Fibrous histiocytomas are characterized by a variable combination of cells with fibroblastic and histiocytic features. They exhibit a distinctive but inconstant cellular arrangement referred to as a storiform or cartwheel pattern. Considerable corfusion has enveloped these tumors as a result of their various terminology-fibrous histiocytoma, dermatofibroma, sclerosing hemangioma, fibroxanthoma, subepidermal nodular fibrosis, xanthogranuloma, giant cell tumor of tendon sheath. A histologically benign but locally infiltrating, 15 * 20cm sized, fibrous histiocytoma was found in the posterior aspect of left thigh of a 17-year-old man. The tumor was incompletely excised due to adhesion of the tumor mass to sciatic nerve and then radiation therpy was combined, Histogenesis and prognostic aspects of the tumor are discussed.
Adolescent ; Fibroblasts ; Fibrosis ; Giant Cell Tumors ; Histiocytoma ; Histiocytoma, Benign Fibrous* ; Humans ; Sciatic Nerve ; Tendons ; Thigh

The onset of systemic scleroderma in the first. decade of lif occurs in less than 1.5% of instances. Systemic sclerodrma in childhood have been characterized by less severe visceral involvement and a benign course We report a boy, aged 7 years, with a history of Raynaid; phenomenon and dysphagia. He had a mask-like face, flexion contracture of hands and knee joints, digital pitting scars, ichthyosiform skin change on leg and hyperpigrnented induration on all extremities and trunk. Antinuclear antibodies were positive in nucleolar type and Scl-70 antiocy was also present. On radiologie study, the pattern of reflux esophagitis and resorption of the listal ends of all phalanges were nated. Histopathological findings were compatible with sclerodma. He was treated with Penicillamine-D and oral corticosteroic with good improvernent.
Antibodies, Antinuclear ; Cicatrix ; Contracture ; Deglutition Disorders ; Esophagitis, Peptic ; Extremities ; Hand ; Humans ; Knee Joint ; Leg ; Male ; Scleroderma, Systemic* ; Skin

No abstract available.

PURPOSE: To assess the role of the preoperative portal vein embolization (PVE) in patients in need of major hepatectomy. MATERIALS AND METHODS: Total of 11 cases consisted of Klatskin tumor (n:6), gallbladder cancer (n=2), and hepatocellular carcinoma (n=3). After percutaneous transhepatic puncture of portal vein (right:7, left:4), the embolization of 1st order branch of right portal vein was done with Gentamicin soaked Gelfoam cubes. Radiologically, the angle between the middle hepatic vein and the inferior vena cava was measured on pre- and post-PVE CT (F/U :10 days) to evaluate the hypertrophy of the left lobe. Clinically, amount and nature of the drained bile through the PTBD tube of both lobes were analyzed in 5 patients with Klatskin tumor. The interval between PVE & operation was 10-24 days. Operative findings & the changes of postop. total bilirubin were analyzed and the complication after procedure was checked. RESULTS: There was decrease in mean angle between the middle hepatic vein and the inferior vena cava from 35.9 degree to 23.9 degree, but it was insignificant statistically (p=0.09). The embolization of right portal vein was done and there was increase in amount of drained bile from the nonembolized left lobe by 2-3 folds 8-14 days after PVE. The color and consistency between both lobes were significantly different; right lobe was darker in color and softer in consistency. Postoperative total bilirubin increased by 2-3 folds 1 to 4 days after PVE and normalized 10 to 14 days after PVE. Most of the patients had mild abdominal pain and fever after PVE and 1 patient had localized hematoma at puncture site which was subsided spontaneously. CONCLUSION: The preoperative portal vein embolization is a useful method for minimizing postoperative liver failure in patients in need of major hepatectomy.
Abdominal Pain ; Bile ; Bilirubin ; Carcinoma, Hepatocellular ; Fever ; Gallbladder Neoplasms ; Gelatin Sponge, Absorbable ; Gentamicins ; Hematoma ; Hepatectomy* ; Hepatic Veins ; Humans ; Hypertrophy ; Klatskin's Tumor ; Liver Failure ; Portal Vein* ; Punctures ; Vena Cava, Inferior

