Aneurysmal fibrous histiocytoma(AFH) is a histologic variant of dermatofibroma. The importance of the recognition of AFH as a variant of dermatofibroma lies in the differential diagnosis because the histologic appearance of AFH is very similar to dermatofibrosarcoma protuberans and other vascular malignancies, such as Kaposi's sarcoma and angiosarcoma. A 32-year-old man was seen for a nodular mass on the right popliteal fossa of 4 years' duration. The excisional biopsy specimen showed a relatively well circumscribed tumor mass in the dermis. In addition to compact storiform proliferation of spindle cells, there were multiple, irregular, blood-filled, aneurysmal tissue spaces that were devoid of lining of endothelial cells. Also, deposition of hemosiderin was prominent, particularly in the periphery of the aneurysmal spaces. Immunohistochemical stain for CD34 were negative to most tumor cells. After excisional therapy, there was no evidence of recurrence during the period of ten months' follow-up.
Adult ; Aneurysm* ; Biopsy ; Dermatofibrosarcoma ; Dermis ; Diagnosis, Differential ; Endothelial Cells ; Follow-Up Studies ; Hemangiosarcoma ; Hemosiderin ; Histiocytoma, Benign Fibrous* ; Humans ; Recurrence ; Sarcoma, Kaposi

STUDY DESIGN: A retrospective study. OBJECTIVES: To evaluate the relationships between spinal canal occlusion and neurologic deficits, and between spinal canal decompression and neurologic recovery in thoracolumbar burst fractures. Kyphotic deformities, based on the fracture types in short-segment instrumentation and fusion, were evaluated to determine effective operative methods. SUMMARY OF LITERATURE REVIEW: In thoracolumbar burst fractures, the relationship between spinal canal occlusion and neurologic deficits remains controversial; and definitive guidelines for short-segment instrumentation and fusion have not been established . MATERIALS AND METHODS: Surgically treated thoracolumbar burst fractures (N=112) were analyzed retrospectively. Spinal canal occlusion in both neurologically intact and deficient groups, and neurologic recovery as a result of spinal canal decompression, were evaluated based on Frankel's grades. Kyphotic deformities based on the Denis classification and McCormack's load sharing classification were evaluated in 86 short-segment instrumentation patients. RESULTS: Spinal canal occlusion in the neurologically deficient group (51.8%) was significantly higher than that in the neurologically intact group (31.4%) (p < 0.05). Although 29 patients who recovered neurologically and 25 who did not, demonstrated 20.4% and 19.5% of spinal canal decompression, respectively, it was not significant (p > 0.05). Kyphotic deformities were increased significantly in Denis type A, B and groups with more than 7 points in the load sharing classification (p < 0.05). CONCLUSION: In thoracolumbar burst fractures, the degree of initial spinal canal occlusion was more significantly related with neurologic deficits than with postoperative spinal canal decompression. Extended instrumentation and fusion is recommended for reducing postoperative kyphotic deformities in Denis type A, B and groups with more than 7 points in the load sharing classification.
Classification ; Congenital Abnormalities* ; Decompression ; Humans ; Neurologic Manifestations* ; Retrospective Studies ; Spinal Canal

PURPOSE: Assessment of the diameters of the aortic arches in the human fetus may be helpful in the prenatal diagnosis of aortic arch anomalies. The purpose of this study is to construct valuable reference ranges of fetal aortic arch for various fetal growth parameters in an unselected Korean population. METHODS: A prospective, cross-sectional study was performed in 98 normal singleton fetuses between 20 and 38 weeks of gestation. The transverse aortic arch diameter (TAD) and distal aorta isthmus diameter (AID) were measured in the longitudinal view during systole. The bi-parietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL) were obtained at the same time. Ultrasound examinations were performed with a 2.0-6.0 MHz convex probe by abdominal ultrasound. RESULTS: TAD and AID as a function of gestational age (GA) was expressed by the regression equation TAD= -1.246+0.168 X GA, and AID = -1.341+0.180 X GA; TAD and AID are expressed in millimeters and GA in weeks. TAD and AID as a function of BPD was expressed by the regression equation TAD= -1.147+0.664 X BPD, and AID = -1.152+0.696 X BPD. TAD and AID as a function of HC was expressed by the regression equation TAD = -1.187+0.182 X HC, and AID = -1.350+0.198 X HC. TAD and AID as a function of AC was expressed by the regression equation TAD = -0.528+0.173 X AC, and AID = -0.533+0.183 X AC. TAD and AID as a function of FL was expressed by the regression equation TAD = -0.519+0.799 X FL, and AID = -0.601+0.860 X FL; BPD, HC, AC and FL are expressed in centimeters. Correlations were found to be highly statistically significant in relation to GA, BPD, HC, AC, and FL respectively (P<0.0001 in all). Normal mean of TAD and AID per GA, BPD, HC, AC and FL and 95% prediction limits were also defined, respectively. CONCLUSION: New reference ranges of fetal aortic arch related to other fetal bio-parameters representing fetal growth were obtained successfully. The normative date will be helpful in the prenatal accurate diagnosis of aortic anomalies and abnormal growth of fetal aortic arches in Korea.
Aorta ; Aorta, Thoracic ; Cross-Sectional Studies ; Echocardiography ; Femur ; Fetal Development ; Fetus ; Gestational Age ; Head ; Humans ; Korea ; Pregnancy ; Prenatal Diagnosis ; Prospective Studies ; Reference Values ; Systole

