A 18-year-old male patient presented with the skin colored, dome-shaped, soft, movable mass in his left retroauriculr region. The mass has slowly increased in size since birth. Histopathologic exarnination revealed sebaceous gland, eccrine gland and crosssectioned hair in the surrounding tissue, hair shaft projected into the lumen, and laminated horny material in the cyst. Transitional zone between stratified squarnous epithelium and the wall lined by histiocytes showed homogenous degenerative change. After surgical removal of the lesion, no recurrence was observed during 15 months of follow-up.
Adolescent ; Dermoid Cyst* ; Eccrine Glands ; Epithelium ; Follow-Up Studies ; Hair ; Histiocytes ; Humans ; Male ; Parturition ; Recurrence ; Sebaceous Glands ; Skin

OBJECTIVE: To examine the association between age at menopause and mortality in a population-based sample of women in Kangwha, Korea. METHODS: From the Kangwha Cohort, followed-up from 1985 to 1999, the data of the over 55 year old female group(n=3,596) was used in this study to examine the association between age at menopause and mortality. We calculated the all causes mortality risk ratio and the cancer mortality risk ratio by age at menopause grouping using the Cox Proportional Hazards Model with adjustments for age, BMI, smoking, education, chronic disease, self-rated health status, alcohol consumption and age at first birth. RESULT AND CONCLUSION: Compared to women who had menopause at 45-49 years, the all causes mortality risk ratio was 1.24 for women with menopause at less than 40 years(95% CI=1.01-1.53) and 1.05 for women with menopause at over 50 years(95% CI=0.92-1.20). Also, compared to women who had menopause at 45-49 years, the cancer mortality risk ratio was 1.53 for women with menopause at less than 40 years(95% CI=0.78-2.98) and 1.17 for women with menopause at over 50 years(95% CI=0.77-1.80).
Alcohol Drinking ; Birth Order ; Chronic Disease ; Cohort Studies* ; Education ; Female ; Humans ; Korea ; Menopause* ; Middle Aged ; Mortality ; Odds Ratio ; Proportional Hazards Models ; Smoke ; Smoking

No abstract available.
Pericardial Effusion* ; Radionuclide Imaging* ; Technetium Tc 99m Medronate*

PURPOSE: Many articles have proposed that osteonecrosis of the femoral head (ONFH) is caused by fat embolism or intravascular coagulation linked to hyperlipidemia. To determine whether hyperlipidemia is an associated factor for ONFH, serum lipid levels were measured. MATERIALS AND METHODS: Nighty-eight patients presenting with ONFH and 110 controls were investigated. We compared the average value of serum lipid levels and the incidence of hyperlipidemia of the two groups. RESULTS: ONFH group showed generalized increase in lipid level and statistically significant difference in the average value of total cholesterol (P=0.0001), HDL-cholesterol (P=0.0261) and phospholipid (P=0.0465) compared with the control. The incidence of hyperlipidemia of the two groups showed statistically significant difference in HDL-cholesterol (P=0.019) and triglyceride (P=0.024). CONCLUSION: Hyperlipidemia seems to be associated with pathogenesis of ONFH. We speculated that hyperlipidemia might be a contributing factor of ONFH. Hyperlipidemia may play a role as a triggering factor in the pathogenetic process that results in osteonecrosis. However, it can not be ruled out that secondary hyperlipidemia might be a finding following ONFH.
Cholesterol ; Embolism, Fat ; Head* ; Humans ; Hyperlipidemias ; Incidence ; Osteonecrosis* ; Triglycerides

OBJECTIVE: The presence of the various cytokines in human peritoneal fluid has been evaluated incompletely. Changes in cytokine lefels may be related to activation of peritoneal macrophage and T-lymphocyte, development of endometriosis, and infertility. This study assesses peritoneal fluid levels of interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and tumor necrosis factor-alpha (TNF-alpha) in infertile women with endometriosis and normal women without endometriosis. Design : Prospective and case-control study in university hospital. MATERIALS AND METHODS: Cytokine levels in peritoneal fluid obtained during laparotomy or laparoscopy from 21 patients in infertile patients in infertile patients with endometriosis and 24 controls undergoing laparotomy or laparoscopy with no evidence of pelvic endometriosis were determined by enzymelinked immunosorbent assay. RESULTS: The mean levels of interleukin-6 in infertile patients with endometriosis and controls were 72.7+/-23.7 pg/ml and 18.5+/-9.7 pg/ml respectively (p=0.02). Similarly, the mean levels of interleukin-8 in infertile patients with endometriosis was significantly higher than that of controls (445.0+/-89.6, vs 45.1+/-48.4, p=0.04). The mean concentration of interleukin-10 in infertile patients with endometriosis was significantly lower than that of controls (1.09+/-0.04 vs 2.19+/-0.03, p=0.03). The level of tumor necrosis factor-alpha was not significantly different between the two study groups. CONCLUSIONS: Increased IL-6 and IL-8 and decreased IL-10 levels in the peritoneal fluid may be related to pathogenesis in the endometriosis and infertility, suggesting that partially contribute to the disturbed immune regulation observed in infertili women with endometriosis.
Ascitic Fluid* ; Case-Control Studies ; Cytokines ; Endometriosis* ; Female ; Humans ; Infertility ; Interleukin-10 ; Interleukin-6 ; Interleukin-8 ; Laparoscopy ; Laparotomy ; Macrophages, Peritoneal ; Prospective Studies ; T-Lymphocytes ; Tumor Necrosis Factor-alpha