Multinucleate cell angiohistiocytoma is a rare benign fibrohistiocytic vascular condition with distinctive histologic features. It tends to occur more frequently in middle-aged women, to favor the extremities, and to appear as grouped reddish-brown papules. We describe a case of solitary multinucleate cell angiohistiocytoma that appeared as a papule on the upper lip of a 24-year-old man.
Extremities ; Female ; Humans ; Lip ; Young Adult

This retrospective study was undertaken to investigate the current clinical trend in the management of ectopic pregnancy. 562 patients of ectopic pregnancy were admitted and managed at the Department of Obstetrics and Gynecology, Chonbuk National University Hospital from Jan. 1. 1985 to Dec. 31. 1996. All cases had a reliable medical record and were divided into two groups, of which group A includes patients admitted from Jan. 1. 1985 to Dec. 31. 1990, group B from the Jan. 1. 1991 to Dec. 31. 1996. The results were obtained as follows. 1. The number of cases of ectopic pregnancy were 248 in group A and 314 in group B. 2. The age group of 20 to 29 years of age was top ranked in group A(49.6%) as well as in group B(46.8%). The age group of 30 to 39 years was 43.2% in group A and 46.6% in group B, respectively. 3. In group A, the case who experienced two deliveries was 31.9%, and nulliparous woman was 30.6%. In group B, the case who experienced two deliveries was 33.1%, nulliparous woman was 33.1%. 4. On reviewing the past medical history, ectopic pregnancy was 11.2% in group A, 10.8% in group B, respectively. Pelvic inflammatory disease was 8.1% in group A and 11.0% in group B, respectively. 5. The interval between the last menstrual period and the onset of symptoms was prevalently in 4 to 8 weeks(64.5% in group A, 61.8% in group B). The terval of 12 weeks or more was 2.0% in group A and 6.0% in group B, respectively. 6. In considering the chief complaints, low abdominal pain was 85.9% and vaginal spotting was 69.0% in group A. On the other hand, low abdominal pain was 91.4% and vaginal spotting was 76.4% in group B, meanwhile nausea and vomitting was 8.6% and dizziness was 3.5% in group A, there were 23.4% of nausea and vomitting and 9.7% of dizziness in group B,7. In relation of the diagnostic methods, the positive rate of culdocentesis in group B was lower than the rate in group A. Diagnostic laparoscopy was done in 5.6% of group A and 14% of group B. The detection rate of adnexal mass and fluid collection in the pelvic cavity was higher in group B than in group A on the ultrasonographic examination. 8. Initial hemoglobin value of 10.1mg/dl or more was 70.9% in group A and 73.2% in group B. The value of 8.0gm/dl or less was 6.4% in group A and 7.0% of group B, respectively. Initial systolic pressure of 110mmHg or more was 74.6% in group A and 66.6% in group B. The systolic pressure of 90mmHg or less was 3.6% in group A and 8.3% in group B.9. The conceptus was almost implantd in the fallopian tube. The ampullary portion was the most common site of ectopic implantation in both groups. 10. Intraabdominal hemorrhage of 500ml or less in amount was 52.4% in group A and 61.1% in group B, individually. However transfusion was not given in 55.6% of group A and in 71.0% of group B. 11. In the therapeutic modalities, laparotomy was performed in 96.8% of group A and in 82.8% of group B, respectively. The pelviscopic operation was done in 2.4% of group A and in 22.3% of group B. In conclusion, ectopic pregnancy was diagnosed increasingly prior to the onset of the hypovolemic symptoms according to developement of high-resolution ultrasonogram, diagnostic laparoscopy and beta-hCG test, therefore the use of minimally invasive techniques in the management of ectopic pregnancy was increasing.
Abdominal Pain ; Blood Pressure ; Diagnosis* ; Dizziness ; Fallopian Tubes ; Female ; Gynecology ; Hand ; Hemorrhage ; Humans ; Hypovolemia ; Jeollabuk-do ; Laparoscopy ; Laparotomy ; Medical Records ; Metrorrhagia ; Nausea ; Obstetrics ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Ectopic* ; Retrospective Studies ; Ultrasonography

No abstract available.
Collagen Type I* ; Skin* ; Wound Healing* ; Wounds and Injuries*

About 40% of patients with rheumatoid arthritis show extra-articular manifestations. The presence of rheumatoid nodules is the most common extra-articular manifestation, which is commonly seen at pressure points. Rheumatoid nodules can also occur in the lung, heart, and larynx. Laryngeal rheumatoid nodules may lead to phonatory and respiratory symptoms and can be mistaken for other medical conditions such as inflammation and neoplasm. Recently, we encountered a case of rheumatoid nodules involving the larynx in a 56-year-old woman with a 3-year history of rheumatoid arthritis and Sjogren's syndrome. Herein, we report the case with a review of the literature.

