Targetoid hemosiderotic hemangioma is a benign vascular tumor with a peculiar clinical presentation and histologic features sometimes difficult to differentiate from the patch stage of Kaposi's sarcoma, progressive lymphangioma, eosinophilic hemangioma, retiform hemangioendothelioma. We report a case of targetoid hemosiderotic hemangioma on upper back and right upper arm of a 28-year-old male. He has a 5mm × 5mm sized slightly raised violaceous papule surrounded by an ecchymotic halo on upper back and right upper arm. We took a biopsy of the lesion and identified it as targetoid hemosiderotic hemangioma. This is a case of targetoid hemosiderotic hemangioma with typical clinical and histopathological findings.
Adult ; Arm ; Biopsy ; Eosinophils ; Hemangioendothelioma ; Hemangioma* ; Humans ; Lymphangioma ; Male ; Sarcoma, Kaposi

We clinically reviewed four patients who were suffering from aseptic meningitis combined with polio-like paralysis and performed radiological. neurological and virological studies on them. Three patients were admitted to the department of Pediatrics. Asan Medical Center from March to August 1990, and one patient was admitted to the department of Pediatrics. Kangnam General Hospital. The results were as follows; 1) During the period of study, 18 patients (10.1%)out of 178 aseptic meningitis patients also suffered from hand, foot and mouth disease, and three patients (1.69%) out of 178 patients also suffered from polio-like paralysis. 2) The age of the patients who also suffered from polio-like paralysis were eight months, 22 months, 23 months and four years old respectively. Three patients were male and one patient was female. 3) Paralysis developed three to five days after aseptic meningitis infection. 4) In two cases, Magnetic Resonance Imaging (MR) showed two small cavitary lesions that means anterior horn cell necrosis in concordant with residual paralysis. Axial T1-weighted image showed decreased signal intensity and axial T2-weighted image showed increased signal intensity. In another case 20 days after onset of illness MR was performed, the transverse myelitis showed mild swelling of cornus medullaris. Follow up MR in 2 months revealed atropic change in lower thoracic spinal cord. 5) The electromyography and nerve conduction velocity test revealed acute polyradiculoneuropathy. 6) Serologic virus study were carried out in three cases for Coxsackievirus A16 and Enterovirus 71. The Enterovirus 71 antibody titer were 1:128 in two cases and 1:64 in one case. The Coxsackievirus A16 antibody titer were less than 1:4. This study showed that the causative agents for polio-like paralysis during this period seemed to be the Enterovirus 71 infection.
Anterior Horn Cells ; Chungcheongnam-do ; Cornus ; Electromyography ; Enterovirus ; Female ; Follow-Up Studies ; Hand, Foot and Mouth Disease ; Hospitals, General ; Humans ; Magnetic Resonance Imaging ; Male ; Meningitis, Aseptic* ; Myelitis, Transverse ; Necrosis ; Neural Conduction ; Paralysis* ; Pediatrics ; Polyradiculoneuropathy ; Spinal Cord

Purpose: Surgery is prioritized for a splenic injury when the patient is hemodynamically unstable or the injury is severe and there is an increased risk of bleeding. This study aimed to examine the outcomes of splenectomies where a surgical stapling device was used to reduce operation time and rapidly control bleeding. Methods: This retrospective study included 53 patients who underwent a splenectomy for traumatic splenic injury at Chosun University Hospital between 2012 and 2017. Clinical outcomes including operation time (duration), blood transfusion amount (number of units), length of hospital stay, length of intensive care unit stay, and mortality rate were compared between patients who received conventional ligation [conventional group (CG)] and patients who received a splenectomy where a surgical stapling device was used [stapling group (SG)]. Results: The SG showed an average operation time of 17 minutes less than the CG, although the reduction was not statistically significant. No significant differences in estimated blood loss and blood transfusion amount were determined between the 2 groups, although the SG received 1 more unit of red blood cells for transfusion in the 48-hour post-operative period compared with the CG. One case of pancreatic fistula as a postoperative complication was reported in the SG. Conclusion The use of a surgical stapling device in a splenectomy may be considered for a hemodynamically unstable patient with splenic injury which caused severe anatomical damage.

