Arteriovenous malformation of the uterus is rarely encountered. It is potentially lethal because of profuse, uncontrollable bleeding at the time of diagnostic dilatation and curettage. To our knowledge, only 38 cases of localized uterine arteriovenous malformation have been reported in English and Korean literature. Recently we experienced a case of uterine arteriovenous malformation in a 28-year-old multiparous woman. Under the clinical impression of uterine tumors or arteriovenous malformation, a total hysterectomy was done. Gross examination demonstrated a vascular nature of the mass in the posterior wall of the fundus. Microscopically, there was an ill-defined mass composed of numerous irregular, anastomosing large vessels with various diameters.
Female ; Humans

PURPOSE:To describe the features of displaced bucket-handle tears of the menisci on magnetic resonance (MR) images and to assess associated knee injuries. MATERIALS AND METHODS: We retrospectively reviewed coronal and sagittal MR images in 21 bucket-handle tears. The subjects were patients who had underwent preoperative MR evaluations of the knee and were identified from the arthroscopic surgical records as bucket-handle tear. We also described patterns of associated injuries. RESULTS:On coronal MR images, (a) in all cases, peripheral portion of the meniscus(bucket) had the appearance of a truncated or altered wedge;(b) central fragments(handle) were observed to be sitting in the intercondylar notch(16 cases) or located between the fernoral condyle and tibial plateau (5 cases). On sequential sagittal MR images, (c) the bow-tie appearance of the body of the meniscus was not seen (13 cases);(d) the bow-tie appearance of the displaced inner fragment was seen at the intercondylar notch level (9 cases);(e) "double posterior cruciate ligament" sign was presented (7 cases). Associated joint abnormalities included anterior cruciate ligament tears(l 1), contralateral meniscal tears(l 1), posterior cruciate ligament tears(3), medial collateral ligament tears(3), osteoarthritis(1), and Baker's cyst(l). CONCLUSION:Awareness of these characteristic MR findings(a-e) may increase the sensitivity of MR imaging in the diagnosis of displaced bucket-handle tears, and the MRI may be helpful to correctly characterize the displaced fragment and patterns of associated injury, providing arthroscopists a guide to appropriate surgical plans.
Anterior Cruciate Ligament ; Collateral Ligaments ; Diagnosis ; Humans ; Joints ; Knee ; Knee Injuries ; Magnetic Resonance Imaging* ; Posterior Cruciate Ligament ; Retrospective Studies

PURPOSE: The purpose of this study is to analyze left ventricular (LV) circumferential strain (S) and strain rate (SR) in children with dilated cardiomyopathy (DCM) and to evaluate whether the impairment of circumferential wall motion correlates with global ventricular dysfunction in DCM. METHODS: Ten DCM children (range 0.6-15 years, median 6.5 years, 3 females) and 17 age and sex matched normal controls were examined. After conventional echocardiography and tissue Doppler imaging analysis, segmental and global circumferential S and SR were measured using two dimensional speckle tracking imaging (STI) method at three levels of LV. RESULTS: Circumferential S and SR were markedly heterogeneous and decreased in almost all segments of LV in DCM. Peak global Sc (Sc G) was significantly reduced at three levels of LV (basal level; -15.7+/-3.8% vs. -9.5+/-3.6%, P=0.001, midventricular level; -13.5+/-3.5% vs. -6.5+/-3.3%, P<0.001, apical level; 14+/-5.1% vs. 6.2+/-4.1%, P=0.005). Global circumferential S and SR were correlated closely with other indices of global LV function and longitudinal and radial motion in normal and DCM children. CONCLUSION: In DCM, decreased circumferential S and SR are the major components of LV dysfunction. Analysis of circumferential S and SR with STI method can give further information on 3 dimensional LV mechanics in DCM.
Cardiomyopathy, Dilated* ; Child* ; Echocardiography ; Heart Ventricles ; Humans ; Mechanics ; Ventricular Dysfunction

