The epithelioid angiosarcoma is recently described ns a variant of ang-osarcoma based on its pathological feature, which is characterized by the epithelioid or histiocytoid morphology af the malignant tumor cells. The existence of vascular endothelial tumor with an epithelioid feature has been accepted for many years, most notablyn the forms of epithelioid hemangioma and epithelioid hemangioendo thelioma. In recent years, cutaneous angiosarcoma with epitheloid morphology have been reported as a cutaneos epithelioid angiosarcoma in the literatures. A 60-year-old man presente with a mild tender erythematous 2 x 2 x 2.5cm sized soft fluctuating single nodule with dark hemorrhagic crust on the left forehead for 3 months. He had had an abrasion wound on the lesion site of the forehead by an accidental trauma 5 month before the lesion appeared. Histopathological findings revealed that the tumor mass was chiefly composed of solid sheets of poorly differentiated malignant cells with an epithelioid feature. The characteristics of classical angiosarcoma such as primitive vascular spaces and clefts with malignat cells, and proliferating vessels were also found in some areas. The immunohistochemical stain wi.h the factor VIII related antigen ivas focally reactive in the tumor cells. Unfortunately he refused further treatment and expired 7 months after discharge at home without knowing the direct cause of his health. We report herein an interesting and rare case of the cutaneous epitheioid angiosarcoma which had typical clinical and histopathological findings and suggested as a case with a very aggressive course.
Forehead ; Hemangioma ; Hemangiosarcoma* ; Humans ; Middle Aged ; von Willebrand Factor ; Wounds and Injuries

PURPOSE: To evaluate CT findings of normal anatomic alteration after neck dissection. MATERIALS AND METHODS: The postoperative CT findings were retrospectively reviewed in 40 patients with neck dissection, comparing to preoperative CT. There were 28 patients with radical neck dissection and 12 patients with modified radical neck dissection or selective neck dissection. In addition to the neck dissection, 10 patients had undergone pectoralis major myocutaneous flap reconstruction, 20 patients taken laryngectomy, and 25 patients treated with radiotherapy. RESULTS: The typical CT findings of radical neck dissection were non-visualization of internal jugular vein and sternocleidomastoid muscle(28/28), ipsilateral neck flattening(26/28), and trapezius muscular atrophy(12/28). The other non-specific findings were tissue plane eftacement, subcutaneous reticular pattern, platysma muscle thickening, and adjacent soft tissue contrast enhancement which was the only evidence of previous operation in the cases of modified radical neck dissection or selective neck dissection. Reconstruction with myocutaneous flap was shown as ipsilateral bulk of fat and muscle(10/10). In cases with radiation therapy there was much increased density of submandibular gland(12/25). 15 patients showed recurrence on follow up CT scan, including regional metastasis in 10, stomal recurrence in two, and residual mass at primary site in three patients. CONCLUSION: CT is useful in evaluation of patients with neck dissection and in whom postoperative change impese diagnostic problem.
Follow-Up Studies ; Humans ; Jugular Veins ; Laryngectomy ; Myocutaneous Flap ; Neck Dissection* ; Neck* ; Neoplasm Metastasis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Superficial Back Muscles ; Tomography, X-Ray Computed

Pleural involvement in paragonimiasis is relatively common, either unilateral or bilateral, and may occur without pulmonary parenchymal infiltrates. Common radiologic findings of pleural paragonimiasis are pleural effusion, pneumothorax, hydropneumothorax, empyema and pleural thickening. However, pleural calcification as a manifestation of paragonimiasis is a rare condition. We report two cases of paragonimiasis manifested only as pleural calcifications which were confirmed pathologically.
Empyema ; Hydropneumothorax ; Paragonimiasis* ; Pleural Effusion ; Pneumothorax

