Dermatofibrosarcoma protuberans(DFSP) is a rare, distinctive cutsneous tumor originating in the dermis that appears as a raised uninodular or multinodular lesion on the trunk or the proximal extremities. In about 10% of the cases, DFSP arises in childhood and it is rarely evident already at birth. Histopathologically, DFSP shows the chsracteristic storiform and cartwheel patterns, with the fibroblasts arranged radially about a small central hub of fibrous tissue. We report herein a case of childhood DFSP in a 7-year-old boy.
Child ; Dermatofibrosarcoma* ; Dermis ; Extremities ; Fibroblasts ; Humans ; Male ; Parturition

OBJECTIVES: The multiple sleep latency test (MSLT) is commonly used as a valid objective measure of sleepiness. The procedure of MSLT is well standardized but the sleep onset criterion is somewhat variable. One epoch of stage 1 sleep is the most commonly used criterion, and the criterion of three epochs of stage 1 sleep is also used. The purpose of this study was to compare the two criteria used to determine sleep onset. METHODS: We retrospectively analyzed 60 consecutive MSLT that were performed according to a standaridized protocol. We scored each test using the two different criteria for sleep onset and then statistically analyed the results. RESULTS: Using the different criteria, 20 patients among 60 showed changes in mean sleep latency (33.3%). The extent of change ranged from 1.3% to 38.5% (mean 15.9%). Non-narcoleptic patients showed a significantly higher incidence of change than other sleep disorder patients. CONCLUSION: Changes in mean sleep latency occurred according to the different criteria of sleep onset. But the difference arising from different criteria was statistically not significant in patients with moderate to severe sleepiness. Considering that 1 epoch criterion for sleep onset is more sensitive in detecting clinically significant sleepiness, the authors suggest that the 1 epoch criterion is more reliable than the 3 epochs criterion.
Humans ; Incidence ; Retrospective Studies

BACKGROUND: As an airplane has been developed, the man could experienced the new environment. In these circumstances, the research of human's physical changes in the air was commended. About 80% of airplane's accidents was occurred by human factors and about 4% was related to the pilot's physical state. According to the many studies, the most common cause of the permanent grounding of the pilot is coronary artery disease(CAD). Therefore the tool of prevention and early detection for CAD was needed. PURPOSE: The purpose of this study is to evaluate the effect of routine and regular Exercise Treadmill Test(ETT) to the civil airline pilots especially 1) in decreasing the correctable risk factors of coronary artery disease 2) in reducing the medical disqualification rate of pilots. METHOD: Routine ETT has been performed to the Asiana Airlines' pilot during his regular physical check up. When the pilot showed abnormal resting ECG or abnormal ETT results, Echocardiography, 24hour Holter monitoring, Cardiac SPECT or Coronary angiography were done to rule out coronary artery disease. Review the medical records from June 1993 through December 1998. Compare the medical disqualification rate between Asiana Airlines pilot & other pilot groups. Compare the individual correctable risk factors of coronary artery disease and the numbers of risk factors between pilot and non-pilot group using SPSS 8.0 t-test. RESULTS: 1. The results showed no evidence of CAD and there was no case of CAD as a pilot's disqualifying conditions. 2. The levels of cholesterol and the numbers of risk factors of pilot had a statistically significantly lower than non-pilot group. CONCLUSIONS: Routine and regular ETT will be effective in educating the pilot to do his best to decrease the correctable risk factors of CAD.
Aircraft ; Cholesterol ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Echocardiography ; Electrocardiography ; Electrocardiography, Ambulatory ; Exercise Test* ; Humans ; Medical Records ; Risk Factors ; Tomography, Emission-Computed, Single-Photon

