Although sacrococcygeal mass is rare and usually found in infants or children, adolescent or adult patients with protruding mass in sacrococcygeal region occasionally come to us simply for a cosmetic problem. In this situation, even though there is no definite neurological deficit, it should be evaluated whether or not the underlying bony pathology or dural defect exists. Few cases about the sacrococcygeal mass have been reported in adults. We reviewed our cases including preoperative evaluation methods and postoperative diagnosis. From March, 1993 to February, 1997, we experienced 6 adult patients with sacrococcygeal mass and no neurological abnormality. Preoperative evaluation were made by plain X-ray, myelogram, computed tomography(CT), and magnetic resonance imaging (MRI), as needed. Postoperative diagnoses were 2 meningoceles, 2 lipomyelomeningoceles, 1 desmoid tumor, and 1 teratoma. From our experiences, CT or MRI is essential to evaluate the sacrococcygeal mass preoperatively. These methods can visualize the precise anatomic location and extent of the mass, its relation to the spinal cord, and associated bony abnormalities. MRI is superior to CT, especially in defining the nature of the mass and involvement of the spinal cord. Conclusively, even a simple mass in the sacrococcygeal region in adults needs MRI or CT evaluation, and MRI is the most valuable method of evaluating the mass preoperatively and provides important information to establish a treatment plan.
Adolescent ; Adult* ; Child ; Diagnosis ; Fibromatosis, Aggressive ; Humans ; Infant ; Magnetic Resonance Imaging ; Meningocele ; Pathology ; Sacrococcygeal Region* ; Spinal Cord ; Teratoma

To investigate the effects of prostaglandin E1(PGX1) in prevention of proliferative scar formation, we cultured fibroblasts of normal skin (NS), hypertrophic scar (HS) and keloid (KL) tissues obtained from patients. We have compared type I collagenase production of cultured fibroblasts from normal skin, hypertrophic scar, and keloid tissues under various concentrations of PGE1. Our results demonstrate that type I collagenase production was significantly increased after addition of PGE1 in HS and KL, but not NS. Type I collagenase production of HS and KL fibroblasts were increased similarly in 10M and 10M of PGE1 and maximally increased in the concentration of 10M. This promotive effects of PGE1 on the production of type I collagenase was larger in KL than in HS. These results also suggest that PGE1 may play the promotive effects on type I collagenase production in dose-dependent manner. PGE1 may have a role in the prevention of hypertrophic scar and keloid by enhancing the production of type I collagenase of HS and KL fibroblasts. The promotive effects of PGE1 on type I collagenase production was variable depending on its concentration, and its effects was maximum in certain optimal condition. The maximally effective concentration of PGE1 in the prevention of proliferative scar formation should be searched in further investigations for clinical use.
Alprostadil ; Cicatrix ; Cicatrix, Hypertrophic* ; Collagenases* ; Fibroblasts* ; Humans ; Keloid* ; RNA, Messenger* ; Skin

With the development of devices and techniques, including complex shape coils, balloons, multiple catheter techniques, and intracranial stents, endosaccular treatment of ruptured or unruptured wide-necked cerebral aneurysms has advanced rapidly with respect to indications and outcomes. In contrast to other options, stent-assisted aneurysm embolization has a distinct feature in which the stent is permanently implanted in the cerebral vessels. Therefore, we must consider the short-term effect of stent-assisted aneurysm embolization in the prevention of coil migration and adverse thrombogenicity, but also the permanent mechanical, hemodynamic, and biological influence on the parent vessels and the aneurysm. We have reviewed the current experimental and clinical data on stent-assisted coil embolization of cerebral aneurysms.
Aneurysm ; Catheters ; Hemodynamics ; Humans ; Intracranial Aneurysm ; Parents ; Stents

Purpose: To report a case of multiple retinal capillary hemangioma associated with neurofibromatosis type 1 and resulting neovascularglaucoma.Case summary: A 13-year-old boy was admitted with complaint of visual disturbance and dull pain in his left eye which had beguntwo weeks prior. Lisch nodules were observed in his left iris and corneal opacity with neovascularization of the iris and anglewere detected in the same eye. Multiple retinal capillary hemangiomas with increased tortuosity and congestion of feeding retinalvessels were observed on the upper equator of the left retina; in addition, vitreous hemorrhage was observed. There were noother abnormalities except iris mammillations in the right eye. Numerous café au lait macules were observed on the patient’s entirebody. He also exhibited axillary freckling. On brain magnetic resonance imaging, T2-weighted signal intensity was increasedin the basal ganglia, left thalamus, and cerebellar white matter; however, no vessel abnormalities were observed on magneticresonance angiography. High intraocular pressure (IOP) persisted despite the use of IOP lowering agents and IOP was normalizedafter trabeculectomy with mitomycin C administration. Conclusions This case shows that multiple retinal capillary hemangiomas can be accompanied by neurofibromatosis type 1,which may result in neovascular glaucoma.

