The clinical and pathological features of trichoadenoma are presented. Trichoadenoma is very rare, and as far as we know, no report on the trichoadenoma has been published in korea literature. We experienced a case of trichoadenoma occured in a 29 year-old male, who had a 0.9x0.7x0.4cm sized and slowly growing mass in the right buttock. The histopathological findings and histogenesis of trichoadenoma were discussed and a brief review of the literature was made.

Four total knee arthroplasties were performed in 3 patients with the diagnosis of classical Charcot's joints associated with syphilis during past 4 years from 1985 to 1988. All patients had positive reaction in serology test(VDRL, TPHA). We corrected the bone loss and severe joint instability with allograft or autogenous bone grafting and ligament balancing. The knee score was increased from preoperative 37 points to postoperative 87.3 points. We expect that total knee arthroplasty may be the alternative treatment to the conservative treatment or knee arthrodesis in Charcots joints.
Allografts ; Arthrodesis ; Arthropathy, Neurogenic ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Bone Transplantation ; Diagnosis ; Humans ; Joint Instability ; Knee ; Ligaments ; Syphilis

The Kaposi's sarcoma, which was found in an immunosuppressed patient of renal transplantation, may have been developed by long term use of immunosuppressant agent after the renal transplantation. The case was a 29-year-old woman who was diagnosed as chronic renal failure in 1988, and since then, she had been on CAPD until May, 1997. After the renal transplantation in May 1997, the patient has been prescribed cyclosporin and prednisone as immunosuppressant agent. In June 1997, she showed clinical symptom of Kaposi's sarcoma with multiple papules and nodules in the skin and viscera, such as ureter, urinary bladder, stomach, duodenum and subcutaneous tissue of the chest. Multiple excisional biopsies were carried out in the skin, ureter, urinary bladder, stomach and duodenum. All of excisional biopses indicated nodular stages with extensive proliferation of spindle shaped, somewhat pleomorphic cells which have slit-like vascular spaces, proliferation of small vessels, and extravasation of erythrocytes. These lesions nearly diminished after sytemic chemotherpy, excision and discontinuity of immunosuppressive agents.
Adult ; Biopsy ; Cyclosporine ; Duodenum ; Erythrocytes ; Female ; Humans ; Immunosuppressive Agents ; Kidney Failure, Chronic ; Kidney Transplantation ; Peritoneal Dialysis, Continuous Ambulatory ; Prednisone ; Sarcoma, Kaposi* ; Skin ; Stomach ; Subcutaneous Tissue ; Thorax ; Ureter ; Urinary Bladder ; Viscera

The Kaposi's sarcoma, which was found in an immunosuppressed patient of renal transplantation, may have been developed by long term use of immunosuppressant agent after the renal transplantation. The case was a 29-year-old woman who was diagnosed as chronic renal failure in 1988, and since then, she had been on CAPD until May, 1997. After the renal transplantation in May 1997, the patient has been prescribed cyclosporin and prednisone as immunosuppressant agent. In June 1997, she showed clinical symptom of Kaposi's sarcoma with multiple papules and nodules in the skin and viscera, such as ureter, urinary bladder, stomach, duodenum and subcutaneous tissue of the chest. Multiple excisional biopsies were carried out in the skin, ureter, urinary bladder, stomach and duodenum. All of excisional biopses indicated nodular stages with extensive proliferation of spindle shaped, somewhat pleomorphic cells which have slit-like vascular spaces, proliferation of small vessels, and extravasation of erythrocytes. These lesions nearly diminished after sytemic chemotherpy, excision and discontinuity of immunosuppressive agents.
Adult ; Biopsy ; Cyclosporine ; Duodenum ; Erythrocytes ; Female ; Humans ; Immunosuppressive Agents ; Kidney Failure, Chronic ; Kidney Transplantation ; Peritoneal Dialysis, Continuous Ambulatory ; Prednisone ; Sarcoma, Kaposi* ; Skin ; Stomach ; Subcutaneous Tissue ; Thorax ; Ureter ; Urinary Bladder ; Viscera

