No abstract available.
Hyperplasia* ; Islets of Langerhans* ; Nesidioblastosis*

BACKGROUND: Many difficulties exist in establishing a treatment plan for slow-flow vascular malformation (SFVM). In particular, little research has been conducted on the surgical treatment of SFVMs. Thus, we investigated what proportion of SFVM patients were candidates for surgical treatment in clinical practice and how useful surgical treatment was in those patients. METHODS: This study included 109 SFVM patients who received care at the authors' clinic from 2007 to 2015. We classified the patients as operable or non-operable, and analyzed whether the operability and the extent of the excision varied according to the subtype and location of the SFVM. Additionally, we investigated complications and self-assessed satisfaction scores. RESULTS: Of the 109 SFVM patients, 59 (54%) were operable, while 50 (46%) were non-operable. Total excision could be performed in 44% of the operable SFVM patients. Lymphatic malformations were frequently non-operable, while capillary malformations were relatively operable (P=0.042). Total excision of venous malformations could generally be performed, while lymphatic malformations and combined vascular malformations generally could only undergo partial excision (P=0.048). Complications occurred in 11% of the SFVM patients who underwent surgery; these were minor complications, except for 1 case. The average overall satisfaction score was 4.19 out of 5. CONCLUSIONS: Based on many years of experience, we found that approximately half (54%) of SFVM patients were able to undergo surgery, and around half (44%) of those patients were able to fully recover after a total excision. Among the patients who underwent surgical treatment, high satisfaction was found overall and relatively few complications were reported.
Capillaries ; Follow-Up Studies ; Humans ; Treatment Outcome ; Vascular Malformations*

Mesenchymal chondrosarcomas are rare malignant tumors of the bone and soft tissue. Spinal mesenchymal chondrosarcomas are even rarer and, to the best of our knowledge those that are concomitantly located in the intradural and extradural regions, have never been reported. We report a case of a 25-year-old man with back pain and bilateral progressive weakness of the lower extremities. Magnetic resonance imaging revealed a markedly enhanced dumbbell-shaped mass at the T7 level. The lesion was intradurally located at the left side of the spinal cord, and extended extradurally to the extraforminal space through the T7-8 intervertebral foramen. The tumor was completely excised through a posterior approach. Microscopic examination and immunohistochemical studies confirmed mesenchymal chondrosarcoma. Postoperative radiation therapy and chemotherapy were also performed to prevent local recurrence and metastasis. The patient has been symptom-free for two years after surgery. Herein, we reviewed and discussed the clinical characteristics, treatments, and outcomes of primary intraspinal mesenchymal chondrosarcomas in the literature.
Adult ; Back Pain ; Chondrosarcoma, Mesenchymal ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Recurrence ; Spinal Cord

PURPOSE: To explore whether genetic and environmental factors influenced ophthalmic disease among children of multicultural families, ethnic Koreans, and native Koreans. METHODS: In this retrospective study, 120 patients who visited the pediatric ophthalmology clinic of a university hospital were included. They were equally divided into three groups: a multicultural group, an ethnic Korean group, and a native Korean group. Parental nationalities, age, gender, chief complaint, visual acuity, refractive error, diagnosis at the initial visit and the extent of compliance with treatment were analyzed. RESULTS: Of the multicultural group, 14 (35%) of 40 patients were Chinese immigrants, and constituted the most common subgroup. None of the age at initial visit, gender, the prevalence of refractive error, or amblyopia status differed significantly among the three groups. In the multicultural and native Korean groups, the proportions of abnormal eye positioning as the chief complaint were higher than that of the ethnic Korean group (p = 0.005). The most common diagnosis in the two former groups was strabismus. Myopia was the most common diagnosis in the ethnic Korean group. The prevalence of strabismus in the multicultural group (55%) was significantly higher than that in the native Korean group (30%) and the ethnic Korean group (20%) (p = 0.003). The prevalence of strabismus in the multicultural group was significantly higher than in the other groups (p = 0.003). However, we found no significant difference in strabismus subtype among the three groups. In the general family group, the extent of loss to follow-up was significantly higher than in the other groups (p = 0.002). CONCLUSIONS: The chief complaint, the prevalence of ophthalmic disease, and the compliance rate differed significantly among the three groups. Both genetic and environmental factors may have played a role.
Amblyopia ; Asian Continental Ancestry Group ; Child ; Compliance ; Diagnosis ; Emigrants and Immigrants ; Ethnic Groups ; Follow-Up Studies ; Humans ; Myopia ; Ophthalmology ; Parents ; Prevalence ; Refractive Errors ; Retrospective Studies ; Strabismus ; Visual Acuity