PURPOSE: The purpose of this study was to construct and test a structural equation model to investigate the risk factors of metabolic syndrome in rural women. METHODS: The raw data in this study was collected from the Korean Genome and Epidemiology Study supervised by the Korea Centers for Disease Control and Prevention from 2005 to 2010. The data included physical examinations and surveys of 1,125 women, who resided in three rural areas of South Korea. The structural model in this study was composed of five latent variables: depression, stress, social support, health behavior, and metabolic syndrome. The structural equation model was used to assess the relationships among the variables. RESULTS: The results of the study showed that depression and stress had direct effects on metabolic syndrome. Social support had a direct effect on health behavior and metabolic syndrome. Also, health behavior had a direct effect on metabolic syndrome. CONCLUSION: This study may serve as a guideline for interventions and strategies used to reduce metabolic syndrome in rural women.
Centers for Disease Control and Prevention (U.S.) ; Depression ; Epidemiology ; Female ; Genome ; Health Behavior ; Humans ; Korea ; Models, Structural ; Physical Examination ; Risk Factors

PURPOSE: We evaluated the abdominal uttrasonographic findings of Salmonellosis. MATERIALS AND METHODS: This study included 64 patients who were confirmed as salmonellosis by blood culture. We retrospectively analyzed the abdominal ultrasonographic findings with particular attention to enlarged mesenteric lymph nodes(mesenteric lymphadenitis), thickening of bowel wall, especially terminal ileum and cecum(ileocecitis), hepatosplenomegaly, ascites, gallbladder wall thickening, and enlarged lymph nodes in porta hepatis. RESULTS: The 64 cases were observed as mesenteric lymph node enlargement(44 cases), wall thickening of the terminal ileum and cecum(36 cases), hepatomegaly and/or splenomegaly(42 cases), minimal ascites(8 cases), gallbladder wall thickening(6 cases), and enlarged lymph nodes in porta hepatis(4 cases). No abnormal finding was seen in 10 patients. CONCLUSION: The mesenteric lymph node enlargement, wall thickening of the terminal ileum and cecum, hepatomegaly and/or splenomegaly, minimal ascites, gallbladder wall thickening, and enlarged lymph nodes in porta hepatis are suggestive findings of salmonellosis on abdominal ultrasonography in patients with fever and acute abdomen.
Abdomen, Acute ; Ascites ; Cecum ; Fever ; Gallbladder ; Hepatomegaly ; Humans ; Ileum ; Lymph Nodes ; Retrospective Studies ; Salmonella Infections* ; Splenomegaly ; Ultrasonography

Simultaneous occurrence of remote intracerebral hemorrhage (ICH) and intracranial aneurysmal subarachnoid hemorrhage is very rare. We report on a case of concurrent hypertensive ICH at the left thalamus and rupture of an intracranial aneurysm at the bifurcation of the single A2 segment of the anterior cerebral artery in a 64-year-old woman, which was clipped previously, with review of the literature. To our knowledge, this is the first case report demonstrating bleeding of previously clipped aneurysm with simultaneous hypertensive ICH. Hypertensive crisis following ICH seems to have provoked rupture of the residual aneurysm.
Aneurysm ; Anterior Cerebral Artery ; Cerebral Hemorrhage ; Female ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Intracranial Hemorrhage, Hypertensive ; Middle Aged ; Rupture ; Subarachnoid Hemorrhage ; Thalamus

