A malignant granular cell tumor (MGCT) occurred in the left shoulder of a 62-year-old man. The patient underwent wide marginal excision followed by chemotherapy and radiotherapy. A metastatic tumor was identified in the axillary lymph node 22 months after the excision of the shoulder mass. The primary tumor was a poorly circumscribed mass measuring 5 5 4 cm. On cut section, it was a solid mass with yellowish tan color. Histologically, both primary and metastatic tumor consisted of polygonal cells with abundant granular cytoplasm and a vesicular nucleus with a prominent nucleolus. Two to three mitotic figures per ten high power fields at 200 were counted. Tumor cells were weakly stained with periodic acid-Schiff (PAS) preparation both before and after diastase digestion, and were positive for S-100 protein, neuron-specific enolase (NSE), and vimentin. By electron microscopy, the cytoplasm was filled with numerous autophagolysosomes containing myelin figures, mitochondria, and fragmented rough endoplasmic reticula. Basal laminae and angulated bodies were also noted. These findings suggest schwannian differentiation of this tumor.
Amylases ; Basement Membrane ; Cytoplasm ; Digestion ; Drug Therapy ; Granular Cell Tumor* ; Humans ; Immunohistochemistry ; Lymph Nodes ; Microscopy, Electron ; Middle Aged ; Mitochondria ; Myelin Sheath ; Phosphopyruvate Hydratase ; Radiotherapy ; S100 Proteins ; Shoulder* ; Triacetoneamine-N-Oxyl ; Vimentin

We experienced a case of adenocarcinoma arising in sacrococcygeal teratoma. The patient was a 52-year-old woman. She was admitted due to one month of sacral pain. She had a sacral mass since birth. On physical examination, anal fistula was present at the perianal area and pus drainage was noted. MR image showed multiple variable-sized cysts with inhomogeneous density. Resected specimen, mesuring 12.5 7.0 cm in diameter, showed multiple variable-sized cystic lesions admixed with grayish solid portion. The cysts contained mucoid material. The microscopic examination showed mature teratoma composed of cysts lined by pseudostratified ciliated columnar epithelium, intestinal mucosa, mature cartilage, bone, and fat tissue. A moderately differentiated adenocarcinoma developed from the cystic area in the mass.
Adenocarcinoma* ; Adult ; Cartilage ; Drainage ; Female ; Humans ; Intestinal Mucosa ; Middle Aged ; Mucous Membrane ; Parturition ; Physical Examination ; Rectal Fistula ; Suppuration ; Teratoma*

Clinical and histopathological studies were made on 202 cases of malignancy of cervix, that were visited to the Department of Obstetrics and Gynecology, Yeungnam University Hospital, during 5 years from 1983 to 1987. The results were summarized as follows. 1. Malignancies of the uterine cervix were 10% of total female malignancies. 2. Among 202 cases, 195 cases (96.5%) were squamous cell carcinoma, in which 60 cases (30.0%) of carcinoma in situ, 9 cases (4%) of microinvasive, and 126 cases (62.5%) of invasive carcinoma were included. 3. The average age of the patients with squamous cell carcinoma was 49.4 years old; In case of carcinoma in situ, it was 43.8, microinvasive, 40.0, invasive 52.1 years old. 4. Clinical symptoms of the patient with squamous cell carcinoma in order of frequency were as follows; vaginal bleeding (47.5%), abnormal cytology (15.4%), and abnormal vaginal discharge (9.4%). 5. Duration of the chief complaints was most commonly less than 6 months (73.2%), and the average duration was 3.8 months. 6. The most common age of marriage was between 19 to 22 years old (46.5%). The average was 21.5 years old. 7. The gravity was 51.5% in 5-8 times, and average 6.2 times. The parity was 61.9% in 1-4 times, and average 3.9 times. 8. The subdivision of 126 cases of invasive carcinoma was made according to FIGO stage classification, stage I, 40 cases (31.8%), stage II, 54 cases(42.9%), stage III, 11 cases (8.7%), and stage IV, 8 cases (6.3%). 9. The histologic subtypes of invasive squamous cell carcinoma were distributed as follows; large cell keratinizing type, 25 cases (19.8%), large cell nonkeratinizing type, 101 cases (80.2%). 10. In the cytologic diagnosis, class I was 2 cases (1.9%), class II was 16 cases (15.1%), class III was 33 cases (31.1%), class IV was 31 cases (29.3%), class V was 24 cases (24.6%). 11. The frequency of lymph node metastasis was 7.5% in stage I, and 11.1% in stage II.
Carcinoma in Situ ; Carcinoma, Squamous Cell ; Cervix Uteri* ; Classification ; Daegu* ; Diagnosis ; Female ; Gravitation ; Gynecology ; Humans ; Lymph Nodes ; Marriage ; Neoplasm Metastasis ; Obstetrics ; Parity ; Uterine Hemorrhage ; Vaginal Discharge

