No abstract available.
46, XY Disorders of Sex Development* ; Humans ; Male*

No abstract available.
Humans ; Insulin Resistance* ; Insulin*

Hereditory Sensory Autonomic Neuropathy(HSAN) is variable rare disorder. So the classification of HSAN could be somewhat unsettled. There are intermingled overlap variants of HSAN in view of clinical manifestations and pathologic findings. Five types of HSAN have been described by Dyck(1993). Type I is dominantly inherited and affects both myelinated(MFs) and unmyetinated fibers(Ufs). Type II is recessively inherited and nerve biopsies show total absence of MFs but presence of Ufs. Type III is a recessive inherited dysautonomia. Type IV is characterized by insensitive to pain anhidrosis, and mild mental retardation with virtually absence of Ufs. Type V affects small MFs. We report a 5 year-old girl who presented with congenital insensitivity to pain, anhidrosis with mild mental retardation. In sural nerve biopsy, Ufs were virtually absent by electron microscopy. We reconfirmed previous pathologic findings in sural nerve of HSAN IV.
Biopsy ; Child, Preschool ; Classification ; Female ; Hereditary Sensory and Autonomic Neuropathies ; Humans ; Hypohidrosis* ; Intellectual Disability ; Microscopy, Electron ; Pain Insensitivity, Congenital* ; Primary Dysautonomias ; Sural Nerve

PURPOSE: Control of bleeding and preservation of liver function are still major keys for successful liver resection. We applied right hemihepatic vascular exclusion (RHVE) in patients with a right lobe liver tumor to verify the usefulness and safety of RHVE. METHODS: Between March 1998 and August 2002, 12 patients (Control group) underwent right liver surgeries without inflow occlusion, and 22 patients (RHVE group) underwent right liver surgeries under RHVE. Hemodynamic changes during the operation, amount of transfusion, and post- operative liver function were compared between the two groups. RESULTS: The mean duration of RHVE was 32.3+/-13.9 (15~60) minutes. The mean arterial pressure of the control group and the RHVE group after liver resection were reduced, but these changes were not statistically significant. The amount of transfusion in the RHVE group (2.66+/-1.4 unit) was significantly lower (P<0.05) than that of the control group (4.56+/-3.3 unit). AST/ALT level of the RHVE group were significantly higher on POD#1, but there were no statistically significant differences on POD#3, 5 and 7. Also, the differences in the changes of total bilirubin and IL-6 after liver resection were not significant. Cirrhotic patients in both groups were compared with the same analysis. Only the amounts of transfusion in the RHVE group were significantly lower (P<0.05) than that of the control group. CONCLUSION: RHVE is a safe and useful procedure for right liver surgery with minimal blood loss, but without significant hemodynamic alteration and functional deterioration. These characteristics are shown especially in cirrhotic liver and non-anatomical resection of metastatic cancer.
Arterial Pressure ; Bilirubin ; Carcinoma, Hepatocellular ; Hemodynamics ; Hemorrhage ; Humans ; Interleukin-6 ; Liver*

Essential thrombocythemia is one type of the related chronic myeloproliferative disorders that also include poly-cythemia vera, chronic myelogenous leukemia, and idiopathic myelofibrosis. It is a rare disorder of unknown origin characterized by thrombocytosis, excessive megakaryocytes, hemorrhage, and thrombotic complication. Several cases of ischemic stroke in essential thrombocythemia have been reported, but cerebral infarction combined with cerebral hemorrhage has been very rare and has not been reported in Korea. We report a case of cerebral infarction and chronic subdural hematoma in a pateint with essential thrombocythemia. A 59-year-old woman with essential thrombocythemia was admitted with mild left hemiparesis that developed 3 days prior. She had a history of minor trauma 15 days prior. A brain MRI showed an infarction in the right temporal lobe and a chronic subdural hematoma in the right frontoparietal area. A cerebral angiography revealed an occlusion of the M2 portion of the right middle cerebral artery.
Brain ; Cerebral Angiography ; Cerebral Hemorrhage ; Cerebral Infarction* ; Female ; Hematoma, Subdural, Chronic* ; Hemorrhage ; Humans ; Infarction ; Korea ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Magnetic Resonance Imaging ; Megakaryocytes ; Middle Aged ; Middle Cerebral Artery ; Myeloproliferative Disorders ; Paresis ; Primary Myelofibrosis ; Stroke ; Temporal Lobe ; Thrombocythemia, Essential* ; Thrombocytosis

Solitary fibrous tumor(SFT) is a spindle cell neoplasm that usually arises in the pleura. Its involvement of the meninges is rare but increasingly being reported. Our case was a 33-year-old man who presented with clonic seizure around the right mouth angle and sensory disturbance at the right hand. Radiological studies showed a large extra-axial, dural-based mass in the left fronto-parietal region, typically isointense with gray matter and heterogeneous strong enhancement on T1-weighted images. Histologically, the tumor was composed of spindle-shaped cells growing in fascicles within the collagenous matrix. Immunohistochemical staining demonstrated diffuse CD34 positivity. Awareness of this neoplasm is necessary to accurate diagnosis.
Adult ; Collagen ; Diagnosis ; Hand ; Humans ; Meninges* ; Mouth ; Pleura ; Seizures ; Solitary Fibrous Tumors*

