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

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

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

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

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

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: 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

A cornual pregnancy occurs when the conceptus implants at the cornus of the uterus which is the junction between the fallopian tube and uterine cavity. It accounts for 2 to 4% of tubal pregnancy and rupture usually occurs between 8 weeks and 16 weeks of gestation. The rich vascularity in this location makes the rupture particularly dangerous, resulting in higher maternal mortality. The presented case was unique in that the pregnancy was believed to be a normal intrauterine pregnancy till 24 week's of gestation, when it ruptured and presented as the pregnant patient with hypovolemic shock of unknown cause. We present this case with a brief review of the literature.
Cornus ; Fallopian Tubes ; Female ; Humans ; Maternal Mortality ; Pregnancy Trimester, Second ; Pregnancy* ; Pregnancy, Tubal ; Rupture ; Shock ; Uterine Rupture ; Uterus

Adrenal cysts are a rare disease, and its prevalence is reported to be 0.06~0.18%. Its frequency of being recognized is increasing due to the widespread use of ultrasonography and computed tomography (CT) scans. We report here on a case of adrenal cyst that was mistaken as biliary cystadenoma prio-ocation and features. Laparoscopic exploration was performed via the transabdominal approach and this revealed a right adrenal cystic mass in the retroperitoneum beneath the liver (segment IV). We present here a case of adrenal cyst with endothelial lining along with a review of the literature to address the clinical presentation, histology, imaging features and differential diagnosis of this interesting and rare entity.
Cystadenoma* ; Diagnosis, Differential ; Laparoscopy ; Liver ; Prevalence ; Rare Diseases ; Ultrasonography

We reviewed the clinical findings of infectious mononucleosis and performed Epstein-Barr virus (EBV) serologic antibody tests in infectious mononucleosis and healthy group. One groupwas 18 cases of children, diagnosed as infectious mononucleosis who had been admitted to the department of Pediatrics, Asan Medical Center for two years and eight months, from November, 1989 to June, 1992. Another group was 20 cases of healthy 5-year old children. @ES The results wereas follows: 1) The age distributions of 18 patients with infectious mononucleosis were as follows: nine patients were less than 5 year old and nine patients (50%)were older than 5 year old. 2) The hematologic findings revealed increased atypicallymphocytes in sixteen patients (88%), leukopenia in one patient (6%), thrombocytopenia in one patient (6%). In addition, we observed transient hepatitis in eight patients (44%) and jaundice in one patient (6%). 3) Hemophagocytic sydrome wasdeveloped in one patient who expired due to meningitis. 4) The heterophil antibody tests werepositive in two cases (11%) out of eighteen infectious mononucleosis patients. 5) EBV serologic antibody tests for IgM antibody to EBV-viral capsid antigen (VCA) in 18 patients were all positive, which implies primary infection. 6) EBV serologic antibody tests for IgG antibody to EBV-VCA and antibody to Epstein-Barr nuclear antigen (EBNA) in helathy 5-year old children were negative in 3 cases (15%) out of 20 cases each other, which suggests primary infection might occur afer five years of age. 7) Recently, more cases of clinically typical infectious mononucleosis are detected and the onset of EBV primary infection is becoming late in Korea, which is thought to be due to economic developments and improvements of environmental hygine. And we recommend EBV serologic antibody test for the confirmative diagnostic test of infectious mononucleosis.
Age Distribution ; Capsid ; Child* ; Child, Preschool ; Chungcheongnam-do ; Diagnostic Tests, Routine ; Hepatitis ; Herpesvirus 4, Human ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Infectious Mononucleosis* ; Jaundice ; Korea ; Leukopenia ; Meningitis ; Pediatrics ; Thrombocytopenia