Ossifying fibroma is not a well recognized entity, and only rarely affects the long bones. The main differential diagnosis is with fibrous dysplasia and with adamantinoma, non-ossifying fibroma of the long bone. Ossifying fibroma seldom has even a moderate tendency to progress during childhood, but it recurs frequently after curettage or subperiosteal resection. Any progression of the lesion comes to an end after puberty. So, surgery should be delayed as long as possible. But, if the lesion is rapidly progressive, or if a patient has repeated fractures, it would be necessary to resort to wide extraperiosteal resection. We have experienced 7 cases of ossifying fibroma from Octover 1979 to November 1988. The results were as follows; 1. The male and female ratio, was 5 to 2 and six patients were at their first decade, and one patient was 13 years old. 2. The lesion site was six cases in the tibia, one case in the fibula. 3. In six patients, we had done wide resection with free-vasculaized fibular graft in five cases and wide resection of the distal one-third of the fibula in one case. Two patients among them had recurrence. One case of recurrence was performed incomplete wide resection with free vascularized fibular graft because the lesion was too close to the distal epiphysis of the tibia.
Adamantinoma ; Adolescent ; Curettage ; Diagnosis, Differential ; Epiphyses ; Female ; Fibroma ; Fibroma, Ossifying ; Fibula ; Health Resorts ; Humans ; Male ; Puberty ; Recurrence ; Tibia ; Transplants

The diagnosis of internal jugular vein thrombosis (IJVT), a vascular disorder, can be easily overlooked. Disruption of blood flow through the internal jugular vein can take place in a variety of clinical settings. CT and ultrasonography are useful diagnostic tools. Recently, we experienced a case of IJVT after deep neck infection. This case showed sore throat, odynophagia and swelling of right submandibular area. CT scan revealed diffuse neck swelling and incomplete occlusion of the right internal jugular vein at the thyroid level. Treatment began with antibiotics and hydration. We present a case of IJVT after deep neck infection with literature review.
Anti-Bacterial Agents ; Diagnosis ; Jugular Veins* ; Neck* ; Pharyngitis ; Thrombosis* ; Thyroid Gland ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND: Quality control is important for accurate diagnosis of human immunodeficiency virus (HIV) infection, and proficiency testing with external quality controls is an important part of quality control. This study intended to develop and supply customized external quality controls for HIV antigen/antibody testing fitted with currently used reagents for standardization of HIV infection diagnosis and evaluation of HIV testing competency of laboratories in Korea. METHODS: Serological tests and inactivation were performed on the obtained HIV antibody positive plasma. To manufacture quality controls having the required antibody titers, dilution ratio was searched using VIDAS (bioMérieux, France), Architect (Abbott Laboratories, USA), and Cobas 8000 (Roche Diagnostics, Germany) analyzers. Diluted source plasma was divided into aliquots after filtering. Homogeneity and stability of the produced external quality controls were evaluated. RESULTS: The collected HIV antibody positive plasma was confirmed by Western blot. Dilution ratios for source plasma were produced for each analyzer showing signal-to-cut-off 2–3, 5–7, and 15–16 reactivity. Diluted plasma was made to 1 mL aliquots and total set of 1,500 external quality controls for HIV antigen/antibody were manufactured. Produced controls satisfied the required criteria of homogeneity and showed less than 10% coefficient of variation for stability except negative controls. CONCLUSIONS: Customized external quality controls were developed and qualified for HIV testing reagents used in Korea. Continuous external quality control assessment for HIV tests with controls would be required.
Blotting, Western ; Diagnosis ; HIV Infections ; HIV* ; Humans* ; Indicators and Reagents ; Korea* ; Plasma ; Quality Control* ; Serologic Tests