Restless legs syndrome (RLS) is a neurogenic disorder with the patients having a sensation of discomfort and an urge to move continuously. These symptoms can get worse during night and cause sleep disturbance. These symptoms can be misdiagnosed as lower leg pain of a spinal origin and the treatment can be wrongly focused on this. This treatment for an unproven state of symptoms can place clinicians in a difficult situation. We experienced RLS associated with spondylolisthesis and spinal stenosis, and we originally misdiagnosed the patient and wrongly treated the patient operatively with spinal fusion and posterior instrumentation. After an insufficient result, we diagnosed the patient with having RLS with the help of the neurology department and rehabilitation medical department. In one other case we diagnosed a RLS patient with the help of a neurologist and the patients had arrived an our department for total knee arthroplasty and spinal root block. We report on these cases so other orthopedic surgeons will not make same mistakes.
Arthroplasty ; Humans ; Hypogonadism ; Knee ; Leg ; Mitochondrial Diseases ; Neurology ; Ophthalmoplegia ; Orthopedics ; Restless Legs Syndrome ; Sensation ; Spinal Fusion ; Spinal Nerve Roots ; Spinal Stenosis ; Spondylolisthesis

Capsule endoscopy is being increasingly recognized as a gold standard for diagnosing small bowel disease, but along with the increased usage, capsule retention is being reported more frequently. We report a case of capsule endoscopy retention in a diverticulum of the duodenal proximal third portion, which we treated by esophagogastroduodenoscopy. A 69-year-old male visited hospital with hematochezia. He had hypertension and dyslipidemia for several years, and was taking aspirin to prevent heart disease. CT and colonoscopy revealed a diverticulum in the third portion of the duodenum, rectal polyps, and internal hemorrhoids. Capsule endoscopy was performed but capsule impaction occurred. The capsule was later detected by CT in the diverticulum. Endoscopy was performed a day later and the capsule was removed using a net. A small bowel series was conducted after capsule removal, and no stenosis was found. The patient fully recovered and no recurrence of hematochezia was observed at his one month exam. This is the first case in Korea of capsule retention in a duodenal diverticulum, with successful removal by endoscopy.
Abdomen/diagnostic imaging ; Aged ; Capsule Endoscopy ; Diverticulum/*diagnosis/diagnostic imaging ; Endoscopy, Digestive System ; Humans ; Male ; Tomography, X-Ray Computed

Pulmonary arteriovenous malformation (PAVM) is a rare vascular anomaly. The vascular anomaly usually occurs congenitally, and enlarges progressively with aging. Although PAVM has many pulmonary manifestations, its most common symptom is known to be dyspnea on exertion. Non pulmonary complications, such as ischemic stroke, have rarely been reported. In this paper, we report a case of a patient with both cerebellar infarction and an isolated PAVM. The PAVM was diagnosed with transesophageal echocardiography, transcranial Doppler and pulmonary angiography, and treated with embolization.
Aging ; Angiography ; Arteriovenous Malformations ; Dyspnea ; Echocardiography, Transesophageal ; Humans ; Infarction ; Stroke

