Spindle cell hemangioendothelioma was first described in 1986 by Weiss and Enzinger as a low grade angiosarcoma resr mbling a cavernous hemangioma and kaposis sarcoma. Recently, it is suggested to be non neoplastic lesion or reactive process arising from pre-existing vascular mal- formation. We report a case of spindle cell hemangioendothelioma in a 9-month-old boy. He had multiple, variable sized, colorful, cutaneous or subcutaneous nodules on the forearm and hand. The tumor first appeared on the forearm as erythematous patches at birth and grew rapidly with- in 3 months. Histopatholgical findings showed that the lesion was composed of thin walled cavernous spaces mixed with spindle cells and occasional epithelioid endothelial cells containing intracytoplasmic vacuole. Most af the endothelial cells lining the cavernous spaces and intracytoplasmic lumina, were positive for factor VIII associated antigen. But the spindle cells were negative. Atypical vascular structures resembling arteriovenous shunts were noted around the tumor suggesting a reactive proliferation due to disturbance of local blood flow. Several turnors were excised. No recurrence has been recognized in the one year- follow-up period.
Endothelial Cells ; Factor VIII ; Follow-Up Studies ; Forearm ; Hand ; Hemangioendothelioma* ; Hemangioma, Cavernous ; Hemangiosarcoma ; Humans ; Infant ; Male ; Parturition ; Recurrence ; Sarcoma, Kaposi ; Vacuoles

Recent studies suggest that apolipoproteins may be better predictor of ischemic heart disease than are plasma lipids, such as total cholesterol and high density lipoprotein cholesterol(HDL-C). To examine this hypothesis, plasma levels of major lipids and major apolipo-proteins were measured and their derivatives were calculated in 30 male patients with ischemic heart disease(16 angina pectoris and 14 old myocardial infarction) and 30 age-matched male healthy controls. Plasma levels of lipids were obtained by conventional methods and apolipoproteins by Rocket immunoelectrophoresis. Levels of HDL-C, HDL2-cholesterol(HDL2-C), and apolipoprotein-AII, and ratios of HDL-C/total cholesterol, HDL2-C/total cholesterol, and apolipoprotein-AI/apolipoprotein-B were lower in the group of patients than in controls. Levels of low density lipoprotein cholesterol(LDL-C) and apolipoprotein-B, and ratios of lDL-C/HDL-C and apolipoprotein-AI/apolipoprotein-AII were higher in the group of patients. There were no statistically significant differences in the levels of total cholesterol and apolipoprotein-AI between the two groups. Stepwise discriminators analysis showed that apolipoprotein-B and apolipoprotein-AII were better discriminators than plasma lipids for identifying those with ischemic heart disease. One could correctly classify 78% of the cases by using the levels of the two apolipoproteins. By using the level of apolipoprotein-B, one could correctly classify 73% of the cases. There were no correlations between the levels of total cholesterol and HDL-C in the controls whereas there were positive correlations between the levels in the group of patients. In conclusion, this study showed that apolipoprotein-B was the best single discriminator for identifying the patients with ischemic heart disease, followed by apolipoprotein-AII.
Angina Pectoris ; Apolipoproteins A* ; Apolipoproteins* ; Cholesterol ; Heart ; Humans ; Immunoelectrophoresis ; Lipoproteins ; Male ; Myocardial Ischemia* ; Plasma* ; Risk Factors*

The common errors in preoperative treatment plan for the orthognathic surgery can be occurred during cast impression, cast mounting procedure with face-bow transfer, surgical stent fabrication, and so on. One of the most common errors exists during mounting process of the model on the articulator. Accurate mounting of dental casts to articulator should be achieved by transferring the 3- dimensional spatial relationship of the maxillary arch to an articulator. A face-bow is used for transfer this relationship to articulator, usually by relating the face-bow to a plane of reference of maxillary cast. The purpose of this study is evaluation of the accuracy of face-bow transferring of maxillary model to the articulator. The maxillary casts of thirty patients for orthognathic surgery were mounted on articulator with an face-bow instrument. The relationship of occlusal plane angle to Frankfort horizontal plane relations were compared the cephalogram with the cast-mounted articulator. As a result of this study, the significant difference between the maxillary occlusal planes angle in the cephalogram and articulator were found . The results were followed,1. The mean occlusal plane angle in cast-mounted articulator was 13.5.(SD+/-5.4).2. The mean occlusal plane angle in cephalogram was 10.4.(SD+/-4.3).3. The mean difference of occlusal plane angle between cast-mounted articulator and cephalogram was 3.3.(SD+/-4.6).According to the result, we should suggest that the occlusal plane angle to Frankfort plane in cast-mounted articulator is more steeper than that of cephalogram.And then, maxillofacial surgeon should try to get a more predictable result by suggesting the proper correction method and mounting the cast accurately.
Dental Articulators ; Dental Occlusion* ; Humans ; Orthognathic Surgery ; Stents

Epstein's syndrome is a rare disease whish is characterized by the association of thrombocytopenia, macrothrombocytopathia, nephritis and deafness. We experienced a case of Epstein's syndrome in a 12 years old male patient who was presented with a life long history of bleeding, usually as epistaxis, bilateral sensorineural deafness and hematuria with proteinuria starting in late childhood. Hematologic studies showed thrombocytopenia with giant platelets and anemia. A bone marrow aspirate revealed the megakaryocytes to be adequate in number and many giant size platelets. Platelet do not respond to addition of A and epinephrine; collagen and ristocetin induced agglutination response is decreased. It is difficult to be certain the association of thrombocytopenia with giant platelets, nephritis and deafness constitutes a new hereditary disease with a distinct pathogenesis or if it is an expansion of the well recognized Alport's syndrome of hereditary nephritis deafness. We report a case of Epstein's syndrome syndrome with brief review of related literatures.
Agglutination ; Anemia ; Blood Platelets ; Bone Marrow ; Child ; Collagen ; Deafness ; Epinephrine ; Epistaxis ; Genetic Diseases, Inborn ; Hematuria ; Hemorrhage ; Humans ; Male ; Megakaryocytes ; Nephritis ; Nephritis, Hereditary ; Proteinuria ; Rare Diseases ; Ristocetin ; Thrombocytopenia

