Granular Cell Myoblastoma is typically encountered in the skin, subcutaneous tissue nr oral cavity, but was rarely been found in the large intestine. In a series of 110, the two were in the cecum(18). Both patients, 36-and 43-year-old women, underwent radial excision of the lesion because of the clinical impresaion of the malignancy. The other Three patients with granular cell myoblastoma of the cecum, all asymptomatic and found incidentally, have been reported. From the available data, one was a man(22) and two were women (26,27). They were 17 (27), 40(26) and 71(22) years of age. One lesion, in the cecum, was excised at laparotomy that was performed under the irnpression of acute appendicitis, and disclosed a small polypoid submucosal nodule in the cecum incidentally(27). Another lesion, in the cecum, was excised at laparotomy following the discovery of a small cecal defect on barium enema examination 9260. The other lesion, in the cecum, was found at autopsy(22), This paper reports a case of granular cell myoblastoma of the cecum, including its colonoscopic finding.
Adult ; Appendicitis ; Barium ; Cecum* ; Enema ; Female ; Granular Cell Tumor* ; Humans ; Intestine, Large ; Laparotomy ; Mouth ; Skin ; Subcutaneous Tissue

A large mass as a sign of an infection is rare, and it might convince a physician that it had the appearance of a malignancy. The patient in this case visited our clinics after attending several hospitals, with a mass that had the appearance of a malignancy, based on the severe destructive findings observed on plain radiographs. We report the first documented case of a patient with a large mass (12×7×20 cm) and a low-grade infection, which developed at the proximal thigh after a hip arthroplasty. It is important to realize that an infection accompanied by a large mass, can mimic a highly destructive malignant lesion on plain radiographs.
Arthroplasty* ; Hip* ; Humans ; Thigh*

Acute osteomyelitis is usually shown as a localized area of increased activity (hot uptake) in the infectious focus on bone scintigraphy. In our patient, absence of radioactivity (cold lesion) was noted in the distal metaphyseal and diaphyseal regions of his right femur. Initial x-ray was interpreted as normal except for mild soft tissue swelling in the right thigh. The lesion was confirmed as an acute osteomyelitis with subperiosteal abscess on surgery. Staphylococcus aureus was the etiologic organism. We describe a case of acute osteomyelitis in a one-year-old boy shown as a cold lesion on bone scan.
Abscess ; Femur ; Humans ; Male ; Osteomyelitis* ; Radioactivity ; Radionuclide Imaging ; Staphylococcus aureus ; Technetium Tc 99m Medronate ; Thigh

No abstract available.
Anesthesia, General* ; Humans ; Laryngeal Masks* ; Pierre Robin Syndrome*

Medico-legal investigations in Korea depend mostly on postmortem inspection without autopsy. Both untrained physicians and experienced forensic pathologists may not be able to determine the cause and manner of death only by postmortem inspection. The aim of our study was to show the limitations of postmortem inspection by evaluating the discrepancy between the results of postmortem inspection and autopsy after natural death. The manner of death by postmortem inspection changed to unnatural death in 9.4% of the cases (12 cases/127 cases) after autopsy. The cause of death in most cases was consumption of alcohol, agricultural chemicals, and antipsychotic intoxication. The cause of death by postmortem inspection changed in 24.3% of the cases (26 cases/107 cases) among cases of confirmed natural death after autopsy. The positive predictive value of cause of death by postmortem inspection was higher for cardiovascular disease (79.0%) and lower for chronic alcoholism and/or chronic liver disease (28.6%). This study shows that forensic pathologists could make considerable errors in determining the cause and manner of death without autopsy and emphasizes the necessity to refine medico-legal investigations in Korea by introducing the limited autopsy with toxicologic study and supportive postmortem imaging.
Agrochemicals ; Alcoholism ; Autopsy ; Cardiovascular Diseases ; Cause of Death ; Korea ; Liver Diseases

