Painful fat hemiation is characterized. by the soft, skin colored painful papules on the heels that appears only when weight is bome and disappears when weight. is taken off the heels. The papules were thought to be caused by hemiation of adipose tissue through connective tissue defect. To our knowledge, such a case or similar one has not been reported previously in Korea. The patient was 30 year-old housewife, who have had soft, skin colored painful papules on the medial aspect of the both heels when weight was placed on the foot. Routine laboratory findings were within normal limit. Skin biopsy revealed nodules of lobulated adipose tissue on the mid-dermis far above the original subcutaneous tissue and large venous channels with thick muscular walls. Hypertrophied peripheral nerve trunks were scattered adjacent to the above vascular structure. Diagnosis was confirmed by clinical and histopathological features. Literatun was briefly reviewed.
Adipose Tissue ; Adult ; Biopsy ; Connective Tissue ; Diagnosis ; Foot ; Heel ; Humans ; Korea ; Peripheral Nerves ; Skin ; Subcutaneous Tissue

PURPOSE: Dipyridamole stress myocardial perfusion SPECT could predict prognosis, however, long-term follow-up showed change of hazard ratio in patients with suspected coronary artery disease. We investigated how long normal SPECT could predict the benign prognosis on the long-term follow-up. MATERIALS AND METHODS: We followed up 1169 patients and divided these patients into groups in whom coronary angiography were performed and were not. Total cardiac event rate and hard event rate were predicted using clinical, angiographic and SPECT findings. Predictive values of normal and abnormal SPECT were examined using survival analysis with Mantel-Haenszel method, multivariate Cox proportional hazard model analysis and newly developed statistical method to test time-invariance of hazard rate and changing point of this rate. RESULTS: Reversible perfusion decrease on myocardial perfusion SPECT predicted higher total cardiac event rate independently and further to angiographic findings. However, myocardial SPECT showed independent but not incremental prognostic values for hard event rate. Hazard ratio of normal perfusion SPECT was changed significantly (p<0.001) and the changing point of hazard rate was 4.4 years of follow up. However, the ratio of abnormal SPECT was not. CONCLUSION: Dipyridamole stress myocardial perfusion SPECT provided independent prognostic information in patients with known and suspected coronary artery disease. Normal perfusion SPECT predicted least event rate for 4.4 years.
Coronary Angiography ; Coronary Artery Disease ; Dipyridamole* ; Follow-Up Studies ; Humans ; Perfusion ; Prognosis ; Proportional Hazards Models ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: The purpose of this study is to empirically find out the affecting factors on the willingness to platelet apheresis. METHODS: Data were collected from 505 platelet apheresis donors and college students of major cities in Korea using the self-administered questionnaire. RESULTS: First, the level of positive cognition and affectivity to platelet apheresis donation and satisfaction for service during donation process among platelet apheresis donors were significantly higher than that among students only experiencing whole blood donation and students never experiencing blood donation. Second, valence for external and internal reward and knowledge of platelet apheresis among platelet apheresis donors were significantly higher than that among students only experiencing whole blood donation and students never experiencing blood donation. Third, platelet apheresis donors and students experiencing whole blood donation were more sound in character and more active in volunteer works, and had healthier behavior than students never experiencing blood donation. Fourth, the results of multiple regression analysis showed a statistically significant positive relationship between the willingness to platelet apheresis and valence for internal and external reward, satisfaction for service during donation process, and health behavior. CONCLUSIONS: These findings suggest that strategy for effective public relation and improvement of blood donor satisfaction should be developed in order to enhance willingness to platelet apheresis.
Blood Component Removal* ; Blood Donors ; Blood Platelets* ; Cognition ; Health Behavior ; Humans ; Korea ; Reward ; Tissue Donors ; Volunteers ; Surveys and Questionnaires

