We report a case of Becker's nevus associated with smooth muscle hamartoma, in a 21-year-old male patient, which shows clinically match-head sized, flat topped, round to oval, grouped papules with hairs on the outer surface of the right arm, and microscopically reveals numerous bundles of smooth muscle fiber in the dermis.
Arm ; Dermis ; Hair ; Hamartoma* ; Humans ; Male ; Muscle, Smooth* ; Nevus* ; Young Adult

Although the ultrasonography & CT have been regarded as a primary procedure in the differential diagnosis of upper abdominal mass, the CT was more superior in the diagnosis, its extent and relationship to the bowel in the cases of the leiomyosarcoma & leiomyoma of the stomach than those of the ultrasonography. The authors studied CT findings of 9 cases of pathologically proven gastric smooth muscle tumor (leiomyosarcoma 7, leiomyoma 2) during the last two years. The results were as follows: 1. CT findings of gastric leiomyosarcoma were often quite large mass, average 15 cm in diameter; extensive central necrotic or cystic changes were fou nd in all 7 cases, seen more clearly on postcontract scan; calcification and peripheral rim enhancement of the tumor were seen in one case each other. 2. Metastasis to the liver and the spleen was seen only in one case, which revealed centrally necrotic and ascites was found in one case. 3. Two cases of gastric leiomyoma were smaller in size, average 6.3 cm in diameter than those of leiomyosarcomaj central necrotic or cystic changes were less common and less extensive. 4. If there were no evidence of central necrotic or cystic changes in large peri-or juxtagastric tumor, ohe should consider other diagnostic possibilities such as left lobe hepatoma, exophytic stomach cancer, Iymphoma or other mesenchymal tumors than leiomyosarcoma.
Ascites ; Carcinoma, Hepatocellular ; Diagnosis ; Diagnosis, Differential ; Leiomyoma ; Leiomyosarcoma ; Liver ; Muscle, Smooth ; Neoplasm Metastasis ; Smooth Muscle Tumor ; Spleen ; Stomach ; Stomach Neoplasms ; Ultrasonography

High tibial osteotomy (HTO) is a widely performed procedure to treat medial knee arthrosis. In general, published studies on HTO report good long-term results with a correct patient selection and a precise surgical technique. The ideal candidate for an HTO is a middle aged patient (60 to 65 years of age), with isolated medial osteoarthritis, with good range of motion and without ligamentous instability. Some issues that need resolution remain; these include the choice between opening and closing wedge tibial osteotomy, the graft selection in opening wedge osteotomies, the type of fixation, the comparison with unicompartmental knee arthroplasty and whether HTO significantly affects a subsequent total joint replacement. Precise indication, preoperative planning, and operative technique selection are essential to achieve good results.
Arthroplasty ; Humans ; Joints ; Knee ; Ligaments ; Middle Aged ; Osteoarthritis ; Osteotomy ; Patient Selection ; Range of Motion, Articular ; Transplants

PURPOSE: To evaluate the radiographic, clinical results and the complications between who had intertrochanteric fracture, treated with the ITST or the PFN. MATERIALS AND METHODS: We selected each 30 patients of intertrochanteric fracture which were treated with ITST or PFN from July 2002 to November 2005. We evaluated the radiographic results by follow-up radiography and the clinical results with the mobility score of Parker and Palmer, Salvati and Wilson hip function scoring system and Jensen index. RESULTS: The mean distance of lag screw sliding was 4.1 mm at the ITST group and 6.6 mm at the PFN group. Decrease of mobility score of Parker and Palmer, Salvati and Wilson hip function score were similar. Patients complaint pain over lateral thigh area in 5 cases (ITST group) and 8 cases (PFN group). CONCLUSION: The ITST nail and PFN were seen good results in treatment of stable and unstable intertrochanteric fracture.
Femur* ; Follow-Up Studies ; Hip ; Hip Fractures* ; Humans ; Radiography ; Thigh

Cotinine ; Daegu ; Firefighters ; Fires ; Humans ; Male ; Sensitivity and Specificity ; Smoke ; Smoking ; Tobacco Use