During a 12-month period high-resolution, real-time ultrasonography (US) with graded compression was performed on 268 consecutive patients with clinically suspected acute appendicitis and its complication. US visualization of a fluid-filled, non-compressed appendix or a decompressed, thick-walled appendix was the primary criterion for a diagnosis of acute appendicitis. The sonographic findings were correlated with surgical-pathologic outcome in 92 cases and with the findings of clinical follow-up in the remainder. US was found to be accurate in the diagnosis of acute appendicitis and its complication with a sensitivity of 93.3%, a specificity of 98.9%, and an accuracy of 97%. The predictive value of a positive test was 97.7%; that of a negative test was 96.7%. There were two false-positive examination in patients with a thick-walled appendix or periapperdiceal abscess, which were surgically confirmed as appendiceal adenocarcinoma and perforated cecal diverticulitis respectively. There were six false-negative examination in patients with a sonographically no-visible appendix, which were confirmed surgically as acute appendicitis(n=5) and perforated appendicitis(n=1). Our results show that high-resolution, real-time US is an accureate imaging modality in the diagnosis of acute appendicitis and the evaluation of its complication.
Abscess ; Adenocarcinoma ; Appendicitis* ; Appendix ; Diagnosis* ; Diverticulitis ; Follow-Up Studies ; Humans ; Sensitivity and Specificity ; Ultrasonography*

The precise mechanism of set-point regulation in hypothalamus was not elucidated. Nitric oxide synthases (NOS) were detected in hypothalamus, however, the roles of NO in hypothalamus was not fully studied. So, we tested the effects of NO on body temperature because preoptic-anterior hypothalamus was known as the presumptive primary fever-producing site. NO donor sodium nitroprusside (SNP, 4 nmol, i.c.v.) elicited marked febrile response, and this febrile response was completely blocked by indomethacin (a cyclooxygenase inhibitor). But, ODQ (selective guanylate cyclase inhibitor, 50 microgram, i.c.v.) did not inhibit fever induced by SNP. The cyclic GMP analogue dibutyryl-cGMP (100 microgram, i.c.v.) induced significant pyreses, which is blocked by indomethacin. NG-nitro-L-arginine methyl ester (L-NAME, non selective NOS inhibitor) inhibited fever induced by interleukin-1 beta (IL-1 beta, 10 ng, i.c.v.), one of endogenous pyrogens. These results indicate that NO may have an important role, not related to stimulation of soluble guanylate cyclase, in the signal pathway of thermoregulation in hypothalamus.
Body Temperature ; Body Temperature Regulation ; Central Nervous System* ; Cyclic GMP ; Fever ; Guanylate Cyclase ; Humans ; Hypothalamus ; Indomethacin ; Interleukin-1beta ; NG-Nitroarginine Methyl Ester ; Nitric Oxide* ; Nitroprusside ; Prostaglandin-Endoperoxide Synthases ; Pyrogens ; Signal Transduction ; Tissue Donors