PURPOSE: The aneurysmal aortitides could be classified into 4 categories by clinical features, and each category has a different principle of treatment and prognosis. The purposes of this study were 1) to classify the CT findings of the aneurysmal aortitides by the 4 categories-aortic aneurysm, aortic dissection, penetrating atheromatous aortic ulcer, and annuloaortic ectasis, and 2) to evaluate the complications of each category. MATERIALS AND METHODS: We reviewed the CT findings of 33 cases of aneurysmal aortitides, and classified them into the above-mentioned 4 categories. Thirty-two patients were examined with CT with or without ultrasound, angiography, echocardiography, or MRI. Among them, 15 cases were confirmed with operation and the rest were diagnosed with radiologic and clinical findings. RESULTS: There were 17 aortic aneurysms, 9 aortic dissections, 4 penetrating atheromatous aortic ulcers, and 3 annuloaortic ectases. Aortic rupture, the most serious complication of aortitides, occurred in 9 cases. The causes of the rupture were aortic dissection, aneurysm, and penetrating aortic ulcer in descending order of frequency. The most frequent site of rupture was retroperitoneum. CONCLUSION: Using CT with or without other diagnostic tools, we could classify the aneurysmal aotitides into 4 categories and evaluate the complications.
Aneurysm* ; Angiography ; Aortic Aneurysm ; Aortic Rupture ; Aortitis* ; Classification* ; Echocardiography ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Rupture ; Ulcer ; Ultrasonography

Our experience includes seven cases of ossifying fibroma. The condition also appears in the literature under diagnostic names such as congenital fibrous dysplasia, congenital osteitis fibrosa, congenital fibrous defect of the tibia, and osteofibrous dysplasia of the tibia and fibula. The lesions develop in childhood and are located in the diaphysis of the tibia, or fibula. Of seven patients, we performed wide excision with free vascularized fibular graft in five cases, wide resection of the distal one-third of the fibula in one case, and curettage and bone graft in one case. Two of the patients who had wide excision with free vascularized fibular graft had recurrence. One case of recurrence occurred where incomplete wide excision with free-vascularized fibular graft was performed because the lesion was too close to the distal epiphysis of the tibia. One of the patients who had curettage and bone graft also had recurrence. It was concluded that children who have an ossifying fibroma requiring surgery can safely be treated with wide excision with or without free-vascularized fibular graft.
Adolescent ; Bone Neoplasms/diagnosis/pathology/*surgery ; Case Report ; Child ; Female ; Fibroma/diagnosis/pathology/*surgery ; Human ; Male ; Osteoma/diagnosis/pathology/*surgery ; Tibia

BACKGROUND: Pulse wave velocity (PWV) and pulse transit time (PTT) are influenced by the arterial wall stiffness and compliance. Also, the PTT is dependent on blood pressure changes that can be accompanied by the anesthesia. The simply measured PTT has difficult to discriminate the arterial compliance changes from blood pressure changes. Therefore, we investigated that the differences of PTT between toe and finger as an independent parameter on blood pressure. METHODS: Eighteen patients scheduled for elective lower abdominal gynecologic surgery were studied. General anesthesia was achieved with sevoflurane and epidural block was done with 0.2% ropivacaine and fentanyl 100microgram via epidural catheter inserted into L1 - L2 epidural space. PTT was measured in a finger (PTTf) and a toe (PTTt) by the time difference between the ECG R wave and the pulse wave of PPG. Blood pressure and PTT was measured at three instances such as preinduction (Pre), 5 minutes after intubation (Int5) and 30 minutes after injection of epidural dose (Epi). The time delay of PTT between toe and finger (PTTt-f) was measured. RESULTS: PTTf and PTTt was prolonged at Int5 and Epi. But the PTTt-f was not different between the Int5 and Epi because of prolonged PTTf caused by the blood pressure decrement after the epidural block. CONCLUSIONS: PTTf, PTTt and PTTt-f can be a one of the convenient measurement of the arterial compliance but it was suggested that there need to be a parameter less dependent on the blood pressure changes.
Anesthesia ; Anesthesia, Epidural* ; Anesthesia, General ; Blood Pressure ; Catheters ; Compliance ; Electrocardiography ; Epidural Space ; Female ; Fentanyl ; Fingers* ; Gynecologic Surgical Procedures ; Humans ; Intubation ; Photoplethysmography ; Pulse Wave Analysis* ; Toes*

Lemierre's syndrome is characterized by anaerobic bacterial infection in the head and neck, causing thrombophlebitis of the jugular vein. This disease is usually associated with a history of pharyngitis. The most common pathogens are Fusobacterium species, particularly Fusobacterium necrophorum. Lemierre's syndrome is seen most commonly in teenagers and young adults. We present a case report of a 67-year-old man with an atypical clinical manifestation of an uncommon pathogen in Lemierre's syndrome with epilepsia partialis continua.
Adolescent ; Aged ; Bacterial Infections ; Epilepsia Partialis Continua ; Fusobacterium ; Fusobacterium necrophorum ; Head ; Humans ; Jugular Veins ; Lemierre Syndrome* ; Neck ; Pharyngitis ; Thrombophlebitis ; Venous Thrombosis ; Young Adult

