PURPOSE: To evaluate the usefulness, patterns and appearances of false positive lesions, and technical problems of CTAP(CT Arterioportography). MATERIALS AND METHODS: CTAP was done in 45 patients in whom hepatic lesions were suggested on other radiologic studies. CTAP findings were compared with the informations obtained by operations, biopsies, and follow-up imagings. Additional findings, which were not detected in other radiologic studies, false positive manifestations, and technical errors were analyzed. RESULTS: CTAP detected 51 additional hepatic lesions which are not detected in other imaging studies. Of the 51 lesions, ten were true positive hepatic tumors, 2 were inflammatory lesions and 39 were false positive .lesions. False positive lesions included perfusion defects of periportal and perifissural areas, subcapsular perfusion defects and nonlobar, nonsegmental geographic perfusion defects. In 2 cases, CTAP aided in deciding the surgical strategy. On the other hand, there were 4 cases causing interpretational confusion and 6 cases of improper imaging due to technical errors. CONCLUSION: CTAP was valuable in detection of additional hepatic cancer lesion as well as in making the treatment plan. However, since many false positive lesions and improper imaging due to technical error occur during the examination, the understanding of such problems is essential for correct interpretation of CTAP.
Biopsy ; Follow-Up Studies ; Hand ; Humans ; Liver Neoplasms ; Perfusion

PURPOSE: The purpose of this study was to compare mammography and breast sonography in detection of breast cancer and to suggest reasonable guideline of breast imaging in breast cancer patients under 30 years of age in whom breast cancer shows different clinicopathologic characteristics compared with breast cancer in older women. MATERIALS AND METHODS: A. uthors reviewed medical records of 27 patients under 30 years of age with pathologically-proven breast cancer. Age, family history, physical examination findings, indications for breast s0nography were reviewed. Cases in whom breast cancer lesion is detectable and cases in whom not detectable using mammography or breast sonography were reviewed. And then, authors evaluated the usefulness of each method and reasons for nonvisualization of lesion on mammography. RESULTS: Among 27 patients, 25 patients had palpable breast mass as indication of mammography and breast sonography. Cancer lesions were detectable in 16 of 25 patients (64%) on mammography and 24 of 25 patients (96%) on breast ultrasonography. Reasons for nonvisualization of cancer lesions on mammography were dense breast with nodular parenchyma pattern and minimal breast change of ductal carcinoma in situ. CONCLUSION: In breast cancer patients under 30 years of age who have palpable breast mass as a initiaJ, and main clinical problem, breast ultrasonography is superior to mammography in detecting and diagnosing breast cancer. We suggest that guidelines can avoid unnecessary mammography in these patients.
Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Female ; Humans ; Mammography ; Medical Records ; Physical Examination ; Ultrasonography* ; Ultrasonography, Mammary

PURPOSE: The purpose of this study was to compare mammography and breast sonography in detection of breast cancer and to suggest reasonable guideline of breast imaging in breast cancer patients under 30 years of age in whom breast cancer shows different clinicopathologic characteristics compared with breast cancer in older women. MATERIALS AND METHODS: A. uthors reviewed medical records of 27 patients under 30 years of age with pathologically-proven breast cancer. Age, family history, physical examination findings, indications for breast s0nography were reviewed. Cases in whom breast cancer lesion is detectable and cases in whom not detectable using mammography or breast sonography were reviewed. And then, authors evaluated the usefulness of each method and reasons for nonvisualization of lesion on mammography. RESULTS: Among 27 patients, 25 patients had palpable breast mass as indication of mammography and breast sonography. Cancer lesions were detectable in 16 of 25 patients (64%) on mammography and 24 of 25 patients (96%) on breast ultrasonography. Reasons for nonvisualization of cancer lesions on mammography were dense breast with nodular parenchyma pattern and minimal breast change of ductal carcinoma in situ. CONCLUSION: In breast cancer patients under 30 years of age who have palpable breast mass as a initiaJ, and main clinical problem, breast ultrasonography is superior to mammography in detecting and diagnosing breast cancer. We suggest that guidelines can avoid unnecessary mammography in these patients.
Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Female ; Humans ; Mammography ; Medical Records ; Physical Examination ; Ultrasonography* ; Ultrasonography, Mammary

