Chromosomal abnormalities are higher in twin gestations than in the singleton population. Turner's syndrome(gonadal dysgenesis) variety may result from chromosome loss during gametogenesis in either parent or a mitotic error during one of the early cleavage divisions of the fertilized zygote. The vast majority of 45, XO conceptions result in first or second-trimester miscarriage. Fetuses with Tumer's syndrome commonly exhibit posterior nuchal cystic hygromas and generalized edema. Recently we experienced one fetal demise in twin pregnancy. The affected fetus was associated with Turner's syndrome which was diagnosed by amniocentesis and karyotyping. The fetus was associated with cystic hygroma which was antenatally diagnosed by ultrasonogram. The unaffected fetus had normal karyotype and was delivered through cesarean section without any abnormalities. we report this case with brief review of literatures.
Abortion, Spontaneous ; Amniocentesis ; Cesarean Section ; Chromosome Aberrations ; Edema ; Female ; Fertilization ; Fetus ; Gametogenesis ; Humans ; Karyotype ; Karyotyping ; Lymphangioma, Cystic ; Parents ; Pregnancy ; Pregnancy, Twin* ; Turner Syndrome ; Ultrasonography ; Zygote

Investigations of the anti-tumor activity of recombinant mouse TNF and etoposide(VP-16) in a nude mouse subcutaneous implantation xenograft model utilizing the CURC-1 human renal cell carcinoma cell line were performed. Recombinant mouse tumor necrosis factor-alpha(rTNF-alpha) and VP-16. both well known cytotoxic and cytostatic anticancer agents were evaluated singly and in combination against subcutaneously growing CURC-1. The results were as follows : 1. In the absence of treatment(Group I). subcutaneously growing CURC-1 tumor nodules demonstrated continued rapid growth. 2. Administration of rTNF(Group II) induced significant tumor regression in the subcutaneous nodules. 3. Administration of rTNF and Etoposide(Group III) demonstrated significant tumor growth inhibition. On histopathological findings, Group I (control) shows rare leukocyte infiltration and no tumor necrosis. In contrast, Group II shows tumor necrosis and more leukocyte infiltration than Group I . Group III demonstrates tumor necrosis. tumor cell degeneration and more leukocyte infiltration than Group II. These results suggest that TNF have antineoplastic effect against subcutaneous human renal cell carcinoma nodule but the synergistic effect of TNF with VP-l6 is uncertain.
Animals ; Antineoplastic Agents ; Carcinoma, Renal Cell* ; Cell Line ; Etoposide* ; Heterografts* ; Humans ; Leukocytes ; Mice ; Mice, Nude* ; Necrosis ; Robenidine ; Tumor Necrosis Factor-alpha*

Sexual histories of 176 patients of the sexual dysfunctions, who visited Department of Urology of Chung-Ang University Hospital from May, l986 to Aug. l986, were reviewed and compared with findings of the diagnostic examinations. The results were as follows. 1. The erectile dysfunction was 92.6% and the ejaculatory dysfunction was 7.4%. Of the erectile dysfunctions, 58.2% was psychogenic and 4l.8% was organic. The most common etiology of the organic impotence was diabetes mellitus, followed by vascular, trauma, drug, neurogenic, and endocrinogenic in order. 2. Ages of 20 years was the most common, followed by ages of 30, 40, 50, 60 and 70 years in order Unmarraged single patients were 42.6%. 3. The patients whose living conditions and anxiety had influence on their sexual life were 27.3%, and the patients whose sexual problems had influence on their daily life or married life were 84.3 %. But the patients who had ever visited psychiatrists for sexual problems were only 8.6%. 4. Sexual desire of the patients was low, as compared with their ages, in 37.3%. The patients who never had sexual desire from their sexual partners were 24.3%. And indifference of their sexual partners to the patients or lack of their sexual desire was l8.4% or 21.8%. 5. Out of the 20 cases who was considered as definitely psychogenic impotent patients on the base of the sexual histories, 5 were proved to be organic by the diagnostic examinations. And out of 11 cases of organic impotences, 5 cases were turned out to be pychogenic. In conclusion, the fact that the patients of the sexual dysfunction were much more common in younger ages than expected, implies lack of sexual education and sexual knowledge with insufficient sexual expecience make them patients of the psychogenic sexual dysfunction. And the effects of sexual dysfunction on their daily life are very serious in most patients, particularly in the younger ages.
Anxiety ; Diabetes Mellitus ; Education ; Erectile Dysfunction ; Humans ; Male ; Psychiatry ; Sexual Partners ; Social Conditions ; Urology

