BACKGROUND: Tufted angioma is an uncommon slowly progressive vascular tumor found typically in infants and young children with characteristic histologic findings, so called "cannonball" appearance. OBJECTIVE: The purpose of this study was aimed to investigate the clinical and histopathological characteristics of tufted angioma and the response to intralesional steroid. METHODS: Clinical information of 10 patients with tufted angioma diagnosed in Severance hospital and Pundang CHA hospital from 1983 to 1999 was obtained from the medical records and clinical follow-ups. We re-evaluated 10 biopsy specimens obtained from them with routine H&E staining. RESULTS: Five male and five female patients were included. In 9 patients the lesion appeared before 2 months of age. Four had a lesion at birth. The thigh was the most common site. The clinical symptoms were diverse, but characteristically tenderness was present in most cases. In all the patients the lesions had a tendency to spread progressively. Microscopically, numerous, distinct, variably sized, tightly packed capillary and endothelial cellular lobules were scattered in the dermis. There were characteristic semilunar spaces adjacent to the capillary tufts. Six patients received intralesional triamcinolone. This treatment was found to be effective in 5 patients who experienced remarkable improvement. The improved cases had similar histologic findings which were composed of cellular mass more than lumen formation. We classified our specimens into two categories, one with more cellular mass and the other with more lumen formation in relative proportion. The former was different from the latter in that it had more solid appearance and more definite margin. And we realized that it was useful to divide into these two categories since its response to treatment could be different. CONCLUSIONS: Tufted angioma is a relatively uncommon disease with characteristic histopathologic findings. It seems not to regress spontaneously. So early treatment is required to pre-vent further spreading up to the extent. We treated 6 patients with intralesional injection of triamcinolone and 5 patients experienced marked improvement which had more cellular mass more than lumen formation histopathologically.
Biopsy ; Capillaries ; Child ; Dermis ; Female ; Follow-Up Studies ; Hemangioma ; Humans ; Infant ; Injections, Intralesional ; Male ; Medical Records ; Parturition ; Thigh ; Triamcinolone

The wrist, or carpus, is a deformable anatomic entity composed of 8 small carpal bones (scaphoid, lunate, triquetrum, pisiform, hamate, capitate, trapezium and trapezoid) and the surrounding soft-tissue structures. We should get radiological knowledge of normal wrist in order to identify pathology of that. So we measured the several values on AP, PA and lateral roentgenograms of 228 normal wrist(male : 124 cases, femal: 104 cases). The following results were obtained: 1. Scapholunate gap : 1.4±0.5mm 2. Ulnar variance : 1.3 ±1.7mm, Positive variance … 59.7%, Neutral variance … 25.4% 3. Carpal height ratio : 0.543 ±0.078 4. Carpal ulner distance ratio : 0.32 ±0.04 5. Scapholunate angle : 45.8 ± 8.7° 6. Capitatolunate angle : 19.3 ± 8.2° 7. Radiolunate angle : 8.9 ± 4.7° 8. Ulnar tilt: 23.5 ± 3.3° 9. Volar tilt: 12.0 ± 4.7°
Carpal Bones ; Pathology ; Wrist

Gastric tuberculosis is a rare disease and the diagnoeis of gastric tuberculosis is based on either positive histological or bacteriological study. We experienced a case of gastric tuberculosis with pleural effuaion in 59 year-old woman, diagnosed by the histological study of the endoscopic biopsy specimen. Follow up endoscopic finding revealed marked improvement of gastric lesion after anti-tubercadoua medication. We reported the case with review of literature.
Biopsy ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Rare Diseases ; Tuberculosis*