Diabetic nephropathy is a common complication of diabetes mellitus and is the leading cause of chronic kidney disease. Glycemic and blood pressure control constitute the main strategies of diabetic nephropathy prevention and treatment. However, despite current therapies, nephropathy progresses to renal failure and end-stage renal disease in many patients. Therefore, new therapeutic strategies targeting different pathophysiological mechanisms are needed. This review article briefly summarizes the standard therapy for diabetic nephropathy and also describes recent advances in potential renoprotective agents that could be used to prevent the development or progression of diabetic nephropathy.
Blood Pressure ; Diabetes Mellitus ; Diabetic Nephropathies* ; Humans ; Kidney Failure, Chronic ; Renal Insufficiency ; Renal Insufficiency, Chronic

BACKGROUND/AIMS: A self-report questionnaire is frequently used to measure symptoms reliably and to distinguish patients with functional gastrointestinal disorders (FGIDs) from those with other conditions. We produced and validated a cross-cultural adaptation of the Rome III questionnaire for diagnosis of FGIDs in Korea. METHODS: The Korean version of the Rome III (Rome III-K) questionnaire was developed through structural translational processes. Subsequently, reliability was measured by a test-retest procedure. Convergent validity was evaluated by comparing self-reported questionnaire data with the subsequent completion of the questionnaire by the physician based on an interview and with the clinical diagnosis. Concurrent validation using the validated Korean version of the Short Form-36 Health Survey (SF-36) was adopted to demonstrate discriminant validity. RESULTS: A total of 306 subjects were studied. Test-retest reliability was good, with a median Cronbach's alpha value of 0.83 (range, 0.71-0.97). The degree of agreement between patient-administered and physician-administered questionnaires to diagnose FGIDs was excellent; the kappa index was 0.949 for irritable bowel syndrome, 0.883 for functional dyspepsia and 0.927 for functional heartburn. The physician's clinical diagnosis of functional dyspepsia showed the most marked discrepancy with that based on the self-administered questionnaire. Almost all SF-36 domains were impaired in participants diagnosed with one of these FGIDs according to the Rome III-K. CONCLUSIONS: We developed the Rome III-K questionnaire though structural translational processes, and it revealed good test-retest reliability and satisfactory construct validity. These results suggest that this instrument will be useful for clinical and research assessments in the Korean population.
Dyspepsia ; Gastrointestinal Diseases* ; Health Surveys ; Heartburn ; Humans ; Irritable Bowel Syndrome ; Surveys and Questionnaires*

PURPOSE: To demonstrate activation signals within the cerebellar cortex and to determine the side of thecerebellar cortex eliciting activation signals in response to complex motor tasks, as seen on EPI fMRI MATERIALS AND METHODS: Seven right-handed subjects (M:F=3:4;mean age, 30.3 years) underwent repetitive finger appositionwith the dominant right hand. Using a 1.5T MRI scanner, EPI fMR images were obtained. MR parameters used for EPIfMRI were TR/TE/Flip angle : 0.96 msec/64 msec/90 degree, FOV 22cm, 128 X 128 matrix, 10 slices, 10mm thickness whilethose for SE T1 weighted localized images were TR/TE : 450/16, FOV 23cm, 256 X 256 matrix. The paradigm was threesets of alternate resting and moving fingers for six cycles, resulting in times of 360 seconds (10 slices X 15 EPIX 6 cycles = 900 images). Image processing involoved the use of a 200mHz Dual Pentium PC with homemade software.T-testing (p<0.005) and time series analysis were performed, and to verify the locations of activated regions,resulting images were analyzed in a color-coded overlay to reference T1-weighted spin echo coronal images.percentage change in signal intensity (PCSI) was calculated from the processed data. RESULTS: All normal subjectsshowed significant activation signals in both the contralateral (left) primary motor cortex (PCSI=3.12%+/-0.96) andipsilateral (right) cerebellar cortex (PCSI=3.09%+/-1.14). Signal activation was detected in the contralateralsupplemental motor area (2.91%+/-0.82), and motor activation in the anterior upper half of the contralateralcerebellum (PCSI=2.91%+/-0.69). The difference in activation signals between both sides of the cerebellar cortexwas not statistically significant. All data were matched with time-series analysis. CONCLUSION: Bilateralcerebellar activation is associated with unilateral complex finger movements, as seen on fMRI. This result maysupport the recent neurological observation that the cerebellum may exert bilateral effects on motor performance.
Cerebellar Cortex ; Cerebellum* ; Fingers ; Hand ; Magnetic Resonance Imaging* ; Motor Cortex

