Although embryonal rhabdomyosarcoma has been frequently reported in genitourinary tract, head and neck, embryonal rhabdomyosarcoma of the biliary tree is an extremely rarte. It must be considered in differential diagnosis of jaundice in childhood. About 35 cases have been reported in world literatures, since first description on 1875, by Moxon and Wilks. We present a case of embryonal rhabdomyosarcoma of the biliary tree in a 25 months old boy with brief review of literatures. Since chief complaints of this case were jaundice and loss of appetite, the first clinical diagnosis was infectious hepatitis. On ultrasound examination, there is a space occupying lesion in right lobe of liver and it was diagnosed as hepatoma. Choledochoduodenostomy with biopsy was done. The operation revealed dilated common bile dut and both hepatic ducts which were filled with light brown jelly like materials and diagnosed as embryonal rhabdomyosarcoma on frozen and permanent senions. In gross and histologic characteristics, this tumor resembles embryonal rhabdomyosarcoma(sarcoma botryoides) in other locations. In spite of chemo-and radiotherapy after operation, the boy was died.
Child ; Male ; Female ; Humans ; Diagnosis, Differential ; Biopsy

Breast carcinoma has been infrequently reported in children. About 25 cases have been reported in world literatures since first description in 1913, by Bryan. We present a case of juvenile breast carcinoma in a 17 months old girl with brief review of literatures. Grossly, the submitted specimen is grayish white and measured by 1.3x1.0x0.8 cm in size. It is not encapsulated and its cut surfaces are homogeneous. Microscopic examination showed a neoplastic proliferation of duct cells forming mainly glandular spaces with focal papillary pattern, solid sheets or cribriform pattern. The glandular spaces were filled with collections of PAS-positive eosinophilic secretory materials. The individual cell varied from columnar to polygonal and showed moderate hyperchromatism and variation of nuclear size. Mitoses and necrosis are not found. Tumor cell invasion into the stroma was found.
Child ; Male ; Female ; Humans

Electron microscopic study of two malignant fibrous histiocytomas confirmed the presence of previously described tumor cells in the literature. In addition, there existed intermediate cells with morphologic features of both myofibroblasts and histiocytes, or both histiocytes and smooth muscle cells. Our result supported the idea that malignant fibrous histiocytoma may be derived from the undifferentiated mesenchymal cells that differentiate primarily along a fibroblastic and histiocytic cells.

PURPOSE: The purpose of this study was to investigate symptom frequency and symptom discomfort in liver, kidney and heart transplant recipients. METHODS: This descriptive, comparative study included 191 subjects (86 liver, 81 kidney, 24 heart: 135 male, 56 female). The symptom frequency and distress questionnaires were used to examine the symptom experience of the subjects. RESULTS: The most frequent and distressing symptom was fatigue. Increased hair, increased appetite, poor concentration and poor vision were frequently reported and poor vision, poor concentration, muscle weakness, and headache were causing high distress. Women reported a significantly higher level of symptom frequency and discomfort than men. Heart recipients reported a significantly higher level of symptom frequency and discomfort than renal or liver recipients. Significant (P<0.05) differences were found in symptom frequency and discomfort depending on transplant organs, numbers of immunosuppressants genders, age and types of drug and time after transplantation. Most of symptoms were related to the side effects of cyclosporine or corticosteroids. CONCLUSION: The results provide a basis for patient and family education and for symptom management. Further investigation of the symptom experience of the transplant patients is needed, especially in relation to quality of life.
Adrenal Cortex Hormones ; Appetite ; Cyclosporine ; Education ; Fatigue ; Female ; Hair ; Headache ; Heart ; Humans ; Immunosuppressive Agents ; Kidney ; Liver ; Male ; Muscle Weakness ; Quality of Life ; Surveys and Questionnaires ; Transplantation ; Transplants*

