Leiomyomatosis peritonealis disseminata is a rare benign condition characterised by the occurrence of multiple leimyomas scatterred throughout the peritoneal cavity, giving the clinical impression of a wide spread malignant tumor. The histopathology of leiomyomatosis peritonealis disseminata is that of a benign leiomyoma, probably originating from the multipotent subcoelomic mesenchymal cells. Three cases with malignant transformation were described among previous reported fifty cases. Many of the early reports described the disorder in premenopausal women, and now the histogenesis is considered to be a metaplastic change by abnormal tissue response to the relatively or absolutely elevated female sex hormone. We report a case of leiomyomatosis peritonealis disseminata, which was diagnosed by multiple scattered submucosal and subseroal leimyomas of stomach, small bowel and colon, combined with advanced gastric cancer in a 58 years old man, Multiple submucosal tumors of the stomach combined with advanced gastric cancer were demonstrated by fibergastroscopy, upper gastrointestinal barium study and abdominal ultrasonography. During radical subtotal gastrectomy multiple submucosal and subserosal tumors of stomach, and subserosal tumors of small bowel and colon were observed and these tumors were confirmed as leiomyoma without malignant potential.
Barium ; Colon ; Female ; Gastrectomy ; Humans ; Leiomyoma ; Leiomyomatosis ; Middle Aged ; Peritoneal Cavity ; Stomach ; Stomach Neoplasms* ; Ultrasonography

No abstract available.
Eosinophilia*

No abstract available.

Strongylodiasis is universal in distribution but is most abundant in countries with a tropical climate. Although infestation by Strongyloides stercoralis is usually limited to the intestines, dessemination of this helminth in debilitated host can be lead to death with various clinical disorders. characterized by profound malabsorption, diarrhea, electrolyte imbalance, gram negative or opportunistic fungal sepsis, coma and death. Cell-mediated immunity contributing significantly to the control of helminthic infections, may be suppressed by carcinoma, immunosuppressive chemotherapy and use of corticosteroids. Diagnosis of Strongyloidiasis is achieved by an examination of samples of feces, duodenal aspirates and sputum of patients for Strongyloides stercoralis. Treatment of strongyloidiasis is twofold : correction of the immunosuppressive state by withdrawal of immunosuppressive drug, if possible, and vigorous treatment with thiabendazole. Testing for strongyloidiasis is especially recommanded before treating a patients should be monitored for infection by Strongyloides stercoralis and other opportunistic infection. We are reporting a case patient with Strongyloides stercoralis hyperinfection and pulmonary tuberculosis who had been. used corticosteroid for persisting polyarthritis.
Adrenal Cortex Hormones ; Arthritis ; Coma ; Diagnosis ; Diarrhea ; Drug Therapy ; Feces ; Helminths ; Humans ; Immunity, Cellular ; Intestines ; Opportunistic Infections ; Sepsis ; Sputum ; Strongyloides stercoralis* ; Strongyloides* ; Strongyloidiasis ; Thiabendazole ; Tropical Climate ; Tuberculosis, Pulmonary

Sebaceous epithelioma is a rare skin appendage tumor with sebaceous differentiation. It may occur as a primary lesion or may arise within a nevus sebaceus. We present two cases of sebaceous epithelioma developed on the scalp in a 55-year old woman and on the forehead in a 75-year old wornan. Histopathologically the tumors are composed of irregularly shaped cell masses. The majority of cells are undifferentiated basaloid cells, but some cells show differentiation toward sebaceous cells.
Aged ; Carcinoma* ; Female ; Forehead ; Humans ; Middle Aged ; Nevus ; Scalp ; Skin