BACKGROUND: Pyoderma gangrenosum is a rare disease in which a painful nodule or pustule breaks down to form a progressive enlarging ulcer. Until now, only 8 cases of pyoderma gangrenosum have been reported in Korea. Therefore, we thought it necessary to perform a clinical analysis of pyoderma gangrenosum in Korea with a review of literature. OBJECTIVE: Our purpose was to find the clinical features of pyoderma gangrenosum in Korea. METHODS: Fourteen cases with pyoderma gangrenosum were investigated by reviewing medical records. Results There were 6 males and 8 females. The onset age was between 4 years and 65 years, and most(9 cases) had developed the condition between the ages of 20 and 60. Thirteen cases involved the extremities and 3 cases had whale body involvement, Seven cases(50%) had multiple lesions. All cases had pain at the lesional sites. Two cases were classified as the bullous type and the others were ulcerative in nature. The histological fmdings were non-specific. Dense inflarnmatory infiltrates composed of lymphocytes and predominant neutrophils were found in the epidermis and dermis associated with ulceration. Two cases were treated only with systemic steroids, and 2 cases with dapsone and steroids, 2 cases with colchicine and steroids, and 1 case with steroids, dapsone and colchicine. One case was treated with colchicine and anti-Tbc drug, 1 case with dapsone, 3 cases with antibotics, 1 case with the anti-Tbc drug and 1 case with anti-cancer drugs. Systemic disease was present in 5D% of the cases. The associated diseases were Behcets disease(3 cases), tuberculosis(2 cases), systemic lupus erythematosus(1 case), pancytopenia(1 case), iron deficiency anemia(1 case), acute leukemia(1 case), and colon adenoma(1 case). Recurrence developed in 2 cases and positive pathergy reactions were observed in 3 cases. CONCLUSION: Pyoderma gangrenosum was eccompanied with systemic disease in 50% of the cases and the most common therapeutic drugs were steroids. It is therefore impartant to detect the presence of any underlying disease and to treat this alongside pyoderma gangrenosum.
Age of Onset ; Colchicine ; Colon ; Dapsone ; Dermis ; Epidermis ; Extremities ; Female ; Humans ; Iron ; Korea ; Lymphocytes ; Male ; Medical Records ; Neutrophils ; Pyoderma Gangrenosum* ; Pyoderma* ; Rare Diseases ; Recurrence ; Steroids ; Ulcer ; Whales

No abstract available.
Drug Therapy*

The purpose of this study was to investigate the effect that three resin indexing materials had on the distortion of split cast in the procedures of solder indexing and block fabrication. The specimen had two cylinders and connecting bar. Two cylinders were a reference cylinder and a test cylinder that were machined precisely and placed on metal base. The total of specimens wee 30 and they were divided into 3 groups according to the resin indexing materials : Acrylic solder , G-C Pattern resin , Z-100 . The relative coordinates (X, Y, Z) of centroids of both cylinders were measured by using 3-D coor dinates measuring machine. The value of indexing distortion was obtained after application of indexing material, and the value of the block distortion was obtained after fabrication of soldering block, and the value of total distortion was a value sum of indexing distortion and block distortion. Intercentroidal linear distortion({{{{ SQRT {X'^2 + Y'^2 +Z'^2 }- SQRT {X^2 + Y^2 +Z^2} }} }}) and global distortion {{{{rm SQRT {(X'-X)^2 +(Y'-Y^)2 +(Z'-Z^)2} }} }} were calculated from data of coordinates of centroids at each mea s u r ing stages. The results of this study were as belows ; 1. The intercentroidal distance between the split casts was reduced by indexing distortion and increased by block distortion. 2. The indexing global distortion between the split casts was smaller than block global distortion. 3. The intercentoidal linear distortion and the global distortion were no significant difference between indexing materials.
Abstracting and Indexing as Topic

Incidence of aseptic loosening of hip prostheses is increasing in recent years. Previous studies suggested the involvement of proteinases and cytokines in the accelerated bone lysis associated with loosening. To investigate the role of matrix metalloproteinases (MMPs) in the loosening, Gelatin/Type IV collagenases, namely, 72 KDa matrix metalloproteinase (MMP)-2 type and 92 KDa MMP-9 type were analyzed in 14 cases of the loosened endoprostheses of the hip. Zymographic and densitometric analyses revealed production of MMP-2 ancl elevated induction of MMP-9 in tissue extracts from both the interface hetween hone and implants and the capsular tissues when compared with those in synovium obtained from a patient with a t'ractured femoral neck. MMP-9 showed stronger activity than MMP-2. In the sample of a fractured femoral neck, MMP-2 was detected, but MMP-9 was not detected. In matched samples, the activity of MMP-2 and MMP-9 in the interface tissues showed stronger activity than those in the capsular tissues. There was no difference between cemented and uncemented femoral prostheses. The state of prostheses(loosening, osteolysis, and cup wear) did not influence on the activity of MMP-2 and MMP-9. Theses findings suggest a role for MMP-2 and MMP-9 type gelatinase/Type IV collagenases in the degradation of extracellular matrix of periprosthetic tissues, where they may cause weakening of the connective tissue hed and the loosening of total hip replacement endoprostheses. Consequently. we could confirm the role of MMP cascade in aseptic loosening of total hip prostheses. The further study ahout other types of MMP and the inhihitor of MMP will be needed.
Arthroplasty, Replacement, Hip ; Collagenases ; Connective Tissue ; Cytokines ; Extracellular Matrix ; Femur Neck ; Hip Prosthesis* ; Hip* ; Humans ; Incidence ; Matrix Metalloproteinases* ; Osteolysis ; Peptide Hydrolases ; Prostheses and Implants ; Synovial Membrane ; Tissue Extracts

