Tailgut cyst of retrorectal space is uncommon and its classification and prognosis are unclear. The lesion usually consists of a multiloculated cyst lined by squamous, transitional, and glandular epithelium. Disorganized fascicles of smooth muscle may be seen in the wall. Glomus coccygeum, normally located at the tip of coccyx, is incidentally discovered in the presacral mass including tailgut cyst. We report a case of tailgut cyst in a 35 year old female who had internal hemorrhoid and intermittent anal pain for 3 years. Pelvic computerized tomography revealed a 3x2 cm sized mass in the presacral area. The mass was multicystic and lined by squamous, transitional, and peudostratified ciliated columnar epithelium with inflammatory cells and scattered smooth muscle in the wall. Dermal adnexal structures were not present, which excluded dermoid cyst. A glomus body was identified in the surrounding soft tissue.
Female ; Humans ; Cysts

BACKGROUND AND OBJECTIVES: Recurrent vestibulopathy is defined a disease characterized by more than a single episode of vertigo of duration characteristic of endolymphatic hydrops but without auditory or clinical neurological symptoms or signs. To investigate the clinical characteristics and the efficacy of combination therapy, we analyzed the clinical records of the patients diagnosed as recurrent vestibulopathy. MATERIALS AND METHOD: Clinical records of sixty four patients diagnosed as recurrent vestibulopathy were retrospectively reviewed. The data on age, sex distribution, natural history, family history of recurrent vestibulopathy, concurrent headache, caloric response was analyzed. The efficacy of combination therapy for vertigo control in the patients with a minimum 24-month follow-up was also evaluated. RESULTS: Mean onset age of recurrent vestibulopathy was 43 years and there was a female preponderance. Concurrent headache and elevated SP/AP ratio in electrocochleogram was frequently observed in these patients. After the combination medical therapy, patients with severe recurrent vestibulopathy showed significant decrease in the number of vertigo spells with 37.5% of complete control of vertigo. CONCLUSION: As a distinctive clinical disorder with unknown cause, recurrent vestibulopathy should be always considered to the patients complaining recurrent episodic vertigo. Combination therapy individualized to the symptoms and signs of the patients with recurrent vestibulopathy might be effective in reducing the frequency of vertigo attacks. Further case-control studies with large population should be necessary.
Age of Onset ; Case-Control Studies ; Endolymphatic Hydrops ; Female ; Follow-Up Studies ; Headache ; Humans ; Natural History ; Retrospective Studies ; Sex Distribution ; Vertigo ; Vestibular Neuronitis*

PURPOSE : The 17beta-hydroxysteroid dehydrogenases(17HSDs) play an important role in the regulation of the physiologic activities of sex steroid hormones. The predominance of 17HSD type 1 in the malignant breast tissue could increase the estrogen-dependent proliferation and stimulate the cancer progression. On the other hand, the oxidative 17HSD type 2 may protect the normal breast cells from an excessive estradiol effect. To identify the role of 17HSD type 2 in the carcinogenesis of breast cancer, we investigate the mutation of 17HSD type 2 in 35 breast cancers. METHODS : We analyzed the entire coding region of the 17 HSD type 2 gene for detection of the somatic mutations in 35 invasive ductal carcinomas of the breast by polymerase chain reaction, single strand conformation polymorphism, and DNA sequencing. RESULTS : We found one missense mutation in exon 6(2.86%). It revealed the CCT-->CTT (Pro-->Leu) transition type at codon 262 in exon 6. CONCLUSION : In present study, we found only a mutation of the 17beta -HSD type 2 gene in breast cancer and could not demonstrate the direct relationship between the mutation of the 17beta -HSD type 2 gene and the development of breast cancer. These results suggest that the mutation of 17HSD type 2 doesn? play a major role in the development of breast cancer.
Breast Neoplasms ; Breast* ; Carcinogenesis ; Carcinoma, Ductal ; Clinical Coding ; Codon ; Estradiol ; Exons ; Gonadal Steroid Hormones ; Hand ; Mutation, Missense ; Oxidoreductases* ; Polymerase Chain Reaction ; Sequence Analysis, DNA

