The malignant fibrous histiocytoma (MFH) was first introduced in 1963 to refer to a group of soft-issue tumors characterized by a storiform or cartwheel-ike growth pattern and predominantly fibroblastic appearance. It was postulated that they were derived from histiocytes that could assume the appearance and function of fibroblasts. MFH has been recognized to be the most common sarcoma in the soft tissue of late adult life which involves the deep fascia or skeletal muscles of the extremities or retroperitoneum. It has been noted in other organs, however, it rarely arises in the liver. We report two cases of primary malignant fibrous histiocytoma of the liver histopathologically confirmed after surgical resection-storiform pleomorphic and myxoid subtypes in the 55 year old male and 49 year old female patients, respectively, and describes the clinical courses, characteristics and pathologic aspects with review of the related literatures.
Adult ; Extremities ; Fascia ; Female ; Fibroblasts ; Histiocytes ; Histiocytoma, Malignant Fibrous* ; Humans ; Liver* ; Male ; Middle Aged ; Muscle, Skeletal ; Sarcoma

OBJECTIVE: The purpose of this study was to evaluate the outcome and safety of vaginal delivery after previous cesarean birth. METHODS: This study was based on 303 cases of delivery with previous cesarean birth at Masan, Fatima Hospital from May, 1997 to April, 1998. Among them, 62 cases had performed trial of labor. We had made a comparison between elective repeat section group and trial of labor group by analizing the frequency, successful rate, maternal morbidity, perinatal morbidity and mortality. RESULTS: Among 303 cases with previous cesarean birth, trial of labor was done in 62 cases(20.5%). Among trial of labor group, vaginal delivery was done in 54 cases (87.1%) and repeat section was done in 8 cases(12.9%). Indications for elective repea section before the onset of labor were refuse trial of labor(51.9%), request for tubal ligation(17.4%), and previous section > or =2(7.5%), etc. The successful rate of vaginal delivery according to indication for previous cesarean birth was 85.0%(17/20) in the cases of dystocia and 88.1%(37/42) in the cases except dystocia. The successful rate was not influenced by the indication for previous cesarean birth(P>0.05). There were no maternal death or uterine rupture in the cases of trial of labor. There were no significant difference between elective repeat section group and trial of labor group in maternal morbidity, perinatal morbidity and mortality(P>0.05). CONCLUSION: Under strict indications, vaginal delivery subsequent to cesarean birth may be safe, and can reduce the rate of cesarean section that was increased constantly.
Apgar Score ; Cesarean Section ; Dystocia ; Eclampsia* ; Female ; Fetal Distress ; Fetus ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Maternal Death ; Mortality ; Parturition ; Parturition* ; Perinatal Mortality ; Pre-Eclampsia* ; Pregnancy ; Premature Birth ; Respiration, Artificial ; Rheology ; Trial of Labor ; Umbilical Arteries* ; Uterine Rupture

The Wallenberg's syndrome is produced by infarction of lateral medulla. Isolated ipsilateral axial lateropulsion without other common symptoms of Wallenberg syndrome has rarely been reported as manifestation of lateral medullary infarction. The responsible anatomical structure of ipsilateral axial lateropulsion is still uncertain. We describe a patient with lateral medullary infarction who present with isolated ipsilateral axial lateropulsion without other symptoms of Wallenberg syndrome.
Humans ; Infarction* ; Lateral Medullary Syndrome

No abstract available.
Facial Paralysis ; Myasthenia Gravis*

Primary hyperparathyroidism is a relatively rare disease entity in Korea. It is characterized by severe skeletal and renal changes due to hypersecretion of parathyroid hormone and rarely shows peptic ulceration, hypertension, pancreatitis and impaired mentality. Primary hyperparathyroidism is most commonly caused by an adenoma, or hyperplasia and rarely by cancer of the parathyroid gland. The authors experienced a case involving a giant parathyroid adenoma in a 62-year-old female. The main symptoms were general weakness, anorexia, and constipation. We detected the giant parathyroid adenoma on the anterior neck by using preoperative localization methods, such as ultrasonography, and a thallium-technetium subtraction scan. A parathyroidectomy was carried out, and the parathyroid adenoma measured 5.0 cm 3.2 cm in size and 12 gm in weight. Clinical laboratory reports and symptoms were normalized with no sequelae. We report this case with a review of the literature related to sizes and weights of adenomas.
Adenoma ; Anorexia ; Constipation ; Female ; Humans ; Hyperparathyroidism, Primary* ; Hyperplasia ; Hypertension ; Korea ; Middle Aged ; Neck ; Pancreatitis ; Parathyroid Hormone ; Parathyroid Neoplasms* ; Parathyroidectomy ; Peptic Ulcer ; Rare Diseases ; Ultrasonography ; Weights and Measures

A 69-year-old woman presented with a progressive limb weakness. Both clinical and neurophysiological findings were consistent with diagnosis of Guillain-Barre syndrome (GBS). Two days after admission, the patient suffered from an acute coronary syndrome without stenosis at coronary arteriography. Echocardiography revealed left ventricular inferior wall and apical akinesia and decreased ejection fraction. A diagnosis of Takotsubo cardiomyopathy was then made. Left ventricular dysfunction and electrocardiography normalized within one month. Takotsubo cardiomyopathy can be developed as a complication of GBS.
Acute Coronary Syndrome ; Aged ; Angiography ; Constriction, Pathologic ; Diagnosis ; Echocardiography ; Electrocardiography ; Extremities ; Female ; Guillain-Barre Syndrome* ; Heart Failure ; Humans ; Takotsubo Cardiomyopathy* ; Ventricular Dysfunction, Left

