Lipoma Arborescens is rarely encountered in hip joint. This term was first used by Mueller in 1838, to describe a fatty trmor of the knee which presented branched villous-like projection. The etiology is unknown, Suggests its probable reationship to tuberculosis, rheumatoid arthitis, trauma, chronic inflammation, diabetes mellitus and degenerative arthritis. It frequently involves knee joint, hand, wrist, foot, ankle, tendon sheath and hip joint. It usually presents bilaterally. Their nonspecific symptoms and signs are mild pain, joint swelling with minimum effusion, festriction of joint motion, redness, local heating and crepitus. We experienced a case of lipoma arborescens of hip joint, which was treated by synovectomy with excision of lesion.
Ankle ; Arthralgia ; Diabetes Mellitus ; Foot ; Hand ; Heating ; Hip Joint ; Hip ; Hot Temperature ; Inflammation ; Joints ; Knee ; Knee Joint ; Lipoma ; Osteoarthritis ; Tendons ; Tuberculosis ; Wrist

Cellular schwannoma is a very rare benign tumor involving peripheral nerves, mimicking malignant nerve sheath tumor in histological appearance. It is a clinico-pathological variant of benign schwannoma characterized by a high cellularity, increased mitotic figures and occasional presence of bone destruction. A 6-month-old female patient was admitted with progressive quadriparesis. Magnetic resonance imaging of the cervical spine showed a well-enhancing extramedullary mass on the C4 to C6 area. Total laminectomy was performed on C4-7, and intradural extramedullary tumor was removed. Histologically, the tumor was composed of proliferated spindle cells. Most of the tumor was composed of Antoni A area with hypercellular spindle cells arranged in fascicular pattern. The tumor cells showed mild atypism with mitotic figure upto 4/10HPF and diffuse, strong S-100 protein immunostaining. The patient was improved postoperatively.
Female ; Humans ; Infant* ; Laminectomy ; Magnetic Resonance Imaging ; Neurilemmoma* ; Peripheral Nerves ; Quadriplegia ; S100 Proteins ; Spinal Cord Neoplasms ; Spine*

OBJECTIVE: Because of the limited penetration into the central nervous system after systemic administration of numerous therapeutic compounds, intratumoral chemotherapy for brain tumors has also been used. However, the efficacy of intratumoral drug administration is restricted by the poor diffusion of drug through tumor and brain interstitium. In order to enhance the diffusion of chemotherapeutic agent and increase the cytotoxicity with minimal dose, the authors report the results of convection-enhanced delivery(CED) of chemotherapeutic agent to the malignant brain tumor as a method of enhancing cerebral drug delivery. METHODS: Authors used "CADD-Micro(R) ambulatory infusion pump" from Deltec, which can be programmed for continuous infusion. Intratumoral injection of chemotherapeutic drug using the pump was applied to eight patients with glioma and one patient with lymphoma. Surgery was done and tumor was removed as much as possible. The tip of catheter was placed in the center of tumor cavity. Adriamycin (0.16~0.32mg) was put in the reservoir which was connected to the proximal catheter and fixed in the pump device. Twenty-four hours after surgery, Adriamycin was infused. RESULTS: There was no adverse reaction of CED technique. Compared with current delivery techniques, the improvement of survival rate has been observed(5 patients: alive, 3 patients: dead, 1 patient: lost(alive to 5 mo.)). CONCLUSION: CED can be useful method for distributing therapeutic molecules in the interstitial space of tumor and can be utilized for chemotherapeutic agents, immunotoxins, and gene etc..
Brain ; Brain Neoplasms ; Catheters ; Central Nervous System ; Diffusion ; Doxorubicin ; Drug Therapy ; Glioma ; Humans ; Immunotoxins ; Lymphoma ; Survival Rate

