Primary cystic neoplasia of the liver is rare. We report a cystadenoma with mesenchymal stroma (CMS) and a cystadenocarcinoma, and make a review of literature with particular reference to their histogenesis. The CMS has many similarities to the ovarian mucinous cystadenoma; occurring almost exlusively in female, being lined by mucus-secreting epithelial cells, and containing dense ovarian-like stroma. These features suggest that CMS may arise from the ectopic ovarian tissue within the liver. Cystadenocarcinoma may have its origin in CMS or cystadenoma without mesenchymal stroma of CMS. Cholangiocarcinoma arising from the congenital hepatic cysts can be differentiated only when it contains benign epithelia.
Female ; Humans ; Cysts

We evaluated the clinical manifestations of 326 patients of vitiligo who had visited Seoul National University Hospital. The results were as follows : 1) There were 141 males (43.3%) and 185 females (56.7%). 2) The mean age of onset was 19.6 years (male : 18.3 years, female : 20.6 years). 3) The mean age at the first visit wss 23.9 years (male : 22.5 years, female : 24.9 years). 4) Duration of disease was less than 2 year in 156 patients (47.9%). 5) The most common site of initial involvement was face (36.2%). The common sites of involvement were face (55.2), abdomen (32.5%), neck (26.7%) and scalp (24.8%) in decreasing order of frequency. 6) There were 167 cases (51.2%) of generalized type, 118 cases (36.2%) of localized type, 31 cases (9.5%) of dermatomal type and 10 cases (3.1) of halo nevus. The most frequent site of dermatomal type was neck. Gray hair was noted in 91 cases (27.9%) and mucosal involvement was present in 43 cases (13.2%). 7) Family history was obtained in 24 cases (7.4%). Koebner phenomenon was present in 48 cases (14%). There were no precipitating factors in 309 cases (94.8%) prior to development of vitiligo. 8) The associated diseases were 1 csse of thyroiditis and 3 cases of alopecia areata.
Abdomen ; Age of Onset ; Alopecia Areata ; Female ; Hair ; Humans ; Male ; Neck ; Nevus, Halo ; Precipitating Factors ; Scalp ; Seoul ; Thyroid Gland ; Thyroiditis ; Vitiligo*

BACKGROUND: For the purpose of early detection of breast cancer, a localization biopsy is necessary in case of mammographically or ultrasonographically suspicious, but nonpalpable, breast lesions. METHODS: One hundred nine consecutive localization biopsies for nonpalpable lesions of the breast were performed upon 101 patients from May 1992 to September 1998. RESULTS: The localizations were done in 48 cases under the guidance of mammography and in 61 cases under the guidance of ultrasonography. Complications occurred in 15 cases (13.7%). The mean volume of the excised specimens was 11.6 cm3. The miss rate was 3.6% (4 cases). Malignant lesions of the breast were found in 16 cases (14.7%). Among the malignant lesions, 10 cases involved invasive ductal cancer. Among the patients diagnosed as having breast cancer, 8 patients were treated with a conservative operation, 5 patients with a modified radical mastectomy, and 2 patients with observation; 1 patient was discharged. The chance of a biopsy containing a malignant lesion was 16.7% if the biopsy was done because of mass, 9.8% for a microcalcification, and 11.1% for an abnormal asymmetric density. CONCLUSIONS: A needle localization biopsy can be performed accurately under local anethesia, and the volume of the excised specimen can be minimized, so the cosmetic effect is excellent and proper early treatment is possible in diagnosed cases of breast cancer.
Biopsy* ; Breast Neoplasms ; Breast* ; Humans ; Mammography ; Mastectomy, Modified Radical ; Needles* ; Ultrasonography

To understand better the complex natural course of HBV infection, the expression patterns of HBcAg and HBsAg in the liver of 51 inactive serum HBsAg carriers (24 CPH and 27 NPD) were studied by immunohistochemical methods. The inactive serum HBsAg carriers were devided into 3 groups by the following expression patterns of serum HBeAg/anti-HBe status and tissue HBcAg and HBsAg. Pattern A (18 cases) : HBeAg+, cHBcAg+ (94.4%), mHBsAg+ (61.1%), pATTERN B (14 cases) : anti-HBe+, nHBcAg+, cHBsAg+, Pattern C (19 cases) : anti-HBe+, HBcAg-, cHBsAg+ (89.5%). There were no significant differences between CPH and NPD, lthough the core free pattern was more common in the latter. The cHBcAg was expressed in 17 of 18 (94.4%) HBeAg seropositive cases but only one of 33 cases with serum anti-HBe, suggesting that the cHBcAg is intimately related to HBeAg. Since the inactive HBsAg carriers also expressed cHBcAg and/or mHBsAg, the necro-inflammatory activity of HBV infected liver is assumed to depend on the host immune response rather than their presence alone

