T-cell lymphomas primarily involving subcutaneous tissue and minicking panniculitis have rarely been described. In addition, some cases may have been orviously reported as malignant histiocytosis. Some of the affected patients have developed a hemohagocytic syndrome. A 44-year-old wornan showed multiple, recurrent, ill-defined, sarble sized, erythematous, tender subcutnaeous nodules on the trunk and extremities. Histopathological findings levealed the infiltration of hyperchrorriatiatypical large lymphocytes and nurnerous beanbag-like cells in the subcutaneous fat. The infitrted cells were positively stained with Leucocyte common antigen, UCHL-1 antigen, Lysozyme, that ot with CD20. Bone marrow biopsy showed mild erythreid hyperplasia and erythorophagocytic. hitiocytes. These histopathological features were consistent with cutnaeous T cell lymphoma involvnig the subcutaneous tissue.
Adult ; Biopsy ; Bone Marrow ; Extremities ; Histiocytic Sarcoma ; Humans ; Hyperplasia ; Lymphocytes ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Cutaneous* ; Muramidase ; Panniculitis ; Subcutaneous Fat ; Subcutaneous Tissue*

The authors experienoed a case of morning glory syndrome which is an unusual congenital anomaly of optic nerve. The "morning glory" disc of our case was unilaterally enlarged optic disc with a funnel-shaped excavation and an elevated peripapillary tissue annulus. The retinal vessels were straiht andd narrow, and their origins may be obscured by a central mass of whitish tissue overlying the optic disc. Also slit-lamp examination revealed a posterior capsular lens opacity consistent with a Mittendorf's dot. So, we report this case with the review of the literatures.
Cataract ; Optic Nerve ; Retinal Vessels

Background: s/Aims: This study explored the initial institutional experience of using gold fiducial markers for stereotactic body radiotherapy (SBRT) in treating malignant hepatic tumors using real-time ultrasound-computed tomography (CT)/magnetic resonance (MR) imaging fusion-guided percutaneous placement. Methods: From May 2021 to August 2023, 19 patients with 25 liver tumors that were invisible on pre-contrast CT received fiducial markers following these guidelines. Postprocedural scans were used to confirm their placement. We assessed technical and clinical success rates and monitored complications. The implantation of fiducial markers facilitating adequate treatment prior to SBRT, which was achieved in 96% of the cases (24 of 25 tumors), was considered technical success. Clinical success was the successful completion of SBRT without evidence of marker displacement and was achieved in 88% of cases (22 of 25 tumors). Complications included one major subcapsular hematoma and marker migration into the right atrium in two cases, which prevented SBRT. Results: Among the treated tumors, 20 of 24 (83.3%) showed a complete response, three of 24 (12.5%) remained stable, and one of 24 (4.2%) progressed during an average 11.7-month follow-up (range, 2-32 months). Conclusions This study confirms that percutaneous gold fiducial marker placement using real-time CT/MR guidance is effective and safe for SBRT in hepatic tumors, but warns of marker migration risks, especially near the hepatic veins and in subcapsular locations. Using fewer markers than traditionally recommended-typically two per patient, the outcomes were still satisfactory, particularly given the increased risk of migration when markers were placed near major hepatic veins.

Thyroglossal duct cysts develop in the persistent remnants of the thyroglossal tract between the origin of the thyroid at the foramen cecum and the final position of the thyroid gland. Thyroglossal duct cyst can present anywhere from the base of the tongue to the manubrium, but its occurrence within the thyroid gland is very rare. We report here on a 41-year-old woman who presented with a cystic thyroid nodule that was due to an intrathyroid thyroglossal duct cyst. The sonogram, showed a hypoechoic nodule that measured 0.7 x 0.6 cm in the left thyroid lobe. Left lobectomy of the thyroid gland was performed and microscopic examination revealed a cyst lined by non-keratinized squamous epithelium, which was consistent with a thyroglossal duct cyst in the thyroid gland. Intrathyroid thyroglossal duct cyst should be considered in the differential diagnosis of a cystic thyroid nodule. This is the first reported case of a intrathyroid thyroglossal duct cyst in a Korean adult.
Adult ; Cecum ; Diagnosis, Differential ; Epithelium ; Female ; Humans ; Manubrium ; Thyroglossal Cyst* ; Thyroid Gland ; Thyroid Nodule ; Tongue