PURPOSE: The purpose of this study is to compare the results of using a locking compression plate and an unlocked plate for treating proximal humeral fractures. MATERIALS AND METHODS: This study was based on 20 patients who underwent plate fixation for proximal humeral fractures out of the 87 patients with proximal humeral fractures and who were admitted from 2003 to 2007 in our hospital. Of the 20 patients, 10 were treated with a locking compression plate and the other 10 were treated with an unlocked plate. Each group was evaluated according to the humeral neck shaft angle, the period until bony union, the complications and the Constant score. The humeral neck shaft angle was based on plain x-rays taken immediately after the operation and at 6 months postoperatively. The Constant score was evaluated on the last visit to our clinic. RESULTS: There was no significant statistical difference between the two groups in terms of the neck shaft angle, the period until bony union and the Constant score. Yet, there were three cases of screw migration in the unlocked plate group. CONCLUSION: There was no significant difference between the two groups in terms of the neck shaft angle, the period until bony union and the Constant score. The locking compression plate is considered to achieve more effective fixation for proximal humerus fractures because there were less complications such as screw migration.
Humans ; Humerus ; Neck ; Shoulder Fractures

PURPOSE: Immune thrombocytopenic purpura (ITP) is divided into acute and chronic forms. Unfortunately, there have been no known specific laboratory or clinical predictors for the diagnosis of chronic ITP. This study was performed to elucidate the prognostic significance of various clinical and laboratory parameters, including reticulated platelet percentage. METHODS: We retrospectively analyzed 60 patients who were diagnosed as ITP at the Department of Pediatrics, Wonju Christian Hospital from January, 1989 to January, 2001. Various kind of clinical parameters such as age, sex, symptom duration, prior URI history, response to treatment, and laboratory parameters like platelet count at initial presentation, lowest platelet count, duration of thrombocytopenia, initial reticulated platelet percentage, antiplatelet antibody IgG and IgM, antinuclear antibody (ANA), direct and indirect Coombs' test were compared between acute and chronic ITP. RESULTS: Fifteen % of patients (9/60) was chronic ITP. The peak age incidence was from 1 to 3 year of age in both acute (29.4%) and chronic ITP (22.2%). The acute ITP was prevalent in spring season, May and June. There was no difference in the incidence of prior URI history between acute and chronic ITP. Higher proportion of chronic ITP patients (5/9; 55.5%) than acute ITP patients (7/51; 13%) had symptom duration longer than 1 month (P <0.05). Increased initial reticulated platelet percentage (more than 8%) was noted in 55.3% (21/38) of acute ITP and in 40% (2/5) of chronic ITP. There were no significant differences in initial platelet count, lowest platelet count, antiplatelet IgM, antiplatelet IgG, ANA and Coombs' test between two groups. The response to initial treatment were excellent in acute and chronic ITP. Six cases of acute ITP relapsed within 1 month from initial presentation. Eight cases of chronic ITP relapsed, among them 5 cases relapsed after 2 months from initial presentation. CONCLUSION: We suggest that patients with > or =1 months duration of presenting symptoms and relapse after 2 months from initial presentation have the propensity of developing chronic ITP. Reticulated platelet percentage could not discriminate acute and chronic ITP. A more accurate detection method should be developed for reticulated platelets.
Antibodies, Antinuclear ; Blood Platelets* ; Coombs Test ; Diagnosis ; Gangwon-do ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Pediatrics ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic* ; Recurrence ; Retrospective Studies ; Seasons ; Thrombocytopenia

No abstract available.
Diabetes Mellitus, Type 2* ; Heart Rate* ; Heart* ; Humans ; Korea*

BACKGROUND: Many modalities of treatment for vitiligo have been elucidated and yet the treatment of vitiligo remains to be a challenge. OBJECTIVES: The purpose of this article is to review our results and experiences with narrow-band ultraviolet B phototherapy for vitiligo. METHOD: We studied 9 patients with vitiligo who received narrow band UVB phototherapy for 6 months in our department. This is a retrospective analysis of our experiences and results. RESULTS: Nine patients were able to be evaluated for the purpose of this analysis. Their ages ranged from 6 to 68 years(mean, 18.4 years). Six patients of 9 patients achieved more than 75% repigmentation with a mean of 25 sessions of phototherapy. The remaining three patients had 50%, 40% and 30% repigmentation after 44, 40, and 45 sessions of phototherapy, respectively. Adverse effects were mild. CONCLUSION: Narrow-band UVB is a useful and well-tolerated therapy for vitiligo in comparsion with other therapies.
Humans ; Phototherapy ; Retrospective Studies ; Vitiligo*