BACKGROUND: In firefighters, smoking management is important because they are exposed to various harmful substances in their occupational environment. Accurate surveys of smoking status are essential to control tobacco use. The main disadvantage of self-report questionnaires, which are commonly used for investigating smoking status, is the possibility that the subjects' response are invalid. If the validity of firefighters' answers on smoking questionnaires is not adequate, different methods will be needed for investigating smoking status in firefighters. METHODS: This study was conducted on 445 male firefighters from 9 fire stations in Daegu (the city in South Korea) who visited a medical institution for medical checkup in 2016. The urine cotinine test strip (DCT-102; CLIAwaived Inc., cut-off value = 200 ng/mL) was used to classify the actual smoking status and to assess the validity of self-reported smoking status on questionnaires. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the smoking questionnaires were analyzed. Subjects testing positive in the urine cotinine test (assumed the actual current smokers) were selected. The frequency at which actual current smokers were misclassified as current non-smokers by the questionnaire was calculated. Subjects' characteristics were analyzed for possible association with any discrepancy between self-reported smoking status and urine cotinine test results. RESULTS: The smoking rates among firefighters surveyed using the smoking questionnaire and the urine cotinine test were 22.47% and 51.24%, respectively. Of the all subjects, 29.66% (n = 132) were misclassified. The sensitivity of the smoking questionnaire was 42.98%, the specificity was 99.08%, the PPV was 98.00%, and the NPV was 62.32%. In the 228 subjects classified as current actual smokers by the urine cotinine test, 57.02% (n = 130) were misclassified on the questionnaire. The misclassification rate increased with age. The degree of misclassification also increased when subjects had a history of disease. CONCLUSIONS In present study, the validity of the smoking questionnaire for firefighters was not suitable for investigating smoking status due to low sensitivity. To increase the validity of smoking status monitoring in firefighters, consideration of the various factors like survey environment, subjects' characteristics, and occupational factors is needed.

BACKGROUND: In firefighters, smoking management is important because they are exposed to various harmful substances in their occupational environment. Accurate surveys of smoking status are essential to control tobacco use. The main disadvantage of self-report questionnaires, which are commonly used for investigating smoking status, is the possibility that the subjects' response are invalid. If the validity of firefighters' answers on smoking questionnaires is not adequate, different methods will be needed for investigating smoking status in firefighters. METHODS: This study was conducted on 445 male firefighters from 9 fire stations in Daegu (the city in South Korea) who visited a medical institution for medical checkup in 2016. The urine cotinine test strip (DCT-102; CLIAwaived Inc., cut-off value = 200 ng/mL) was used to classify the actual smoking status and to assess the validity of self-reported smoking status on questionnaires. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the smoking questionnaires were analyzed. Subjects testing positive in the urine cotinine test (assumed the actual current smokers) were selected. The frequency at which actual current smokers were misclassified as current non-smokers by the questionnaire was calculated. Subjects' characteristics were analyzed for possible association with any discrepancy between self-reported smoking status and urine cotinine test results. RESULTS: The smoking rates among firefighters surveyed using the smoking questionnaire and the urine cotinine test were 22.47% and 51.24%, respectively. Of the all subjects, 29.66% (n = 132) were misclassified. The sensitivity of the smoking questionnaire was 42.98%, the specificity was 99.08%, the PPV was 98.00%, and the NPV was 62.32%. In the 228 subjects classified as current actual smokers by the urine cotinine test, 57.02% (n = 130) were misclassified on the questionnaire. The misclassification rate increased with age. The degree of misclassification also increased when subjects had a history of disease. CONCLUSIONS In present study, the validity of the smoking questionnaire for firefighters was not suitable for investigating smoking status due to low sensitivity. To increase the validity of smoking status monitoring in firefighters, consideration of the various factors like survey environment, subjects' characteristics, and occupational factors is needed.