No abstract available.
Ulcer*

Osteoblastoma is a relatively rare benign bone tumor representing less than 1% of all bone tumors. The tumor usually involves the spine and sacrum of young individuals, less than 10% being localized to the skull, and nearly half of these affect the mandible, especially the posterior segments. In clinical finding, osteoblastoma present mainly with pain, swelling, and expansion of bone cortex. Radiographic appearances are variable, but frequently a well-delineated radiolucent lesion containing varying amounts of mineral deposits is seen. Histologically, ostoeblastoma is consists of irregular trabeculeae of osteoid and immature bone present within highly vascular connective tissue matrix. Osteoblastoma must be differentiated from a number of bone-producing lesions, including osteoid osteoma, fibrous dysplasia, ossifying fibroma, fibrous dysplasia, and osteosarcoma. If diagnosis may be mistaken for osteosarcoma, there are risks of more aggressive and irreversible treatment. Differential diagnosis of osteoblastoma is important. The preferred treatment of osteoblastoma is conservative approach and surgical excision. Recurrence following surgical intervention is rare. We treated osteoblastoma located in premolar area of mandible by excision with preservation of vital structure, such as nerves and teeth. So we report our clinical treatment with literature review
Bicuspid ; Connective Tissue ; Diagnosis, Differential ; Fibroma, Ossifying ; Mandible ; Osteoblastoma ; Osteoma, Osteoid ; Osteosarcoma ; Recurrence ; Sacrum ; Skull ; Spine ; Tooth

PURPOSE: Many of the enzymes handling environmental factors are polymorphic and may confer variable susceptibility to renal cell carcinoma (RCC). Among those, the author studied genetic polymorphisms of CYP2D6 (B & T) and CYP1A1 in RCCs and controls in Korean. MATERIALS AND METHODS: Using 132 RCCs and 94 controls, first PCR products were obtained in 104 RCCs and 94 controls with CYP2D6, and 74 RCCs and 56 controls with CYP1A1. Res triction enzyme - BstN I/EcoN I for CYP2D6 (B & T), and NCo I for CYP1A1-digestion was followed to analyze constitutive DNA. RESULTS: In both RCCs and controls, no mutant allele of CYP2D6 (B & T) was detected and the susceptibility for occurrence of RCC was unable to evaluate. With CYP1A1 RFLP, homozy gous wild type (WW) was seen in 68 (52.3%; 37 RCCs, 31 controls), heterozygous mutant type (WM) in 54 (41.5%; 32 RCCs, 22 controls) and homozygous mutant type (MM) in 8 (6.2%; 5 RCCs, 3 controls). The odds ratios (95% CI) of RCC susceptibility for CYP1A1 genotype were 1.15 for WM and 1.36 for MM. Even though not significant statistically, higher tendency in MM presented. CONCLUSION: There is no association between susceptibility for the occurrence of RCC and genetic polymorphism of CYP2D6 (B & T) and CYP1A1.
Alleles ; Carcinoma, Renal Cell* ; Cytochrome P-450 CYP1A1* ; Cytochrome P-450 CYP2D6* ; DNA ; Genotype ; Odds Ratio ; Polymerase Chain Reaction ; Polymorphism, Genetic* ; Polymorphism, Restriction Fragment Length

PURPOSE: Locally administered corticosteroids have been widely used in the treatment of inflammatory eye disease. The main purpose of this study is to analyze the treatment effects and the complications of posterior subtenon steroid injection in uveitis patients. METHODS: Retrospective study was performed on 36 eyes of 32 patients diagnosed as uveitis and treated with subtenon steroid injection. RESULTS: Sixty eight consecutive injections of triamcinolone were performed, and the mean follow-up duration was 6.9 months (1~28 months). Visual acuity was improved in 28 (88%) of 32 patients, and mean time to improvement was three weeks after the injection. Intraocular pressure was increased (>21 mmHg) in 10 eyes (31%) of 10 patients, with mean onset of three weeks after the initial injection. The increased pressures was not controlled by medical treatment and additional filtration surgery was needed in 2 eyes (6%). Cataracts were newly developed or worsen in 5 eyes (15.6%) of 4 patients and 2 eyes underwent cataract surgery. CONCLUSIONS: Although a postrerior subtenon steroid injection effectively improved visual acuity in most uveitis patients, side effects, such as the increased intraocular pressure or cataract were developed. The complication rate as well as treatment effect should be taken into consideration when using this treatment method.
Adrenal Cortex Hormones ; Cataract ; Eye Diseases ; Filtering Surgery ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Retrospective Studies ; Triamcinolone ; Uveitis* ; Visual Acuity

