Congenital dilatation of the common bile duct is relatively rare anomaly. Its pathogenesis has not been completely understood. Complications of the choledochal cyst are mainly suppurative cholangitis, liver cirrhosis, stone formation, malignant change, bile peritonitis due to spontaneous and traumatic rupture. We experienced one case of choledochal cyst associated with hemorrhagic tendency and a cerebral hematoma, which is extremely rare complication. The 3 months old male patient reported here was treated with complete excision of cyst and Roux-en-Y choledochojejunostomy after correction of bleeding tendency and removal of cerebral hematoma. Postoperative course was relatively uneventful. 11 days after operation, the patient was discharged with full improvement.
Bile ; Cholangitis ; Choledochal Cyst* ; Choledochostomy ; Common Bile Duct ; Dilatation ; Hematoma* ; Hemorrhage ; Humans ; Liver Cirrhosis ; Male ; Peritonitis ; Rupture

Granular cell tumor (GCT) of the breast is a rare clinical entity, and is believed to be of schwannian origin and to follow a benign clinical course. A 50-year-old woman presented with a slowly growing mass in the right breast. Fine needle aspiration cytology revealed a cellular smear containing isolated or clustered cells showing round to oval nuclei with abundant oncocytic granular cytoplasm. Nuclei showed a fine granular chromatin pattern and occasional small single nucleoli. Cell boundaries were poorly defined, and naked nuclei were frequently found. Histologically, the tumor showed features of typical GCT, and immunohistochemical staining findings strongly supported the diagnosis. The present study demonstrates that GCT of the breast can mimic malignant lesions of breast both clinically and radiologically. The recognition of its cytologic features and suspicion of this lesion would undoubtedly aid the correct diagnosis of mammary GCT.
Biopsy, Fine-Needle* ; Breast* ; Chromatin ; Cytoplasm ; Diagnosis ; Female ; Granular Cell Tumor* ; Humans ; Middle Aged

OBJECTIVE: Lower extremity orthoses are important in the rehabilitation of the patients with stroke and traumatic brain injury. But it is unknown how much they are used in the social activity after the discharge from the hospital. This study was carried out to investigate the status of using orthosis in social activity and complaints about orthosis. METHOD: The questionnaires were given to 42 cases with stroke and 17 cases with traumatic brain injury. RESULTS: The user of lower extremity orthosis in social activity were 55.9%, and the causes of disuse were patient's poor condition, improved gait pattern, inappropriate design and defect of orthosis, and patient's refusal. The degree of satisfaction with orthosis for comfort, external appearance and weight were 79.3%, 86.2%, and 72.4%, respectively. CONCLUSION: Physiatrists should give more attention in orthosis at follow-up of patients with stroke and traumatic brain injury and make efforts to improve function and external appearance of orthosis.
Brain Injuries* ; Disulfiram ; Follow-Up Studies ; Gait ; Humans ; Lower Extremity* ; Orthotic Devices* ; Surveys and Questionnaires ; Rehabilitation ; Stroke*

To identify the long-term survival rate and prognostic factors of AMI in Korea, total 404 patients who presented between Jan 1984 and mar 1989 at Seoul National University Hospotal were followed for and average of 24.9+/-18.2 months(range 1 to 69 months). 50 patients(12.4%) died during the in-hospital period and 25 patients(6.2%) died after discharge. Among the survivors reinfarction developled in 11 patients(3.3%). Overall survival rates were 0.87, 0.85, 0.83, 0.81, 0.79, 0.77 and event-free survival rates were 0.87, 0.84, 0.83, 0.79, 0.77, 0.72 at 1, 6, 12, 24, 36, 48 months respectively. During the in-hospital period sex, age, peak creatine kinase level, Killip class, Q wave in ECG, heart failure, and AV block in anterior infarction were of prognostic value. After discharge age, exercise duration on pre-discharge treadmill test, cardiac index, ejection fraction, and presence of heart failure were significant prognostic factors. Pre-discharge coronary angiographies were performed in 217 cases. There was no statistically significant difference in survival rate between multiple vessel disease and single vessel disease. But the more the number of involved vessels was, the higher the incidence of reinfarction was. In the group with jeopardy score less than 8, event-free survival rate was signigicantly higher. Overall survival rate was higher and reinfarction rate was lower in the group, but both were not statistically significant. On discriminant analysis of in-hospital prognostic factors, Killip class, heart failure and age were independent prognostic factors, but other factors had no additional prognostic value.
Atrioventricular Block ; Coronary Angiography ; Creatine Kinase ; Disease-Free Survival ; Electrocardiography ; Exercise Test ; Heart Failure ; Humans ; Incidence ; Infarction ; Korea ; Myocardial Infarction* ; Seoul ; Survival Rate* ; Survivors

