Infantile hemangioendothelioma of the liver is a common vascular tumor in infancy. The tumor is usually multinodular or diffuse and classified into two types. We present a case of infantile hemangioendothelioma of the liver, which predominantly consists of type 2. A 4-month-old female was admitted for an evaulation of an abdominal distension. A CT scan of the liver showed a multinodular mass. The right lobectomy was done. Grossly, the mass consisted of round nodules ranging from 2cm to 5cm in diameter. Microscopically, the tumor revealed proliferation of small vascular channels lined by endothelial cells. Bizarre cells and mitotic cells were frequently noted. Vesicular nuclei and multilayering of the endothelial cells were also noted.
Endothelial Cells ; Female ; Hemangioendothelioma* ; Humans ; Infant ; Liver* ; Tomography, X-Ray Computed

PURPOSE: Our objective was to evaluate mammographic findings of breast cancer in men. MATERIALS AND METHODS: This study includes 9 man with breast cancer diagnosed pathologically by radical mastectomy. Clinical and pathologic data were obtained by review of patients' medical record. Mammograms were analysed retrospectively. RESULTS: Of the 9 patients, eight had masses with spiculated margin or schirrous pattern with irregular margin. One patient had no specific evidence of breast cancer mammographically. Microcalcifications were seen in three patients, these calcifications were irregular in shape and were clustered. Of the 8 cases, four patients had the masses at the right breast, four at the left breast. Locations of breast cancer were subareolar(n=4) and were eccentric(n=4) from the nipple. The most common location was the upper outer quadrant. On histologic evaluation, 7 cases were infiltrating ductal carcinomas, one case was mucinous adenocarcinoma, and the remainder was proved as combined form of intraductal and infiltrating ductal carcinoma. Axillary lymph node metastasis were found in 4 cases. CONCLUSION: Mammographic findings of male breast carcinoma were that of subareolar or eccentrically located mass. Calcifications were same to the patterns of calcification as female breast cancer.
Adenocarcinoma, Mucinous ; Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Carcinoma, Ductal ; Female ; Humans ; Lymph Nodes ; Male ; Male* ; Mastectomy, Radical ; Medical Records ; Neoplasm Metastasis ; Nipples ; Retrospective Studies

PURPOSE: Our objective was to evaluate mammographic findings of breast cancer in men. MATERIALS AND METHODS: This study includes 9 man with breast cancer diagnosed pathologically by radical mastectomy. Clinical and pathologic data were obtained by review of patients' medical record. Mammograms were analysed retrospectively. RESULTS: Of the 9 patients, eight had masses with spiculated margin or schirrous pattern with irregular margin. One patient had no specific evidence of breast cancer mammographically. Microcalcifications were seen in three patients, these calcifications were irregular in shape and were clustered. Of the 8 cases, four patients had the masses at the right breast, four at the left breast. Locations of breast cancer were subareolar(n=4) and were eccentric(n=4) from the nipple. The most common location was the upper outer quadrant. On histologic evaluation, 7 cases were infiltrating ductal carcinomas, one case was mucinous adenocarcinoma, and the remainder was proved as combined form of intraductal and infiltrating ductal carcinoma. Axillary lymph node metastasis were found in 4 cases. CONCLUSION: Mammographic findings of male breast carcinoma were that of subareolar or eccentrically located mass. Calcifications were same to the patterns of calcification as female breast cancer.
Adenocarcinoma, Mucinous ; Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Carcinoma, Ductal ; Female ; Humans ; Lymph Nodes ; Male ; Male* ; Mastectomy, Radical ; Medical Records ; Neoplasm Metastasis ; Nipples ; Retrospective Studies

