An 8-year-old girl had a rice sized erythematous nodule secreting mucoid fluid situated above the right sternoclavicular joint area since birth. Histopathological findings of the lesion revealed predominant mucous acini, serous acini, demilunes of mixed acini and excretory ducts in the deep dermis compatible with salivary gland. Electron microscopic findings revealed a lumen and serous cells containing serous granules and rough endoplasmic reticulurn. Recurrence has not been noted following total excision of the nodule.
Child ; Dermis ; Female ; Humans ; Neck* ; Parturition ; Recurrence ; Salivary Glands* ; Sternoclavicular Joint

No abstract available in English.
Clinical Study ; Extremities ; Fractures, Spontaneous

We report one case of bilateral naviculo-medial cuneiform coalition in ten year old girl. She complained of pain in the medial aspect of the mid-foot related to long periods of standing and activity. Routine roentgenographs, specifically lateral views showed a bony bridge between the navicular bone and medial cuneiform. A biopsy revealed as fibrocartilaginous tissue. The bony bridge consists about one third in lateral view and 30 degree cephalad tilting in the antero-posterior view. Bilateral resection arthroplasty, with interposing flesh muscle fibers of the abductor hallucis, was performed for restoration of motion in the naviculo-medial cuneiform joint and relief of localized pain. Four months after surgery, pain around the mid-foot had almost complete subsided. One year postoperative, neither recurrence nor disability was observed. We will discuss the diagnosis and treatment of this rare case of bilateral naviculo-medial cuneiform coalition.
Arthroplasty ; Biopsy ; Diagnosis ; Female ; Humans ; Joints ; Recurrence

Abnormalities in the number and function of platelets may contribute to thromboembolic complications in patients with essential thrombocythemia(ET). Physicians often use hydroxyurea which reduces the platelet count for the initial treatment of ET. A 74-year-old man with ET was presented with headache, dysarthria, and right hemiparesis 10 months after discontinuation of hydroxyurea. Initial platelet count was 450x103/microliter and we gave him heparin. However, his platelet count rised upto 1,019x103/microliter within 4 days. He was on hydroxyurea 1.5 g/day and his symptoms improved with decrease of platelet count. We report a case of left MCA(middle cerebral artery) multifocal infarction in ET after discontinuation of hydroxyurea.
Aged ; Cerebral Infarction* ; Dysarthria ; Headache ; Heparin ; Humans ; Hydroxyurea* ; Infarction ; Paresis ; Platelet Count ; Thrombocythemia, Essential*

Vertigo mimicking labyrinthine lesions may have resulted from ischemic insult to the inner ear or the vestibular nerve and nucleus in the AICA infarction syndrome. A 56-year-old female was admitted to the emergency room with vertigo and hearing loss in right ear. On neurological examination, she had left beating jerky torsional and horizontal nystagmus with falling and past pointing to right side. Brain magnetic resonance images showed high signal intensity in anterolateral portion of inferior pons on T2- weighted images. Severe right facial palsy of peripheral type developed 24 hours after admission. Audiometry and electronystagmography documented absent auditory and vestibular function on the affected side. We argue that vertigo of the acute infarction in AICA territory can be involved the eight and seventh nerve root entry zoon and mimic labyrinthine lesions
Audiometry ; Brain ; Ear ; Ear, Inner ; Electronystagmography ; Emergency Service, Hospital ; Facial Nerve* ; Facial Paralysis ; Female ; Hearing Loss ; Humans ; Infarction* ; Middle Aged ; Neurologic Examination ; Nystagmus, Pathologic ; Pons ; Vertigo* ; Vestibular Nerve

This study is a clinical review of 154 patients with fistula-in-ano, which were treated at the Department of General Surgery of Ewha Womans University Hospital from January, 1993 to December, 1996. The male to female ratio was 4:1, and the prevalent of groups were in the 3rd and 4th decade. The symptoms were anal discharge in 123 cases(79.8%), pain in 21 cases (13.6%), palpable mass in 9 cases(5.8%). 53.8% of the patients showed a duration of symtoms which were within 6 mouths. The previous or combined anal diseases were anal abscess in 62.4%, postfistulectomy in 29.0%, hemorrhoid in 4.3%, and anal fissure in 1.2%. The histopathologic etiologies were chronic non-specific inflammation in 94.8%, and tuberculosis in 3.2%. 38.8% of the patients showed an external openings in the anterior midline, 25.9% in the posterior midline, 13.0% in the left lateral, and 10.4% in the right lateral portion of the anus. In 84.4% of the patients, the interval opening was identified. The intersphincteric type was the most common. The operative procedures included fistulotomy with lay open in 129 cases(83.8%), fistulotomy with seton in 16 cases(10.4%), and fistulectomy in 8 cases(5.2%). The days of hospital stay were mostly within 14 days. The main postoperative complications were urinary retention and reccurance, which were identified in 4.6% each of the patients. The acuracy and the predictive value of fistulography, a method of identification of the internal openings showed an accuracy of 73%, the predictive value of positive tests was 95% and that of the negative test was 30%.
Abscess ; Anal Canal ; Female ; Fissure in Ano ; Hemorrhoids ; Humans ; Inflammation ; Length of Stay ; Male ; Mouth ; Postoperative Complications ; Rectal Fistula ; Surgical Procedures, Operative ; Tuberculosis ; Urinary Retention