Renovascular hypertension caused by renal artery stenosis is an uncommon but curative cause of hypertension in children. We report a case of recurrent severe hypertension caused by renovascular hypertension. After recurrence of hypertension after redo percutaneous transluminal renal angioplasty, the blood pressure was finally controlled by renal autotransplantation. This case demonstrates the importance of considering renovascular hypertension as a cause of severe hypertension in children. Also, renal autotransplantation should be considered as a viable treatment option for treatment of renovascular hypertension that is recurrent after renal angioplasty.
Angioplasty ; Blood Pressure ; Child ; Humans ; Hypertension ; Hypertension, Renovascular* ; Recurrence ; Renal Artery ; Renal Artery Obstruction ; Transplantation*

OBJECTIVE: The purpose of this study was to review the incidence, types, chemotherapy regimens, operation methods, pregnancy rate and propiosis of the ov#arian malignancy under the age of twenty years old. METHODS: Retrospective reviews of the medical recordings for 22 patients with ovarian malignancy under the age of twenty years old in the Department of Obstetrics and Gynecology, Hanyang University from 1986 to 1997 were done. RESULTS: Gerin cell tumor accounts for the majority of cases (77%), whereas 5 patients(23%) belong to the common epithelial poup which were all mucinous type. Our experiences with 22 cases are as followings: 5 mucinous cystadenocarcinoma, 8 immature teratoma, 4 endodermal sinus tumor, 3 dysgernma and 2 mixed germ cell tumor. The incidence of this group was 8.2% (22/266) in all ovarian malignancy. Fourteen of them are stage I, each one is, stage II and IV, and six patients are stage III. The average age was 14.9 years old in germ cell tumor and 18.4 yems old in mucinous cystadenoearcinoma. Malignant ovarian cancer under the age of twenty can be treated with conservative surgery, followed by adjuvant chemotherapy. Commonly used chemotherapeutic regimens were VAC(Vincristine, Actinomycin-D; Cyclophosphamide), VBP(Vinblastine, Bleomycin, Cisplatin) and BEP(Bleomycin, Etoposide, Cisplatin). Second look operations were done in 11 patienth and histologic positive findings were detected in 4 of them. The length of follow-up ranged ftom 3 months to 137 months and median value was 44 rnonths. CONCLUSIONS: It is concluded that for young women who wish to preserve child-bearing capacity, regardless of the stage of the tumor, fertility preserving surgery with complete surgical staging, if necessary followed by combination chemotherapy is an appropriate treatment.
Bleomycin ; Chemotherapy, Adjuvant ; Cystadenocarcinoma, Mucinous ; Drug Therapy ; Drug Therapy, Combination ; Endodermal Sinus Tumor ; Etoposide ; Female ; Fertility ; Follow-Up Studies ; Gynecology ; Humans ; Incidence ; Medical Records ; Mucins ; Neoplasms, Germ Cell and Embryonal ; Obstetrics ; Ovarian Neoplasms ; Pregnancy Rate ; Retrospective Studies ; Teratoma

Coronary artery fistula is an unusual anomaly that consists of a communication between one of the coronary arteries and a cardiac chamber or vein. It has hemodynamic significance, complicated by congestive heart failure, bacterial endocarditis, rupture or thrombosis of the fistula or an associated arterial aneurysm, myocardial ischemia, and arrhythmias. It occurs in congenital, traumatic, neoplastic, or artherosclerotic cardiac disorders. It is being diagnosed with increasing frequency with widespread use of selective coronary angiography. However, acquired coronary artery fistula after acute myocardial infarction is a rare clinical entity, and it has not been reported in Korea yet. We observed a 62-year-old male patient with intermittent chest pain at rest, in whom serial coronary angiography showed newly developed communications from the left anterior descending coronary artery to the left ventricular chamber several months after acute myocardial infarction of the anteroseptal wall. The area of communication corresponded to the site of infarction as established by contrast echocardiography.
Aneurysm ; Arrhythmias, Cardiac ; Chest Pain ; Coronary Angiography ; Coronary Vessels* ; Echocardiography ; Endocarditis, Bacterial ; Fistula* ; Heart Failure ; Heart Ventricles* ; Hemodynamics ; Humans ; Infarction ; Korea ; Male ; Middle Aged ; Myocardial Infarction* ; Myocardial Ischemia ; Rupture ; Thrombosis ; Veins