We report herein a case of subcutaneous granuloma pyogenicum developed on the fourth interdigital space of right foot of 36-year-old housewife. Histopathological findings showed characteristic lobular capillary hemangioma. The subcutaneous nodule had a thick fibrous capsule and were composed of multiple, confluent cellular, angiomatous lobules separated by loose fibrous tissue. Most lobules contained round, oval or angular capillaries, lined by proliferated prominant endothelial cells projecting into the lumina of the vessels. Clinically, the lesion was a tender subcutaneous nodule with macerated surface aind soft corn or traumatic epidermal cyst were considered in the differential diagnoses.
Adult ; Capillaries ; Diagnosis, Differential ; Endothelial Cells ; Epidermal Cyst ; Foot ; Granuloma* ; Granuloma, Pyogenic* ; Humans ; Zea mays

PURPOSE: To evaluate the efficacy and safety of retroperitoneoscopic nephroureterectomy in patients with a transitional cell carcinoma of the renal pelvis and the ureter. MATERIALS AND METHODS: A total of 30 patients underwent nephroureterectomy for an upper tract transitional cell carcinoma. Of these, 16 underwent a retroperitoneoscopic nephroureterectomy(RNU) and 14 an open nephroureterectomy(ONU). After the retroperitoneal radical nephrectomy had initially been performed, a 5-6cm modified Gibson incision was then created to allow dissection of the lower ureter and bladder cuff and extraction of the intact specimen. A retrospective chart review was performed and the operating time, blood loss, analgesic requirement, ambulation time, interval to resume oral intake, hospital stay and complications assessed in both surgical groups. RESULTS: The RNU was superior to the ONU group with regard to blood loss(240.6+/-103.1 versus 519.3+/-62.3ml, p<0.05), analgesic requirement (118.8+/-24.7 versus 240+/-26mg, p<0.05), ambulation time(21.5+/-3.7 versus 36.3+/-5.1 hours, p<0.05), interval to resume oral intake(34+/-3.3 versus 58+/-7.1 hours, p<0.05), and hospital stay(5.5+/-1.4 versus 10.9+/-3.9days, p<0.05). Complications developed in 6 and 14 of the RNU and ONU patients, but all of complications in both group were resolved with conservative management. The mean operating time of the RNU group was longer than that of the ONU group(270.6+/-53.2 versus 233.6+/-20.2 mins, p<0.05). The operating time of the initial 8 patients in the RNU group(311.3+/-38.8 mins) was significantly longer than that of the ONU group(p<0.05). However, the difference in the operating times between the final 8 patients in the RNU group(230+/-7.5 mins) and those in the ONU group were not significant(p>0.05). CONCLUSIONS: A retroperitoneoscopic nephroureterectomy is better tolerated by patients than an open nephroureterectomy as the surgery for an upper tract transitional cell carcinoma, and is also an efficacious alternative to open surgery. However, a long-term oncological evaluation will be required.
Carcinoma, Transitional Cell* ; Humans ; Kidney Pelvis ; Laparoscopy ; Length of Stay ; Nephrectomy ; Pelvis ; Retrospective Studies ; Ureter ; Urinary Bladder ; Walking

A 42 year-old male with a history of multidrug-resistant pulmonary tuberculosis suddenly developed massive hemoptysis. Embolization of a bronchial artery branch and the collateral systemic arteries did not resolve the recurrent bleeding. Spiral computerized tomography(spiral CT) of the chest showed contrast enhanced nodules within a large cavity at the left lower lobe in the arterial phase suggesting a Rasmussen aneurysm. A pulmonary angiogram showed abnormal vascular nodules at that site. Coils were deployed at both the proximal and distal vessels of this aneurysmal sac for embolization. Transcatheter arterial embolization is a safe and effective means of controlling bleeding from this pulmonary arterial pseudoaneurysm. Here we report a case of a Rasmussen aneurysm diagnosed by spiral CT, which was successfully treated by pulmonary arterial embolization with a coil.
Aneurysm* ; Aneurysm, False ; Arteries ; Bronchial Arteries ; Embolization, Therapeutic ; Hemoptysis ; Hemorrhage ; Humans ; Male ; Respiratory Insufficiency ; Thorax ; Tomography, Spiral Computed ; Tuberculosis, Pulmonary

