We report a case of embryonal rhabdomyosarcoma with palpable right inguinal lymph node in a 6-year-old girl which developed rapidly on the right labia minora over a period of 2 montha. Histopathological study showed characteristic findings of spindle shaped rhabdomyoblast with hyperchromatic nuclei and cytoplasmicprocesses. After a preoperative chemotherapy with vincristine, actinomycin D, and cytoxan, the size of the mass was reduced, and lymph nodes were not palpable. And then, simple vulvectomy. postoperhtive cheirnatherapy and radiotherapy were done.
Child ; Cyclophosphamide ; Dactinomycin ; Drug Therapy ; Female ; Female* ; Genitalia, Female* ; Humans ; Lymph Nodes ; Radiotherapy ; Rhabdomyosarcoma, Embryonal* ; Vincristine

Linear porokeratosis is a rare variant of porokerstosis and usually occurs after childhood. We report herein a case of linesr porokeratosis in an 18-year-old female. The lesions had developed since birth and were found on the nearly whole body, including the face, neck, axilla, chest, abdomen, back, and upper and lower extremities. Palms and soles were also affected. Biopsy specirnens from the left forearm and right sole showed typical cornoid lamellae. We could not see any improvement with a course of oral etretinate for 6 weeks.
Abdomen ; Acitretin ; Adolescent ; Axilla ; Biopsy ; Etretinate ; Female ; Forearm ; Humans ; Lower Extremity ; Neck ; Parturition ; Porokeratosis* ; Thorax

The recent discovery of plasmid derived beta-lactamase production by N. gonorrhoeae has changed the outlook of treatment of gonococcal infections and may well become the single most important factor in gonorrhoea control. Penicillinase is a beta-lactamase that splits the beta-lactam ring of penicillin hetween the C and N atoms to form penicilloic acids. We have been trying to assess the prevalence of PPNG in Korea since May 1980. We report here 7 strains of beta-lactamase producing N. gonorrhoae detected by chrornogenic cephalosporin method from Jan. 1981 to Mar. 1981 at the Joong Ku puhlic health center in Seoul. In January, I strain (l.3%); February, 2 strains (5.0%); and March, 4 strains .(6 4%) have been isolated. All restrains were confirmed by sugar feriventation test. Previously only one strain of PPNG had been reported among Korean laymen. The sudden appearance of PPNG among Korean laymen in 1981 may mean the barruer between U.S. Army enc1aves and Korean public has been broken recently and/or direct irnport of PPNG frorn abroad especially from South East Asia.

We report herein a case of desmoplastic trichoepithelioma in a 73-year-old female, who is the oldest among the patients of the disease reported in Korea. She had an asymptomatic, hard, annular lesion, measuring 0.6 x 0.7 cm with an elevated border and a depressed center on the left nasolsbial fold. Histopathological findings showed narrow strands of basaloid tumor cells, horn cysts and a desmoplastic stroma.
Aged ; Animals ; Female ; Horns ; Humans ; Korea

PURPOSE: To determine the accuracy of automated computer aided volumetry for simulated small pulmonary nodules at computed tomography using various types of phantoms MATERIALS AND METHODS: Three sets of synthetic nodules (small, calcified and those adjacent to vessels) were studied. The volume of the nodules in each set was already known, and using multi-slice CT, volumetric data for each nodule was acquired from the three-dimensional reconstructed image. The volume was calculated by applying three different threshold values using Rapidia(R) software (3D-Med, Seoul, Korea). RESULTS: Relative errors in the measured volume of synthetic pulmonary nodules were 17.3, 2.9, and 11.5% at -200, -400, and -600 HU, respectively, and there was good correlation between true volume and measured volume at -400 HU (r=0.96, p<0.001). For calcified nodules, relative errors in measured volume were 10.9, 5.3, and 16.5% at -200, -400, and -600 HU, respectively, and there was good correlation between true volume and measured volume at -400 HU (r=1.03, p<0.001). In cases involving synthetic nodules adjacent to vessels, relative errors were 4.6, 16.3, and 31.2 % at -200, -400, and -600 HU, respectively. There was good correlation between true volume and measured volume at -200 HU (r=1.1, p<0.001). CONCLUSION: Using computer-aided volumetry, the measured volumes of synthetic nodules correlated closely with their true volume. Measured volumes were the same at each threshold level, regardless of window setting.
Cone-Beam Computed Tomography ; Seoul

BACKGROUND/AIMS: Patient compliance and resistance to antibiotics are main factors determining the success of Helicobacter pylori eradication. This study provides basic data to verify the efficacy of currently implemented eradication therapy and reports changes in H. pylori resistance to all antibiotics used at Asan Medical Center, Seoul, Korea from 2004 to 2010. METHODS: We investigated the resistance rates to amoxicillin, clarithromycin, metronidazole, ciprofloxacin, and levofloxacin in 88, 100, and 47 strains isolated from adult patients without H. pylori eradication history in 2004, 2007, and 2010. RESULTS: The resistance rate to amoxicillin increased from 5.0% in 2007 to 10.6% in 2010. The resistance rate to clarithromycin increased from 10.2% in 2004 and 11.0% in 2007 to 14.8% in 2010. However, no difference was observed in the resistance rate to metronidazole, and strains resistant to tetracycline were not detected at all in this study. The resistance rates to quinolone lingered at 15-17% for 3 years. The non-resistant strains to antibiotics accounted for 56% of the total in 2004 and 62% in 2007. In contrast, a decreasing tendency was found for those strains in 2010 (43%). No significant differences were shown in the multi-drug resistance rate or the co-resistance rates of amoxicillin and clarithromycin over the 3 years. CONCLUSIONS: We showed increased resistance rates to clarithromycin and amoxicillin over the last 7 years, aligning with the results of previous studies performed domestically. Efforts are needed to inhibit the increase in resistant bacteria to maintain the effectiveness of eradication therapy.
Adult ; Amoxicillin ; Anti-Bacterial Agents ; Bacteria ; Chungcheongnam-do ; Ciprofloxacin ; Clarithromycin ; Drug Resistance, Microbial* ; Drug Resistance, Multiple ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea ; Levofloxacin ; Metronidazole ; Patient Compliance ; Seoul* ; Tetracycline

