Keratosis punctata of the palmar creases (KPPC) is rare skin condition characterized by punctiform hyperkeratotic pits confined to the palmar and digital creases. Although this condition has been regarded as a variant of classical punctate keratoses, there are some differences between classical punctate keratosis and KPPC. We herein report a case of KPPC in a 22-year-old man who had numerous, tiny, hyperkeratotic pits limited to the palmar creases of both hands with typical histologic findings.
Hand ; Humans ; Keratosis* ; Skin ; Young Adult

A case of established infected nonunion of femur after open reduction and internal fixation of proximal femoral fracture with plate and screws in a 20-year-old man has been satisfactorily treated with a conventional Kiintscher nail filled with antibiotic laden bone cement in its hollow cavity. Though the removal of plate and screws, wound debridement, insertion of antibiotic laden bone cement bead at the nonunion site with temporary external skeletal fixation and skeletal traction preceded, a rigid fixation by the nail and vancomycin elution from the cement are believed to have contributed for bony union without troublesome complication of infection in this case.
Debridement ; Femoral Fractures ; Femur* ; Fracture Fixation ; Humans ; Traction ; Vancomycin ; Wounds and Injuries ; Young Adult

Radiologic findings of hemangioendothelioma of the liver were retrospectively analyzed in twelve infants. The radiological examinations included were sonography in 12 patients, computed tomograpy (CT) in six, magnetic resonance (MR) imaging in five, and angiography in two. Four patients were diagnosed pathologically, two by angiography, five by follow-up sonography, and one by clinical presentation with sonography. The common radiologic findings of the hemangioendothelioma were well circumscribed heterogeneous echogenic mass (75%) on sonography, peripheral massive enhancement (67%) on CT, bright high signal intensity on T2-weighted MR image (100%), and homogenous or peripheral enhancement (75%) on Gd-DTPA enhanced T1-weighted MR image. Dilated proximal aorta and enlarged draining hepatic veins on angiography an d other studies were also important findgdings. The follow-up sonography demonstrated the involution of lesions with some calcification in four patients and complete resolution in one. The authors believe that these findings in an under the age of 6 months strongly suggest the diagnosis of hemangioendothelioma of the liver, and follow-up sonography should be done.
Angiography ; Aorta ; Diagnosis ; Follow-Up Studies ; Gadolinium DTPA ; Hemangioendothelioma* ; Hepatic Veins ; Humans ; Infant ; Liver* ; Retrospective Studies

PURPOSE: To evaluate ethanolamine oleate (EAO)-microfibrillar collagen (MFC) mixture as a new scleroembolic material for the interventions requiring both permanent obliteration of vascular lumen and atrophy of mass, such as for the facial AVM and other hypervascular soft tissue masses. MATERIALS AND METHODS: Twenty-nine transcatheter transarterial embolizations of renal arteries were performed in six groups of rabbits classified by the EAO concentration and the addition of MFC. Postembolization angiography, gross morphological and microscopic examinations of embolized kidneys were performed immediately, 3 days, 2 weeks and 4 weeks after embotization. Analysing points were the usefulness as a scleroembolic material (endovascular retention, thrombogenic-sclerosing effect, perivascular fibrosis and inflammatory reaction), effects of the EAO concentration and the addition of MFC. RESULTS: EAO-MFC mixture satisfied all ideal conditions of scleroembolic agent;persistent endovascular retention, good thrombogenic-sclerosing effect with a mild inflammatory reaction and significant atrophy of kidney. The effect of increasing concentration of EAO was proximal embolization. The effects of MFC were promotion of proximal embolization, endovascular retention and sclerosing effect. CONCLUSION: EAO-MFC mixture can be used as a new effective scleroembolic material for the various hemodynamic situations in which embolic level can be controlled by EAO concentration and the addition of MFC.
Angiography ; Atrophy ; Collagen* ; Ethanolamine* ; Fibrosis ; Hemodynamics ; Kidney ; Oleic Acid* ; Rabbits* ; Renal Artery

From the Department of Dermatology, College of Medicine, The Catholic University of Korea, Kangnam St. Mary's Hospital, 505, Banpo-Dong, Seocho-Gu, 137-040, Seoul, Korea, Gastrointestinal stromal tumors are usually late manifestations of neurofibromatosis (von Recklinghausen's disease) and most become clinically apparent in middle-aged patients as multiple benign tumors. To our review of the literature, solitary malignant stromal tumor of gastrointestinal tract is exceptionally rare in von Recklinghausen's disease. We herein present a case of solitary jejunal stromal tumor in a 50-year-old woman with NF1, which histopathologically showed a malignant change and combined smooth muscle-neural type.
Dermatology ; Female ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Humans ; Korea ; Middle Aged ; Neurofibromatoses* ; Neurofibromatosis 1* ; Seoul

