We report a case of congenital vellus hamartoma, which consists of numerous matured vellus hair follicles and sebaceous glands. This patient is 4-month-old male with multiple, variable sized nodules on the right epicanthsl fold area since birth. Histopathologically, some of the infundibular portion of the vellus hair shows irregular and reticulated hyperplasia. There are numerous well-formed vellus hair follicles surrounded with thick fibrous sheath and some of them are associated with rudiment sebaceous glands.
Hair ; Hair Follicle ; Hamartoma* ; Humans ; Hyperplasia ; Infant ; Male ; Parturition ; Sebaceous Glands

Measurements of mitral flow velocity by pulsed Doppler echocardiography are very useful in evaluating left ventricular diastolic filling properties. In hypertensive patients, abnormalities of diastolic function may precede systolic abnormalities and may serve as a more sensitive marker of end organ damage. We estimated left ventricular nass by 2-D echo short axis area-length method and compared with peak mitral flow velocity in early diastole(PFVE)and during atrial systolic(PFVA). There was a significant increase of LV mass and LV mass indices in the hypertensive patients and PFVE/PFVA ratio was decreased in them. Aithough there was no relationship between blood pressure and PFVE/PFVA ratio, a significant relationship was demonstrated between LV mass index and PFVE/PFVA ratio in the hypertensive patients.
Axis, Cervical Vertebra ; Blood Pressure ; Echocardiography, Doppler, Pulsed ; Humans

The spindle and epithelioid cell nevus, is known also as Spitz's nevus or benign juvenile melanoma. The histologic picture of the lesion often closely resembles that of a malignant melanoma, but spindle and epithelioid cell nevus hehaves benignly. Criteria for accurate histological diagnosis of this nevus now exist. However, a difficult lesion occasionally brings one to the worrisome situation even now. We experienced four cases (three children and one adult) of spindle and epithelioid cell neveus with nodular or macular skin lesions. In children (7/F, 9/F, 4/M), all of the lesion show a solitary pinkish red or light brown nodular firm masses, 0.7 cm to 1.0 cm in greatest dimension, which are located at the left posterior thigh, posterior neck and right anterior neck region, respectively. In adult (36/F), the lesion shows a light brown, erythematous macule, 0.8 cm in greatest diameter, in the skin of the back. Microscopically, both spindle and epithelioid cells are found in all the four cases, but epithelioid cells predominate in children and spindle cells predominate in adult.
Child ; Adult ; Male ; Female ; Humans

BACKGROUND: The purpose of this study was to evaluate the postoperative magnetic resonance imaging (MRI) results of minimal-tying (one medial-row tie among 4 medial-row sutures) on the medial-row in double-row suture-bridge configuration (2x2 anchor with 4x4 suture stands). METHODS: From 2011 March to 2012 July, 79 patients underwent arthroscopic rotator cuff repair using 2x2 anchor double-row configuration. The mean age was 61.3 years (range, 31-81 years). Two double-loaded suture anchors were used for medial-row. Four medialrow stitches were made with only one medial-row knot-tying (the most anterior suture). Lateral-row was secured using the conventional suture-bridge anchor technique; all 4 strands were used for each anchor. Repair integrity was evaluated with MRI at mean 6.2 months postoperatively. Retear and the pattern of retear, change of fatty infiltration, and muscle atrophy of supraspinatus were evaluated using pre- and postoperative MRI. RESULTS: Repaired tendon integrity was 38 for type I, 30 for type II, 6 for type III, 4 for type IV, and 1 for type V, according to Sugaya classification. Considering type IV/V as retear, the rate was 6.3% (5 out of 79 patients). Medial cuff failure was observed in 4 patients. Fatty atrophy of supraspinatus was significantly improved postoperatively according to Goutallier grading (p=0.01). The level of muscle atrophy of supraspinatus was not changed significantly after surgery. CONCLUSIONS: Minimal tying technique with suture configuration of four-by-four strand double-row suture-bridge yielded a lower retear rate (6.3%) in medium to large rotator cuff tears.
Arthroscopy ; Atrophy ; Classification ; Humans ; Magnetic Resonance Imaging ; Muscular Atrophy ; Rotator Cuff* ; Shoulder ; Suture Anchors ; Sutures ; Tears* ; Tendons

