Cryptococcus is native to the environment and thrives in any type of environment inhabited by birds. Cryptococcal genito-urinary infection has been reported in immunnocompromised patients and can involve the adrenal gland, kidney, prostate, or penis. To our knowledge, there have been no reports of cases where cryptococcal epididymo-orchitis infects an uncompromised healthy host. Here, we report a case of primary cryptococcal epididymo-orchitis in a healthy male.
Adrenal Glands ; Birds ; Cryptococcus ; Humans ; Kidney ; Male ; Orchitis ; Penis ; Prostate

This study shows a case of neoadjuvant chemotherapy application for the management of a 34-year-old male patient diagnosed with invasive intraductal papillary mucinous neoplasm (IPMN), for which curative margin-negative resection initially seemed challenging. Five cycles of the FOLFIRINOX regimen (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) were administered preoperatively, resulting in a significant reduction of the intraductal mass size and deformity of the main vessels. The patient subsequently underwent a successful robotic pylorus-preserving pancreatoduodenectomy. Postoperatively, the patient received adjuvant chemotherapy with FOLFIRINOX, and after 5 months, showed no signs of tumor recurrence or specific complications. These findings suggest that neoadjuvant therapy can be a potentially effective strategy even in advanced invasive IPMN. Further research is necessary to establish guidelines for its application.

Kallmann's syndrome is characterized by hypogonadotrophic hypogonadism resulting from insufficient release of GnRH and associated with anosmia or hyposmia, which has been related to agenesis of olfactory bulbs. We experienced a case of 17 year-old Kallmann's syndrome woman and a case of successful pregnancy of 29 year-old Kallmann's syndrome woman with hMG and hCG treatment and present two cases with a review of literatures.
Adolescent ; Adult ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Hypogonadism ; Kallmann Syndrome* ; Olfaction Disorders ; Olfactory Bulb ; Pregnancy*

OBJECTIVE: Recently, the incidence of elderly primipara is increasing. Thus, impact of old age on pregnancy outcomes became important. Our purpose was to assess the effect of maternal age on pregnancy outcomes. METHODS: 73 cases of the elderly primipara over 35 years at the department of obstetrics and gynecology, Chon-ju presbyterian medical center, from Jan. 1, 1995 to Dec. 31, 1998, were compared with 73 cases randomly chosen young primiparas during same period. RESULTS: Elderly primipara had higher rate of infertility and spontaneous abortion history, antenatal complications, cesarean section, poorer neonatal outcome than young primipara. CONCLUSION: The pregnancy outcome of elderly primipara is considered to be less favorable than those of young primipara. Careful antenatal and intrapartal care should be performed for the elderly primipara. We think that many clinical study of congenital anomaly in elderly primipara will be necessary.
Abortion, Spontaneous ; Aged* ; Cesarean Section ; Female ; Gynecology ; Humans ; Incidence ; Infertility ; Jeollabuk-do ; Maternal Age ; Obstetrics ; Pregnancy Outcome ; Pregnancy* ; Protestantism ; Statistics as Topic*

Despite debates regarding the safety of well-selected left-sided pancreatic cancer, minimally invasive distal pancreatosplenectomy is considered safer and more effective than open distal pancreatosplenectomy in well-selected patients. Previous studies have shown that minimally invasive surgery yields comparable oncologic outcomes to open surgery. While patients who undergo minimally invasive distal pancreatosplenectomy also experience recurrences and metastases after surgery, port-site metastasis is particularly rare. In this report, we report an extremely rare case of port-site metastasis following minimally invasive distal pancreatosplenectomy for left-sided pancreatic cancer.

This study was performed to evaluate the relationship between biological markers of lead exposure and thyroid functions among male workers occupationally exposed to inorganic lead. 30 male workers exposed to inorganic lead at smelting and battery factories were investigated, and 30 male control workers who were not exposed to inorganic lead occupationally were chosen for this study. The data were obtained using direct interview and assessment of biological markers of lead exposure and thyroid indices. As biological markers for lead exposure, blood ZPP. blood lead, urine lead and hemoglobin were measured. As thyroid indices. TSH and FT4were determined. The results of the study were summarized as follows 1. Levels of ZPP, blood lead, and urine lead were significantly higher in lead-exposed group than in nonexposed control group(p<0.01 all). Hemoglobin level was significantly lower in lead-exposed group than in nonexposed group(p<0.01). 2. Study subjects had normal values of TSH and FT4 But TSH level was insignificantly lower in lead-exposed group than in nonexposed control group(p=0.11) and FT4 level was significantly lower in lead-exposed group than in nonexposed group(p<0.01). 3. As the result of simple regression analysis in lead-exposed group. FT4 level was negatively correlated with the amount of smoke, blood ZPP, and blood lead(p < 0.05 all). 4. In lead-exposed group, FT4 was used as a independent variable and age, the amount of smoke, blood ZPP, and blood lead were entered as a dependent variables in the model. As the result of multiple regression analysis with stepwise selection method, the amount of smoke and blood ZPP were negative predictors of FT4(p=0. 04, p=0.09, respectively). In conclusion, levels of TSH and FT4were lower in lead-exposed group than in nonexposed control group. In lead-exposed group, FT4 level was negatively correlated with amount of smoke, blood ZPP, and blood lead in simple regression analysis. To clarify this relation, further research between lead exposure and thyroid function may be required for worker with long-term lead exposure or high lead exposure.
Biological Markers ; Humans ; Male* ; Occupations* ; Osmeriformes ; Reference Values ; Smoke ; Thyroid Gland*