Background: Lead, which is widely used in various industrial settings, is a major health hazard for manufacturing workers. Therefore, control of lead exposure has been implemented in an effort to prevent lead-related health problems. In this study, our aim was to evaluate temporal trends in occupational lead exposure in Korean lead workers using data from monitoring of workplace exposure. Methods: A nationwide work environment monitoring database, data from a work environment monitoring institution, and data extracted from a review paper were utilized. Different versions of standard industrial classification codes were aligned with the 10th Korean Standard Industrial Classification, which is generally consistent with the 4th revision of the International Standard Industrial Classification. The multiple data sources were combined and temporal trends over the period from 1994–2021 were estimated. In addition, separate estimation of temporal trends in the storage battery manufacturing industry over the period from 1987–2021 was also performed. Results: A total of 444,296 personal airborne lead measurements were used for the estimation process. The temporal trends in occupational exposure to lead declined by −6% annually over the study period. In particular, levels of lead exposure in the storage battery manufacturing industry showed a steeper decline of −12% annually. Conclusions Findings of our study showed that occupational exposure to lead declined over the period from 1994 to 2021 in Korea. However, adverse effects of exposure to lead on health should be regarded with caution. The results will be useful in conduct of epidemiological studies examining lead-related effects on health.

BACKGROUND/AIMS: Chronic cholecystitis and contraction of gallbladder (GB) have been regarded as precancerous lesions. The aim of study is to clarify whether chronic cholecystitis and GB contraction have clinical significance. METHODS: This study included 409 patients underwent cholecystectomy for chronic cholecystitis between January 2006 and June 2011 at a single center. Data regarding radiologic findings and blood tests were collected retrospectively. RESULTS: About 384 patients (94%) had GB stones. Among 409 patients, 104 (25.4%) patients had contracted GB and 305 (74.6%) patients did not. Biliary pain was more common in the contracted GB group (42.3% vs. 31.1%). The contracted GB group had a higher proportion of diffuse wall thickening type and a higher conversion rate to open cholecystectomy. Only seven patients (1.7%) were finally diagnosed with GB cancers. All patients were over 60 years of age and complained of biliary pain; however, only one patient had contraction of GB. CONCLUSIONS: Biliary pain, diffuse wall thickening, and conversion to open cholecystectomy were more frequent in the contracted GB group. Although incidental GB cancers were rarely diagnosed, all were older and had biliary pain. These will be used as significant evidences when making a treatment plan in chronic cholecystitis and contracted GB.
Cholecystectomy ; Cholecystitis* ; Gallbladder Neoplasms ; Gallbladder* ; Hematologic Tests ; Humans ; Retrospective Studies

BACKGROUND/AIMS: Chronic cholecystitis and contraction of gallbladder (GB) have been regarded as precancerous lesions. The aim of study is to clarify whether chronic cholecystitis and GB contraction have clinical significance. METHODS: This study included 409 patients underwent cholecystectomy for chronic cholecystitis between January 2006 and June 2011 at a single center. Data regarding radiologic findings and blood tests were collected retrospectively. RESULTS: About 384 patients (94%) had GB stones. Among 409 patients, 104 (25.4%) patients had contracted GB and 305 (74.6%) patients did not. Biliary pain was more common in the contracted GB group (42.3% vs. 31.1%). The contracted GB group had a higher proportion of diffuse wall thickening type and a higher conversion rate to open cholecystectomy. Only seven patients (1.7%) were finally diagnosed with GB cancers. All patients were over 60 years of age and complained of biliary pain; however, only one patient had contraction of GB. CONCLUSIONS: Biliary pain, diffuse wall thickening, and conversion to open cholecystectomy were more frequent in the contracted GB group. Although incidental GB cancers were rarely diagnosed, all were older and had biliary pain. These will be used as significant evidences when making a treatment plan in chronic cholecystitis and contracted GB.
Cholecystectomy ; Cholecystitis* ; Gallbladder Neoplasms ; Gallbladder* ; Hematologic Tests ; Humans ; Retrospective Studies

