Parosteal lipoma is a rare and generally asymptomatic benign tumor of mature adipose tissue that is located in direct apposition to the external surface of the bone. These tumors are occasionally associated with reactive changes in the underlying bone. The reactive bone formation is generally restricted to the base of the tumor, that is, near the periosteum. We recently experienced a case of parosteal lipoma in the proximal femur, which displayed exuberant bone and cartilage formation, and this led us to a misdiagnosis of chondroblastic osteosarcoma on the initial biopsy. We report here on this case with a special emphasis on making the differential diagnosis from osteosarcoma.
Adipose Tissue ; Biopsy ; Cartilage ; Chondrocytes ; Diagnosis, Differential ; Diagnostic Errors ; Femur* ; Lipoma* ; Osteogenesis ; Osteosarcoma ; Osteosarcoma, Juxtacortical ; Periosteum

PURPOSE: To evaluate the efficacy and safety of vitreoretinal surgery using a 23-gauge transconjunctival sutureless vitrectomy (TSV) system for various vitreoretinal diseases. METHODS: A retrospective, consecutive, interventional case series was performed for 40 eyes of 40 patients. The patients underwent vitreoretinal procedures using the 23-gauge TSV system, including idiopathic epiretinal membrane (n=7), vitreous hemorrhage (n=11), diabetic macular edema (n=10), macular hole (n=5), vitreomacular traction syndrome (n=5), diabetic tractional retinal detachment (n=1), and rhegmatogenous retinal detachment (n=1). Best corrected visual acuity (BCVA), intraocular pressure (IOP), and intra- and post-operative complications were evaluated. RESULTS: Intraoperative suture placement was necessary in 3 eyes (7.5%). The median BCVA improved from 20/400 (LogMAR, 1.21+/-0.63) to 20/140 (LogMAR, 0.83+/-0.48) at 1 week (p=0.003), 20/100 (LogMAR, 0.85+/-0.65) at 1 month (p=0.002), 20/100 (LogMAR, 0.73+/-0.6) at 3 months (p=0.001). In 1 eye, IOP was 5 mmHg at 2 hours and 4 mmHg at 5 hours, but none of the eyes showed hypotony after 1 postoperative day. No serous postoperative complications were observed during a mean follow-up of 8.4+/-3.4 months (range 3-13 months) CONCLUSIONS: The 23-gauge TSV system shows promise as an effective and safe technique for a variety of vitreoretinal procedures. It appears to be a less traumatic, more convenient alternative to 20-gauge vitrectomy in some indications.
Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Retinal Diseases/*surgery ; Retrospective Studies ; *Suture Techniques ; Treatment Outcome ; Visual Acuity ; Vitrectomy/*methods ; Vitreous Hemorrhage/*surgery

Pneumocystis carinii causes serious pulmonary infection in immunosuppressed patients. This study was undertaken to observe the cytoskeletal proteins of P. carinii by immuno-electron microscopy. P. carinii infection was experimentally induced by immunosuppression of Sprague-Dawley rats for seven weeks, and their lungs were used for the observations of this study. The gold particles localized actin, tropomyosin, and tubulin. The actin was irregularly scattered in the cytoplasm of the trophic forms but was much more concentrated in the inner space of the cell wall of the cystic forms called the inner electron-lucent layer. No significant amount of tropomyosin was observed in either trophic forms or cystic forms. The tubulin was distributed along the peripheral cytoplasm and filopodia of both the trophic and cystic forms rather than in the inner side of the cytoplasm. Particularly, in the cystic forms, the amount of tubulin was increased and located mainly in the inner electron-lucent layer of the cell wall where the actin was concentrated as well. The results of this study showed that the cell wall of P. carinii cystic forms is a structure whose inner side is rich in actin and tubulin. The location of the actin and tubulin in P. carinii suggests that the main role of these proteins is an involvement in the protection of cystic forms from the outside environment by maintaining rigidity of the cystic forms.
Actins/analysis ; Animals ; Cytoskeletal Proteins/*analysis ; Fungal Proteins/*analysis ; Histocytochemistry ; Microscopy, Immunoelectron ; Pneumocystis/*chemistry/cytology ; Rats ; Rats, Wistar ; Support, Non-U.S. Gov't ; Tropomyosin/analysis ; Tubulin/analysis

No abstract available.
Endometriosis* ; Exons* ; Female ; Humans ; Polycystic Ovary Syndrome*

