No abstract available.
Cesarean Section* ; Female ; Myotonic Dystrophy* ; Pregnancy

Small round cell tumors (SRCTs) are a heterogeneous group of neoplasms composed of small, primitive, and undifferentiated cells sharing similar histology under light microscopy. SRCTs include Ewing sarcoma/peripheral neuroectodermal tumor family tumors, neuroblastoma, desmoplastic SRCT, rhabdomyosarcoma, poorly differentiated round cell synovial sarcoma, mesenchymal chondrosarcoma, small cell osteosarcoma, small cell malignant peripheral nerve sheath tumor, and small cell schwannoma. Non-Hodgkin\'s malignant lymphoma, myeloid sarcoma, malignant melanoma, and gastrointestinal stromal tumor may also present as SRCT. The current shift towards immunohistochemistry and cytogenetic molecular techniques for SRCT may be inappropriate because of antigenic overlapping or inconclusive molecular results due to the lack of differentiation of primitive cells and unavailable genetic service or limited moleculocytogenetic experience. Although usage has declined, electron microscopy (EM) remains very useful and shows salient features for the diagnosis of SRCTs. Although EM is not always required, it provides reliability and validity in the diagnosis of SRCT. Here, the ultrastructural characteristics of SRCTs are reviewed and we suggest that EM would be utilized as one of the reliable modalities for the diagnosis of undifferentiated and poorly differentiated SRCTs.
Chondrosarcoma, Mesenchymal ; Cytogenetics ; Diagnosis ; Gastrointestinal Stromal Tumors ; Genetic Services ; Humans ; Immunohistochemistry ; Lymphoma ; Melanoma ; Microscopy ; Microscopy, Electron ; Microscopy, Electron, Transmission* ; Neurilemmoma ; Neuroblastoma ; Neuroectodermal Tumors ; Osteosarcoma ; Pathology ; Peripheral Nerves ; Reproducibility of Results ; Rhabdomyosarcoma ; Sarcoma, Myeloid ; Sarcoma, Synovial

A 44-year-old man was cutting an outer plate of a ship, at a depth of 25 m below sea level. Following a sudden explosion, he was discovered unconscious and was carried to the surface by other divers. There was no evidence of vital signs upon arrival at the hospital. Postmortem computed tomography, which was performed prior to autopsy, revealed massive pneumocephalus in the brain, pneumohemothorax, diffuse lung contusions with multiple traumatic lung cysts, air-fluid level in the cardiac chamber of the chest, and pneumoperitoneum in the abdomen. Postmortem external examination showed a circular abrasion on the jaw, diffuse subcutaneous emphysema, and contusion in the right upper arm. An internal examination revealed intravascular air bubbles in all four chambers of the heart, and diffuse pulmonary trauma including contusion, laceration, and multiple traumatic cysts. Blast injury to the chest, and air embolism due to the underwater explosion were established as the underlying cause of death.
Abdomen ; Adult ; Arm ; Autopsy ; Blast Injuries ; Brain ; Cause of Death ; Contusions ; Diving ; Embolism, Air ; Explosions* ; Heart ; Humans ; Jaw ; Lacerations ; Lung ; Pneumocephalus ; Pneumoperitoneum ; Ships ; Subcutaneous Emphysema ; Thorax ; Vital Signs

PURPOSE: To evaluate the effects of bilateral inferior oblique transposition (BIOT) on horizontal deviation from primary position among patients with bilateral dissociated vertical deviation (DVD) associated with inferior oblique overaction (IOOA) in infantile strabismus. METHODS: Retrospective chart review was conducted among 19 patients with infantile strabismus. All patients had DVD and IOOA with consecutive or recurrent horizontal deviation and underwent modified BIOT surgery. Patients were divided into three subgroups: patients who underwent BIOT (BIOT group, n = 9) alone, BIOT with medial rectus recession or lateral rectus resection simultaneously (ET BIOT group, n = 6), or BIOT with lateral rectus recession or medial rectus resection simultaneously (XT BIOT group, n = 4). Postoperative angle of horizontal deviation (prism diopter, PD) and corrected magnitude of horizontal deviation (PD) at final visit after surgery were analyzed in each group. RESULTS: The mean age was 55.11 ± 21.05 months (range, 32 to 115). The mean follow-up period was 8.68 ± 2.87 months (range, 6 to 18). Preoperative horizontal deviation was 4.23 ± 5.99 PD (range, 0 to 16) in BIOT, −17.33 ± 6.76 PD (range, −30 to −10) in ET BIOT, and 17.50 ± 2.52 PD (range, 14 to 20) in XT BIOT. Esodeviation is represented by negative values. DVD and IOOA were reduced less than +1 in all patients. The corrected amount of horizontal deviation was 3.56 ± 5.18 PD (range, 0 to 16) in BIOT surgery alone and larger in XT BIOT (18.50 ± 3.41 PD) than in ET BIOT (12.33 ± 5.57 PD, p = 0.004). CONCLUSIONS: Minimal exodeviation was corrected by BIOT alone. In addition, secondary eso- or exodeviation at great magnitudes should be corrected with proper horizontal muscle surgery along with BIOT.
Esotropia ; Exotropia ; Follow-Up Studies ; Humans ; Retrospective Studies ; Strabismus*