No abstract available.
Rubinstein-Taybi Syndrome*

Congenital megacalyces is a congenital renal disease characterized by hypoplasia of the medulla and a non-obstructive dilatation of the calyces. More than 100 cases have been reported in the literature after first described by Puigvert in 1963, but it has been reported only three cases (two cases of adults and one case of child) in the literatures in Korea. The etiology of the congenital megacalyces is unknown. Renal pelvis and ureter are mostly normal in size and there is no urinary obstruction or reflux. Renal medulla of congenital megacalyces is thinner than that of normal kidney but renal cortex retains its normal thickness and function. This is features that help to distinguish megacalyces from obstructive atropy. The calyces are polygonal in shape and the majority of kidney with megacalyces have increased number of calyces. Since congenital megacalyces is a non-progressive lesion, it is important to recognize the clinical entity and avoid unnecessary surgery. We report one case of congenital megacalyces without urinary obstruction or reflux with a brief review of related literatures.
Adult ; Dilatation ; Humans ; Kidney ; Kidney Pelvis ; Korea ; Unnecessary Procedures ; Ureter

Tumoral form of pseudoangiomatous stromal hyperplasia (PASH) of male breast is a rare disease entity. We report on a case of PASH that presented as a palpable subareolar breast mass in a 46-year-old male who has been on hemodialysis due to chronic renal failure. To the best of our knowledge, no case of PASH in a male with chronic renal failure has yet been reported. We describe its mammographic and sonographic findings with correlative histopathologic features, confirmed by surgical excision.
Angiomatosis ; Breast ; Breast Diseases ; Humans ; Hyperplasia ; Kidney Failure, Chronic ; Male ; Rare Diseases ; Renal Dialysis

Background: Thioacetamide is a classic hepatotoxic reagent which leads to the reproducible hepatic fibrosis in rats. Thioacetamide-induced fibrosis is an appropriate model for cirrhosis in humans due to the long duration of course and similiar histology. Thioacetamide produces hepatotoxicity through lipid peroxidation but it is unclear whether lipid peroxidation directly correlated with hepatic fibrosis. Pentoxifylline, a derivative of the methylxanthine, showed an antifibrogenic effect in cell cultures of human fibroblasts and some animal models. But this antifibrogenic effect is controversial. Pentoxifylline revealed a hepatoprotective effect in some toxic hepatitis. This hepatoprotective effect seems to influence cell cycle regulatory protein during regeneration. This study aimed to evaluate an effect of pentoxifylline on fibrosis and cell cycle regulatory protein during liver regeneration in thioacetamide-induced rat cirrhosis. Lipid peroxidation assay was compared with collagen content so as to evaluate the correlation with fibrosis. METHOD: Liver cirrhosis was induced by 0.03% oral administration of thioacetamide. Pentoxifylline was administered simultaneously with thioacetamide. The semiquantitative fibrosis index was measured based on histologic finding. Collagen content was estimated by spectrophotometric assay. Activated hepatic stellate cells were counted using alpha-SMA immunohistochemistry. Malondialdehyde, lipid peroxidation metabolite, was estimated by thiobarbituric acid reactive substance assay. Cell cycle regulatory protein was evaluated by western blot. RESULTS: There was no difference in semiquantitative fibrosis index, collagen content and hepatic stellate cell count between thioacetamide treated rats and simultaneous pentoxifylline treated rats. Lipid peroxidation product was not correlated with collagen content. Western blot showed no difference in cell cycle regulatory protein. CONCLUSION: Pentoxifylline does not show an antifibrogenic effect in thioacetamide-induced rat cirrhosis, in which thioacetamide induced hepatocellular damage and fibrosis. Lipid peroxidation may be a secondary effect rather than primary mediating mechanism in hepatic fibrosis.
Administration, Oral ; Animals ; Blotting, Western ; Cell Culture Techniques ; Cell Cycle* ; Collagen ; Drug-Induced Liver Injury ; Fibroblasts ; Fibrosis* ; Hepatic Stellate Cells ; Humans ; Immunohistochemistry ; Lipid Peroxidation ; Liver Cirrhosis* ; Liver Regeneration ; Liver* ; Malondialdehyde ; Models, Animal ; Negotiating ; Pentoxifylline* ; Rats* ; Regeneration ; Thioacetamide