PURPOSE: We evaluated the technical feasibility and clinical efficacy of subintimal stent placement for long segment occlusion of the iliac artery. MATERIALS AND METHODS: From March 2003 to February 2007, subintimal stent placement for long segment occlusion of the iliac artery of 24 limbs in 22 patients was analyzed retrospectively. Endovascular access was performed via the ipsilateral femoral artery in 7 cases, via the contralateral femoral artery in 6 cases, via both femoral arteries in 10 cases and via the brachial artery in one case. The SAFARI (subintimal arterial flossing with antegrade-retrograde intervention) technique using a microcatheter was performed to recannalize iliac artery occlusion in three cases. Medical records were reviewed for the collection of follow-up data. The stent patency rate was analyzed by use of the Kaplan-Meier method. RESULTS: Subintimal stent placement was technically successful in 23 of 24 procedures (95.8%). The mean ankle-brachial index (ABI) increased from 0.26 to 0.82. The Fontaine classification was improved after stent placement in all patients. Major complications occurred in four procedures: three distal embolizations and one arterial rupture. All of the complications were successfully treated by endovascular intervention. The primary stent patency rates at 6-months, 1-, 2- and 3-years were 95%, 88%, 88% and 88%, respectively. CONCLUSION: Subintimal stent placement is a safe and effective treatment for long segment occlusion of the iliac artery.
Ankle Brachial Index ; Arterial Occlusive Diseases ; Brachial Artery ; Extremities ; Femoral Artery ; Follow-Up Studies ; Humans ; Iliac Aneurysm ; Iliac Artery ; Medical Records ; Retrospective Studies ; Rupture ; Stents

PURPOSE: To determine which contrast media are both efficient and safe for the imaging of airways. MATERIALS AND METHODS: We evaluated five contrast media (barium, gastrografin, iotrolan, ioxaglate, iopentol) in terms of image quality and their effects on the lungs of 25 white rabbits. For bronchography 0.5ml of contrast media was used. In each contrast group, HRCT scans were obtained immediately (n=5), 12 hours (n=4), 1 day (n=3), 2 days (n=2), and 1 week (n=1) after bronchography. Histopathologic specimens were obtained immediately, 12 hours, 1 day, 2 days, and 1 week later. Bronchograms were evaluated for image quality by three radiologists working independently, and were scored as 1(poor), 2(moderate), or 3(good) in terms of contrast quality and bronchial coating. HRCT was evaluated by two radiologists who reached a concensus; they determined the presence of contrast media, and then the pattern and extent of pulmonary opacity, and any related changes. Histopatholgic specimens were evaluated by two pathologists who sought consensus as to the extent of inflammation, pulmonary edema, and hemorrhage, and any changes in these aspects. RESULTS: Bronchography indicated that the sum of scores for contrast quality was 45 for barium, 33 for gastrografin, 28 for iotrolan, 30 for ioxaglate, and 28 for iopentol, while for each of these media, the sum of scores for bronchial coating was 39, 19, 25, 23, and 21, respectively. Barium showed the best image quality. In all rabbits, HRCT demonstrated the variable extent of groundglass attenuation and/or consolidation. Lesions were most extensive at 1-2 days and then regressed at 1 week; these HRCT findings correlated well with histologic findings. In histologic studies of all five contrast media groups, variable severe inflammatory reactions were observed, with or without necrosis, congestion, edema, and hemorrhage. It was noted that ioxaglate appeared to cause least tissue reaction. CONCLUSIONS: The imaging results of this experimental study indicate that for bronchography, barium is the best available contrast media, On the basis of the histologic and HRCT results, however, ioxaglate is the best.
Barium ; Bronchography* ; Consensus ; Contrast Media* ; Diatrizoate Meglumine ; Edema ; Estrogens, Conjugated (USP) ; Hemorrhage ; Ioxaglic Acid ; Lung ; Necrosis ; Pneumonia ; Rabbits

BACKGROUND AND OBJECTIVES: Pediatric rhinosinusitis continues to be a challenging problem to otolaryngologists. This study aims to assess the clinical characteristics of chronic rhinosinusitis and the treatment outcomes of endoscopic sinus surgery (ESS) in children. SUBJECTS AND METHOD: Forty eight patients (13 women and 35 men with an age range of 7 to 17 years) were available for analysis by medical records and questionnaire. We classified the patients into three groups: 25 cases of chronic rhinosinusitis with nasal polyposis (CRSNP), 11 cases of chronic rhinosinusitis without nasal polyposis (CRS), 12 cases of antrochoanal polyps (ACP). Objective outcome of ESS was evaluated through endoscopic examination and subjective outcome through questionnaire. Postoperative follow-up period ranged between 6 and 26 months. RESULTS: Thirty-nine patients were treated with ESS and nine with ESS with concomitant adenoidectomy. Thirty-nine patients (81.2%) showed good outcomes by endoscopic examination. Also, thirty-eight patients (79.2%) reported high satisfaction by questionnaire. There were no statistical differences in the results through endoscopy and subjective satisfaction through questionnaire among three groups. CRSNP and ACP groups tended to have higher recurrence rate than CRS group. CRSNP group showed higher CT Lund-Mackay scores than ACP group and CRS group. Synechia occurred in 4 (8.3%) of 48 patients. Ten patients (20.8%) required endoscopic polypectomy or revision surgery. CONCLUSION: While pediatric ESS is still in progress and its role continues to be defined, the results of current study suggest that pediatric ESS is a safe and efficacious therapy for management of chronic rhinosinusitis in children.
Adenoidectomy ; Child ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Polyps ; Surveys and Questionnaires ; Recurrence ; Sinusitis ; Treatment Outcome

