Choledochal cysts are rare congenital anomalies of the bile ducts. They consist of cystic dilatations of the extrahepatic biliary tree, intrahepatic radicles, or both. The standard treatment of choledochal cyst is complete excision of cyst and drainage procedure. I report a case of 48-year-old women who was diagnosed with type IV-A choledochal cyst with intrahepatic bile duct stricture and large stones in extrahepatic choledochal cyst. Sixteen years ago, she received a cholecystectomy and Reux-en Y cystojejunostomy due to choledochal cyst. Because of the intrahepatic bile duct stricture I performed a left hepatectomy, complete cyst excision and hepaticojejunostomy. I report this case with a review of the literature.
Bile Ducts ; Bile Ducts, Intrahepatic ; Biliary Tract ; Cholecystectomy ; Choledochal Cyst ; Constriction, Pathologic ; Dilatation ; Drainage ; Female ; Hepatectomy ; Humans ; Middle Aged

Median raphe canal is an uncommon disease and represents a defect abnormality of the male genitalia. It occurs along the ventral median raphe from the glans penis to the anus. Histologically the canal is lined by stratified squamous epithelium which dose not communicate with the urethra. Surgical excision is the treatment of choice. Recently we observed a 25-year-old male patient who had had a median raphe canal located in the ventral aspect of penis.
Adult ; Anal Canal ; Epithelium ; Genitalia, Male ; Humans ; Male ; Penis* ; Urethra

Sebaceous trichofolliculoma, which is a variant of trichofolliculoma, is a rare disease that clinically show a centrally depressed lesion usually singly on the nose, and histologically a centrally located cavity, lined by squamous epithelium, with numerous sebaceous lobules connected to them. We describe a case of sebaceous trichofolliculoma in a 27-year-old woman who had several brown papules on the nose. We think that this is the first report of sebaceous trichofolliculloma in Korean literature.
Adult ; Epithelium ; Female ; Humans ; Nose ; Rare Diseases

Vesicles and bullae are the primary lesions in many diseases. The histologic classification of bullous disorders is based on the level in the skin on which that cleavage developed. We report a 44-year-old man with vitiligo at dorsum of hand who has experienced spontanous bullae at recipient site after epidermal graft for the treatment of vitiligo. Histopathologic examination revealed a subepidermal bullae and moderate lymphocytes and eosinophil infiltration in the dermis. Direct immunofluorescence test was negative. There was a change of CD4/CD8 ratio in immunohistochemical staining for CD4 and CD8 monoclonal antibody. There were no clinical signs of infection and drug eruption, and friction did not seem to have been a contributing factor.
Adult ; Classification ; Dermis ; Drug Eruptions ; Eosinophils ; Fluorescent Antibody Technique, Direct ; Friction ; Hand ; Humans ; Lymphocytes ; Skin ; Transplants* ; Vitiligo*

We report here on a rare case of sarcomatoid carcinoma that contained an epithelial component of squamous cell carcinoma. A 77-year-old woman was found to have a gallbladder mass. The gallbladder showed a diffuse infiltrative wall mass with a polypoid lesion, and the mass measured 8x7x3 cm. There were no gallstones. Histologically, the tumor was composed of two components of squamous cell carcinoma and spindle cell malignancy. The tumor extended to the perimuscular connective tissue and one regional lymph node. The postoperative course was uneventful and the patient was well without tumor recurrence at one and a half months after surgery.
Aged ; Carcinoma, Squamous Cell ; Connective Tissue ; Female ; Gallbladder ; Gallstones ; Humans ; Lymph Nodes ; Recurrence

PURPOSE: The aim of this retrospective study was to determine the association between dental implants in the posterior region and traumatic occlusion in the adjacent premolars, using data collected during from 2002 to 2015. METHODS: Traumatic occlusion in the adjacent premolars was assessed by examining clinical parameters (bleeding on probing, probing pocket depth, fremitus, and tooth mobility) and radiographic parameters (loss of supporting bone and widening of the periodontal ligament space) over a mean follow-up of 5 years. Clinical factors (gender, age, implant type, maxillary or mandibular position, opposing teeth, and duration of functional loading) were evaluated statistically in order to characterize the relationship between implants in the posterior region and traumatic occlusion in the adjacent premolars. RESULTS: The study inclusion criteria were met by 283 patients, who had received 347 implants in the posterior region. The incidence of traumatic occlusion in the adjacent premolars was significantly higher for splinted implants (P=0.004), implants in the maxillary region (P<0.001), and when implants were present in the opposing teeth (P<0.001). The other clinical factors of gender, age, and duration of functional loading were not significantly associated with traumatic occlusion. CONCLUSIONS: This study found that the risk of traumatic occlusion in the adjacent premolars increased when splinted implants were placed in the maxillary molar region and when the teeth opposing an implant also contained implants.
Bicuspid* ; Dental Implants* ; Dental Implants, Single-Tooth ; Follow-Up Studies* ; Humans ; Incidence ; Molar ; Periodontal Ligament ; Retrospective Studies ; Splints ; Tooth ; Tooth Mobility

