Polyvesicular vitelline tumor of the ovary is an extremely rare variant of yolk sac tumor. We present a case of pure polyvesicular vitelline tumor in a 43-year-old woman. Light microscopy revealed a predominantly polyvesicular pattern embedded in mesoblastic stroma with the cysts showing two type of lining; tall columnar and cuboidal, or mesothelioid cells. The lining atypical cells showed occasional mitoses and intracytoplasmic PAS positive hyaline globules. In some areas, the cystic space contained a large amount of intraluminal hyaline material. Immunohistochemically, alpha- fetoprotein and alpha-1-antitrypsin were detected as a fine granular deposit in the cytoplasm of epithelial cells and hyaline globules. Electron microscopically, marked specialization of the vesicular lining cells suggested a differentiation toward gut structures and mature yolk sac.
Adult ; Cytoplasm ; Endodermal Sinus Tumor ; Epithelial Cells ; Female ; Fetal Proteins ; Humans ; Hyalin ; Microscopy ; Mitosis ; Ovary* ; Vitellins* ; Yolk Sac

Polyvesicular vitelline tumor of the ovary is an extremely rare variant of yolk sac tumor. We present a case of pure polyvesicular vitelline tumor in a 43-year-old woman. Light microscopy revealed a predominantly polyvesicular pattern embedded in mesoblastic stroma with the cysts showing two type of lining; tall columnar and cuboidal, or mesothelioid cells. The lining atypical cells showed occasional mitoses and intracytoplasmic PAS positive hyaline globules. In some areas, the cystic space contained a large amount of intraluminal hyaline material. Immunohistochemically, alpha- fetoprotein and alpha-1-antitrypsin were detected as a fine granular deposit in the cytoplasm of epithelial cells and hyaline globules. Electron microscopically, marked specialization of the vesicular lining cells suggested a differentiation toward gut structures and mature yolk sac.
Adult ; Cytoplasm ; Endodermal Sinus Tumor ; Epithelial Cells ; Female ; Fetal Proteins ; Humans ; Hyalin ; Microscopy ; Mitosis ; Ovary* ; Vitellins* ; Yolk Sac

BACKGROUND: Epidermal cysts are the most common of all cysts. OBJECTIVE: The purpose of this paper is to report the clinical and histopathologic features of epidermal cysts. METHODS: We reviewed the clinical and histopathologic features of 205 cases that were diagnosed with epidermal cysts at the department of dermatology in Anam Hospital of Korea University for 11 years, from January 1983 to December 1993. RESULTS: 1. Of the 3,400 cases of skin biopsy specimens, 205 cases were epidermal cysts(6%). There were 141 male cases (68.8%) and 64 female cases (32.2%). The ratio of male to female was 1:0.45. 2. Most patients with epidermal cysts belonged to age ranging from 20 to 59 with the highest incidence in the 3rd decade. 3. The site of predilection of the epidermal cysts were face 94(45.9%), trunk 37(18.0%), neck 23(11.2%), leg 21(10.2%), arm 19(9.3%),scalp 7(3.4%), scrotum 2(1.0%), and vagina 2(1.0%). 4. Histopathologically, 61 cases (29.3%) were ruptured. The most common cystic wall change was acanthosis followed by atrophy, hyperplasia, hypergranulosis, parakeratotis, basalioma-like change, squamous eddies, dyskeratosis. The most common cystic content was keratinous material followed by parakeratotic cells, pigment, bacterial colony, RBC, inflammatory cells, hair shaft, calcification, trichilemmal keratinization, pilomatricoma-like change. The most common stromal change was giant cells followed by fibrosis, granulation tissue formation,vessel proliferation, pigment. CONCLUSION: According to our results, which agree with those of Chung, the epidermal cysts occur as a disease particular to young men, especially on the face. Histopathologically, when an epidermal cyst ruptures and the contents of the cyst are released into the dermis, a considerable foreign body reaction with numerous multinucleated giant cells results.
Arm ; Atrophy ; Biopsy ; Dermatology ; Dermis ; Epidermal Cyst* ; Female ; Fibrosis ; Foreign-Body Reaction ; Giant Cells ; Granulation Tissue ; Hair ; Humans ; Hyperplasia ; Incidence ; Korea ; Leg ; Male ; Neck ; Rupture ; Scrotum ; Skin ; Vagina