BACKGROUND: Serial volumetric changes of reconstructed breasts have not been studied in detail. In this study, we analyzed serial volumetric changes of reconstructed and contralateral normal breasts during long-term follow-up, with a focus on the effect of various adjuvant therapies. METHODS: Among all patients who underwent immediate breast reconstruction with a unilateral pedicled transverse rectus abdominis musculocutaneous (p-TRAM) flap, 42 patients with valid data from ≥3 postoperative positron emission tomography-computed tomography (PET-CT) scans were included. The volumes of the reconstructed and normal breasts were measured, and the ratio of flap volume to that of the contralateral breast was calculated. Serial changes in volume and the volume ratio were described, and the effects of chemotherapy, radiation therapy, and hormone therapy on volumetric changes were analyzed. RESULTS: The mean interval between the initial reconstruction and each PET-CT scan was 16.5, 30, and 51 months respectively. Thirty-five, 36, and 10 patients received chemotherapy, hormone therapy, and radiation therapy, respectively. The flap volume at each measurement was 531.0, 539.6, and 538.0 cm3, and the contralateral breast volume was 472.8, 486.4, and 500.8 cm3, respectively. The volume ratio decreased from 115.1% to 113.4%, and finally to 109.6% (P=0.02). Adjuvant therapies showed no significant effects. CONCLUSIONS: We demonstrated that the p-TRAM flap maintained its volume over a long-term follow up, while the volume of the contralateral native breast slowly increased. Moreover, adjuvant breast cancer therapies had no statistically significant effects on the volume of the reconstructed p-TRAM flaps or the contralateral native breasts.
Breast Neoplasms ; Breast ; Drug Therapy ; Electrons ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Myocutaneous Flap ; Radiotherapy ; Rectus Abdominis ; Surgery, Plastic

A rare gastric mucosal lesion characterized by Russell body-containing plasma cell infiltration is termed as Russell body gastritis. This lesion is highly suggested to be correlated with Helicobacter pylori-induced chronic gastritis, and often misdiagnosed as mucosa-associated lymphoid tissue lymphoma, signet ring cell carcinoma, plasmacytoma, or xanthoma. However, Russell body gastritis is easily discriminated by its polyclonal immunoreaction to immunoglobulin light chains contrary to monoclonal immunoreaction of neoplastic disease. We report here a case of Russell body gastritis associated with H. pylori infection, which disappeared after H. pylori eradication.
Carcinoma, Signet Ring Cell ; Gastritis* ; Helicobacter pylori* ; Helicobacter* ; Immunoglobulin Light Chains ; Lymphoma, B-Cell, Marginal Zone ; Plasma Cells ; Plasmacytoma ; Stomach ; Xanthomatosis

A spontaneous pneumoperitoneum is air in the peritoneal space that is detectable radiologically and can be managed successfully by observation alone or a laparotomy. A 73-year-old man was admitted for low back pain. He had a giant bulla in the left upper lung, detected radiologically 7 years earlier. On admission, he had free air in the subphrenic area bilaterally, while the previous giant bulla was not seen. Based on the physical examination, we thought that the new free air did not indicate a surgical abdomen, and performed additional examinations to rule out other disease. There was no abnormal finding linked to the free air. The free air had almost disappeared on a subsequent chest X-ray. We report a rare case of spontaneous pneumoperitoneum caused by a giant bulla, with a literature review
Abdomen ; Aged ; Blister ; Humans ; Laparotomy ; Low Back Pain ; Lung ; Physical Examination ; Pneumoperitoneum ; Thorax

The definition of C1q nephropathy has been categorized since 1985. However, the clinical correlation and pathophysiology has not yet been fully revealed. Therefore, the treatment of C1q nephropathy has not been established. Our subject was a 23 year-old female patient with both leg edema and oliguria, who was presented with weight gain. Renal biopsy confirmed C1q nephropathy. Prednisolone and cyclosporine therapy was selected for treatment. After 2 weeks of treatment, the patient lost 8 kg of body weight and all laboratory examination results were normalized. Both leg edema and oliguria were resolved. After 21 weeks of regular follow-up, she stopped the medicine by herself. Eight weeks later, the patient came to the Emergency room because both leg edema recurred. Same regimen was administered for 3 weeks, and complete remission was achieved again.
Biopsy ; Body Weight ; Cyclosporine ; Edema ; Emergencies ; Female ; Follow-Up Studies ; Humans ; Leg ; Oliguria ; Porphyrins ; Prednisolone ; Weight Gain

