Clear cell sarcoma of kidney(CCSK) is a rare pediatric neoplasm characterized by a predominating component of clear cells, a predilection for metastases to bone, and a poor prognosis. The incidence of CCSK peaks during the 2nd year of life and adult cases are very rare. We report a case of CCSK encountered in the right kidney of a 39-year-old man. Grossly, it was a lobulated mass showing infiltrative margin, measured 7x5.5x5cm and had a homogeneous gray-tan color with a soft, fish-flesh consistency. Microscopically, about half of the tumor revealed the classic pattern of CCSK, having tumor cell cords or nests separated by the characteristic alveolar capillary networks. The tumor cells had clear pale cytoplasm, bland looking round nuclei and inconspicuous nucleoli. The other half showed the epithelioid-trabecular pattern forming pseudorosette or cord-like structures. Immunohistochemically, there was only a focal positive reaction to vimentin. Ultrastructurally, the tumor cells showed the primitive nephrogenic mesenchymal differentiation such as electron lucent cytoplasm, a small amount of organelles, scanty heterochromatin, inconspicuous nucleoli, and a lack of flocculant basal lamina material around the cytoplasmic membrane. We consider that this is a case of CCSK occuring in the oldest patient ever reported, confirmed by both immunohistochemistry and electron microscopy.
Adult ; Male ; Female ; Humans ; Incidence ; Neoplasm Metastasis

PURPOSE: We analyzed the oncological outcome and prognostic factor of the chondrosarcoma arising from benign bone tumor due to malignant transformation. MATERIALS AND METHODS: From April 1986 to April 2009, 18 cases were considered eligible. We analyzed retrospectively the patient's characteristics and prognostic factors that affect to the local recurrence and distant metastasis. RESULTS: As classified by primary benign bone tumor, 4 cases were solitary osteochondroma, 11 cases were multiple osteochondromatosis and 3 cases were multiple enchondromatosis. The mean follow-up period was 85 months. The 5-year disease free survival rate of 18 patients was 85.9%. Their overall MSTS score was 25.2 (84%). There were local recurrence in 3 cases and no distant metastasis. We found that tumor location and surgical margin affected to the prognosis significantly. CONCLUSION: In secondary chondrosarcoma patients, the prognosis was good relatively and tumor location and surgical margin are important prognosis factor.
Chondrosarcoma ; Disease-Free Survival ; Enchondromatosis ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Osteochondroma ; Osteochondromatosis ; Prognosis ; Recurrence ; Retrospective Studies

BACKGROUND: A number of factors can cause dark circles around the eyes including excessive pigmentation, thin and translucent lower eyelid skin overlying the orbicularis oculi muscle, and shadowing due to skin laxity and tear trough. Autologous fat graft is an effective method for the treatment of lower lid dark circles, but irregularities caused by leaving visible lumps of the fat can occur. Tonnard et al. suggested 'nanofat' grafting and introduced its characteristics and clinical applications. The authors used their nanofat grafting to correct lower eyelid dark circles. METHODS: Nanofat grafting was performed in 19 patients for dark lower eyelids. The grafts were injected into subdermal layer using blunt cannula. Microfat grafting with nasojugal fold was performed to all the patients. Among them, 18 patients received transconjunctival fat removal at the same time. RESULTS: All the patients showed much improvement from preoperative dark coloration. There were no visible lumps of fat, contour irregularities, or fat necrosis. Postoperative edema and ecchymosis were minimal. CONCLUSIONS: Nanofat grafting methods provide a good alternative for correcting dark circles by augmenting thin skin with lower complications. This simple, cost effective procedure is suitable for correction of dark circles and various skin rejuvenation purposes.
Catheters ; Ecchymosis ; Edema ; Eyelids* ; Fat Necrosis ; Humans ; Hyperpigmentation ; Pigmentation ; Rejuvenation ; Shadowing (Histology) ; Skin* ; Transplantation ; Transplants*

