Benign triton tumors (BTT) are very rare lesions composed of mature skeletal muscle and neural tissue. We report a case of a 14-year-old boy who presented with asymptomatic swelling of the chin over an 18-month duration which increased gradually to involve the left side of the lower lip. Clinically, a diagnosis of neurofibroma was made. Excisional biopsy confirmed the diagnosis of a BTT. Having an affinity for large nerve trunks like the brachial and sciatic, these tumors rarely occur in the head and neck region. When they do, they may involve the large central cranial nerve trunk and present as intracranial masses or involve the smaller peripheral nerve twigs and present as asymptomatic skin nodules, of which only four cases involving peripheral nerves are reported in the English literature. Here, we report the fifth documented case of a BTT involving the mental branch of the trigeminal nerve. A brief review of the literature is also provided.
Biopsy ; Chin ; Cranial Nerves ; Head ; Lip ; Muscle, Skeletal ; Neck ; Neptune ; Neurofibroma ; Peripheral Nerves ; Skin ; Trigeminal Nerve

Subcutaneous form of neuromuscular hamartoma is extremely rare and histologically different from the conventional neuromuscular hamartoma of the peripheral nerve or benign Triton tumor by an indistinct nodular growth with ill-defined margin and marked collagen interposition. It is usually not associated with a major nerve. We report a case of subcutaneous neuromuscular hamartoma developed in the forehead of 24-year-old man. The tumor showed proliferation of dense, hyalinized fibrous tissue, in which single or group of mature skeletal muscle fibers and nerve fibers were haphazardly intermixed. Recognition of abnormally arranged muscle and nerve fibers is important not to miss this lesion.
Collagen ; Forehead ; Hamartoma* ; Humans ; Hyalin ; Muscle Fibers, Skeletal ; Neptune ; Nerve Fibers ; Peripheral Nerves ; Skin ; Young Adult

Malignant triton tumor is a rare and usually aggressive sarcoma consisting of a malignant schwannoma with rhabdomyoblastic differentiation. Although this tumor is usually found at the extremities, 20% of cases are located in the head and neck region. This unusual tumor has not yet been described in the Korean Journal of Otolaryngology-Head and Neck Surgery. Malignant triton tumor is histologically high-grade, with large numbers of mitoses, prominent necrosis, and cellular pleomorphism. The clinical course for malignant triton tumor is usually one of rapid growth, early metastasis, and poor outcome in spite of therapy. Recently we experienced a case of malignant triton tumor, which involved the nasal cavity, maxillary and ethmoid sinus. The malignant tumor was treated with wide surgical excision followed by radiation therapy.
Ethmoid Sinus ; Extremities ; Head ; Mitosis ; Nasal Cavity* ; Neck ; Necrosis ; Neoplasm Metastasis ; Neptune* ; Neurilemmoma ; Sarcoma

OBJECTIVE: To evaluate if there is a difference in gait pattern when applying two different shapes of energy storing prosthetic feet for trainstibial amputation we conducted a comparative study. Energy storing prosthetic feet for transtibial amputation are increasing in use, but there are few studies that evaluate the effects of the shape of energy storing feet on gait patterns. METHODS: Ten unilateral transtibial amputees were recruited. Two different shapes of dynamic response feet were applied to each subject either 1C30 Trias or 1C60 Triton. The main differences between the two are a split forefoot and the presence of a heel wedge. Spatiotemporal, kinematic, and kinetic data was obtained through gait analysis. Differences between intact and prosthetic side and differences between the two prosthetics were assessed. RESULTS: On a side to side comparison, cadence asymmetry with 1C30 Trias was observed. Ankle plantarflexion at the end of stance and ankle supination at the onset of preswing was smaller with both prosthetic feet compared to the intact side. Other spatiotemporal, kinematic, and kinetic data showed no significant differences in a side to side comparison. In a comparison between the two prosthetics, stance and swing ratio and ankle dorsiflexion through mid-stance was closer to normal with 1C60 Triton than 1C30 Trias. Other spatiotemporal, kinematic, and kinetic data showed no statistically significant differences between prosthetics. CONCLUSION: Both energy storing feet implants showed symmetric gait in unilateral transtibial amputees who are functionally independent in daily living. And 1C60 Triton showed closer to normal gait patterns than 1C30 Trias in our study.
Amputation ; Amputees* ; Ankle ; Foot* ; Gait* ; Heel ; Humans ; Neptune ; Prostheses and Implants ; Supination