A wide range of denomination has been used for inflammatory myofibroblastic tumor (IMT). IMT is not entirely homogeneous, even though it shows some overlapping histologic features such as haphazard proliferation of spindle cell and polymorphic chronic inflammatory cell infiltraion. The spindle cell is considered to be of myofibroblastic origin but follicular dendritic cell origin was reported recently. IMT is known as nonneoplastic, aberrant inflammatory response. However, IMT could show local invasion, recurrence, vascular invasion, and malignant transformation, and clonal characteristics and aneuploidy of IMT support the hypothesis that IMT may be a neoplastic process. In order to define the nature of spindle cell of IMT, immunohistochemical stains for smooth muscle actin (SMA), vimentin (VMT), lysozyme, S-100 protein, cytokeratin, CD21 were done. Additional immunohistochemical stains for MIB-1 for proliferating activity and LMP (latent membrane protein) for Epstein-Barr virus (EBV) were done. IMTs were composed of each 2 cases from lung, liver and lymph node and one case from common bile duct, maxillary sinus, bladder and thigh, and were histologically subclassified according to Coffin et al. Nine cases (90%) were positive for SMA and VMT, but no correlation between SMA and VMT immunoreactivity and histologic types was identified. Five cases (50%) were positive for lysozyme and S-100 protein, and histologic type III was negative for lysozyme and S-100 protein, and immunoreactivity for S-100 protein was different according to the histologic subtypes. All 11 cases were negative for CD21 and EBV LMP. MIB-1 labelling index was less than 1% in all cases. In summary, the spindle cell is regarded as myofibroblastic origin rather than follicular dendritic cell origin. Relationship with EBV is not clear, and negligible MIB-1 reaction suggests that IMT might have a good prognosis.
Actins ; Aneuploidy ; Coloring Agents ; Common Bile Duct ; Dendritic Cells, Follicular ; Herpesvirus 4, Human ; Immunohistochemistry ; Keratins ; Liver ; Lung ; Lymph Nodes ; Maxillary Sinus ; Membranes ; Muramidase ; Muscle, Smooth ; Myofibroblasts* ; Prognosis ; Recurrence ; S100 Proteins ; Thigh ; Urinary Bladder ; Vimentin

To evaluate the effect of adjunctive use of mitomycin C on endoscopic endonasal dacryocystorhinostomy(DCR), a total of 75 eyes of 66 patients diagnosed with naso-lacrimal duct obstruction were assigned randomly to either a mitomycin C group or a control group.The surgical procedures in both groups were exactly the same, except in the patients of mitomycin C group, a topical 0.2 mg/ml solution of mitomycin was applied to the osteotomy site intraoperatively for 5 minutes. Mean follow-up period was 6.8 months in the mitomycin C group and 7.2 months in the control group. The success rate of endoscopic DCR with intraoperative mitomycin C was 89% whereas the success rate of endoscopic DCR without mitomycin C was 79%. Membranous obstruction, causing failure of surgery occurred in five eyes in the control group while it occurred in two eyes in the mitomyicn C group. Synechia with middle turbinate was found in one eye in the control group, but there was no such synechia found in the patients in the mitomycin C group. Granulation tissue formation also occurred in two eyes in the mitomycin C group as well as in two eyes in the control group. During follow-up period, no complications such as mucosal necrosis, or infection were noted in any patients of mitomycin C group. Adjunctive use of mitomycin C as a wound healing inhibitor is considered to increase the success rate of endoscopic endonasal DCR.
Follow-Up Studies ; Granulation Tissue ; Humans ; Mitomycin* ; Necrosis ; Osteotomy ; Turbinates ; Wound Healing

OBJECTIVES: Hepatotoxicity of acetaminophen has been widely studied. However, the adverse effects on the heart have not been sufficiently evaluated. This study was performed to investigate cytotoxicity and alterations of gene expression in cultured cardiomyocytes (H9C2 cells) after exposure to acetaminophen. METHODS: H9C2 cells were incubated in a 10 mM concentration of acetaminophen for the designated times (6, 12, and 24 hours), and cytotoxicity was determined by the 3-(4, 5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide method. Alteration of gene expression was observed by microarray analysis, and RT-PCR was performed for the three representative oxidative stress-related genes at 24 hours after treatment. RESULTS: It revealed that acetaminophen was toxic to cardiomyocytes, and numerous critical genes were affected. Induced genes included those associated with oxidative stress, DNA damage, and apoptosis. Repressed genes included those associated with cell proliferation, myocardial contraction, and cell shape control. CONCLUSIONS: These findings provide the evidences of acetaminophen-induced cytotoxicity and changes in gene expression in cultured cardiomyocytes of H9C2 cells.
Acetaminophen ; Apoptosis ; Benzeneacetamides ; Cell Proliferation ; Cell Shape ; DNA Damage ; Gene Expression ; Heart ; Microarray Analysis ; Myocardial Contraction ; Myocytes, Cardiac ; Oxidative Stress ; Piperidones

