No abstract available.
Child* ; Drug Therapy* ; Graves Disease* ; Humans ; Receptors, Thyrotropin* ; Thyroid Function Tests* ; Thyroid Gland*

Lentigo maligna, a precancerous tumor arising from abnormal melanocytes, is a chronic, slowly progressive, pigmented lesion with a range of colors from pale tan to black and an irregular shape, The commonest location of lentigo maligna is the face during the sixth and seventh decades of life. Less frequently, the lesion occurs on an extrafacial area such as the hand or lower leg. In the late stage, lentigo maligna transforms into invasive malignant melanoma. A 50-year-old male patient had a well-defined, black pigmented patch on the right sole for 30 years. The histopathologic examination revealed numerous vacuolated melanocytes clusters at the dermo-epidermal junction with invasion of the epidermis. There was no evidence of dermal invasion by atypical melanocytes.
Epidermis ; Hand ; Humans ; Hutchinson's Melanotic Freckle* ; Leg ; Lentigo* ; Male ; Melanocytes ; Melanoma ; Middle Aged ; Triacetoneamine-N-Oxyl

BACKGROUND: Obesity is a risk factor of hyperlipidemia, DM, hypertension and cardiovascular diseases. In clinical practice the evaluation of obesity has been done indirectly by anthropomet ric indices such as BMI, waist to hip ratio, waist and hip circumference. This study was attempted to show whether waist circumference is better simple anthropometric index of abdominal obesity and has better correlation of metabolic profile than waist to hip ratio which has been commonly used. METHODS: We gathered 286 cases who have undergone medical examination from May 1997 to July 1997 at Dankook University Hospital and measured BMI, relative ideal body weight by Modified Broca method, waist circumference, waist to hip ratio, metabolic profiles, fasting blood sugar, systolic and diastolic blood pressure. RESULTS: Waist to hip ratio and waist circumference showed high correlation with BMI and Modified Broca index. In men, correlation coefficient of waist circumference and waist to hip ratio with BMI was r=0.761, r=0.467, and correlation coefficient of waist circumference and waist to hip ratio with Modified Broca index was r=0.726, r=0.458. In women, correlation coefficient of waist circumference and waist to hip ratio with BMI was r=0.791, r=0.628, and correlation coeffience of waist circumference and waist to hip ratio with Modified Broca index was r=0.769 r=0.660. This finding showed waist to hip ratio and waist circumference is more closely related to BMI and Modified Broca index in women than men and showed higher correlation with waist circumference than waist to hip ratio. There were significant differences of correlation coefficient of obesity indices between waist circumference and waist to hip ratio (p<0.00001). Waist circumference showed relatively significant correlation with metabolic profiles, but we could not observe high correlation coefficient. But there was significant difference of distribution between normal group and obese group defined as BMI>25 and modified Broca index>120%. CONCLUSION: Waist circumference, index of abdominal obesity has better correlation with obesity indices than waist to hip ratio and is a simpler method.
Blood Glucose ; Blood Pressure ; Cardiovascular Diseases ; Fasting ; Female ; Hip ; Humans ; Hyperlipidemias ; Hypertension ; Ideal Body Weight ; Male ; Metabolome ; Obesity ; Obesity, Abdominal* ; Risk Factors ; Waist Circumference* ; Waist-Hip Ratio

BACKGROUND: Trisomy 16 in mice is considered to be an animal model for Down's syndrome in human. We studied the morphologic characteristics of the heart and the edema, and their significance to the teratogenesis in this animal model. METHODS: A total of 30 dams were sacrificed to bear 125 (61.9%) normal fetuses 35 (17.3%) abnormal fetuses and 42 (20.8%) resorptions. Cytogenetic study and morphological examination were performed using microdissection agar-mount sectioning histologic examination and scanning electron microscope. RESULTS: The crown-rump length was significantly shorter in abnormal (trisomic fetuses) than the normal (eusomic) fetuses. Trisomic fetuses showed massive edema at the back from the vertex to the lumbar area. Four-chamber view section of the agar-mount and histologic section showed a common atrioventricular valve bridging the left and the right atrioventricular junction. Scanning electron microscopic examination on atrioventricular valves showed three types of atrioventricular valves:five cases with common atrioventricular orifice, three cases with partitioned atrioventricular orifice and two cases with atresia of the right atrioventricular orifice. CONCLUSION: This study confirmed the presence of massive edema and cardiac anomalies in the mouse with trisomy 16. But there was morphologic diversity of cardiac anomaly in this model.
Animals ; Crown-Rump Length ; Cytogenetics ; Down Syndrome ; Edema* ; Endocardial Cushion Defects ; Fetus* ; Heart ; Humans ; Hydrops Fetalis ; Mice ; Microdissection ; Models, Animal ; Pathology* ; Teratogenesis ; Trisomy*

No abstract available.

PURPOSE: The aim of this study was to evaluate the long term therapeutic results and complications of an anterior vaginal wall sling (AVWS) for female patients with stress urinary incontinence (SUI) followed up for over 3 years. MATERIALS AND METHODS: We analyzed 23 of 43 patients who could have been followed up for more than 3 years following an AVWS operation. The mean follow-up period was 40.2+/-5.3 months. The cystography and urodynamic study, including preoperative valsalva leak point pressure and subjective SEAPI scores, were examined in the patients. Postoperative analyses, including subjective SEAPI scores, success rates, satisfaction and complications were performed 3 years following the operations. RESULTS: The total preoperative subjective SEAPI score of 6.1+/-3.4 decreased postoperatively to 1.4+/-1.5 (p<0.001). Twenty one patients (91.3%) answered as "completely resolved" and one patient (4.3%) as "improved". Of the 12 patients accompanied by urgency preoperatively, 8 were completely improved directly following the operation, but the remaining 4 suffered longstanding urgency. De novo urgency occurred in 3 patients, but they all improved within 3 months with conservative management. Five patients (21.7%) suffered from postoperative inguinal pain, which improved in 4 after 3 months, an in about 9 months in the other. Subjective satisfaction exceeding 3 years following the operation was "very satisfactory" in 22 patients (95.6%). CONCLUSIONS: After more than 3 years, the 3 year follow-ups after AVWS operations in female patients with SUI showed a high success rate, high patient subjective satisfactions and reasonable complications. We think that an AVWS operation is an effective therapeutic procedure for female patients with SUI.
Female* ; Follow-Up Studies* ; Humans ; Urethra ; Urinary Incontinence* ; Urodynamics ; Vagina

