Membranous lipodystrophy is a peculiar type of fat necrosis, present in patients with various types of skin diseases. It is charaeterized by the presence of microcysts and macrocysts lined by amorphous eosinophilic material with a crenelated arabesque appearance and microgranules in the subcutis with massive fat necrosis. The eosinophilic lining and microgranules stain positively with periodic acid-Schiff, are resistant to diastase, and also stain with Sudan black B. We report three cases of subcutanous membranous lipodystrophy in patients with erythema induratum, posttraumatic panniculitis and morphea with typical clinical and histopathologic findings.
Amylases ; Eosinophils ; Erythema Induratum ; Fat Necrosis ; Humans ; Lipodystrophy* ; Panniculitis ; Scleroderma, Localized ; Skin Diseases ; Sudan

Eosinophilic panniculitis is characterized by a prominent infiltration of numerous eosinophils in subcutaneous fat, and has been identified in patients with a variety of associated clinical conditions. A case of eosinophilic panniculitis in a 20-year-old woman with a history of atopic dermatitis is reported. She later developed superior sagittal sinus thrombosis, and we stress the importance of systemic evaluations in patients with eosinophilic panniculitis.
Dermatitis, Atopic ; Eosinophils* ; Female ; Humans ; Panniculitis* ; Subcutaneous Fat ; Superior Sagittal Sinus* ; Thrombosis* ; Young Adult

Three patients with complex partial seizures had dysembryoplastic neuroepithelial tumor (DNET) in temporal lobe. In all cases, longterm video-EEG monitoring showed epileptogenic focus in left temporal lobe where small mass lesion was located. For further seizure localization and functional mapping, subdural grids were placed on left temporal lobe including lesions. Lateral temporal lobectomy with lesionectomy was performed in two cases. Lateral temporal lobe resection and amygdalohippocampectomy was done in one case. The pathological findings of all lesions were characterized by intracortical location, multiple nodular architecture, foci of dysplastic cortical disorganization and the presence of a specific glioneuronal element. All patients have been seizure free.
Epilepsy, Temporal Lobe* ; Humans ; Neoplasms, Neuroepithelial* ; Seizures ; Temporal Lobe*

Bladder cancer is generally manifested with gross hematuria and this is the most common urinary tract neoplasm in Korea, but it is very rare to find it combined with a contracted bladder. A case of contracted bladder was suspected as being recurred urinary tuberculosis; because of her past history, the urine analysis and cystoscopic findings seemed to resemble the chronic inflammation associated with urinary tuberculosis, and the transurethral biopsy reported only chronic inflammation. Yet the final histopathologic report after cystectomy and urinary diversion revealed that there was no tuberculosis, but rather, there was bladder transitional cell carcinoma (TCC). Therefore, any contracted bladder found in an older age patient is considered to be a urinary TCC until proven otherwise. To the best of our knowledge, this is the first case of bladder TCC combined with contracted bladder.
Biopsy ; Carcinoma, Transitional Cell* ; Cystectomy ; Hematuria ; Humans ; Inflammation ; Korea ; Tuberculosis ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urinary Diversion ; Urologic Neoplasms

BACKGROUND: Experimental data indicate that low-flow reperfusion following prolonged cardiocirculatory arrest may aggravate early cerebral microcirculatory repefusion disorders. We investigated the influence of cerebral repefusion flow change to the ischemic histopathologic damage of brain tissue after incomplete forebrain ischemia in rats. MATERIALS AND METHOD: Anesthetized Sprague-Dawley rats were undergone ligation of both infernal carotid artery by microvascular clamp for 10 minutes. After release of the clamp, reperfusion was started with several different flow levels (0, 10, 20, 30, 50, and 100%) of infernal carotid artery comparing to pre-clamping phase using flowmeter. After 15minutes of reperfusion, rat brains were prepared by perfusion-fixation with 3% formaldehyde. Under light microscopic examination of Hematoxylin-Eosin stained tissue slide, histopathologic damage was examined at cortex, putamen, and hippocampus regions. Categorical hisotopathologic damage scores were derived in each regions by manual counts of ischemic neurons. RESULT: The histopathologic damage scores were 0, 10. 2+/-0.5, 7.6+/-1.5, 5.9+/-1.4, 5.0+/- 2.8, 3.5+/-0.7, and 1.0+/-0.0 in control, 0, 10, 20, 30, 50, and 100% reperfusion groups, respectively(p<0.05). CONCLUSION: Our insults showed significant increment of brain histopathologic damage scores along with decreasing amount of cerebral reperfusion know after incomplete forebrain ischemia. We believe restoration of repefusion flow to pre-ischemic level would be a critical component in attenuation of brain ischemic damage.
Animals ; Brain ; Carotid Arteries ; Flowmeters ; Formaldehyde ; Hippocampus ; Ischemia* ; Ligation ; Models, Animal* ; Neurons ; Prosencephalon* ; Putamen ; Rats* ; Rats, Sprague-Dawley ; Reperfusion*

