The first case of testicular teratocarcinoma in Korea, found in 24 year old service man was reported. Complication of the metastases to various organs, gynecomastia and hydrocele was seen at the first examination and simple orchiectomy and delayed x-ray deep therapy were not effective to survive this case. The patient died 3 months after the affliction. Autopsy revealed matastases were to lung, spleen, lower poles of both Kidneys, mediastinal and lumbar paraaortic lymph nodes and histopathological examination showed the teratocarcinoma composed of seminoma, embryonic carcinoma and chorioepitheliomatous elements. Additionally, 13 cases of testis tumors reported in literatures of recent years in-country have peen reviewed.
Autopsy ; Gynecomastia ; Humans ; Kidney ; Korea ; Lung ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Orchiectomy ; Seminoma ; Spleen ; Teratocarcinoma* ; Testis* ; Young Adult

No abstract available.
Diagnosis ; Myotonia ; Polyneuropathies ; Relaxation

OBJECTIVE: To investigate the expression of apoptosis related proteins and apoptotic cells on the human ovarian follicles. MATERIALS AND METHODS: Thirty five Formalin-fixed paraffin-embedded human ovarian tissue blocks were selected from the surgical pathology files of the department of pathology, College of Medicine, Yonsei University, for the period from 1996 to 1998. All specimen were from premenopausal women aged from 32~45. Ovarian tissues were collected from the patients performing hysterectomy for benign uterine diseases. Immunohistochemical staining was performed for the detection of DNA fragmented cell, Bcl-2, Bax, Fas and Fas-ligand. RESULTS: Bcl-2 and bax were not expressed on the surrounding cells and oocyte of the primary, primordial and preantral follicles. Fas and Fas-ligand (Fas-L) were not expressed on the surrounding cells on the primordial and primary follicles. But expressed on the surrounding granulosa cells and oocyte in the primordial and primary follicles. In the healthy follicles, Bcl-2 was expressed on the granulosa cells, however, Bax was not expressed. DNA fragmented cells were expressed on the inner granulosa cell layer of atretic follicles. CONCLUSION: Fas, Fas-ligand, and Bax may be responsible for the follicular atresia and Bcl-2 may be involved in the follicular survival in the human ovary.
Apoptosis* ; DNA ; Female ; Follicular Atresia ; Granulosa Cells ; Humans* ; Hysterectomy ; Oocytes ; Ovarian Follicle* ; Ovary ; Pathology ; Pathology, Surgical ; Uterine Diseases

Acute eosinophilic pneumonia is reported as a specific disease entity. But, it is different from chronic eosinophilic pneumonia in its onset, clinical course and recurrence. Badesh et al reported the following diagnostic criteria os acute eosinophilic pneumonia a less than one-month history of symptoms prior to diagnosis, no evidence of asthma, the absence of other organic disease, no obvious etiology and an evidence of recurrent disease. We experienced a case of acute eosinophilic pneumonia in 37 old male. Pathologically eosinophilic pneumonia is confirmed and other features meet Badesh's criteria.
Asthma ; Diagnosis ; Eosinophils* ; Humans ; Male ; Pulmonary Eosinophilia* ; Recurrence

Hansen's disease(HD) is a chronic infectious disorder acquired by inoculation of Mycobacterium leprae. With the establishment of complex multidrug therapy, the incidence rate of leprosy patients has continually shown to decline by 90% compared to the incidence rate in the 1990s. However, the prevalence of the disease still remains high in southeast asian countries. Due to the rarity and diverse nature of cutaneous presentation, HD is often misdiagnosed with other dermatoses or infectious conditions. Especially, when a patient presents with unusual presentation with leprosy reaction with no classical feature such as sensory disorders and skin lesion, the diagnosis is further delayed with misguided treatments. Herein we present a 27-year-old Indonesian immigrant who displayed clinical features mimicking that of orbital cellulitis who was later diagnosed with borderline lepromatous leprosy through histologic and PCR confirmation, in light of alerting the probability of leprosy in immigrants with intractable skin presentations.
Adult ; Asian Continental Ancestry Group ; Diagnosis ; Emigrants and Immigrants ; Humans ; Incidence ; Leprosy ; Leprosy, Borderline ; Leprosy, Multibacillary ; Mycobacterium leprae ; Orbit ; Orbital Cellulitis ; Polymerase Chain Reaction ; Prevalence ; Sensation Disorders ; Skin ; Skin Diseases