With the increase of frequency and the recent development of surgical treatment in brachial plexus injury, the requirement for accurate assessment between supra and infraganglionic injury is increased. Cervical myelography has been the popular tool in evaluating the root lesion since the first introduction of Murphey et al. in 1947. However, the invasiveness of procedure has been the impediment to the common-use. But with the utilization of water-soluble contrast media, Metrizamide, such impediment can be alleviated. Author has performed myelography in 27 patients along with surgical exploration in 18 patients since 1984. And the results were as follows. 1. 85% of 27 patient revealed anomaly of root in myelography. 2. Traumatic menimgoceles were typical findings and most of them were located at C7 and C5. 3. Myelography reaveled 70%(28 root) of anomalies among 40 root lesions, confirmed by surgical explorations. 4. Myelography is considered to be very effective in evaluating supra and infraganglionic root lesions when its results is correlated with physical and other neurological examination.
Brachial Plexus ; Contrast Media ; Humans ; Metrizamide ; Myelography ; Neurologic Examination

Myocardial bridging is defined as a condition where a segment of a major epicardial coronary artery running intramurally through the myocardium. Although this abnormality is usually regarded as an incidental finding at angiography, it has been associated with myocardial ischemia, infarction, and sudden death. Standard treatment involves beta-adrenergic receptor blockers, surgery with dissection of the overlying muscle fibers, or coronary artery bypass grafting. A few cases of the intracoronary stent implantation have been reported as an alternative treatment in individual patients with myocardial bridging. We report a case of intracoronary stenting in a severe systolic narrowing at the middle segment of the left anterior descending artery in a patient complaining of recurrent chest pain despite medical treatment.
Angiography ; Arteries ; Chest Pain ; Coronary Artery Bypass ; Coronary Vessels ; Death, Sudden ; Humans ; Incidental Findings ; Infarction ; Myocardial Bridging* ; Myocardial Ischemia* ; Myocardium ; Running ; Stents*

OBJECTIVE: From November 30, 2016, the Korean Government carried the revised Medical Dispute Mediation and Arbitration Act into effect. Mediation will start automatically without agreements of the defendant, when the outcome of the patient was death, coma more than a month or severe disability. Cerebral aneurysm has a definite risk of bad outcome, especially in the worst condition. Any surgical intervention to this lesion has its own high risk of complications. Recently, Seoul central district court decided 50% responsibility of the doctors who made a rupture of the aneurysm during coiling (2015Ga-Dan5243104). We reviewed judicial precedents related to cerebral aneurysms in lawsuit using a web search.METHODS: We searched judicial precedents at a web search of the Supreme Court, using the key words, "cerebral aneurysm".RESULTS: There were 15 precedents, six from the Supreme Court, seven from the High Court, and two from district courts. Seven precedents were related to the causation analysis, such as work-relationship. Five precedents were malpractice suits related bad results or complications. Remaining three precedents were related to the insurance payment. In five malpractice precedents, two precedents of the Supreme Court reversed former two precedents of the High Court.CONCLUSION: Judicial precedents on the cerebral aneurysm included not only malpractice suits, but also causation analysis or insurance payment. Attention to these subjects is needed. We also need education of the independent medical examination. To avoid medical disputes, shared decision making seems to be useful, especially in cases of high risk condition or procedures.
Aneurysm ; Coma ; Decision Making ; Dissent and Disputes ; Education ; Expert Testimony ; Humans ; Insurance ; Intracranial Aneurysm ; Malpractice ; Negotiating ; Rupture ; Seoul