PURPOSE: To introduce autologous tragal perichondrium transplantation as a novel surgical modality for the management of intractable symptomatic bullous keratopathy. METHODS: In three eyes of three patients with painful bullous keratopathy, autologous tragal perichondria were transplanted on the corneal surface with the human amniotic membrane transplanted above. We included an additional three eyes of three patients with painful bullous keratopathy who received amniotic membrane transplantation only to serve as controls. Clinical symptom outcomes were assessed using a visual analogue scale at postsurgical months 1, 3, 5, 7, and 9. In addition, transplanted tragal perichondrium and amniotic membrane complex tissue button obtained from one patient who underwent penetrating keratoplasty was evaluated by immunohistochemical analysis of CD34, vimentin, and alcian blue staining. RESULTS: All three patients who underwent autologous tragal perichondrium and human amniotic membrane co-transplantation showed improvements in pain and tearing. However, all three patients in the control group experienced aggravation of tearing and no further improvement of pain 3 months after surgery. In addition, one patient in the control group developed premature degradation of the amniotic membrane. Histopathologic and immunohistochemical analysis showed intact surface epithelization and positive CD34, vimentin and alcian blue staining of transplanted tragal perichondria. CONCLUSIONS: The tragal perichondrium has a high mechanical structural force and high potency due to well-organized epithelization and the presence of mesenchymal stem cells. Autologous tragal perichondrium transplantation may be an effective modality for the management of painful bullous keratopathy.
Adult ; Aged ; Amnion/*transplantation ; Corneal Diseases/*pathology/*surgery ; Ear Cartilage/*transplantation ; Female ; Humans ; Keratoplasty, Penetrating/*methods ; Male ; Middle Aged ; Transplantation, Autologous ; Treatment Outcome

Fifty four preparations of the cavernous sinus from twenty seven cadavers were studied in detail under microscopic magnification, with special attention to nerves and arteries related to the wall of the sinus. Significant findings were: 1) Three types of relationship between the nerves and arteries in relation to the wall of the sinus were found. Type I: The nerves III, IV and V-1 were embedded in the lateral wall, and the internal carotid artery(I.C.A.) and nerve IV passed through the cavity of the sinus(26 specimens, 48%), Type II: The cavity of the sinus was divided into two compartments by a septum close to the lateral wall, with nerves VI and V-I located within the septum(18 specimens, 33%), Type III: Anatomy was similar to the type I, except that the I.C.A. was included in the medial or lateral wall(10 specimens, 19%). 2) Arterial variations branching from the intracavernous portion of the I.C.A. were classified into four types. Type I: Meningohypophyseal trunk arising from I.C.A.(28 specimens). Type II: Dorsal meningeal artery from I.C.A.(10 specimens). Type III:Tentorial artery from I.C.A.(4 specimens). Type IV: Meningohypophyseal trunk from I.C.A. in addition, the artery of inferior cavernous sinus(12 specimens). 3) The main three brahcnes of the intracavernous portion of the I.C.A. were the meningohypophyseal artery, which was presented presented in 100% of our specimens, the artery of inferior cavernous sinus(78%), and McConnell's capsular artery(43%). Intracavernous origin of the ophthalmic artery were observed in four specimens(8%). 4) The surgical triangle spaces were found to be present in all our specimens, which were formed by the superior margin of it with the lower margin of nerve IV and by the inferior margin with the upper margin of nerve V-I.
Arteries ; Cadaver ; Cavernous Sinus* ; Meningeal Arteries ; Ophthalmic Artery

