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

BACKGROUND: Several antibiotics can be used to treat ventilator-associated pneumonia caused by carbapenem-resistant A. baumannii (CRAB-VAP) including high-dose sulbactam. However, the effectiveness of high-dose sulbactam therapy is not well known. We report our experience with high-dose sulbactam for treatment of CRAB-VAP. METHODS: Medical records of patients with CRAB-VAP who were given high-dose sulbactam between May 2013 and June 2015 were reviewed. RESULTS: Fifty-eight patients with CRAB-VAP were treated with high-dose sulbactam. The mean age was 72.0 ± 15.2 years, and the acute physiology and chronic health evaluation II (APACHE II) score was 15.1 ± 5.10 at the time of CRAB-VAP diagnosis. Early clinical improvement was observed in 65.5% of patients, and 30-day mortality was 29.3%. Early clinical failure (odds ratio [OR]: 8.720, confidence interval [CI]: 1.346-56.484; p = 0.023) and APACHE II score ≥ 14 at CRAB-VAP diagnosis (OR: 10.934, CI: 1.047-114.148; p = 0.046) were associated with 30-day mortality. CONCLUSIONS: High-dose sulbactam therapy may be effective for the treatment of CRAB-VAP. However, early clinical failure was observed in 35% of patients and was associated with poor outcome.
Acinetobacter baumannii* ; Acinetobacter* ; Anti-Bacterial Agents ; APACHE ; Diagnosis ; Humans ; Medical Records ; Mortality ; Pneumonia, Ventilator-Associated* ; Sulbactam*

Maligant melanomas of the oral or nasal cavity, and the vulvovaginal area are relatively common among the melanomas of non-ocular mucosa. But, primary malignant melanoma arising in the mucosa of the palatine tonsil is rare. We present a case of primary malignant melanoma arising in the mucosa of the palatine tonsil. A 36-year-old male was admitted for evaluation of a recurrent sore throat. Tonsillectomy was performed on the basis of clinical suspicion of chronic tonsillitis. Grossly, the left tonsil was focally dark. Microscopically, the tonsillar mucosa was diffusely infiltrated with tumor cells. Tumor cells revealed numerous melanin pigments. Intraepithelial nests of tumor cells were noted, but pagetoid spread of tumor cells was not found. Tumor cells were positive for S-100 protein and HMB45 stain. There was no evidence of melanoma in the skin or eye.
Male ; Humans

Nevus lipomatosus cutaneous superficialis is a very rare skin disease which usually is present from birth. This uncommon condition is due to collections of ectopic. fat cells within the upper and mid dermis. There are two clinical varieties. The first is a lesion of zonal distribution, present from birth or childhood, usualIy on the buttocks or the lower back. The second form, a dome or sessile, papule, begins. in adult life and is less restricted in distribution. Cerebriform plaques tend to form from the coalescence of soft, yellowish papules. The authors observed two cases of typical nevus lipomatosus cutaneous superficialis. The first case is a 25-year-old female who has had asymptomatic, soft, skin colored, and huge confluent nodules on the right infragluteal fold and upper thigh for 15 years; and the second case is a 15-year-old male who has had multiple, skin colored and soft papules or nodules in zosteriform distribution affecting the right side of the lower back and coccygeal area and right buttock for 4 years. The authors made the diagnosis of nevus lipomatosus cutaneous superficialis from the characteristic clinical and histopathological findings.
Adipocytes ; Adolescent ; Adult ; Buttocks ; Dermis ; Diagnosis ; Female ; Fluconazole ; Humans ; Male ; Nevus* ; Parturition ; Skin ; Skin Diseases ; Thigh

No abstract available.
Causality* ; Humans ; Infant, Newborn* ; Pneumothorax*

Malignant struma ovarii is a rare tumor of the ovary. This can be diagnosed by histologically when carcinomas of the thyroid gland are excluded. We present a case of malignant struma ovarii arising from cystic teratoma. A 42-year-old female was admitted for evaluation of lower abdominal mass. Hysterectomy and both adnexectomy were performed on the basis of a clinical impression of uterine leiomyoma and an ovarian mass. The uterus revealed intramural leiomyoma, measuring 8 cm in diameter. Ovarian mass was predominantly cystic and partly solid. Microscopically, thyroid tissue with papillary structures were found in the solid area Papillae were complex, branching and randomly oriented. These papillae were infiltrated in the adjacent fibrous capsule, Clinical evidence of a primary thyroid carcinoma was not found.
Female ; Humans