STUDY DESIGN: A retrospective analysis was performed on 40 patients who had had previous lux bar spine surgeries. OBJECTIVE: To determine what factors most influenced surgical outcome and to analyze results in a series of revision lumbar surgeries. SUMMARY OF BACKGROUND DATA: Satisfactory surgical outcome of the revision lumbar surgery range from 28% to 82% and are rarely comparable to primary surgery. Many factors predicting outcome from repeat lumbar surgery haute been listed. METHODS: Forty patients were analyzed who had had previous lumbar surgeries. The patients were classified into 5 groups according to diagnosis: 3 Infection,5 instability,8 nonunion, 14 HNP and 10 spinal stenosis. of 40 patients,33 patients(82.5%) underwent fusion with instrumentation for repeat surgery. Their clinical course was followed for a minimum of 1 year. The number of surgery on each mpatient was 1.3 times on an average. RESULTS: Overall, 80% of patients had a satisfactory result. Obviously extruded or sequestrated HNP in MRI findings, complete block of contrast with severe radiculopathy and/or myelopathy in spinal stenosis, complete decompression, neurolysi s and fusion with instrumentation, and longer than 6 month pain relief after precious surgery were correlated with satisfactory outcome. However, the number of precious operation, age, repair of pseudarthrosis , no abnormality at surgery and combined multiple degenerative joint disease were significantly correlated with poor surgical outcome. The most common complication during repeat surgery was dural tear in 5 cases(12.5%). CONCLUSIONS: Success rate of revision surgery was low as compared to primary operation. Therefore, erroneous diagnosis and faulty surgical technique understandably lead to failure, and precise attention to preoperative and intraoperative detail can minimize these sources of error.
Decompression ; Diagnosis ; Humans ; Joint Diseases ; Magnetic Resonance Imaging ; Pseudarthrosis ; Radiculopathy ; Reoperation ; Retrospective Studies ; Spinal Cord Diseases ; Spinal Stenosis ; Spine* ; Tears

We noticed a group of thoracolumbar and lumbar spine fractures showing a unique fracture pattern that consisted of 1) superior disc injury, 2) crush fracture of the upper half of the vertebral body, 3) sagittal fracture of the lower half of the vertebral body, 4) bone fragments in the spinal canal, and 5) lamina fracture. Some of these fracture patterns were present in type B burst fracture of Denis classification. The purpose of this study was to compare the difference between crush-cleavage fracture and type B burst fracture in the viewpoint of neural canal involvement and neurologic status, and functional outcome with surgical treatment. Ten cases were identified as crush-cleavage fractures in 22 type B burst fractures during a 5 year period from Mar. 1989 to Jun. 1993 at the Department of Orthopedic Surgery of Chonbuk National University Hospital. Four out of 10 crush-cleavage fractures and 4 out of 12 type B burst fractures were paraparetic. Crush-cleavage fracture must be an unstable thoracolumbar comminuted fracture, but there were no significant differences in the neural canal involvement, incidence of neurologic deficit, and in the functional outcome, compared with type B burst fracture (P>0.05). It could be classified as a progressed form of type B burst fracture in Denis classification, or as a burst-split fracture in Magerl classification in the anatomical viewpoint. In conclusion, crush-cleavage fracture must be a variant of burst fracture.
Classification ; Fractures, Comminuted ; Incidence ; Jeollabuk-do ; Neural Tube ; Neurologic Manifestations ; Orthopedics ; Spinal Canal ; Spine

BACKGROUND: REM sleep behavior disorder (RBD) commonly occurs in old-age group and shows very good response to clonazepam. However, clonazepam can aggravate or even precipitate sleep-disordered breathings (SDBs) that is highly prevalent among elderly people. Melatonin has been known to be effective in RBD treatment and is much less likely to increase the airway resistance. The aim is to document the efficacy of melatonin therapy in RBD with co-existing significant SDB. METHODS: We recruited consecutive patients who have both RBD and significant SDB (apnea-hypopnea index, AHI>15) confirmed by nocturnal polysomnography. Melatonin was started at the dose of 0.5 mg/night and increased according to the clinical response. Successful response is defined when symptoms are free or reduced in frequency more than 90% and any physical injury or violence should not be present. RESULTS: Eleven among 16 RBD patients were eligible and enrolled (eight male, median age 69 years, range 54-89). All had significant obstructive sleep-disordered breathings (mean AHI = 28.8, range 22.6-35.2). Melatonin was prescribed(dosage 2-8 mg/night, treatment duration, 7-35 months). Nine patients showed successful response (2-8 mg/night) but two showed unsatisfactory response to 6 mg or 8 mg/night. Two of nine patients with favorable response complained of mild sleepiness. CONCLUSIONS: Melatonin can be effective for controlling RBD with co-existing SDB. Effective dosage range is variable without intolerable adverse effect.
Aged ; Airway Resistance ; Clonazepam ; Humans ; Male ; Melatonin* ; Polysomnography ; REM Sleep Behavior Disorder* ; Sleep Apnea Syndromes* ; Sleep Apnea, Obstructive ; Sleep, REM* ; Violence