A 46-year-old female was admitted to Soon Chun Hyang University hospital with a complaint of intermittent epigastric pain. X-ray and endoscopic pictures showed diffase irregular shallow depression which is similar to the macroscopic pattern of the type IIc early gastric cancer. But endoseopic biopsy showed no malignant cell infiltration. Hndoaeopic biopsy plays an important role in excluding the possibility of carcinoma. But operation shoud be considered inspite of biopsy result because malignant lymphoma ean not be completely ruled out. Histopathologic diagnosis was pseudolymphoma of stomach.
Biopsy ; Depression ; Diagnosis ; Female ; Humans ; Lymphoma ; Middle Aged ; Pseudolymphoma* ; Stomach ; Stomach Neoplasms

No abstract available.
Angioplasty* ; Budd-Chiari Syndrome* ; Heart Ventricles* ; Stents*

PURPOSE: Biliary stones, situated in the proximal sites from the confluence level of the right and left main bile ducts, are considered to be intrahepatic stones. Synonyms include hepatolithiasis and recurrent pyogenic cholangitis. The exact etiology of this condition is unknown, but it causes serious problems, such as obstructive jaundice, cholangitis and liver abscesses and so on. Hepatic resection is the treatment of choice for intrahepatic stones. With improving techniques in hepatobiliary surgery and aggressive surgical treatment, the outcome of intrahepatic stones has improved. The aim of this study was to evaluate the clinical outcomes after a hepatectomy for intrahepatic stones. METHODS: 77 patients underwent hepatic resections due to intrahepatic stones at the Department of Surgery, Kyung-Hee University between January 1996 and December 2002. The surgical outcome and follow-up were analyzed by a retrospective clinical review. RESULTS: The gender ratio of the patients was 1: 1.9 male to female, with a mean age of 54-years. The most common preoperative symptom was RUQ pain (81.8%). Concomitant diseases were common bile duct stones (53.2%), gallstones (23.4%), liver abscesses (7.8%), malignant neoplasms (6.5%) and choledochal cysts (5.2%). Nineteen patients (24.7%) had a history of cholecystectomy and 2 (2.6%) had had a hepatectomy at other hospitals due to intrahepatic stones. The stone locations were the right hemi-liver 18.2%, the left hemi-liver 66.2%, especially the left lateral section 44.2%, and bilaterally 15.6%. The operation methods were as follows; a right hemihepatectomy in 11 patients (14.3%), a posterior sectionectomy in 3 (3.9%), a left hemihepatectomy in 14 (18.2%), a lateral sectionectomy in 42 (54.5%), segmental resections at both lobes in 7 (9.1%) and biliary-enteric bypass in 24 (31.2%). The most common complication was wound infection (26.0%). Two patients had remaining stones and 1 had recurrent stones 4 years later. The morbidity and mortality were 42.9 and 1.3%, respectively. With a mean follow-up period of 49.6 months, 59 patients (76.6%) were free of symptoms. 15 patients (19.5%) had mild to moderate RUQ discomfort or pain, but no detectable stones on radiological studies. 3 patients (3.9%) needed admission for severe symptoms, one due to recurrent stones, but the others had no abnormal findings. CONCLUSION: There was low mortality, despite the high complication rates with hepatic resections for intrahepatic stones. Low rates of remaining stones and recurrence of intrahepatic stones can be achieved.
Bile Ducts ; Bile Ducts, Intrahepatic ; Cholangitis ; Cholecystectomy ; Choledochal Cyst ; Cholelithiasis ; Common Bile Duct ; Female ; Follow-Up Studies ; Gallstones ; Hepatectomy* ; Humans ; Jaundice, Obstructive ; Liver Abscess ; Male ; Mortality ; Recurrence ; Retrospective Studies ; Wound Infection