Spontaneous rupture of the rectosigmoid colon and herniation of the small intestine through the rupture site and eventual evisceration through the anus is a very rare event. In the literature, only 42 cases have been reported. The majority of them occurred in patients with rectal prolapse and one case was reported in association with a third-degree uterine prolapse. We experienced an 81-year-old female patient with rectal prolapse and second-degree uterine prolapse complicated by spontaneous perforation of the rectosigmoid colon and anal evisceration of the small intestine. Segmental resection of the nonviable small intestine, primary repair of the ruptured rectosigmoid colon, and sigmoid loop colostomy were performed, and the patient recovered well. In our patient, both rectal and uterine prolapses cooperatively damaged the anterior wall of the rectosigmoid colon and resulted in perforation. So, rectal and uterine prolapses should be treated before the complication develops. In this patient, uterine prolapse should be treated because of the recurrence of this rare episode.
Aged ; Aged, 80 and over ; Case Report ; Colonic Diseases/etiology* ; Female ; Human ; Rectal Prolapse/complications* ; Rupture, Spontaneous ; Uterine Prolapse/complications*

PURPOSE: The presence of histologic coagulative necrosis in the primary tumors of patients with renal cell carcinoma has been suggested to be an important predictor of survival. This study aimed to evaluate the relationship of tumor necrosis and tumor location as compared to the other clinical features. MATERIALS AND METHODS: From June 1995 to April 2004 we retrospectively reviewed the records of 204 patients who underwent unilateral radical nephrectomy for stage T1a renal cell carcinoma. The presence of histologic coagulative necrosis in the primary tumors was recorded and the location of tumor was classified based on the computed tomography (CT) scan. Overall survival was estimated using the Kaplan-Meier method and the log-rank test, and the prognostic factors that influenced on survival were estimated using the Cox proportional hazard regression model. RESULTS: In this study, radical nephrectomy was performed in 148 men and 56 women with a mean age of 54.9 years (age range: 23 to 77). The mean follow-up was 31.3 months (range: 6 to 106 months). The average size of the renal cell carcinoma was 3.0cm (range: 1 to 4). The tumor locations were categorized into 2 types according to the centrality and verticality. The incidence of necrosis in T1a renal cell carcinoma was 8.7% (n=18). On the analysis of the overall survival using the log rank test, tumor necrosis (p=0.01) was a statistically significant factor. CONCLUSIONS: For the patients with T1a renal cell carcinoma (2002 TNM stage), the presence of tumor necrosis was significantly associated with overall survival.
Carcinoma, Renal Cell* ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Necrosis* ; Nephrectomy ; Retrospective Studies

PURPOSE: To investigate the incidence and histopathological factors of perirenal fat invasion (pT3a) in cT1a renal cell carcinomas. The implication for postoperative perirenal fat invasion, as a prognostic factor in patients with tumors less than 4cm tumor in size is also discussed. MATERIALS AND METHODS: Of 503 patients who underwent an operation for a renal cell carcinoma at our institution, between June 1995 and April 2004, we retrospectively reviewed the records of 176 with T1a renal cell carcinomas. We evaluated the pathological grade, cell type, tumor size, location and incidence of perirenal fat invasion using the Fisher's exact test. The overall survival was estimated using the Kaplan-Meier method and log-rank test, and the prognostic factors influencing the survival were estimated using the Cox proportional hazard regression model. RESULTS: In this study, a radical nephrectomy was performed in 128 men and 48 women, with a mean age of 54.6 years, ranging from 23 to 77. The mean follow-up was 31.3 months, ranging from 6 to 106 months. The average size of the renal cell carcinomas was 3.0cm, ranging from 1 to 4cm. The incidence of perirenal fat invasion in the T1a renal cell carcinomas was 5.7% (n=10). The nuclear grade (p<0.001) was a statistically significant factor in the incidence of postoperative perirenal fat invasion. CONCLUSIONS: In the patients with a renal cell carcinoma less than 4cm in size (cT1a), those in the postoperative perirenal fat invasion group had a significantly poorer prognosis. The tumor size and Fuhrman nuclear grade were implicated in the incidence of perirenal fat invasion in the T1a renal cell carcinomas. Therefore, in the case of nephron sparing surgery, more precise preoperative staging of the primary tumor is required.
Carcinoma, Renal Cell* ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Neoplasm Staging ; Nephrectomy ; Nephrons ; Prognosis ; Retrospective Studies