Malignant fibrous histiocytoma, which is interesting because of its pleomorphic nature, is a rare soft tissue sarcoma possibly arising from histiocyte. The tumors are usually situated in the skin or subcutaneous tissues, especially of the extremities, but they may also involve deeper structures, such as the retroperitoneum or genital organs. Herin we report a case of malignant fibrous histiocytoma in the retroperitoneal space and discuss the pathologic and clinical features.
Extremities ; Genitalia ; Histiocytes ; Histiocytoma, Benign Fibrous ; Histiocytoma, Malignant Fibrous* ; Retroperitoneal Space ; Sarcoma ; Skin ; Subcutaneous Tissue

No abstract available.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Salivary Glands*

Nineteen patients with lichen striatus were investigated by clinical data, clinical photographs and histopathologic study by the pattern analysis method of Ackermsn. Results were as follows '. 1. The male to female ratio was 1: 1.1, and average age was 7.8 years. Seven- teen patients (about 90%) visited hospitals during summer season. 2. Nine cases showed superficial perivascular dermatitis, 9 cases interface dermatitis (vacuolar type : 7, lichenoid type, 2), 1 case nodular dermatitis and 2 rases interface dermatitis with nodular dermatitis. 3. In the epidermis, 9 cases showed variable nurnber of dyskeratotic cells. One case showed finding of perforating lichen striatus. 4. Two cases showed inflammation around acrosyringium, 4 cases around hair follicle, 6 cases around eccrine sweat gland and 1 case showed perineural inflamrnation. Summarizing above results, histopathology of lichen striatus characteristically shows superficial perivascular dermatitis, interface dermatitis, and infiltration of inflammatory cells around the sweat gland, which helps to diagnose the disease.
Adolescent ; Dermatitis ; Epidermis ; Female ; Hair Follicle ; Humans ; Inflammation ; Lichens* ; Male ; Seasons ; Sweat Glands

PURPOSE: The purpose of this study was to compare the effects of intravenous fluid warming and skin surface warming on peri-operative body temperature and acid base balance of abdominal surgical patients under general anesthesia. METHOD: Data collection was performed from January 4th, to May 31, 2004. The intravenous fluid warming(IFW) group(30 elderly patients) was warmed through an IV line by an Animec set to 37 degrees C. The skin surface warming(SSW) group(30 elderly patients) was warmed by a circulating-water blanket set to 38 degrees C under the back and a 60W heating lamp 40 cm above the chest. The warming continued from induction of general anesthesia to two hours after completion of surgery. Collected data was analyzed using Repeated Measures ANOVA, and Bonferroni methods. RESULTS: SSW was more effective than IFW in preventing hypothermia(p= .043), preventing a decrease of HCO3-(p= .000) and preventing base excess(p= .000) respectively. However, there was no difference in pH between the SSW and IFW(p= .401) groups. CONCLUSION: We conclude that skin surface warming is more effective in preventing hypothermia, and HCO3- and base excess during general anesthesia, and returning to normal body temperature after surgery than intravenous fluid warming; however, skin surface warming wasn't able to sustain a normal body temperature in elderly patients undergoing abdominal surgery under general anesthesia.
Abdomen/*surgery ; Acid-Base Equilibrium ; Aged ; Anesthesia, General ; *Body Temperature Regulation ; Female ; *Hot Temperature ; Humans ; Hypothermia/etiology ; Infusions, Intravenous ; Intraoperative Complications/prevention & control ; Male ; Middle Aged ; Oximetry ; Preoperative Care/*methods ; *Skin Temperature