Purpose: Surgery is prioritized for a splenic injury when the patient is hemodynamically unstable or the injury is severe and there is an increased risk of bleeding. This study aimed to examine the outcomes of splenectomies where a surgical stapling device was used to reduce operation time and rapidly control bleeding. Methods: This retrospective study included 53 patients who underwent a splenectomy for traumatic splenic injury at Chosun University Hospital between 2012 and 2017. Clinical outcomes including operation time (duration), blood transfusion amount (number of units), length of hospital stay, length of intensive care unit stay, and mortality rate were compared between patients who received conventional ligation [conventional group (CG)] and patients who received a splenectomy where a surgical stapling device was used [stapling group (SG)]. Results: The SG showed an average operation time of 17 minutes less than the CG, although the reduction was not statistically significant. No significant differences in estimated blood loss and blood transfusion amount were determined between the 2 groups, although the SG received 1 more unit of red blood cells for transfusion in the 48-hour post-operative period compared with the CG. One case of pancreatic fistula as a postoperative complication was reported in the SG. Conclusion The use of a surgical stapling device in a splenectomy may be considered for a hemodynamically unstable patient with splenic injury which caused severe anatomical damage.

BACKGROUND: The aim of this study was to investigate the effect of a botulinum toxin type A (BTX-A) injection in the masseter muscle using electromyography (EMG) in an animal model. METHODS: Ten male adult (>3 months of age) New Zealand white rabbits were used. Muscle activity was continuously recorded from 8 hours before to 8 hours after BTX-A injection. The rabbits received unilateral BTX-A injections of either 5 units (group 1, n = 5) or 20 units (group 2, n = 5). RESULTS: The masseter muscle activity of the rabbits was significantly reduced immediately after BTX-A injection (P < 0.05 for both groups). When the results from group 1 were compared with those from group 2, only the peak voltage was significantly decreased in group 2 (P = 0.013). CONCLUSION: Masseter muscle activity measured by EMG was immediately decreased after a BTX-A injection.
Adult ; Botulinum Toxins, Type A* ; Electromyography ; Humans ; Male ; Masseter Muscle* ; Models, Animal* ; Rabbits

Although very rare, the incidence of tricuspid valve regurgitation after blunt chest trauma has risen in line with the increasing rate of car accidents and steering wheel trauma. It is easy to miss the diagnosis of tricuspid valve regurgitation following blunt chest trauma because most patients feel no symptoms at trauma, and the condition is sometimes overlooked for a long period of time due to its mild symptoms. A 49-year-old man suffered dyspnea on exertion for 1 month due to right heart failure 8 years after accidentally falling from a third floor. Preoperative echocardiography revealed severe tricuspid valve regurgitation resulting from prolapse of the anterior leaflet with annular dilatation. The patient underwent tricuspid valvuloplasty with a 36-mm Carpentier tricuspid ring. Intraoperative transesophageal echocardiography showed mild tricuspid valve regurgitation. We report a case of successful native valve salvage of ruptured tricuspid valve after blunt chest trauma, and present a review of the relevant literature.
Diagnosis ; Dilatation ; Dyspnea ; Echocardiography ; Echocardiography, Transesophageal ; Heart Failure ; Humans ; Incidence ; Middle Aged ; Prolapse ; Thorax* ; Tricuspid Valve Insufficiency ; Tricuspid Valve* ; Wounds, Nonpenetrating

Although very rare, the incidence of tricuspid valve regurgitation after blunt chest trauma has risen in line with the increasing rate of car accidents and steering wheel trauma. It is easy to miss the diagnosis of tricuspid valve regurgitation following blunt chest trauma because most patients feel no symptoms at trauma, and the condition is sometimes overlooked for a long period of time due to its mild symptoms. A 49-year-old man suffered dyspnea on exertion for 1 month due to right heart failure 8 years after accidentally falling from a third floor. Preoperative echocardiography revealed severe tricuspid valve regurgitation resulting from prolapse of the anterior leaflet with annular dilatation. The patient underwent tricuspid valvuloplasty with a 36-mm Carpentier tricuspid ring. Intraoperative transesophageal echocardiography showed mild tricuspid valve regurgitation. We report a case of successful native valve salvage of ruptured tricuspid valve after blunt chest trauma, and present a review of the relevant literature.
Diagnosis ; Dilatation ; Dyspnea ; Echocardiography ; Echocardiography, Transesophageal ; Heart Failure ; Humans ; Incidence ; Middle Aged ; Prolapse ; Thorax* ; Tricuspid Valve Insufficiency ; Tricuspid Valve* ; Wounds, Nonpenetrating