Osteoporosis is a major health-care problem for aging communities. And postmenopausal osteoporosis is a common disorder characterized by an increase in bone resorption relative to bone formation, generally in conjunction with an increased rate of bone turnover. Twenty female rats were used as rat model of osteoporosis. They randomly were divided into two groups: a normal control group, and calcium-free diet groups treated with bilateral ovariectomy. The animals were sacrified at 12 weeks after treatment. In the rats with osteoporosis, there was significant thining and loss of trabeculae, accompanied by a disconnection of trabeculae. And acid mucopolysaccharides were decreased in osteoporotic animals. In order to setup conditions of invivo micro-CT, proper anesthetic is ketamine (50 mg/kg) /xylazine (6 mg/kg). And proper breathing rate of experimental animals is 1.3~1.6/sec. Our finding suggest that bilateral ovariectomy and calcium-free diet induce decrease in thickeness of trabecular bone and decrease in acid mucopolysaccharide, therefore cause weakness of bone. And micro-CT imaging system is useful to evaluate trabecular bone. Anesthetic time, anesthetics and respiration rate also signify much in micro-CT imaging system.
Aging ; Anesthetics ; Animals ; Bone Resorption ; Diet ; Female ; Glycosaminoglycans ; Humans ; Ketamine ; Models, Animal ; Osteogenesis ; Osteoporosis* ; Osteoporosis, Postmenopausal ; Ovariectomy ; Rats ; Respiration ; Respiratory Rate

We investigate the potentials and limitations of computational fluid dynamics (CFD) analysis of patient specific models from 3D angiographies. There are many technical problems in acquisition of proper vascular models, in pre-processing for making 2D surface and 3D volume meshes and also in post-processing steps for display the CFD analysis. We hope that our study could serves as a technical reference to validating other tools and CFD results.
Angiography ; Arteries ; Carotid Arteries ; Hemodynamics ; Humans ; Hydrodynamics

PURPOSE: To analyze factors influencing clinical results after microfracture surgery in patients with osteoarthritic knee. MATERIALS AND METHODS: After microfracture surgery, in sixty-six patients with sixty-eight knees having full thickness chondral defect by arthroscopic evaluation, clinical results were evaluated with Baumgartner's nine-point scale during the follow-up of 1 year 4 months (range, 1-2 years 5 months). Results were analyzed according to age, the degree of preoperative varus and the existence of flexion contracture. RESULTS: Sixty-three knees showed excellent or good results at clinical evaluation. According to age, a significant difference was observed about 65 years old (p<0.05). The patients without flexion contracture and with less varus change had better clinical results, as did patients whose medial deviation of mechanical axis was less than 75% (p<0.05). CONCLUSION: Better clinical results, after microfracture surgery, were obtained in patients who were under the age of 65, with less than 75% of medial deviation of the mechanical axis on standing AP radiogram and no flexion contracture.
Aged ; Axis, Cervical Vertebra ; Contracture ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis

