No abstract available.
Spine* ; Spondylitis, Ankylosing*

We report a case of subcutaneous panniculitic T-cell lymphoma (SPTCL) which occurred in a 10-year-old Korean girl. Her disease presented as multiple erythematous subcutaneous nodules on the right cheek, left chest, abdomen, left flank, both calves, and left shin with systemic symptoms. She had a protracted course of multiple erythematous subcutaneous nodules for 2 months often with spiking fever. Histopathologic findings for the subcutaneous nodules revealed lobular panniculitis-like findings composed of atypical small, bland lymphocytes and histiocytes. Characteristically, atypical lymphocytes rimmed individual fat cells in a lace-like pattern and some histiocytes occasionally phagocytosed WBCs. Bone marrow findings revealed increased phagocytic histiocytes with engulfed hematopoietic cell. The immunophenotypic studies showed CD45RO (UCHLl)+, CD20-, CD4-, CD8+ and CD56+ (focal), lysozyme+, CD45 (LCA)+ and EBV-. She received three cycles of high-dose cyclophosphamide, adriamycin, vincristine, prednisolone (CHOP) and methotrexate, intrathecal methotrexate and one cycle of fludarabine, mitoxantrone and dexamethasone (FND) chemotherapy. She died of acute renal failure during multiple chemotherapy.
Abdomen ; Acute Kidney Injury ; Adipocytes ; Bone Marrow ; Cheek ; Child* ; Cyclophosphamide ; Dexamethasone ; Doxorubicin ; Drug Therapy ; Female ; Fever ; Glycogen Storage Disease Type VI ; Histiocytes ; Humans ; Lymphocytes ; Lymphoma, T-Cell* ; Lymphoma, T-Cell, Cutaneous ; Methotrexate ; Mitoxantrone ; Prednisolone ; T-Lymphocytes* ; Thorax ; Vincristine

BACKGROUND: Infectious complications frequently occur after cardiac arrest and may be even more frequent after therapeutic hypothermia. Pneumonia is the most common infectious complication associated with therapeutic hypothermia, and it is unclear whether prophylactic antibiotics administered during this intervention can decrease the development of early-onset pneumonia. We investigated the effect of antibiotic prophylaxis on the development of pneumonia in cardiac arrest patients treated with therapeutic hypothermia. METHODS: We retrospectively reviewed the medical records of patients who were admitted for therapeutic hypothermia after resuscitation for out-of-hospital cardiac arrest between January 2010 and July 2015. Patients who died within the first 72 hours or presented with pneumonia at the time of admission were excluded. Early-onset pneumonia was defined as pneumonia that developed within 5 days of admission. Prophylactic antibiotic therapy was defined as the administration of any parenteral antibiotics within the first 24 hours without any evidence of infection. RESULTS: Of the 128 patients admitted after cardiac arrest, 68 were analyzed and 48 (70.6%) were treated with prophylactic antibiotics within 24 hours. The frequency of early-onset pneumonia was not significantly different between the prophylactic antibiotic group and the control group (29.2% vs 30.0%, respectively, p = 0.945). The most commonly used antibiotic was third-generation cephalosporin, and the class of prophylactic antibiotics did not influence early-onset pneumonia. CONCLUSION: Antibiotic prophylaxis in cardiac arrest patients treated with therapeutic hypothermia did not reduce the frequency of pneumonia.
Anti-Bacterial Agents ; Antibiotic Prophylaxis* ; Heart Arrest* ; Humans ; Hypothermia* ; Medical Records ; Out-of-Hospital Cardiac Arrest ; Pneumonia* ; Resuscitation ; Retrospective Studies

Obturator hernia is a rare type of pelvic hernia and occurs most commonly in elderly and debilitated women. It is still a challenge for surgeons to diagnose precisely in early stages because of its nonspecific symptoms and consequently delayed diagnosis could lead to high morbidity and mortality. We experienced a 92-year old patient who was diagnosed as obturator hernia which was confirmed by computed tomography scan of the abdomen and pelvis. The operation was delayed due to the refusal of family members but eventually done after 12 days from initial diagnosis. After manual reduction of small bowel impacted into right obturator foramen, segmental resection of impacted small bowel and anastomosis was done. The hernial defect was closed by primary closure with Dexon suture material. After the operation, the patient was discharged without significant complications. We report here successful results of delayed operation for obturator hernia.
Abdomen ; Aged ; Benzenesulfonates ; Delayed Diagnosis ; Disulfiram ; Female ; Hernia ; Hernia, Obturator ; Humans ; Pelvis ; Sutures

No abstract available.
Drug Therapy* ; Drug Therapy, Combination* ; Fluorouracil* ; Humans ; Stomach Neoplasms*

This article describes the orthodontic treatment of a 31-year-old Korean female patient with gummy smile and crowding. The patient showed excessive gingival display in both the anterior and posterior areas and a large difference in gingival heights between the anterior and posterior teeth in the maxilla. To correct the gummy smile, we elected to intrude the entire maxillary dentition instead of focusing only on the maxillary anterior teeth. Alignment and leveling were performed, and a midpalatal absolute anchorage system as well as a modified lingual arch was designed to achieve posterosuperior movement of the entire upper dentition. The active treatment period was 18 months. The gummy smile and crowding were corrected, and the results were stable at 21 months post-treatment.
Crowding ; Dentition ; Female ; Humans ; Maxilla ; Tooth

