Tracheobronchial aspergillosis is an unusual form of invasive aspergillosis characterized by noninvasive or only superficially invasive tracheobronchitis with a propensity for dissemination. We report a two-year-old male who suddenly died of respiratory failure. Postmortem examination revealed a pseudomembrane covering the mucosa of larynx, trachea and bronchial tree of both lungs. This pseudomembrane was composed predominantly of Aspergillus hyphae. There was transmural necrotizing bronchitis with fungal invasion to the narrow zone of peribronchial tissue, and dissemination to the stomach and kidney. This form of pulmonary aspergillosis had not been reported in this country.
Aspergillosis* ; Aspergillus ; Autopsy* ; Bronchitis ; Humans ; Hyphae ; Kidney ; Larynx ; Lung ; Male ; Mucous Membrane ; Pulmonary Aspergillosis ; Respiratory Insufficiency ; Stomach ; Trachea

With the recent development of tumor prosthesis, limb salvage technique has attributed to the preservation of the limb function in patients with malignant bone tumors around the knee without substantial difference of local recurrence and the survival rate. From Feb., 1991 to Sep., 1992, 9 patients were treated with limb salvage operation with total knee arthroplasty due to the malignant bone tumor around the knee at Dept. of Orthopedic Surgery, Kyungpook National University Hospital. We applied the above procedure mainly to young adult whose tumor was expected to be excised wide marginally without damaging major neurovascular structures. We evaluated the functional status of all 9 patients(4 osteosarcoma, 2 chodrosarcoma, 2 malignant fibrohistiocytoma, 1 malignant giant cell tumor) to estimate the efficacy of limb salvage operation with tumor prosthesis total knee arthroplasty. Mean follow up period was 10 months. Primary tumor site was 4 in distal femur, 5 in proximal tibia and stage was 4 IIa, 5 IIb. Range of the motion of knee is maximum 0°
Arthroplasty ; Arthroplasty, Replacement, Knee ; Artificial Limbs ; Extremities ; Femur ; Follow-Up Studies ; Giant Cells ; Gyeongsangbuk-do ; Humans ; Knee ; Limb Salvage ; Methods ; Orthopedics ; Osteosarcoma ; Prostheses and Implants ; Recurrence ; Survival Rate ; Tibia ; Young Adult

PURPOSE: To determine the significance of anomalous position of the gallbladder. MATERIALS AND METHODS: Sixteen patients with anomalous position of the gallbladder were evaluated for analysis. The diagnosis was confirmed by ultrasonography(15 patients) and oral cholecystography(1patient). Among those, six patients underwent CT scan and a patient had 99mTc-DISIDA scan. The images were analysed with respect to the location of the GB and configuration and associated abnormality of the liver and hepatobiliary systems. Medical records of each patient were also reviewed. RESULTS: Among 16 patients having an anomalous position of the gallbladder, nine had retrodisplaced gallbladder, four had left-sided gallbaldder, two had suprahepatic gallbladder, and one had floating gallbladder. Except for one patient, fifteen had abnormality in the liver such as focal atrophic or hypoplastic change and liver cirrhosis. Intrahepatic stones were demonstrated in 6 patients. CONCLUSION: Our results showed that anomalous position of the gallbladder was commonly associated with atrophy or hypoplasia of the liver rather than congenital in origin. The possiblity of an anomalous location of gallbladder should be kept in mind when GB is not in its normal location.
Atrophy ; Diagnosis ; Gallbladder* ; Humans ; Liver ; Liver Cirrhosis ; Medical Records ; Technetium Tc 99m Disofenin ; Tomography, X-Ray Computed

No abstract available.
Hyperparathyroidism, Primary*

A 34-year-old woman presented with several intensely pruritic erythematous serpiginous thread-like skin lesions which began as a small papule on the epigastrium 4 months prior to her visit and was migrating to the left chest area. The laboratory examination showed eosinophilia and the total serum IgE level was slightly increased. Histopathologic examination revealed a pustular burrow in the epidermis with a larva-like cystic lesion apart from the burrow in the epidermis. The patient was treated with topical 10 % albendazole cream 3 times daily for 1 week without recurrence for 22 months up to now. We thought this was a rare case which was confirmed by a skin biopsy showing larva in the epidermis.
Adult ; Albendazole ; Biopsy ; Eosinophilia ; Epidermis ; Female ; Humans ; Immunoglobulin E ; Larva ; Larva Migrans* ; Recurrence ; Skin ; Thorax

We experience a case of plexiform neurofibroma in a 10-year-old girl who had unusual giant pigmentation and multiple skcletal abnormalities including pectus cariimtum. Histologic examination of the lesion taken from right upper arm permitted a diagnosis of plexiform neurofibroma.
Arm ; Child ; Diagnosis ; Female ; Humans ; Neurofibroma, Plexiform* ; Pigmentation*