This study was carried out to determine the seropositivity for Orientia tsutsugamushi infection among wild rodents captured in farms and mountains of Korea. A total 965 wild rodents of 7 species and 48 Crocidura laciura were captured in farms and mountains of 6 province during 1997~2000 in Korea. Serological evidence for O. tsutsugamushi infection was obtained using O. tsutsugamushi antigens by indirect immunofluorescent antibody technique (IFA). Four hundred eighty four Apodemus agrariusus, 246 Apodemus peninsulae, 179 Eothenomys regulus, 44 Microtus fortis, 6 Micromys minutus, 5 Mus musculus, and 1 Cricetula triton were captured in Gyeonggi, Gangwon, Chungnam, Gyeongbuk, Gyeongnam, and Jeonbuk province. Among them, 59 (12.2%) A. agrariusus, 22 (8.9%) A. peninsulae, 12 (6.7%) E. regulus, 5 (11.4%) M. fortis and 1 (16.7%) M. minutus were IF antibody positive against O. tsutsugamushi Gilliam or Karp strain.
Animals ; Arvicolinae ; Chungcheongnam-do ; Gangwon-do ; Gyeonggi-do ; Gyeongsangbuk-do ; Jeollabuk-do ; Korea* ; Mice ; Murinae ; Neptune ; Orientia tsutsugamushi* ; Rodentia*

Benign triton tumor (BTT) or neuromuscular hamartoma is an uncommon tumor composed of mature neural and well-differentiated striated muscular elements. Its development is exceptionally rare in the adult and head region. This report describes a case of adulthood BTT that occurred in the orbit. The patient was a 53-year-old woman who presented with right periorbital swelling and pain in eyeball over 2 months. Magnetic resonance imaging revealed a well-enhancing mass surrounding optic nerve and ocular muscles in the right retrobulbar area. The tumor was subtotally removed via transcranial approach. Its pathological diagnosis was confirmed to be a neuromuscular hamartoma. She developed diplopia postoperatively. Adulthood BTT should be considered in the differential diagnosis of head and neck tumors. It is also important to make adequate therapeutic strategy to avoid postoperative neural dysfunction.
Adult ; Diagnosis ; Diagnosis, Differential ; Diplopia ; Female ; Hamartoma ; Head ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Muscles ; Neck ; Neptune* ; Optic Nerve ; Orbit*

PURPOSE: To evaluate foveal avascular zone (FAZ) microvascular structural changes in healthy Korean subjects stratified by age using optical coherence tomography angiography (OCTA). METHODS: Eighty eyes of 43 healthy volunteer subjects who had 20/20 or better best corrected visual acuity without other ocular or systemic disease except vitreous floaters and dry eye syndrome were enrolled and stratified by age group. To measure FAZ size and vascular density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP), OCTA (DRI OCT Triton, Swept Source OCT, Topcon, Tokyo, Japan) scans were performed over fovea-centered 3 × 3 mm² regions, and then compared with central macular thickness (CMT) and subfoveal choroidal thickness. RESULTS: Mean age of the participants was 46.4 ± 16.1 (20–78). The SCP and DCP FAZ sizes were 0.32 ± 0.11 mm² and 0.41 ± 0.14 mm², respectively. There was a significant difference by age group (p < 0.001, p < 0.001), respectively. The FAZ VD for SCP and DCP was 28.96 ± 3.05% and 33.15 ± 3.64%, respectively. There was no difference between age groups (p = 0.118, p = 0.637). Univariate and multiple linear regression analysis showed that the FAZ size of SCP and DCP was significantly correlated with age (p = 0.039, p = 0.002) and CMT (p = 0.007, p = 0.013), respectively. The SCP and DCP FAZ size were positively correlated with age (R² = 0.279, p < 0.001, R² = 0.344, p < 0.001), and negatively correlated with CMT (R2 = 0.354, p < 0.001, R2 = 0.285, p < 0.001), respectively. CONCLUSIONS: The FAZ size of SCP and DCP increased with age and were negatively correlated with CMT. These results suggest that consideration of age and CMT is important when performing the clinical evaluation of FAZ size in healthy subjects.
Angiography* ; Capillaries ; Choroid ; Dry Eye Syndromes ; Healthy Volunteers ; Humans ; Linear Models ; Neptune ; Tomography, Optical Coherence* ; Visual Acuity

BACKGROUND: We compared the performance of the modified Hodge test (MHT), Triton Hodge test (THT), Carba NP test (CNPt), simplified Carba NP test (CNPt-direct), blue-Carba NP test (BCT), and carbapenem inactivation method (CIM) for rapid and accurate carbapenemase detection. METHODS: The methods were evaluated by using 256 gram-negative isolates, including 197 Enterobacteriaceae (79 Enterobacter spp., 74 Klebsiella spp., 33 Escherichia coli, 10 Citrobacter spp., and 1 Serratia marcescens), 51 Acinetobacter baumannii, and 8 Pseudomonas aeruginosa strains. The collection included 117 non-carbapenemase, 18 Klebsiella pneumoniae carbapenemases (KPC) producers, 46 New Delhi metallo-β-lactamases (NDM) producers, 11 imipenemases (IMP) producers, and 51 oxacillinases (OXA) producers, and 13 strains harboring two different carbapenemase genes. RESULTS: The specificity of the THT (91.5%) was significantly lower than other methods, each of which had 100% specificity (P<0.003). This can be attributed to the false detection of Ampler class C β-lactamases (AmpC) carriers. The CNPt-direct and CIM yielded the highest sensitivities (P<0.003), which were comparable (92.8% vs 93.5%, P>0.999). Because of improved detection of NDM carriers, THT showed significantly higher sensitivity than the MHT (84.9% vs 75.5%, P<0.001). However, poor performances in detecting OXA still influenced the sensitivities of the CNPt (66.2%) and BCT (82.0%), as well as the MHT and THT. CONCLUSIONS: CNPt-direct and CIM demonstrated the best performance for the efficient detection of carbapenemase among the six evaluated methods. Except the MHT and THT, the detection of carbapenemase-producing Enterobacteriaceae by all the other methods was acceptable, when the OXA-type carbapenemase was not prevalent.
Acinetobacter baumannii ; Citrobacter ; Enterobacter ; Enterobacteriaceae ; Escherichia coli ; Gram-Negative Bacteria* ; Klebsiella ; Klebsiella pneumoniae ; Methods* ; Neptune ; Pseudomonas aeruginosa ; Sensitivity and Specificity ; Serratia