PURPOSE: Autoimmune hepatitis is a chronic inflammatory liver disease with unknown cause that is characterized by liver histology, circulating autoantibodies and increased levels of immunoglobulin G. Only sporadic reports are available on autoimmune hepatitis in children. The aim of this study was to evaluate the clinical, biochemical, and histological features, and the long-term outcome of autoimmune hepatitis in Korean children. METHODS: We reviewed the medical records of 14 children diagnosed as having autoimmune hepatitis at Seoul National University Children's Hospital from 1990 to 2004, and analyzed clinical, biochemical, and histological features, and clinical outcomes. RESULTS: Mean age at diagnosis was 9 years and 11 of the 14 children were female. Six children presented with acute hepatitis-like manifestations. Jaundice and fatigue were the most common symptoms. Other autoimmune diseases accompanied in 6 children. Anti-nuclear antibody was detected in 13 patients and anti-smooth muscle antibody was positive in 8. All 14 patients were type 1 autoimmune hepatitis. The main histologic findings were interface hepatitis, rosette formation, and cirrhosis. Clinical and biochemical features were improved in six patients treated with ursodeoxycholic acid. Eight patients were treated with corticosteroid alone or in combination with azathioprine and five of them are in biochemical remission. CONCLUSION: Autoimmune hepatitis is an inflammatory liver disease, which has a favorable long-term outcome if it is diagnosed and treated promptly. Therefore, autoimmune hepatitis should be suspected in children with chronic hepatitis of unknown etiology, especially in female patients who show hypergammaglobulinemia or some clinical features of autoimmune disease.
Autoantibodies ; Autoimmune Diseases ; Azathioprine ; Child* ; Diagnosis ; Fatigue ; Female ; Fibrosis ; Hepatitis ; Hepatitis, Autoimmune* ; Hepatitis, Chronic ; Humans ; Hypergammaglobulinemia ; Immunoglobulin G ; Jaundice ; Liver ; Liver Diseases ; Medical Records ; Prognosis* ; Rosette Formation ; Seoul ; Ursodeoxycholic Acid

No abstract available.
Arthritis* ; Immunoblastic Lymphadenopathy*

PURPOSE: Cancers are highly individual in their response to chemotherapy, however attempts to predict tumor response to drugs using in vitro cell culture have largely failed. A new technology, the histoculture drug response assay (HDRA), appears to have solved many previous problems. The purpose of this study is to evaluate the reliability of HDRA in a chemosensitivity test for breast cancer. MATERIALS AND METHODS: Tumor specimens from breast cancer patients were evaluated by HDRA using different chemotherapeutic agents. Each specimen was tested using a blind method in order to determine the reproducibility of HDRA results for the same tissue and with a triplicated assay in order to determine reproducibility by different examiners. The evaluative power of this assay and the chemosensitivity of drugs for each specimen was determined. RESULTS: Specimens of 92.9% (65/70) were successfully cultured and evaluated for chemosensitivity. The reproducibility of HDRA for the same tissue was 75% (100% agreement) and 100% (over 70% agreement), respectively. And the reproducibility by different examiners was 78.9% (100% agreement) and 94.7% (over 70% agreement), respectively. Each specimen demonstrated a response to at least one agent. CONCLUSION: The evaluative power and reproducibility of HDRA were high, therefore it might serve as a reliable clinical method for chemosensitivity testing. However, there is a need for clinical trial in which patients are initially randomized for treatment either by HDRA direction or by clinician's choice.
Breast Neoplasms* ; Breast* ; Cell Culture Techniques ; Drug Therapy ; Humans

PURPOSE: We analyzed the causative factors of femoral component radiologic abnormality after total knee arthroplasty (TKA) using a Legacy Posterior Stabilized (LPS)-Flex prosthesis. MATERIALS AND METHODS: 140 cases of TKA using LPS-Flex and 140 cases of Vanguard from Jan 2008 to June 2010 were analyzed and radiographic abnormalities around the femoral stems were compared. Secondly, TKA using LPS-Flex was divided into two groups according to the posterior femoral cutting technique, which were single cutting method and additional cutting method. Accuracy of the femoral posterior resection was compared. RESULTS: Radiographically, anterior radiolucent line was found in eight cases with LPS-Flex but no case with Vanguard. Posterior overhang more than 30% was found in ten cases in both groups. Posterior bone defect more than 50% was found in 23 and seven cases respectively. Anterior radiolucent line and posterior bone defect were observed significantly more in LPS-Flex. In the second study, we found femoral posterior bone defect in 20 cases with additional cutting method which was caused by flexion of the femoral box-cutting guide. CONCLUSION: Posterior bone defect from LPS-Flex was caused by inappropriate resection due to flexion of the box cutting guide. Single cutting method should be adopted for more accurate posterior femoral cutting.
Arthroplasty ; Knee ; Osteoarthritis ; Prostheses and Implants