The purpose of this study is to present our experience of distraction osteogenesis procedure used to improve the functional and consmetic problems of two patients associated with Pierre-Robin sequence, which is an uncommon congenital disease in combination with micrognathia, glossoptosis, and respiratory obstruction. A female child of 42 months and a male infant of 4 months suffering from pneumonia, difficult breathing, cyanosis and insomnia were admitted. We performed temporary tongue to lip dhesion by modified Routledge method and bilateral mandibular distraction. After the operation, symptoms of insomnia and impaired breathing had improved. We found an extension of the mandibular length. In addition, the posterior airway space and lower face area were expanded in the cephalometric tracing and profilogram. We report that bilateral distraction provedure could be an effective and safe method for improving of impaired breathing and cosmetic problems of patients with Pierre-Robin sequence.
Child ; Cyanosis ; Female ; Humans ; Infant ; Lip ; Male ; Osteogenesis, Distraction ; Pneumonia ; Respiration ; Sleep Initiation and Maintenance Disorders ; Tongue

Adenoid cystic carcinoma (ACC) of the breast is an uncommon carcinoma accounting for less than 1% of the breast carcinoma. This type of carcinoma has a distinctive histology, such as cylindromatous, cribriform, glandlike space and solid pattern in the variable proportion. Prognosis is favorable with rare recurrence or metastasis and the guideline for therapy is not well established. We experienced a case of ACC of right breast in the 48 year-old woman. Cytologically, it showed numerous three-dimensional, well outlined cell clusters with central core of homogeneous, eosinophilic material. The mass was well demarcated, firm and measured 2.5 2.5 2 cm. Cut surface was yellowish white and granular with focal necrosis. Histologically, the tumor was composed of cylindromatous, adenoid and solid area with marked cellular atypia. Focal invasion was identified in the adipose tissue around the tumor. Histologic and nuclear grade was III by Kleer's grade. Nodal metastasis was not found.
Adenoids* ; Adipose Tissue ; Breast Neoplasms ; Breast* ; Carcinoma, Adenoid Cystic* ; Eosinophils ; Female ; Humans ; Middle Aged ; Necrosis ; Neoplasm Metastasis ; Prognosis ; Recurrence

Herpes simplex esophagitis has been recognized with increased frequency as an opportunistic infection in immunosuppressed or debilitated patients. However, it is also documented as self-limited esophagitis in apparently healthy patients. We report two cases of herpetic esophagitis diagnosed by biopsies. One case was noted in an immunocompetent patient having gastric peptic ulcer who had clinical improvement with symptomatic treatment. And the other was noted in an immunosuppressed patient having chemotherapy for gastric carcinoma who had resolution of symptoms with acyclovir therapy. Histologically, esophageal mucosa exhibited erosion and inflammatory cellular exudate with intranuclear eosinophilic inclusions in the epithelial cells. These were confirmed by the PCR and immunohistochemical stain for herpes simplex virus using a biopsy material.
Acyclovir ; Biopsy ; Drug Therapy ; Eosinophils ; Epithelial Cells ; Esophagitis* ; Exudates and Transudates ; Herpes Simplex* ; Humans ; Mucous Membrane ; Opportunistic Infections ; Peptic Ulcer ; Polymerase Chain Reaction ; Simplexvirus

A 52-year-old woman was admitted with a palpable mass on the abdominal wall. This tumor had developed at the same site of a previously resected dermatofibrosarcoma protuberans. The biopsy specimen from the recurrent tumor revealed malignant fibrous histiocytoma. Immunohistochemistry with anti-CD34 antibody revealed diffuse linear positivity on the tumor cells of dermatofibrosarcoma protuberans and negativity on malignant fibrous histiocytoma. Anti CD34 antibody was valuable for a differential diagnosis of these two lesions.
Abdominal Wall ; Biopsy ; Dermatofibrosarcoma* ; Diagnosis, Differential ; Female ; Histiocytoma, Malignant Fibrous* ; Humans ; Immunohistochemistry ; Middle Aged

