Fibrous hamartoma of infancy is a rare benign lesion that presents as a solitary, painless, flesh-colored, subcutaneous mass. Most of these lesions occur in the axillary region, the upper arm, the upper trunk, the inguinal area and the external genital area. The lesion histologically consists of three different components in varying proportions: well-defined fibrous trabeculae, primitive mesenchyme and, mature adipose tissue. Overlying skin changes are uncommon, including alternations in pigmentation, eccrine gland hyperplasia and increased hair. To the best of our knowledge, only 6 cases of fibrous hamartoma of infancy with hypertrichosis have been reported. In these six cases, the lesions were located on the buttocks and back, which were non-predilection sites. We report the first case of fibrous hamartoma of infancy with hypertrichosis on the axilla, which is known as a predilection site.
Adipose Tissue ; Arm ; Axilla ; Buttocks ; Eccrine Glands ; Hair ; Hamartoma ; Hyperplasia ; Hypertrichosis ; Mesoderm ; Pigmentation ; Skin

BACKGROUND: Simple ventricular septal defect(VSD) is the most common congenital heart disease. Although closure of VSD is currently associated with a relatively low risk, experience with younger and smaller infants has been variably less satisfactory. We assessed the results of surgical closure of VSD in infant. MATERIALS AND METHODS: Between 1996 and 2000, 45 non-restrictive VSD patients underwent patch repair and retrospective analysis was done. Patients were divided into two groups based on weight: group I infants weighed 5kg or less(n=16), and group II infants weighed more than 5kg(n=29). Both groups had similar variation in sex, VSD location, aortic cross clamp time and total bypass time. But combined diseases (ASD, PDA, MR) were more in group I. We closed VSD with patch and used simple continuous suture method in all patients. RESULTS: There were no operative mortality, no reoperation for hemodynamically significant residual shunt and no surgically induced complete heart block. As a complication, pneumonia(group I: 2 cases, group II: 2 cases), transient seizure(group II: 2), wound infection(group I: 1, group II: 1), urinary tract infection(group I: 1) and chylopericardium(group I: 1) developed, and there was no significant difference between two groups(p>0.05). CONCLUSION: Early primary closure with simple continuous suture method was applicable in all patients with non-restrictive VSD without any serious complications.
Heart Block ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular* ; Humans ; Infant* ; Mortality ; Reoperation ; Retrospective Studies ; Sutures ; Urinary Tract ; Wounds and Injuries

PURPOSE: Bladder tissue fibrosis is characterized by the abnormal deposition of connective tissue within different layers of the bladder wall, resulting in "non-compliance". The different etiologies of bladder fibrosis are either neurogenic, which encompasses myelodysplasia and spinal cord injury, or nonneurogenic, due to a bladder outlet obstruction. In this study, bladder fibrosis was examined to see if it was due to the effect of an abnormal innervation or to abnormal bladder dynamics. MATERIALS AND METHODS: Thirty-five male Sprague-Dawley rats (250-300g) were divided into four groups; the normal (n=5), bilateral pelvic nerve transection; denervation (n=10), vesicostomy (n=10) and vesicostomy after denervation (n=10) groups. After 4 weeks, the bladders of the animals in each group were obtained. In the histological study, the collagen to muscle ratio from Masson's trichrome staining, and the elastin density (%) from Van Gieson staining, were determined using a Metamorph ver 4.6r5 image analyzer. The TGF-beta1 and collagen III protein expressions were detected by Western blotting. RESULTS: The collagen to muscle ratios of the normal, vesicostomy, denervation and vesicostomy after denervation groups were; 0.67+/-0.04*, 0.67+/-0.04*, 1.25+/-0.03* and 0.96+/-0.02 (*p<0.001) and the elastin densities were 14.73+/-1.09**, 16.38+/-2.27, 23.6+/-1.93** and 18.35+/-1.27, respectively (**p<0.01). From the Western blotting, the denervation group showed significantly increased TGF-beta1 and collagen III protein expressions compared with the normal and vesicostomy groups. CONCLUSIONS: The orders of the collagen to muscle ratio and the deposition of elastin were; denervation>vesicostomy after denervation>vesicostomy>normal from the histological study. The levels of TGF-beta1 and of collagen III in the denervation group were higher than those in the vesicostomy after denervation group. The above findings show that pressure and nerve innervation in the bladder both have significant effects on the process of bladder fibrosis. Meanwhile, a vesicostomy could reduce the fibrotic effect caused by denervation, although this is not complete.
Animals ; Blotting, Western ; Collagen ; Connective Tissue ; Cystostomy ; Denervation ; Elastin ; Fibrosis* ; Humans ; Male ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; Transforming Growth Factor beta1 ; Urinary Bladder Neck Obstruction ; Urinary Bladder*