Being described first 1912 by Hashimoto, Chronic lymphocytic thyroiditis has been most commonly diagnosed as inflammatory thyroid disease. Despite of worldwide reports about the concomitant malignancy with Hashimoto's thyroiditis, the definite incidence of coexsiting malignancy and the etiologic relationship between these different pathologic conditions remains to be brought out. Analyzing 18 cases of coexisting thyroid carcinoma among 80 cases of Hashimoto's thyroiditis, confirmed by pathologic study at Presbyterian medical center in Chonju between 1991 and 1995, the authors intended to make guideline of management for them. The results are as follows: 1. The incidence of coexisting carcinoma with HT was 18/80(22.5%). 2. The average age of patients with coexisting carcinoma was 44.1 years and all of them were female.3. Cold nodules on thyroid scan were noticed in 23 cases(22.7%) of HT and 7 cases(33.8%) of coexisting carcinoma with HT. 4. Calcified lesions on thyroid sonography were detected in 0 cases of HT and 4 cases(50%) of coexisting carcinoma. 5. The pathologic types of carcinoma were papillary(17/18, 94.4%) and follicular(1/18, 5.6%). 6. 3 cases of coexisting carcinoma had metastatic lesions on peritracheal lymph nodes and another 3 cases had on ipsilateral jugular nodes. 7. The carcinoma of smaller than 0.5cm were 7 cases, of 0.6-1.0cm were 3 cases, of 1.1-1.5cm were 5 cases, and so 15 cases(83.3%) were occult carcinoma. Only 3 cases were larger than 1.6cm. 8. Coexisting carcinoma patients with HT underwent subtotal thyroidectomy (4 cases), subtotal thyroidectomy & anterior compartment dissection (ACD, 6 cases), subtotal thyroidectomy & modified RND (2 cases), thyroid lobectomy & ACD (4 cases), thyroid lobectomy & modified RND (1 cases), or near total thyroidectomy & ACD (1 case).
Hashimoto Disease ; Humans ; Incidence ; Jeollabuk-do ; Lymph Nodes ; Protestantism ; Thyroid Diseases ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Thyroiditis*

Nevus anemicus is a congenital anomaly characterized by pale macules of varying size and shape, and it is due to the increased sensitivity of blood vessels to catecholamines. However, the clinical features of nevus anemicus are not yet fully established. A clinical observation was made analyzing 26 cases of nevus anemicus over a 10-year period. Histopathological investigation in 6 cases, stain with Fontana-Masson in 4 cases, irradiation of ultraviolet B in 5 cases, digital infrared thermal imaging in 5 cases and color analysis using true-color imaging in 12 cases were also performed. The results were as follows: 1. The ratio of men to women was 1.2:1. The lesions were mostly(80%) present before the age of 18, but only 15% of the patients' lesions were present at birth. 2. The lesions were most frequently found on the face(33.3%) and neck(33.3%), followed by the chest(14.8%), lower extremities(7.4%) and back(7.4%). 3. Most patients(92.3%) had a single lesion. The extent of the lesions did not exceed 10% of the body surface area and the lesions did not show any progression or resolution. 4. The stainability of Fontana-Masson in nevus anemicus lesions showed no significant change compared with perilesional normal skin. 5. Irradiation of ultraviolet B ray(minimal erythemal dose to 80mJ/cm2) did not induce erythema on nevus anemicus lesions. 6. There was no significant temperature difference between nevus anemicus lesions and perilesional normal skin. 7. There was no significant correlation between chrominance and age. In conclusion, nevus anemicus in Korea shows the same incidence in both sexes, it usually arises at birth or childhood, but it may also develop later in life. Most patients show focal lesions that do not progress or resolve.
Blood Vessels ; Body Surface Area ; Catecholamines ; Erythema ; Female ; Humans ; Incidence ; Korea ; Male ; Nevus* ; Parturition ; Skin

BACKGROUND AND OBJECTIVES: Facial nerve dysfunction in Bell's palsy is evaluated using various parameters including physical examination and electrophysiological studies. Associated symptoms of facial numbness or paresthesia are reported by some patients with Bell's palsy. The aim of this study was to investigate trigeminal nerve involvement in Bell's palsy using blink reflex test. SUBJECTS AND METHODS: Facial nerve and trigeminal nerve functions were assessed using House-Brackmann (HB) grading system, electroneuronography (ENoG) and blink reflex tests in 28 patients diagnosed as Bell's palsy. RESULTS: HB grades correlated with degeneration ratio from ENoG (p=0.002, chi-square test). The ipsilateral R1 reponse of the blink reflex was absent or abnormal in 27/28 patients (96.4%), and ipsilateral R2 response was absent or abnormal in 26/28 patients (92.8%). Contralateral R2 was abnormal in 5/28 patients (17.8%), suggesting involvement of trigeminal nerve in a portion of patients. The results of blink reflex test showed no significant correlation to the outcome of facial nerve function (HB grade) in Bell's palsy patients. CONCLUSIONS: Blink reflex test provides information about trigeminal and facial nerve functions in addition to ENoG results. Our study suggests that subclinical involvement of trigeminal nerve may accompany facial nerve dysfunction in Bell's palsy.
Bell Palsy ; Blinking ; Facial Nerve ; Humans ; Hypesthesia ; Paresthesia ; Physical Examination ; Trigeminal Nerve

