DCIS and ADH. However, absent or extreme delayed enhancement at the central portion of the tumor was more frequently seen in infiltrating ductal carcinoma rather than DCIS or ADH. CONCLUSION: Gd-DTPA enhanced dynamic MRI was valuable in the diagnosis of breast cancer and in differentiating DCIS from ADH. Furthermore, it was effective in analyzing the extension of breast carcinoma, multiplicity, and bilaterality of breast carcinoma.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Gadolinium DTPA* ; Humans ; Injections, Intravenous ; Magnetic Resonance Imaging

PURPOSE: To evaluate the specific findings of infiltrating ductal carcinoma from the ductal carcinoma in situ (DCIS) and to differentiate from the atypical ductal hyperplasia(ADH). MATERIALS AND METHODS: Fifty breast lesions in 48 patients including thirty-six breasts of 36 patients with infiltrating ductal carcinoma, fourteen breasts of 12 patients with DCIS, and nine breasts of 7 patients with ADH were examined with FLASH technique using Gd-DTPA. We evaluated the maximal amount, the speed, and the pattern of enhancement after intravenous injection of Gd-DTPA(0.16mmol/kg body weight). Also we evaluated the diagnostic accuracy in the patients with breast cancer. RESULTS: The maximal amount of enhancement were 1,161.84 +/- 394.44 NU in infiltrating ductal carcinoma, 982.11 +/- 458.35 NU in DCIS, and 1,035.94 +/- 305.20 NU in ADH. The speed of enhancement was 827.33 +/- 384.20 NU within the first 1 minute with a sudden increase in signal intensity after injection and a much slighter in- crease thereafter in infiltrating ductal carcinoma. DCIS showed in creasing signal intensity within the first 2 minutes(749.70 +/- 487.36 NU), and ADH showed significant increased enhancement(765.40 +/- 313.61 NU) at 3 minutes after injection of Gd-DTPA. The patterns of enhancement were focal with irregular margins in infiltrating ductal carcinoma and irregular peripheral enhancement in DCIS and ADH. However, absent or extreme delayed enhancement at the central portion of the tumor was more frequently seen in infiltrating ductal carcinoma rather than DCIS or ADH. CONCLUSION: Gd-DTPA enhanced dynamic MRI was valuable in the diagnosis of breast cancer and in differentiating DCIS from ADH. Furthermore, it was effective in analyzing the extension of breast carcinoma, multiplicity, and bilaterality of breast carcinoma.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Gadolinium DTPA* ; Humans ; Injections, Intravenous ; Magnetic Resonance Imaging