The pure epithelioid malignant schwanoma is a rare form of malignant schwanoma and differs from the ordinary epithelioid malignant schwanoma because of the absence of a spindle cell component. We present a case of purely epithelioid malignant schwanoma arising in the parapharyngeal area from vagus nerve without difinite evidence of von Recklinghausen's disease. The patient was a 28-year-old man with palpable right neck mass and swallowing difficulty during 2 years. The mass was an ovoid encapsulated tumor and measured 5x3x3 cm in dimension. The cut surface showed brownish tan homogeneous nodular appearance with partly myxoid area. Microscopically the tumor showed nodular pattern composed of epitheliod cells which were arranged in both tight clusters and stringy cords. The cells were ovoid in shape and had vesicular nuclei with single prominent eosinophilic nucleolei and sometimes abundant intracytoplasmic mucin. Mitoses were infrequent. Ultrastructural study showed rudimentary cell junction and degenerated cytoplasmic organelles including scattered mitochondriae, short segments of rough endoplasmic reticulum and lipid droplets. There were no definite basement membrane and melanosome. Immunohistochemical study showed the cells being positive for S100 protein, neuron specific enolase and myelin basic protein and negative for cytokeratin.
Male ; Humans

No abstract available.
Thanatophoric Dysplasia*

No abstract available.
Thanatophoric Dysplasia*

A 23-year-old woman with Down syndrome presented erythematous keratotic plaques with whitish scales on the elbows, forearm, knee and leg. Histopathological findings revealed acanthosis with broad and short rete ridges, alternating orthokeratosis and parakeratosis oriented in both vertical and horizontal directions, and dermal superficial perivascular lymphocytic infiltration, compatible with pityriasis rubra pilaris.
Down Syndrome* ; Elbow ; Female ; Forearm ; Humans ; Knee ; Leg ; Parakeratosis ; Pityriasis Rubra Pilaris* ; Pityriasis* ; Weights and Measures ; Young Adult

Cutaneous manifestations of Vibrio vulnificus septicemia are bullae, vesicles, necrotic ulcers, localized swelling, cyanosis, and gangrene, which begin to occur mostly on the legs. The characteristic cutaneous lesions associated with pain often give an informative clue for the suspicion of Vibrio vulnificus infection in endemic area. We report a case of Vibrio vulnificus septicemia with atypical cutaneous manifestation of generalized erythema multiforme-like eruption in a Korean man, who died within 9 hours following hospitalization in spite of the intensive therapy. We suggest EM-like eruption of V. vulnificus septicemia is the novel cutaneous manifestation and may indicate poor prognosis.
Cyanosis ; Erythema* ; Gangrene ; Hospitalization ; Leg ; Prognosis ; Sepsis* ; Ulcer ; Vibrio vulnificus* ; Vibrio*

BACKGROUND: Plaque compression (and/or redistribution) and vessel expansion are important mechanisms of percutaneous coroanry balloon angioplasty. We investigated the mechanisms of balloon angioplasty according to plaque characteristics by intravascular ultrasound and assessed the time-sequencing morphometric changes of target vessel after balloon dilation without catheter change using intravascular ultrasound balloon catheter. METHOD: We studied balloon angioplasty in 10 patients (eight male, average age of 55.3 years). Quantitative coronary angiography and intravascular ultrasound images were attained at baseline and at timed intervals of 0sec, 60sec and 180sec post-balloon angioplasty. The following categories were attained : reference diameter, minimal lumen diameter, cross sectional area (CSA) of lumen (L), external elastic membrane (EEM), and plaque + media (P+M). We also assessed the plaque morphology of target lesion and classified them into two groups according to intravascular ultrasound imaging : a soft plaque group versus a group characterized by fibrous and/or mildly calcified plaque. RESULTS: The proportions of plaque compression in the total luminal gain were 80% in the soft plaque group and 70% in the other ; the absolute amount of plaque compression was 26.9% in soft plaque and 24.0% in the other group. The time sequencing changes of target lesion EEM CSA of both group were 14.4+/-2.9mm2, 14.3+/-3.8mm2 (baseline) 15.1+/-2.5mm2, 15.4+/-3.7mm2 (immediate) 15.0+/-2.8mm2, 14.5+/-3.9mm2 (180sec), those of P+M CSA (target lesion) were 10.4+/-3.3mm2, 10.7+/-2.4mm2 (baseline) 7.6+/-2.7mm2, 8.1+/-2.4mm2 (immediate) 7.9+/-2.9mm2, 8.5+/-3.4mm2 (180sec). Target lesion lumen CSA were 4.0+/-1.1mm2, 3.6+/-2.0mm2 (baseline) 7.5+/-1.1mm2, 7.3+/-3.2mm2 (immediate) 7.1+/-1.3mm2, 6.0+/-1.7mm2 (180sec) respectively. CONCLUSION: Plaque compression (and/or redistribution) is the predominant mechanism of luminal gain in both groups. The absolute amounts of P+M CSA changes and time sequencing increment of target lesion were similar in both groups. In the non-soft group, the immediate increment and time sequencing reduction of EEM CSA in target lesion were greater than those of the soft plaque group.
Angioplasty ; Angioplasty, Balloon ; Angioplasty, Balloon, Coronary* ; Catheters ; Coronary Angiography ; Humans ; Male ; Membranes ; Phenobarbital ; Ultrasonography

In the published article by Choi et al., a part of expression of the Abstract and the Conclusion section in the main body text have been corrected. Underlined text should be read carefully.

BACKGROUND: We investigated the risk factors for the recurrence of anterior shoulder instability after arthroscopic surgery with suture anchors and the clinical outcomes after reoperation. METHODS: A total of 281 patients (February 2001 to December 2012) were enrolled into our study, and postoperative subluxation and dislocation were considered as recurrence of the condition. We analyzed radiologic results and functional outcome including the American Shoulder and Elbow Surgeons Evaluation Form, the Korean Shoulder Society Score, and the Rowe scores. RESULTS: Of the 281 patients, instability recurred in 51 patients (18.1%). Sixteen out of 51 patients (31.4%) received a reoperation. In terms of the functional outcome, we found that the intact group, comprising patients without recurrence, had a significantly better functional outcome than those in the recurrent group. The size of glenoid defect at the time of initial surgery significantly differed between intact and recurrent group (p<0.05). We found that the number of dislocations, the time from the initial presentation of symptoms to surgery, and the number of anchor points significantly differed between initial operation and revision group (p<0.05). The functional outcome after revision surgery was comparable to intact group after initial operation. CONCLUSIONS: Eighteen percent of recurrence occurred after arthroscopic instability surgery, and 5.6% received reoperation surgery. Risk factors for recurrence was the initial size of glenoid defect. In cases of revision surgery, good clinical outcomes could be achieved using additional suture anchor.
Arthroscopy* ; Dislocations ; Elbow ; Humans ; Joint Instability ; Recurrence* ; Reoperation ; Risk Factors* ; Shoulder* ; Surgeons ; Suture Anchors* ; Sutures*

No abstract available.
Fetus* ; Humans ; Pregnancy, Twin*

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