Malignant fibrous histiocytoma(MFH) is well known as a soft tissue tumor of the extremities and retroperitoneum, but MFH of the skull is very rare. We report a case of MFH arising from the temporal bone in a 27-year-old male. This tumor presented as an osteolytic lesion and soft tissue mass on the left temporal bone without obvious invasion of the underlying brain parenchyma. The patient underwent tumor and bone removal, follwed by radiation therapy. Hostologic examination disclosed pleomorphic spindle cells in a storiform pattern and tumor cells showed positive reaction for vimentin, lysozyme, alpha 1-antitrypsin and (1-antichymotrypsin in immunohistochemical stain.
Adult ; alpha 1-Antitrypsin ; Brain ; Extremities ; Histiocytoma, Malignant Fibrous* ; Humans ; Male ; Muramidase ; Skull ; Temporal Bone* ; Vimentin

OBJECTIVE: The operative indications on cerebellar hemorrhage have been controversial especially when the patient condition is grave. Therefore we investigated whether it can be justifiable if we perform the surgery in poor clinical grade. METHODS: Clinical records and computerized tomography(CT) films of the 89 patients, who were undergone hospital treatment due to spontaneous cerebellar hemorrhage between May 1997 and May 2004, were retrospectively researched. RESULTS: The study population consisted of 36 males and 53 female patients. The mean age was 65years (range 23~89). As a result of treatment, the patients, whose Glasgow coma scale(GCS) score were higher, showed better outcomes (p=0.001). 13 patients (14.6%) were below 5 in GCS score and 10 patients of these were operated. Among 10 patients, 4 patients (40%) showed good outcome and 5 patients (50%) had been dead. 3 patients (60%) of these dead patients had the findings of intraventricular hemorrhage, fourth ventricular obliteration and hydrocephalus in CT scan. CONCLUSION: This study suggests that operation may be justifiable in clinically poor grade patient with spontaneous intra cerebellar hemorrhage.
Coma ; Female ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Hemorrhage* ; Humans ; Hydrocephalus ; Male ; Retrospective Studies ; Tomography, X-Ray Computed

Typhlitis is one of the most ominous complications in immunocompromised patients. Neutropenic enterocolitis or typhlitis is a clinical syndrome characterized by fever, diarrhea and abdominal pain that occurs in neutropenic patients. It has been reported as a complication of childhood leukemia, but is now known to occur in adults with solid malignancies, acquired immunodeficiency syndrome (AIDS) or bone marrow transplantation (BMT). The association of typhlitis and propylthiouracil has not been previously reported. We report a case of a 42-year-old female patient with typhlitis due to propylthiouracil patient with hyperthyroidism.
Abdominal Pain ; Acquired Immunodeficiency Syndrome ; Adult ; Bone Marrow Transplantation ; Diarrhea ; Enterocolitis, Neutropenic ; Female ; Fever ; Humans ; Hyperthyroidism* ; Immunocompromised Host ; Leukemia ; Propylthiouracil* ; Typhlitis*

No abstract available.
Neoplasm Metastasis*

OBJECTIVE: Although posterior wiring techniques have been commonly used with good results in treating the traumatic atlantoaxial instabilities, screw fixation technique has been gaining popularity to secure atlantoaxial arthrodesis in recent years. The purpose of this study is to compare the surgical results of posterior arthrodesis for the traumatic atlantoaxial instability between these two methods. METHODS: Twenty patients underwent 21 procedures over a 6-year period with a mean follow-up of 23 months. The most common condition of traumatic atlantoaxial instability was dens fracture(15 patients) followed by transverse atlantal ligament injury(4 patients), and traumatic os odontoideum(2 patients). Thirteen posterior wiring and eight posterior screw fixations were performed. Among 13 wiring methods, nine Galli fusions, two occipito-cervical fusions, one Brooks fusion, and one C1-C3 fusion were done. RESULTS: No patient developed neurological worsening after surgery. Compared to wire method, all patients of screw group had significant pain reduction when the patients was younger than 50 years old(p=0.01). The postoperative changes in distances of space available for cord(SAC) was not statistically significant between wire and screw methods(p=0.7). The rate of complication(23% in wire vs 25% in screw) was comparable to two methods. Although two screw malposition(25%) among screw fixations were developed, all revealed solid fusion without additional surgeries. The rate of fusion(85% in wire vs 100% in screw) was excellent in screw group. Postoperative loss of reduction, including redisplacement and kyphosis, was present only in wire group(31%). Two(15%) of wire fusions had redisplacement; both of these patients were type 2 dens fracture. Three procedures(23%) of wire fusions resulted in kyphotic change which occurred when delayed surgeries were done between 40 days and 90 days(mean: 63 days) after trauma. CONCLUSION: Considering both reduction loss and fusion rate, wire method caused more spinal deformity than screw method(38% vs 0%). This study demonstrates that screw method is a better surgical option for management of traumatic atlantoaxial instability.
Arthrodesis* ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Kyphosis ; Ligaments