PURPOSE: Recently there have been some reports that percutaneous absces drainage(PAD) was ineffective in treating multiloculated liver abscess. We therefae, reviewed our results of catheter drainage in jultiloculated liver absces. MATERIALS AND METHODS: PADs in 10 cases of multiloculated liver abscesses were performed with 8.5F Pig tail, 12 & 14F Sump cahteters, under ultrasonic & fluoroscopic guidance. RESULTS: All the 10 cases were successfully drained without major complications. Mean drainage duration was 16.3 day and the result was not significantly different from those obtained by draining unilocular pyogenic liver abscess. The success was the result of using large caliber catheter and repetition in insertion of guidewire deeply into abscess cavity to make communications between the Iocules which was proven by abscessogram. CONCLUSION: PAD was safe and effective method for multiloculated abscess as unilocular liver abscess, and it is recommended that the multiloculated liver abscess be draincd.
Abscess* ; Catheters ; Drainage* ; Liver Abscess* ; Liver Abscess, Pyogenic ; Liver* ; Ultrasonics

This study was done to examine ER nurses' burn-out, as an understanding in the relationship of nursing performance and professional identity. The subjects of the study were nurses working in the emergency room of the general hospital with over 300 beds, located in D metropolitan city and C city. The self-report questionnaires were administered and 120 were collected. For the data analysis, SPSS WIN 12.0 was used. ER nurses' burn-out was 2.99, the mean of nursing performance was 3.69, and professional identity was 3.51. The extent of ER nurses' burn-out showed significantly negative correlation with the extent of nursing performance(r=-.257), along with professional identity(r=-.192). While ER nurses' nursing performance showed significantly positive correlation with professional identity(r=.696). In conclusion, the higher professional identity, the fewer ER nurses experienced burn-out, and the higher extent of nursing performance was obtained. It is necessary to create activities and programs to reduce and prevent burn-out.
Emergencies ; Hospitals, General ; Surveys and Questionnaires ; Statistics as Topic

PURPOSE: Hepatic atrophy has been recognized as a complication of hepatic and biliary disease but we have often found it in follow up CT after transcatheter arterial embolization {TACE). The purpose of this study is to evaluate the characteristics of hepatic atrophy after TACE. MATERIAL AND METHODS: Of 53 patients who had TACE, We evaluated the relationship between the incidence of hepatic atrophy and the number of TACE, and also evaluated the average number of TACE in patients with hepatic atrophy. Of 20 patients who had received more than average number of TACE for development of hepatic atrophy (2 times with portal vein obstruction, 2.7 times without portal vein obstruction in this study), we evaluated the relationship between the tipiodol uptake pattern of tumor and the incidence of hepatic atrophy. RESULTS: There were 8 cases of hepatic atrophy (3 with portal vein obstruction, 5 without portal vein obstruction), average number for development of hepatic atrophy were 2.5 times. As the number of TACE were increased, the incidence of hepatic atrophy were also increased. Of 20 patients who received more than average number of TACE for development of hepatic atrophy, we noted 6 cases of hepatic atrophy in 11 patients with dense homogenous lipiodol uptake pattern of tumor and noted only 1 case of hepatic atrophy in 9 patient with inhomogenous lipiodol uptake pattern. CONCLUSION: Hepatic atrophy was one of the CT findings after TACE even without portal vein obstruction. Average number of TACE was 2.5 times and risk factors for development of hepatic atrophy were portal vein obstruction, increased number of TACE, and dense homogenous lipiodol uptake pattern of tumor.
Atrophy* ; Ethiodized Oil ; Follow-Up Studies ; Humans ; Incidence ; Portal Vein ; Risk Factors