Purpose: No consensus currently exists regarding the maximal pressure of hyperbaric oxygen (HBO2) therapy performed within 24 hours of acute carbon monoxide (CO) poisoning. This study aimed to evaluate the difference in therapeutic effects according to the first HBO2 pressure (3.0 atmospheres absolute [ATA] vs. 2.8 ATA). Methods: We used prospectively collected registry data on CO poisoning at a tertiary academic hospital in the Republic of Korea. Adult patients with acute CO poisoning treated with HBO2 within 24 hours after arrival at the emergency department and without the use of additional HBO2 after 24 hours between January 2007 and February 2022 were included. Data from 595 patients were analyzed using propensity score matching (PSM). Patients with mild (non-intubated) and severe (intubated) poisoning were also compared. Neurocognitive outcomes at 1 month after CO poisoning were evaluated using the Global Deterioration Scale combined with neurological impairment. Results: After PSM, the neurocognitive outcomes at 1-month post-CO exposure were not significantly different between the 2.8 ATA (110 patients) and 3.0 ATA (55 patients) groups (p=1.000). Similarly, there was also no significant difference in outcomes in a subgroup analysis according to poisoning severity in matched patients (165 patients) (mild [non-intubated]: p=0.053; severe [intubated]: p=1.000). Conclusion Neurocognitive sequelae at 1 month were not significantly different between HBO2 therapy pressures of 2.8 ATA and 3.0 ATA in patients with acute CO poisoning. In addition, the 1-month neurocognitive sequelae did not differ significantly between intubated and non-intubated patients.

Primary pulmonary hypertension is a condition characterized by sustained elevations of pulmonary artery pressure without demonstrable cause. It is incurable and progressive clinical entity. The incidence has been estimated at approximately 1 to 2 cases per million people in the general population. The maternal mortality of primary pulonary hypertension in pregnancy was said to be 30% and the first month after delivery represents the period of highest risk. We experienced a 27-year-old women with primary pulmonary hypertension diagnosed in postpartum period. She was transferred from the department of obstetrics to internal medicine due to dyspnea on the first day of postpartum. She was diagnosed by perfusion lung scan, chest CT and confirmed by echocardiography. This diagnosis were supported by findings of pulmonary angiogram and cardiac catheterization. Initially she was treated with diuretics, aspirin and anticoagulant therapy, and as a result of the treatment, her symptoms improved. However after 8months has elapsed, exertional dyspnea was worsening. Thus she was treated with calcium channel blocker, aspirin and diuretics and was followed at 1 month interval on the outpatient clinics.
Adult ; Ambulatory Care Facilities ; Aspirin ; Calcium Channels ; Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Diuretics ; Dyspnea ; Echocardiography ; Female ; Humans ; Hypertension ; Hypertension, Pulmonary* ; Incidence ; Internal Medicine ; Lung ; Maternal Mortality ; Obstetrics ; Perfusion ; Postpartum Period* ; Pregnancy ; Pulmonary Artery ; Tomography, X-Ray Computed

Peripartum cardiomyopathy(PPCM) is a rare form of cardiomyopathy of unclear cause that can have life-threatening consequences. Cardiac dilatation and congestive heart failure of unexplained cause may develop during the last month of pregnancy or within the first few months after delivery. It is rare, but it varies among geographic regions. Recent estimates of incidence range from 1: 15,000 in the United States, 1: 6000 in Japan, and 1: 1000 in South Africa. The cause of this disorder is unknown but in some patients endomyocardial biopsy has shown evidence of myocarditis, Necropsy shows cardiac enlargement, often with mural thrombi, endocardial thickening and pericardial effusion, along with histologic evidence of myocardial degeneration, fibrosis and lymphocyte infiltration. However, based on recent data, it seems that endocardial biopsies are currently of minor diagnostic and therapeutic benifit in patients with PPCM. The symptoms, signs, and treatment are similar to those in patients with idiopathic dilated cardiomyopathy, but thromboembolic complications are particularly common. The mortality rate is quite variable but may be as high as 25 to 50 percent. We experienced three case of peripartum cardiomyopathy after delivery. The patients were treated with digitalis, vasodilator and diuretic, which induced improvement of the clinical and echocardiographic finding.
Biopsy ; Cardiomyopathies* ; Cardiomyopathy, Dilated ; Digitalis ; Dilatation ; Echocardiography ; Fibrosis ; Heart Failure ; Humans ; Incidence ; Japan ; Lymphocytes ; Mortality ; Myocarditis ; Pericardial Effusion ; Peripartum Period* ; Pregnancy ; South Africa ; United States