Liposarcoma is the second most common soft tissue sarcoma next to malignant fibrous histiocytoma and occurs almost exclusively in adults. It is thought to originate from primitive mesenchymal cells rather than from mature adipose tissue. Most liposarcomas usually occur in the deep soft tissue of the extremities and the retroperitoneum, and rarely occur in the cutaneous or subcutaneous tissue. We report a case of an atypical lipomatous tumor in a 63-year-old male, who presented with an asymptomatic, subcutaneous mass on his right axilla.
Adipose Tissue ; Adult ; Axilla ; Extremities ; Histiocytoma, Malignant Fibrous ; Humans ; Liposarcoma ; Male ; Middle Aged ; Sarcoma ; Subcutaneous Tissue

Fibroelastolytic papulosis is proposed as the diagnostic term for cases previously identified as pseudoxanthoma elasticum-like papillary dermal elastolysis and white fibrous papulosis of the neck. Clinical presentation of fibroelastolytic papulosis is asymptomatic to mildly pruritic whitish-yellow papules that may coalesce into cobblestone- patterned plaques resembling pseudoxanthoma elasticum. Histology is characterized by normal, decreased, or absent elastic fibers in the papillary dermis sometimes accompanied by a thickening of collagen fibers. We report a 60-year-old woman with flesh to yellowish colored papules with cobblestone appearance, which were histologically consistent with fibroelastolytic papulosis.
Collagen ; Dermis ; Elastic Tissue ; Female ; Humans ; Middle Aged ; Neck ; Pseudoxanthoma Elasticum

The liver is a distinctly unusual locus for a primary leiomyosarcoma. In October 1994, a 64-year-old female patient was admitted with palpable mass at the right upper abdomen for 2 months. Ultrasonography and Computed Tomography revealed a big cystic nature tumor at the right lobe of the liver. A right lobectomy was undertaken. On gross examination of the specimen, the tumor size was measured a 7.5 cm 16.0 cm 4.5 cm. On a cut section, cystic degeneration was showed and the color of the solid component was grayish. Microscopic examination growth pattern of the tumor to be expansive with no capsule. Finally the leiomyosarcoma of the liver was diagnosed with 5 to 6 mitosis per 10 high power fields. In September 1995, follow-up Computed Tomography revealed a recurred mass on segment 4 of the liver. A tumonectomy was performed. Twenty-one months after the second operation, recurrence was noted on the remaining liver and intraabdomen. Debulking surgery of the intraabdominal mass with intraperitoneal chemotherapy was undertaken. We report this case of primary hepatic leiomyosarcoma with a review of the literatures.
Abdomen ; Drug Therapy ; Female ; Follow-Up Studies ; Hepatectomy ; Humans ; Leiomyosarcoma* ; Liver ; Middle Aged ; Mitosis ; Recurrence ; Ultrasonography

Many drugs have been known to induce lupus-like syndrome, composing approximately 10% of all SLE cases. Isoniazid-induced lupus erythematosus affects either sex equally and the most common presenting feature is arthralgia or arthritis with anemia. Fever and pleuritis occur in approximately half of the cases, and pericarditis in approximately 30% of cases. We discribe a 28-year-old woman receiving antituberculous medications including isoniazid for one month. She was hospitalized with fever, arthralgia and newly developed pleural effusion The analysis of pleural fluid and serum revealed an elevated level of antinuclear antibody. We suspected of drug induced lupus and stopped isoniazid medication. After discontinuation of isoniazid and short course of prednisolone treatment, her symptoms and pleural effusion disappeared. This case is to our knowledge, the fist report of isoniazid induced SLE in Korea.
Adult ; Anemia ; Antibodies, Antinuclear ; Arthralgia ; Arthritis ; Female ; Fever ; Humans ; Isoniazid* ; Korea ; Lupus Erythematosus, Systemic* ; Pericarditis ; Pleural Effusion ; Pleurisy ; Prednisolone

PURPOSE: To evaluate the cause and treatment results of nonunion of humerus shaft fractures. MATERIALS AND METHODS: 39 cases were treated for humerus shaft nonunion between February 1990 and May 2002. The presence of open wounds, initial treatment modality after injury, treatment method for the nonunion and time to union were studied using medical records. The fracture type and appropriateness and problems of the initial surgical treatment were reviewed. Also, Pain and functional recovery in daily living were evaluated in the outpatient clinic, after surgery for nonunion. RESULTS: Amongst the 30 cases, transverse fracture was the most common with 19cases. Most of 29 cases, initially surgically treated, revealed incorrect selection of the internal fixator or technical errors. For surgical treatment of nonunion, open reduction and internal fixation with cancellous bone graft was performed, most commonly, in 36 cases (92.3%). All cases showed clinical and radiographic union at an average of 13.3 weeks. More than 90% of the patients replied minimal pain and excellent functional recovery of daily living at final follow-up. CONCLUSION: If treated with surgery by correct selection of internal fixation methods and accurate technical skills, nonunion incidence can be reduced.
Ambulatory Care Facilities ; Follow-Up Studies ; Humans ; Humerus* ; Incidence ; Internal Fixators ; Medical Records ; Transplants ; Wounds and Injuries