Although the required extent of lymph node dissection remains controversial, surgery is the cornerstone of the treatment of advanced gastric cancer. However, only approximately 30% of patients are diagnosed as operable, and an R0 resection will be achieved in only 40~60% of these. Since R0 resection and the treatment response of the primary cancer or resected specimen are significant prognostic factors in locally advanced gastric cancer, various preoperative treatment modalities have been attempted to induce downstaging and improve complete nodal resection. Several recent studies revealed that preoperative chemoradiation therapy can prolong patient survival by improving the R0 resection rate and treatment response. Here, we present an advanced gastric cancer patient with serosal penetration involving multiple perigastric and celiac lymph nodes who underwent radical surgery and entered complete remission after S1 and cisplatin-based concurrent chemoradiation therapy. Pathology revealed total necrosis of the tumor cells, and fibrous nodules in 2 out of 47 resected lymph nodes indicated dead cancer cells due to chemoradiation therapy. Subsequently, the patient received an additional six rounds of postoperative adjuvant chemotherapy with uracil/tegafur (UFT) and cisplatin. Follow-up imaging showed no evidence of tumor recurrence.
Chemotherapy, Adjuvant ; Cisplatin ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymph Nodes ; Necrosis ; Recurrence ; Stomach Neoplasms

Bullous pemphigoid may, very rarely, occur in infants, although it is usually a bullous disease of the elderly which is characterized by subepidermal bullae on erythematous and normal skin. We describe an infant with severe subepidermal blistering disorder with typical features for bullous pemphigoid.
Aged ; Blister ; Humans ; Infant* ; Pemphigoid, Bullous* ; Skin

PURPOSE: This study was designed to investigate the long-term oncologic outcomes for locally advanced rectal cancer patients after treatment with preoperative concurrent chemoradiotherapy followed by total mesorectal excision, and to identify prognostic factors that affect survival and pathologic response. MATERIALS AND METHODS: From June 1996 to June 2009, 135 patients with locally advanced rectal cancer were treated with preoperative concurrent chemoradiotherapy followed by total mesorectal excision at Kyung Hee University Hospital. Patient data was retrospectively collected and analyzed in order to determine the treatment outcomes and identify prognostic factors for survival. RESULTS: The median follow-up time was 50 months (range, 4.5 to 157.8 months). After preoperative chemoradiotherapy, sphincter preservation surgery was accomplished in 67.4% of whole patients. A complete pathologic response was achieved in 16% of patients. The estimated 5- and 8-year overall survival, loco-regional recurrence-free survival, and distant metastasis-free survival rate for all patients was 82.7% and 75.7%, 76.8% and 71.9%, 67.9% and 63.3%, respectively. The estimated 5- and 8-year overall survival, loco-regional recurrence-free survival, and distant metastasis-free survival rate for pathologic complete responders was 100% and 100%, 100% and 88.9%, 95.5% and 95.5%, respectively. In the multivariate analysis, pathologic complete response was significantly associated with overall survival. The predictive factor for pathologic complete response was pretreatment clinical stage. CONCLUSION: Preoperative chemoradiotherapy for locally advanced rectal cancer resulted in a high rate of overall survival, sphincter preservation, down-staging, and pathologic complete response. The patients achieving pathologic complete response had very favorable outcomes. Pathologic complete response was a significant prognostic factor for overall survival and the significant predictive factor for a pathologic complete response was pretreatment clinical stage.
Chemoradiotherapy ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Preoperative Care ; Rectal Neoplasms ; Retrospective Studies ; Survival Rate