BACKGROUND: Common and effective treatments for calcific tendinitis involve needling procedures. However, it has been widespread practice to refer patients with calcific tendinitis, which is a predominantly orthopedic condition, to radiology department. The purpose of this study was to compare clinical and radiological outcomes after ultrasound-guided needling for calcific tendinitis between the orthopedics and radiology department. METHODS: Seventy-seven shoulders (Group 1) and 38 shoulders (Group 2) treated in the radiology and orthopedic department, respectively. A fellowship-trained orthopedic surgeon and a musculoskeletal radiologist each performed the procedure of ultrasound-guided needle decompression with subacromial steroid injection. Clinical outcomes was evaluated using the visual analogue scale for pain (pVAS) and the American Shoulder and Elbow Surgeons (ASES) shoulder score before treatment and at each follow-up. The pre- and post-needling size and shape of the calcific deposits were compared between the two groups. RESULTS: We analyzed a total of 56 shoulders for Group 1 and 32 shoulders for Group 2. The mean age and sex ratio of the patients no significantly different. We found that the mean decrease in the diameter of calcification between pre- and post-needling was 9.0 mm for Group 1 and 13.1 mm for Group 2; the difference was significantly larger in Group 2 than in Group 1. Both groups showed improved pVAS and ASES scores after needling but the extent of these improvements did not differ with the type of operator. CONCLUSIONS: Needling decompression performed by orthopedic surgeons could a viable option for the treatment of calcific tendinitis.

No abstract available.
Polyarteritis Nodosa*

PURPOSE: Pediatric cardiac arrhythmias are increasing but there is no normal values of cardiac electrophysiologic studies(EPS) in Korean children. So we performed cardiac EPS in children undergoing cardiac catheterization for mild congenital heart disease without cyanosis and ECG abnormality. METHODS: We studied 24 children(male : 9, female : 15) with mild congenital heart disease(PDA : 10, VSD : 8, ASD : 6, age range 1.8 years to 9.3 years, mean 4.3 years). All studies were performed under propofol intravenous anesthesia. Fifteen minutes after cardiac angiography, two elctrophysiologic catheters were inserted through the right femoral vein into the right atrial appendage and His hundle area. Using atrial pacing with various cycle lengths for 30 seconds, we evaluated the sinus node recovery time(SNRT) and corrected sinus node recovery time(CSNRT) and atrioventricular block cycle length(AVBCL). Using atrial extrastimuli during sinus rhythm and paced 8 atrial rhythm, we evaluated the atrioventricular node effective refractory period(AVNERP) and total sinoatrial conduction time(TSACT). RESULTS: Baseline sinus cycle length was 661 +/- 107 msec. SNRT and CSNRT were 955 +/- 181 msec, 264 +/- 68 msec each. AVBCL and AVNERP were 365 +/- 56 msec, 264 +/- 63 msec each. TSACT was 220 +/- 55 msec. CONCLUSION: Considering the importance of pediatric cardiac arrhythmias, we have to have the normal EPS values in Korean children. But it is impossible to perform a invasive EPS for normal children without heart disease. So we believe that these measured values in children with mild congenital heart disease may be used as the normal value in Korean children.
Anesthesia, Intravenous ; Angiography ; Arrhythmias, Cardiac ; Atrial Appendage ; Atrioventricular Block ; Atrioventricular Node ; Cardiac Catheterization ; Cardiac Catheters ; Catheters ; Child* ; Cyanosis ; Electrocardiography ; Female ; Femoral Vein ; Heart ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Propofol ; Reference Values ; Sinoatrial Node

We report three cases of rat mite dermatitis caused by Ornithonysus bacoti(Hirst, 1913), commonly referred to it as the tropicalrat mite. The first case, a 26-year old female had multiple pinhead sized vesicles with peripheral erythematous macule on the upper arms. The second case, a 34-year-old femal had multiple variable sized vesicles with erythematous base on the extremeties. The third case, a 43-year old male had multiple erythematous macules and papules with central punctum on the trunl: and extremities. Histopathologic sections from lesions of the first and second patient showed moderate perivascular lymphahistiocytic infiltration intermingled with some eosinophils. Causative mites, Ornithonyssus bacoti, female were collected around the skin lesion in rase 1, from the house dust in case 2 and furniture in case 3.
Adult ; Animals ; Arm ; Dermatitis* ; Dust ; Eosinophils ; Extremities ; Female ; Humans ; Interior Design and Furnishings ; Male ; Mites* ; Rats* ; Skin

No abstract available.
Aged* ; Femur Neck* ; Femur* ; Humans

Intrsneural ganglion cysts of the peroneal nerve are rare. The precise etiology and pathological changes remain obscure. We have experienced recently a case of intraneural ganglion cyst developed in the sheath of the peroneal nerve. A 28 year old male had suffered from lump producing pain over the posterolateral aspect of the upper portion of the fibula, weakness of dorsiflexion of the ankle and of extension of the toes and diminution of sensation on the dorsum of the foot. He underwent excision of the ganglion and the prognosis for recovery of function is good.
Ankle ; Fibula ; Foot ; Ganglion Cysts ; Humans ; Male ; Peroneal Nerve ; Prognosis ; Recovery of Function ; Sensation ; Toes