In human, Human Papilloma Virus(HPV) is associated with benign squamous tumors in a variety of body sites. But the relationship between HPV infection and malignant epithelial lesions is not clear. Esophageal squamous papilloma is relatively rare tumor but it is reported with increasing frequency recently. We reviewed twenty six patients of esophageal papilloma diagnosed by endoscopic biopsy from 1990 to 1994. The results are as follows; The peak age is fifth decade, men and women ratio is 1: 1.2. Most papillomas located in distal esophagus and have no specific symptoms related to papilloma. All case are sessile form and no malignant change in follow up endoscopy.
Biopsy ; Endoscopy ; Esophagus ; Female ; Follow-Up Studies ; Humans ; Male ; Papilloma*

Subdural hematoma (SDH) due to spontaneous rupture of intracranial aneurysm rarely occurs. The prevalence of subarachnoid hemorrhage (SAH) with SDH is approximately 0.5%–10.3% of all aneurysmal SAH. We report a case of aneurysmal rupture with SDH and SAH due to arachnoid defect after aneurysm clipping. The decedent was a 51-year-old woman who underwent brain surgery for SAH a few years ago. Two days before she died, she had nausea and sentinel headache. She was alive in the morning and was found dead at 6 PM. Injuries in the external surface were not found. A fresh SDH, measured approximately 90 mL, was found in the right hemisphere. SAH was diffusely distributed at the base of the brain and the right sylvian fissure. Two aneurysmal clippings were found in the anterior communicating artery and right internal carotid artery. A ruptured de novo aneurysm was also found in the right proximal middle cerebral artery. An uncal herniation was also observed. The cause of death was SAH with SDH due to de novo intracranial aneurysm. The tearing caused by the adhesion between the aneurysm and arachnoid, high blood pressure, and massive bleeding has been thought to be the causative mechanism of aneurysmal SAH with SDH. However, in this case, the arachnoid defect was caused by aneurysmal clipping through pterional approach. This defect served as the passage between the subarachnoid and subdural spaces. The autopsy for recurrent intracranial aneurysm will increase according to the extending life expectancy of patients after aneurysmal clipping.
Aneurysm ; Arachnoid ; Arteries ; Autopsy ; Brain ; Carotid Artery, Internal ; Cause of Death ; Female ; Headache ; Hematoma, Subdural ; Hemorrhage ; Humans ; Hypertension ; Intracranial Aneurysm ; Life Expectancy ; Middle Aged ; Middle Cerebral Artery ; Nausea ; Prevalence ; Rupture ; Rupture, Spontaneous ; Subarachnoid Hemorrhage ; Subdural Space ; Tears

Subdural hematoma (SDH) due to spontaneous rupture of intracranial aneurysm rarely occurs. The prevalence of subarachnoid hemorrhage (SAH) with SDH is approximately 0.5%–10.3% of all aneurysmal SAH. We report a case of aneurysmal rupture with SDH and SAH due to arachnoid defect after aneurysm clipping. The decedent was a 51-year-old woman who underwent brain surgery for SAH a few years ago. Two days before she died, she had nausea and sentinel headache. She was alive in the morning and was found dead at 6 PM. Injuries in the external surface were not found. A fresh SDH, measured approximately 90 mL, was found in the right hemisphere. SAH was diffusely distributed at the base of the brain and the right sylvian fissure. Two aneurysmal clippings were found in the anterior communicating artery and right internal carotid artery. A ruptured de novo aneurysm was also found in the right proximal middle cerebral artery. An uncal herniation was also observed. The cause of death was SAH with SDH due to de novo intracranial aneurysm. The tearing caused by the adhesion between the aneurysm and arachnoid, high blood pressure, and massive bleeding has been thought to be the causative mechanism of aneurysmal SAH with SDH. However, in this case, the arachnoid defect was caused by aneurysmal clipping through pterional approach. This defect served as the passage between the subarachnoid and subdural spaces. The autopsy for recurrent intracranial aneurysm will increase according to the extending life expectancy of patients after aneurysmal clipping.

Objectives: The aim of this study was to evaluate brain activity in youth during chewing gum and wood stick using functional magnetic resonance imaging (fMRI). Methods: Two participants chewed wax gums and wood stick on the rhythm of 1 Hz during MRI scanning. The task paradigm was a block design and each chewing-rest procedure was repeated five times for 30s. Results: The brain regions activated during chewing gum and wood stick were the precentral gyrus, postcentral gyrus, supplementary motor area, thalamus cerebellum. The medial prefrontal cortex (mPFC), anterior cingulate cortex (ACC), hippocampus, and precuneus were additionally activated by mastication of the wood stick. Brain activation induced by chewing wood stick was higher than chewing gum. Conclusions Our results suggest that mastication contribute to cognitive improvement through brain activity, this effect is stronger during chewing wood than gum. Therefore, eating harder foods may improve cognitive function more effectively.

