BACKGROUND: Dystrophic calcification can occur in any soft tissue with the absence of a systemic mineral imbalance and is often associated with trauma, infection, or inflammation. It is easily found in the site of the heart and skeletal muscles and rarely appears in the head and neck area. CASE REPORT: We present a rare case of multiple calcified masses in the left masseter muscle of a 26-year-old female with a history of trauma in the area. In computed tomography, multiple radiopaque masses were observed inside the left masseter muscle and blood test results were normal. The calcified masses were diagnosed as dystrophic calcification and removed by surgery without any complications. CONCLUSION: Different types of calcifications may occur in the cheek area, and they need to be distinguished from dystrophic calcification. Thorough clinical examination and history taking is required together with blood testing and radiographic examinations.
Adult ; Cheek ; Female ; Head ; Heart ; Hematologic Tests ; Humans ; Inflammation ; Masseter Muscle* ; Miners ; Muscle, Skeletal ; Neck

No abstract available.
Cell Proliferation* ; Cyclooxygenase Inhibitors* ; Lipoxygenase* ; Meningioma* ; Prostaglandin-Endoperoxide Synthases*

No abstract available.
CREST Syndrome*

A hemothorax usually occur, due to injuries to the intercostal and great vessels, pulmonary damage, and sometimes fractured ribs. We report a case in which the hemothorax that occurred, neither intrathoracic injury nor injury to internal thoracic vessels and organs, via lacerated diaphragmatic and liver laceration due to a right upper part of anterior chest stab injury caused by a sharp object. The patient's general conditions gradually worsened, so chest and abdominal computed tomogram were taken. The abdominal computed tomogram revealed diaphragmatic injuries and bleeding from the lacerated liver. We performed an exploratory laparotomy to control the bleeding from the lacerated liver with simple primary sutures. In addition exploration was performed in the right pleural space through the lacerated diaphragm with a thoracoscopic instrument. There were no bleeding foci in the right pleural space, the vessels, or the lung on the thoracoscopic video. Closure of the lacerated diaphragm was achieved with simple, primary sutures. The postoperative course of the patient was uneventful, and the patient was discharged.
Diaphragm ; Hemorrhage ; Hemothorax ; Humans ; Lacerations ; Laparotomy ; Liver ; Lung ; Pleural Cavity ; Ribs ; Sutures ; Thoracoscopes ; Thorax ; Wounds, Stab

OBJECTIVE: To evaluate the potential value of in vitro, ex vivo, and localized in vivo 1H Magnetic resonance spectroscopy(MRS) for detecting and characterizing squamous cell carcinoma of uterine cervix. MATERIALS AND METHODS: Eleven cases of squamous cell carcinoma and 6 cases of normal cervical tissue underwent in vitro and ex vivo 1H MRS. In vitro analysis was carried out after processing the specimen with dual phase extraction method. In ex vivo test, at least 500microliter of tissue specimen was directly analyzed by 100.14 MHz NMR spectrometer (Bruker 11.7T AMX, Germany) without any processing procedure. In addition, 29 patients with squamous cell carcinoma of uterine cervix and 6 normal women were examined by in vivo 1H MRS. Localized in vivo 1H MR spectra of the human uterine cervix were obtained using PRESS sequence with homebuilt endovaginal surface coil. Surface coil T2 weighted images were used as the localizer images where voxel (1-3 mm3) was located to contain the cancer area only. The following spectral acquisition parameters were used: SW=2500 Hz, SI=2048, TR=3.0 sec, TE=20/135 msec, NEX=2, and NS=36. H2O signal suppressed down to 96-99% by 3-pulse CHESS technique. The spectra were processed with 0.5 Hz of exponential line broadening, zerofilling of 8K followed by linear phasing. RESULTS: The intense resonance signal at 0.9 ppm and 1.3 ppm by lipid component of triglyceride was visible in all cases (11/11) of squamous cell cancer of cervix both in vitro and ex vivo test. But in 6 normal cervical tissues, such peaks were not detected at all. The in vivo spectrum of the cervical cancer was comparable with that in in vitro and ex vivo spectrum. In the in vivo spectra of the cervical cancer, the resonance peaks at 0.9 ppm, 1.3 ppm, 3.0 ppm, and 3.2 ppm from CH3 and CH2 groups of neutral mobile lipid (triglyceride), creatine, and choline containing residues respectively, were consistent with results reported earlier. The resonance peak at 1.3 ppm which is from acyl chains of triglyceride was characteristically intense and seen in 25 of 29 cancer patients. But triglyceride peak at 1.3 ppm was not detected in normal cervix (sensitivity 86.2%; specificity 100%; positive predictive value 100%; negative predictive value 60%). CONCLUSION: The study shows that 1H MRS can effectively discriminate squamous cell cancer from normal cervix in most cases. It also demonstrates the feasibility of localized in vivo 1H MRS technique as a new diagnostic modality in the detection of squamous carcinoma of uterine cervix.
Carcinoma, Squamous Cell* ; Cervix Uteri* ; Choline ; Creatine ; Female ; Humans ; Magnetic Resonance Spectroscopy* ; Neoplasms, Squamous Cell ; Sensitivity and Specificity ; Triglycerides ; Uterine Cervical Neoplasms