To differentiate the postoperative changes from the recurrence of tumor and to evaluate MR imaging of early postoperative leptomeningeal seeding in medulloblastoma, We have retrospectively analysed 34 cases of MR images of 17 patients who were confirmed as medulloblastoma by histopathology. Noncontrast and postcontrast T1 weighted MR images were obtained in all patients. In 11 patients follow-up MR was done more than once (average:1.5 times) and average interval of MR imaging was 6 months. The timing of 34 MR images was as follow: 6 case within 2 months, 9 cases between 2 months and 1 year, 19 cases more than 1 year after surgery respectively. MR images within 2 month after surgery revealed contrast enhancement at operation site and adjacent meninges, hemorrhage, residual tumor. In patients who had no evidence of tumor recurrence, these early postoperative changes were markedly decreased within 6 month after sugery. MR images obtained more than 1 year after sugery showed no abnormal contrast enhancement or mild focal dural enhancement at operation site. Diffuse moderate dural enhancement was noted in one patient who had the history of post-surgical subdural hemorrhage. In six patients with tumor recurrences which were detected from as early as 9months to 6 years after surgery, the findings of recurrence included leptomeningeal enhancement of brain stem and cerebellar surface at early stage, variable sized enhancing leptomeningeal nodules, linear or irregular sulcus obliterating enhancing lesions, enhancing mass at primary or metastatic site. We have concluded that leptomeningeal enhancement detected after 6 months of surgery is an important MR finding suggesting the possibility of tumor recurrence. Small nodular and linear enhancement of leptomeninges at brainstem or cerebellar surface is considered as the early manifestation of intracranial tumor seeding.
Brain Stem ; Follow-Up Studies ; Hematoma, Subdural ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Medulloblastoma* ; Meninges ; Neoplasm, Residual ; Recurrence ; Retrospective Studies

No abstract available.
Carcinoma, Basal Cell* ; Dermoscopy*

Augmentation ileocystoplasty is the most available method of enlargement of capacity for the contracted bladder by using the intestinal segment. Contracture of bladder is the result of chronic vesical infections such as tuberculosis, interstitial cystitis, radiation cystitis, or neurogenic bladder, among them tuberculosis is the most common cause of bladder contracture in Korea. Contracted bladder usually demands active correction, while it may lead to considerable vesicoureteral reflux and deterioration of renal function. Herein we describe a clinical observation and follow-up study for more than 2 years on the 5 cases of augmentation ileocystoplasty, which we experienced during the periods from December 1978 to November 1980.
Contracture ; Cystitis ; Cystitis, Interstitial ; Follow-Up Studies* ; Korea ; Tuberculosis ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Vesico-Ureteral Reflux