Brunner's gland adenoma is a rare tumor of duodenum. Patients are usually aymptomatic and most are discovered incidentally during the upper gastrointestinal (GI) series or esophagogastroduodenoscopy. These lesions are most commonly located in the duodenal bulb and clinical manifestations are variable. In symptomatic patients, the most common manifestations are GI hemorrhage and duodenal obstruction. On histologic examination, Brunner's gland adenoma that causes clinical symptoms is composed of hyperplastic Brunner's glands and contains mostly an admixture of glandular, adipose, and muscular tissues. We report a case of large Brunner's gland adenoma causing upper gastrointestinal hemorrhage in a 47-year-old woman which was successfully removed by endoscopic resection without complications such as bleeding or perforation. Microscopically, it was entirely composed of variable Brunner's glands.
Adenoma/complications/*pathology/surgery ; Brunner Glands/*pathology/surgery ; Duodenal Neoplasms/complications/*pathology/surgery ; Duodenoscopy ; Female ; Gastrointestinal Hemorrhage/etiology ; Humans ; Middle Aged

BACKGROUND/AIMS: Gastric schwannomas are rare benign mesenchymal tumors that are difficult to differentiate from other mesenchymal tumors with malignant potential, such as gastrointestinal stromal tumors. This study aimed to evaluate the characteristic findings of gastric schwannomas via endoscopic ultrasonography (EUS). METHODS: We retrospectively reviewed the EUS findings of 27 gastric schwannoma cases that underwent surgical excision at Pusan National University Hospital during 2007 to 2014. RESULTS: Gastric schwannomas were mainly located in the middle third of the stomach with a mean tumor size of 32 mm. All lesions exhibited hypoechoic echogenicity, and 24 lesions (88.9%) exhibited heterogeneous echogenicity. Seventeen lesions (63.0%) exhibited decreased echogenicity compared to the normal proper muscle layer. Distinct borders were observed in 24 lesions (88.9%), lobulated margins were observed in six lesions (22.2%), and marginal haloes were observed in 24 lesions (88.9%). Hyperechogenic spots were observed in 21 lesions (77.8%), calcifications were observed in one lesion (3.7%), and cystic changes were observed in two lesions (7.4%). CONCLUSIONS: During EUS, gastric schwannomas appear as heterogeneously hypoechoic lesions with decreased echogenicity compared to the normal proper muscle layer. These features may be helpful for differentiating gastric schwannomas from other mesenchymal tumors.
Busan ; Endosonography ; Gastrointestinal Stromal Tumors ; Neurilemmoma* ; Retrospective Studies ; Stomach

PURPOSE: Since I-125 emits low energy (27-35 keV) radiation, thinner crystal and collimator could be employed and, hence, it is favorable to obtain high quality images. The purpose of this study was to derive the optimized parameters of I-125 SPECT using a new simulation tool, GATE (Geant4 Application for Tomographic Emission). MATERIALS AND METHODS: To validate the simulation method, gamma camera developed by Weisenberger et al. was modeled. NaI (Tl) plate crystal was used and its thickness was determined by calculating detection efficiency. Spatial resolution and sensitivity curves were estimated by changing variable parameters for parallel-hole and pinhole collimator. Performances of I-125 SPECT equipped with the optimal collimator were also estimated. RESULTS: In the validation study, simulations were found to agree well with experimental measurements in spatial resolution (4%) and sensitivity (3%). In order to acquire 98% gamma ray detection efficiency, NaI (Tl) thickness was determined to be 1 mm. Hole diameter (mm), length (mm) and shape were chosen to be 0.2: 5: square and 0.5: 10: hexagonal for high resolution (HR) and general purpose (GP) parallel-hole collimator, respectively. Hole diameter, channel height and acceptance angle of pinhole (PH) collimator were determined to be 0.25 mm, 0.1 mm and 90 degree. The spatial resolutions of reconstructed image of the I-125 SPECT employing HR: GP: PH were 1.2: 1.7: 0.8 mm. The sensitivities of HR: GP: PH were 39.7: 71.9: 5.5 cps/MBq. CONCLUSION: The optimal crystal and collimator parameters for I-125 imaging were derived by simulation using GATE. The results indicate that excellent resolution and sensitivity imaging is feasible using I-125 SPECT.
Animals* ; Computer Simulation* ; Gamma Cameras ; Gamma Rays ; Hydrogen-Ion Concentration ; Tomography, Emission-Computed, Single-Photon*