Malignant struma ovarii is a rare tumor of the ovary. This can be diagnosed by histologically when carcinomas of the thyroid gland are excluded. We present a case of malignant struma ovarii arising from cystic teratoma. A 42-year-old female was admitted for evaluation of lower abdominal mass. Hysterectomy and both adnexectomy were performed on the basis of a clinical impression of uterine leiomyoma and an ovarian mass. The uterus revealed intramural leiomyoma, measuring 8 cm in diameter. Ovarian mass was predominantly cystic and partly solid. Microscopically, thyroid tissue with papillary structures were found in the solid area Papillae were complex, branching and randomly oriented. These papillae were infiltrated in the adjacent fibrous capsule, Clinical evidence of a primary thyroid carcinoma was not found.
Female ; Humans

The effect of pinacidil, a K+ channel opener, on the contraction of rabbit carotid artery was investigated by using muscle contraction and Ca2= uptake experiments. Pinacidil reduced phenylephrine-induced contraction by dose dependent manner, which was antagonized by glibenclamide, a blocker of the ATP sensitive K+ channel. Phenylephrine-induced tonic contraction was more reduced by pinacidil than its phasic contraction. In the effect of pinacidil on the Ca2+ uptake of rabbit carotid artery, pinacidil decreased it at the resting state of tissue, dose-dependently. Phenylephrine-induced stimulation of Ca2+ uptake was also reduced by pinacidil. Pinacidil 10micrometer reduced high potassium-induced contraction, which was not reversed by glybenclamide 10micrometer. Threshold concentration of K+ increased by pinacidil pretreatment. Phorbol 12, 13-dibutyrate, an activator of protein kinase C, induced sustained contraction of rabbit carotid artery, which was reduced by pinacidil but not antagonized by glibenclamide. In Ca2+-free buffer, pinacidil also decreased phorbol 12, 13-dibutyrate-induced contraction. These results indicate that pinacidil reduces Ca2+ uptake of vascular smooth muscle by stimulation of K+ channel which could be antagonized by glibenclamide, and another mechanism of vasorelaxation which could not be antagonized by glibenclamide. It was indecated that pinacidil affects the contaction of smooth muscle by the inhibition of protein kinase C.
Adenosine Triphosphate ; Carotid Arteries* ; Glyburide ; Muscle Contraction ; Muscle, Smooth ; Muscle, Smooth, Vascular ; Pinacidil* ; Protein Kinase C ; Vasodilation

Native valve endocarditis (NVE) without preexisting structural valve or congenital cardiac malformation especially in pediatric group is rare. A case of isolated tricuspid valve endocarditis in a 7-year-old child without any cardiac malformation is described. This child had suffered from fever and productive cough for 3 weeks. Blood culture grew Staphylococcus aureus. Fever was not controlled even with proper antibiotic treatment. Transthoracic echocardiogram and lung perfusion scan revealed a large vegetation on the tricuspid valve with multiple embolism Surgical procedures included vegetectomy partial cusps resection and pericardial patch valvuloplasty. Th patient was in NYHA class I during follow up.
Child ; Cough ; Embolism ; Endocarditis* ; Endocarditis, Bacterial ; Fever ; Follow-Up Studies ; Humans ; Lung ; Perfusion ; Staphylococcus aureus ; Tricuspid Valve*

The vagina is an infrequent site of primary sarcomas, which are less than 2% of all malignant vaginal neoplasm. The most common malignant mesenchymal tumor of the vagina is rhabdomyosarcoma, but leiomyosarcoma is rare type tumor of the vagina. Microscopically, spinle cells with pleomorphic nuclei and mitotic figures were frequently noted, but cross-striations were not found in the tissue. Alpha-smooth muscle actin and desmin were positive, but sarcomeric actin was negative in the tumor cells. The authors report a case of primary leiomyosarcoma of the vagina with brief literature review.
Actins ; Desmin ; Leiomyosarcoma* ; Rhabdomyosarcoma ; Sarcoma ; Vagina* ; Vaginal Neoplasms