Forty eight skin biopsies obtained from 24 patients were reviewed, and clinical, histological and immunohistochemical findings were analyzed. Results obtained are as follows: 1) Skin manifestation was plaque, erythroderma, scale and hyperpigmentation in mycosis fungoides, and subcutaneous nodule, mass and ulcerated patch in cutaneous lymphoma. The skin of lymphomatoid papulosis revealed hemorrhagic ulcerated and erythematous papules which healed spontaneously. 2) Histologically, mycosis fungoides showed epidermotropism in most cases. Pautrier's micro-abscesses were present in one-fourth of the cases. Malignant lymphoma was different in histology from mycosis fungoides. As compared with mycosis fungoides, it showed less frequent epidermotropism, more compact and diffuse infiltration of atypical lymphocytes, more often association with ulcer and necrosis, and more frequent mitotic figures. Lymphomatoid papulosis showed striking hemorrhage and edema of the papillary dermis. 3) Based on the results of immunohistochemical study, mycosis fungoides and lymphomatoid papulosis were considered as a T cell proliferative disorder of the skin. According to these findings, lymphoproliferative disorders of the skin occurred predominantly in the elderly and males. Clinical and histopathologic findings overlapped and were similar each other. It was difficult to make a definite diagnosis in early lesions, and a sequential follow up biopsy was required. It is concluded that strict criteria such as marked atypia and clustering of atypical cells are necessary for a histologic diagnosis of malignant lymphoproliferative disorder of the skin.
Biopsy

No abstract available.
Female ; Pregnancy ; Pregnancy, Abdominal* ; Ultrasonics*

The nose occupies the most prominent position of the face, a position that makes it vulnerable to loss and deformity by trauma. The degree of loss and deformity usually dictates the type and quantity of tissue required for the most satisfactory reconstruction. The surgeon must consider all of the alternatives to reach the goal with the fewest number of procedures in the most predictable manner and to leave the least amount of donor deformity. Composite grafts of auricular skin and cartilage have been used for comparatively small nasal tip defect. We have reconstructed the nasal tip defect including alar and collumellar defect by 3 dimensional folding of composite ear graft. The method was satisfactory in achieving a good nasal projection. We report this method with the related references.
Cartilage ; Congenital Abnormalities ; Ear* ; Humans ; Nose ; Skin ; Tissue Donors ; Transplants*

No abstract available.
Lymphoma*

Purpose: This study aimed to compare the intraoperative and postoperative outcomes between robotic and laparoscopic transperitoneal adrenalectomies. Methods: In this retrospective study, 93 patients underwent adrenalectomy using 2 surgical modalities: 45 patients underwent adrenalectomy using the da Vinci Xi system (robotic group), and 48 patients using laparoscopic devices (laparoscopic group). We compared the operation time, intraoperative bleeding, and hospital stay according to the surgical modality and tumor characteristics. Results: There were no significant differences in the operative time (P = 0.827), hospital stay (P = 0.177), and intraoperative bleeding (P = 0.174) between the groups. However, the robotic group showed a lower coefficient of variation in total operative time than that of the laparoscopic group (100.6 ± 23.3 minutes vs. 101.9±32.7 minutes, 0.230 vs. 0.321). When divided into 2 subgroups based on the tumor size (<3 cm and ≥3 cm), the robotic group with a tumor sized >3 cm had a shorter operative time than that of the laparoscopic group (P = 0.032). The robotic group also had fewer cases of intraoperative bleeding (P = 0.034). Conclusions Compared to the laparoscopic transperitoneal adrenalectomy, the robotic one achieved a lower deviation in total operative time and showed less bleeding and a shorter operative time, especially for tumors sized >3 cm.

PURPOSE: This study assessed the incidence and cancer rate of probably benign lesions detected on bilateral whole-breast screening ultrasound (US), which corresponded to US Breast Imaging Reporting and Data System (BI-RADS) category 3, and evaluated the proper management of those lesions. METHODS: This study was approved by the Institutional Review Board in our institution, which waived informed patient consent. We retrospectively reviewed US images of 1,666 patients who underwent bilateral whole-breast screening US as a supplemental screening test to negative screening mammography or screening US only. The incidence, clinical course, and cancer rate of screening US-detected probably benign lesions corresponding to US BI-RADS category 3 were investigated, and the size and multiplicity of screening US-detected category 3 lesions were evaluated. RESULTS: Probably benign lesions corresponding to US BI-RADS category 3 were detected in 689 of 1,666 patients (41.4%) who underwent screening US. Among them, 653 had follow-up US images for at least 24 months, and among these 653, 190 (29.1%) had multiple bilateral category 3 lesions. Moreover, 539 of 1,666 patients (32.4%) had lesions ≤1 cm in size and 114 of 1,666 (6.8%) had lesions >1 cm (median, 0.82 cm; range, 0.3–4.2 cm). Four of the 653 patients (0.6%) showed suspicious interval changes and were categorized into BI-RADS category 4. Biopsy analysis confirmed only one lesion as invasive ductal carcinoma at the 6-month follow-up; another lesion was an intraductal papilloma and the remaining two were fibroadenomas. Overall cancer rate of the screening US-detected BI-RADS category 3 lesions was 0.2%. CONCLUSION: The incidence of category 3 lesions detected on screening US only was very high, but the cancer rate was very low. Therefore, in an average-risk population, routine screening US is preferable over short-term follow-up for BI-RADS category 3 lesions detected on whole-breast screening US.
Biopsy ; Breast* ; Carcinoma, Ductal ; Ethics Committees, Research ; Fibroadenoma ; Follow-Up Studies ; Humans ; Incidence ; Information Systems* ; Mammography ; Mass Screening* ; Papilloma, Intraductal ; Retrospective Studies ; Ultrasonography*