PURPOSE : The 17beta-hydroxysteroid dehydrogenases(17HSDs) play an important role in the regulation of the physiologic activities of sex steroid hormones. The predominance of 17HSD type 1 in the malignant breast tissue could increase the estrogen-dependent proliferation and stimulate the cancer progression. On the other hand, the oxidative 17HSD type 2 may protect the normal breast cells from an excessive estradiol effect. To identify the role of 17HSD type 2 in the carcinogenesis of breast cancer, we investigate the mutation of 17HSD type 2 in 35 breast cancers. METHODS : We analyzed the entire coding region of the 17 HSD type 2 gene for detection of the somatic mutations in 35 invasive ductal carcinomas of the breast by polymerase chain reaction, single strand conformation polymorphism, and DNA sequencing. RESULTS : We found one missense mutation in exon 6(2.86%). It revealed the CCT-->CTT (Pro-->Leu) transition type at codon 262 in exon 6. CONCLUSION : In present study, we found only a mutation of the 17beta -HSD type 2 gene in breast cancer and could not demonstrate the direct relationship between the mutation of the 17beta -HSD type 2 gene and the development of breast cancer. These results suggest that the mutation of 17HSD type 2 doesn? play a major role in the development of breast cancer.
Breast Neoplasms ; Breast* ; Carcinogenesis ; Carcinoma, Ductal ; Clinical Coding ; Codon ; Estradiol ; Exons ; Gonadal Steroid Hormones ; Hand ; Mutation, Missense ; Oxidoreductases* ; Polymerase Chain Reaction ; Sequence Analysis, DNA

Familial juvenile polyposis is a rare intestinal polyposis characterized by the occurrence of multiple juvenile polyps in the gastrointestinal tract. We report a case of familial juvenile polyposis in a 17-year-old man with a review of the literature. This patient underwent total colectomy due to a 6 years history of rectal bleeding. Grossly, the colon showed 36 variable sized pedunculated polyps, measuring 2.5cm x 2cm from the largest size and 0.2cm x 0.2cm to the smallest size. Histologically, the polyps consisted of cystically dilated glands, lined by normal colonic epithelial cells, scattered in loose, edematous stroma containing inflammatory cell infiltration. There were no areas of tubular adenoma or malignancy in any of the polyp.
Adenoma ; Adolescent ; Colectomy ; Colon ; Epithelial Cells ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Intestinal Polyposis ; Polyps

The prevalence and related diseases of otitis media with effusion(OME) which is a very common disease in infants and young children were investigated in a group of 3 to 6 year old children. The study population includes 374 children with 185 boys and 189 girls enrolled in 7 kindergartens in Puchun city. The middle ear status was assessed by combination of findings of otomicroscope, pneumatic otoscope, impedence audiometry. The related diseases were evaluated by radiologic findings and questionnare with statistic analysis. Fifty-nine children were considered to have OME(prevalence: 15.8%) with peak at 3 years of age(30.6%). Of the 59 children with OME, fifty-four percent had bilateral involvement and all the remainder had unilateral involvement. The risk for otitis media with effusion increased in children with adenoid enlargement, tonsillar enlargement, and paranasal sinusitis, and this was confirmed to be statistically significant(p<0.01).
Adenoids ; Audiometry ; Child* ; Cross-Sectional Studies* ; Ear, Middle ; Female ; Gyeonggi-do* ; Humans ; Infant ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Otoscopes ; Prevalence* ; Sinusitis