OBJECTIVE: The aim of this study was to analyze significant motion factors that affected the outcome of medial branch blocking(MBB) in patients with low back pain(LBP) after trivial trauma. METHODS: Twenty-four patients(10men and 14 women; 70 vertebrae) complained of LBP after trivial trauma and under went bilateral MBB in the lumbar spine between January 2007 and August 2008. Visual Analogue Scale(VAS) scores of discomfort were measured before and after MBB. The motion factors considered were sitting, standing, flexion, extension and rotation. RESULTS: Sitting-, standing- and rotation-related LBPs were identified in 11 patients(44.5%, 11/24), 10 patients(41.7 %, 10/24) and 8 patients(33.3%, 8/24), respectively. The ratios of flexion- and extension-related LBPs in the enrolled patients were 66.7%(16/24) and 54.2%(13/24), respectively. The reduction in VAS score after treatment in the patients with sitting-related LBP was less than that of patients without sitting-related LBP(3.2+/-2.27 and 5.2+/-2.87, p=0.169). There was no difference between patients with standing-related LBP and those without(4.3+/-2.75 and 4.3+/-2.86). Although the mean VAS score improvement of the patients with extension- and rotation-related LBP(4.4+/-2.99 and 5.4+/-2.67) was higher than that of patients without extension and rotation LBP(4.1+/-2.59 and 3.7+/-2.71), the difference was not significant(p=0.721 and p=0.552, respectively). The mean VAS score improvement of the patients with flexion- related LBP was significantly higher than that of patients without it(6.1+/-1.81 vs 2.8+/-2.59, p=0.042). CONCLUSIONS: In patients with LBP after trivial trauma, flexion- and extension-related LBP was more common than sitting-, standing- and rotation-related LBP. Flexion was a significant motion factor affecting the outcome of MBB after trivial trauma.
Humans ; Low Back Pain ; Spine

OBJECTIVE: To analyze the incidence and risk factors of subsequent vertebral fracture after percutaneous vertebral augme- ntation(PVA) in patients with osteoporotic compression fractures(OCF). METHODS: The authors reviewed 27 patients(20 women and 7 men, 39 vertebrae) who underwent vertebral augmentation for the treatment of osteoporotic compression fracture at a single institute between January 2000 and January 2009. The patients were divided into 2 groups: Group I included patients without subsequent fracture and Group II included those with subsequent fracture. Subsequent fractures, including adjacent-level and nonadjacent-level vertebral fractures, were confirmed with radiographs or MRI. Factors such as smoking, diabetes mellitus(DM), previous bisphosphonate use, body mass index(BMI), bone mineral density(BMD), the amount of polymethylmethacrylate(PMMA), intradiscal leakage of PMMA and unilateral approach were analyzed statistically. RESULTS: Nine patients(33.3%, Group II) sustained 16 subsequent vertebral fractures(9 adjacent-level vertebral fractures and 7 nonadjacent-level vertebral fractures). Subsequent vertebral fractures at the lumbar level(81.3%) were more fre- quent than those at thoracic level(18.8%). BMI, BMD, smoking, DM, amount of PMMA, unilateral approach, and bis- phosphonate use did not correlate with the risk of subsequent fracture. Intradiscal leakage of PMMA was the only signifi- cant risk factor(P=0.027). CONCLUSIONS: The high rate of subsequent vertebral fracture should be considered before vertebral augmentation with PMMA. The intradiscal leakage of PMMA could increase the risk of subsequent fracture.
Female ; Fractures, Compression ; Humans ; Incidence ; Male ; Osteoporosis ; Polymethyl Methacrylate ; Risk Factors ; Smoke ; Smoking ; Vertebroplasty

BACKGROUND: Smoking is a very dangerous behavior and people know that it will lead to fatal health problems. But, many people continue to smoke. We studied psychiatric aspect of smoking. METHODS: We distributed self-questionnaire to people who visited Dong-San Medical Hospital for periodical examination and checkups between the months of April and June, 1996. It consisted of inquiries on their smoking status and symptom check list for minor psychiatric disorders(SCL-MPD). Among the total of 147 men 58 were current smokers, 63 non-smokers, 26 ex-smokers. We compared minor psychiatric differences between each groups by Student t-test. RESULTS: The mean age of current smokers, ex-smokers and non-smokers were 44.9 +/-8.9, 44.8+/-8.4 and 46.6+/-9.6, respectively. Among 10 dimensions of SCL-MPD, the smokers (includes current smokers and ex-smokers) had significantly higher scores on anger-hostility, interpersonal sensitivity and obsessive-compulsive dimensions than those of non-smokers(p<0.05). When comparing with current smokers and non-smokers, current smokers had significantly higher scores on anger-hostility and obsessive-compulsive dimensions(p<0.05). Between ex-smokers and non-smokers, ex-smokers had significantly higher scores on anger-hostility and obsessive-compulsive dimensions(.p<0.05). But, no significant differences were observed between current smokers and ex-smokers. CONCLUSIONS: Smokers(current smokers and ex-smokers) were highly associated with anger-hostility, interpersonal sensitivity and obsessive-compulsive disorders compared to non-smokers. But, no minor psychiatric differences were observed between current smokers and ex-smokers.
Dangerous Behavior ; Humans ; Male ; Obsessive-Compulsive Disorder ; Smoke* ; Smoking*