The preoperative serum level of tumor marker CA 125 has served as rough orientation in making the distinction between a benign and a malignant adnexal mass or as a reference for monitoring the success of therapy. But there were some reports suggesting that the stage of the disease and tumor grade, which are known to be the independent prognostic factors in ovarian cancer patients, may exert an influence on the preoperative CA 125 level. In this retrospective study we analysed the significance of preoperative serum CA 125 level with respect to tumor grade and tumor stage. Between June, 1989 and January, 1997, 82 patients with epithelial ovarian cancer managed at Asan Medical Center were evaluated, in whom serum level CA 125 were measured preoperatively. Tumor grade bears no meaningful influence on the preoperative CA 125 level, and also the correlation is low and statistically insignificant (r=0.12, p=0.29 in all stages; r=0.01, p=0.97 in stage I; r=-0.09, p=0.83 in stage II; r=0.06, p=0.72 in stage III; r=0.25, p=0.41 in stage IV). There was no significant effect of FIGO stage on preoperative CA 125 level (r=0.21, p=0.06 in all grades; r=0.32, p=0.10 in G1; r=0.08, p=0.74 in G2; r=0.17, p=0.30 in G3). However, we found a significant correlation between FIGO stage and tumor grade (r=0.45, p<0.01). In conclusion, our data suggests that both tumor grade and FIGO stage have no significant effect on preoperative serum CA 125 level.
Chungcheongnam-do ; Humans ; Ovarian Neoplasms* ; Retrospective Studies

The aim of this study is to evaluate the clinical feature and pregnancy outcome in patients with ovarian cancer diagnosed during pregnancy. We retrospectively analyzed the medical records of 27 patients diagnosed with ovarian cancer during pregnancy at Cheil General Hospital & Women's Healthcare Center from January 1996 to December 2006. Mean age of the patients was 29.1 yr (range 23-40), and a mean follow-up period was 57 months (range 7-112 months). Of 27 patients, 15 (55.5%) had borderline malignancies, 7 (25.9%) had epithelial malignancies and 5 (18.6%) had germ cell tumors. A total of 26 patients received a conservative surgery preserving pregnancy. The mean time for surgical intervention during pregnancy was 20 weeks of gestational age. Of the 27 patients, 26 had full term delivery of a healthy baby without any congenital malformation. Only one patient with epithelial ovarian cancer had a relapse at 19 months after the first conservative operation with adjuvant chemotherapy. There were few data for managing patients with ovarian cancer diagnosed during pregnancy. This study results could help establish a guideline for management of ovarian malignancy complicating pregnancy.
Adult ; Female ; Gestational Age ; Humans ; Neoplasms, Germ Cell and Embryonal/*diagnosis/pathology/secondary ; Neoplasms, Glandular and Epithelial/*diagnosis/pathology/secondary ; Ovarian Neoplasms/*diagnosis/pathology/surgery ; Pregnancy ; Pregnancy Complications, Neoplastic/*diagnosis/pathology/surgery ; *Pregnancy Outcome ; Retrospective Studies ; Term Birth

This study was done to evaluate clinical usefulness of cystatin C levels of serum and urine in predicting renal impairment in normoalbuminuric patients with type 2 diabetes and to evaluate the association between albuminuria and serum/urine cystatin C. Type 2 diabetic patients (n = 332) with normoalbuminuria (n = 210), microalbuminuria (n = 83) and macroalbuminuria (n = 42) were enrolled. Creatinine, urinary albumin levels, serum/urine cystatin C and estimated glomerular filtration rate (eGFR by MDRD [Modification of Diet in Renal Disease] and CKD-EPI [Chronic Kidney Disease Epidemiology Collaboration] equations) were determined. The cystatin C levels of serum and urine increased with increasing degree of albuminuria, reaching higher levels in macroalbuminuric patients (P < 0.001). In multiple regression analysis, serum cystatin C was affected by C-reactive protein (CRP), sex, albumin-creatinine ratio (ACR) and eGFR. Urine cystatin C was affected by triglyceride, age, eGFR and ACR. In multivariate logistic analysis, cystatin C levels of serum and urine were identified as independent factors associated with eGFR < 60 mL/min/1.73 m2 estimated by MDRD equation in patients with normoalbuminuria. On the other hand, eGFR < 60 mL/min/1.73 m2 estimated by CKD-EPI equation was independently associated with low level of high-density lipoprotein in normoalbuminuric patients. The cystatin C levels of serum and urine could be useful markers for renal dysfunction in type 2 diabetic patients with normoalbuminuria.
Aged ; Albuminuria/urine ; *Biological Markers/blood/urine ; Creatinine/blood/urine ; *Cystatin C/blood/urine ; Diabetes Mellitus, Type 2/*blood/physiopathology/*urine ; Diabetic Nephropathies/*blood/physiopathology/*urine ; Female ; Glomerular Filtration Rate ; Humans ; Kidney Function Tests ; Male ; Middle Aged ; ROC Curve ; Retrospective Studies