BACKGROUND/AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) is an uncomfortable procedure that requires adequate sedation for its successful conduction. We investigated the efficacy and safety of the combined use of intravenous midazolam and propofol for sedation during ERCP. METHODS: A retrospective review of patient records from a single tertiary care hospital was performed. Ninety-four patients undergoing ERCP received one of the two medication regimens, which was administered by a nurse under the supervision of a gastroenterologist. Patients in the midazolam (M) group (n=44) received only intravenous midazolam, which was titrated to achieve deep sedation. Patients in the midazolam pulse propofol (MP) group (n=50) initially received an intravenous combination of midazolam and propofol, and then propofol was titrated to achieve deep sedation. RESULTS: The time to the initial sedation was shorter in the MP group than in the M group (1.13 minutes vs. 1.84 minutes, respectively; p<0.001). The recovery time was faster in the MP group than in the M group (p=0.031). There were no significant differences between the two groups with respect to frequency of adverse events, pain experienced by the patient, patient discomfort, degree of amnesia, and gag reflex. Patient cooperation, rated by the endoscopist as excellent, was greater in the MP group than in the M group (p=0.046). CONCLUSIONS: The combined use of intravenous midazolam and propofol for sedation during ERCP is more effective than midazolam alone. There is no difference in the safety of the procedure.
Amnesia ; Cholangiopancreatography, Endoscopic Retrograde* ; Conscious Sedation ; Deep Sedation ; Humans ; Midazolam* ; Organization and Administration ; Patient Compliance ; Propofol* ; Reflex ; Retrospective Studies ; Tertiary Healthcare

Cephalic tetanus is defined as a combination of trismus and paralysis of one or more cranial nerves. Cranial nerves III, IV, VI, VII, and XII may be affected, but the facial nerve is most frequently implicated. A 64-year-old female visited hospital for left ptosis followed by facial palsy after a left forehead abrasion in a car accident. At nine days post injury, left ptosis developed, left facial palsy developed twelve days post injury, and at fifteen days post injury, trismus and dysphagia developed. The following day, there was progression of symptoms to generalized tetanus, such as dyspnea and generalized rigidity. Videofluoroscopic swallow study showed penetration and aspiration. We report a case of cephalic tetanus with ptosis, facial palsy, and dysphagia, which progressed to generalized tetanus.
Cranial Nerves ; Deglutition Disorders ; Dyspnea ; Facial Nerve ; Facial Paralysis ; Female ; Forehead ; Humans ; Middle Aged ; Paralysis ; Tetanus ; Trismus

PURPOSE: It is known that carriage rates of Staphylococcus aureus (S. aureus) are highest in newborns and that the asymptomatic carriage of methicillin-resistant Staphylococcus aureus (MRSA) is associated with invasive MRSA infection with the colonizing strain. This study was carried out to investigate the carriage rates of MRSA in neonates with neonatal jaundice. METHODS: We reviewed the medical records of 545 neonates admitted with neonatal jaundice to neonatal intensive care units between January 2006 and December 2010. Nasal and inguinal swab specimens had been taken from them and cultured for the isolation of S. aureus. Antimicrobial susceptibility tests had been done for such isolates to determine methicillin-resistance. RESULTS: Out of 545 neonates, 318 (58.3%) were colonized with S. aureus and 214 (39.3%) were colonized with MRSA. Results of the antibiogram analysis showed that 65.7% of MRSA isolates were likely to be community-associated (CA) MRSA. CONCLUSION: Based on the MRSA carriage rate of 39.3%, a surveillance program for MRSA colonization is considered necessary in neonates transferred from other clinics or hospitals. Out of MRSA isolates, 65.7% were likely to be CA-MRSA. This suggests that CA-MRSA strains were already present in obstetric clinic environments where the neonates were born. It is thought that MRSA surveillance programs in these environments are also necessary.
Colon ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Jaundice, Neonatal ; Medical Records ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Sprains and Strains ; Staphylococcus aureus

Candida was found in the oral cavity, jejunum, and ileum of the healthy population. In case of alimentary tract, the factors of favorable to candida colonization include old age, malnutrition, diabetes, burns, trauma, surgical operations, parenteral nutrition, intravascular or bladder catheterization, H2-blocker therapy, steroid therapy, immunosuppresive treatment and the use of wide spectrum antibiotics: however, gastrointestinal candida colonization is rarely found in the healthy adult. No case of duodenal ulcer with candidiasis has been reported in healthy people. Recently we experienced a case of asymptomatic duodenal ulcer with candidiasis in a healthy male, who had taken H2-blocker and proton pump inhibitor for 3 months after primary closure of duodenal ulcer perforation. Therefore we report this case with review of several literatures.
Adult ; Anti-Bacterial Agents ; Burns ; Candida ; Candidiasis* ; Catheterization ; Catheters ; Colon ; Duodenal Ulcer* ; Humans ; Ileum ; Jejunum ; Male ; Malnutrition ; Mouth ; Parenteral Nutrition ; Proton Pumps ; Urinary Bladder