We report a case of Descemet's membrane detachment, a rare complication of viscocanalostomy. During the operation, the injection cannula was directed slightly oblique to the Schlemm's canal rather than parallel to it. Localized corneal whitening developed adjacent to the injection site during viscoelastic injection. One week postoperatively, corneal edema decreased and Descemet's membrane detachment was noted. Nine months after surgery, the cornea was clear while the Descemet's membrane detachment remained. And IOP was 19 mmHg without any medications. We think that improper cannula positioning during viscoelastic injection may cause Descemet's membrane detachment, a rare complication of viscocanalostomy.
Aged ; Case Report ; Corneal Diseases/*etiology ; *Descemet's Membrane ; Human ; Hyaluronic Acid/administration & dosage ; Injections/adverse effects ; Intraoperative Complications ; Male ; Ocular Hypertension/*surgery

Carcinosarcoma of gallbladder (CSGB) is a rare malignancy characterized by malignant epithelial and mesenchymal components. Its pathogenesis is unknown and most CSGBs are associated with poor survival because the disease normally presents at an advanced stage, and as a result, curative resection is uncommon. This report describes a case that underwent curative resection. A 77-year-old woman presented with right upper quadrant pain. The preoperative diagnosis was gallbladder (GB) cancer, and thus, curative radical cholecystectomy was performed. However, pathologic examination of the surgical specimen revealed that the tumor was composed of two histologic components of squamous cell carcinoma and spindle cell sarcoma, which was consistent with a diagnosis of carcinosarcoma. The tumor was found to extend to the perimuscular connective tissue and to have metastasized to one lymph node (LN). The prognosis of CSGB remains poor despite curative resection, and thus, the authors recommend that effort be made to improve surgical outcomes.
Aged ; Carcinoma, Squamous Cell ; Carcinosarcoma ; Cholecystectomy ; Connective Tissue ; Female ; Gallbladder ; Humans ; Lymph Nodes ; Prognosis ; Sarcoma

Leiomyoma and adenomyosis of the uterus are the most common gynecologic disorders in an enlarged uterus. The characteristic US and MR findings in differentiation between both lesions were prospectively evaluated in 30 patients. Of 30 patients, 15 were leiomyomas, 6 were adenomyosises, 8 were leiomyomas and adenomyosises, and 1 was a normal pregnancy, histologically. The total number of leiomyom nodules were 49 while adenomyosises were 14 (9 diffuse and 5 focal). Among 49 myomas nodules, 36 were correctly diagnosed by sonography. The characteristic US findings of uterine leiomyoma were well defined nodules (36), hypoechoic peripheral rim (16), and whorl-like internal echoes (13). Forty four of the 49 myoma nodules were correctly diagnosed by MRI. The characteristic MR findings of myoma were well defined nodules (43), peripheral low signal intensity rim on T1WI (13) and T2WI (9), and peripheral high signal intensity rim on T2WI (5). Among 14 adenomyosises, 9 were correctly diagnosed by sonography. The characteristic US findings of adenomyosis were diffuse uterine hypertrophy more than 5.5cm in AP diameter with endometrial displacement and no significant echo change in myometrium All 14 adenomyosis as were correctly diagnosed from MRI. On T2WI, adenomyosis appeared as ill defined localized or diffuse thickening of the junctional zone more than 1cm in thickness. It was our conclusion that to differentiate between leiomyoma and adenomyosis focused on should be the detection of existence of nodule in leiomyoma, the primary sign, not on the secondary indirect sign.
Adenomyosis* ; Animals ; Female ; Humans ; Hypertrophy ; Leiomyoma* ; Magnetic Resonance Imaging ; Mice ; Myoma ; Myometrium ; Pregnancy ; Prospective Studies ; Uterus

One step TaqMan reverse transcription polymerase chain reaction (RT-PCR) using TaqMan probe was developed for detection of Japanese encephalitis virus (JEV). Real-time RT-PCR was optimized to quantify JEV using the detection system (Rotor Gene 2000 detector) and dual-labeled fluorogenic probes. The gene specific labeled fluorogenic probe for the 3' non-translated region (3' NTR) was used to detect JEV. When the specificity of the assay using specific JEV primers was evaluated by testing three different JEV strains, other swine viruses and bovine viral diarrhea virus, no cross-reactions were detected with non-JE reference viruses. A single tube TaqMan assay was shown to be 10-fold more sensitive than the conventional two-step RT-PCR method. Detection limits of two step and real-time RT-PCR for JEV were 112 TCID50 /ml and 11.2 TCID50 /ml, respectively. Quantification of JEV was accomplished by a standard curve plotting cycle threshold values (Ct ) versus infectivity titer. Real-time RT-PCR assay using single tube method could be used as a sensitive diagnostic test, and supplied the results in real time for detection and quantification of JEV. We could detect JEV RNA genome in plasma samples of pigs inoculated with KV1899 strain at 2 days post inoculation, but couldn't in 41 fetus samples. This assay was sensitive, specific, rapid and quantitative for the detection of JEV from laboratory and field samples.
Animals ; DNA Primers/chemistry ; DNA Probes/chemistry ; Encephalitis Virus, Japanese/genetics/*isolation&purification ; Encephalitis, Japanese/diagnosis/*veterinary/virology ; RNA, Viral/analysis ; Reproducibility of Results ; Reverse Transcriptase Polymerase Chain Reaction/methods/*veterinary ; Sensitivity and Specificity ; Swine ; Swine Diseases/*diagnosis/virology ; *Taq Polymerase