PURPOSE: The Suprapubic Arc (SPARC) procedure has recently been introduced as a new surgical treatment option for stress urinary incontinence in women. We have reported our early results of SPARC procedures. MATERIALS AND METHODS: A total of 23 patients received SPARC procedures at our hospital between November 2002 and August 2003. All the patients were evaluated with history taking, physical examination, urodynamic study and cystography preoperatively. The procedure was carried out under IV propofol or spinal anesthesia. The enrolled patients were followed-up for more than 3 months postoperatively. The cure rate was evaluated and perioperative and postoperative complications were assessed. RESULTS: The mean age of the patients was 48.8 years (ranges from 32 to 67 years) and eight patients had past history of previous abdominal or pelvic surgery. The mean hospital stay was 1.9 days (ranges from 1 to 7 days). Mean follow-up period was 7.9 months (ranges from 3.7 to 14.0 months). Nineteen of the 23 patients (82.6%) were completely cured and 2 patients (8.7%) were much improved, hence the total success rate of the procedure was 91.3%. Bladder perforation during procedure occurred in 7 patients (30.4%) but conservative management sufficed. No serious complication was occurred. CONCLUSION: Our early results show that the SPARC procedure is a effective treatment option for the management of stress urinary incontinence. But we suggest that surgeons should be careful to avoid the bladder injury especially in their early period of experience.
Anesthesia, Spinal ; Female* ; Follow-Up Studies ; Humans ; Length of Stay ; Physical Examination ; Polypropylenes ; Postoperative Complications ; Propofol ; Urinary Bladder ; Urinary Incontinence* ; Urodynamics

Purpose: The diagnostic usefulness of fetal echocardiography in congenital heart disease is well known. One of the indications for fetal echocardiography is presence of extracardiac anomalies and such coexistent congenital heart disease may have important implications for obstetric and neonatal management. MATERIALS AND METHODS: 496 women with singleton pegnancies with amgenital anomalies that underwent penatal care and follow-up in Severance Hospital for 5 years from 1991 to 1995 were evaluated for the incidence of congenital heart disease. RESULTS: The incidence of congenital heart disease in fetuses with the associated extracardiac anomalies were as follows; central nervous system 6.9%(11/160), gastro-intestinal system 10.7%(8/75), genito-urinary sysem 4.7%(4/85), others 5.6%(4/72). Thirty-one of eighty-ane fetuses with congenital heart disease were found to have the associated extracardidac anomalies and ten of them chenoscenal abnormalities. CONCLUSION: We recommend that fetuses with congenital extracardiac anomalies sbould be checked for the presence of congenital heart disease and chmmosomal abnormalities, if needed.
Central Nervous System ; Echocardiography ; Female ; Fetus ; Follow-Up Studies ; Heart Defects, Congenital* ; Humans ; Incidence

PURPOSE: This study was undertaken to determine the adequate cutoff value of the neonatal screening test to decrease recall and false-positive rates. METHODS: During the period of January 1999 through December in Asan Medical Center, newborn screening tests for phenylketonuria, congenital hypothyroidism, congenital adrenal hyperplasia, and galactosemia were performed in 3,775, 3,707, 3,783, and 3,806 newborns respectively using commercial ELISA kits. We reviewed and analyzed the recall rate at currently used cutoff values. RESULTS: 1)In neonatal screening test for congenital hypothyroidism, using a current cutoff value, 17 microIU/mL, the recall rate was 0.9% and using a 99.7% cutoff value, 21.3 microIU/mL, the predictive recall rate was 0.4%. There were no significant differences in the other reports that suggest adequate recall rate. 2)In neonatal screening test for phenylketonuria, using a current cutoff value, 3.6 mg/dL, the recall rate was 1.5% which was no significant difference compared with expected presumptive positive rate, 1.44%. 3)In neonatal screening test for congenital adrenal hyperplasia and galactosemia, the recall rate was high when using current cutoff value. But all results were within normal limits in reevaluation. CONCLUSION: The cutoff values of screening test which are currently recommended by manufacturers of commercial kits for congenital hypothyroidism, congenital adrenal hyperplasia and galactosemia, are needed to be reset to decrease the recall rate by false-positive results on the basis of data from an individual newborn screening laboratory.
Adrenal Hyperplasia, Congenital ; Chungcheongnam-do ; Congenital Hypothyroidism ; Enzyme-Linked Immunosorbent Assay ; Galactosemias ; Humans ; Infant, Newborn ; Mass Screening ; Neonatal Screening* ; Phenylketonurias

Although studies on malrotation of the humerus possibly leading to dysfunction of the shoulder have been reported, studies on its causes are inadequate. The authors encountered a patient complaining of malrotation accompanied by dysfunction of the shoulder which occurred during treatment of a distal humeral fracture. The patient recovered the shoulder function by only correcting malrotation of the humerus without direct treatment on the shoulder, and we report it herein with a review of the literature.
Humans ; Humeral Fractures ; Humerus* ; Shoulder*