This study evaluated the degree and the frequency of cervical lesions after treatment with LEEP(loop electrosurgical excision procedure) in patients with abnormal Pap smears according to the presence or absence of high-risk HPV infection. From June 1994 to May 1997, eighty patients who showed CIN or chronic cervicitis on LEEP specimens were followed up with Pap smears. The histologic results and follow-up Pap smear data were analyzed. In all cases HPV test by Hybrid Capture assay was performed. Those with neoplastic lesion underwent follow-up Pap smears at least for 1 year with 3 month interval after LEEP. In HPV-positive group(N 38), 63.2% of the cases revealed neoplastic lesion(CIN) on final histologic evaluation, and in HPV-negative group(N 42) 54.8% of the cases did(p 0.26). HPV-positive group represented 25.0%(6/24) of abnormal Pap smear result on follow-up, which is higher than that of HPV-negative group(4.3%; 1/23), showing significant difference (p<0.05). There was a significant difference in the rate of neoplastic lesion developed during follow-up between resection margin-positive group and resection margin-negative group on LEEP(p 0,04). Also, HPV-positive group had significantly higher chance to show abnormal Pap smear results during follow-up(p 0.02). In conclusion, HPV test and margin status were shown to be useful parameters to predict the recurrence or persistence of CIN lesion treated by LEEP.
Follow-Up Studies ; Humans ; Recurrence ; Uterine Cervicitis

OBJECTIVE: To evaluate the efficacy and side effects of cispaltin and carboplatin each in combination with paclitaxel in recurrent epithelial ovarian cancer who had not taken paclitaxel-based chemotherapy. MATERIALS AND METHODS: Between January 1994 and October 1999, in department of obstetrics and gynecology, Asan medical Center, 42 recurrent ovarian cancer patients who had initial platinum-based chemotherapy except paclitaxel were treated with paclitaxel-based chemotherapy. One group was 14 patients treated with paclitaxel-cisplatin and the other group was 28 patients treated with paclitaxel-carboplatin. Disease free interval before recurrence was 6 months at least. Patients received paclitaxel 135mg/m2 followed by either cisplatin 75mg/m2 or carboplatin 300mg/m2. The schedule was repeated every 3 weeks for at least 6 cycle. Response was evaluated by physical examination, serial serum CA 125 measurement, chest PA before each cycle, and abdomino-pelvic CT scan every 3 cycles. RESULTS: As paclitaxel-cisplaitin group, with a median follow-up of 34.5 months (range, 9-60 months), 1 patient had complete response, 6 patients had partial response, 3 patients had stable disease and 4 patients had persistent disease, overall response rate was 50%, mean survival duration was 40 months. As paclitaxel-carboplatin group, with a median follow-up of 25.5 months (7-36 months), 4 patients had complete response, 11 patients had partial response, 6 patients had stable disease, and 7 patients had persistent disease, overall response rate was 53.4%, mean survival of 24 months. As grade of side effects in each group, we evaluated leukopenia, anemia, thrombocytopenia, nausea, vomiting, fever, neurological abnormality, and renal abnormality. The rate of grade 3 to 4 leukopenia was 11% in paclitaxel-cisplatin arm and 17% paclitaxel-arboplatin, in arm. CONCLUSION: These results demonstrate that the combined chemotherapy of paclitaxel followed by cisplatin or carboplatin is highly effective and safe in recurrent epithelial ovarian cancer who had taken no previous paclitaxel-based chemotherapy.
Anemia ; Appointments and Schedules ; Arm ; Carboplatin ; Chungcheongnam-do ; Cisplatin ; Drug Therapy ; Drug Therapy, Combination* ; Fever ; Follow-Up Studies ; Gynecology ; Humans ; Leukopenia ; Nausea ; Obstetrics ; Ovarian Neoplasms* ; Paclitaxel ; Physical Examination ; Recurrence ; Thorax ; Thrombocytopenia ; Tomography, X-Ray Computed ; Vomiting