Stercoraceous ulcerations of the colon are produced by hard fecaloma that collect in the coton. Bleeding and more seriously perforation are complications of these ulcerations. These are generally thought to be rare, but this may reflect the difficulty of establishing the diagnosis, both before and during operation. This disease is relatively neglected as well. This is reflected by the small number of case reported in the literature. Authors report a case of stercoraceous ulcer of cecum which confirmed under the colonofiberscopy and managed in the Department of General Surgery, College of Medicine, Ewha Womans University,
Cecum* ; Colon ; Diagnosis ; Female ; Hemorrhage ; Humans ; Ulcer*

OBJECTIVE: We report here on two cases of pseudoaneurysms that were diagnosed using computed tomographic angiography (CTA), with one arising in the superficial temporal artery and the other arising in the occipital artery. METHODS: Case 1: A 29-year-old man presented with a slow growing, pulsatile mass on the left side of his forehead following a blow from a fist 10 days earlier. CTA revealed an 11 x 8 x 11-mm oval pseudoaneurysm arising from the frontal branch of the left superficial temporal artery. Case 2 : A 36-year-old man presented with a pulsatile mass in the right suboccipital region that had been present for the past year. He had no history of direct trauma. CTA revealed a 15 x 8 x 13-mm oval dye-filled sac arising from the right occipital artery. RESULTS: Based on the CTA images, the parent arteries were exposed and ligated proximally and distally to the pseudoaneurysms and then they were completely excised. CONCLUSION: CTA is a minimally invasive technique for making the diagnosis of scalp pseudoaneurysms and CTA is also useful for the preoperative planning.
Adult ; Aneurysm, False ; Angiography ; Arteries ; Diagnostic Tests, Routine ; Forehead ; Humans ; Parents ; Scalp ; Temporal Arteries

Since the myofascial trigger point(MFTrP) has been described fifty years ago, its underlying pathophysiology has been remained unclear. The diagnosis also depends on the characteristic pain, tenderness and physical findin gs, which is yery subjective. In recent years, some physicians investigated the objective findings of MFTrP, using the pressure algometer and thermography. We investigated the electromyographic findings of MFTrP to evaluate the clinical usefulness of local twitch response(LTR) and sympathetic skin response (SSR), and to evaluate the electrophysiologic characteristics of MFTrP. 21 patients, diagnosed as myofascial trigger point syndrome on upper trapezius and so on, were evaluated for the triggering pain with visual analog scale(VAS), pressure threshold(THpr) using pressure algometer(Dolorimeter), LTP with concentric needle electrode and SSR on the palm. There was a significant negative correlation between VAS and THpr, but no significant correlation with electromyographic findings of LTR. Thus LTR could support the existence of MFTrP electrodiagnostically, but, could not explain the clinically correlated severity of MFTrP. There were only 3 patients showing abnormal SSR, who were all complaining the sympathetic sympathetic symptoms on the affected arm with reffered pain. Even though referred pain to arm and hand existed. SSR was normal because suggested autonomic dysfunction of MFTrP is localized mechanism. Among the 13 patients underwent the trigger point block, 8 patients who showed no residual LTR immediate after MFTrP block, had a great symptomatic improvement of MFTrP in a week, but 5 patients who showed the residual LTR did not, Regardless of complaint of pain and soreness immediate after block, loss of LTR would be predicted as a good treatment result. In some cases, spontaneous EMG activity exist within the 3-4mm sized focus of MFTrP. although the taut band of MFTrP is 3-4cm length and depth. But this focus of MFTrP is a electrophysiologic changes within a muscle, not a structural changes seen by ultrasonography.
Arm ; Diagnosis ; Electrodes ; Electromyography ; Hand ; Humans ; Needles ; Pain, Referred ; Skin ; Superficial Back Muscles ; Thermography ; Trigger Points* ; Ultrasonography

Lymphomatous involvement of the gallbladder is rarely identified and manifests mostly as a local involvement of disseminated disease. There have been reported only about 20 primary malignant lymphomas of the gallbladder without involvement of other sites. A 63-year-old woman presented with jaundice, epigastric pain, and weight olss of two months duration. There was no systemic lymphadenopathy elsewhere. Abdominal computed tomograph revealed a focal thickening of the gallbladder wall. The removed gallbladder contained a well circumscribed, 5x3 cm-sized, slightly elevated firm area with accentuated mucosal papillary excrescences near the neck protion. The lesion involved whole thickness of the wall, and was made up of diffuse atypical lymphoid cell infiltrates of variable size accompanying plasmacytoid differentiation in areas. Some large tumor cells were pleomorphic and contained prominent nucleoli. To our knowledge, this is the first case of primary malignant lymphoma of the gallbladder in Korean literature.
Female ; Humans