We experience a case of plexiform neurofibroma in a 10-year-old girl who had unusual giant pigmentation and multiple skcletal abnormalities including pectus cariimtum. Histologic examination of the lesion taken from right upper arm permitted a diagnosis of plexiform neurofibroma.
Arm ; Child ; Diagnosis ; Female ; Humans ; Neurofibroma, Plexiform* ; Pigmentation*

Wilms' tumor is one of the most common primary malignant tumors of the kidney during infancy and childhood and is known to be originated from the primitive cells of metanephric blastema. It presents difficulties when encountered in deciding the presence of anaplasia or in differentiating it from other renal tumors of childhood with different biologic behavior because of its diverse histologic patterns and varying degrees of differentiation. Evaluation of clinical and histopathologic features in terms of prognostication was done of 32 cases of Wilms' tumor which were surgically resected and diagnosed in the period from January 1979 through June 1992. Immunohistochemical reaction for cytokeratin, vimentin, actin and desmin was also analysed on all cases of Wilms' tumor in conjunction with clear cell sarcoma of the kidney(CCSK), malignant rhabdoid tumor of the kidney(MRTK) and congenital mesoblastic nephroma(CMN) to assess the validity of immunohistochemistry in differentiating Wilms' tumor from these renal tumors. Twenty four(75%) cases were diagnosed before the age of 5 and 40.7% were under 2 years old. Mixed type was most common(62.5%), followed by epithelial, blastemal and stromal predominant type in descending order of frequency. Anaplasia was observed in 3 cases(9.4%), two of which were epithelial predominant type and one blastemal predominant type. Treatment modality and presence of anaplasia were significantly correlated with 5 year survival rate of patients. Immunohistochemical stain revealed that all epithelial component of Wilms' tumor were positive for cytokeratin and 56.3% of Wilms' tumor had blastemal component which were positive for both cytokeratin and vimentin. Twenty cases(62.5%) of Wilms' tumor had blastemal component which were positive for cytokeratin with a proportion of more than 5% of reactive cells. Stromal component of Wilms' tumor generally did not show differentiation into the specialized type of tissue and all revealed positive reactions for vimentin among which some revealed positive reactions for actin. Only 3 out of 6 cases with rhabdomyoblastic differentiation were positive for desmin. CCSK, MRTK and CMN which have different biologic behavior and treatment modality compared to Wilm's tumor showed positivity only for vimentin and/or actin. In summary, treatment modality and presence of anaplasia are significantly correlated with patients' survival and the immunohistochemical stain for cytokeratin is very helpful in confirming the presence of blastemal component and useful in the differential diagnosis of Wilms' tumor from other kinds of pediatric renal tumors.
Child ; Male ; Female ; Humans ; Diagnosis, Differential

Hepatolithiasis is common in east Asia, but rare in the Western world. Recently, epidemiologic study on Korea gallstone disease showed that the portion of patients with hepatolithiasis among total gallstone patients is 14.1%. Hepatolithiasis is the cause of recurrent cholangitis and it is that risk factor of liver abscess, hepatic failure, or sepsis. Also, biliary cirrhosis and cholangiocarcinoma were developed from hepatolithiasis. The incidence of cholangiocarcinoma associated with hepatolithiasis is about 2.4~10% . We present three cases of unresectable cholangiocarcinoma diagnosed after removal of hepatolithiases by percutaneous transhepatic cholangioscopy.
Cholangiocarcinoma* ; Cholangitis ; Far East ; Gallstones ; Humans ; Incidence ; Korea ; Liver Abscess ; Liver Cirrhosis, Biliary ; Liver Failure ; Risk Factors ; Sepsis ; Western World

The titanium miniplate osteosynthesis system has been used for fixation of bone fragments in the maxillofacial areas due to easy manipulation and even has been proposed for unnecessity of miniplate removal because of the biocompatibility and the corrosion resistance. But recently, there have been some suggestions for its removal, on the basis of findings that there have been pigmentations around the adjacent tissues during miniplate removal procedure and they are the depositions of metal particles. Purposes of this study are to ascertain the presence and nature of pigmentation observed within tissues adjacent to titanium miniplate, and to suggest possible causes of it. We could observe the black pigmentation during miniplate removal procedure for recent about 1.5 year. Pigmented tissues were stained with hematoxylin-eosin(H-E) for light microscophic(LM) examination to investigate the black pigmentations and the histomorphology around them. The scanning electron microscopy(SEM) with energy dispersive X-ray(EDX) analysis was used to examine the ultrastructural nature of pigmentations. Many metal particles with variable sizes and shapes were seen in the connective tissue by SEM and were identified as titanium by EDX.
Connective Tissue ; Corrosion ; Pigmentation* ; Titanium*