We report a case of pigmented spindle cell nevus occurred in a 4-year-old girl. The lesion was well-demarcated, 2.5 x 3mm sized black macule on the left thenar area. The histopathologic findings of excisional biopsy specimen revealed the prociferation of uniform spindle-shaped pigmented melanocytes at the dermoepidermal junction and sharply definded lateral margins.
Biopsy ; Child, Preschool ; Female ; Humans ; Melanocytes ; Nevus, Spindle Cell*

No abstract available.
Muscular Diseases*

Intracranial vasculitis is a rare and disastrous complication of tuberculous meningitis if not treated properly. Focal neurologic deficits according to the vessels involved are common manifestation. Here, we report a 29-year-old man who suffered abrupt, bizarre behavioral changes caused by vasculitis complicating tuberculous meningoencephalitis. The diagnosis of tuberculous meningitis is based upon both the CSF findings and a chest X-ray. His systemic symptoms disappeared by after being administered antituberculous medication but various psychotic features such as hypersomnia, hyperphagia and aggressivebehavior continued. A brain MRI showed multiple small parenchymal tuberculous nodules, and the brain MR angiography revealed a narrowing of the proimal middle cerebral arteries and a reduced visualization of the cerebral vessels, suggesting widespread vasculitis. Intravenous dexamethasone successfully ameliorated his behavioral changes. In addition both the follow up brain MRI and angiography showed a normalization of the previous findings.
Adult ; Angiography ; Brain ; Dexamethasone ; Diagnosis ; Disorders of Excessive Somnolence ; Follow-Up Studies ; Humans ; Hyperphagia ; Magnetic Resonance Imaging ; Meningoencephalitis* ; Middle Cerebral Artery ; Neurologic Manifestations ; Thorax ; Tuberculosis ; Tuberculosis, Meningeal ; Vasculitis

Pancreatic islet cell adenoma is a benign tumor of pancreatic beta-cell and a rare cause of hyperinsulinemic hypoglycemia in children. The authors experienced a case of pancreatic islet cell adenoma(Insulinoma)in a 11 year and 8 month old male who had frequent loss of consciousness and seizure. Enucleation was done after localization of tumor by selective celiac artery angiography and abdominal computed tomography. Diagnosis was confirmed by histologic findings as pancreatic-adenoma, gyriform growth pattern. A brief review of related literature was made.
Adenoma* ; Angiography ; Celiac Artery ; Child ; Diagnosis ; Humans ; Hyperinsulinism ; Hypoglycemia ; Infant ; Islets of Langerhans ; Male ; Seizures ; Unconsciousness

In the past two decades, open reduction and internal fixation has been the preferred treatment of posterior pelvic ring disruption with instability. Despite of rigid fixation, it can induce bleeding, wound infection, wound necrosis and prolong operation time in the patient with combined injuries. To compensate for these disadvantages, we have implemented closed reduction and percutaneous iliosacral fixation under fluoroscopy in reducible posterior pelvic ring disruption. In spite of anatomical risk during screw insertion, the percutaneous iliosacral screw technique after closed reduction of the posterior pelvic ring disruption minimally violates the soft tissue envelope and reduces both the operative blood loss and infection rate. We are reporting the early results of our 6 patients treated between Aug. 1995 to Aug. 1996. The operation time was shorter than open reduction and internal fixation. There was no significant bleeding, wound infection and nerve injury by screws.
Fluoroscopy ; Hemorrhage ; Humans ; Necrosis ; Wound Infection ; Wounds and Injuries