PURPOSE: To investigate the incidence and significance of localized fluid collection in the hepatic bare area re-sulting from blunt abdominal trauma in children. Materias and Methods:We retrospectively reviewed the CT scans and medical records of eighty children with blunt abdominal trauma and evaluated the incidence of fluid collection in the hepatic bare area. The findings were correlated with the presence of injury to adjacent organs. RESULTS: Fluid collection in the hepatic bare area was noted in 23 of 80 patients (28.7%). Associated organ in-juries included liver laceration (17/23), contusion of the right hemidiaphragm (7/23), right adrenal injury (5/23), and right renal injury (5/23). In one patient, organic injury was not detected in spite of fluid collection in the hepatic bare area. Eight of 23 patients (34.8%) showed fluid collection in this area, but not intraperitoneally. CONCLUSION: Fluid collection in the hepatic bare area after blunt abdominal trauma was noted in about 30% of patients and was frequently accompanied by injury to adjacent organs. Since right hemidiaphragmatic contusion associated with fluid collection in the bare area was a not uncommon CT finding, close observation of the condition is warranted.
Child* ; Contusions ; Humans ; Incidence ; Lacerations ; Liver ; Medical Records ; Retrospective Studies ; Tomography, X-Ray Computed

The pseudolymphoma of the skin has the architectural and cytological features of a neoplastic proliferation of lymphoid tissue but pursue a benign course. Cutaneous B cell pseudolymphoma (CBPL) shares many histopathologic and clinical features with cutaneous B cell lymphoma (CBCL). Therefore, the differentiation between CBPL and CBCL is often very difficult, but it is important because each of them has a different therapeutic consequence. Recently, immunoglobulin gene rearrangement is considered as a reliable technique for differentiation of CBPL with CBCL. We herein report a case of idiopathic lymphocytoma cuffs, showing a typical nodular infiltrate of lymphocytes that formed a follicular germinal center resembling reactive lymph nodes with numerous tingible bodies, and that revealed a polyclonality in the immunoglobulin gene rearrangement.
Genes, Immunoglobulin ; Germinal Center ; Lymph Nodes ; Lymphocytes ; Lymphoid Tissue ; Lymphoma, B-Cell ; Pseudolymphoma* ; Skin

Yonsei University College of Medicine, Seoul, Korea Maffucci's syndrome is characterized by dysccondroplasia with hemangiomata. Since Angelo Maffucci (1881) first described this entity, 105 cases and some more were reported in the literature till 1976. We recently observed a patient suffering from this disorder. The patient is 21 year-old girl, who has multiple hemangiomes on her right foot, right buttock, left wrist and enchondromas on both proximal phalanx, distal phalanx of both great toes and proximal, middle phalanx of right second toe. The disease started at age of 11 and these lesions grew rapidly last 3 years. The diagnosis was based on clinical, radiological and histological findings. Because of its rarity, we report it with brief review of literature.
Buttocks ; Chondroma ; Diagnosis ; Female ; Foot ; Humans ; Korea ; Osteochondrodysplasias ; Seoul ; Toes ; Wrist

PURPOSE: Asthma is an important worldwide pediatric public health problem and rapidly increasing prevalence has been reported. Environmental tobacco smoke (ETS) is known to be an important aggravation factor of asthma. The aim of this study was to determine whether ETS exposure is associated with exacerbations of asthma, and therefore to define the possibility of improving illness by cessation of smoking. METHODS: One hundred one (101) asthmatic children who visited and followed up at Korea university hospital pediatric allergy clinic were enrolled. Their chart was reviewed retrospectively and their family members were also interviewed. RESULTS: Sixty nine patients were exposed to ETS and thirty two patients were not exposed. Among exposed group (n=69), fourteen patients were no longer exposed due to cessation of smoking. The difference in the number of hospital admissions between exposed group and non-exposed was statistically significant (P=0.002). But the difference in the number of emergency room visits and PFT value (FEV1, PEFR, FEF25-75%) between the two groups was statistically insignificant. Statistical relationship between the duration of ETS and number of hospital admissions was significant (Pearson Correlation Coefficient=0.243, P=0.015). Comparing current smoking group and smoking cessation group, differences in out-patient clinic follow up period, number of hospital admissions, and number of emergency room visits between the two groups were statistically insignificant. CONCLUSION: We found that ETS exposure is associated with exacerbations of asthma. Possibility of improving illness by reduction of ETS exposure indicates the significance of education for cessation of smoking.
Asthma* ; Child ; Education ; Emergency Service, Hospital ; Follow-Up Studies ; Humans ; Hypersensitivity ; Korea ; Outpatients ; Peak Expiratory Flow Rate ; Prevalence ; Public Health ; Retrospective Studies ; Smoke* ; Smoking ; Smoking Cessation ; Tobacco*