Tubular apocrine adenoma and papillary eccrine adenoma are rare sweat gland neoplasms that appear as a small solitary lesion on the scalp or extremities, respectively. Although these lesions are thought to be distinct entities, there are enough similarities between them to group them under the term tubulopapillary hidradenoma or papillary tubular adenoma. We describe a case showing many tubular structures with papillary projection, syringocystadenoma-like structures, and eccrine hirocystoma-like structures in the axillary area. The term of papillary tubular adenoma or tubulopapillary hidradenoma may be prefered in this case.
Acrospiroma ; Adenoma* ; Extremities ; Scalp ; Sweat Gland Neoplasms

OBJECTIVE: The purposes of this study were to determine the renal function by radioisotope renography and to compare the findings of radioisotope renography in the spinal cord injured patients to the clinical presentations and findings of other conventional urologic examinations. METHOD: Intravenous pyelogram(IVP), voiding cystourethrogram(VCUG) and urodynamic study were performed in twenty-five spinal cord injured patients along with serum BUN/Creatinine levels and 24 hour creatinine clearance tests. Technetium-99 m mercaptoacetyltriglycine was used for the radioisotope renography. RESULTS: One abnormal radioisotope renography finding was noted among 22 normal findings by IVP and VCUG studies, while no abnormal finding by IVP and VCUG studies was noted among the subjects with a normal radioisotope renography. Effective renal plasma flow(ERPF) was significantly lower in patients with lower creatinine clearance. ERPF, cortical retention and creatinine clearance values for hyperreflexic bladders were significantly different from areflexic bladders. ERPF was significantly higher in a clean intermittent catheterization group than in a percussion and Cred method group for the hyperreflexic bladders. CONCLUSION: The study proves that the radioisotope renography is a sensitive and valuable study to evaluate the renal dysfunction in the spinal cord injured patients.
Creatinine ; Humans ; Intermittent Urethral Catheterization ; Percussion ; Plasma ; Radioisotope Renography* ; Renal Plasma Flow, Effective ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder ; Urodynamics

BACKGROUND: Superior migration of humeral head has been conventionally determined by measuring the acromiohumeral distance (AHD), We sought to devise a novel measurement system more reliably and accurately than AHD. We described a structural landmark called 'C-line'. In this study, we investigated the clinical usefulness of 'step-off of the C-line (SOC)' compared to that of AHD. METHODS: The C-line formed from the medial margin of the proximal humeral head continuing up to the inferior margin of the articular glenoid and then to the lateral border of the scapula. The superior migration of the humeral head triggered by a rotator cuff tear introduces a discontinuity in this C-line. We measured the distance of this discontinuity. We enrolled 144 patients who underwent a rotator cuff repair. We selected 58 controls who didn't have any cuff lesions apparent on magnetic resonance imaging. Using radiographs derived from standardized true anteroposterior views of the shoulder, we measured the SOC and the AHD. We used t-tests for statistical analyses. RESULTS: A rotator cuff tear was associated with an increase in SOC and a decrease in AHD. In control group, the mean SOC was 1.29 ± 1.71 mm and AHD was 9.71 ± 2.65 mm. In cuff tear group, the mean SOC was 3.15 ± 3.41 mm and AHD was 8.28 ± 1.76 mm. The mean SOCs of the patient group in relation to the mean SOC of the control group according to tear size, the SOCs of medium tear and lager groups showed statistically significant increase (p<0.05). CONCLUSIONS: The SOC may be a similarly effective to diagnose cuff tears of medium size and larger compared with AHD.
Humans ; Humeral Head* ; Magnetic Resonance Imaging ; Methods* ; Rotator Cuff ; Scapula ; Shoulder ; Tears

No abstract available.
Carcinoma, Hepatocellular* ; Child* ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans

The hyperimmunoglobulinemia E (Jobs) syndrome (HIES) is characterized by marked elevated levels of IgE, recurrent cutaneous and systemic staphylococcal infections, atopic-like dermatitis, and defective neutrophil chemotaxis. Three cases of HIES have been reported in Korea, but not in the dermatology literature. We report a case of HIES with cutaneous infections and MRSA (methicillin-resistant Staphylococcus aureus). A 15-month-old girl presented with intractable pruritic excoriated papular pustular skin lesions and multiple subcutaneous abscesses. Surgical drainage of the abscesses and a course of antibiotic treatment in addition to topical steroids for about 7 weeks resulted in a remarkable improvement.
Abscess ; Chemotaxis ; Dermatitis ; Dermatology ; Drainage ; Female ; Humans ; Hypergammaglobulinemia* ; Immunoglobulin E ; Infant ; Job Syndrome* ; Korea ; Methicillin-Resistant Staphylococcus aureus ; Neutrophils ; Skin ; Staphylococcal Infections ; Staphylococcus ; Steroids