Systemic lupus erythematosus is a multisystemic autoimmune disease in which the kidneys are frequently involved. Clinical diagnosis of SLE is based on the criteria of American Rheumatism Association (ARA). A few cases who were classified as SLE by the ARA criteria but were antinuclear antibody (ANA)-negative have been reported. It was reported that critical factor in ANA positivity is the choice of substrate. It is generally accepted that the cultured cell of human origin, especially HEP-2 cell, is better than tissue section or animal cells. Thus, the ANA test is negative only in approximately 2M of SLE patients when human tissue culture cells are used as substrate. We report a 25-year-old man admitted to our hospital because of generalized edema. He was found to have active lupus nephritis(WHO class IV), photosensitivity and pancytopenia. The result of FANA test which used HEP-2 cell as substrate was repeatedly negative, but anti-ds DNA and anti-Ro antibody were positive.
Adult ; Animals ; Antibodies, Antinuclear ; Autoimmune Diseases ; Cells, Cultured ; Diagnosis ; DNA ; Edema ; Humans ; Kidney ; Lupus Erythematosus, Systemic ; Lupus Nephritis* ; Pancytopenia ; Rheumatic Diseases

This study was conducted to investigate the effect of nutrition counseling program and related factors on weight control for obese university students. Subjects were 24 students with a body mass index (BMI) of 25 or above. The program was conducted from September 16th to November 18th, 2015. Change of body composition, blood index and nutrient intake were observed in subjects before and after the program. The average age of the subjects was 23.2 years old and the percentage of male and female was 66.7% and 33.0%, respectively. There were tendencies of decrease in weight, amount of body fat, BMI, and body fat percentage. The blood test showed that values of all biochemical parameters were in the normal range before and after the program. When the change of the nutrient intake was examined and compared with the Dietary Reference Intakes for Koreans (KDRIs), there was a tendency of decreased intake in most of the nutrients including protein. However, the nutrient quality index showed increasing tendency, which implies that the intake of micronutrients was getting balances simultaneously with the decrease of calorie intake.
Adipose Tissue ; Body Composition ; Body Mass Index ; Counseling* ; Female ; Hematologic Tests ; Humans ; Male ; Micronutrients ; Recommended Dietary Allowances ; Reference Values

PURPOSE: The purpose of this study was to analyze patient factors including smoking, body mass index, correction angle, graft material, presence of lateral cortex fracture, and age for the effect on bone union after open-wedge high tibial osteotomy and the effect of graft material used for lateral cortex fractures. MATERIALS AND METHODS: This retrospective study was conducted on 54 patients and 58 cases with osteoarthritic change Kallgren-Lawrence grade 2 or less from May 2012 to June 2014. Average follow-up period was 22 months (14–38 months). The patients were divided into two groups according to patient related factors and graft materials (allograft, n=6; beta-tricalcium phosphate [β-TCP], n=6) used for lateral cortex fractures and were analyzed for the relationship with bone union after open-wedge high tibial osteotomy. Radiographic and clinic analyses were performed, and van Hemert grading was used for grading bone union at 6 weeks, 3 months, 6 months, and 1 year postoperatively. RESULTS: The non-smoking group and the group without lateral cortex fracture showed significantly higher bone union rates than the control group. No significant clinical or radiological difference was observed between the two groups in 12 cases and the allograft group showed significantly higher rates of union at 6 months and 1 year postoperatively according to the van Hemert grading. CONCLUSION: Smoking and the presence of a lateral cortex fracture is a risk factor for nonunion in medial open-wedge high tibial osteotomy. The use of allograft material rather than β-TCP for lateral cortex fractures is thought to result in better bone union.
Allografts ; Body Mass Index ; Follow-Up Studies ; Humans ; Knee ; Osteoarthritis ; Osteotomy* ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Transplants*