Recently short term chemotherapy has become popular for the treatment of genitourinary tuberculosis. But it is questionable weather short term chemotherapy can cure all cases of genitourinary tuberculosis regardless of their severity ;and the role of nephrectomy in patients with renal tuberculosis is still controversial. Herein we analyzed 52 patients with confirmed urinary tuberculosis who were treated with triple drugs, including isoniazid, rifampicin and ethambutol, for 6 to 9 months. The patients ranged from 13 to 71 years of age, and the male to female ratio was 2.4: 1. Follow up period ranged from 6 to 65 months with a mean period of 19.7 months. The patients were classified according to the severity of renal tuberculosis on pyelography into Group I ( minimal, 8 patients), II (moderate, 9 patients) and III (severe, 35 patients), and treatment result were analyzed in each group. Of 52 patients, 19 were treated by chemotherapy only and 33 (63.5%) reconstructive surgery. Success rates of short term chemotherapy in terms of cure of tuberculosis and preservation of functional renal tissue were :overall 75%, 100% in Group I , 77% in Group II and 68.6% in Group III. Two of 9 patients in Group II and 10 of 17 in Group III who were treated with chemotherapy only, deteriorated with loss of the kidney. Poor vascular pyonephrotic kidney and progressive ureteral stricture were suggested as the main cause of failure. Ureteroneocystostomy and double J enting were helpful not only in the preservation of the kidney but also in the rapid cure of a renal tuberculosis. 24 patients who were treated with 6 to 9 months chemotherapy after removal of their nonfunctioning kidney were relapse-free on follow up. In conclusion, 6 to 9 months chemotherapy is adequate minimal urinary tuberculosis. For the treatment of moderate to advanced urinary tuberculosis, a longer period of chemotherapy may be adequate, and meticulous follow up with IVP and aggressive management of ureteral stricture is essential. A far advanced, nonfunctioning, unilateral tuberculosis kidney is better to be removed early, followed by 6 to 9 months' chemotherapy.
Constriction, Pathologic ; Drug Therapy* ; Ethambutol ; Female ; Follow-Up Studies ; Humans ; Isoniazid ; Kidney ; Male ; Nephrectomy ; Rifampin ; Tuberculosis* ; Tuberculosis, Renal ; Ureter ; Urography ; Weather

Heart transplantation is an accepted procedure for treatment of end-staged cardiac failure. A return to near-normal quality on life can be expected in many patients with a nonrejecting cardiac allograft, and many of these patients will return to the operating room for noncardiac surgical procedures. Anesthesiologists should be alert to recognizing problems caused by the presence of infection in immunosuppressed patients, modes of presentation of rejection phenomena and how transplanted organs, notably significantly denervated ones, may behave and respond under the pathophysiologic circumstance that arise during surgery, resuscitation and intensive care. The use of regional techniques require adequate preloading to avoid exaggerated hypotension and aseptic technique to avoid infection. Hypobaric spinal anesthesia has some benefit. It does not depress cardiovascular and respiratory system and keep adequate venous return by trendelenberg position. We report herein a case of successfully undergone total hip replacement in a patient who had previously undergone orthotopic heart transplantation under hypobaric spinal anesthesia.
Allografts ; Anesthesia, Spinal* ; Arthroplasty, Replacement, Hip ; Heart Failure ; Heart Transplantation ; Heart* ; Humans ; Hypotension ; Critical Care ; Operating Rooms ; Respiratory System ; Resuscitation

Lymphomatous involvement of the gallbladder is rarely identified and manifests mostly as a local involvement of disseminated disease. There have been reported only about 20 primary malignant lymphomas of the gallbladder without involvement of other sites. A 63-year-old woman presented with jaundice, epigastric pain, and weight olss of two months duration. There was no systemic lymphadenopathy elsewhere. Abdominal computed tomograph revealed a focal thickening of the gallbladder wall. The removed gallbladder contained a well circumscribed, 5x3 cm-sized, slightly elevated firm area with accentuated mucosal papillary excrescences near the neck protion. The lesion involved whole thickness of the wall, and was made up of diffuse atypical lymphoid cell infiltrates of variable size accompanying plasmacytoid differentiation in areas. Some large tumor cells were pleomorphic and contained prominent nucleoli. To our knowledge, this is the first case of primary malignant lymphoma of the gallbladder in Korean literature.
Female ; Humans

Translational initiation is regulated in response to nutrient availabilty and growth stimuli and is coupled with cell cycle progression and cell growth. There is now growing body of evidence which suggests links between translational regulation and the disruption of cell behavior that results in the development and progression of cancer. mRNA translation can be overactivated in breast cancer through eIF4E overexpression or abnormal activation of signal transduction pathways. Among them, rapamycin-sensitive signal transduction pathway (mTOR signaling pathway) is now being studied as a novel target for cancer therapy. In this article, the basic principles of translational control, the alterations encountered in cancer and selected therapy targeting mTOR signaling pathway are reviewed and the preclinical study regarding the determinants of rapamycin sensitivity in breast cancer is presented in order to help elucidate new avenues for breast cancer therapy.
Breast Neoplasms* ; Breast* ; Cell Cycle ; Eukaryotic Initiation Factor-4E ; Protein Biosynthesis ; Signal Transduction ; Sirolimus