PURPOSE: This study was conducted to determine how a manual therapy (joint mobilization and flexion-distraction technique) would affect pain and function with the chronic low back pain. METHODS: Thirty patients were assigned to either the experimental group (n=15) or the control group (n=15). Patients in the experimental group performed joint mobilization and flexion-distraction technique. Patients in the control group performed spinal decompression therapy. Both exercises were performed for three days per week, for a period of six weeks. Pain was measured by the visual analogue scale (VAS) and functional disability was measured using the Oswestry disability index (ODI). A paired t-test was used for identify differences before and after treatment, and an independent t-test was used to identify differences between treatment groups. RESULTS: In the within group comparison, the experimental group and control group differed significantly for all variables (p<0.05). However, no significant differences were observed in any variables between groups (p>0.05). CONCLUSION: The above results confirmed that it is necessary to confirm the various benefits of therapy with the joint mobilization and the flexion-distraction technique. The findings of the concerned study will be useful to doctors applying therapy to treat patients with the chronic low back pain.
Decompression ; Exercise ; Humans ; Joints ; Low Back Pain* ; Musculoskeletal Manipulations*

Anticonvulsant hypersensitivity syndrome is a life threatening immunologic reaction of anticonvulsants therapy such as phenytoin, phenobarbital, or carbamazepine, characterized by multiple abnormalities such as fever, rash, lymphadenopathy, acute hepatocellular injury, leukocytosis, and eosinophilia. We report a case of anticonvulsant hypersensitivity syndrome thought to be caused by the use of carbamazepine in a 65-year-old male. He developed erythematous skin eruption four weeks after beginning therapy with carbamazepine. The clinical, laboratory and histologic findings of this patient were compatible with anticonvulsant hypersensitivity syndrome.
Abnormalities, Multiple ; Aged ; Anticonvulsants ; Carbamazepine* ; Eosinophilia ; Exanthema ; Fever ; Humans ; Hypersensitivity* ; Leukocytosis ; Lymphatic Diseases ; Male ; Phenobarbital ; Phenytoin ; Skin

This study was to assess the relation of thyroid dysfunction to metabolic syndrome (MetS) at an earlier stage in Korean population. Metabolic parameters such as body composition, blood pressure (BP), fasting glucose, total cholesterol, triglyceride (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), thyroid-stimulating hormone (TSH) and free thyroxine 4 (fT4) were measured. During a mean follow-up of 3 yr, 5,998 Koreans ages over 18 yr were assessed. There were 694 cases of MetS at follow-up. The mean age of the subjects was 45.6 +/- 9.5 yr. Mean level of TSH was 2.02 +/- 1.50 mIU/L, mean level of fT4 was 1.23 +/- 0.20 rhoM/L. At baseline, TSH levels and fT4 levels were associated to waist circumference, BP, glucose and lipids in the subjects. Increase in systolic blood pressure, diastolic blood pressure (DBP), total cholesterol and TG were significantly associated with changes in TSH levels after adjustment. Changes in DBP, TG, HDL-C and fasting glucose were significantly associated with changes in fT4 levels after adjustment. Increase in TSH levels even after further controlling for baseline TSH level predicted the MetS over the study period. In conclusion, there is a relationship between thyroid function and cardiovascular risk factors, such as BP, total cholesterol, TG, HDL-C and fasting glucose. Also, higher levels of TSH may predict the MetS in Korean.
Adult ; Asian Continental Ancestry Group ; Blood Glucose/analysis ; Blood Pressure ; Cholesterol, HDL/blood ; Cholesterol, LDL/blood ; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Male ; Metabolic Syndrome X/*physiopathology ; Middle Aged ; Predictive Value of Tests ; Republic of Korea ; Risk Factors ; Thyroid Gland/*physiopathology ; Thyrotropin/blood ; Thyroxine/blood ; Triglycerides/blood ; Waist Circumference