PURPOSE: To observe the abnormal white matter findings on the magnetic resonance imaging (MRI) scans of very-low-birth-weight (VLBW) infant brains at term-equivalent age and to determine the clinical risk factors for the development of periventricular leukomalacia (PVL). METHODS: In all, MRI was performed in 98 VLBW infants and the white matter abnormalities were observed. Clinical risk factors for cystic and noncystic PVL were determined. RESULTS: MRI scans of 74 infants (75.5%) showed diffuse excessive high signal intensity (DEHSI) in the periventricular white matter, 17 (17.3%) lateral ventricle dilation, 5 (5.1%) and 11 (11.2%) focal punctate lesions and cystic changes in the periventricular white matter, respectively, 9 (9.1%), germinal layer hemorrhage (GLH) or subependymal cysts 3 (3.1%) intraventricular hemorrhage (>grade 2) 2 (2.0%) posthemorrhagic hydrocephalus and 2 (2.0%) periventricular hemorrhagic infarct. Gestational age (GA), 1-minute Apgar score, Clinical Risk Index for Babies-II (CRIB-II) score, and inotrope use, and GA, CRIB-II score, postnatal steroid administration, inotrope use, and abnormal white blood cell (WBC) count at admission were related to cystic PVL and noncystic PVL development, respectively (P<0.05). However, in logistic regression analysis, CRIB-II (odds ratio, 1.63, 295% confidence interval, 1.15-2.30 P=0.006) for cystic PVL, and GA (odds ratio 0.90, 95% confidence interval, 0.82-9.99 P=0.036) for noncystic PVL were only significant independently. CONCLUSION: White matter abnormalities could be observed on MRI scans of the VLBW infant brains at term-equivalent age, and CRIB-II and GA were only independently significant for cystic and noncystic PVL development, respectively.
Apgar Score ; Brain ; Gestational Age ; Hemorrhage ; Humans ; Hydrocephalus ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Lateral Ventricles ; Leukocytes ; Leukomalacia, Periventricular ; Logistic Models ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Risk Factors

Fifteen women with symptomatic uterine myomas, diagnosed by clinical examination and confirmed by pelvic ultrasonography, were treated with intranasal insufflation of Nafarelin acetate, 200 micrograms, twice a day, for a total treatment period of 6 months. Treatment was evaluated with respect to subjective symptoms, changes in myoma size and uterine volume, variations in blood estradiol, FSH, LH and CA 125, and side effects. The following results were obtained: 1. All patients showed a marked reduction(p<0.001) in uterine volume. Before treatment volume measured 312.3+/-24.2cm3, after 12 weeks volume was 132.4+/-40.6cm3, and after 24 weeks it was 123.6+/-48.3cm3. 2. Blood estradiol and LH levels were decreased significantly(p<0.05) after treatment. The FSH level was decreased, but not significantly. 3. Blood CA 125 levels were increased 6 cases(40.0%) before treatment. The levels were normalized in all 6 cases after treatment. 4. Symptoms of uterine myoma disappeared or decreased. 5. Minor side effects, such as hot flushes, headache, general myalgia and fatigue, and vaginal dryness were encountered frequently although none necessitating discontinuation of treatment, These data suggest that Nafarelin acetate is useful for the treatment of uterine myoma. However, appropriate indications should be selected in the treatment of uterine myoma because the possible regrowth of uterine myoma after treatment limits the use of GnRH agonist.
Estradiol ; Fatigue ; Female ; Gonadotropin-Releasing Hormone* ; Headache ; Humans ; Insufflation ; Leiomyoma* ; Myalgia ; Myoma ; Nafarelin ; Ultrasonography