Benign hemangioma of the mediastinum is rare. This slowly growing tumor is described as well circumscribed, cystic, hemorrhagic tumor. Histologically it can be differentiated into capillary or cavernous form. We present a case of mediastinal hemangioma. A 20-year-old-man was presented with a slowly growing posterior mediastinal mass of 6 years duration, 8x6 cm in size. The mass was relatively well defined but focally invasive. Microscopically, it was differentiated into vessels of capillary, cavernous, and venous patterns. A solid cellular proliferation with inconspicuous capillary lumens was focally seen. The stroma between variable-sized vessels showed marked myxoid change associated with some smooth muscle bundles and adipose tissue. Ultrastructurally, areas of solid cellular proliferation showed formation of lumens. These lumens were lined by active endothelial cells showing plasmalemmal vesicles and Weibel-Palade bodies on the abluminal surface.
Adipose Tissue ; Capillaries ; Cell Proliferation ; Endothelial Cells ; Hemangioma* ; Mediastinum ; Muscle, Smooth ; Weibel-Palade Bodies

Renal dysplasia results from aberrant histogenesis in metanephric differentiation. It is characterized morphologically by abnormal organization and a persistence of primitive structures, such as cartilage, undifferentiated mesenchyme, and immature tubules. Six cases of renal dysplasia from five children and one adult are reviewed. Five patients were female and one patient was male. The chief complaint was urinary incontinence in four patients, dysuria in one patient, and the sixth patient suffered from vesicoureteral reflux. No evidence of family history of renal dysplasia in any patient was seen. According to Risdon's classification, three cases were hypoplastic dysplasia, one case was dysplasia in a duplex system, one case was dysplasia in a triplex system, and one case was dysplasia with vesicoureteral reflux. The ipsilateral ectopic ureteral orifice was identified in four patients, two of which drained into a Gartner's duct cyst, and the orifice was suggested in one patient. On histologic examination, all cases showed primitive ducts surrounded by concentrically arranged primitive mesenchyme. Nests of metaplastic cartilage were observed within the stroma in three of the six cases.
Adult ; Cartilage ; Child ; Classification ; Dysuria ; Female ; Humans ; Male ; Mesoderm ; Ureter ; Urinary Incontinence ; Vesico-Ureteral Reflux

PURPOSE: The purpose of this study was to investigate the physiological index, anxiety and depression by the severity of lower urinary tract symptoms in patients with benign prostatic hyperplasia. METHODS: This research was conducted from the 4th to the 27th of May in 2016 on112 patients with benign prostatic hyperplasia. The data were analyzed using a chi-square test, ANOVA, and Pearson Correlation Coefficients. RESULTS: The results demonstrated a difference depending on the dysuria period of each lower urinary tract symptom, marital status, occupation and perceived health state of the patient. The physiological index by lower urinary tract symptoms showed a difference in the maximum flow rate, amount of post-void residual urine and Prostate-Specific Antigen (PSA), and anxiety and depression factors also revealed a difference. Lower urinary tract symptoms showed a positive correlation to the amount of post voided residual urine and PSA, a negative correlation to the maximum flow rate and also indicated a positive correlation to depression. CONCLUSION: The results of the study belonging to the moderate and severe categories were high when the result was based on the categorization of subjects with benign prostatic hyperplasia with lower urinary tract symptoms. Considering that depression levels increase as the symptom intensifies and the anxiety score is also high with mild symptoms, psychological support intervention is needed when a pattern of benign prostatic hyperplasia appears.
Anxiety* ; Depression* ; Dysuria ; Humans ; Lower Urinary Tract Symptoms* ; Marital Status ; Occupations ; Prostate-Specific Antigen ; Prostatic Hyperplasia* ; Urinary Tract

STATEMENT OF PROBLEM: Little information is available about the buccal gingival level of multiple implant restorations. PURPOSE: This study was aimed to evaluate the relationship between width and height of buccal soft tissue around single and 2 adjacent implant restorations. MATERIAL AND METHODS: Four implant restoration groups (first and second molars, single second molars, posterior single restorations between teeth, and anterior single restorations between teeth) were randomly chosen from one dental institute. Each group comprised of 6 patients. After 6 months of function, silicone impressions were taken and stone models were fabricated for each restoration group. The stone models were cut in bucco-lingual direction at the most apical point of buccal gingival margin. The height and width of buccal supra-implant soft tissue were measured. One way ANOVA and Tukey HSD post hoc tests were performed to analyze the data obtained (P < .05). RESULTS: The most unfavorable width-height ratio was noted for the group, which was comprised of the second molar in the multiple adjacent (first and second molar) implant-supported restorations. The group also resulted in the shorter height of buccal supra-implant mucosa rather than that of anterior single implant restorations between natural teeth. CONCLUSION: To achieve a favorable level of buccal gingival margin, greater thickness of buccal supra-implant mucosa is required for the implant restorations without a neighboring natural tooth compared to the implant restorations next to a natural tooth.
Humans ; Molar ; Mucous Membrane ; Silicones ; Tooth