We clinically reviewed four patients who were suffering from aseptic meningitis combined with polio-like paralysis and performed radiological. neurological and virological studies on them. Three patients were admitted to the department of Pediatrics. Asan Medical Center from March to August 1990, and one patient was admitted to the department of Pediatrics. Kangnam General Hospital. The results were as follows; 1) During the period of study, 18 patients (10.1%)out of 178 aseptic meningitis patients also suffered from hand, foot and mouth disease, and three patients (1.69%) out of 178 patients also suffered from polio-like paralysis. 2) The age of the patients who also suffered from polio-like paralysis were eight months, 22 months, 23 months and four years old respectively. Three patients were male and one patient was female. 3) Paralysis developed three to five days after aseptic meningitis infection. 4) In two cases, Magnetic Resonance Imaging (MR) showed two small cavitary lesions that means anterior horn cell necrosis in concordant with residual paralysis. Axial T1-weighted image showed decreased signal intensity and axial T2-weighted image showed increased signal intensity. In another case 20 days after onset of illness MR was performed, the transverse myelitis showed mild swelling of cornus medullaris. Follow up MR in 2 months revealed atropic change in lower thoracic spinal cord. 5) The electromyography and nerve conduction velocity test revealed acute polyradiculoneuropathy. 6) Serologic virus study were carried out in three cases for Coxsackievirus A16 and Enterovirus 71. The Enterovirus 71 antibody titer were 1:128 in two cases and 1:64 in one case. The Coxsackievirus A16 antibody titer were less than 1:4. This study showed that the causative agents for polio-like paralysis during this period seemed to be the Enterovirus 71 infection.
Anterior Horn Cells ; Chungcheongnam-do ; Cornus ; Electromyography ; Enterovirus ; Female ; Follow-Up Studies ; Hand, Foot and Mouth Disease ; Hospitals, General ; Humans ; Magnetic Resonance Imaging ; Male ; Meningitis, Aseptic* ; Myelitis, Transverse ; Necrosis ; Neural Conduction ; Paralysis* ; Pediatrics ; Polyradiculoneuropathy ; Spinal Cord

PURPOSE: To evaluate the repeatability of retinal layer thickness measurements in normal eyes imaged using spectral domain optical coherence tomography (SD-OCT). METHODS: Sixty-eight eyes of 34 healthy subjects were enrolled in this study. Imaging was performed 4 times using 9 × 9 mm macular scans with SD-OCT (RS 3000 Advance HD OCT, NIDEK, Gamagori, Japan) at the same visit by an experienced examiner. After automatic retinal segmentation (layering) in 5 layers, the thickness of each layer was calculated. Macular thickness of 9 Early Treatment of Diabetic Retinopathy Study (ETDRS)-like regions was obtained. Repeatability for each of the 9 subfield areas was calculated by their repeatability coefficients and intraclass correlation coefficients (ICCs). RESULTS: There was no significant difference in average retinal thickness and each retinal layer thickness between all measurements acquired by the experienced examiner. The ICCs of retinal layer thickness ranged from 0.826 to 0.847 for the ganglion cell layer + inner plexiform layer, inner nuclear layer + outer plexiform layer and outer nuclear layer + external limiting membrane in the fovea. The ICCs were greater than 0.909 for the other intra-retinal layers in all 9 ETDRS subfield thickness between all measurement pairs. CONCLUSIONS: Excellent repeatability was observed for SD-OCT retinal segmented layer thickness measurements in healthy subjects.
Diabetic Retinopathy ; Ganglion Cysts ; Membranes ; Retinaldehyde* ; Tomography, Optical Coherence*

Infantile acne is a much less common disease than adolescent and postadolescent acne. It occurs in children approximately at 3 to 6 months of age. An 8 month-old male infant, accompanied by his mother, visited our clinic with a history of erythematous skin lesions on both cheeks, which started 5 months ago. Physical examination revealed closed comedones, several relatively well demarcated, erythematous papules, nodules and pustules. Inflammatory lesions left scars scattered over the face. For further evaluation of endocrinologic abnormalities or other systemic diseases, an additional abdominal ultrasound was done after a visit to the pediatrician. A skin biopsy revealed findings compatible with acne. Skin lesions were improved by treatment with oral and topical antibiotics, adapalene and isotretinoin. We report herein a case of infantile acne which has not been reported in Korean dermatological literature.
Acne Vulgaris* ; Adolescent ; Anti-Bacterial Agents ; Biopsy ; Cheek ; Child ; Cicatrix ; Humans ; Infant ; Isotretinoin ; Male ; Mothers ; Physical Examination ; Skin ; Ultrasonography ; Adapalene