No abstract available.
Magnetic Resonance Imaging* ; Osteosarcoma*

Authors retrospectively analysed the diagnostic values of oblique tomography of hilum over simple chest PA &AP tomography in 129 cases at Seoul National University Hospital during 3yrs from may 1979 to may 1982. Theresults are as follows; 1. Among 129 cases, 42 cases were lung cancer, 24 cases were tuberculosis, 22 cases wereprominent pulmonary artery, 10 cases were metastasis, & etc. 2. In 42 cases of lung cancer. 1) Diagnostic accuracyof oblique tomography in the evaluation of hilar lymphadenopathy was 92%, that of AP tomography & simple chest PAwere 67% & 54% respectively. 2) Diagnotic accuracy of oblique tomography in the evaluation of endobronchial lesionwas 95%, that of AP tomography & simple chest PA were 24% 14% respectively. 3. It is suggested that in lung cancerif there is no evidence of hilar enlargement in simple X-ray, 55degrees oblique tomography is recommended forevaluation of hilum, or if hilar enlargement is shown in simple X-ray, then AP tomography or CT is recommended forevaluation of mediastinum.
Lung Neoplasms ; Lung ; Lymphatic Diseases ; Mediastinum ; Neoplasm Metastasis ; Pulmonary Artery ; Retrospective Studies ; Seoul ; Thorax ; Tuberculosis

OBJECTIVES: The objective of this study was to evaluate the performance of risk-adjusted mortality models for colorectal cancer surgery. METHODS: We investigated patients (n=652) who had undergone colorectal cancer surgery (colectomy, colectomy of the rectum and sigmoid colon, total colectomy, total proctectomy) at five teaching hospitals during 2008. Mortality was defined as 30-day or in-hospital surgical mortality. Risk-adjusted mortality models were constructed using claims data (basic model) with the addition of TNM staging (TNM model), physiological data (physiological model), surgical data (surgical model), or all clinical data (composite model). Multiple logistic regression analysis was performed to develop the risk-adjustment models. To compare the performance of the models, both c-statistics using Hanley-McNeil pair-wise testing and the ratio of the observed to the expected mortality within quartiles of mortality risk were evaluated to assess the abilities of discrimination and calibration. RESULTS: The physiological model (c=0.92), surgical model (c=0.92), and composite model (c=0.93) displayed a similar improvement in discrimination, whereas the TNM model (c=0.87) displayed little improvement over the basic model (c=0.86). The discriminatory power of the models did not differ by the Hanley-McNeil test (p>0.05). Within each quartile of mortality, the composite and surgical models displayed an expected mortality ratio close to 1. CONCLUSIONS: The addition of clinical data to claims data efficiently enhances the performance of the risk-adjusted postoperative mortality models in colorectal cancer surgery. We recommended that the performance of models should be evaluated through both discrimination and calibration.
Adult ; Aged ; Colorectal Neoplasms/*mortality/surgery ; Databases, Factual ; Female ; Hospital Mortality ; Hospitals, Teaching ; Humans ; Logistic Models ; Male ; Middle Aged ; Models, Psychological ; *Models, Theoretical ; Neoplasm Staging ; Odds Ratio ; Quality of Health Care ; Risk Adjustment

No Abstract available.
Transcription Factors*

Ceftriaxone, a third-generation cephalosporin, is a very potent, broad spectrum antibiotic commonly used in patients with meningitis, osteomyelitis, pyelonephritis, Lyme disease and many other severe infectious diseases. Up to 46% of those receiving this antibiotic develop gallbladder sludge. Most of them are asymptomatic, but a small proportion may develop right upper quadrant pain, nausea, vomiting and even cholecystitis. We report a case of ceftriaxone-induced pseudocholelithiasis in a 5-year-old boy. We also emphasize the fact that surgical interventions such as cholecystectomy is not necessary, because the condition may resolve spontaneously after cessation of the drug.
Ceftriaxone ; Child, Preschool ; Cholecystectomy ; Cholecystitis ; Communicable Diseases ; Gallbladder ; Humans ; Lyme Disease ; Male ; Meningitis ; Nausea ; Osteomyelitis ; Pyelonephritis ; Sewage ; Vomiting