BACKGROUND: Abalone, which is a member of the shellfish family, can often induce severe allergic reactions in sensitized individuals, but there have been only a few studies ofn its allergenic components. A recent study has identified two major allergens with molecular weights of 38 and 49 kDa in South African abalone. OBJECTIVES: The aim of this study is to evaluate skin test prevalence and IgE sensitization to northern disk abalone (Haliotis discus hannai) which is one of the major abalones in this country, and to identify its allergenic components. METHODS: Skin prick tests were performed with 62 home-made extracts of domestic foods including abalone, turban shell, triton shell, shrimp etc. in 1,738 patients with various allergic diseases. Serum specific IgE antibodies to abalone were determined by ELISA in 81 positive responders on skin prick tests to abalone extract and 40 non-atopic healthy controls. ELISA inhibition tests were performed to evaluate cross-allergenecity between abalone and other sea foods(turban shell, triton shell, shrimp and house dust mite). Allergenic components of Haliotis discus hannai were identified by SDS-PAGE and IgE-immunoblot analysis. RESULTS: The positive response rate(A/H ratio> or=2+) to abalone on skin prick test was 4.7% in patients with various allergic diseases. Serum spcecific IgE to abalone was detected in 23(34.5%) of 67 patients. Serum specific IgE levels to abalone tended to increase according to skin test reactivity without statistical significance(p>0.05). ELISA inhibition tests showed significant dose-dependent inhibitions with addition of turban shell, triton shell and shrimp extracts IgE immunoblot analysis showed ten allergenic components (33, 37, 40, 60, 63, 71, 76, 86, 92, 111 kDa), of which seven allergens (40, 60, 63, 71, 76, 86, 92 kd) were bound to IgE in more than 50% of the sera tested. CONCLUSION: The sensitization rate to abalone was 4.7% in allergy patients. Serum specific IgE to abalone was detected by ELISA, and 7 major allergens within abalone were identified. Further studies will be needed to elucidate their clinical significances.
Allergens ; Antibodies ; Dust ; Electrophoresis, Polyacrylamide Gel ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Molecular Weight ; Neptune ; Prevalence ; Shellfish ; Skin ; Skin Tests

PURPOSE: To investigate the systemic parameters related to changes in the retinal microvasculature using optical coherence tomography angiography (OCTA) in diabetic patients without diabetic retinopathy. METHODS: We retrospectively reviewed the medical records of diabetic patients without diabetic retinopathy. All patients showed normal fundus on dilated fundus examinations. OCTA (DRI OCT Triton, Topcon Corporation, Tokyo, Japan) was performed on a 3 × 3 mm area centered at the fovea. The foveal avascular zone (FAZ) area and vascular density (VD) of the superficial and deep capillary plexus (SCP/DCP) were measured. Multiple regression analysis was conducted to evaluate the relationship between microvascular indexes on OCTA and systemic parameters including sex, age, duration of diabetes mellitus (DM), hemoglobin A1c (HbA1c), total cholesterol, presence of hypertension (HTN) and systolic and diastolic blood pressure (SBP/DBP). RESULTS: A total of 35 eyes of 35 patients were included in this study. The mean age was 55.7 ± 11.6 years, the mean duration of DM was 52.4 ± 88.7 months and the mean HbA1c was 8.8 ± 2.3%. The FAZ area of the DCP increased significantly as the HbA1c level increased (p < 0.001), but the other parameters, i.e., sex, age, duration of DM, total cholesterol, presence of HTN, SBP and DBP, did not exhibit significant relations in the DCP (p = 0.727, 0.280, 0.385, 0.816, 0.206, 0.055 and 0.092, respectively). There were no significant relationships between systemic parameters and the FAZ area in the SCP (p > 0.05). No systemic parameters exhibited significant relationships with VD in either the SCP or the DCP (p > 0.05). CONCLUSIONS: The FAZ area of the DCP detected via OCTA increased as the level of HbA1c increased, although the patients did not show diabetic retinopathy on dilated fundus examinations. Therefore, clinicians should consider this when screening diabetic patients for diabetic retinopathy.
Angiography ; Blood Pressure ; Capillaries ; Cholesterol ; Diabetes Mellitus ; Diabetic Retinopathy* ; Humans ; Hypertension ; Mass Screening ; Medical Records ; Microvessels* ; Neptune ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence