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

PURPOSE: To investigate the accuracy and reproducibility of Optical Low Coherence Reflectometry (OLCR) corneal thickness measurements compared with the Orbscan system and ultrasound pachymeter (IOPac, Mentor). METHODS: Two examiners measured corneal thicknesses of 78 normal eyes and in 36 eyes that had undergone LASIK, and five sequential measurements of corneal thickness with OLCR, Orbscan system, Mentor, and IOPac were performed. Remeasurements of corneal thickness in 24 normal eyes were performed after two days to investigate intra-examiner reproducibility. RESULTS: The average corneal thickness measured in normal subjects was 536.3+/-23.8 micrometer in OLCR, 542.4+/-25.3 micrometer in the Orbscan system, 535.4+/-23.7 micrometer in Mentor, and 534.2+/-24.1 micrometer in IOPac. The average corneal thickness measured in patients who had undergone LASIK was 487.3+/-30.8 micrometer in OLCR, 492.5+/-36.5 micrometer in the Orbscan system, 487.5+/-30.8 micrometer in Mentor, and 485.3+/-30.8 micrometer in IOPac. There was no statistically significant difference between the four pachymeters. The inter-examiner and intra-examiner reproducibilities were shown to be highly reliable. CONCLUSIONS: The OLCR showed similar measurments of corneal thickness with the Orbscan system and ultrasound pachymeter, and showed no difference in reproducibility with different examiners.
Corneal Pachymetry* ; Humans ; Keratomileusis, Laser In Situ ; Mentors ; Ultrasonography*

Lumbar spinal fusions have been performed for spinal stability, pain relief and improved function in spinal stenosis, scoliosis, spinal fractures, infectious conditions and other lumbar spinal problems. The success of lumbar spinal fusion depends on multifactors, such as types of bone graft materials, levels and numbers of fusion, spinal instrumentation, electrical stimulation, smoking and some drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs). From January 2000 to December 2001, 88 consecutive patients, who were diagnosed with spinal stenosis or spondylolisthesis, were retrospectively enrolled in this study. One surgeon performed all 88 posterolateral spinal fusions with instrumentation and autoiliac bone graft. The patients were divided into two groups. The first group (n=30) was infused with ketorolac and fentanyl intravenously via patient controlled analgesia (PCA) postoperatively and the second group (n=58) was infused only with fentanyl. The spinal fusion rates and clinical outcomes of the two groups were compared. The incidence of incomplete union or nonunion was much higher in the ketorolac group, and the relative risk was approximately 6 times higher than control group (odds ratio: 5.64). The clinical outcomes, which were checked at least 1 year after surgery, showed strong correlations with the spinal fusion status. The control group (93.1%) showed significantly better clinical results than the ketorolac group (77.6%). Smoking had no effect on the spinal fusion outcome in this study. Even though the use of ketorolac after spinal fusion can reduce the need for morphine, thereby decreasing morphine related complications, ketorolac used via PCA at the immediate postoperative state inhibits spinal fusion resulting in a poorer clinical outcome. Therefore, NSAIDs such as ketorolac, should be avoided after posterolateral spinal fusion.
Adult ; Aged ; *Analgesia, Patient-Controlled ; Anti-Inflammatory Agents, Non-Steroidal/*administration & dosage/*adverse ; Case-Control Studies ; Drug Therapy, Combination ; Female ; Fentanyl/administration & dosage/therapeutic use ; Humans ; Injections, Intravenous ; Ketorolac/*administration & dosage/*adverse effects/therapeutic use ; Male ; Middle Aged ; Postoperative Care/*adverse effects ; Research Support, Non-U.S. Gov't ; Retrospective Studies ; *Spinal Fusion/standards ; Treatment Outcome

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

Placenta accreta is a rare but potentially lethal obstetric emergency due to massive hemorrhage, uterine perforation, and infection. Traditionally, hysterectomy was performed in the occurrence of serious hemorrhage. Currently, several conservative treatments including the use of uterine packing, leaving the placenta in situ, argon-beam coagulation, uterine artery ligation, administration of methotrexate, and uterine artery embolizations are introduced to preserve future reproductive potential. We present a patient with placenta accreta treated successfully with selective uterine artery embolization followed by methotrexate with brief review of literature.
Emergencies ; Hemorrhage ; Humans ; Hysterectomy ; Ligation ; Methotrexate* ; Placenta Accreta* ; Placenta* ; Uterine Artery Embolization* ; Uterine Artery* ; Uterine Hemorrhage

In a series of rabbits, two craniectomies were made in both side of the parietal hone. Each lesion was filled with gelfoam, lyocura, fat and dural film. Five rabbits were left empty as a control group. The animals were killed in one month after the operation. The degree of adhesion between the soft tissue of the scalp and various dural substitute was evaluated at the time of operative dissection and studied histopathologically. The results were as follows. 1) The insertion of dural substituted substances can prevent the adhesion between the scalp and dura mater. 2) The dural film was most effective in prevention of adhesion. 3) The dural film inserted group exhibited inflammatory reaction. 4) The gelfoam, lyodura and fat inserted groups were though to have had a moderate prevention effect of adhesion. With these results, we could conclude that the insertion of material between the dura and scalp can prevent adhesion. However the ideal inserted material which can pevent inflammatory reaction and adhesion has not been determined. At this point we have not found and ideal substitute. To get an ideal material for prevention of adhesion, further intensive study is required.
Animals ; Dura Mater ; Gelatin Sponge, Absorbable ; Rabbits ; Rabeprazole ; Scalp