A 49-year old man was admitted to the Korea university hospital, department of surgery, for evaluation of anterior neck mass which was slowly growing for five years. His past history was unremarkable except for known hypertension for several years. Physical examination revealed high blood pressure, measuring 180 mmHg in systolic phase and 120 mmHg in diastolic phase. A soft nontender mass was palpated at anterior neck just above the sternal notch with smooth surface and its size was about 4 x 5 cm in cross. On laboratory examination, diabetic evidence such as high blood sugar (FBS 170 mg/dl, PP2hr. 234 mg/dl) and glucosuria. The CBC finding suggested polycythemia with high hemoglobin (18.0 g/dl) and hematocrit (54%) levels. The differential count and platelet count were within normal limits.
Male ; Humans

Infertility is a world wide problem affecting up to 15% of married couples. Although it is well known that male factor is the important cause of the infertility in 40-50% of the cases, the appropriate drugs for treating this condition have not yet been established. With certain exceptions, the etiology of many cases of male infertility is unknown. For such cases, various drugs including both hormonal and non-hormonal agents are sometime prescribed, but there have been no entirely satisfactory results. The present investigation would assess the effectiveness of Korean Ginseng, herbal medicine in the treatment of male infertility during the period from September to December, 1988, at the Andrology Clinic of the Department of Urology, Seoul National University Hospital. This herbal medicine was selected because its ingredients accelerate the metabolism of lipids and synthesis of DNA, RNA and proteins. This medicine contains ingredients which build resistance against stress since many of male infertility are under stress and also is to control immunological disorders. Ginseng has steroid-like, anti-allergic and anti-inflammatory actions, and accommodates the blood-testis barrier, improve digestive functions and peripheral blood flow. Accordingly, Ginseng has been used as an agent restoring healthy conditions to maintain homeostasis or to keep physical and mental balance. Extensive chemical investigation on Ginseng has revealed that Ginseng contains characteristic dammarane-type triterpenoid saponins as the main principles. These saponins are called ginsenosides and represent the principal pharmacological actions of Ginseng. The ginsenosides react at the hypothalamus-pituitary-gonadal axis. The decreases of sexual drive and disorders of fecundity under challenge of stress are prevented by oral administration of ginsenosides. To assess the efficacy of treatment with Ginseng which is alleged to improve spermatogenesis in idiopathic infertile selected patients. Participants in this study are men with primary idiopathic oligospermia and asthenospermia. The inclusion criteria would be as follows : a) men aged 20-40 years, whose female partners are entirely normal. b) men having vaginal intercourse with one partner and without psycho-sexual problems. c) men willing to enter this clinical trial and relying only on the drug administered throughout the study. d) no history of serious chronic physical or psychological diseases. e) men whose female partners are not using any method of birth control. f) men with no history of drugs to treat sperm disorders within 3 months. A total of 12 patients with sperm counts of less than 20 x 10 6/ml (oligospermia group), and 5 patients with sperm motility of less than 20% (asthenospermia group) are selected as the study subjects. Parameters to be assessed are as follows : Before and after Ginseng administration, history taking, physical examination with testis size measurement, laboratory works including urinalysis, CBC, seminal fructose, semen analyses (pH, volume, density, motility, activity grade, morphology, fertility unit, and WBC), plasma hormonal assays (FSH, LH, testosterone, estradiol, and prolactin). Before starting the treatment, 2 semen samples are obtained preteded by 3 days of abstinence. For follow-up, patients will have a semen sample taken every month while in treatment. After the treatment, more than 2 semen analyses will be undertaken for the final evaluation. Treatment scheme is as follows : The composition of the Ginseng extract used in this clinical trial consisted of the standardized highly concentrated Ginseng extract G115, 100mg : concentrated standardized lectithin, 95mg , alpha tocopherol, 10mg ; and excipients q.s.ad. This Ginseng extract named Ginsana capsule produced by Pharmaton-Korea Co., Ltd. Four capsules of Ginsana are given twice a day by mouth before meal for more than 90 days to be justified on the basis of general assumption that spermatogenesis cycle lasts approximately 74 days. The results of the clinical investigation are considered to be effective, if more than double of improvemant being noted on the count or more than 30% ot improvement being noted on motility beyond the pre-treatment levles. Clinical characteristics of a total of 17 patients are listed in the table 1. The outcomes of this trial are presented as follows : (tables 2 and 3). Coital frequency increased from 2.6/week before Ginsana exposure to 3.1/week after the treatment. General health such as stamina, body weight and spirits improved in 10 patients of the 17 after Ginsang treatment. Regarding hormonal partmeters (table 2), Plasma FSH and LH were not changed much before and after Ginsana administration. Patients with low FSH and LH levels before the treatment and patients with high range of prolactin levels before the treatment have a tendency to improve more in semen parameters after the treatment. Hyperestrogenemia was decreased and plasma testosterone levels increased after Ginsana treatment. Subsequently, T/E2 ratio resulted in normal to help spermatogenesis. Regarding the semen parameters (table 3), sperm counts increased in 58% of the patients in oligosperrnia group after oligospermia group. Sperm motility improved in 33% of the patients rn oligospermia group after the treatment. Mean motility increased from 34% to 45% after the treatment in oligospermia group. Activity grade and fertility unit were also improved in oligospermia group after the treatment Other parameters such as volume, normal morphology, pH and seminal fructose were not changed significantly before and after Ginstna treatment. Only one case showed an improvement in sperm counts and motility of a total of 5 patients with asthenospermia. Pregnancy resulted in 2 patients of improved cases and 1 patient of not improved cases in oligopsermia group after Ginsana administration. So that, pregnancy rate was 25 % of the oligospermia group. The study results of some imvestigators are summarized in the table 4. From these results, Ginsana appears mainly act on testis directly, restore the steroidogenesis, resulting in the stimulation of spermatogenesis. in conclusion, the authors clinical experience confirmed that Ginsana, a traditional Chinese medicine, appears to be of value particularly in the trettment of idiopethic oligospermia without any noticeabel adverse side effects.
Administration, Oral ; alpha-Tocopherol ; Andrology ; Axis, Cervical Vertebra ; Blood-Testis Barrier ; Body Weight ; Capsules ; Coitus ; Contraception ; DNA ; Estradiol ; Excipients ; Family Characteristics ; Female ; Fertility ; Fibrinogen ; Follow-Up Studies ; Fructose ; Ginsenosides ; Herbal Medicine ; Homeostasis ; Humans ; Hydrogen-Ion Concentration ; Infertility ; Infertility, Male ; Male ; Meals ; Medicine, Chinese Traditional ; Metabolism ; Mouth ; Oligospermia* ; Panax* ; Physical Examination ; Plasma ; Pregnancy ; Pregnancy Rate ; Prolactin ; RNA ; Saponins ; Semen ; Semen Analysis ; Seoul ; Sperm Count ; Sperm Motility ; Spermatogenesis ; Spermatozoa ; Testis ; Testosterone ; Tocopherols ; Urinalysis ; Urology