Running for a long distance in runners with exercise-induced hypertension (EIH) increases high blood pressure (BP) which causes myocardial burden, inducing elevation of cardiac markers. It is assumed to be associated with endothelial dysfunction, but has not been studied so far. The purpose of this study is to exam the responses of anti-inflammatory, inflammatory, and endothelial regulation factors to 100 km ultra-marathon of athletes who have EIH. For this study, we obtain and analysis interleukin-6, tumor necrosis factor-α, interleukin-10 (IL-10), monocyte chemoattractant protein-1, creatine kinase and nitric oxide (NO) from 100 km ultra-marathoners before and right after the 100 km race. There were 40 volunteers who had ever won the 100 km marathon race before more than one time. They had the graded exercise test with measurement of BP for assessing EIH. Among them, eight athletes were categorized to normal control group (NCG) and 10 athletes were assessed by EIH group (EIHG). The graded exercise test with treadmill was performed for the maximal strenuous exercise and BP. EIH was diagnosed as <140/90 mm Hg in normal and ≥210 mm Hg in maximal exercise. Marathoners including EIHG (n=10) and NCG (n=8) participated in the race and blood extracted from them before the race and right after the race. As results, EIHG had lower IL-10 than NCG during resting states and after the 100 km race EIHG had significantly lower NO concentration than NCG. Therefore, the NO in the endothelial is inhibited during strenuous endurance exercise, resulting in vasoconstriction with increasing the BP.
Athletes* ; Cardiovascular Diseases ; Chemokine CCL2 ; Continental Population Groups ; Creatine Kinase ; Cytokines ; Exercise Test ; Humans ; Hypertension* ; Interleukin-10 ; Interleukin-6 ; Necrosis ; Nitric Oxide ; Running* ; Vasoconstriction ; Volunteers

PURPOSE: The purpose was to evaluate the procedure-related complications of the TIPS and its clinical significance. MATERIALS AND METHODS: The materials consisted of 52 patients who had 57 TIPS procedures for the management of variceal bleeding due to portal hypertension. To detect the occurrence of complications during transhepatic needle puncture(from hepatic vein to the portal vein), contrast material was injected with the withdrawl of the puncture needle. RESULTS: Procedure-related complications occurred in 28 patients (54%) among 52 patients. The corn lications were biliary tree puncture(15 cases), transperitoneal puncture(14 cases), stent malposition(3 cases) stent migration(1 case), hepatic arteries puncture(1 case), splenic vein perforation(1 case), and paroxysmal tricular tachycardia(1 case). Three patients had acute stent thrombosis with rebleeding immediately after procedure. The procedure was repeated in two patients. One patient was expired due to rebleeding. CONCLUSION: The procedure related complications were clinically insignificant in most instances, when stent thrombosis or proxysmal ventricular tachycardia was developed.
Biliary Tract ; Esophageal and Gastric Varices ; Hepatic Artery ; Hepatic Veins ; Humans ; Hypertension, Portal ; Needles ; Portasystemic Shunt, Surgical* ; Punctures ; Splenic Vein ; Stents ; Tachycardia, Ventricular ; Thrombosis ; Zea mays

We found an error in this article. The Fig. 2B should be corrected.

BACKGROUND: The optimal management of malignant obstruction of the left colon and rectum is controversial. METHODS: A retrospective study was performed of 33 patients who underwent one-stage operation(n=11), staged operation(n=20), and palliative colostomy(n=2) at Kwangju Christian Hospital between January 1992 and December 1996. RESULTS: Eleven patients underwent one-stage operations(7 cases with anterior resection, 3 cases with left hemicolectomy, 1 case with Miles' operation). In this group, postoperative morbidity was 36.3% including 1 wound infection(9.0%), 1 anastomotic leakage (9.0%), 1 postoperative intestinal obstruction and 1 pulmonary complication, but there was no postoperative death. The average of hospital stay in this group was 18.1 days and the first day of normal diet was 6.0 days. Twenty patients underwent staged operations including 12 cases of Hartmann's procedure. In this group, postoperative morbidity was 35.0% including 3 wound infections(15.0%), 2 pulmonary complications(10.0%), 1 parastomal hernia and 1 fistula. There were two postoperative deaths as a result of sepsis. The average of hospital stay in this group was 34.9 days and the first day of normal diet was 6.8 days. CONCLUSION: We believe that one-stage operation was of value in management of malignant obstruction of the left colon and rectum in selected patients.
Anastomotic Leak ; Colon* ; Diet ; Fistula ; Gwangju ; Hernia ; Humans ; Intestinal Obstruction ; Length of Stay ; Rectum* ; Retrospective Studies ; Sepsis ; Wounds and Injuries

No abstract available.
Humans ; Turner Syndrome*