Placental site nodules and plaques have been recently described to designated single or multiple, well-circumscribed, rounded lesions at the placental site, composed of viable or degenerating intermediate trophoblastic cells and extensive hyalinization between the cells. We described clinicopathologic findings of 14 cases of placental site nodules and plaques. The age of 14 patients ranged from 25 to 39(average 33) years and all of them had been pregnant in the past. Ten of them presented with vaginal spotting, which was preceded by recent pregnancy in only 3 cases. Three patients presented with secondary infertility and one with secondary infertility and vaginal spotting. Urine pregnancy tests were negative in all 14 cases at the time of presentation. Ultrasonographic examination disclosed abnormalities in only 3 cases and the remaining cases were normal. Hysterosalpingography was performed in 3 patients who presented with 2 degrees infertility and revealed moderate to severe intrauterine adhesions. Microscopically, chronic endometritis of varying degrees evidenced by plasma cells and eosinophiles were present in all cases and these were more prominent in the vicinity of the lesions. It is presumed that the placental site nodules and plaques are not sloughed at the time of menstruation and it may cause chronic endometritis or intrauterine adhesions at any time after previous delivery.
Pregnancy ; Female ; Humans

PURPOSE: Malignant phyllodes tumors are rare lesions of the breast. The purpose of this study was to evaluate the clinical charateristics and the recurrence patterns of malignant phyllodes tumors. METHODS: Twelve patients with malignant phyllodes tumors who had undergone surgery at the Breast Clinic, Asan Medical Center, from February 1991 to October 1997 were analyzed retrospectively. Histologic criteria of malignant phyllodes tumor was more than 10 mitoses/10 high-power fields in this study. RESULTS: The mean age of the patients was 40.7 years. As regards to preoperative histological confirmation, malignant phyllodes tumors were proven in all 6 cases with an excision biopsy, but in only one of the 4 cases with fine needle aspiration. All the patients received surgical treatment: a modified radical mas tectomy in 4 cases, a simple mastectomy in 5 cases, a simple mastectomy with reconstruction in 2 cases, and a subcutaneous mastectomy in one case. During 34 months of mean follow-up, 3 patients had a recurrence. One patient had a chest wall recurrence at 29 months and lung metastasis at 48 months; the others had lung metastasis at 14 and 16 months, respectively. CONCLUSION: Malignant phyllodes tumors were difficult to confirm with fine needle aspiration preoperatively. The lung was the main site of metastasis, and if metastasis occurred, the prognosis was very poor.
Biopsy ; Biopsy, Fine-Needle ; Breast ; Chungcheongnam-do ; Diagnosis ; Follow-Up Studies ; Humans ; Lung ; Mastectomy, Simple ; Mastectomy, Subcutaneous ; Neoplasm Metastasis ; Phyllodes Tumor* ; Prognosis ; Recurrence* ; Retrospective Studies ; Thoracic Wall

The fabella is a small sesamoid bone generally located in the tendon of the lateral head of the gastrocnemius behind the lateral condyle of the femur. Fabella syndrome is the occurrence of posterolateral knee pain associated with the fabella. It is a rare cause of knee pain that is often misdiagnosed. Fabella syndrome can be managed with conservative or surgical treatment. We applied radial extracorporeal shock wave therapy as a new treatment strategy for fabella syndrome and achieved a successful outcome.
Femur ; Head ; Humans ; Knee ; Sesamoid Bones ; Shock* ; Tendons ; Ultrasonography

OBJECTIVE: To investigate the effect of radial extracorporeal shock wave therapy (rESWT) on hemiplegic shoulder pain (HSP) syndrome. METHODS: In this monocentric, randomized, patient-assessor blinded, placebo-controlled trial, patients with HSP were randomly divided into the rESWT (n=17) and control (n=17) groups. Treatment was administered four times a week for 2 weeks. The visual analogue scale (VAS) score and Constant-Murley score (CS) were assessed before and after treatment, and at 2 and 4 weeks. The Modified Ashworth Scale and Fugl-Meyer Assessment scores and range of motion of the shoulder were also assessed. RESULTS: VAS scores improved post-intervention and at the 2-week and 4-week follow-up in the intervention group (p<0.05). Respective differences in VAS scores between baseline and post-intervention in the intervention and control groups were -1.69±1.90 and -0.45±0.79, respectively (p<0.05), between baseline and 2-week follow-up in the intervention and control groups were -1.60±1.74 and -0.34±0.70, respectively (p<0.05), and between baseline and 4-week follow-up in the intervention and control groups were -1.61±1.73 and -0.33±0.71, respectively (p<0.05). Baseline CS improved from 19.12±11.02 to 20.88±10.37 post-intervention and to 20.41±10.82 at the 2-week follow-up only in the intervention group (p<0.05). CONCLUSION: rESWT consisting of eight sessions could be one of the effective and safe modalities for pain management in people with HSP. Further studies are needed to generalize and support these results in patients with HSP and a variety conditions, and to understand the mechanism of rESWT for treating HSP.
Follow-Up Studies ; Hemiplegia ; High-Energy Shock Waves ; Humans ; Pain Management ; Range of Motion, Articular ; Shock* ; Shoulder Pain* ; Shoulder* ; Stroke ; Visual Analog Scale

OBJECTIVE: To investigate the effect of radial extracorporeal shock wave therapy (rESWT) on hemiplegic shoulder pain (HSP) syndrome. METHODS: In this monocentric, randomized, patient-assessor blinded, placebo-controlled trial, patients with HSP were randomly divided into the rESWT (n=17) and control (n=17) groups. Treatment was administered four times a week for 2 weeks. The visual analogue scale (VAS) score and Constant-Murley score (CS) were assessed before and after treatment, and at 2 and 4 weeks. The Modified Ashworth Scale and Fugl-Meyer Assessment scores and range of motion of the shoulder were also assessed. RESULTS: VAS scores improved post-intervention and at the 2-week and 4-week follow-up in the intervention group (p<0.05). Respective differences in VAS scores between baseline and post-intervention in the intervention and control groups were -1.69±1.90 and -0.45±0.79, respectively (p<0.05), between baseline and 2-week follow-up in the intervention and control groups were -1.60±1.74 and -0.34±0.70, respectively (p<0.05), and between baseline and 4-week follow-up in the intervention and control groups were -1.61±1.73 and -0.33±0.71, respectively (p<0.05). Baseline CS improved from 19.12±11.02 to 20.88±10.37 post-intervention and to 20.41±10.82 at the 2-week follow-up only in the intervention group (p<0.05). CONCLUSION: rESWT consisting of eight sessions could be one of the effective and safe modalities for pain management in people with HSP. Further studies are needed to generalize and support these results in patients with HSP and a variety conditions, and to understand the mechanism of rESWT for treating HSP.
Follow-Up Studies ; Hemiplegia ; High-Energy Shock Waves ; Humans ; Pain Management ; Range of Motion, Articular ; Shock* ; Shoulder Pain* ; Shoulder* ; Stroke ; Visual Analog Scale