Balloon cell malignant melanoma (BCMM) is a rare histologic variant of malignant melanoma, which is composed either predominantly or entirely of large clear or foamy cells. The incidence of balloon cell malignant melanoma is about 0.15% of all cutaneous malignant melanomas. Recently, we experienced a case of cutaneous balloon cell malignant melanoma in the right lower abdomen with right inguinal and both axillary lymph node metastasis in a 56-year-old man. The cutaneous lesion was 4.5 3.5 cm in size, a well-demarcated black nodular mass, involving abdominal skin and subcutaneous tissue. The tumor was histologically composed of two types of tumor cells: predominant clear cell and focal, pigmented spindle cell. The nodal lesion was composed entirely of clear cells. Both clear and spindle cells showed positive reaction for S-100 protein and HMB-45 on immunohistochemistry.
Abdomen ; Humans ; Immunohistochemistry ; Incidence ; Lymph Nodes ; Melanoma* ; Middle Aged ; Neoplasm Metastasis ; S100 Proteins ; Skin ; Subcutaneous Tissue

The incidence of pancreatic trauma is increasing and still remains a major source of morbidity and mortality. We have graded the pancreatic trauma on CT according to its pattern into four grades. We also determine the accuracy of CT in the evaluation of pancreatic trauma and the role of CT for delineation of pancretic ductal injury which is critical factor in outcome of pancreatic trauma. CT correctly diagnosed the pancreatic trauma and its traumatic pattern and severity in 22 of 25 cases. Pancreatic enlargement was the most common findings observed in 19 cases. Other findings were 15 cases of intrapancreatic low density hematoma, 12 cases of parenchymal fracture which were predilected in pancreatic neck area. CT grade III and IV could predict the pancreatic ductal injury, and was well correlated with severity of posttraumatic pancreatitis, duration of admission days and incidence of complications. So we concluded that CT can play a definite role for diagnosing and determining the prognosis of pancreatic trauma.
Diagnosis* ; Hematoma ; Incidence ; Mortality ; Neck ; Pancreatic Ducts ; Pancreatitis ; Prognosis

Trichophyton tonsurans is a major causative agent of tinea capitis in the United States, Canada, Mezico and other Latin American countries, but the infection of T.tonsurans has not been reported in Korea. We report a case of tinea capitis caused by T. tonsurans in a 15-year-old student wrestler. He had a 3*3cm sized non-inflammatory alopecia with black dots on the right occipital area of the scalp. The diagnosis was established by a hght microscopic examination of the affected hairs and by mycological studies from cultures. To our knowledge, this is the first case in which T. tonsurans has been isolated in Korea, It is likely that the student acquired the infection through contact with a foreign wrestler during interaational games and practice. We should be concerned about the potential of spread of this infection in our country.
Adolescent ; Alopecia ; Canada ; Diagnosis ; Hair ; Humans ; Korea ; Scalp ; Tinea Capitis ; Tinea* ; Trichophyton* ; United States

Purpose: : This study aimed to identify the incidence of peripheral cyanosis and the characteristics and clinical results of patients with therapeutic hypothermia after a cardiac arrest. Methods: : Data were collected from April to June 2021 via the electrical medical records of 95 patients with therapeutic hypothermia for 72 hours after a cardiac arrest admitted to an acute care unit at a tertiary hospital between January 1, 2016, and December 31, 2019. The data were analyzed using descriptive statistics and a t-test, Mann–Whitney U test, Chi-squared test, Fisher’s exact test, and logistic regression using SPSS/WIN. Results: : The incidence of peripheral cyanosis was 20%. In the peripheral cyanosis group, peripheral vascular disease, fibrinogen, vasopressor, infection, disseminated intravascular coagulation, acute physiology, chronic health evaluation II score on the second hospital day, nursing intervention, and mortality on the seventh hospital day were higher. The level of fibrinogen and use of vasopressors affected the occurrence of peripheral cyanosis. Conclusion : Considering the influencing variables, careful observation is necessary for patients with high fibrinogen levels and vasopressor use. These results provide basic data to recognize the need for nursing intervention for peripheral cyanosis and encourage nurses to deliver them during therapeutic hypothermia.

In this study the effect of insulin and aminoguanidine on the expression of iNOS and the development of insulitis in the multiple low dose streptozotocin (SZ) induced diabetic (LDSD) mice was evaluated. Eighty mice (Charles-River CD-1 mice) were divided into four groups. Group I received SZ for five days. Group II received SZ for five days and was followed by insulin treatment. Group III received SZ for five days and was followed by aminoguanidine treatment. Group IV was normal control group. The blood glucose level and body weight were measured weekly. On the 35th day, pancreat ic sections were observed to evaluate the frequency and the severity of insulitis in addition to the immunohistochemical expression of iNOS in the pancreatic islets. Blood glucose levels of group IV were significantly lower than other experimental groups on the 21st, 28th, and 35th day. The difference in blood glucose levels was not statistically significant. Incidence of the insulitis was lower in group II than in groups I and III. The severity of insulitis correlated with the increase in blood glucose level only in group II. The expression of iNOS was more pronounced in group I than in groups II and III. Aminoguanidine did not inhibit development of the insulitis but decreased expression of iNOS in the pancreatic islets. Therefore it is speculated that iNOS production is one of the factors and other pathogenetic mechanisms might be involved in the development of insulitis.
Animals ; Blood Glucose ; Body Weight ; Incidence ; Insulin* ; Islets of Langerhans ; Mice* ; Nitric Oxide Synthase Type II* ; Streptozocin