Fine needle aspiration of the breast is an important diagnostic tool in malignant lesions, but is also useful in differentiation of inflammatory breast diseases mimicking carcinoma clinically and radiologically. Recently, the authors have experienced eight biopsy-proven cases of chronic inflammatory diseases of the breast, which consisted of 4 cases of duct ectasia, 2 cases of fat necrosis, and a case of tuberculous mastitis and granulomatous mastitis respectively, Their cytoiogic features mainly based on the components and the relative frequency of inflammatory cells were evaluated for differential diagnosis of chronic inflammatory breast diseases. The results are as follows ; 1. In cases of duct ectasia, varying amount of neutrophils, mononuclear leukocytes, histiocytes and multinucleated giant cells were intermixed with benign epithelial cell clusters. 2, Abundant fat tissue fragments were diagnostic for fat necrosis. Histiocytes and mononuclear cells were main components but not rich, and neutrophils and giant cells were infrequently observed. 3. Characteristic granulomas composed of epithelioid cells, mononuclear leukocytes and Langhans' type giant cells and lymphocytic infiltrates were conspicuous in tuberculous mastitis, and occasionally neutrophils, necrotic materials and epithelial cell clusters were found. 4. In granulomatous mastitis, epithelioid cell granulomas were also noted but numerous neutrophils and histiocytes were intermingled within or outside the granulomas.
Biopsy, Fine-Needle ; Breast ; Breast Diseases ; Child* ; Diagnosis, Differential ; Dilatation, Pathologic ; Epithelial Cells ; Epithelioid Cells ; Fat Necrosis ; Female ; Giant Cells ; Granuloma ; Granulomatous Mastitis ; Histiocytes ; Humans ; Leukocytes, Mononuclear ; Mastitis ; Mothers* ; Neutrophils ; Salivary Glands

In a six-year period(1988. 5-1994. 4), fine needle aspiration cytology(FNAC) of 322 pulmonary lesions from 296 patients were performed at Soonchunhyang University Hospital. Of these 322, malignancy was diagnosed cytologically in 139(43.2%), suspicious malignancy in 7(2.2%), negative in 164(50.8%), and insufficient material in 12(3.8%). Malignant lesions consisted of 54 cases of adenocarcinoma, 50 cases of squamous cell carcinoma, 18 cases of small cell carcinoma. They were verified by histologic examination in 70 cases. There were 2(0.6%) false positive cases due to florid bronchoalveolar hyperplasia and atypical bronchial epithelial cells associated with granulomatous lesion. The overall accuracy rate was 90%, the sensitivity 84.3% and the specificity 94.7%.
Adenocarcinoma ; Biopsy, Fine-Needle ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Child* ; Epithelial Cells ; Humans ; Hyperplasia ; Multicystic Dysplastic Kidney* ; Sensitivity and Specificity ; Tuberculosis, Pulmonary

PURPOSE: In children on anticancer chemotherapy, bloodstream infections (BSIs) are a major cause of morbidity and mortality. We investigated febrile episodes and bloodstream infections in pediatric cancer patients to guide proper selection of empiric antibiotics for febrile pediatric hemato-oncologic patients. METHODS: All febrile episodes treated in the division of hematology-oncology, the department of pediatrics, Hanyang University Hospital, between July 2005 and June 2008 were reviewed. Episodes with and without bloodstream infections were compared. RESULTS: Forty cases (18.9%, 25 patients) of BSI occurred in 212 febrile episodes (63 patients). Thirty-seven cases (23.6%, 22 patients) of BSI occurred in 157 febrile episodes with neutropenia (54 patients). Microorganisms identified in BSI corresponded to 23 gram-positive bacteria (51.2%), 20 gram-negative bacteria (44.5%), and 2 fungi (4.4%). Rates of BSI between those who had received umbilical cord blood transplantation and those who had received transplantation from other source were significantly different (55.0% vs. 7.7%, P=0.001). No differences in mortality rate were observed among organisms in BSI patients. For febrile episodes the rate of BSI was higher among those with Chemoport than those with Hickman catheter (P=0.029) and gram-positive pathogens were more likely to be associated with Chemoport (P=0.001). CONCLUSION: The study showed the rate of BSI, distribution of pathogens with regard to neutropenia, transplantation, central venous catheters, and antimicrobial susceptibility of pathogens in order to help guide in the choice of optimal empiric antibiotics in pediatric febrile neutropenic hemato-oncologic patients.
Anti-Bacterial Agents ; Bacteremia ; Catheters ; Central Venous Catheters ; Child ; Fetal Blood ; Fever ; Fungi ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Neutropenia ; Pediatrics ; Transplants