Proliferative myositis is very rare and was first described as a specific entity in 1960 by Kern. Proliferative myositis is a benign reactive condition that appears as a rapidly growing mass in the proximal muscles of the extremities of adults. Proliferative myositis can be confused with sarcoma clinically as well as microscopically. Proliferative myositis is a bizarre, self-limiting fibroblastic proliferation, the presence of very large basophilic cells with vesicular nucleoli and very prominent nucleoli which resemble ganglion cells or rhabdomyoblast, the cause of which is unclear. The symptoms are non-specific and the diagnosis always rests on a histological examination of the tissue. Local excision is curative and recurrence or metastasis has not been reported even when the abnormal tissue has not been completely excised. The authors report a case of Proliferative myositis in a 59-year-old male.
Adult ; Male ; Female ; Humans

PURPOSE: This study was performed to determine the natural history of histologically confirmed IgA nephropathy in pediatric patients who presented with hematuria and proteinuria. PATIENTS AND METHODS: We reviewed the clinical course of 57 patients diagnosed with IgA nephropathy at the age of 15 years or younger from 1981 to 2000. All patients presented with hematuria or minimal proteinuria(<40 mg/m2/day) and had normal renal function and blood pressure at the time of renal biopsy. Based on the clinical and pathological findings at the time of diagnosis, we sought for complications of IgA nephropathy such as heavy proteinuria(> or =40 mg/m2/day), hypertension, and chronic renal failure. RESULTS: The mean age at presentation was 9.5+/-2.8 years(4 to 15 years) and 42(74%) were male. Isolated gross hematuria was observed in 20 patients(35%), microscopic hematuria in 3(5%), minimal proteinuria in 4(7%), both gross hematuria and minimal proteinuria in 15(26 %), and both microscopic hematuria and minimal proteinuria in 15(26%). During a median follow-up of 7.0+/-3.5 years, 38(67%) had complete resolution of hematuria and proteinuria, 12(21%) had persistently abnormal urinalysis without development of adverse events. Only 7(12%) developed adverse events:4(7%) developed severe proteinuria, 1(2%) became hypertensive, and 2(3%) developed impaired renal function. By univariate analysis using the chi-square test, the age at presentation(>10 years)(P<0.01) and poor histological classes of the Lee or Haas classification at onset(P<0.05) were significantly correlated with adverse events, whereas sex and clinical signs at onset were less concordant. CONCLUSION: We can conclude that the prognosis of IgA nephropathy diagnosed in early childhood is better and a good correlation exists between the clinical manifestations of this disease and the histological classes.
Biopsy ; Blood Pressure ; Child* ; Classification ; Diagnosis ; Follow-Up Studies ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Hypertension ; Immunoglobulin A* ; Kidney Failure, Chronic ; Male ; Natural History ; Prognosis* ; Proteinuria ; Urinalysis

Branchio-oto-renal (BOR) syndrome is a rare congenital anomaly that is characterized by preauricular pits, branchial fistula and hearing impairment and it is often combined with renal anomalies. BOR syndrome is inherited in an autosomal dominant mode and the mutations of two genes, EYA1 and SIX1, have been identified. We experienced a case of a 14-year-old female who complained of bilateral neck openings and hearing loss that were found at birth the girl's family had a familial tendency for these features. A skin biopsy from the cervical lesion showed the characteristic features of branchial fistula. We report here on a case of BOR syndrome and we review the relevant literature.
Adolescent ; Biopsy ; Branchio-Oto-Renal Syndrome ; Female ; Fistula ; Hearing Loss ; Humans ; Neck ; Parturition ; Skin

Schwannoma is a common soft tissue tumor, but it appears to be rare among the spindle cell mesencymal tumors of the gastrointestinal tract. Gastrointestinal Schwannomas (GIS) are rare and most of them originate in the stomach or the small bowel. GIS of the colon is extremely rare. The most important issue to be addressed for this type of tumor is the difficulty in making the correct preoperative diagnosis. Less than 10% of cases have been diagnosed as schwannoma preoperatively. A 58-year-old man was found to have a 3.5cm sized submucosal transverse colon tumor on the preoperative colonoscopy, abdominal CT and MRI. Wedge resection was done and the submucosal mass was diagnosed as schwannoma on the immunochemical staining. The immunochemical results were negative staining for CD 117(KIT) and CD 34 and positive staining for S-100 protein, which is all consistent with schwannoma. We report here on the first case of colonic schwannoma in Korea, along with a review of the literature.
Colon* ; Colon, Transverse ; Colonoscopy ; Diagnosis ; Gastrointestinal Tract ; Humans ; Korea ; Magnetic Resonance Imaging ; Middle Aged ; Negative Staining ; Neurilemmoma* ; S100 Proteins ; Stomach ; Tomography, X-Ray Computed

No abstract available.