PURPOSE: To introduce the surgical technique of acute acromioclavicular joint dislocation using a Wolter plate and to evaluate its efficacy after surgical treatment. MATERIALS AND METHODS: Twenty-six patients who underwent surgical treatment of the acute acromioclavicular joint dislocation using a Wolter plate and who were followed up minimally for one year were reviewed. We analyzed the clinical results of pain, function, range of motion and radiologic reduction state of the acromioclavicular joint. RESULTS: All cases showed satisfactory results. By clinical evaluation, twelve cases (46%) were excellent and fourteen cases (54%) were good. By radiologic evaluation, twenty cases (77%) were excellent and six cases (23%) were good. By postoperative X-ray, vertical displacement of the clavicle was restored in all cases. No complications such as infection, loosening of screws, plate failure or redislocation after removal of the plate occurred. CONCLUSION: Acromioclavicular joint reconstruction using a Wolter plate is believed to be a useful method, which minimizes injury of the joint articular surface and provides enough stability for postoperative rehabilitation.
Acromioclavicular Joint* ; Clavicle ; Dislocations* ; Humans ; Joints ; Range of Motion, Articular ; Rehabilitation

The 55 years old male patient, undergoing maintenance hemodialysis, was admitted on our department because of painful swelling on left knee joint. At 19th hospital day, he complained of severe dyspnea. He had a large amount of pleural effusion of the left chest that was shown to be hemothorax by thoracentesis. After closed thoracostomy, about amount of 3,000 mL of blood was drained and bleeding was sustained from pleural cavity, and then emergency thoracotomy was done. We cannot find any bleeding focus in thoracic cavity, but oozing blood was seen on entire inner thoracic cavity. He had no previous invasive procedure or history of trauma before 6 months. We think that hemothorax may be developed because of defected coagulopathy and increased bleeding tendency due to platelet dysfunction in renal failure patient. Immediately thoracotomy and cryoprecipitate were helpful for this patient. We report a rare case of spontaneous hemothorax in a maintenance hemodialysis patient with literature review.
Blood Platelets ; Dyspnea ; Emergencies ; Hemorrhage ; Hemothorax* ; Humans ; Knee Joint ; Male ; Middle Aged ; Pleural Cavity ; Pleural Effusion ; Renal Dialysis* ; Renal Insufficiency ; Thoracic Cavity ; Thoracostomy ; Thoracotomy ; Thorax

Right sided aortic arch is an uncommon congenital anomaly. It can be classified into three types, depending on the left aortic arch's degenerating pattern and the branching pattern of the great vessels. It can be associated with major congenital heart disease, depending on the type of right sided aortic arch. We report a case of an 18-years-old female who has right sided aortic arch with atrial septal defect (ASD). In our case, the patient had a right sided aortic arch and aberrant left subclavian artery, also she had ASD (ostium secundum) and moderate tricuspid regurgitation with pulmonary hypertension. The patient was successfully performed patch closure of ASD and tricuspid valve annuloplasty via midline sternotomy. The patient had uneventful postoperative course.
Aneurysm ; Aorta, Thoracic ; Cardiovascular Abnormalities ; Deglutition Disorders ; Female ; Heart Diseases ; Heart Septal Defects, Atrial ; Humans ; Hypertension, Pulmonary ; Sternotomy ; Subclavian Artery ; Tricuspid Valve ; Tricuspid Valve Insufficiency

Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in the neonatal population. The aim of this study is to evaluate surgical indication and prognostic factors of NEC. Clinical data of seventy patients, diagnosed as NEC between January 2000 & January 2007, were reviewed retrospectively. Fifty-seven patients had medical treatment and 7 of them died. Thirteen patients who presented with pneumoperitoneum on plain abdominal film or were refractory to medical treatment received surgical treatment, and 5 of them died. All the expired 12 patients weighed less than 2500g. Twenty out of seventy patients showed thrombocytopenia, and 11 patients of them died. The finding of pneumoperitoneum and thrombocytopenia could be the most important surgical indication. Prematurity, low birth weight and thrombocytopenia were related to a bad prognosis. NEC patients who presents with these findings must be considered for close observation and intensive care.
Emergencies ; Enterocolitis, Necrotizing ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Pneumoperitoneum ; Prognosis ; Retrospective Studies ; Thrombocytopenia