A 46 years old male patient had visited to our Ophthalmology department due to abrupt onset of decreased visual acuity in his left eye. He had taken an operation for correction of high myopic astigmatism on both eyes 23 years ago in Japan by Dr. Sato. His visual acuity was: (R)0.3(0.7 x Sph. + 0.75D. = Cyl. - 5.50D.A10 degrees) (L)0.15(0.2 x Sph. - 2.50D. = Cyl. - 2.25D. A180 degrees). On slit lamp examination. hoth cornea had 3mm. (length) radiated linear scars in a number about 50 resulted from myopic operation. In his left cornea, several small vesicles and mild corneal central opacity were observed. We have diagnosed this symptom as artificial corneal endothelial Dystrophy.
Astigmatism ; Cicatrix ; Cornea ; Humans ; Japan ; Male ; Middle Aged ; Myopia* ; Ophthalmology ; Visual Acuity

PURPOSE: To investigate the shifting trends of pathogenic organisms, antibiotic resistance, and clinical characteristics of patients with Gram-positive bacterial keratitis and to elucidate the prognostic factors. METHODS: We performed a retrospective chart review of 152 isolates in 146 eyes with Gram-positive bacterial keratitis between January 1998 and December 2012. The study was divided into 5 periods for analysis of the bacteriological profiles and in vitro antibiotic resistance. The epidemiological and clinical characteristics were compared according to bacterial isolates. Logistic regression analysis was performed to determine the risk factors. RESULTS: Gram-positive bacterial keratitis tended to decrease and significant change in the distribution of isolates was not observed. Commonly isolated organisms were S. epidermidis (48.7%), S. aureus (25.0%), and S. pneumoniae (7.2%) in order of frequency. The resistance to fluoroquinolone tended to increase (p = 0.104) and resistance to gentamicin was significantly decreased (p = 0.01). S. epidermidis had the shortest corneal epithelium healing time (p = 0.035) and the most favorable visual outcome after treatment (p = 0.035) compared with the other species. Risk factors for poor visual outcomes included a best corrected visual acuity less than 0.1 at initial evaluation and an epithelial healing time greater than 10 days. CONCLUSIONS: Gram-positive bacterial keratitis tended to decrease and S. epidermidis was the most common isolate. The clinical prognosis was most favorable in S. epidermidis. The BCVA less than 0.1 at initial evaluation was an important risk factor for poor visual outcome and surgical treatment in Gram-positive bacterial keratitis.
Drug Resistance, Microbial ; Epithelium, Corneal ; Gentamicins ; Humans ; Keratitis* ; Logistic Models ; Pneumonia ; Prognosis ; Retrospective Studies ; Risk Factors ; Staphylococcus aureus ; Staphylococcus epidermidis ; Visual Acuity

To evaluate the etiology and treatment of options in patients with hemospermia, we retrospectively reviewed 21 patients who had both transrectal ultrasound and MRI and have been followed for more than 6 months after initiation of treatment. Mean age was 40 years (range 20 - 50 years) with duration of infliction being 24 months (range 1 week to 16 years). Among the 14 patients with prostatic cyst, 9 patients underwent transurethral unroofing (TUUR) of cyst. All 9 patients were completely cured, but one patient developed postoperative epididymitis. Among the 6 patients with prostatitis, hemospermia was resolved in 4 patients after mean treatment of 12 weeks with antibiotics. In DES (Diethylstilbestrol) group, 50 % showed resolution of symptoms among 6 patients after 4 weeks of treatment, and two patients complained breast discomfort which were developed after medication. In conclusion, the antibiotic treatment is advisable in hemospermia patients with prostatitis. Prostatic cystic lesion is believed to be a factor in hemospermia, thus TUUR of cyst wall and removal of stone and hematoma in cyst can be a viable option.
Anti-Bacterial Agents ; Breast ; Epididymitis ; Hematoma ; Hemospermia* ; Humans ; Magnetic Resonance Imaging ; Male ; Prostatitis ; Retrospective Studies ; Ultrasonography