When jaundice persists for more than 14 days postnatally, the early diagnosis of surgical jaundice is important for the prognosis in extrahepatic biliary atresia after draining procedure. The role of diagnostic laparoscopy to differenctiate medical causes of jaundice from biliary atresia is evaluated in this report. Four patients with prolonged jaundice have been included in this study. When the gallbladder was not visualized we proceeded to laparotomy. In patients with enlarged gallbladder visualized at laparoscopy, laparoscopic guided cholangiogram was performed, and laparoscopic liver biopsy was done for those who had a patent biliary tree. Two patients had small atretic gallbladder and underwent a Kasai hepato-portoenterostomy. One patients showed a patent gallbladder and common bile duct with atresia of the common hepatic and intrahepatic ducts, and they underwent a Kasai hepatic-portoenterostomy. One patient showed an enlarged gallbladder and laparoscopic-guided cholangiogram were normal. Laparoscopic liver biopsy was performed. There were no complications. Laparoscopy wth laparoscopic-guided cholangiogram may be a valuable method in accurate and earlier diagnosis in an infant with prolonged jaundice.
Biliary Atresia ; Biliary Tract ; Biopsy ; Common Bile Duct ; Diagnosis ; Early Diagnosis ; Gallbladder ; Humans ; Infant ; Jaundice ; Jaundice, Obstructive* ; Laparoscopy* ; Laparotomy ; Liver ; Prognosis

No abstract available.
Carcinoma, Basal Cell ; Nose

Limb salvage operation was introduced to treat, low grade malignant bone tumors about 100 years ago. However, amputation has been the most popular choice for primary malignant bone tumors. Recent improvement of chemotherapy, diagnostic methods and surgical techniques enabled us to treat more malignant bone tumors such as osteogenic sarcoma with limb salvage operation. 6 cases of malignant bone tumors were treated with wide resection and tumor prosthesis from Oct., 1987 to Jan., 1989 at Dept. of Orthopedic Surgery, Seoul National University Hospital. 4 cases of osteosarcoma, 1 case of parosteal osteosarcoma and 1 case of chondrosarcoma were identified. MRI was useful for determining the extent of tumor and surgical planning. All the patients osteosarcoma had neoadjuvant chemotherapy. The mean follow-up was 14.5 months ranging from 8 to 22 months, and theirresults are so far good except one pulmonary metastasis and one local recurrence. We present this as a preliminary report.
Amputation ; Chondrosarcoma ; Drug Therapy ; Follow-Up Studies ; Humans ; Limb Salvage ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Orthopedics ; Osteosarcoma ; Prostheses and Implants ; Recurrence ; Seoul

Purpose: To investigate the usefulness of imaging features for differentiating between small lobular carcinoma in situ (LCIS) and invasive lobular carcinoma (ILC). Materials and Methods: It included 52 female with LCISs (median 45 years, range 32–67 years) and 180 female with ILCs (median 49 years, range 36–75 years), with the longest diameter of ≤ 2 cm, who were evaluated between January 2012 and December 2016. All the female underwent mammography and ultrasonography. Twenty female with LCIS and 150 female with ILC underwent MRI. The clinical and imaging features were compared, and multivariate analysis was performed to identify the independent predictors of LCIS. Female with LCIS were also subgrouped by lesion size and compared with the female with ILC. Results: Multivariate analysis showed that younger age (odds ratio [OR] = 1.100), smaller lesion size (OR = 1.103), oval or round shape (OR = 4.098), parallel orientation (OR = 5.464), and isoechotexture (OR = 3.360) were significant independent factors predictive of LCIS. The area under the receiver operating characteristic curve for distinguishing LCIS from ILC was 0.904 (95% confidence interval, 0.857–0.951). Subgroup analysis showed that benign features were more prevalent in female with smaller LCISs (≤ 1 cm) than in those with ILC. Conclusion Small LCISs tend to demonstrate more benign features than small ILCs. Several imaging features are independently predictive of LCIS.

Purpose: To investigate the usefulness of imaging features for differentiating between small lobular carcinoma in situ (LCIS) and invasive lobular carcinoma (ILC). Materials and Methods: It included 52 female with LCISs (median 45 years, range 32–67 years) and 180 female with ILCs (median 49 years, range 36–75 years), with the longest diameter of ≤ 2 cm, who were evaluated between January 2012 and December 2016. All the female underwent mammography and ultrasonography. Twenty female with LCIS and 150 female with ILC underwent MRI. The clinical and imaging features were compared, and multivariate analysis was performed to identify the independent predictors of LCIS. Female with LCIS were also subgrouped by lesion size and compared with the female with ILC. Results: Multivariate analysis showed that younger age (odds ratio [OR] = 1.100), smaller lesion size (OR = 1.103), oval or round shape (OR = 4.098), parallel orientation (OR = 5.464), and isoechotexture (OR = 3.360) were significant independent factors predictive of LCIS. The area under the receiver operating characteristic curve for distinguishing LCIS from ILC was 0.904 (95% confidence interval, 0.857–0.951). Subgroup analysis showed that benign features were more prevalent in female with smaller LCISs (≤ 1 cm) than in those with ILC. Conclusion Small LCISs tend to demonstrate more benign features than small ILCs. Several imaging features are independently predictive of LCIS.