BACKGROUND: The radiocephalic arteriovenous fistula (AVF), which provides the best vascular access for hemodialysis, continues to have a high incidence of early failure. This was studied to determine primary and secondary patency rate of percutaneous transluminal angioplasty (PTA) in hemodialysis patients who had early dysfunction of this AVF within 1 year after the operation. METHODS: This retrospective study enrolled 39 hemodialysis patients with early dysfunction of radiocephalic AVF who received PTA between January, 1997 and December, 2002 at Uijongbu St. Mary's Hospital. The lesions occurred at proximal vein of upper arm and central vein were excluded. The primary and secondary patency rate of PTA was evaluated using Kaplan-Meier method. According to diabetes, age, sex, onset of AVF dysfunction after the operation, thrombosis, patency rate was compared with log-rank test. RESULTS: The mean age of the patients was 54+/-13 years and the number of male was 16 (41.2%). Twenty-four patients (61.5%) had diabetes and Among 39 lesions observed at venography, there were 33 cases of stenosis and 6 cases of complete occlusion due to thrombosis. The onset of AVF dysfunction after the operation was 5.3+/-3.6 months and 11 cases developed before the first needling. Total PTAs were performed and initial success rate was 94.2% (n=49). Primary patency rate at 6, 12, 24, and 48 months was 74.8%, 55.8%, 55.8%, and 55.8%, respectively. Secondary patency rate at 6, 12, 24, 48 months was 89.7%, 86.1%, 81.8%, 81.8%. Diabetes, age, sex, onset of AVF dysfunction after the operation, thrombosis did not influenced primary patency rate of PTA. There was no PTA-related complication. CONCLUSION: Percutaneous transluminal angioplasty is considered to be effective and safe treatment for early dysfunction of radiocephalic arteriovenous fistula in hemodialysis patients.
Angioplasty* ; Arm ; Arteriovenous Fistula* ; Constriction, Pathologic ; Humans ; Incidence ; Male ; Phlebography ; Renal Dialysis ; Retrospective Studies ; Thrombosis ; Veins

BACKGROUND: Fistulography is usually performed through transvenous approach in hemodialysis patients. We preformed this study to evaluate the clinical significance of the brachial arterial approach for the fistulography from the hemodialysis patients. METHODS: This study included 13 cases from 12 hemodialysis patients who had the fistulogram or percutaneous transluminal angioplasty through brachial arterial approach between November 2003 and June 2005. We investigated the indication, the radiologic finding, the complication and the outcome of the fistulography and the percutaneous transluminal angioplasty. RESULTS: Indication of transbrachial artery approach was immaturation of the arteriovenous fistula or poor visualization of venous route. The brachial artery puncture was successfully performed in all patients. For 10 cases, the stenoses or occlusions were observed in the arteriovenous anastomosis site, distal radial artery or proximal cephalic vein. Four patients had severe arterial stenosis. Additionally, the percutaneous transluminal angioplasty were performed in 8 cases of 13 cases. The procedure-related complication demonstrated focal pseudoaneurysm formation at brachial artery puncture site, resulting in transient radial nerve palsy in only one case. CONCLUSION: Tranbrachial artery approach is considered as effective in the immaturation of hemodialysis arteriovenous fistulas or arterial vascular problem. However, we should give attention to the brachial arterial approach because of its significant complication.
Aneurysm, False ; Angioplasty ; Arteries ; Arteriovenous Anastomosis ; Arteriovenous Fistula ; Brachial Artery* ; Constriction, Pathologic ; Humans ; Paralysis ; Punctures ; Radial Artery ; Radial Nerve ; Renal Dialysis* ; Veins