OBJECTIVE: The purpose of this study is to evaluate the role of cold knife conization in the diagnosis and management of cervical neoplasia. METHODS: Cold knife conization was performed in total 163 patients from January 1992 to December 2003. The results of PAP smear and colposcopy-directed biopsy were compared with the pathologic diagnosis of conization. And we evaluated the rate of positive margin and the presence of residual lesion. And then, we reviewed the pregnancy outcome after conization. RESULTS: The rate of agreement between PAP cytology and conization was 45.4%, and the rate of agreement between colposcopy-directed biopsy and conization was 65.6%. Hysterectomy was done in 102 patients (62.6%). The positive rate of resection margin was 19.6%. The incidence of residual lesion after conization was 31.2% in margin (+) and 1.4% in margin (-). We evaluated 7 cases of pregnancy after conization. CONCLUSION: Cervical conization as surgical treatment was effective in cervical neoplasia patients, especially young patients, with continuous follow-up.
Biopsy ; Conization* ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Incidence ; Pregnancy ; Pregnancy Outcome

Malacoplakia is an uncommon granulomatous inflammatory disease, which predomina- ntly affected the urinary tract, particularly the urinary bladder. The prostatic involve- ment of malacoplakia is extremely rare and may clinically mimic prostate cancer. A correct diagnosis of malacoplakia can be made by histopathologic findings characterized by accumulations of macrophages containing typical intracytoplasmic inclusions(Michael is-Gutmann bodies). We report a case of prostatic malacoplakia, which was incidentally found in prostate biopsy performed to confirm clinically suspected prostate cancer.
Biopsy ; Diagnosis ; Macrophages ; Malacoplakia* ; Prostate* ; Prostatic Neoplasms ; Urinary Bladder ; Urinary Tract

BACKGROUNDS/AIMS: The aim of this study was to compare operative versus non-operative management of patients with liver injury and to ascertain the differences of the clinical features. METHODS: From April 2000 to July 2012, 191 patients were admitted to Seoul St. Mary's Hospital and St. Vincent's Hospital for liver injuries. Of these, 148 patients were included in this study. All patients were diagnosed using computed tomography (CT). The liver injury was graded in accordance with the American Association for the Surgery of Trauma liver injury scoring scale. Patients were divided into two groups: those who underwent surgery and those treated with non-operative management (NOM). There was a comparison between these two groups concerning the clinical characteristics, grade of liver injury, hemodynamic stability, laboratory findings, and mortality. RESULTS: According to the 148 patient records evaluated, 108 (72.9%) patients were treated with NOM, and 40 (27.1%) underwent surgery. Patients treated with NOM had significantly fewer severe injuries as rated using the Revised Traumatic Injury Scale, Injury Severity Score, and Glasgow Coma Scale. Grade of liver injury and number of patients with extravasation of contrast dye on CT and hemoperitoneum were higher in the operative group than in the NOM group. There were significant differences between the two groups for: heart rate, respiratory rate, systolic blood pressure, and mean hemoglobin levels at admission and after 4 hours. The operative group experienced a significantly higher mortality than the NOM group. CONCLUSIONS: The results of our study suggest that hemodynamic stability and the following should be considered for deciding the treatment for liver injuries: grade of liver injury, amount of blood loss, and injury scales scores.
Abdominal Injuries ; Blood Pressure ; Glasgow Coma Scale ; Heart Rate ; Hemodynamics ; Hemoperitoneum ; Humans ; Injury Severity Score ; Liver* ; Mortality ; Respiratory Rate ; Seoul ; Weights and Measures

The expression of two intermediate filaments, nestin and vimentin, was studied in spinal cord injury (SCI) to elucidate their roles in the formation of glial scars. Rats were sacrificed 1, 4, and 7 days after induction of compression injury of the spinal cord using an aneurysm clip. The affected spinal cords were studied using antibodies against nestin and vimentin intermediate filaments. One day after spinal cord injury, some clusters of nestin-positive vessels were detected in the center of the injury, but few were seen in other cell types. Vimentin immunostaining was detected in some glial cells in the center and its level of immunoreactivity was enhanced in the ependymal cells of the central canal. On days 4 and 7 after spinal cord injury, astrocytes and some ependymal cells in the central canal were stained positively for nestin and increased expression of nestin was observed in vessels. Vimentin was detected in some macrophages and astrocytes in the lesions. Nestin was co-localized with glial fibrillary acidic protein in some glial cells in SCI. These findings imply that spinal cord cells in adult animals have embryonic capacity, and these cells are activated after injury, which in turn contributes to repair of spinal cord injury through formation of a glial scar.
Animals ; Cicatrix/pathology ; Glial Fibrillary Acidic Protein/analysis ; Immunohistochemistry ; Intermediate Filament Proteins/analysis ; Intermediate Filaments/*physiology ; *Nerve Tissue Proteins ; Neuroglia/*pathology ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries/*pathology ; Vimentin/analysis