In the published article by Choi et al., a part of expression of the Abstract and the Conclusion section in the main body text have been corrected. Underlined text should be read carefully.

BACKGROUND: We investigated the risk factors for the recurrence of anterior shoulder instability after arthroscopic surgery with suture anchors and the clinical outcomes after reoperation. METHODS: A total of 281 patients (February 2001 to December 2012) were enrolled into our study, and postoperative subluxation and dislocation were considered as recurrence of the condition. We analyzed radiologic results and functional outcome including the American Shoulder and Elbow Surgeons Evaluation Form, the Korean Shoulder Society Score, and the Rowe scores. RESULTS: Of the 281 patients, instability recurred in 51 patients (18.1%). Sixteen out of 51 patients (31.4%) received a reoperation. In terms of the functional outcome, we found that the intact group, comprising patients without recurrence, had a significantly better functional outcome than those in the recurrent group. The size of glenoid defect at the time of initial surgery significantly differed between intact and recurrent group (p<0.05). We found that the number of dislocations, the time from the initial presentation of symptoms to surgery, and the number of anchor points significantly differed between initial operation and revision group (p<0.05). The functional outcome after revision surgery was comparable to intact group after initial operation. CONCLUSIONS: Eighteen percent of recurrence occurred after arthroscopic instability surgery, and 5.6% received reoperation surgery. Risk factors for recurrence was the initial size of glenoid defect. In cases of revision surgery, good clinical outcomes could be achieved using additional suture anchor.
Arthroscopy* ; Dislocations ; Elbow ; Humans ; Joint Instability ; Recurrence* ; Reoperation ; Risk Factors* ; Shoulder* ; Surgeons ; Suture Anchors* ; Sutures*

No abstract available.
Prostatectomy* ; Prostatic Intraepithelial Neoplasia*

No abstract available.
Prostatectomy* ; Prostatic Intraepithelial Neoplasia*

Although the method to obtain a good results of treatment is still controversial in ankle fracture, most authors agree with open reduction and internal fixation for unstable ankle fracture. They also emphasize the importance of accurate reduction and rigid fixation of fractured lateral malleolus. Recently, the good results of early weight bearing and joint motion has been recognized. Therefore the cast immobilization for long duration is eliminated after surgery by many authorities. In addition to positive role of early ankle motion and weight bearing, we could expect the advantage of subsidence of stiffness, osteoporosis, and early returning to social activity. The seventy-eight unstable ankle fractures treated at Severance Hospital, Yonsei University College of medicine with open reduction and internal fixation were analyzed in clinical and radiological aspects. The following results were obtained. 1. In unstable ankle fracture, the good functional results were obtained with early joint motion and weight bearing after accurate reduction and rigid fixation. 2. The accurate reduction and rigid fixation for lateral malleolar fracture was the most significant factor in contributing to good results. 3. Syndesmotic ligament should be examined on each exploration of fractured fibular. In spite of the immediate weight bearing, the transfixion screw has remained in place without loosening or breakage. 4. The reduction of medial malleolar fracture was relatively easy and seems not to affect the results.
Ankle Fractures ; Ankle ; Clinical Study ; Immobilization ; Joints ; Ligaments ; Methods ; Osteoporosis ; Weight-Bearing