PURPOSE: Studies to determine the relation between oxygen tension and outcome in cardiac arrest survivors treated with therapeutic hypothermia (TH) are lacking. We investigated the relation of time-weighted mean oxygen tension (TWMO2) and outcome in cardiac arrest survivors treated with TH. METHODS: This was a retrospective observational study including 177 out-of-hospital cardiac arrest (OHCA) survivors. The patients were divided into four categories according to quartile values of TWMO2. The primary outcome was neurologic outcome at discharge and the secondary outcome was all cause in-hospital mortality. We assessed neurologic outcome using the Cerebral Performance Categories (CPC) at hospital discharge. Neurologic outcome was dichotomised as either good neurologic outcome (CPC1 and CPC2) or poor neurologic outcome (CPC 3 to 5). The odds ratio with 95% confidence interval (CI) was estimated. RESULTS: The median value of PaO2 was 139(104.5-170.0) mmHg. Among a total of 1,239 PaO2 values, 22(1.8%) values were hypoxia (<60 mmHg) and 16(1.3%) values were hyperoxia (>300 mmHg). Results of univariate logistic regression analysis showed a significantly low odds ratio for poor neurologic outcome [0.353(95% CI, 0.133-0.938) and 0.321(95% CI, 0.121-0.850), respectively] and for in-hospital mortality [0.338(95% CI, 0.132-0.870) and 0.387(95% CI, 0.154-0.975), respectively] for the third quartile and the fourth quartile. However, results of multivariate logistic regression analysis showed no significant relation between TWMO2 and outcomes. CONCLUSION: In OHCA survivors treated with TH, time-weighted oxygen tension did not show an association with neurologic outcome and in-hospital mortality.
Anoxia ; Heart Arrest ; Hospital Mortality ; Humans ; Hyperoxia ; Hypothermia* ; Logistic Models ; Observational Study ; Odds Ratio ; Out-of-Hospital Cardiac Arrest* ; Oxygen* ; Retrospective Studies ; Survivors*

PURPOSE: Hypothermia has been demonstrated to protect the brain from reperfusion injury in patients suffering from cardiac arrest. We hypothesized that infusion of normal saline at 4 degrees C into the carotid artery (hypothermic carotid arterial flush, HCAF) during cardiac arrest would achieve selective cerebral hypothermia during cardiac arrest and cardiopulmonary resuscitation (CPR), without a detrimental effect on the rate of return of spontaneous circulation (ROSC) or significant impairment of cardiopulmonary function after ROSC. METHODS: Ventricular fibrillation was induced in 18 dogs weighing 12~18 kg, and circulatory arrest was maintained for 9 minutes. The subjects were then resuscitated using open cardiac massage. Group I (n=6) received no normal saline, while the dogs of group II (n=6) and group III (n=6) received infusions of 15 ml/kg and 30 ml/kg of normal saline solution, respectively, at 4 degrees C into both carotid arteries (cephalad) via 18 gauge catheters. RESULTS: Tympanic temperature decreased from 37.7 (37.5~37.7) degrees C to 34 degrees C within 1.2 (1~2) min and 1.0 (1~2) min from the start of HCAF in groups II and III, respectively. Thereafter, tympanic temperatures were maintained below 34 degrees C to 7.7 (1.5~14.5) min and 21.2 (12~37) min, respectively, from the start of HCAF in groups II and III. There were no significant differences in CPR-related variables or post-ROSC hemodynamic and laboratory variables between the two groups. CONCLUSION: HCAF rapidly induces selective cerebral hypothermia without detrimental effects on the rate of ROSC or significant impairment of cardiopulmonary function after ROSC.
Animals ; Brain ; Cardiopulmonary Resuscitation ; Carotid Arteries ; Catheters ; Dogs ; Heart Arrest* ; Heart Massage ; Hemodynamics ; Humans ; Hypothermia* ; Reperfusion Injury ; Sodium Chloride ; Ventricular Fibrillation