Perineuriomas are composed of differentiated perineurial cells. Perineuriomas have been recently recognized by the immunoreactivity for epithelial membrane antigen (EMA). Microscopically, perineuriomas show proliferation of spindle cells with wavy nuclei and delicate elongated bipolar cytoplasmic processes. The tumor cells are usually negative for the S-100 protein. Ultrastructurally, perineurial cells reveal slender, nontapered processes containing pinocytic vesicles and discontinuous basal lamina. Interestingly, hybrid tumors of benign peripheral nerve sheath tumor (PNST) have been recently reported by using immunohistochemical and ultrastructural investigations. Herein, we report a case of soft tissue perineurioma arising in the skin of a 56-year-old female; another case of a hybrid tumor of perineurioma and schwannoma in the posterior mediastinum occurred in a 53-year-old male, which is the first case of the hybrid PNST tumor reported in Korea.
Basement Membrane ; Chimera ; Cytoplasm ; Humans ; Korea ; Male ; Mediastinum ; Middle Aged ; Mucin-1 ; Nerve Sheath Neoplasms ; Neurilemmoma ; Peripheral Nerves ; S100 Proteins ; Skin

BACKGROUND: V. parahaemolyticus, an important seafood-borne pathogen, is the causative agent of gastroenteritis in humans. In this study, the occurrence and distribution of the thermostable hemolysin (tdh) gene and the tdh-related hemolysin (trh) gene were investigated, and as many as 72 different O:K serovar combinations were determined from diarrheal patients and environmental sources in Gyeongbuk provinceas during the 2000-2001. METHODS: A total of 50 strains of V. parahaemolyticus isolated from diarrheal patients and environmental sources were analyzed for the tdh gene and trh gene. The strains were analyzed for kanagawa phenomenon (KP) with the wagatsuma blood agar medium test. Furthermore, the strains belonging to O and K serotypes were determined. DNA sequence determination of the tdh gene were verified using GenBank and analyzed. RESULTS: In the KP experiments of V. parahaemolyticus, 80% of the strains isolated from diarrheal patients showed positive, but all of the strains isolated from environment sources were negative The distribution of O and K serotypes were O3:K29, O3:K6, and O3:K31, atc. isolated from diarrheal patients, and O2:K28, O3:K29, and 04:K34 atc. isolated from environmental sources. As for the tdh and trh gene of V. parahaemolyticus, the tdh gene was detected from 88.0% of diarrheal patients and 16.0% of environmental sources. The trh gene was not detected from diarrheal patients and 8.0 % of environmental sources, whereas all urease positive strains possessed the trh gene. The DNA sequence of tdh gene were verified using GenBank and analyzed the difference, tdh nucleotide sequence was found among the V. parahaemolyticus. CONCLUSION: V. parahaemolyticus is distributed with high frequency in the environmental sources such as sea water, fishes and shellfishes sampled at the Gyeongbuk coastal area, and the O3:K6 strains producing TDH were confirmed, which is prevalent throughout the world, from diarrheal patients. Thus, it is very important to establish a measure to prevent food poisoning by V. parahaemolyticus.
Agar ; Base Sequence ; Databases, Nucleic Acid ; Fishes ; Foodborne Diseases ; Gastroenteritis ; Gyeongsangbuk-do* ; Humans ; Seawater ; Sequence Analysis, DNA ; Shellfish ; Urease ; Vibrio parahaemolyticus* ; Vibrio* ; Virulence Factors* ; Virulence*

Purpose: To report the first case of Curtobacterium endophthalmitis within 6 hours after open globe injury, with extensive phlebitis and secondary subretinal neovascularization. Case summary: A 53-year-old man with hypersensitivity to beta-lactam antibiotics was admitted due to visual disturbance in the left eye experienced while working in a rural area. Fundus examination was impossible due to a full-layer corneal laceration and traumatic cataract in the left eye. B-scan ultrasonography and orbital computed tomography showed no shadowing of retained intraocular foreign bodies. After a corneal scraping smear, primary closure, lensectomy, and vitrectomy were performed. Organic material was observed in a focal area of pale macula, accompanied by extensive retinal phlebitis in the mid-periphery. After diagnosing acute bacterial endophthalmitis, intravitreal vancomycin and dexamethasone were injected. Curtobacterium pusillum was cultured on an automated microbial identification system. Intravenous vancomycin and oral clarithromycin were administered for 2 weeks. After 3 months, endophthalmitis had not recurred, and the visual acuity reached 20/100. However, subretinal neovascularization was newly detected under the damaged macula. No complications of neovascularization were observed until 6 months after primary closure. Conclusions Curtobacterium pusillum can induce acute endophthalmitis through direct penetration in cases of ocular trauma, and may be accompanied by extensive phlebitis and secondary subretinal neovascularization. In cases of open globe injury sustained in rural areas, acute endophthalmitis caused by a rare Gram-positive bacillus, such as Curtobacterium species, should be considered.