BACKGROUND: Congenital aortic stenosis in children is characterized by "excessive" left ventricular hypertrophy with reduced left ventricular systolic wall stress that allows for supernormal ejection performance. We hypothesized that left ventricular wall stress was decreased immediately after surgical correction of pure congenital aortic stenosis. Also measuring postoperative left ventricular wall stress was a useful noninvasive measurement that allowed direct assessment for oxygen consumption of myocardium than measuring the peak systolic pressure gradient between ascending aorta and left ventricle for the assessment of surgical results. MATERIAL AND METHOD: Between September 1993 and August 1999, 8 patients with isolated congenital aortic stenosis who underwent surgical correction at Yonsei cardiovascular center were evaluated. There were 6 male and 2 female patients ranging in age from 2 to 11 years(mean age, 10 years). Combined Hemodynamic-Ultrasonic method was used for studying left ventricular wall stress. We compared the wall stress peak systolic pressure gradient and ejection fraction preoperatively and postoperatively. RESULT: After surgical correction peak aortic gradient fell from 58.4+/-17.6, to 23.7+/-17.7 mmHg(p=0.018) and left ventricular ejection fraction decreased but it is not statistically significant. In the consideration of some factors that influence left ventricular end-systolic wall stress excluding one patient who underwent reoperation for restenosis of left ventricular outflow tract left ventricular end-systolic pressure and left ventricular end-systolic dimension were fell from 170.6+/-24.3 to 143.7+/-27.1 mmHg and from 1.78+/-0.4 to 1.76+/-0.4 cm respectively and left ventricular posterior wall thickness was increased from 1.10+/-0.2, to 1.27+/-0.3cm but it was not statistically singificant whereas left ventricular end-systolic wall stress fell from 79.2+/-24.9 to 57.1+/-27.6 kdynes/cm2(p=0.018) in 7 patients. For one patient who underwent reoperation peak aortic gradient fell from 83.0 to 59.7 mmHg whereas left ventricular end-systolic wall stress increased from 67.2 to 97.0 kdynes/cm2 The intervals did not change significnatly. CONCLUSION: We believe that probably some factors that are related to left ventricular geometry influenced the decreased left ventricular wall stress immediately after surgical correction of isolated congenital aortic stenosis. Left ventricular wall stress is a noninvasive measurement and can allow for more direct assesment than measuring peak aortic gradient particularly in consideration of the stress and oxygen consumption of the myocardium therefore we can conclude it is a useful measurement for postoperative assessment of congenital aortic stenosis.
Aorta ; Aortic Valve Stenosis* ; Blood Pressure ; Child ; Equidae ; Female ; Follow-Up Studies* ; Heart Ventricles ; Humans ; Hypertrophy, Left Ventricular ; Male ; Myocardium ; Oxygen Consumption ; Reoperation ; Stroke Volume

The pure epithelioid malignant schwanoma is a rare form of malignant schwanoma and differs from the ordinary epithelioid malignant schwanoma because of the absence of a spindle cell component. We present a case of purely epithelioid malignant schwanoma arising in the parapharyngeal area from vagus nerve without difinite evidence of von Recklinghausen's disease. The patient was a 28-year-old man with palpable right neck mass and swallowing difficulty during 2 years. The mass was an ovoid encapsulated tumor and measured 5x3x3 cm in dimension. The cut surface showed brownish tan homogeneous nodular appearance with partly myxoid area. Microscopically the tumor showed nodular pattern composed of epitheliod cells which were arranged in both tight clusters and stringy cords. The cells were ovoid in shape and had vesicular nuclei with single prominent eosinophilic nucleolei and sometimes abundant intracytoplasmic mucin. Mitoses were infrequent. Ultrastructural study showed rudimentary cell junction and degenerated cytoplasmic organelles including scattered mitochondriae, short segments of rough endoplasmic reticulum and lipid droplets. There were no definite basement membrane and melanosome. Immunohistochemical study showed the cells being positive for S100 protein, neuron specific enolase and myelin basic protein and negative for cytokeratin.
Male ; Humans