Although the obstruction of the right colon is usually handled by primary anastomosis following resection, fear of the increased incidence of septic complication, especially anastomotic leakage with sepsis has turned surgeons away from doing anastomosis in the face of acute obstruction of the left colon. However, from recent reports, enough experiences have been accumulated to show that primary anastomosis is associated with minimum morbidity and mortality in the acute obstruction of the left colon. We experienced 54 cases of colon cancer obstruction at Holy Family Hospital from January 1988 to December 1997. Twenty six cases of them were right colon cancers, 24 cases were left colon cancers and 4 cases were rectal cancers. We reviewed these three groups for evaluation of the safety of one-stage resection and anastomosis of left colon cancer obstruction. The postoperative complication rate was 18% in right colon obstruction versus 38% in left colon obstruction. The most common complication was wound infection(43%). In using of primary resection and anastomosis, complication of right colon revealed 15% and left colon was 29%. But in a method of primary resection and anastomosis with decompression, complication of right colon was 17% and left colon was 13%. Especially on the left colon, primary resection and anastomosis with decompression revealed lower complication(13%) than that without decompression(67%). The mortality of colon cancer obstruction was 2% but this was a patient who had a poor general condition and took a primary resection and anastomosis without decompression. In cases of left colon cancer obstruction primary resection and anastomosis with decompression of left colon cancer obstruction can be a safe operation method with low morbidity and mortality.
Anastomotic Leak ; Colon* ; Colonic Neoplasms* ; Decompression ; Humans ; Incidence ; Mortality ; Postoperative Complications ; Rectal Neoplasms ; Sepsis ; Wounds and Injuries

No abstract available.
Thyroiditis, Autoimmune ; Turner Syndrome

BACKGROUND: Nowdays, modernization and industrialization cause many social problems and the abdominal stab wound is one of them. Recently, the number of accidents has increased along with the population of Puchen city where Holy Family Hospital is located. For the treatment of abdominal stab wounds, it is important to make a proper diagnosis. METHODS: We perform a retrospective clinical study of 52 patients who were operated on for abdominal stab wounds at Holy Family Hospital during the 10 years from January 1989 to December 1998. RESULTS: The age distribution revealed a high incidence in the twenties (44%), and the sex distribution, with a male-to-female ratio of 3:1, showed a male predominance. The seasonal distribution showed the highest incidence in the summer (35%) but there was no prominent difference in the seasonal incidence. It was made by others (44%), self (31%) and accident (25%) but 5 cases (10%) were made by the family circle. The most common clinical manifestations and the most commonly used instrument were abdominal pain (69%) and a knife (69%). In the most anemic patients, major vessel injury and thoracic injuries were combined. Among the 29 gastrointestinal injuries, 6 cases (21%) showed free air on radiologic study, and in the 13 cases with abdominal paracentesis, the sensitivity was 83% and the predictability was 91%. Among the abdominal injuries, except those to the omentum, the most commonly injured organ and combined organ were the small bowel (48%) and the thorax (55%). The average time interval from emergency-room treatment to surgery was 60 minutes. In 23 cases (45%), there was no blood transfusion during treatment. Blood transfusions above 11 units were required in 4 cases (2%). The complication rate was 15% and, no injured organs were overlocked. CONCLUSIONS: This review revealed that abdominal stab wounds were mainly caused by unknown male in their twenties, in the summer, and with a knife, but 10% were caused by number of the family circle. The diagnosis to operate was made with various methods, but we recommend a diagnostic laparoscopy with paracentesis in order to decrease negative laparotomies.
Abdomen ; Abdominal Injuries ; Abdominal Pain ; Age Distribution ; Blood Transfusion ; Diagnosis ; Humans ; Incidence ; Laparoscopy ; Laparotomy ; Male ; Omentum ; Paracentesis ; Retrospective Studies ; Seasons ; Sex Distribution ; Social Change ; Social Problems ; Thoracic Injuries ; Thorax ; Wounds, Stab*

Rapunzel syndrome is a rare form of gastric trichobezoar extending through the small bowel and develops after swallowing hairs or carpet which are trapped in the gastric mucosa and become enmeshed. In adult, it occurs most frequently after a gastric resection, but in children, it is frequently associated with pica, mental retardation, and coexistent psychiatric pathologic disorders. This syndrome is usually found in girls with varying gastrointestinal symptoms due to gastric outlet obstruction or secondary ulcerations. Although most small trichobezoars are removed easily by using a gastrofiberscope, surgical removal is recommended for large or complicated trichobezoar. In this syndrome, psychiatric treatment should follow to diminish the frequency of recurrence. We report the case report of a 6-year-old girl who frequently swallowed of her hairs for 3 years, resulting in frequent vomiting and an epigastric palpable mass in which a gastric trichobezoar extended to the duodenum and proximal jejunum.
Adult ; Bezoars ; Child* ; Deglutition ; Duodenum ; Female ; Floors and Floorcoverings ; Gastric Mucosa ; Gastric Outlet Obstruction ; Hair ; Humans ; Intellectual Disability ; Jejunum ; Pica ; Recurrence ; Ulcer ; Vomiting