Carbon monoxide (CO) binds to soluble guanylate cyclase to lead its activation and elicits smooth muscle relaxation. The vascular tissues have a high capacity to produce CO, since heme oxygenase-2 (HO-2) is constitutively expressed in endothelial and smooth muscle cells, and HO-1 can be greatly up-regulated by oxidative stress. Moreover, the substrate of HO, heme, is readily available for catalysis in vascular tissue. Although the activation of heme oxygenase pathway under various stress conditions may provide a defence mechanism in compromised tissues, the specific role of HO-1-derived CO in the control of aortic contractility still remains to be elucidated. The present study was done to determine the effect of HO-1 induction on the aortic contractility. Thus, the effects of incubation of aortic tissue with S-nitroso-N-acetylpenicillamine (SNAP) for 1 hr on the aortic contractile response to phenylephrine were studied. The preincubation with SNAP resulted in depression of the vasoconstrictor response to phenylephrine. This effect was restored by HO inhibitor or methylene blue but not by NOS inhibitor. The attenuation of vascular reactivity by preincubation with SNAP was also revealed in endothelium-free rings. AlF4--evoked contraction in control did not differ from that in SNP-treated group. These results suggest that increased production of CO was responsible for the reduction of the contractile response to phenylephrine in aortic ring preincubated with SNAP and this effect of SNAP was independent on endothelium.
Carbon Monoxide ; Catalysis ; Depression ; Endothelium ; Guanylate Cyclase ; Heme Oxygenase (Decyclizing)* ; Heme* ; Humans ; Methylene Blue ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Oxidative Stress ; Phenylephrine ; Relaxation ; S-Nitroso-N-Acetylpenicillamine ; Tissue Donors*

The purpose of this animal study is to evaluate, by histomorphometric analysis, bone regeneration in rabbit's maxillary sinuses with blood clots alone, Bio-Oss, β-tricalcium phosphate (β-TCP), and demineralized tooth dentin (DTD) grafting. Bilateral sinus augmentation procedures were performed in 18 adult male rabbits. Rectangular replaceable bony windows were made with a piezoelectric thin saw insert. In the group 1, blood clots were filled; group 2, anorganic bovine graft (Bio-Oss) was grafted; group 3, β-TCP was grafted; group 4, DTD was grafted, and covered by replaceable bony windows. Animals were sacrificed at 2, 4, and 8 weeks after surgical procedure. The augmented sinuses were evaluated by histomorphometric analysis using hematoxylin and eosin and Masson's trichrome stains. Histologically, new bone formation was revealed along the elevated sinus membrane and all graft materials. The new bone area of the group 2 was significantly greater than the group 1, and of the group 3 was significantly greater than the group 2, and of the group 4 was significantly greater than the group 3 at 8 weeks with P < 0.05. The bone marrow area of group 1 was significantly greater than other groups at 8 weeks. The DTD area was significantly lesser than Bio-Oss or β-TCP particles area at 8 weeks. This present study suggests that DTD can be effective graft materials for bone regeneration of the maxillary sinus augmentation.
Adult ; Animals ; Bone Marrow ; Bone Regeneration ; Coloring Agents ; Dentin ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Male ; Maxillary Sinus* ; Membranes ; Osteogenesis ; Rabbits ; Tooth ; Transplants*

OBJECTIVES: This study was conducted to investigate the association between health risk factors and mortality in Juam cohort. METHODS: The subjects were 1,447 males and 1,889 females who had been followed up for 68.5 months to 1 January 2001. Whether they were alive or not was confirmed by the mortality data of the National Statistical Office. A total of 289 persons among them died during the follow-up period. The Cox's proportional hazard regression model was used for survival analysis. RESULTS: Age, type of medical insurance, self cognitive health level, habit of alcohol drinking, smoking, exercise and BMI level were included in Cox's proportional hazard model by gender. The hazard ratio of age was 1.07(95% CI: 1.05-1.10) in men, 1.09(95% CI: 1.06-1.12) in women. The hazard ratio of medical aid(lower socioeconomic state) was 1.43(95% CI 1.02-2.19) in women. The hazard ratios of current alcohol drinking and current smoking were respectively 1.69(95% CI: 1.01-2.98), 1.52(95% CI: 1.02-2.28) in women. The hazard ratio of underweight was 1.56(95% CI 1.08-2.47) in men. The hazard ratios of underweight, normoweight, overweight, and obesity were respectively 1.63(95% CI: 1.02-2.67), 1.0(referent), 0.62(95% CI: 0.32-1.63), 1.27(95% CI: 0.65-3.06), which supported the U-shaped relationship between body mass index and mortality among the men over 65. CONCLUSIONS: The health risk factors increasing mortality were age, underweight in male, age, lower socioeconomic state, current alcohol drinking, current smoking in female. To evaluate long-term association between health risk factors and mortality, further studies need to be carried out.
Alcohol Drinking ; Body Mass Index ; Cohort Studies* ; Female ; Follow-Up Studies ; Health Status ; Humans ; Insurance ; Male ; Mortality* ; Obesity ; Overweight ; Proportional Hazards Models ; Risk Factors* ; Smoke ; Smoking ; Thinness