PURPOSE: Acute poststreptococcal glomerulonephritis(APSGN) follows infection of group A beta-hemolytic streptococci. The prognosis of APSGN has been reported as favorable. However, several studies have reported that some patients progress to chronic renal failure. In an attempt to clarify this, we analyzed the clinical course of patients with APSGN. METHODS: Between January 2000 and December 2004, a total of 48 children who were diagnosed with APSGN according to the presence of hematuria, transient hypocomplementemia and evidence of group A beta-hemolytic streptococcal infection were evaluated. RESULTS: Six(12.5%) patients showed elevation of serum creatinine level but there was no patient with persistent renal dysfunction. Blood pressure was controlled with ease in all patients and there was no case of persistent hypertension. Renal biopsy was done in 5 patients who showed heavy proteinuria or renal insufficiency and the outcomes showed findings consistent with ordinary APSGN except one with findings of rapidly progressive glomerulonephritis(RPGN). Serum complement levels normalized within 8 weeks(92.9%). Hematuria disappeared within 6 months(79%) and proteinuria within 6 months(100%) from the disease onset. CONCLUSION: Prolonged renal dysfunction or heavy proteinuria found in five patients(10.4%) led to renal biopsy. All these problems resolved within 6 months. Our data support that the prognosis of childhood APSGN is favorable without any serious sequela.
Biopsy ; Blood Pressure ; Child* ; Complement System Proteins ; Creatinine ; Glomerulonephritis* ; Hematuria ; Humans ; Hypertension ; Kidney Failure, Chronic ; Prognosis* ; Proteinuria ; Renal Insufficiency ; Streptococcal Infections

PURPOSE: This study aimed to evaluate the changes in dorsiflexion and balance following proximal and distal tibiofibular joint manipulation in individuals with a history of lateral ankle sprain (LAS). METHODS: Fifteen participants with a history of unilateral LAS, exhibiting a restriction in ankle dorsiflexion were included in this study. LAS ankle received a manipulation to the proximal and distal tibiofibular joint, while the opposite control ankle received no manipulation intervention. The outcome measures included ankle dorsiflexion and balance. Ankle dorsiflexion was measured using weight-bearing lunge test. Static and dynamic balances were measured using the overall, anterioposterior, and mediolateral balance index via the biodex balance system. Measurements were obtained prior to and following manipulation. RESULTS: This study showed that ankle dorsiflexion and dynamic balance were improved following the manipulation compared to those prior to the manipulation (p<0.05). There was no significant change in static balance (p>0.05). CONCLUSION: The joint manipulation technique applied to the ankle of those with a history of LAS appears to improve ankle dorsiflexion and dynamic balance. This suggest that a manipulation to the proximal and distal tibiofibular joint could be provided as preliminary data regarding the prophylactic effects of recurrent LAS.
Ankle Injuries* ; Ankle* ; Joints* ; Lung ; Outcome Assessment (Health Care) ; Weight-Bearing

Ganglioneuromas are a fully differentiated tumor that contains no immature elements. The majority of ganglioneuromas are diagnosed in patients older than 10 years and are most often located in the posterior mediastinum, followed by the retroperitoneum. The location of these tumors in the parapharyngeal region is extremely uncommon and there are only a few reports on the cytologic appearance of the tumor. We report a case of ganglioneuroma presenting in a parapharyngeal location in a 4 year-old boy, diagnosed by fine needle aspiration cytology. The smears revealed scattered large oval to polygonal cells with voluminous, granular cytoplasms. The nuclei were one to two in number and had a prominent nucleolus. Clusters of benign spindie-shaped cells were also present.
Biopsy, Fine-Needle* ; Child, Preschool ; Cytoplasm ; Ganglioneuroma* ; Humans ; Male ; Mediastinum

Second primary malignancy (SPM) is a well-known cause of death in head and neck cancers. Recently, with reports of many incidences of human papilloma virus (HPV) associated SPM, the disease has been widely investigated. We report a HPV-positive tracheal cancer in a 49-yearold male who had been diagnosed with HPV-positive squamous cell carcinoma of the right tonsil within intervals of two years. In this case, the metachronous tracheal cancer lesion as well as the primary tonsillar cancer showed the same subtype HPV-16.