The result of clinical survey of seventy-five children with supracondylar fractures of the humerus is presented. Sixty-eight fractures had gross displacement, and seven were undisplaced ones. Seven children with undisplaced fractures were treated with simple splinting. Twenty-one fractures with gross displacement were closedly reduced and immobilized by cast. Twenty cases treated with over-head skin traction or skeletal traction, and followed by cast immobilization, and twenty-seven were operatively reduced and were fixed with 2 K-wires. The results obtained were as follows: 1. The average age of children was 6.8 years, and the male and female ratio was 2.1:l. 2. 97.1% (66 cases) was the extension type and 2.9% (2 cases) was the flexion type. 3. Good end results were obtained in the well-reduced groups, such as undisplaced fractures and surgically reduced fractures. Of 27 operated cases, 19 who had early operation without manipulative trial or traction, had excellent results, while 8 who had surgery in delay developed limitation of flexion and/or extension motion of the elbow. Of these 19, two cases developed mild extension limitation as sequella. 4. As complications, incomplete ulnar nerve palsy developed in one case, but it spontaneously recovered in 3 weeks after open reduction. During treatment utilizing the olecranon pin traction, pin tract infection developed in 2 cases, but the infection was controlled by the antibiotic administration and wound dressing. Severe cubitus varus deformity developed in 4 cases among the conservatively treated group (manipulatively reduced group and skeletal traction group). These 4 children had corrective osteotomy. Mild deformity was the inevitable one when it is treated conservatively. Limitation of elbow motion developed in 23 cases (32%) as a sequella. 5. Fracture healed mostly in three weeks after reduction and immobilization. Average hospital stay for conservatively treated patients was 17.2 days, whereas that for surgically treated patients was 5.8 days in average. 6. Early anatomical reduction by any means whether it is surgical or nonsurgical, proved to be only the methods which bring the satisfactory results, and minimize the sequellae.
Bandages ; Child ; Congenital Abnormalities ; Elbow ; Female ; Humans ; Humerus ; Immobilization ; Length of Stay ; Male ; Olecranon Process ; Osteotomy ; Skin ; Splints ; Traction ; Ulnar Neuropathies ; Wounds and Injuries

Most cases of spondylolisthesis are asymptomatic and successfully managed with conservative treatment. Operation was performed in 20% of symptomatic cases having severe back pain, neurological symptoms and or progressive slipping. Although surgical treatments are divided into decompression and fusion, various methods were tried frorn simple Gill's resection to posterior and/or anterior fusion with instrumentation in case of severe slipping. The authors reviewed 49 cases of symptomatic spondylolisthesis, who were surgically treated, and well followed up at Kang-Nam St. Mary's Hospital during past 6 years from January, 1981, to June, 1987. l. Among 49 cases, 23 were isthmic type and 26 were degenerative in nature, and 40 were females. 24 patients(92.3%) of degenerative type were female over 4th decade. Mean age was 47.9 years. 2. The most common site of involvement was L4–5 intervertebral space(25 cases,; 51.0%). 17 cases(73.9%) of isthmic thpe were involved in L5-Sl intervertebral space, and 21 cases (80.8%) of degenerative type were involved L4–L5 intervertebral space. 3. The symptoms were low back pain, intermittent claudication and sciatica in order of incidence. 4. The average slipping measured by Taillard method was 19.5%, and Meyerding's grade I slipping(69.3%) was the highest in the percentile incidence. The average degree of slipping in isthmic type(23.6%) was greater than that of degenerative type(16.4%). 5. Myelogram mainly showed complete or near complete block in degenerative type and ventral indentation in isthmic type. C–T myelogram showed mainly central stenosis in degenerative type, and nerve root compression in isthmic type. 6. In 9 cases,anterior fusions were done ; 5 degenerative and 4 isthmic. In 37 cases, decompression and posteriolateral fusions were done with or without instrumentation ; instrumented in 11 cases. 7. Clinically, the results were judged as excellent in 16 cases(32.7%), good in 26 cases(53.1 %), fair in 6 cases(12.2%), poor in 1 case(2.1%). Thus, 42 cases(85.8%) were considered satisfactory. The satisfactory results were obtained in 77.8% of anterior interbody fusion cases, 88 5% of posterolateral fusion cases, 90.7% of decompression and posterolateral fusion with instrumentation cases. There was no appreciable difference in clinical results between isthmic and degenerative types. 8. There were no changes in slipping in 35 cases(71.5%), Partial reduction were possible in 13 cases(28.5%), and further splipping developed in a patient who had decompression surgery alone. Among 46 cases of vertebral fusion, complete fusion was obtained in 43 cases(93.5%) within one year. 9. Solid anterior spondylodesis was obtained in all the cases of degenerative type, while in 2 cases(50%) of the isthmic type, graft crumbled with redisplacement and delayed fusion. Through the results, it is concluded that posterior instrumentation may not be essential for the successful spondylodesis in cases of posterolateral fusion, since there was no statistical significance in the results between the instrumented and non-instrumented, and isthmic type and degenerative type, and that anterior interbody fusion is best indicated for the treatrment of the degenerative type and not for the isthmic type. Therefore, if anterior interbody fusion is chosen for the successful treatment of isthmic type, a certain type of internal fixator should be combined.
Back Pain ; Clinical Study ; Constriction, Pathologic ; Decompression ; Female ; Humans ; Incidence ; Intermittent Claudication ; Internal Fixators ; Low Back Pain ; Methods ; Radiculopathy ; Sciatica ; Spinal Fusion ; Spondylolisthesis ; Transplants