In Korea, the proportion of B-cell and T-cell lymphomas has not yet been clearly estimated. In the present study, we analysed clinicopathologic and immunophenotypic findings in 60 cases of non-Hodgkin's lymphomas(NHL) and in 17 cases of polymorphic reticulosis. Immunohistochemical studies for monoclonal antibodies, such as MB2, UCHL-1, Kappa/Lambda light chains, and IgG/IgM/IgD heavy chains were performed on formaldehyde-fixed paraffin embedded tissue sections. Among 60 cases of NHL, 28 cases(46.7%) expressed B-cell markers, 29 cases(48.3%) T-cell markers, and 3 cases(5.0%) lacked detectable markers, whereas 16 of 17 cases(94.2%) of polymorphic reticulosis reacted with T-cell markers. The mean survival of the 16 cases of T-cell lymphoma group was shorter than that of the lymphoma group positive for B-cell markers.

Congenital self-healing reticulohistiocytosis (CSHRH) typically presents at birth or in the first few weeks of life as a widespread eruption of cutaneous red-brown papulonodules that resolve spontaneously without involvement of other organs. While multiple lesions are common, a solitary lesion is rare. We describe a solitary type of CSHRH in a full-term, male neonate. He had an erythematous papule with a yellowish crust on the left heel without any systemic symptoms. Four weeks later, the skin lesion had disappeared spontaneously.
Heel ; Humans ; Infant, Newborn ; Male ; Parturition ; Skin

Sarcomatoid carcinomas are malignant epithelial neoplasms in which the tumor cells assume a partial or complete spindle cell pattern of growth, leading to the erroneous classification of some true carcinomas as sarcomas. These spindle cells are malignant and manifest various amount of both vimentin and cytokeratin. Positive reaction of some of the spindle cells for cytokeratin antibodies is confirmatory. Clinical features do not differ significantly from those of patients with high-grade transitional cell carcinoma. So far, 13 cases of sarcomatoid transitional cell carcinoma of the renal pelvis have been reported in English and Korean literature. In this report, we describe clinicopathologic features of recently observed two cases of sarcomatoid transitional cell carcinoma of the renal pelvis and summarize the pathologic findings of previously reported cases with review of the literature.
Antibodies ; Carcinoma ; Carcinoma, Transitional Cell* ; Carcinosarcoma ; Classification ; Humans ; Keratins ; Kidney Pelvis* ; Sarcoma ; Vimentin

Trichloroethylene (TCE) is currently used as a degreasing agent in the jewelry manufacturing industry. The characteristic sign arising after the exposure of TCE are hepatitis and contact dermatitis. The incidence of toxicity is relatively rare, therefore, the mechanism of occurrence is considered as hypersensitivity. A previously healthy 21-year-old male began to work at jewelry industry. The solvent used in that place was TCE. Over the next month, he experienced symptoms of weakness, fever, dry skin, red rash and bumps, peeling face, and jaundice. At that time, he had marked liver enzyme elevation with evidence of cholestasis. After two weeks of avoidance of TCE exposure, his liver enzymes showed a marked reduction in ALT from a peak of 1132 to 131 IU/L. The total bilirubin reduced from 9.3 to 4.6 mg/dL. Tests for hepatitis A, B, and C, CMV, HIV were all negative. The patch test showed primary irritant reaction to TCE and its metabolite, trichloroethanol. This is the second report of TCE induced hepatotoxicity in Korea. We consider this case as a TCE induced hepatotoxicity due to possibly hypersensitivity mechanism.
Bilirubin ; Cholestasis ; Dermatitis, Contact ; Exanthema ; Fever ; Hepatitis A ; Hepatitis* ; HIV ; Humans ; Hypersensitivity ; Incidence ; Jaundice ; Jewelry ; Korea ; Liver ; Male ; Occupational Exposure* ; Patch Tests ; Skin ; Trichloroethylene ; Young Adult