BACKGROUND: Extravasation of chemotherapeutic agents during intravenous infusion may cause extensive inflammatory reaction, ulceration, crust formation, and skin necrosis. But the exact mechanism of cutaneous reactions after extravasation of adriamycin remains unknown. OBJECTIVE: Our purpose was to evaluate the clinical and histological features in rabbits after injection of adriamycin and a mixed solution of adriamycin and triamcinolone. METHODS: Three rabbits were divided into three groups and were subcutaneously injected with the following materials on the back:adriamycin, a mixed solution of adriamycin and triamcinolone and 0.9% saline respectively. The injection sites including the skin and subcustaneouskfat were excised and fixed with natural huffered formalin. The biopsied specimens were stained with hematoxylin and eosin. RESULTS: l. In the adriamycin injected group, there were induration, crust formation and ulceration after three weeks. After seven weeks crust and focal ulceration were found. Histologically, after one day mild epidermal necrosis, dermal inflammatory infiltration, destruction of epidermal appendag es, edema and hemorrhage were seen. After one week collagen necrosis was advanced and granulation tissue formation and calcium deposition were found. After seven weeks granulation tissue formation and calcium d position still remained. 2. In the adriamycin and triamcinolone injected group, focal healing ulceration was seen after three weeks. After seven weeks the ulceration healed and normal gross finding was seen. Histologically, destructior of epidermal appendages and edema were found after one day. After three weeks granulation tissue formation and fatty changes in the dermis were seen. After five weeks normal histologic findings were seen in the epidermis. Collagen necrosis became less prominent and hyalinizationand transepidermal elimination were found. After seven weeks nearly normal histological findings in the epidermis and dermis were seen. CONCLUSION: We conclude that there was a marked difference in the gross and histological findings between two groups of adriamycin injected and a mixed solution of adriamycin and triamcinolone injected rabbits. Therefore, we suggest triamcinolone can be used as an adjuvant mode in the treatment of lesions where adriamycin is extravasated.
Calcium ; Collagen ; Dermis ; Doxorubicin* ; Edema ; Eosine Yellowish-(YS) ; Epidermis ; Formaldehyde ; Granulation Tissue ; Hematoxylin ; Hemorrhage ; Infusions, Intravenous ; Injections, Intralesional* ; Necrosis ; Rabbits ; Skin ; Triamcinolone ; Ulcer

Goltz syndrome, also known as focal dermal hypoplasia syndrome, is a rare congenital mesoectodermal disorder. Two cases, which we experienced, showed erythematous, tan skin rashes and atrophic scars on the whole body, but there were some differences in clinical manifestations. Histopathologic findings in both cases showed diminution in the thickness of the dermis with subcutaneous fat extending upward to the epidermis. Therefore, we report a comparison of two cases of Goltz syndrome, especially with respect to clinical manifestations.
Cicatrix ; Dermis ; Epidermis ; Exanthema ; Focal Dermal Hypoplasia* ; Subcutaneous Fat ; Triacetoneamine-N-Oxyl

BACKGROUND & PURPOSE: This purpose of this study was to determine the prognostic factors for hepatocellular carcinoma (HCC) in patients who received curative hepatectomies at our institution. PATIENT AND METHOD: A retrospective analysis was performed on 457 patients who had undergone hepatectomies between Mar 1987 and Feb 2008 for HCC at the Korea Cancer Center Hospital, Seoul, Korea. The number of males enrolled in the study was 366 and the number of females enrolled was 91. The mean age of the patients was 52.8 years old. Hepatitis B virus-related disease was the most frequent etiology (335/457 patients). Two hundred nine (209) patients had liver cirrhosis, and 93.9% of patients were classified in Child-Pugh Class A. RESULT: The complication rate was 30.6% (140/457) and the operative mortality was 1.5% (7/457). Reoperation was performed in 7 complicated patients. Five-and 10-year overall survival rates of the patients were 57.7% and 41.8% respectively. Poor prognostic factors of overall survival were Child B class, Edmonson-Steiner histologic grade 3 or 4, tumor vascular invasion, and postoperative complications. Five-and 10-year disease-free survival rates were 42.7% and 32.5%, respectively. Poor prognostic factors for disease free survival included the following an Edmonson-Steiner histologic grade of 3 or 4, tumor vascular invasion, and postoperative complications. CONCLUSION: Postoperative complication is independently a poor prognostic factor for overall and disease free survival in our study. We suggest that special care is needed while performing hepatic resections for the treatment of HCC in order to reduce postoperative complications.
Carcinoma, Hepatocellular ; Child ; Disease-Free Survival ; Female ; Hepatectomy ; Hepatitis B ; Humans ; Korea ; Liver Cirrhosis ; Male ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Survival Rate

PURPOSE: In Korea, there are few reports regarding the infiltration of fat tissue in pancreatic parenchyma in surgically resected organs. It is necessary to ascertain the correlation between the presence of fat tissue in the resection margin of the pancreas and the surgery outcome. METHODS: Fifty four patients who underwent pancreatic resection from Jan. 2007 to Nov. 2008 were enrolled in this study. Pathologic examination was performed to determine the presence of fat tissue in resected pancreatic parenchyma. Statistical correlation between the presence of fat tissue with clinical parameters and postoperative complication rates was analyzed. RESULTS: Among the specimens of all fifty four patients, fat tissue was found in 32 specimens of patients (59.3%). Female gender and patients whose body mass index exceeded 24 kg/m2 were statistically correlated with the presence of the fat tissue in pancreatic parenchyma. There was no statistical relationship between infiltration of fat tissue with postoperative complications. CONCLUSION: This study may serve as the base data for study in radiological imaging in detecting pancreatic tissue. A further larger scaled study is needed to validate the result of this study.
Body Mass Index ; Female ; Humans ; Korea ; Pancreas ; Pancreaticoduodenectomy ; Postoperative Complications