Hereditary spastic paraplegia is a group of genetically and clinically heterogeneous neurodegenerative disorder characterized by progressive lower extremity weakness and spasticity. A 49-year-old man presented with progressive gait disturbance. Neurological examination showed spasticity, hyperreflexia in lower extremity and bilateral ankle clonus. He had a family history consistent with autosomal dominant inheritance. Gene testing revealed a heterozygous missense mutation (c.1378C>T [p.Arg460Cys]) in SPAST gene. We report a first Korean family with Arg460Cys mutation in SPAST gene.
Ankle ; Gait ; Humans ; Lower Extremity ; Middle Aged ; Muscle Spasticity ; Mutation, Missense ; Neurodegenerative Diseases ; Neurologic Examination ; Paraplegia ; Reflex, Abnormal ; Spastic Paraplegia, Hereditary* ; Wills

PURPOSE: This study was done to determine the diagnostic efficacy of clinical examination, fine needle aspiration(FNA) cytology, mammography and ultrasonography in palpable breast mass. METHODS: We performed 248 FNA cytology of palpable breast mass, among which 106 cases were histologically examined during the period of from Jan. 1994 to Dce.1997 at the Department of Surgery, Chonbuk National University Hospital. Among 106 patients, mammographys were taken for 96 patients, and ultrasonographys for 73 patients. RESULTS: Main clinical symptom was palpable mass on breast at the she visited the hospital. Clinical diagnosis based on symptoms and physical examination had 96.9% of sensitivity, 57.5% of specificity. Based on definite histologic diagnosis, the sensitivity of FNA cytology was 96.9%, specificity 91.7%, and diagnostic accuracy 93.5%, respectively. 86.1% of cytologic malignancy was proven to be malignant histologically, and 100% of cytologically benign cases were turned out histologically benign. Mammography was performed on 96 cases and the results were as follows; sensitivity 89.3%, specificity 84%, and diagnostic accuracy 86.8%. Ultrasonography in 73 cases showed 93.5% sensitivity, 51.4% specificity, and 74.6% diagnostic accuracy. CONCLUSIONS: FNA cytology was reliable and safe diagnostic method compared to physical examination, mammography, and ultraxonography. And FNA cytology of palpable breast mass should be diagnostic procedure of choice for those patients classified clinically as probably benign or malignant.
Biopsy, Fine-Needle* ; Breast* ; Diagnosis ; Humans ; Jeollabuk-do ; Mammography* ; Needles ; Physical Examination ; Sensitivity and Specificity ; Ultrasonography*

PURPOSE: This study was designed to determine surgeon's opinions on the name of the Department of Surgery in Korea. METHODS: This report is a survey of 797 randomly selected questionnaire (28.8%) from among 2,804 submitted by members of the Korea Surgical Society. The questionnaire consisted of 16 questions. RESULTS: Among the respondents, 70.4% were in the 4th or 5th decade of age, and 51.9% were working for private clinics. Among the names for the Department of Surgery in Korea, 48.9% included the word Surgery and 44.2% the word General surgery. Respondents who consider that we have to make use the unified Korean name of the Department of Surgery were 90.1%. CONCLUSION: The name of our department is considered as a common issue by most members. Most members insist that as much as possible, we should make use of the unified name Department of Surgery. We confirm that it is important to lead the public to a better understanding of our department by means of a far-reaching public information and that policy must be made and carried out by the Korea Surgical Society.
Surveys and Questionnaires ; Korea ; Surveys and Questionnaires

PURPOSE: To assess the effectiveness of low-dose (30 mCi) I-131 ablation therapy for remnant thyroid tissue following total thyroidectomy for differentiated thyroid cancer. METHODS: Between March 1995 and December 1997, 48 patients were given ablative doses (30 mCi) of I-131 following total thyroidectomy for differentiated thyroid cancer in the presence of I-131 uptake in remnant thyroid tissue. The effective ablation of remnant thyroid tissue was determined using a subsequent I-131 whole body scan. If any remnant thyroid tissue remained, we repeated the same management protocol at 6-month intervals. RESULTS: Thirty-eight (79.1%) patients displayed papillary, 8 (16.7%) follicular, 1 (2.1%) medullary and 1 (2.1%) Hurthle cell type cancer. Forty-eight patients underwent total thyroidectomy, 35 cases of which underwent central neck dissection, and 14 cases modified radical neck dissection. Postoperative complication developed in 8 cases, including 4 cases of transient hypoparathyroidism, 1 case of permanent hypoparathyroidism, 2 cases of transient recurrent laryngeal nerve palsy, and 1 case of wound hematoma. There was significant remnant thyroid tissue detected in 46 cases (95.8%) following total thyroidectomy, which were able to be ablated by low dose (30 mCi) I-131. There was no statistical difference between the operative procedures or the numbers of treatment of I-131. CONCLUSION: This data suggests that low-dose (30 mCi) I 131 therapy is effective for the ablation of remnant thyroid tissue following total thyroidectomy for differentiated thyroid cancer.
Hematoma ; Humans ; Hypoparathyroidism ; Neck Dissection ; Postoperative Complications ; Surgical Procedures, Operative ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy* ; Vocal Cord Paralysis ; Whole Body Imaging ; Wounds and Injuries