Lymphangiomas result from a failure of lymphatic drainage into the venous system due to atresia or an insufficiency of the efferent lymphatic channels. The neck and axillary regions are most commonly affected, while the condition is rarely found in the inguinal area, scrotum, retroperitoneal space, abdominal viscera, arm, pelvis or bones. We report a case of a cystic lymphangioma of the lower abdomen, penis and scrotum in a 29-year-old man.
Abdomen* ; Adult ; Arm ; Drainage ; Humans ; Lymphangioma ; Lymphangioma, Cystic* ; Male ; Neck ; Pelvis ; Penis* ; Retroperitoneal Space ; Scrotum* ; Viscera

OBJECTIVES: We carried out tests for neurobehavior by using WHO-NCTB (neurobehavioral core test battery) and Perdue pegboard score test to identify differences between lacunar infarction cases and controls. METHODS: Among the subjects who underwent MRI between February 2001 and March 2002 in a university hospital located in Seoul and who were diagnosed only as lacunar infarction without any intracranial disease, 46 patients were selected as cases (male: 21, female: 25). Controls were selected who had no cerebrovascular disease on MRI by matching age (5 years), gender, and education (2 years) in a ratio of 1: 1. Among WHO-NCTB, the following 5 tests and Perdue pegboard score test were used to categorize the study subjects: digit and symbol matching, simple reaction time, Benton visual retention, digit span, and Pursuit aiming test. RESULTS: Among the above 6 tests of neurobehavior, lacunar infarction cases showed lower score than controls except for the simple reaction time test. As the controlling variables of multivariate analysis in the stepwise regression analysis, the followings were selected due to their significant association: age, education, BMI, gender, drinking, exercise, and systolic blood pressure. From multivariate regression analysis, there was significant difference (p< 0.05) between lacunar infarction cases and controls in digit and symbol matching, Benton visual retention, digit span, pursuit aiming, and Perdue pegboard score test, but not in the score of simple reaction time test. CONCLUSIONS: We suggest that the above 5 tests for neurobehavior, with the exception of the simple reaction time test, might be used as the basis for recommendation of further treatment and other neurological tests by the earlier detection for neurological abnormality in lacunar infarction.
Blood Pressure ; Case-Control Studies* ; Cerebrovascular Disorders ; Drinking ; Education ; Female ; Humans ; Magnetic Resonance Imaging ; Multivariate Analysis ; Reaction Time ; Seoul ; Stroke, Lacunar*

Primary leptomeningeal melanoma is a rare and aggressive tumor that originates from pial melanin-bearing cells typically along the cerebral conveidties or at the. Base of the brain. It has been hypothesized that malignant transformation Of the preexisting precursor cells leads to diffuse infiltration of the meninges by tumor and the onset of neurological symptoms and signs . The typical neurological symptoms and signs include psychiatric disturbances, seizures, and symptoros and signs of raised intracranial pressure secondary to hydrocephalus. Blindness has been reported as a late feature. Radiotherapy and chemotherapy has been using, but prognosis is poor We d be our experience with 24-years-woman in which the diagnosis of primary leptomeningea1 melanoma without melanotic pigmentation of variable areas of the skm was made.
Blindness ; Brain ; Diagnosis ; Drug Therapy ; Hydrocephalus ; Intracranial Pressure ; Melanoma* ; Meninges ; Pigmentation ; Prognosis ; Radiotherapy ; Seizures

PURPOSE: To investigate the relation between retinal nerve fiber layer (RNFL) defect and grade of diabetic retinopathy in diabetic patients with normal intraocular pressure (IOP). METHODS: The medical records of 260 patients with nonproliferative diabetic retinopathy (NPDR) were reviewed retrospectively. Patients with diseases and congenital anomaly were excluded. According to the results of visual acuity, IOP, slit lamp examination and fluorescein angiography, patients were classified into 3 groups, mild, moderate, severe NPDR. RNFL photography was also performed in all patients. RESULTS: Average age of 260 patients (520 eyes) was 60 year-old, and average IOP was 16.8mmHg. 372 eyes were mild NPDR, 76 were moderate, and 72 were severe. 136 eyes (25.2%) had RNFL defects including wedge-shaped defect (107 eyes; 78.7%) and diffuse atrophy (29 eyes; 21.3%). RNFL defects were observed in patients with mild NPDR (84 eyes), moderate (24 eyes), and severe (28 eyes) and there were a significant correlation between RNFL defect and severity of diabetic retinopathy (p=0.008). CONCLUSIONS: Careful examination and continuous follow-up are necessary in patients with diabetic retinopathy because RNFL defect was common in diabetic patients and increased according to the degree of diabetic retinopathy.
Atrophy ; Diabetic Retinopathy* ; Fluorescein Angiography ; Humans ; Intraocular Pressure ; Medical Records ; Middle Aged ; Nerve Fibers* ; Photography ; Retinaldehyde* ; Retrospective Studies ; Visual Acuity