A solitary fibrous tumor (STF) is a relatively unusual neoplasm first described as a distinctive tumor arising from pleura. Some reports have shown that STF also affect extrathoracic regions. A 70-year-old woman was referred to our hospital for surgical treatment of an incidentally discovered thigh mass. We performed complete removal of the tumor. It was a soft tissue tumor with muscle indentation but without invasion to the surrounding muscles. The resected specimen was 7.0x6.3x5.2 cm. Histologically, the tumor was composed of a haphazard proliferation of spindle cells and epitheloid cells with hypercellularity and high mitotic activity. Immunohistochemistry showed positive immunoreactivity for CD34, CD99, bcl-2 protein, CD117, vimentin, smooth muscle actin and epithelial membrane antigen. We report, herein, on a rare case of malignant SFT in the thigh region along with a review of the literature.
Actins ; Aged ; Female ; Humans ; Immunohistochemistry ; Mucin-1 ; Muscle, Smooth ; Muscles ; Pleura ; Solitary Fibrous Tumors ; Thigh ; Vimentin

Diffuse infiltrative lymphocytosis syndrome is an autoimmune syndrome that is characterized by the oligoclonal expansion of CD8+ T-lymphocytes in response to human immunodeficiency virus (HIV) antigens. The clinical manifestations include bilateral enlargement of the parotid glands, lymphocytic interstitial pneumonitis, lymphocytic hepatitis, neurological involvement and systemic lymphadenopathies. In addition to a positive HIV test, the diagnostic histopathological findings are CD8+ T-lymphocytic infiltrations in the lymphnodes, liver, lung, muscle and the salivary or lacrimal glands without granulomatous or neoplastic involvement. We report a case of pulmonary involvement of diffuse infiltrative lymphocytosis syndrome that was associated with a human immunodeficiency virus infection.
Hepatitis ; HIV* ; Humans* ; Lacrimal Apparatus ; Liver ; Lung ; Lung Diseases, Interstitial ; Lymphocytosis* ; Parotid Gland ; T-Lymphocytes

Xanthogranuloma is a benign, fibrohistiocytic lesion that presents as a yellowish, cutaneous papule or nodule. Although the head, neck, and trunk are the most common sites for xanthogranuloma, it can appear at any site on the body. We report a rare solitary xanthogranuloma on the palm of 24-year-old man.
Head ; Humans ; Neck ; Young Adult

Cutaneous metastasis from bladder cancer is very rare. A 48-year-old man presented with a 5 month history of a dome-shaped nodule on his scalp. Histopathologic examination of the skin lesion revealed the proliferation of atypical cells, which were similar to those of urothelial carcinoma of the urinary bladder. We herein report on a case of cutaneous metastasis from urothelial carcinoma of the urinary bladder with a review of the Korean literature.
Carcinoma, Transitional Cell ; Humans ; Middle Aged ; Neoplasm Metastasis* ; Scalp ; Skin ; Urinary Bladder Neoplasms ; Urinary Bladder*

Inflammatory pseudotumor (IPT) is an uncommon benign neoplasm of unknown etiology presenting as an incidental mass, fever, malaise, anemia, and weight loss. Generally, IPT in the lung is asymptomatic. A case of pulmonary IPT presenting as prolonged fever in a 59 year old man is presented with clinicopathological findings. The patient had been febrile for three months before admission. Five months before admission, a chest X-ray showed a small left pulmonary mass which was regarded as old tuberculosis. An chest X-ray taken on admission revealed a left pulmonary mass two times the size of the one on the first x-ray. Percutaneous needle aspiration and biopsy were performed, and the microscopic examination revealed a plasma cell reaction with myofibroblastic proliferation, consistent with IPT. As prolonged unexplained fever is a frequent symptom in patients with IPTs, this disease entity should be included in the differential diagnosis of fever of unknown origin.
Anemia ; Biopsy ; Diagnosis, Differential ; Fever of Unknown Origin* ; Fever* ; Granuloma, Plasma Cell ; Humans ; Lung ; Middle Aged ; Myofibroblasts ; Needles ; Plasma Cell Granuloma, Pulmonary* ; Plasma Cells ; Thorax ; Tuberculosis ; Weight Loss

Inflammatory pseudotumor (IPT) is an uncommon benign neoplasm of unknown etiology presenting as an incidental mass, fever, malaise, anemia, and weight loss. Generally, IPT in the lung is asymptomatic. A case of pulmonary IPT presenting as prolonged fever in a 59 year old man is presented with clinicopathological findings. The patient had been febrile for three months before admission. Five months before admission, a chest X-ray showed a small left pulmonary mass which was regarded as old tuberculosis. An chest X-ray taken on admission revealed a left pulmonary mass two times the size of the one on the first x-ray. Percutaneous needle aspiration and biopsy were performed, and the microscopic examination revealed a plasma cell reaction with myofibroblastic proliferation, consistent with IPT. As prolonged unexplained fever is a frequent symptom in patients with IPTs, this disease entity should be included in the differential diagnosis of fever of unknown origin.
Anemia ; Biopsy ; Diagnosis, Differential ; Fever of Unknown Origin* ; Fever* ; Granuloma, Plasma Cell ; Humans ; Lung ; Middle Aged ; Myofibroblasts ; Needles ; Plasma Cell Granuloma, Pulmonary* ; Plasma Cells ; Thorax ; Tuberculosis ; Weight Loss