Myoepithelioma is a rare benign tumor of salivary gland myoepithelial cells, most commonly as a spindle subtype. Here, we present two cases of fine needle aspiration cytology of plasmacytoid myoepithelioma arising from a parotid gland and a hard palate. Aspirates showed plasmacytoid cells with pink-staining, homogeneous, abundant eosinophilic cytoplasm eccentrically displacing the nucleus in cohesive and dissociated forms. Rarely, nuclear grooves and intranuclear cytoplasmic inclusions were evident. These unfamiliar cytologic findings of uncommon myoepithelioma often cause diagnostic difficulties in preoperative aspiration cytology. Recognition of those rare findings provides a reliable diagnostic clue.
Biopsy, Fine-Needle ; Cytoplasm ; Eosinophils ; Inclusion Bodies ; Myoepithelioma ; Palate, Hard ; Parotid Gland ; Salivary Gland Neoplasms ; Salivary Glands

This study was performed to evaluate the effect of hydrogen peroxide-producing Lactobacillus acidophilus V-2Oonthe replication of periodontal pathogens, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. When A. actinomycetemcomitam and P. gingivalis were incubated alone and in the combination with L. acidophilus V-20, the viable cell numbers of A. actinomycetemcomitans and P. gingivalis were compared between those cultures. The effect of S. mutans, E. durans, and L. lactis on the replication of A. actinomycetemcomitans and P. gingivalis was also evaluated. The change of periodontal indexes(probine depth, gingival index, GCF volume) and the viable cell numbers of A. actinomycetemcomitans and black pigmented bdcteroides in subgingival plaque sample were evaluated following gargling of fermented milk made from L. acidophilus V-20 for 1 month on patients with periodontal disease in maintenance phase. In the mixed culture of L. acidophilus V-20 and A. actinomycetemcomitans or P. gingivalis, the replication of A. adinomycetemcomitam or P. gingivalis was completely inhibited. But in the mixed culture of P. gingivalis and hydrogen peroxide-nonproducing Lactobacillus casei, the viable cell numbers of P. gingivalis was not decreased when compared with the numbers in the mixed culture of P. gingivalis and L. acidophilus V-20. In the mixed culture of A. actinomycetemcomitam and S. mutans, E. durans, or L. lactis, the viable cell number of A. adinomycetemcomitans was not almost changed when compared with the numbers in the culture of A. actinomycetemcomitans alone. And in the mixed culture of P. gingivalis and E. durans or L. lactis, the viable cell numbers of P. gingivalis was not almost changed compared with the counts in the culture of P. gingivalis alone. But the replication of P. gingivalis was completely inhibited in the mixed culture of P. gingivalis and S. mutans. When the change of periodontal indexes following gargling of fermented milk was compared with baseline, probing depth and gingival index were not changed, but GCF volume was significantly dcreased(p (0.05). And when the viable cell numbers of microorganisms in subgingival plaque sample were compared with baseline, total viable cell number was almost unchanged and the viable cell numbers of A. actinomycetemcomitans and black pigmented bdcteroides were significantly decreased(p<0.05). These results suggest that L. acidophilus V-20 inhibit the replication of A. actinomycetemcomitans and black pigmented bacteroides by the formation of hydrogen peroxide.
Aggregatibacter actinomycetemcomitans ; Bacteria* ; Bacteroides ; Cell Count ; Gingival Crevicular Fluid ; Humans ; Hydrogen ; Hydrogen Peroxide ; Lactic Acid* ; Lactobacillus acidophilus ; Lactobacillus casei ; Milk ; Periodontal Diseases ; Periodontal Index ; Porphyromonas gingivalis

