Various epidermal changes overlying a dermatofibroma can be induced through the proliferation of pluripotential epidermal cells by the stimulation of mesenchymal factors. The authors report a case of dermatofibroma in a 55-year-old male who had a reddish brown, asymptomatic nodule of 5 years duration on his left forearm. The biopsy specimen revealed a dermatofibroma of cellular type associated with epidermal changes: (1) acanthosis; (2) elongation of rete ridges; (3) thin interlacing epidermal strands with increased pigmentation resembling seborrheic keratosis or fibroepithelioma; (4) immature hair follicles and sebaceous lobules; (5) hair germ like buddings; (6) superficial basal cell epithelioma-like proliferations.
Biopsy ; Forearm ; Hair ; Hair Follicle ; Histiocytoma, Benign Fibrous* ; Humans ; Keratosis, Seborrheic ; Male ; Middle Aged ; Pigmentation

No abstract available.
Fascia* ; Foot* ; Free Tissue Flaps* ; Hand* ; Rabeprazole*

PURPOSE: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. MATERIALS AND METHODS: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's(R) Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS(R) proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. RESULTS: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. CONCLUSION: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.
Breast Neoplasms ; Carcinoma, Hepatocellular ; Carcinoma, Renal Cell ; Colonic Neoplasms ; Dislocations ; Female ; Femur* ; Follow-Up Studies ; Fractures, Spontaneous ; Hematoma ; Humans ; Limb Salvage* ; Lung Neoplasms ; Male ; Multiple Myeloma ; Osteosarcoma ; Periprosthetic Fractures ; Prostatic Neoplasms ; Prostheses and Implants* ; Recurrence ; Thyroid Neoplasms ; Walking ; Weights and Measures

BACKGROUND: The laparoscopic cholecystectomy has become the treatment of choice for the majority of patients with cholecystopathy. The objectives of this study were to evaluate the safety and the efficacy of the laparoscopic cholecystectomy by reviewing of the case histories of three hundred ten consecutive patients treated with a laparoscopic cholecystectomy. METHODS: We retrospectively analyzed the initial 310 laparoscopic cholecystectomies performed at the Department of General Surgery, Sun General Hospital, from May 1993 to December 1998. Sex, age, associated diseases, previous history of abdominal operation, duration of operation, reason for conversion to open cholecystectomy, hospital stay, and postoperative complications were analyzed. RESULTS: The postoperative diagnosis was chronic cholecystitis in 213 patients, acute cholecystitis in 53 patients, cholesterolosis in 17 patients, gallbladder (GB) empyema in 13 patients, acalculous cholecystitis in 9 patients, and gallbladder carcinomas in 3 patients. The common associated diseases were diabetes mellitus and hypertension. The mean durations of operation, diet, and hospital stay were 77.6 minutes. 1.2 days, and 5 days, respectively. The mean numbers of drainages and injected analgesics were 0.8 and 1.6, respectively. Conversion to an open cholecystectomy was necessary in 8 of the 310 patients (2.6%) who underwent a laparoscopic cholecystectomy either because of severe adhesion (n=6), difficulty with anatomic identification in Calot's triangle (n=1), or severe GB empyema (n=1). The overall postoperative complication rate was 2.6% (8/310). A laparotomy was not required for the treatment of bleeding (5 cases) and residual stones (2 cases). There was no bile duct injury. One patient who had a cerebral infarction died of a cerebrovascular accident. CONCLUSION: We conclude that for benign cholecystopathy the laparoscopic cholecystectomy can be safe and feasible treatment with low morbidity.
Acalculous Cholecystitis ; Analgesics ; Bile Ducts ; Cerebral Infarction ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Cholecystitis, Acute ; Diabetes Mellitus ; Diagnosis ; Diet ; Empyema ; Gallbladder ; Hemorrhage ; Hospitals, General ; Humans ; Hypertension ; Laparotomy ; Length of Stay ; Postoperative Complications ; Retrospective Studies ; Solar System ; Stroke