Behcet's disease is an important cause of fatal vasculitis in young adult males and vascular involvement has been reported in more than 25% of patients. Pulmonary vascular involvement has been found in 1~7.7% of patients and is known to be related to poor prognosis. A incidence of fatal hemoptysis is high in patients whose Behcet`s disease is complicated by pulmonary artery aneurysm (PAA). The recurrence of hemoptysis in PAA of Behcet's disease may result from inadequate medical therapy and complications of surgical treatment. We report a case with Behcet's disease whose fatal hemoptysis has been successfully treated with bronchial artery embolization.
Aneurysm ; Bronchial Arteries* ; Hemoptysis* ; Humans ; Incidence ; Male ; Prognosis ; Pulmonary Artery ; Recurrence ; Vasculitis ; Young Adult

PURPOSE: The purpose of this study was to examine incidence of recompression and risk factors in the patients with osteoporotic vertebral compression fracture (OVCF) after vertebroplasty or kyphoplasty. MATERIALS AND METHODS: This study was conducted on 179 vertebral bodies of 126 patients who underwent vertebroplasty or kyphoplasty on OVCF from January 2004 to August 2013. RESULTS: When anterior vertebral height of fractured vertebrae declined by more than 3 mm from the height immediately after vertebroplasty or kyphoplasty, it was judged that recompression had occurred. Recompression was observed in a total of 58 vertebrae (32.4%). Recompression occurrences were found to be decreasing significantly when fractured vertebrae were the thoracic spine. In addition, osteonecrosis occurred in the preoperative vertebrae and restoration degree of anterior vertebral height immediately after vertebroplasty or kyphoplasty affected recompression occurrences significantly. The other factors (age, sex, bone mineral density, steroid medication history, follow-up duration, cement volume, vertebroplasty or kyphoplasty, and approach method) were compared, but no statistical significance was found. CONCLUSION: The risk of vertebral recompression is more common, especially when osteonecrosis occurred in preoperative vertebrae or when vertebroplasty or kyphoplasty achieved remarkable restoration of anterior vertebra height. When performing vertebroplasty or kyphoplasty, such conditions should be considered carefully.
Bone Density ; Follow-Up Studies ; Fractures, Compression ; Humans ; Incidence ; Kyphoplasty* ; Osteonecrosis ; Osteoporotic Fractures ; Risk Factors ; Spine ; Vertebroplasty*

Emphysematous pyelonephritis is characterized by acute necrotizing renal parenchymal infection with gas formation. It is a serious, life-threatening infection that tends to occur in patients with diabetes mellitus and/or urinary tract obstruction. Early diagnosis and prompt intervention combined with surgical and medical treatment are required for survival. In Korea, there have been a number of cases of emphysematous pyelonephritis reported in patients with diabetes mellitus or urinary tract obstruction. We describe a case of emphysematous pyelonephritis in a patient without diabetes mellitus or urinary tract obstruction.
Diabetes Mellitus ; Early Diagnosis ; Humans ; Korea ; Pyelonephritis ; Urinary Tract

Ramsay Hunt syndrome is caused by reactivation of the varicella zoster virus in the geniculate ganglion of the sensory branch in the face and ears. It is characterized by peripheral facial palsy, ear pain, and vesicles in the auditory canal and auricle. We report on a first case of Ramsay Hunt syndrome in a patient with human immunodeficiency virus in Korea. The patient, a 40-year-old male, first presented with otalgia and ear fullness. On admission, he had right facial palsy of the peripheral type, otorrhea, headache, limited tongue movement, and right auricle vesicular eruptions. He had positive human immunodeficiency virus antibody and Western blot tests. His CD4 T cell count was 281/microL. The patient was treated with valacyclovir and steroid with highly active antiretroviral therapy. His symptoms and facial palsy improved with treatment.
Adult ; Antiretroviral Therapy, Highly Active ; Blotting, Western ; Cell Count ; Ear ; Earache ; Facial Paralysis ; Geniculate Ganglion ; Headache ; Herpes Zoster Oticus* ; Herpesvirus 3, Human ; HIV* ; Humans ; Humans* ; Korea ; Male ; Tongue