In the last years, according to the increasing incidence of measles and other viral diseases, it have been needed to study on not only the fundamental epidemiological characteristics of mumps and measles but also judgement on the effectiveness of vaccine that meet our domestic situation. The author carried out questionnaire to obtain epidemiological characteristics and vaccine efficacy of mumps on epidemics of mumps in one primary school in Hwasung-kun, Kyonggi Do from Feb. to July, 1994. The results are summarized as follows: 1. Total students was 556, but 446(78.4%) responded to the questionnaire. Among that 446,130(29. 1%) have suffered from mumps. From 9 to 10 year old students had the high attack rates, especially 10 year olds has the highest(39. 7%). 2. From Feb. 2, 1994, first case was on, to July 6, 1994, the epidemic was continues, and attack rate was higest in May(50. 5%). 3. Among the 130 mumps patients, 5 have suffered from complication(3.8%) : encephalitis 3(2 in male, 1 in female). 4. Vaccination rate was 91%, and as ages were lowered, the rates were higher. 5. Attack rate was higher in group who had time interval after vaccination less than 5 years than total attack rate, and was higher in group who had been vaccined after 5 year old. 6. Attack rate in vaccinated group was 27.3%. 7. Vaccine efficacies, be judged by three methods of analysis according to case definition and vaccination status, were 37.4 39. 2%. 8. Factors that have significantly affected the mumps epidemic were vaccination status and vaccination age.
Child ; Child, Preschool ; Encephalitis ; Epidemiologic Studies* ; Gyeonggi-do* ; Humans ; Incidence ; Male ; Measles ; Mumps* ; Vaccination ; Virus Diseases ; Surveys and Questionnaires

Malignant salivary gland tumors only represent 0.08% of all childhood tumors and mucoepidermoid carcinoma (MEC) is the most common histologic type. Although there are many reports describing second malignant neoplasm (SMN) in patients treated for childhood cancer, salivary gland tumors rarely appears. In Korea, there has been no report about MEC that developed in children as a SMN. We report a MEC in a 4 years and 8 months old female child that developed after completing treatment for yolk sac tumor of lower abdomen. The primary tumor presented with metastasis at the time of diagnosis, and therefore, the child underwent high-dose chemotherapy with autologous peripheral blood stem cell transplantation along with surgery and radiotherapy. Three years and five months after completing treatment, MEC developed in her submandibular gland. She was treated with surgery and radiotherapy and is in disease free state for 5 months at the time of this writing.
Abdomen ; Carcinoma, Mucoepidermoid ; Child ; Diagnosis ; Drug Therapy ; Endodermal Sinus Tumor ; Female ; Humans ; Korea ; Neoplasm Metastasis ; Peripheral Blood Stem Cell Transplantation ; Radiotherapy ; Salivary Gland Neoplasms ; Salivary Glands ; Submandibular Gland ; Writing

PURPOSE: The usefulness of focused abdominal sonography for trauma (FAST) is now included in the frame work of the advanced trauma life support for examination of thoraco- abdominal trauma. Ultrasonographic screening is controversial in patients with hollow viscus injury. The purpose of this study is to determine the characteristics of emergency trauma sonographic findings in patients with hollow viscus injury. METHODS: All patients with isolated viscus injury after blunt abdominal trauma were retrospectively enrolled in this study during the 5-year period from December 1997 to November 2002. The patients were screened by using ultrasonography and an underwent explolaparotomy. The patients were diagnosed with a hollow viscus injury based on the surgical findings. Patients with viscus injury combined with parenchymal organ injury after abdominal trauma were excluded. Ultrasonographic examinations were performed by the experienced emergency physicians during the trauma resuscitation. RESULTS: Sixty patients were included in this study. The most common injury site was jejunum (23.3%). The common findings of emergency trauma sonography were free fluid collection (56.7%), none of fluid collection (38.3%), free air and fluid collection (3.3%), and free air (1.7%). The presence of mesenteric injury was significantly associated with fluid collection (x2=0009). CONCLUSION: The most common sonographic findings in hollow viscus injury patients after blunt abdominal trauma are free intraperitoneal fluid (anechoic or mixed echo pattern), normal, and free air (reverberation) in that order. Massive intraperitoneal fluid is more often detected in patients who have a viscus injury combined with a ruptured mesenteric vessel.
Abdominal Injuries ; Advanced Trauma Life Support Care ; Emergencies ; Humans ; Intestines ; Jejunum ; Mass Screening ; Resuscitation ; Retrospective Studies ; Ultrasonography ; Wounds, Nonpenetrating