No abstract available.
Anemia, Aplastic* ; Hepatitis*

BACKGROUND: Today, patients with fatty liver have increased by several factors. Some patients with fatty liver have abnormal liver function tests, by the way they have interpreted unwisely and made wrong therapeutic approach about abnoimal liver function tests. So we conducted this study to evaluate the factors related to patients with fatty liver and make basic concept for management. METHODS: We selected 96 patients(71 men, 25 women) who were diagnosed as fatty liver by ultrasound in Asan Medical Health Examination Center, also selected 91 controls(68 men, 23 women) who had similar sex and age distribution from January to December, 1993. We excluded toxic and viral hepatitis cases or patients. We surveyed by questionnaires that composed of 3 day-dietary diary and life style. Nutrient and alcohol intakes were analyzed by nutrient-analysis program that was derivated from Food Composition Table, and we analyzed several biochemical variables. RESULTS: There were 71 men and 25 women with fatty liver, 68 men and 23 women in controls. In cases of men, the mean age was 47 years-old in patient group, 44 years-old in control group. The obesity index was 112.7% in patients, 102.6% in controls, the mean level of triglyceride was 205mg/dl in patients, 150mg/dl in controls. The mean level of serum HDL-C was 46mg/dl in patients, 50mg/dl in controls(p<0.05). The frequency of obesity was 66.2% in patients, 27.9% in controls, hypertriglyceridemia was 42.3% in patients, 22.1% in controls(p<0.05). The frequency of patients who had increased AST was 26.8% in patients, 11.8% in controls, and the frequency of patients or cases who had increased ALT was 26.8%, in patients, 7.4% in controls(p<0.05). There were no significant statistical differences in the nutrient intakes, alcohol drinking and exercise between the male patients and controls. In cases of women, the mean age was 53 years in patient gr oup or among patients, 51 years in controls. The obesity index was 112.2% in patients, 102.1% in controls, and the mean level of serum triglyceride was 198.3mg/dl in patients, 136.4mg/dl in controls(p<0.05). The frequency of obesity was 76.0% in patients, 30.4% in controls, and the frequency of hypertriglyceridemia was 36.0% in patients, 13.0% in controls. There were statistically significant differences in the frequency of obesity and hypertriglyceridemia between patients and controls(p<0,05). There were no statistically significant differences in the frequency of increased AST and ALT, nutrient intakes, alcohol drinking, and excercise between patients and controls. CONCLUSIONS: The fatty liver disease was attributed either to obesity or hypertriglyceridemia. Therefore, it is very important to control of weight and hypertriglyceridemia in the management of patients with fatty liver.
Adult ; Age Distribution ; Alcohol Drinking ; Chungcheongnam-do ; Fatty Liver* ; Female ; Hepatitis ; Humans ; Hypertriglyceridemia ; Life Style ; Liver Function Tests ; Male ; Middle Aged ; Obesity ; Triglycerides ; Ultrasonography ; Surveys and Questionnaires

No abstract available.
Holoprosencephaly*

Brachycephaly is a kind of craniosynostosis. Because of premature closure of the coronal suture, the skull is shorter in the anteroposterior diameter but is widened with a high vault and the occiput and forehead are flattened. Diabetes insipidus had been reported in oxycephaly. We have experienced a case of central diabetes insipidus associated with brachycephaly. A brief review of related literatures is included in this report.
Craniosynostoses* ; Diabetes Insipidus ; Diabetes Insipidus, Neurogenic* ; Forehead ; Skull ; Sutures

Purpose: To analyze various prognostic factors and surgical outcomes in patients who underwent radical nephrectomy and thrombectomy of a renal cell carcinoma with renal vein or inferior vena caval thrombosis. Materials and Methods: Among 44 patients with confirmed renal cell carcinomas and renal vein or inferior vena caval thrombosis, between December 1993 and June 2000, 42 having undergone radical nephrectomy and thrombectomy were retrospectively studied. 2 patients were excluded due to no operation performance. The 5-year disease-specific survival rates were analyzed according to various prognostic factors, including age, gender, clinical symptoms, tumor side (Rt. vs. Lt.), thrombus position (renal vein vs. IVC), histopathological cell type, lymph node involvement, pT stage irrespective of thrombus, Fuhrmann nuclear grade and invasion to perinephric fat, vessel, renal pelvis or adrenal gland. Results: The overall 5-year disease-specific survival rate of all the patients was 55%. A univariate analysis of the 42 patients showed that the position of the tumor thrombus, histopathological cell type and invasion to the adrenal gland had a significant impact on the survival. On multivariate analysis, the tumor thrombus location and histopathological cell type were independent prognostic factors for the survival. The 5-year disease-specific survival rates of the patients with a renal vein thrombus (n=23) and with IVC (inferior vena cava, n=20) were 75 and 20%, respectively. The 5-year disease-specific survival rate of the patients with a conventional cell type (n=32) was 68%, and patients with other pathologic cell types had no significant follow-up periods. Conclusions: The tumor thrombosis position, histopathological cell type and invasion to the adrenal gland are considered as clinically significant prognostic factors in patients with a renal cell carcinoma with vein thrombosis after radical nephrectomy with a thrombectomy. Meticulous radical nephrectomy with thrombectomy will be beneficial to the survival of patients with a renal cell carcinoma and vein thrombus.
Adrenal Glands ; Carcinoma, Renal Cell* ; Follow-Up Studies ; Humans ; Kidney Pelvis ; Lymph Nodes ; Multivariate Analysis ; Nephrectomy ; Prognosis ; Renal Veins ; Retrospective Studies ; Survival Rate ; Thrombectomy ; Thrombosis* ; Veins

No abstract available.
Spinal Cord Diseases*