OBJECTIVES: Our purpose was (1) to determine whether amniotic fluid concentrations of interleukin-6 are of value in the diagnosis of histologic chorioamnionitis of preterm placenta and in the prediction of significant perinatal morbidity and mortality in patients with preterm premature rupture of membranes and (2) to compare the diagnostic performance of amniotic fluid interleukin-6 with that of amniotic fluid microbial culture for these outcome variables. METHOD: The relation among placental histologic finding, perinatal outcome, amniotic fluid culture, and amniotic fluid interleukin-6 concentrations were examined in 65 patients with preterm premature rupture of membranes who delivered preterm neonates within 72 hours after transabdominal amniocentesis. Interleukin-6 level was determined by enzyme-linked immunosorbent assay. Receiver-operator characteristic curve, Mann-Whitney U test, and Fisher's exact test were used for analysis. RESULTS: 1) Patients with acute histologic chorioamnionitis had significantly higher median amniotic fluid interleukin-6 concentrations than those without histologic chorioamnionitis (median 12.6 ng/ml, range 0.03 to 142.2 ng/ml vs median 0.5 ng/ml, range 0.03 to 16 ng/ml; P < 0.0001). 2) Amniotic fluid having interleukin-6 concentrations higher than 3.2 ng/ml had a sensitivity of 78% (35/45) and specificity of 95% (19/20) in the diagnosis of acute histologic chorioamnionitis and sensitivity of 74% (25/34) and specificity of 65% (20/31) in the prediction of significant neonatal morbidity and mortality. 3) These sensitivities were significantly higher than those of amniotic fluid culture, but there were no significant difference in specificities between amniotic fluid interleukin-6 and culture (histologic chorioamnionitis: 78% vs 51%, p<0.01; significant neonatal morbidity and mortality: 74% vs 47%, p<0.01, respectively). CONCLUSIONS: Test of amniotic fluid interleukin-6 is of value and more sensitive than amniotic fluid culture for the antenatal diagnosis of histologic chorioamnionitis and for the prediction of perinatal outcome in patients with preterm premature rupture of membranes.
Amniocentesis ; Amniotic Fluid* ; Chorioamnionitis ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Infant, Newborn ; Interleukin-6* ; Membranes* ; Mortality ; Placenta ; Pregnancy ; Prenatal Diagnosis* ; Rupture* ; Sensitivity and Specificity

Purpose: A nationwide study (2012-2017) of preventable trauma death rates (PTDR) showed a 15.3% decrease after Regional Trauma centers were initiated. However, in non-trauma centers with an Emergency Department there is limited data of preventable mortality in trauma patients. Therefore, the purpose of this retrospective study was to investigate preventable mortality in trauma patients in a nonregional trauma center and determine the effect of initiating a Trauma Team. Methods: There were 46 deaths of trauma patients recorded in the National Health Insurance service Ilsan Hospital (NHISIH) in South Korea from January 2019 to December 2021. These patients’ preventable deaths were analyzed by an expert panel review considering the implementation of the Trauma Team in April 2020. Results: All deaths were attributable to blunt trauma with an average Injury Severity Score of 26.0 ± 19.2, Revised Trauma Score of 5.05 ± 3.20 and Trauma and Injury Score of 56.6 ± 41.3. The most frequent cause of death was traumatic brain injury followed by respiratory arrest. The most frequent error was delayed transfusion followed by delayed treatment of bleeding. Treatment errors occurred the most in the Emergency Room followed by the Intensive Care Unit. The PTDR of patients before the involvement of a Trauma Team (January 2019 to March 2020) and after the Trauma Team was initiated in April 2020 decreased from 27.27% to 4.27%, respectively (p = 0.021). Conclusion The introduction of a dedicated Trauma Team in a non-regional trauma center significantly reduced the overall PTDR in trauma patients.