A total of 335 inguinal hernias in children were analyzed by the authors at the Department of General Surgery, St. Benedict Hospital, for last 10 years, from 1986 to 1995. The male patients were predominant (2.25:1), and 78.2% were under 2 years of age. Right side was 1.63 times more frequent than the left. Among the 19 cases of incarcerated hernias, 84% could be reduced preoperatively in safe. Only 3.6% of the cases were repaired by Bassini procedure, but the others didn't require posterior wall reconstruction. Bilaterality was 25 cases (7.5%), and 8 cases (2.4%) developed later contralateral hernias after primary ipsilateral fix. Complications were in 15 cases (4.5%) such as scrotal seroma and/or hematoma (3%), wound infection (0.6%), pneumonia (0.9%). For the more comprehensive care for the herniated children, specialized practice by a pediatric surgeon would be required in the future.
Child* ; Hematoma ; Hernia ; Hernia, Inguinal* ; Humans ; Male ; Pneumonia ; Seroma ; Wound Infection

PURPOSE: To evaluate the role of combination therapy of external radiotherapy and chemotherapy in the management of advanced esophageal cancer as a primary treatment compared with radiation therapy alone. METHODS AND MATERIALS: A retrospective review of evaluable 55 esophageal cancer patients referredto the Department of Therapeutic Radiology, Paik Hospital for the external radiotherapy between Jul. 1983 and Dec.1994 was undertaken. Combined therapy patients (A group) were 30 and radiation alone patients (B group) were 25. Median age was 60 years old in A group(ranges : 42-81) and 65 years old in B group (ranges : 50-81). The male patients were 53. The fiffy patients had squamous cell carcinomas. Radiation doses of 2520-6480cGy were delivered over a period of 4-7weeks. using 4MV LIVAC. Chemotherapy was administered in bolus injection before, after, or during the course of external radiotherapy. The local control rate and patterns of failure according to both treatment modalities and 1,2 year survival rates according to prognostic factors (stage, tumor length, radiation dose etc.) were analysed. RESULTS: Median follow up period was 7 months (range : 2-73 months). Median survival was 7.5 months (20 days-29 months) in A group and 5 months(20 days-73 months) in B group. The 1,2 YSRs were 26.7%, 8.9% in A group. 12.7%, 4.3% in B group (p>0.05), respectively. The 1,2 YSRs according to stage(II/III), tumor length (5cm more or less). radiation dose(5000cGy more or less) of A and B group were analyzed and the differences of survival rates of both treatments were not statistically significant. But among group B, patients who received 5000cGy or more showed significant survival benefits (p<0.05). The treatment response rates of A and B group were 43.8%, 25.0%, respectively. Complete response rate of 25.0% in A and 8.3% in B were achieved. The local failure and distant metastsis were 52.4%, 23.8% in A group. 64.3%, 14.3% in B group, respectively. The combination therapy revealed more freguent leukopenia and nausea/vomiting than radiation alone group, but degree of side effects was only mild to modereate. CONCLUSION: The combined external radiotherapy and chemotherapy for advanced esophageal cancer appears to improve the response rate, local control rate and survival rate, but the improvement was not statistically significant. The side effects of combined modalities were mild to moderate without significant morbidity. Therefore it may be worthwhile to continue the present combined external radiotherapy and chemotherapy in the management of advanced esophageal cancer to confirm our result.
Aged ; Carcinoma, Squamous Cell ; Drug Therapy ; Esophageal Neoplasms* ; Follow-Up Studies ; Humans ; Leukopenia ; Male ; Middle Aged ; Radiation Oncology ; Radiotherapy* ; Retrospective Studies ; Survival Rate