The superficial lymph nodes may be enlarged in consequence of biologic or non-biologic antigenic stimuli, lymphoreticular maligna ntneoplasm, metastatic tumor or infiltrative disorders such as histiocytosis-X, and biopsy of the enlarged superficial lymph node is a time-honored diagnostic, therapeutic and follow-up tool. At present it is performed with ease and wideness. But in Korea there is no comprehensive studies about the diseases involving superficial ly-mph nodes of pediatric ages based on clinical and histopathological aspects. The present study is an sttempt to research for the histopathological aspects. The present study is an attempt to research for the histopathological findings of the superficial lymphadenopathy in correlation with the clinical characteristics. The histopathological findings of enlarged superficial lymph nodes, biopsied in Yonsei Univ-ersity Hospital for a 5year-period from 1976 to 1980, were reviewed. All patients were under 15year-old age, whose chief complaints were palpable lymph node with or without other sympt-oms. The results were as follows; 1. Of the 150 enlarged superficial lymph nodes, the male to female ratio was 1.68:1. Most of the biopsies were performed after the preschool age group and only 8 were of neonate or inf-ancy. 2. Of the 150 enlarged superficial lymph nodes, 79(52.7%) showed reactive hyperplasia, and inflammatory and malignant lymphadenopathies were 37.3% and 10.0% respectively. 3. Nonspecific reactive hyperplasia was the most common cause of the superfical lymphad-enopathy in pediatric ages, being 52.1% of total. Tuberculous lymphadenitis comprised 26.7%, being the 2nd most common cause, and of the 15 malignant lymphadenopathy 11 were primary lymphoreticular and 6 of the latter were histiocytic medullary reticulosis. 4. Ten percent of the patients with tuberculous lymphadenitis were of infancy, but none of those with both primary and metastatic malignant lymphadenopathy was of that age group. 5. The clinical symptoms and signs observed were fever, hepatosplenomegaly, gastrointest-inal symptoms and signs, rash, upper respiratory infection and others, irrespective of the histol-ogical classification. 6. The duration of superficial lymphadenopathy was less than 6 months in most cases of fu-ngal, acute and subacute nonspecific inflammatory and malignant origin, whereas it was more than 6 months in 38.5% of tyberculous lymphadentis and 41.7% of nonspecific reactive. 7. Superficial lymph node enlargement was most frequently found at cervical area which was followed by inguinal and axillary areas. 8. The superficial lymphadenopathy involved a single node in 63.9% of tuberculous origin but it tended to involve multiple ondes of one or more anatomical sites in nonspecific inflamm-ation, fungal infection, nonspecific reactive hyperplasia and malignancy. 9. The enlarged superficial lymph noded tendes to be soft and nontender in tuberculosis and nonspecific reactive hyperplasia, in contrast to the acute and subacute lymphadenitis and mali-gnant lymphadenopathy where they were more commonly hard with variable tenderness.
Biopsy ; Classification ; Exanthema ; Female ; Fever ; Follow-Up Studies ; Histiocytosis, Langerhans-Cell ; Humans ; Hyperplasia ; Infant, Newborn ; Korea ; Lymph Nodes ; Lymphadenitis ; Lymphatic Diseases* ; Male ; Tuberculosis ; Tuberculosis, Lymph Node

Fabella impingement syndrome after total knee arthroplasty (TKA) is a rare condition. However, the location of the inserted prosthesis and the size of the fabella are considered major causative factors. Thus far, a conventional surgical excision of the impinged fabella is recommended treatment for the impingement. A 72-year-old woman was diagnosed with degenerative arthritis of the knee. She complained of fabella impingement due to an incompletely excised bony spur behind the posterolateral femoral prosthesis after TKA. The fabella and remaining bony spur were removed using an arthroscopic procedure. The impingement has not recurred and the range of motion (ROM) of the knee was improved after a 12 months follow-up. Arthroscopic surgery might be an alternative treatment for fabella impingement after TKA.
Aged ; Arthroplasty* ; Arthroscopy ; Female ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis ; Prostheses and Implants ; Range of Motion, Articular

BACKGROUND: This study aimed to evaluate the clinical and radiological outcomes of arthroscopic bioabsorbable screw fixation in osteochondritis dissecans (OCD) in adolescent patients with unstable lesions causing pain. METHODS: The study included 11 patients (10 males and 1 female) with OCD who underwent arthroscopic bioabsorbable screw fixation between July 2007 and February 2014 and were available for follow-up for more than 12 months. The mean age at diagnosis was 16.3 years (range, 11 to 19 years), and the average follow-up period was 51 months (range, 12 to 91 months). Clinical results were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm knee score, and International Knee Documentation Committee (IKDC) score measured before surgery and at follow-up. Functional evaluation was made using the Tegner activity scale. Magnetic resonance imaging (MRI) and second-look arthroscopy were performed at the 12-month follow-up. RESULTS: Between the preoperative assessment and follow-up, improvements were seen in the KOOS (range, 44.9 to 88.1), Lysholm knee score (range, 32.6 to 82.8), and IKDC score (range, 40.8 to 85.6). The Tegner activity scale also improved from 2.8 to 6.1. Based on postoperative MRI, there were eight Dipaola grade I cases and three grade II cases. No complications due to fixation failure developed in any case. Second-look arthroscopy at 12 months postoperatively revealed that the lesion was covered with cartilage in all cases. CONCLUSIONS: For unstable OCD lesions causing pain in adolescents, arthroscopic bioabsorbable screw fixation provided favorable outcomes with reduced pain and restoration of movement. Therefore, it should be considered as an effective treatment for OCD.
*Absorbable Implants ; Adolescent ; Adult ; Arthroscopy/adverse effects/*instrumentation/methods ; *Bone Screws ; Child ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Osteochondritis Dissecans/*diagnostic imaging/*surgery ; Range of Motion, Articular ; Treatment Outcome ; Young Adult