BACKGROUND: Sorbitol fermenting Escherichia coli O157 were reported. And E. coli O157:H7 produce various Shiga toxin (Stx) such as Stx1, Stx2, or variants of Stx2. In this study, we tried to establish laboratory methods that detect E. coli O157:H7 quickly and precisely by analyzing sensitivity of colony hybridization test and PCR technique. METHODS: Stx1-producing E. coli ATCC 43890, Stx2-producing E. coli ATCC 43889, and Stx2vha- producing E. coli ATCC 51435 were tested. Three strains of E. coli were diluted with 0.1 g of diarrheal stools from 107 CFU to 101 CFU respectively. The stool samples were incubated overnight in MacConkey agar plates. A mean of 63 colonies were hybridized by stx1- and stx2-specific oligonucleotide probes. PCR for stx1 gene and stx2 gene was done after overnight- incubation of stool samples in the LB broth with vancomycin (6 ug/mL). Positive colonies by colony hybridization were confirmed by PCR for stx1 gene and stx2 gene. RESULTS: Colony hybridization test could detect Stx1-producing E. coli at 103 CFU per 0.1 g of stool, Stx2-producing E. coli at 105 CFU per 0.1 g of stool, and Stx2vha-producing E. coli at 104 CFU per 0.1 g of stool. PCR technique after enrichment in LB broth with vancomycin (6 ug/mL) could detect stx1-, stx2-, and stx2vha-containing E. coli at 10 CFU per 0.1 g of stool respectively. CONCLUSOIN: A combination of colony hybridization and PCR after enrichment in broth with vancomycin (6 ug/mL) is useful for the rapid and precise diagnosis of infections of Shiga toxin-producing E. coli O157:H7.
Agar ; Diagnosis ; Escherichia coli O157 ; Escherichia coli* ; Escherichia* ; Oligonucleotide Probes ; Polymerase Chain Reaction ; Shiga Toxin ; Sorbitol ; Vancomycin

Glomangiopericytoma, also referred to as a hemangiopericytoma-like tumor or sinonasal type hemangiopericytoma, is a rare tumor of the nasal cavity and paranasal sinus that has never been reported in the spinal cord. Here, we report a case of a 47-year-old man who developed glomangiopericytoma in the thoracic spine. This lesion showed a heterogeneous high signal intensity compared to the spinal cord on a T2-weighted image and an easily enhanced isointense signal on a T1-weighted image.
Hemangiopericytoma ; Humans ; Middle Aged ; Nasal Cavity ; Spinal Cord* ; Spine

BACKGROUNDS/AIMS: The aim of this study is to clarify the safety and feasibility of laparoscopic hepatectomy, through comparing the early and late periods of perioperative outcomes. METHODS: We retrospectively analyzed 138 patients who underwent laparoscopic hepatectomy from January 2003 to June 2011, at Yeungnam University Hospital. We divided the total patients to early period (from January 2003 to February 2007, n=49) and late period (from March 2007 to June 2011, n=89) groups and compared the perioperative outcomes including the mean operation time, intra-operative blood loss, postoperative hospital stay, intensive care unit (ICU) stay, and duration of liver function test (LFT) normalization. RESULTS: The mean operation time was 308 minutes (range: 140-510) in the early group and 193 minutes (range: 40-350) in the late period group (p<0.001). The mean intraoperative blood loss was 171 ml (range: 50-1,200) in the early and 44 ml (range: 0-400) in the late group (p=0.005). The postoperative hospital stay was 9.7 days (range: 4-31) in the early and 6.8 days (range: 2-9) in the late period (p<0.001). The ICU stay hour was 21.6 hours (range: 0-120) in the early and 2.8 hour (range: 0-24) in the late period (p<0.001). The duration of LFT normalization was 5.7 days (range: 0-39) in the early and 2.1 days (range: 0-20) in the late period (p=0.003). The perioperative outcomes in the late period were better than the early period, which showed a statistically significant difference. CONCLUSIONS: Laparoscopic hepatectomy is feasible and can be safely performed in selected patients but requires a long experience in open liver resection and mastery of laparoscopic surgical skills.
Hepatectomy ; Humans ; Intensive Care Units ; Laparoscopy ; Length of Stay ; Liver ; Liver Function Tests ; Postoperative Hemorrhage ; Retrospective Studies

OBJECTIVES: To assess the relationship between ST segment elevation during exercise testing and coronary artery disease. METHODS: Treadmill exercise electrocardiography and coronary angiography were performed in 137 patients with angina with no Q waves. The J point elevation of > 0.03mV(0.3mm) measured from baseline, the elevation of ST segment at 80msec. from J point(ST80) measured larger in lead V1than in aV1, or both the elevation of ST segment at J point and at ST80 developed earlier than or concomitantly with ST depression were considered as abnormal responses. RESULTS: 1) There was no clinical significance of ST elevation in lead aV1. 2) Exercise-induced ST elevation in lead V1occurred in 29 of 137 patients with angina. 3) Abnormal St elevation in V1was detected in 26 of 86 patients with coronary artery disease, for a specificity of 98%. The patients with left anterior descending coronary artery or left main coronary artery stenosis were observed in 3 of 5(60%) patients with single-vessel disease, in 7 of 9(79%) with two-vessel disease, and in 9 of 10(90%) with three-vessel disease. 4) The standard ST depression yielded a specificity of 55% in the patients with isolated or predominant ST depression in inferior leads(II. III, and aVF) and of 81% in the patients with isolated or predominat ST depressin in precordial leads(p<0.001). 5) Abnormal exercise-induced ST elevation in V1was detected in 13 of 39(33%) patients with isolated or predominat ST depression in inferior leads and yielded a specificity of 94% for coronary artery disease. CONCLUSION: Abnormal ST segment elevation in V1may increase the specificity in isolated or predominat ST segment depression in inferior leads and may predict left anterior descending or left main coronary artery disease.
Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Depression ; Electrocardiography ; Exercise Test* ; Hexamethonium ; Humans ; Sensitivity and Specificity