Clinical observarions were done on 616 cases of cerebrovasculae accidents treated as inpatients at the Sung-Sim hospital, Chung-Ang university over a period of 8 years, from January, 1981 to Agust, 1988. The results were as follows; 1) Of 616 cases of cerebrovascular accidents, cerebral hemorrhage was presented in 56.82%, cerebral thrombosis in 28.57%, subarachnoid hemorrhage in 12.66%, cerebral embolism in 1.95%. 2) The ratio of male to female was 1.01:1. 3) The cerebrovascular accidents were most common in the sixth decade and followed by the fifth and fourth in turn. 4) The seasonal incidence was in order of frequency of Spring, Winter, Autumn and Summer. 5) Among disease preceding the onset of cerebrovascular accidents, hypertension was noted at 75% in cases of cerebral hemorrhge, 61% in cerebral thrombosis and 73% in subarachnoid hemorrhge. 6) The mean duration of underlying hypertension was 13.7 years in cerebral emorrhge, 15.3 years in cerebral thrombosis, 12.2 years in subarachnoid hemorrhage and 14.8 years in cerebral embolism. 7) Major precipitating factor in cerebral hemorrhage and subarachnoid hemorrhage was thought to be physical activity, whereas cerebral thrombosis and cerebral embolism frequently occured during sleeping or resting state. 8) The mean cholesterol level were 204.1mg% in cerebral hemorrhage, 214.9mg% in cerebral thrombosis, 211.7mg% in subaraachnoid hemorrhage and 217.0mg% in cerebral embolism. 9) The mortality rate was 12.2% in total, 16.6% in cerebral hemorrhage 2.3% in cerebral thrombosis, 15.45 in subarachnoid hemorrhage and 25% in cerebral embolism.
Cerebral Hemorrhage ; Cholesterol ; Female ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Inpatients ; Intracranial Embolism ; Intracranial Thrombosis ; Male ; Mortality ; Motor Activity ; Precipitating Factors ; Seasons ; Stroke* ; Subarachnoid Hemorrhage

PURPOSE: The cardiopulmonary exercise test (CPET) is an important clinical tool for evaluating exercise capacity and is frequently used to evaluate chronic conditions including congenital heart disease. However, data on the normal CPET values for Korean children and adolescents are lacking. The aim of this study was to provide reference data for CPET variables in children and adolescents. METHODS: From August 2006 to April 2009, 76 healthy children and adolescents underwent the CPET performed using the modified Bruce protocol. Here, we performed a medical record review to obtain data regarding patient' demographics, medical history, and clinical status. RESULTS: The peak oxygen uptake (VO2Peak) and metabolic equivalent (METMax) were higher in boys than girls. The respiratory minute volume (VE)/CO2 production (VCO2) slope did not significantly differ between boys and girls. The cardiopulmonary exercise test data did not significantly differ between the boys and girls in younger age group (age, 10 to 14 years). However, in older age group (age, 15 to 19 years), the boys had higher VO2Peak and METMax values and lower VE/VCO2 values than the girls. CONCLUSION: This study provides reference data for CPET variables in case of children and adolescents and will make it easier to use the CPET for clinical decision-making.
Adolescent ; Bacterial Toxins ; Child ; Demography ; Exercise Test ; Heart Diseases ; Humans ; Medical Records ; Metabolic Equivalent ; Oxygen

Hemorrhagic cystitis is potentially life-threatening sequellae of chemotherapy using oxazaphosphorine alkylating agents (cyclophosphamide and ifosfamide). Mesna contains a sulfhydryl group that is believed to bind acrolein within the urinary collecting system and reduce the hemorrhagic cystitis without affecting the chemotherapeutic potential. To date, about thirty cases of hypersensitivity or allergic reactions of the delayed and urticarial type associated with mesna have been reported. We reported two patients with systemic lupus erythematosus who developed facial rash and flushing associated with mesna which imitate malar rash.
Acrolein ; Alkylating Agents ; Cyclophosphamide ; Cystitis ; Drug Therapy ; Exanthema* ; Flushing ; Humans ; Hypersensitivity* ; Lupus Erythematosus, Systemic ; Mesna*