BACKGROUND: Recent advances in laboratory information systems have largely been focused on automation. However, the phlebotomy services have not been completely automated. To address this issue, we introduced an automated reception and turnaround time (TAT) management system, for the first time in Korea, whereby the patient's information is transmitted directly to the actual phlebotomy site and the TAT for each phlebotomy step can be monitored at a glance. METHODS: The GNT5 system (Energium Co., Ltd., Korea) was installed in June 2013. The automated reception and TAT management system has been in operation since February 2014. Integration of the automated reception machine with the GNT5 allowed for direct transmission of laboratory order information to the GNT5 without involving any manual reception step. We used the mean TAT from reception to actual phlebotomy as the parameter for evaluating the efficiency of our system. RESULTS: Mean TAT decreased from 5:45 min to 2:42 min after operationalization of the system. The mean number of patients in queue decreased from 2.9 to 1.0. Further, the number of cases taking more than five minutes from reception to phlebotomy, defined as the defect rate, decreased from 20.1% to 9.7%. CONCLUSIONS: The use of automated reception and TAT management system was associated with a decrease of overall TAT and an improved workflow at the phlebotomy room.
Automation, Laboratory ; Efficiency, Organizational/*standards ; Phlebotomy/*statistics & numerical data ; Republic of Korea ; Time Factors ; Workflow

No abstract available.
Prognosis* ; Subarachnoid Hemorrhage, Traumatic*

Intracerebral sparaganosis, caused by the Plerocercoid of Spirometa mansoni, is very rare. A 54-yeas-old man, who has a history of having eaten raw frogs and snakes 20 years ago, was admitted with 2 years duration of focal seizure and monoparesis on right upper extremity. The brain CT scan and MRI demonstrated extensive and irregular hypodense lesion with punctate calcification in subcortical region of left parietal lobe. A whitish ribbon-like moving parasite could be picked up using CRW stereotactic frame under local anesthesia. On pathological examination was disclosed a sparganum with characteristic calcospherule. Also, preoperative ELISA test for sparganum-specific antibody(IgG) showed positive reaction to sparganum absorbance 1.04 in serum and 0.61 in CSF, respectively(normal abs. : below 0.22). Immediately after removal of parasite, the seizure and motor weakness disappeared. Stereotactic removal of cerebral sparganum can be considered a useful method in selected patients.
Anesthesia, Local ; Brain ; Enzyme-Linked Immunosorbent Assay ; Humans ; Magnetic Resonance Imaging ; Parasites ; Paresis ; Parietal Lobe ; Seizures ; Snakes ; Sparganum* ; Tomography, X-Ray Computed ; Upper Extremity

Molecular karyotyping was applied to Pneumocystis carinii(Pc) from two strains of experimental rats, Sprague Dawley(SD) and Fisher(F), in Korea. Field inversion gel electrophoresis and contour clamped homogeneous electric field electrophoresis resolved 15 chromosomal bands from the Pc. The size of the bands was estimated 270kb to 684kb from SD rats, and 273kb to 713 kb from F rats. The bands of 283 kb from SD rats and of 273 kb from F rats stained more brightly suggesting duplicated bands. Total number of chromosomes was at least 16, and total genomic size was estimated 7 x 10(6) bp. All of the bands from F rats hybridized to the probe of repeated DNA sequences of Pc and the band of 448 kb size was proved to contain rDNA sequences, but Pc. chromosome bands from SD rats showed no reactions to the probes. The 2 different karyotypes of P. carinii from 2 strains of rats were maintained consistently for 2 years.
Electrophoresis- ; ; Korea- ; ; Nucleic-Acid-Hybridization ; Pneumocystis-carinii-isolation-and-purification ; Rats- ; *Karyotyping- ; ; *Pneumocystis-carinii-genetics ; *Rats,-Inbred-F344-microbiology ; *Rats,-Sprague-Dawley-microbiology

PURPOSE: To determine the frequency of complications and diagnostic accuracy of CT-guided percutaneous automated gun biopsy, and to compare the results with those reported for fine needle aspiration. MATERIALS AND METHODS: Using automated biopsy devices, 118 CT-guided percutaneous biopsies of pulmonary lesions were performed. An 18-gauge needle was used. Final diagnosis was made with operation or other methods. We retrospectively analyzed the frequency of complications and diagnostic yields of 118 biopsies. RESULT: Four of 118(3.3%) patients developed pneumothorax and two of these required chest tube insertion. Other complications were resolved spontaneously. 106 biopsies (89.8%) yielded sufficient tissue for pathologic evaluation. For cases of malignant and of benign disease, sensitivity was 91.8% and 87.7% respectively ; the corresponding figures for diagnostic accuracy were 88.5% and 78.9%. CONCLUSION: CT-guided automated gun biopsy of the pulmonary lesions is safe, witha pneumothorax rate comparable to that of fine needle aspiration. In the absence of a trained cytologist at the time of biopsy, the diagnostic accuracy of automated gun biopsy of pulmonary lesions compared favorably with the reported accuracy of fine needle aspiration.
Biopsy* ; Biopsy, Fine-Needle ; Chest Tubes ; Diagnosis ; Needles ; Pneumothorax ; Retrospective Studies