A case of Prader - Willi syndrome / 대한내과학회지

Chronic cough is defined as a cough that lasts for more than three weeks. In most patients, chronic cough is caused by four conditions: postnasal drip, asthma, chronic bronchitis, gastroesophageal reflux. Psychogenic chronic cough is not a frequent disorder. Furthermore, chronic vocal tic disorder is a very rare cause of chronic dry cough. A 22- year-old male suffered from chronic dry cough for last two years. His character showed obsessive- compulsive disorder. He has been shrugging both shoulders inadvertently since his childhood. Consequently, he was diagnosed as having chronic motor tic disorder. But after contracting respiratory tract infection, his motor tic disappeared and chronic dry cough was developed concomitantly. He had no history of smoking, chronic rhinitis, sinusitis, asthma, and gastroesophageal reflux. Physical examinations were normal. Chest X-ray, paranasal sinus view, metacholine bronchial provocation test, and esophago-gastroscopy were normal. Chronic cough was never relieved despite empirical treatment. Psychiatric consultation suggested chronic vocal tic disorder. The frequency of cough was diminished two days after administeration of valium and haloperidol and thereafter his complaint disappeared in one month. Here we report a very rare case of chronic motor tic disorder which was transformed into chronic vocal tic disorder presenting as a chronic cough. As far as we know, this is the first case of its kind in Korea.

Clinical Evaluation of Patients with Unilateral Non-functioning Kidney on 99mTc-DMSA scan

The authors report 16 cases of mediastinal fine-needle aspiration cytology from Jan. 1985 to Mar. 1988 at the Seoul National University Hospital. Among them, diagnostic material were obtained in fifteen cases, establishing the dia- gnosis of 7 thymomas, 2 germinomas, 2 neurogenic tumosr, 1 lymphoma, and 3 meastatic carcinomas. The 9 cytologic diagnoses could be confirmed by histologic examination in 8 patients and by another cytologic method in one patient, allowing concordance rate of 77%.

A Case of Thyrotropin - Secreting Pituitary Adenoma with Normal alpha-subunit / TSH Molar Ratio / 대한내과학회지

Thyrotropin(TSH)-secreting pituitary adenoma is a rare disorder causing hyperthyroidism, which is one of the syndrome of inappropriate secretion of TSH. It is characterized by high serum T4, T3 as well as elevated serum TSH. Generally serum free alpha-subunit concentration is also increased and alpha- subunit/TSH molar ratio is more than 1. This alpha- subunit/TSH molar ratio is a clue of diagnosis as well as a useful marker of therapeutic response. We experienced a case of 29-years old man with hyperthyroidism due to TSH-secreting pituitary adenoma. He was underwent 1.5cm sized pituitary tumor removal via transsphenoidal approach in our neurosurgery department. In immunohistochemical stain monotonous tumor cells showed strong positive reaction to antihuman TSH antibody and equivocal reaction to ACTH antibody. After operation, goiter size was progressively decreased and also serum T4, T3 and TSH were decreased in nearly normal range. However, he showed elevated serum T4, T3 and TSH after 1 month due to residual tumor. So he received radiation therapy thereafter. In this case the alpha-subunit and alpha-subunit/TSH molar ratio were not increased. So we report a case of TSH-secreting pituitary macroadenoma which had low alpha-subunit/TSH molar ratio with a literature review.

Successful Transplantation of 3 Cases of Oligomeganephronia

"We retrospectively reviewed the results of 1,850 fine needle aspiration cytology (FNAC) of thyroid nodules performed from 1990 to 1991 in the Department of Pathology, Seoul National University Hospital. Among 1,528 cases and 322 cases aspirated by clinicians and a pathologist, 465 cases (30.4%) and 13 cases (4.0%) of the aspirates were inadequate, respectively. In 227 cases, correlation of the FNAC diagnosis and histologic diagnosis was done. Excluding the inadequate cases, the sensitivity for the detection of neoplasm (malignancy together with follicular adenoma) was 86.4% and the specificity was 70.7%. The overall diagnostic accuracy was 79.0%. There were 16 false-positive cases (7.0%), and 19 false-negative cases (8.4%). The predictive value of each cytologic diagnosis was 92% in papillary carcinoma, and 100% in Hashimoto's thyroiditis. The expectancy of malignancy was 52.8% in ""suspicious malignancy"" and 26.7% in ""atypical lesion""."

Ectopic Pancreas of Stomach in a Child with Recurrent Abdominal Pain

Ectopic pancreas is a rare congenital anomaly defined by the presence of pancreatic tissue that lacks anatomic and vascular continuity with the main body of the pancreas. A 11-year-old girl was admitted to the Department of Pediatrics, Yonsei University College of Medicine with the history of recurrent abdominal pain for 2 years. We performed fiberoptic endoscopy which showed a 1.5x1.5cm sized polypoid mass, and endoscopic polypectomy was performed. The diagnosis of ectopic pancreas of stomach was made by histologic examination which showed the normal gastric mucosa with the lobulated pancreatic tissue in the submucosa. The child did not have any recurrence of abdominal pain during follow-up period of one year after polypectomy. Ectopic pancreas of stomach is known to be very rare, and thus we report this case with the presentation of endoscopic and pathologic findings.

A Case of Choledochal Cyst with Anomalous Pancreaticobiliary Ductal Union

Choledochal cysts are congenital or acquired lesions of the biliary tree with a cystic dilatation of the bile duct. We experienced a choledochal cyst accompanying acute pancreatitis caused by anomalous pancreaticobiliary ductal union (APBDU) in a 2 year old boy. The choledochal cyst associated with APBDU is rarely encountered in the clinical field, and thus we report this case with the presentation of abdominal ultrasonogram, computed tomogram, and intraoperative cholangiogram. A brief review of choledochal cyst associated with APBDU is also presented.