PURPOSE: For early stage non-small-cell lung cancer, surgical resection is the treatment of choice. But when the patients are not able to tolerate it because of medical problem and when refuse surgery, radiation therapy is considered an acceptable alternative. We report on the treatment results and the effect of achieving local control of primary tumors on survival end points, and analyze factors that may influence survival and local control. MATERIALS AND METHOD: We reviewed the medical records of 32 patients with medically inoperable non-small cell lung cancer treated at our institution from June, 1987 through June, 1997. All patients had a pathologic diagnosis of non-small cell lung cancer and were not candidate for surgical resection because of either patients refusal (4), old age (2), lung problem (21), chest wall invasion (3) and heart problems (3). In 8 patients, there were more than 2 problems. The median age of the patients was 68 years (ranging from 60 to 86 years). Histologic cell type included squamous (24), adenocarcinoma (6) and unclassified squamous cell (2). The clinical stages of the patients were T1 in 5, T2 in 25, T3 in 2 patients. Initial tumor size was < or =3.0 cm in 11, between 3.0 cm and 5.0 cm in 13 and more than 5.0 cm in 8 patients. All patients had taken chest x-rays, chest CT, abdomen USG and bone scan. Radiotherapy was delivered using 6 MV or 10 MV linear accelerators. The doses of primary tumor were the ranging from 54.0 Gy to 68.8 Gy (median; 61.2 Gy). The duration of treatment was from 37 days through 64 days (median; 48.5 days) and there was no treatment interruption except 1 patient due to poor general status. In 12 patients, concomitant boost technique was used. There were no neoadjuvant or adjuvant treatments such as surgery or chemotherapy. The period of follow-up was ranging from 2 months through 93 months (median; 23 months). Survival was measured from the date radiation therapy was initiated. RESULTS: The overall survival rate was 44.6% at 2 years and 24.5% at 5 years, with the median survival time of 23 months. Of the 25 deaths, 7 patients died of intercurrent illness, and cause-specific survival rate was 61.0% at 2 years and 33.5% at 5 years. The disease-free survival rate was 38.9% at 2 years and 28.3 % at 5 years. The local-relapse-free survival rate was 35.1%, 28.1%, respectively. On univariate analysis, tumor size was significant variable of overall survival ( p=0.0015, 95% C.I.; 1.4814-5.2815), disease-free survival ( p=0.0022, 95% C.I.; 1.4707-5.7780) and local-relapse-free survival ( p=0.0048, 95% C.I.; 1.2910- 4.1197). T stage was significant variable of overall survival ( p=0.0395, 95% C.I.; 1.1084-65.9112) and had borderline significance on disease-free survival ( p=0.0649, 95% C.I.; 0.8888-50.7123) and local-relapse-free survival ( p= 0.0582, 95% C.I.; 0.9342-52.7755). On multivariate analysis, tumor size had borderline significance on overall survival ( p=0.6919, 955 C.I.; 0.9610-5.1277) and local-relapse-free survival ( p=0.0585, 95% C.I.; 0.9720- 4.9657). Tumor size was also significant variable of disease-free survival ( p=0.0317, 95% C.I.; 1.1028-8.4968). CONCLUSION: Radical radiotherapy is an effective treatment for small (T1 or < or =3 cm) tumors and can be offered as alternative to surgery in elderly or infirmed patients. But when the size of tumor is larger than 5 cm, there were few long-term survivors treated with radiotherapy alone. The use of hyperfractionated radiotherapy, endobronchial boost, radisensitizer and conformal or IMRT should be consider to improve the local control rate and disease-specific survival rate.
Abdomen ; Adenocarcinoma ; Aged ; Carcinoma, Non-Small-Cell Lung* ; Diagnosis ; Disease-Free Survival ; Disulfiram ; Drug Therapy ; Follow-Up Studies ; Heart ; Humans ; Lung ; Lung Neoplasms ; Medical Records ; Multivariate Analysis ; Particle Accelerators ; Radiotherapy* ; Survival Rate ; Survivors ; Thoracic Wall ; Thorax ; Tomography, X-Ray Computed