Primary thyroid lymphoma is a relatively rare thyroid tumor and usually a non-Hodgkin type. Its most common histologic type is the diffuse large B cell lymphoma followed by mucosa-associated lymphoid tissue (MALT). It is known to be frequently associated with autoimmune thyroiditis such as Hashimoto's thyroiditis. We report three cases of thyroid lymphoma at a single institution with a review of the literature.
Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell ; Thyroid Gland ; Thyroiditis ; Thyroiditis, Autoimmune

PURPOSE: There have been reports on the clinical benefits of intravesical electrical stimulation (IVES) in patients with an increased residual urine or reduced bladder capacity. However, studies on the underlying mechanism of IVES have been limited to the A delta afferent and parasympathetic neurons. This study sort to investigate the changes in the expression of the C-fos protein in the thoracolumbar and lumbosacral spinal cord in order to determine the effect of IVES on the C fiber afferent nerve. MATERIALS AND METHODS: Twenty Sprague-Dawley rats were divided into four groups; group 1 (n=5) served as a sham operation, groups 2 (n=5) were instilled with normal saline, groups 3 (n=5) were instilled with 1% acetic acid, and group 4 (n=5) received IVES prior to the administration of 1% acetic acid. The spinal cord was removed at the thoracolumbar (T13-L2) and lumbosacral (L5-S1) levels. Changes in the levels of the C-fos protein in the spinal cord were measured by western-blot analysis. RESULTS: The relative density of the C-fos expression, 2 hours after IVES, was significantly higher, and the fos protein expression induced by IVES was decreased to the sham levels by the 5th day following the IVES. Therefore, it was decided that a 5 day interval between the IVES and the noxious stimulation with acetic acid should be used to avoid the superimposition of C-fos expression. The relative density of the C-fos protein, following noxious stimulation with 1% acetic acid, was significantly higher compared to the saline distension in both the T13-L2 and L5-S1 levels of the spinal cord. However, the IVES prior to the administration of 1% acetic acid significantly decreased the relative density of the C-fos protein at both the T13-L2 and L5-S1 levels of the spinal cord compared to the rats with noxious stimulation alone. CONCLUSIONS: IVES reduces the expression of C-fos, which is mainly conveyed by the unmyelinated C fibers in the noxiously stimulated rats. These results suggest that the bladder C fiber afferent is also involved in modulating the micturition reflex caused by IVES.
Acetic Acid ; Animals ; Electric Stimulation* ; Humans ; Nerve Fibers, Unmyelinated ; Neurons ; Neurons, Afferent* ; Rats ; Rats, Sprague-Dawley ; Reflex ; Specific Gravity ; Spinal Cord ; Urinary Bladder* ; Urination

BACKGROUND: Successful pregnancy outcomes in patients with advanced chronic kidney disease (CKD) are increasingly common in Western countries. However, in Korea, the available literature addressing this clinical issue is scarce. METHODS: We reviewed 5 successful parturitions [1 patient with Stage 5 CKD and 4 with maintenance hemodialysis (HD)] at Seoul St. Mary's Hospital over 3 years and investigated changes in dialysis prescription, anemia management, and the incidence of maternal and neonatal complications. RESULTS: There were no maternal or neonatal deaths in this cohort. The mean age at the time of conception and delivery was 35.8 ± 3.7 and 36.2 ± 3.5 years, respectively. Dialysis patients received more frequent and intensified HD during pregnancy, 20.0 ± 5.7 h/wk of HD over 5 visits with the ultrafiltration dose maintained between 1 and 2 kg per session. All patients received erythropoietin-stimulating agents and iron replacement therapy during pregnancy. The mean hematocrit was 33.1 ± 1.9% before pregnancy and was well maintained during gestation (33.9 ± 3.8% at the first trimester, 29.2 ± 4.2% at the second trimester, and 33.6 ± 8.7% at delivery). The mean gestation period was 32.7 ± 4.7 weeks, with 60% of patients experiencing premature delivery. The primary maternal complication was pre-eclampsia; 3 women developed pre-eclampsia and underwent emergency cesarean sections. Most neonatal complications were related to preterm birth. CONCLUSION: Dialysis-related care and general clinical management improved the clinical outcome of pregnancy for patients with advanced CKD.
Anemia ; Cesarean Section ; Cohort Studies ; Dialysis ; Emergencies ; Female ; Fertilization ; Hematocrit ; Humans ; Incidence ; Iron ; Korea ; Parturition ; Perinatal Death ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnant Women* ; Premature Birth ; Prescriptions ; Renal Dialysis ; Renal Insufficiency, Chronic* ; Seoul ; Ultrafiltration