PURPOSE: To evaluate the usefulness of combination therapy composed of percutaneous ethanol injection treatment and subsequent transarterial chemoembolization in the treatment of single nodular hepatocellular carcinoma(HCC). MATERIALS AND METHODS: A total of eight patients with single nodule hepatocellur carcinoma (+/-5cm)were treated with a combination of initial percutaneous ethonol injection therapy(PEIT) and, a week later, transcatether arterial embolization(TAE). CT was performed 3 weeks after TAE to assess whether or not lipidol uptake had occurred. If lipiodol was accumulated in the nodule, the necrotic rate of the tumor was calculated by the following equation: (initially observed tumor volume - volume of nodule in which lipidol uptake occurred)x100/Initially observed tumor volume. Follow-up CT scan was performed every third or fourth month to evaluate tumor growth or recurrence. RESULTS: A nodule in which lipidol uptake occurred was seen in four of the eight patients; in one of these, a tumor-confirmed by angiogaphic examination and laboratory data-recurred twelve months later. The mean necrotic rate of a tumor treated PEIT alone was 83%(range, 37%-100%). CONCLUSION: Although limited in numbers of cases we studied, use of combination therapy composed of PEIT and subsequent TAE, appears to be effective in achieving the high rate of tumor necrosis as well as in the evaluation of the tumor during follow-up.
Carcinoma, Hepatocellular* ; Ethanol* ; Ethiodized Oil ; Follow-Up Studies ; Humans ; Necrosis ; Recurrence ; Tomography, X-Ray Computed ; Tumor Burden

Cerebral Venous Sinus Thrombosis (CVST) in children is rare and its cause is multifactorial. The clinical manifestations of CVST vary and may cause long-term neurological sequelae and even death on rare occasion. In this case, a 15 year old boy presented with severe headache and vomiting for 1 day. Brain MRI with venography revealed multiple lesions of CVST in superior sagittal sinus and the left transverse sinus. Anticoagulation therapy was performed for 3 months, which led to the complete resolution in superior sagittal sinus and partial resolution in left transverse sinus.
Adolescent ; Brain ; Child ; Headache ; Humans ; Phlebography ; Sinus Thrombosis, Intracranial ; Superior Sagittal Sinus ; Vomiting

BACKGROUND & OBJECTIVES: It is widely believed that the post-lumbar puncture headache(PLPH) is related to CSF leakage through the dural hole made by needle tract. So it is accepted that PLPH is prevented by at least 4 hour bed rest after lumbar puncture (LP). If bed rest was unneccessary, the administrative and nursing advantages would be obvious,, especially in neurologic units, whereLP has been done frequently. Therefore, we evaluate the incidence of PLPH in the ambulant and bed-rest patients prospectively and compared the incidence difference between two group. METHODS: Eighty-eight patients without preceding headache who were done lumbar puncture for diagnostic purpose were selected prospectively. We compared the incidence of PLPH between the ambulant (50 patients) and bed-rest group (38 patient,) at 6 hour and 24 hours. We also evaluated the effect of the CSF profile (count of RBC and WBC, protein level and opening pressure) on PLPH. RESULTS: The PLPH was found in 11 cases(12.5%) among bed-rest and ambulant groups. The frequency of each group was 8% (3/38) in bed-rest group and 16%(8/50) in ambulant group, but there is no significant difference between two groups (p-vaIue = 0.26). The frequency of PLPH is also not correlated to the CSF profiles; count of RBC and WBC, protein level, and opening pressure. CONCLUSIONS: There is no significant difference between the ambulant and bed rest group in the frequency of the PLPH. We conclude that the bed rest after LP is unnecessary for the prevention of the PLPH.
Bed Rest* ; Headache ; Humans ; Incidence ; Needles ; Nursing ; Post-Dural Puncture Headache* ; Prospective Studies ; Punctures ; Spinal Puncture