OBJECTIVE: We investigated the association between lactate clearance or serum lactate levels and neurologic outcomes or in-hospital mortality in cardiac arrest survivors who were treated with targeted temperature management (TTM). METHODS: A retrospective analysis of data from cardiac arrest survivors treated with TTM between 2012 and 2015 was conducted. Serum lactate levels were measured on admission and at 12, 24, and 48 hours following admission. Lactate clearance at 12, 24, and 48 hours was also calculated. The primary outcome was neurologic outcome at discharge. The secondary outcome was in-hospital mortality. RESULTS: The study included 282 patients; 184 (65.2%) were discharged with a poor neurologic outcome, and 62 (22.0%) died. Higher serum lactate levels at 12 hours (odds ratio [OR], 1.157; 95% confidence interval [CI], 1.006 to 1.331), 24 hours (OR, 1.320; 95% CI, 1.084 to 1.607), and 48 hours (OR, 2.474; 95% CI, 1.459 to 4.195) after admission were associated with a poor neurologic outcome. Furthermore, a higher serum lactate level at 48 hours (OR, 1.459; 95% CI, 1.181 to 1.803) following admission was associated with in-hospital mortality. Lactate clearance was not associated with neurologic outcome or in-hospital mortality at any time point after adjusting for confounders. CONCLUSION: Increased serum lactate levels after admission are associated with a poor neurologic outcome at discharge and in-hospital mortality in cardiac arrest survivors treated with TTM. Conversely, lactate clearance is not a robust surrogate marker of neurologic outcome or in-hospital mortality.
Biomarkers ; Heart Arrest* ; Hospital Mortality ; Humans ; Hypothermia, Induced ; Lactic Acid* ; Prognosis ; Retrospective Studies ; Survivors*

BACKGROUND: This study was done to determine whether the Osteoporosis Self-assessment Tool (OST) can predict central bone mineral density in Korean men above 50 years, as defined by dual energy X-ray absorptionmetry (DXA). METHODS: We applied the OST index to Korean men aged over 50 in Health Promotion Center of Konkuk University Hospital from September 2005 to September 2008. The calculated OST risk index was based on weight and age, truncated to an integer. RESULTS: The study population was 276 men. The mean age, height and weight of the men were 59.7 +/- 6.69 years, 167.6 +/- 6.14 cm and 67.5 +/- 8.93 kg respectively. By DXA, 4.7% of the men had a T score of -2.5 or less, and 46.4% had a T score of -2 or less at the spine, total hip, or femoral neck. The OST index ranged from -4 to 7. Using a cutoff score of 0, we predicted osteoporosis with a sensitivity of 85% and a specificity of 62%. The receiver operating characteristic curve showed an area under the curve of 0.77. When the subjects were analyzed by age and smoking status, the predictive value of the OST was maintained. CONCLUSION: The OST is a simple and useful method to predict osteoporosis in Korean men.
Aged ; Bone Density ; Femur Neck ; Health Promotion ; Hip ; Humans ; Male ; Mass Screening ; Osteoporosis ; ROC Curve ; Self-Assessment ; Sensitivity and Specificity ; Smoke ; Smoking ; Spine

Purpose: Tumors of the foot and ankle account for approximately 3%~5% of all musculoskeletal tumors, and accurate diagnosis is often delayed due to their rare prevalence. Therefore, the authors aimed to analyze the incidence, treatment methods, and prognostic factors of foot and ankle tumors treated at the authors’ hospital. Materials and Methods: A retrospective single-center study examined 342 patients treated for foot and ankle tumors at the authors’ hospital from January 2011 to February 2022. Data were collected from the electronic medical records (EMR) and picture archiving and communication systems (PACS). The information analyzed included gender, age, follow-up period, diagnosis, tumor occurrence and recurrence, treatment, and clinical outcomes. Results: Most cases (93.3%) were benign, but 6.7% were malignant. The main treatment for malignant tumors was surgical resection (91.3%). Approximately 53.1% of benign tumors and 91.3% of malignant tumors were treated with surgery, and two of the malignant tumors that did not undergo surgery had metastatic cancer. After surgery, 8.2% of benign lesions and 19.0% of malignant lesions recurred, and 9.5% of the patients with malignant tumors died after surgery. Conclusion Most foot and ankle tumors are benign tumors, and the prognosis is not poor if treated properly, but most malignant tumors often require amputation. In some cases, however, amputation can be avoided with a combination of chemotherapy and radiation therapy.