No abstract available.
Borrelia burgdorferi* ; Borrelia* ; Ixodes* ; Korea* ; Lyme Disease* ; Ticks*

Lymphangioleiomyomatosis(LAM) is a rare disease of women of child-bearing age in which there is progressive hyperplasia of atypical smooth mucle along lymphatics in the lung, and/or axial lymphatics in the thorax and abdomen, resulting in honeycombing of lung. Interestingly there has been a speculation that it represents a forme furste or incomplete expression of tuberous sclerosis complex. This is based on the observation that patients with tuberous sclerosis can manifest pulmonary lesions indistinguishable from LAM. We report a case of LAM occuring in a 39-year-old female, who complained of recurrent pneumothorax, chest pain and shortness of breath. Three years ago, the patient had right nephrectomy under the diagnosis of ruptured angiomyolipoma. A X-ray film of the chest showed honeycombing with a diffusely reticulonodular pattern and cyst-like spaces. She had a characteristic facial appearance of adenoma sebaceum, which her father and uncle had. Microscopically, the lung showed a marked smooth muscle proliferation around the slit-like lymphatic spaces and also some respiratory bronchioles.
Female ; Humans ; Adenoma

No abstract available.
Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Pregnancy*

PURPOSE: To report a case of conjunctival inclusion cysts on the corneal limbus of a patient with chronic vernal keratoconjunctivitis during 16 months' follow up. METHODS: The patient was a 26 year old male without any specific history of surgery or trauma. Giant papillae, shield ulcers, and Horner-Trantas dots were detected. During the 16 month follow-up, Sodium cromoglycate eye drops and Prednisolone acetate 1% eye drops were given 3 times a day. During this period, conjunctival cysts were detected on the corneal limbus in both eyes. In spite of improvement of the corneal and conjunctival conditions, the conjunctival cysts did not seem to show any specific changes. For relief of foreign body sensation, excision of the conjunctival cysts and giant papillae of the left eye and histopathologic examination of the specimen was performed. RESULTS: On histopathological examination, the conjunctival cysts consisted of nonkeratinizing stratified epithelial cells filled with PAS-positive mucous substance. Inflammatory cells were not found in the vicinity. CONCLUSIONS: Conjunctival inclusion cysts can be seen as an atypical finding of long-standing vernal keratoconjunctivitis. Mechanical friction between the giant papillae and conjunctiva may be a factor in inducing the formation of the conjunctival cysts.
Adult ; Chronic Disease ; Conjunctiva/*pathology ; Conjunctivitis, Allergic/*complications/pathology ; Cysts/*etiology/pathology/surgery ; Diagnosis, Differential ; Disease Progression ; Follow-Up Studies ; Humans ; Male ; Time Factors