PURPOSE: The evaluation of a lecture by students is one of the good way to improve a lecture. In one medical school, we started one-year-integrated-lecture curriculum for sophomore. And we evaluated lectures using formal lecture evaluation sheet after completion of each integrated lectures. The results were fed back to lecturers. But lecturers were indifferent to the results. So we performed this study to evaluate the current lecture evaluation method. METHODS: Answering patterns of evaluation sheets were reviewed. 50 students entitled to integrated lectures were given structured questions. 44 of them recovered. And randomly selected 10 students were interviewed. RESULTS: Analysis of evaluation sheets showed that some students checked the items just for fun. More than half of the students answered that they did not check the questions seriously. Reasons why the evaluation of lectures were not going well were; students were not trained to evaluate something; evaluation sheet was not designed to evaluate individual lecturer; listed items were too many in number and inappropriate; some students were suspicious about the impact of evaluation of lectures. In addition to this, it was revealed that students thought the timing of evaluation of lecture was important, too. CONCLUSION: Indifference of lecturers to the results is one form of resistance to the evaluation of lectures by students. To make evaluation of lectures effective, numbers and contents of evaluation items must be selected carefully, students need to be trained, and adequate evaluation timing should be determined with frequent feed backs.
Curriculum ; Humans ; Lectures ; Schools, Medical*

PURPOSE: Deep vein thrombosis (DVT) is a serious disease which causes life-threatening pulmonary embolism and chronic venous insufficiency. In order to prevent pulmonary embolism, inferior vena cava (IVC) filter placement is commonly performed nowadays. We carried out this study to analyze the patterns of the indications for IVC filter placement, the complications associated with procedure, and the follow-up results. METHOD: We treated 42 patients with acute DVT between September 2001 and November 2002 at Gil Medical Center. Our subjects included 10 patients who underwent IVC filter placement during the same period. Duplex sonography and CT venography were performed in all cases. The filter was placed by one interventional radiologist just after checking the nonselective venography. The patients were followed monthly with a physical examination. Plain abdominal film was checked every 3 months, and CT venography every 6 months. RESULT: The mean age was 55.6 years (range 35~72) and the male-to-female ratio was 1:4. The associated diseases were advanced cancer in 3 cases, intracranial hemorrhage in 2 and spinal cord injury and ankylosis of the hip joint in 1. There were 8 cases of hypercoagulable states; 7 of protein S deficiency, 3 of protein C deficiency and 1 of antithrombin III deficiency. Indications for filter insertion were a contraindication to anticoagulation in 5 cases, recurrent pulmonary embolism in 2, floating IVC thrombosis in 2, complication of anticoagulation in 1, prophylactic use before catheter-directed thrombolysis in 1, and quadriplegia in 1. Four Greenfield filters and six TrapEase filters were used. Filters were deployed at infrarenal IVC in 8 cases and suprarenal IVC in 2 cases. There were no major complications related to the procedure. Late complications were not detected during the 7-month follow-up (range 2~16 months). CONCLUSION: We performed 10 IVC filter placements for therapeutic purpose without any serious complications. A wider range of indications, including prophylactic use, might be considered in the future practice for DVT.
Ankylosis ; Antithrombin III Deficiency ; Follow-Up Studies ; Hip Joint ; Humans ; Intracranial Hemorrhages ; Phlebography ; Physical Examination ; Protein C Deficiency ; Protein S Deficiency ; Pulmonary Embolism ; Quadriplegia ; Spinal Cord Injuries ; Thrombosis ; Vena Cava Filters* ; Vena Cava, Inferior* ; Venous Insufficiency ; Venous Thrombosis*