The foreign bodies in the nasal cavity are rare diseases and mostly traumatic in origin. These foreign bodies result in pain, bleeding, and infection and are immediately removed in most cases. However, the foreign body without serious symptoms can remain for several years without treatment. Recently we experienced the penetrating metallic foreign body retained in the nasal cavity over 30 years and complicating orbital abscess. The foreign bodies were two pieces of broken metallic chopsticks. One piece was retained in both ethmoid sinuses and the septum and another in the naso-maxillo-orbital cavity resulting in orbital abscess. The foreign bodies were removed successfully with nasal endoscope, sublabial approach and lower eyelid approach to the orbit without rhino-ophthalmological sequelae.
Abscess ; Endoscopes ; Ethmoid Sinus ; Eyelids ; Foreign Bodies* ; Hemorrhage ; Maxillary Sinus ; Nasal Cavity ; Orbit ; Rare Diseases

BACKGROUND AND OBJECTIVES: There are various surgical approaches for resection of base of tongue cancer, but reports on indications of each approach are lacking. PATIENTS AND METHODS: From 1993 to 1999, surgically treated patients with base of tongue cancer were reviewed retrospectively. Fourteen patients were included in this study. All but one were previously untreated. Approaches used to remove the tongue base lesions were as follows: lateral pharyngotomy, transhyoid pharyngotomy, mandibular swing approach with or without supraglottic partial laryngectomy (SPL), extended supraglottic partial laryngectomy (ESPL), lingual release or lingual-mandibular release technique, and pull through approach. Free flap or myocutaneous flap were used for the reconstruction of surgical defect in five patients. RESULTS: Surgical resection margin was positive in five patients. In these, the lateral wall of oropharynx was the most frequent site of positive margin. All patients, except one total laryngectomee, could do well without tracheostoma and oral feeding was possible in all cases. CONCLUSIONS: In small lateral tumor, transpharyngeal resection was a good alternative for vigorous transmandibular resection. In case of tumor with vallecular or supraglottic involvement, supraglottic partial laryngectomy with or without mandibular swing was needed. For total glossectomy, lip and mandible could be spared with pull through or lingual release approach. Even though we could choose any surgical approach with very wide surgical field, we needed more generous safety margin for this notorious tongue base cancer.
Free Tissue Flaps ; Glossectomy ; Humans ; Laryngectomy ; Lip ; Mandible ; Myocutaneous Flap ; Oropharynx ; Retrospective Studies ; Tongue Neoplasms* ; Tongue*

Nodular fasciitis is a rapidly growing benign soft tissue tumor that is related to the fascia and this tumor is generally seen in young and middle aged adults. It is often seen as a subcutaneous solitary nodule in an upper extremity. Clinically, it is often mistaken for a malignancy. We present here a rare case of nodular fasciitis of the chest wall and that was observed on breast sonography (US) and this lesion clinically simulated palpable breast cancer. US may be helpful for evaluating a chest wall lesion that is misunderstood to be a breast lump. So, if the lesion's location is vague, US can reveal the exact location and characteristics of the mass. Although the incidence of nodular fasciitis is rare, nodular fasciitis should be considered in the differential diagnosis when a lesion is located in the chest wall.
Adult ; Breast ; Breast Neoplasms ; Diagnosis, Differential ; Fascia ; Fasciitis ; Humans ; Incidence ; Middle Aged ; Thoracic Wall ; Thorax ; Upper Extremity