No abstract available.
Knee ; Ligaments* ; Magnetic Resonance Imaging

Nucleolar organizer regions are DNA loops encoding rihbosomal RNA production and detectable by the argyrophilia of their associated proteins(AgNORs). AgNOR numbers correlate with cellular proliferating activity. Many studies have shown a significnt difference in AgNOR counts between benign and malignant tumors. AgNOR counts were also helpful in differential diagnosis. For the evaluation of its diagnostic utility in gastric lesions, a silver staining technique was carried out in paraffin sections of 5 control cases, 5 benign peptic ulcers, 7 hyperplastic polyps, 10 tubular adenomas, 16 early gastric adenocarcinomas and 15 advanced gastric adenocarcinomas. The results were as follows. The mean numbers of AgNORs in early and advanced gastric adenocarcinomas(1.94 and 2.16) were significantly higher than those of normal foveolar epithelium(1.43) and epithelia of benign gastric ulcers(1.54), hyperplastic polyps(1.64) and tubular adenomas(1.79). In malignancy, there was increased variability in size and shape of AgNORs. There was little differences in mean AgNOR numbers between early and advanced gastric adenocarcinomas. Differentiation of the tumor made no difference in AgNOR numbers. From the above results, the AgNORs count, if its morphologic change are taken into consideration, is helpful in differentiation between malignant and non-malignant lesions.
Diagnosis, Differential ; Adenocarcinoma

By means of hospital-based data over 8 years we sought to evaluate the clinical indications and incidence of emergency peripartum hysterectomy by demographic characteristic and reproduction history. From the obstetric record of all deliveries at Chung Goo Hospital between Jan. 1, 1990, and Nov. 31, 1997, we identified all women undergoing emergency cesarean hysterectomy, calculated incidence rates, conducted statistical tests of linear trends and heterogenety, and observed the clinical indicatons preceding the onset of this procedure. There were 16731 deliveries during this period, Cesarean hysterectomy was performed in 24 of 5993 cesarean sections(0.40%) and in 10 of 10738 vaginal deleveries(0.09%), so more frequently after cesarean section than vaginal delivery. The age of patients varied from 22 to 40 years old. The higher the age and the parity of patients, the higher incidence of cesarean hysterectomy was noted. The most common indication of cesarean hysterectomy was uterine atony(52.94%) followed by placental disorders(41.18%), uterine myoma with pregnancy(2.9%) and uterine rupture (2.9%). All patients who had hysterectomy received transfusion from 1 pint to 57 pints. The postoperative complications were bladder injury, febrile morbidity, disseminated intravascular coaguolopathy and wound disruption. There were three maternal deaths, the cause was disseminated intravascular coaguolopathy and amniotic embolism. The data identifiy uterine atony as the primary cause for gravid hysterctomy. The data also illustrated how the incidence of emergency peripartum hysterectomy increases significantly with increasing parity, especially when influenced by a current placenta previa or a prior cesarean section. Maternal morbidity remained high.
Adult ; Cesarean Section ; Embolism ; Emergencies ; Female ; Humans ; Hysterectomy* ; Incidence ; Leiomyoma ; Maternal Death ; Parity ; Peripartum Period* ; Placenta Previa ; Postoperative Complications ; Pregnancy ; Reproduction ; Urinary Bladder ; Uterine Inertia ; Uterine Rupture ; Wounds and Injuries

Intracerebral hemorrhage is the most serious complication of cerebral arteriovenous malformations (AVM). To identify angiographic characteristics of AVM which correlate with a history of hemorrhage, we retrospectively analyzed angiographic findings of 25 patients with AVM. Nine characteristics were evaluated; these include nidus size, location, arterial aneurysm, intranidal aneurysm, angiomatous change, venous drainage pattern, venous stenosis, delayed drainage and venous ectasia. These characteristics were correlated with hemorrhage, which was seen in 18 (72%) patients of CT or MR images. Venous stenosis (P<.05) and delaved venous drainage (P<.05) well correlated with a history of hemorrhage. Arterial aneurysm and intranidal aneurysm also had a tendency hemorrhage although they did not prove to be statistically significant. Detailed analysis of angiographic finding of AVM is important for recognition of characteristics which are related to hemorrhage and may contribute to establishing a prognosis and treatment planning.
Aneurysm ; Cerebral Hemorrhage ; Constriction, Pathologic ; Dilatation, Pathologic ; Drainage ; Hemorrhage* ; Humans ; Intracranial Arteriovenous Malformations* ; Prognosis ; Retrospective Studies

No abstract available.
Carcinoma, Papillary* ; Thyroid Gland*

No abstract available.
Pregnancy* ; Purpura*