The ultimate goal of periodontal therapy is to promote the regeneration of lost periodontal tissue, there have been many attempts to develop a method to achieve this goal, but none of them was completely successful. The purpose of this study is to evaluate the effects of Bio-Oss(R) on alkaline Phosphatase (ALP) activity in human fetal osteoblasts (hFOB1). The results of this study were as follows, in ALP Activity, 100 microgram/ml Bio-Oss(R) treated group showed significantly increased value than negative control group, but positive group(10(-7) M dexamethasone treated group) showed the highest ALP activity at 3 day. In mineralization assay, numerous mineralized nodules were identified as darkly stained spots in 100 microgram/ml Bio-Oss(R) treated group than two control groups, whereas a small number of mineralized nodules were showed in the positive control. ALP may relate to the initial phase of bone nodule formation. On the basis of these results, this study showed Bio-Oss(R) is capable of accelerating new bone formation through hFOB1 differentiation in vitro.
Alkaline Phosphatase ; Calcification, Physiologic* ; Dexamethasone ; Humans* ; Osteoblasts* ; Osteogenesis ; Regeneration

Congenital adrenal hyperplasia (CAH) during pregnancy is a rare condition. Only a few cases have been reported in the literature. CAH patients has lower pregnancy rate compared to normal women. A 27-year-old nulliparous woman, a diagnosed case of 21-hydroxylase deficient simple virilising form of classic CAH visited. She got pregnant spontaneously without any trial of assisted reproductive technology. At the age of 12, she underwent clitoral resection and vaginoplasty. She took dexamethasone or prednisolone after operation. She delivered healthy singleton female baby by cesarean section. Four years later, she delivered healthy singleton female baby by repeat cesarean section. Two female babies have shown normal external genitalia. Here, we report a case of successful pregnancy and delivery in a patient with CAH.
Adrenal Hyperplasia, Congenital* ; Adult ; Cesarean Section ; Cesarean Section, Repeat ; Dexamethasone ; Female ; Fertility ; Genitalia ; Humans ; Prednisolone ; Pregnancy Rate ; Pregnancy* ; Reproductive Techniques, Assisted ; Steroid 21-Hydroxylase

Candidemia is increasing cause of mortality, especially in intensive care unit patients. And Candida endophthalmitis, developed with or without symptoms, has poor outcome. Prompt use of antifungal agents and early diagnosis of Candida endophthalmitis are clinically important to treat candidemia. In this study, we compared clinical, microbiological, ophthalmological characteristics and treatment outcomes whether infectious disease (ID) specialists mediate candidemia or not in a tertiary hospital by retrospective chart review. Group A includes patients who had candidemia at least one time from January 2012 to July 2013, without ID specialists mediation. Group B includes patients who had candidemia at least one time from August 2013 to December 2014, with ID specialists surveillances and mediations. We compared clinical manifestations of candidemia, uses of antifungal agent, ophthalmologic evaluations and treatment outcomes between two groups. In group A, rate of ophthalmologic evaluations was 4.4% and mean duration was 64.60 hours from blood culture to use of antifungal agents. In group B, the rate of ophthalmologic evaluations was 43.2% and mean duration was 50.15 hours. There was no statistically significant difference in clinical characteristics and 30-day mortality between two groups. Increasing rate of ophthalmologic evaluations and decreasing mean duration from blood culture to use of antifungal agents was shown in surveillance and mediation group.
Antifungal Agents* ; Candida ; Candidemia* ; Communicable Diseases ; Early Diagnosis ; Endophthalmitis ; Humans ; Intensive Care Units ; Mortality ; Negotiating ; Retrospective Studies ; Specialization ; Tertiary Care Centers

Acquired ileal atresia is a rare but life-threatening complication that can occur after recovery from necrotizing enterocolitis in premature infants. We present an unusual case of acquired ileal atresia in the distal ileum injured by ischemia after intestinal perforation in an extremely low-birth-weight infant. A 900 g (25 weeks gestation) premature infant developed a pneumoperitoneum without the radiologic manifestations of necrotizing enterocolitis on day 9 of life. Primary peritoneal drainage without further need for surgery was performed in the neonatal intensive care facility. Gastrointestinal gastrografin studies confirmed normal intestinal continuity and regular stools. Several weeks later, while the patient was receiving all nutrition orally with no medical problems, the patient's condition suddenly deteriorated, along with clinical signs of intestinal obstruction including emesis of bilious contents and stools. Laparotomy (on day 45 of life) revealed ileal atresia with V-shaped gap mesenteric defect.
Diatrizoate Meglumine ; Drainage ; Enterocolitis, Necrotizing ; Humans ; Ileum ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Intestinal Obstruction ; Intestinal Perforation ; Ischemia ; Laparotomy ; Pneumoperitoneum ; Vomiting