Therapeutic irradiation can induce angiosarcoma. Radiation-induced angiosarcoma constitutes 20% of all angiosarcomas. Although its common site of origin is the skin and subcutaneous tissue, it rarely arises in small or large bowels with a presentation as multifocal abdominal angiosarcomatosis. We report a case of intra-abdominal angiosarcomatosis involving the jejunum, ileum, transverse colon, mesentery and right ovary in a 63-year-old female. It developed 10 years after therapeutic irradiation for squamous cell carcinoma of uterine cervix. She developed panperitonitis due to intestinal perforation. She died from sepsis 3 days after segmental resection of the small bowel and right oophorectomy. We reviewed the previously reported cases and describe the clinicopathologic features of this tumor.
Carcinoma, Squamous Cell ; Cervix Uteri ; Colon, Transverse ; Female ; Hemangiosarcoma ; Humans ; Ileum ; Intestinal Perforation ; Jejunum ; Mesentery ; Middle Aged ; Ovariectomy ; Ovary ; Sepsis ; Skin ; Subcutaneous Tissue

No abstract available.
Carcinoma, Squamous Cell* ; Poroma*

Ganglia are the most common soft tissue tumors of the hand. Ganglia found on the dorsum of the wrist usually arise from the scapholunate ligament and are usually located between the extensor digitorum communis tendon of the index finger and extensor pollicis longus tendon. Intratendinous ganglion is a very rare lesion of unknown etiology and natural history that originates within the tendon. A patient is described who presented with a painful mass on the dorsolateral aspect of the wrist due to an intratendinous ganglion of the extensor pollicis longus tendon. Treatment consisted of excision of the extensor pollicis longus tendon with ganglion followed by mini free tendon graft using palmaris longus tendon.
Fingers ; Ganglia ; Ganglion Cysts ; Hand ; Humans ; Ligaments ; Natural History ; Tendons ; Transplants ; Wrist

No abstract available.
Amniotic Fluid* ; Female ; Iron* ; Meconium* ; Staphylococcus aureus* ; Staphylococcus*

Factor XIII (fibrin stabilizing factor) has roles of stabilizing clot and cross-linking fibrin polymer, so the congenital factor XIII deficient patient has clot unstability and delayed bleeding episodes. We experienced a case of 11 years old girl who had experienced delayed umbilical healing, several episodes of intraabdominal and intracranial hemorrhage. But her coagulation screening studies with prothrombin time, aPTT (activated partial thromboplastin time), bleeding time showed normal value at each episode. These findings suggested typical features of congenital factor XIII deficiency. We used semiquantitative method to diagnose Factor XIII deficiency and quantify Factor XIII. We has treated her successfully with prophylactic fresh frozen plasma through plasmapheresis from two donors.
Bleeding Time ; Child ; Factor XIII Deficiency* ; Factor XIII* ; Female ; Fibrin ; Hemorrhage ; Humans ; Intracranial Hemorrhages ; Mass Screening ; Plasma ; Plasmapheresis ; Polymers ; Prothrombin Time ; Reference Values ; Thromboplastin ; Tissue Donors

BACKGROUND: We prospectively compared the response to blind and ultrasound-guided glenohumeral injection of corticosteroids for treatment of shoulder stiffness. METHODS: A total of 77 patients with shoulder stiffness between April 2008 and March 2012 were recruited. Patients were randomized to receive either a blind (group 1, n=39) or ultrasound-guided (group 2, n=38) glenohumeral injection of 40 mg triamcinolone. The clinical outcomes and shoulder range of motion (ROM) before injection, at 3, 6, and 12 months after injection and at the last follow-up were assessed. The same rehabilitation program was applied in both groups during the follow-up period. RESULTS: There was no significant difference in demographic data on age, sex, ROM, and symptom duration before injection between groups (p>0.05). There were no significant differences in ROM including forward flexion, external rotation at the side, external rotation at 90o abduction, and internal rotation, visual analogue scale for pain and functional outcomes including American Shoulder and Elbow Surgeons score, Simple Shoulder test between the two groups at any time point (p>0.05). CONCLUSIONS: Based on the current data, the result of ultrasound-guided glenohumeral injection was not superior to that of blind injection in the treatment of shoulder stiffness. We suggest that ultrasound-guided glenohumeral injection could be performed according to the patient's compliance and the surgeon's preference. Once familiar with the non-imaging-guided glenohumeral injection, it is an efficient and reliable method for the experienced surgeon. Ultrasound could be performed according to the surgeon's preference.
Adrenal Cortex Hormones* ; Compliance ; Elbow ; Follow-Up Studies ; Humans ; Prospective Studies ; Range of Motion, Articular ; Rehabilitation ; Shoulder Joint* ; Shoulder* ; Triamcinolone ; Ultrasonography*