No abstract available.
Hepatitis C* ; Interferons* ; Polymyositis*

Congenital stapedial fixation is a type of conductive hearing loss in which impairment of the sound-conduction mechanism is caused by congenital or acquired fixation of the stapes. It is genetically heterogeneous, but it has been recently reported to be also caused by mutations in the Noggin (NOG) gene. The authors have experienced a 6-year old boy with bilateral mixed hearing loss, who has a family history of hearing loss. No stapedial reflex was observed, and temporal bone CT showed no abnormality in the middle ear, as well as in the ossicles. Genetic study revealed novel NOG gene mutations, which have never been reported before as a relevant gene mutation for congenital hearing loss related with stapedial fixation. Under the possible diagnosis of congenital stapedial fixation with mixed hearing loss caused by NOG gene mutations, the patient has started to wear bilateral hearing aids and is being followed up for possible surgical therapy. Here, we report this case of congenital mixed hearing loss caused by novel NOG gene mutations with a review of the literatures.

PURPOSE: The aim of our study was to determine the positive predictive value (PPV) and to evaluate the usefulness of ultrasound BI-RADS, as compared with the histologic results of breast lesions that were categorized and classified by the ultrasound BI-RADS lexicon. MATERIALS AND METHODS: Between January and December 2004, the ultrasound features of 471 breast lesions in 368 patients were analyzed and categorized with using ultrasound BI-RADS. All of the lesions were compared with the histological results. We categorized category 2 and 3 lesions as benign lesions, and category 4 and 5 lesions as malignant lesions. We then calculated the sensitivity, specificity, positive predictive value, negative predictive value and accuracy. RESULTS: The breast lesions were histologically diagnosed as 298 cases of category 2, 21 cases of category 3, 108 cases of category 4 and 44 cases of category 5. The categorical malignancy rate was 1% (3/298) in category 2 lesions, 4.7% (1/21) in category 3 lesions, 8.3% (9/108) in category 4 lesions and 90.9% (40/44) in category 5 lesions. Within category 4, the malignancy rate for category 4a lesions was 5.4% (5/92), the malignancy rate for category 4b lesions was 1.3% (1/8) and the malignancy rate for category 4c lesions was 50% (4/8). The sensitivity, specificity, positive predictive value and negative predictive value were 90.6%, 75.1%, 31.6% and 98.4%, respectively. The statistically valid ultrasound features that were correlated with malignancy were an ill defined margin, a microlobulated mass, an irregular mass, inhomogenic echogenicity, an echogenic halo and an older patient age. CONCLUSION: Ultrasound BI-RADS was useful in differentiating benign from malignant breast lesions.
Breast* ; Humans ; Sensitivity and Specificity ; Ultrasonography*

PURPOSE: The aim of this study was to assess whether the complete removal of a breast mass using ultrasound (US) guided mammotome biopsy was successful using a marginal biopsy after insuring the total visual excision of the breast mass on US images. The relationship of complete breast mass removal, and the hematoma, mass size and shape were also evaluated. MATERIALS AND METHODS: A US guided mammotome biopsy was performed in a total of 136 cases in 133 patients, with marginal biopsies also added when the complete removal of breast mass had been identified by sonography. The results of the marginal biopsies were serially dividing into three groups, as follows: group I were the cases in the initial 6 months, group II after the initial 6 months and group III having undergone two marginal biopsies. The marginal biopsies were performed in four directions around the probe, with "marginal positivity" defined as the same histopathological findings to that of the main mass in at least one direction. A statistical analysis was also used to evaluate between the marginal positivity and the hematoma, mass size and shape. RESULTS: The marginal positivities of groups I, II and III were 48.8, 29.4 and 45.5%, respectively. The marginal positivity of those with a lobular shaped mass was significantly higher (p=0.0121) than those with round or oval shaped masses (61.5 vs. 33.7 vs. 50%), but showed no statistical relationship with hematoma size of the lesions CONCLUSION: Although the lesions were removed by US using a US-guided mammotome biopsy, many residual lesions were still histologically present in the marginal samplings, especially in the lobular shaped masse
Biopsy* ; Biopsy, Needle ; Breast* ; Hematoma ; Humans ; Ultrasonography