Sclerosing mesenteritis (SM) is a rare disease characterized by chronic nonspecific mesenteric inflammation and fibrosis of unknown etiology. Some tumefactive SM shows diffuse accumulation of IgG4-positive plasma cells and is considered as a part of the spectrum of IgG4-related disease. An association between inflammatory bowel disease and IgG4-related disease has been indicated. A 45-year-old woman visited our hospital due to weight loss with intermittent lower abdominal discomfort. Pelvic ultrasound revealed a mass-like lesion in the abdominal wall and pelvis MRI demonstrated a 5.9 cm sized wall-enhancing mass with heterogeneous signal intensity from right adnexa to the abdominal wall. Tumor resection and adhesiolysis was done because of severe adhesion with the small bowel, colon, bladder, uterus, and abdominal wall. Appendectomy was also performed due to adhesion and edematous change. Histological examination of the resected mass showed findings that were compatible with IgG4-related SM. The resected appendix showed chronic granulomatous inflammation without evidence of tuberculosis. She was diagnosed with Crohn's disease after undergoing colonoscopy and CT enterography. Herein, we report a rare case of IgG4-related SM that occurred in conjunction with Crohn's disease.
Anti-Inflammatory Agents/therapeutic use ; Appendix/pathology ; Azathioprine/therapeutic use ; Colonoscopy ; Crohn Disease/complications/*diagnosis/drug therapy ; Female ; Humans ; Immunoglobulin G/*blood ; Magnetic Resonance Imaging ; Mesalamine/therapeutic use ; Middle Aged ; Panniculitis, Peritoneal/*diagnosis/etiology/ultrasonography ; Prednisolone/therapeutic use ; Tomography, X-Ray Computed ; Urinary Bladder/pathology

BACKGROUND: The future health of our increasing senior population depends upon the interrelationship between the onset time of the first major disease, infirmity or disability and the time of death. Reduction of morbidity requires compressing the average period between two points and reducing the average level of morbidity during this period. In this article, authors demonstrated the change of mortality curve and estimated the mortality curve upto 2010. And we intend to use this result as basic data in the future for preventive health service, health promotion, and health policy for senior people. METHODS: In this study, the authors demonstrated the survival curve from 1970 to 1995. And we intended to estimate death rate according to age and year upto 2010 and construct a new forecasting model. By using this model, we can calculate the data upto 2010 and suggest mortality curve. RESULTS: According to the results, the relative and absolute rectangularization and the convergency of survival curves were observed, and all the Keyfitz's H, NH, SD and CV decreased while the life expectancy in creased in the period of 1970 to 2010. So we conclude that the hypothesis of mortality compression suggested by Fries explains the changing pattern of aged population in Korea very well. CONCLUSION: According to Fries theory, this study shows compression of mortality is exist in Korea But when we observe the tail of mortality curve, there are no evidence that life expectancy reaches to limitation in Korea and we expect life expectancy of Korean will continuously increase.
Forecasting ; Health Policy ; Health Promotion ; Korea* ; Life Expectancy ; Mortality ; Preventive Health Services

Alcohol ingestion during pregnancy can be damaging to embryonic and fetal development. A specific pattern of malformation, identified as Fetal alcohol syndrome, has been documented in 1~2 of every 1,000 live infant births Fetal alcohol syndrome is characterized by growth deficiency, facial abnormalities, cardiac defects, minor joint and limb abnormalities, as well as central nervous system dysfunction, including microcephaly, mental retardation and abnormal neurobehavioral development. However, there are few reports of fetal alcohol syndrome associated with hormonal abnormality or amenorrhea. Recently, a case of secondary amenorrhea, which developed in a 19-year-old woman with fetal alcohol syndrome, was experienced at our institute, but the exact cause of the amenorrhea was difficulty to find. Herein, this case is reported, with a review of the literature.
Amenorrhea* ; Central Nervous System ; Eating ; Embryonic and Fetal Development ; Extremities ; Female ; Fetal Alcohol Spectrum Disorders* ; Humans ; Infant ; Intellectual Disability ; Joints ; Microcephaly ; Parturition ; Pregnancy ; Young Adult