Seminal biochemical compositions are to be affected during inflammatory conditions of seminal tract such as chronic prostatitis. Especially chronic prostatitis induces changes in composition of prostatic fluid, and the chronic nature of disease also induces atrophy of prostatic secretory acini and the inflammation of seminal vesicle. We investigated the change of the seminal composition and the possible effect in sperm motility of chronic prostatitis patients. Sperm motility and seminal levels of zinc, citric acid, prostatic acid phosphatase(PAP) and fructose were measured on 12 healthy males and 21 chronic prostatitis patients. Sperm motility in chronic prostatitis patients was decreased and seminal levels of zinc, citric acid, PAP and fructose in control and chronic prostatitis patients were 143+/-10/102+/-7(ug/L), 389+/-17/293+/-25(mg/dl), 446+/-61/ 382+/-28(U/ml), 306+/-7/297+/-6(mg/dl), respectively. The change of zinc was statistically significant. In conclusion, although decrease of seminal zinc in patients with chronic prostatitis was found, there was no convincing evidence to suggest that alterations in seminal composition due to chronic prostatitis lead to decrease of sperm motility.
Atrophy ; Citric Acid ; Fructose ; Humans ; Inflammation ; Male ; Prostatitis* ; Semen ; Seminal Vesicles ; Sperm Motility ; Zinc

Inflammatory white blood cells in semen is related to semen quality affecting fertility. The role of inflammatory cells on the seminal levels of various cytokines associated with inflammation and sperm motility is evaluated. Semens from 10 healthy males and 20 chronic prostatitis patients were evaluated for the levels of interleukin(IL)-1a, IL-6, IL-8 and tumor necrosis factor(TNF)-a. Motility parameters were recorded using Hamilton-Thorne computer semen analysis system. Sperm motility parameters such as including average path velocity(VAP), straight line velocity(VSL), curvilinear velocity(VCL), lateral head displacement(ALH), beat frequency(BCF), straightness(STR), linearity(LIN), elongation and area in control and chronic prostatitis patients were 44.9+/-2.5/38.8+/-1.3(um/sec), 36.4+/-2.4/30.5+/-1.1(um/sec), 64.2+/-3.9/ 58.0+/-2.4(Fm/sec), 3.3+/-0.2/4.8+/-0.3tm), 19.8+/-3.7/13.9+/-0.3(Hz), 77.7+/-5.1/78.8+/-1.2(%), 50.6+/-17.5/53.5+/-1.9(%), 66.8+/-5.4/57.8+/-1.1(9%), 2.9+/-0.3/3.8+/-0.1(um/sec), respectively. Statistical significance was noted in VAP, VSL, ALH, BCF, elongation and area. Semen levels of IL-1a, IL-6, IL-8 and TNF-a in control and chronic prostatitis patients are 15.1+/-1.5/52.9+/-14.2 (pg/ml), 10.5+/-2.2/38.3+/-12.2 (pg/ml), 1.60+/-0.38/ 6.02+/-0.26 (ug/L), 11.8+/-2.5 / 21.7+/-4.0(pg/ml) statistically significant in all. For combined parameters, the correlation coefficient of IL-1a and VSL, ALH, Area were 0.40, 0.41, 0.37 respectively which were significant. The correlation coefficient of IL-8 and VAP, VSL, VCL, ALH, BCF, Elongation, Area were 0.48, 0.49, 0.39, 0.41, 0.55, 0.59, 0.66 respectively which were also significant. Seminal inflammatory cytokines are present in increased quantities if inflammatory white blood cells are present in semen and this increase might be related to sperm motility.
Cytokines* ; Fertility ; Head ; Humans ; Inflammation ; Interleukin-6 ; Interleukin-8 ; Leukocytes ; Male ; Necrosis ; Prostatitis ; Semen ; Semen Analysis ; Sperm Motility* ; Spermatozoa*