No abstract available.
Rhabdomyolysis*

STATEMENTS OF PROBLEM: The fracture of acrylic resin dentures remains an unsolved problem. Therefore, many investigations have been performed and various approaches to strengthening acrylic resin, for example, the reinforcement of heat-cured acrylic resin using glass fibers, have been suggested over the years. Silane is important for bonding between glass fiber and resin. PURPOSE: The aim of the present study was to investigate the effect of various silane on the strength of PMMA resin and roughness of resin-glass fiber complex after abrasion test. MATERIAL AND METHODS: 3mm glass fiber (Chopped strand, Hankuk fiber Co., Milyang, Korea) was treated with 3 kinds of silane (MPS, EPS, APS) (Sila-ace, Chisso chemical, Tokyo, Japan) and mixed with PMMA resin(Vertex RS, Vertex Dental B.V., Zeist, Netherlands). Transverse strength and Young's modulus was measured using Instron (Instron model 4466, Instron, Massachusetts, USA). After abrasion test (The 858 Mini Bionix II Test System, MTS System Co., Minnesota, USA) surface roughness was evaluated using tester (Form Talysurf plus, Taylor Hopson Ltd., Leicester, England). Examination of scanning electron microscope was also performed RESULTS: Within this study, the following conclusions were drawn. 1. Surface treatment of glass fiber with MPS and APS increased transverse strength of PMMA resin complex, but surface treatment with EPS decreased transverse strength of PMMA resin complex (p<0.05). 2. Silane treated glass fiber increased Young's modulus of PMMA resin complex compared to desized glass fiber (p<0.05). 3. Roughness increased after abrasion test in case of PMMA resin reinforced with desized glass fiber (p<0.05). 4. Roughness change was not observed after abrasion test in case of PMMA resin reinforced with silane treated glass fiber (p>0.05).
Dentures ; Elastic Modulus ; Glass* ; Gyeongsangnam-do ; Massachusetts ; Minnesota ; Polymethyl Methacrylate*

Pyoderma gangrenosum is a rare destructive inflammatory skin disease. The lower extremities are most commonly affected, but the head and neck are rarely affected. We call the cases in which the head and neck are involved malignant pyoderma, which could be lethal. We report here on a case of malignant pyoderma in a 66-year-old man. His condition was markedly aggravatedin spite of the medical treatment. The lesions were improved by adjuvant surgery, including aggressive ulcer excision and grafting of autologous skin.
Aged ; Head ; Humans ; Lower Extremity ; Neck ; Pyoderma ; Pyoderma Gangrenosum ; Skin Diseases ; Transplants ; Ulcer

PURPOSE: Heart rate variability (HRV) is a tool used to measure autonomic nervous function; however, there is no evidence that it can be used to define sympathetic hyperactivity in men with lower urinary tract symptoms (LUTS). We suspected that LUTS would differ between sympathetic hyperactive and hypoactive patients. Therefore, we measured HRV and divided the LUTS patients into two groups, a sympathetic hyperactive group and a sympathetic hypoactive group according to the low frequency/high frequency (LF/HF) ratio and made clinical comparisons between the groups. METHODS: A total of 43 patients with symptomatic LUTS (International Prostate Symptom Score [IPSS] over 8) and 49 healthy volunteers were enrolled. No subjects had diseases that could affect the autonomic nervous system, such as diabetes or hypertension. Electrocardiographic signals were obtained from subjects in the resting state and HRV indexes were calculated with spectral analyses. We divided the LUTS patients into two groups by an LF/HF ratio of 1.9, which was the median value in the healthy volunteers, and compared the differences in clinical characteristics, IPSS, prostate-specific antigen (PSA), and transrectal ultrasound (TRUS) results. The parameters were compared by independent sample t-test by use of SPSS ver. 19. RESULTS: There were no significant differences in age, serum PSA, or volume of the prostate between the 2 LUTS groups. However, analyzing IPSS questionnaires between two groups showed that there were significant differences in mean of Q2 score (frequency) and storage symptom score ([Q2+Q4+Q7]/3) (P<0.05). CONCLUSIONS: We suggest that an imbalance of autonomic nervous system activity may be a factor that evokes varieties of symptoms in men with LUTS. LUTS patients with hypoactive sympathetic tone may suffer from frequency and storage symptoms.
Autonomic Nervous System ; Electrocardiography ; Heart Rate ; Humans ; Hypertension ; Lower Urinary Tract Symptoms ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia

Heart failure unresponsive to bed rest, low sodium diet, digitalis, diuretics, vasodilators and cardiac inotropic agents is a difficult therapeutic problem. Although remission was achieved with such treatment, its duration was short and easily recurred. We present a report of severe refractory congestive heart failure in three patients successfully treated with Continuous Ambulatory Peritoneal Dialysis (CAPD). These patients were admitted to the hospital many times and treated by conventional methods but cannon maintain their condition for a long time. In all three patients, edema, pulmonary congestion, electrolyte abnormalities, decreased ejection fraction and fractional shortening of myocardioum were eliminated or improved by CAPD. All three patients improved from Class IV congestive heart to Class II, as defined by the New York Heart Association, and experienced a define improvement in their sense of well being We conclude CAPD as an effective and the useful treatment for servere congestive heart failure refractory to conventional medical treatments.
Bed Rest ; Diet ; Digitalis ; Diuretics ; Estrogens, Conjugated (USP)* ; Heart ; Heart Failure* ; Humans ; Peritoneal Dialysis, Continuous Ambulatory ; Pulmonary Edema ; Sodium ; Vasodilator Agents

BACKGROUND: Studies of the ear-molding technique have emphasized the importance of initiating molding early to achieve the best results. In the present study, we describe the immediate effects and long-term outcomes of this technique, focusing on children who were older than the ideal age of treatment initiation. METHODS: Patients who visited our institution from July 2014 to November 2015 were included. Medical charts were reviewed to collect data on demographics, the duration of treatment, the types of deformities, and the manner of recognition of the deformity and referral to our institution. Parents were surveyed to assess the degree of improvement, the level of procedural discomfort at the end of treatment, any changes in the shape of the molded auricle, and overall satisfaction 12 months after their last follow-up visits. RESULTS: A review of 28 ears in 18 patients was conducted, including the following types of deformities: constricted ear (64.2%), Stahl ear (21.4%), prominent ear (7.1%), and cryptotia (7.1%). The average score for the degree of improvement, rated on a 5-point scale (1, very poor; 5, excellent), was 3.5 at the end of treatment, with a score of 2.6 for procedural discomfort (1, very mild; 5, very severe). After 12 months, the shapes of all ears were well maintained. The average overall satisfaction score was 3.6 (1, very dissatisfied; 5, very satisfied). CONCLUSIONS: We had reasonable outcomes in older patients. After 1 year of follow-up, these outcomes were well maintained. Patients past the ideal age at presentation can still be candidates for the molding technique.
Child ; Congenital Abnormalities* ; Delayed Diagnosis ; Demography ; Ear ; Ear Cartilage ; Follow-Up Studies ; Fungi ; Humans ; Parents ; Referral and Consultation ; Retrospective Studies

Cranioplasty is a method of the correction of defects and deformities of the bony walls protecting the brain. If defects and deformities are located in the frontal region, the correction is often necessary for cosmetic reasons. Rib, iliac bone and calvarium may be used for frontal cranioplasty. Rib bone and iliac bone have the donor morbidity and may result in cosmetically unacceptable contour. Calvarium is superior to the ilium and rib for it causes less donor site morbidity, it's consistency is harder than others and postoperative bone resorption is less. But it is difficult to mold and shape at the operative table, because the contour of parietal bone is different from that of frontal bone. For the last recent two years, we have performed frontal cranioplasty in five patients with frontal defect or deformity, by using calvarial bone graft that is molded with multiple osteotomy and microplate. Follow-up period ranged from 6 to 18 months with a mean of 12 months. There were no complications. This technique was simple and we could get aesthetically good contour on the frontal area.
Bone Resorption ; Brain ; Congenital Abnormalities ; Follow-Up Studies ; Frontal Bone ; Fungi ; Humans ; Ilium ; Osteotomy* ; Parietal Bone ; Ribs ; Skull ; Tissue Donors ; Transplants