A case of hereditary papulotranslucent acrokeratoderma, a variant of familiaI punctate keratoderma, is presented. A 20-year-old female patient had a five-year history of persistent, asymptomatic, yellowish-white translucent papules and plaques on the thenar and hypothenar eminences and knuckles of both hands, and on the dorsa of proximal interphalangeal joints of both feet. She also had a vitiligo lesion on the left side of the face of 1.5 years duration. Her elder brother also had similar papular skin lesions on both hands and feet. Histologic section of a papule from the right thenar eminence showed marked hyperkeratosis, hypergranulosis, and acanthosis of the epidermis.
Female ; Humans

No abstract available.
Skull Base* ; Skull*

The instability of the degenerative spondylolisthetic lumbar spine was clinically evaluated by patients symptoms and serial radiograms. With X-ray films of patients lumbar spine, the lumbosacral angle, the sacral angle, the vertebral height difference between anterior and posterior surface of the 5th lumbar vertebra and the level of intercristal line were analysed. And the results of treatment were analysed too. The Results were as follows: 1) In degenerative spondylolisthetic L3 and L4 spines, facets were arranged in sagittal plane and sacrum was vertically arranged, but in L5 facets were coronally arranged and sacrum and in horizontal plane. 2) The lumbosacral angle was 149.9 and the average difference between anterior and posterior height of L5 vertebral body was 3mm. These results revealed that sacrum was more vertical and the 5th vertebral body was more rectangular, so lumbar lordosis was decreased as a whole. 3) The intercristal line was passed at IA or L4–5 interspace in 72.1% of cases(normal:95.8%), so L4 vertebra was placed in higher level. 4) In group A posterolateral fusion was done in 2 cases. Among group B and C, operation was done in 9 cases;4 cases with laminectomy and 5 cases with laminectomy and posterolateral fusion. Two years after surgery, slipping and instability were far advanced in 2 laminectomized cases for whom posterolateral fusion was followed later. 5) Unstable group of degenerative spondylolisthesis with severe neurological symptoms and claudication must be treated by decompressive laminectomy and posterolateral fusion, especially in patients under 60 years of age. 6) Young woman having flattened lumbar curve without slipping, narrowed disc space of L4–5, high-seated L4 and vertical sacrum is thought to be in prespondylolisthetic stage of degenerative origin; therefore, intensive back muscle exercise to prevent the slipping should be performed and periodic X-ray examinations should be followed up to detect the progress of the disease.
Animals ; Back Muscles ; Female ; Humans ; Laminectomy ; Lordosis ; Sacrum ; Spine ; Spondylolisthesis ; X-Ray Film

Pelvic fistulas may result from obstetric complications, inflammatory bowel disease, pelvic malignancy, pelvic radiation therapy, pelvic surgery, or other traumatic causes, and their symptoms may be distressing. In our experience, various types of pelvic fistulas are identified after pelvic disease or pelvic surgery. Because of its close proximity, the majority of such fistulas occur in the pelvic cavity and include the vesicovaginal, vesicouterine, vesicoenteric, ureterovaginal, ureteroenteric and enterovaginal type. The purpose of this article is to illustrate the spectrum of imaging features of pelvic fistulas.
Bladder Fistula/diagnosis/etiology ; Female ; Fistula/*diagnosis/*etiology ; Human ; Intestinal Fistula/diagnosis/etiology ; *Pelvis ; Ureteral Diseases/diagnosis/etiology ; Urinary Fistula/diagnosis/etiology ; Uterine Diseases/diagnosis/etiology ; Vaginal Fistula/diagnosis/etiology

Choledochal cyst is a relatively rare disease entity considered to be a congenital cyatic dilatation of the common bile duct. Since occurrence of malignant tumor in choledochal cyet was first reported by Irwin and Morrison in 1944, approximately 100 more cases of malignant tumors arising in congenital choledocal cyst have been reported in the world, and the risk of malignant tumor related to choledochal cyst have been reported 2.4-14%. Recently, we experienced a case of adenocarcinoma arising in choledochal cyst in 39 year-old woman who was diagnosed by ERCP and cholangioscopy with forceps biopsy, and was treated with en bloc resection of the choledochal cyst along with the pancreatic head and duodenum.
Adenocarcinoma ; Adult ; Bile Duct Neoplasms ; Biopsy ; Cholangiocarcinoma* ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst ; Common Bile Duct ; Dilatation ; Duodenum ; Female ; Head ; Humans ; Rare Diseases ; Surgical Instruments