Epilepsy surgery can be a safe, effective treatment for individuals with intractable partial epilepsy. There is increasing evidence that brain abnormalities in focal epilepsy are not restricted to a single area. The longstanding debate around the relationship between structural lesions and the epileptic zone remains unresolved. Patients with DNT (dysembryoplastic neuroepithelial tumor), which is an essentially benign tumor, can be cured by epilepsy surgery-oriented approach. Cortical dysplasia is frequently associated with DNT and seems to contribute to epileptogenic activity of DNT. Surgical treatment should be aimed at removal of the associated cortical dysplasia as well as DNT itself for ideal treatment of the disease. Simple lesionectomy of cavernous angioma would relieve seizures significantly, but not always. The concept of epilepsy surgery needs to be recruited in the treatment of cavernous angioma with seizures because diffusion of hemosiderin into the surrounding brain tissue and formation of cortical scars can make epileptogenic areas. Cortical dysplasia is a highly epileptogenic lesion constituting an important cause of medically intractable epilepsy and surgery is a treatment of choice in a selected group of patients. Identification and complete resection of the lesion and ictal onset zone are necessary to achieve a good surgical results. Intractable epilepsy accompanied by benign brain lesions can be treated surgically using the entire armamentarium of presurgical investigations. Deliberate resective procedures aimed at complete removal of dysplastic tissue and epiletogenically active areas on and around the lesion ensure excellent seizure control without permanent neurologic deficit.
Brain* ; Cicatrix ; Diffusion ; Epilepsies, Partial ; Epilepsy* ; Hemangioma, Cavernous ; Hemosiderin ; Humans ; Malformations of Cortical Development ; Neurologic Manifestations ; Seizures

Purpose: We evaluated a new color vision test, thus the ColorDx Cone contrast test HD ([CCT-HD]; Konan Medical, Inc., Irvine, CA, USA) in normal and color vision-deficient (CVD) eyes of Koreans. Methods: The CCT-HD was performed on 66 healthy Koreans (125 normal eyes) and 25 patients (50 eyes) with congenital CVD. The results from normal eyes were compared and analyzed in terms of binocular agreement, patient ages, and spherical equivalents. The CCT-HD results on CVD eyes were compared and analyzed. Results: We found no significant difference in any of the long (L), medium (M), or short wavelength (S) cone cell sensitivity (L-CCT, M-CCT, S-CCT) scores for normal eyes; also, there was no significant effect of age and no significant correlation between the spherical equivalent and the CCT score. In normal eyes, all scores were >75 (normal ≥75). The average protan L-CCT score was significantly reduced (13.0 ± 13.2; p < 0.001) as was the average deutan M-CCT score (31.7 ± 16.6; p < 0.001). The CCT-HD L-CCT and M-CCT exhibited 100% sensitivity and specificity in terms of diagnosing protans and deutans respectively. Conclusions CCT-HD allows classification and quantitative evaluation of protans and deutans, and is thus useful when examining color vision status.

Neurofibromatosis, first clearly described by von Recklinghausen in 1882, is a dominantly inherited mesodermal and ectodermal dysplasia with a broad spectrum of clinical findings. Most common is the classical neurofibromatosis, which has three major features: (1) multiple neural tumors dispersed anywhere on or in the body; (2) numerous pigmented skin lesions, some of which are "cafe au lait" spots; and (3) pigmented iris hamartomas also called Lisch nodules. Other lesions sometimes seen in patients with von Recklinghausen's disease include congenital malformations of various types, vascular lesions, neurilemoma meningioma and other intracranial neoplasms, pheochromocytoma, medullary carcinoma of thyroid gland, neuroblastoma, ganglioneuroma and Wilms' tumor. Approximately 10% of the patients with neurofibromatosis have the gastrointestinal tract tumors as neurofibroma, ganglioneuroma and leiomyoma. Some of them show evidence of malignancy. Increased activity of the protein "nerve growth factor" in the sera of the patients with disseminated neurofibromatosis has been reported. We would like to report here two cases of von Recklinghausen's neurofibromatosis with involvement of the gastrointestinal tract.
Hamartoma ; Meningioma

Liposclerosis is a feature of chronic venous insufficiency. Clinically, liposclerosis is characterized by induration and variable hyperpipmention located on the skin of the leg and ankle. A 49-year-old male was presented with dark brown colored indurated plaque with the appearance of an inverted bottle on the lower leg. He had a history of stasis dermatitis on the area. The main histopathologic finding was broad septal fibrosis, where there were scattered hemosiderin, thick-walled and tortuous vessels, and fibrin deposition stained by phosphotungstic acid-hematoxyline (PTAH) stain.
Ankle ; Dermatitis* ; Fibrin ; Fibrosis ; Hemosiderin ; Humans ; Leg ; Male ; Middle Aged ; Skin ; Venous Insufficiency