Childhood granulomatous perioral dermatitis(CGPD) is a distinctive granulomatous form of perioral dermatitis of unknown cause with a benign and self-limited course and no associated systemic manif estations. It is characterized by an asymptomatic monomorphous papular eruption, with or without scale or pustules, around the mouth, nose, and eyes primarily in prepubertal children. This condition may resemble sarcoidosis both clinically and histologically. A 3-year-old boy first presented with a month-history of mildly pruritic rash around the mouth. When he returned for follow-up after an eight-week period of topical corticosteroid therapy, multiple new follicular papules and pustules developed. Histopathologic examination revealed that a granulomatous lesion consisted of nodular infiltration of multiple histiocytes admixed with lymphocytes in the dermis. The condition resolved in about three weeks after using an unknown topical agent prescribed by a private practicing dermatologist.
Child ; Child, Preschool ; Dermatitis, Perioral* ; Dermis ; Exanthema ; Follow-Up Studies ; Histiocytes ; Humans ; Lymphocytes ; Male ; Mouth ; Nose ; Sarcoidosis

Between January 1986 and December 1995, 24 patients were treated surgically for thymoma. There were 17 males and 7 females, and their ages ranged from 23 to 69 years old and mean age was 49 years. Thymomas were associated with fourteen my asthenia gravis, and classified histologically as lymphocytic in 12 patients, mixed in 8, epithelial in 4, and classified clinically as stage I in 11, stage II in 4, stage III in 8 and stage VI in 1 patient. Eleven patients with non-invasive thymoma had received surgical resection, and 10 out of 13 patients with invasive thymoma were able to undergo complete resection. A partial resection or tissue biopsy followed by radiation or chemotherapy was done with the remaining three patients. Three died, four had improvement of symptom, two had relapse and fifteen had no symptom during follow up ranged from 25 days to 60 months. In fourteen cases of thymoma with myasthenia gravis, one died due to myasthenic crisis, two showed symptom aggravation, six had less medical treatment and five patients had medical treatment as same as dosage received preoperatively.
Aged ; Asthenia ; Biopsy ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Myasthenia Gravis ; Recurrence ; Thymoma*

PURPOSE: In treatment of facial bone fracture, occurred in children, we generally use wires, miniplate, absorbable plate or their combination. These foreign bodies can be palpable, and sometimes may cause infections, and need reoperation for removing. When bone fragments are multiple, small or thin, they are hard to handle and make accurate reduction of all fragments. In these cases, a biodegradable tissue adhesive, Histoacryl(R) (n-butyl-2-cyanoacrylate), can be used as fixation technique for small, multiple, and thin fracture fragments. METHODS: 3 years old and 6 years old children, who has comminuted fracture on frontal sinus, we used Histoacryl(R) for fixation of multiple bone fragments. After approaching by coronal incision, we pulled out all bone fragments and reconstructed bone fragments by Histoacryl(R) and fixed those on frontal sinus by absorbable plates. RESULTS: Photographs and 3-dimensional CT obtained preoperatively and postoperatively. And we compared them each other in terms of accuracy of reconstructed bony contour. We could reconstruct almost all bone fragments easily along 3-dimensional structure and get excellent aesthetic results. There was no complication such as infection. CONCLUSION: In treatment of comminuted facial bone fracture, occurred in children, Histoacryl(R) is an excellent method for accurate reconstruction in small and thin bone fragments which cannot be fixed by wire, miniplate or absorbable plate without complication.
Child ; Enbucrilate ; Facial Bones ; Foreign Bodies ; Fractures, Comminuted ; Frontal Sinus ; Humans ; Reoperation ; Tissue Adhesives