McCune-Albright syndrome, which consists of cafe-au lait spots, multiple fibrous dysplasia, sexual precocity and endocrinal dysfunction such as pituitary, thyroid and adrenal aberrations, has been increasingly recognized recently. The etiology is now suggested that activating mutations on the gene that encodes the alpha subunit of stimulatory G protein cause McCune-Albright syndrome. The child presented with sexual precocity and elevated estrogen level was still persisted after left oophorectomy and right partial oophorectomy due to misdiagnosed as ovarian granulosa-theca cell tumor. Whole body bone scan revealed abnormal radiotracer uptake on left facial bone and left proximal femur. Facial bone MRI showed marked thickening of facial bone from fibrous dysplasia. And the patient had cafe-au-lait pigmentations on neck and buttock area. Other endocrine function was normal. Pathologic finding of ovary was finally confirmed with cystic follicles. Skull biopsy revealed fibrous dysplasia. And she was finally diagnosed McCune-Albright syndrome.
Biopsy ; Buttocks ; Cafe-au-Lait Spots ; Child ; Estrogens ; Facial Bones ; Female ; Femur ; Fibrous Dysplasia, Polyostotic* ; GTP-Binding Proteins ; Humans ; Magnetic Resonance Imaging ; Neck ; Ovariectomy ; Ovary ; Pigmentation ; Skull ; Thyroid Gland

BACKGROUND: Spontaneous bacterial peritonitis(SBP) is an infection of ascitic fluid without any apparent intra-abdominal foci of sepsis. Although the definitive diagnosis of SBP requires a positive ascitic fluid culture, causative organisms are not isolated in up to 65% of patients with well defined SBP probably due to inadequate culture techniques. We compared two culture methods for ascites : conventional and blood culture method. METHODS: From June 1989 until December 1994, the blood culture method of ascitic fluid culture was performed(Group A). Ascitic fluid was inoculated at the bedside directly into one aerobic and one anaerobic BACTEC blood culture bottles. During the period from January to December 1995, ascitic fluid was processed by the conventional culture method of inoculating a sample of ascitic fluid on sheep blood agar, MacConKey agar, brucella agar and into thioglycolate broth(Group B). RESULTS: Ascites cultures were positive more frequently with the blood culture method(25 of 56, 44.6%) than with the conventional method(113 of 370; 30.5%) (P<0.05). Sixteen of the 56 patients in Group A had SBP and 29 had culture negative neutrocytic ascites(CNNA) while 66 of the 370 patients in Group B had SBP and 229 had CNNA The conventional method recovered more contaminating microorganisms than the blood culture method(17.7% vs 6.9%). CONCLUSIONS: The inoculation of ascitic fluid into the BACTEC blood culture bottles at the bedside is more sensitive than the conventional method of inoculation on solid media at the laboratory bench in the recovery of pathogens in SBP and should be used routinely for the optimum diagnosis of SBP.
Agar ; Ascites ; Ascitic Fluid* ; Brucella ; Culture Techniques ; Diagnosis ; Humans ; Peritonitis* ; Sepsis ; Sheep

No abstract available.
Animals ; Cricetinae* ; Mice*

Alveolar soft part sarcoma is a primary Malignant neoplasm that very rarely occurs in the orbit. It commonly occurs in adolescents and young adults, and females are affected more often than males. The present report concerns a histologically proven case of alveolar soft part sarcoma, involving the orbit of a 4 months old girl, who was suffered from unilateral exophthalmos and resently observed at the Kyung Hee University Hospital.
Adolescent ; Exophthalmos ; Female ; Humans ; Infant ; Male ; Orbit* ; Sarcoma, Alveolar Soft Part* ; Young Adult