19 cases of non-pineal intracranial germ cell tumors were reviewed retrospectively with both radiologic andclinical featurses. The results were as follows: 1. The age distribution was 8 to 32 year old (16 year old of meanage) and the sex distribution shows male predominence(15:4). 2. The histopathologic diagnosis included 11 cases ofgeminoma, 2 cases of mixed germ cell tumor, 1 case of embryonal cell carcinoma and 5 cases of unknown. 3. Thelocation of tumors was the suprasellar region in 8 cases, the left basal ganglia and thalamus in 5 cases, and theright frontal lobe in 1 case. Among 11 cases of geminoma, 6 cases involve the suprasellar region and 3 cases theleft basal ganglia and thalamus. 4. In clinical features, there were visual disturbance, diabetes insipidus,increased ICP signs, motor weakness, hormonal disorders, and personal changes in order. 5. In tumor marker studyof 6 cases of geminoma, 5 cases show increase in HCG, titie, but all 6 cases were normal in AFP titer. 6. In brainCT, most of all revealed well-defined homogeneous high density with or without small central low density andhomogenous enhancement at solid portion,and there was calcification in only case with mixed germ cell tumor.
Age Distribution ; Basal Ganglia ; Brain ; Diagnosis ; Frontal Lobe ; Germ Cells ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal ; Retrospective Studies ; Sex Distribution ; Thalamus

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an effective resuscitative modality to temporize noncompressible truncal hemorrhage. Confirming the proper position of the balloon catheter in the target aortic zone is vital. Currently, there is a need for nonradiographical methods. This would overcome the drawbacks of conventional imaging modalities, such as fluoroscopy. Several studies have suggested ultrasound-guided visualization via subxiphoid, transperitoneal, or transesophageal views as an alternative to conventional imaging methods. However, such views are easily obscured in emergency settings. Herein, we report the case of a 70-year-old patient who was successfully resuscitated by REBOA under the guidance of transsplenic ultrasound. REBOA was safely performed using transsplenic visualization without fluoroscopy.

Although prenatal and neonatal intensive care in recent years improved survival of infants, the risk of cerebral palsy (CP) in infants with perinatal asphyxia persisted. Screening criteria for risk factors of cerebral palsy and delayed development (DD) in term infants with perinatal asphyxia are required so that early diagnosis and rehabilitation and physical therapy could decrease the neurologic complications and maximize quality of life. To identify the risk factors of CP and DD in infants with perinatal asphyxia, we undertook a case-control study of 25 infants with perinatal asphyxia (5 min Apgar score below 6). At one year follow-up, 12 infants developed CP and DD and 13 control infants showed normal development. Risk factors associated with an increased risk of CP and DD were the number of abortion (p=0. 031), history of neonatal seizure (p=0.021), hypoxic ischemic encephalopathy (p=0.046), and poor response to resuscitation immediately after birth (p=0.017). In term infants with perinatal asphyxia, the risk factors of CP and DD were increased number of abortion, history of neonatal seizure, and hypoxic ischemic encephalopathy and poor response to resuscutation. Thus infants with these risk factors should be carefully followed up after hospital discharge and further extensive and prospective study in term infants with perinatal asphyxia could elucidate possible mechanisms related to cerebral palsy and delayed development.
Apgar Score ; Asphyxia* ; Case-Control Studies ; Cerebral Palsy* ; Early Diagnosis ; Follow-Up Studies ; Humans ; Hypoxia-Ischemia, Brain ; Infant* ; Infant, Newborn ; Intensive Care, Neonatal ; Mass Screening ; Parturition ; Quality of Life ; Rehabilitation ; Resuscitation ; Risk Factors* ; Seizures