We report a case of primary osteosarcoma of the breast which is rare and exhibits poor prognosis. A 52 years-old-woman was admitted with rapidly growing right mammary mass. A huge lobulated dense mass with speckled calcifications, suggesting malignancy, was observed on mammography. She underwent a radical mastectomy. Grossly, the mass measured 16 14 6 cm and showed grayish white hard lobulated tissue with focal hemorrhage and necrosis. Light microscopically, the tumor was confirmed as an osteosarcoma devoid of any epithelial components. In postoperative whole body bone scan, there was no evidence of the other malignancy. To the best of our knowledge, the present case is the first report of primary osteosarcoma of the breast in Korea.
Breast* ; Hemorrhage ; Korea ; Mammography ; Mastectomy, Radical ; Necrosis ; Osteosarcoma* ; Prognosis

This study was focused on the distribution of different facial types of the Class II division 1 malocclusion groups and skeletal characteristics of the each group and those that anteropsterior relationship of the maxilla and mandible calculated from the analysis of ANB angle and Wits appraisal was quite different from each other, as well. Cephalometric headplates of 140 persons of Class II division 1 malocclusion whose mean age was 11.2 years and 69 persons of normal occlusion whose mean age was 12.2 years were utilized as materials. Measurements were recorded, tabulated and statistically analyzed employing the tracings of the lateral cephalograms, then Class II division 1 malocclusion group was divided into 9 Types according to the angle of SNA and SNB for the anteroposterior relationship of the maxilla and mandible, another 9 Types according to the FH-NPog and SN-MP for the horizontal and vertical relationship, and the other 9 Types according to the ANB and Wits appraisal for intermaxillary relationship as well, with which was based on Mean+/- 1SD of those of normal occlusion. The result allowed the following conclusion: 1. 37.1 % of population demonstrated maxilla within normal range and retrognathic mandible to the cranial base, 30% for both maxilla and mandible within normal range, 20% for retrognathic maxilla and mandible and 12.9 % of the rest were arranged in Class II division 1 malocclusion groups. 2. Retrognathic mandible and hyperdivergent face accounted for 30.7 %, mesognathic mandible and neutrodivergent face for 29.3 %, mesognathic mandible and hyperdivergent face for 16.4 %, retrognathic mandible and neutrodivergent face for 13.6 %, mesognathic mandible and hypodivergent face for 10% of population were computed in Class II division 1 malocclusion groups. 3. It was suggested that skeletal Class II malocclusion might be due to anomaly in size and shape of cranial base, underdevelopment of mandible, retropositioning of mandible, underdevelopment of posterior face against anterior face, or any combination of these factors. 4. Population with underdevelopment and/or retropositioning of the mandible showed hyperdivergent tendency of facial profile. 5. The ANB angle and Wits appraisal did not coincide the severity of anteroposterior dysplasia in 35.7% of Class II division 1 malocclusion group each other, and this inconsistency was suggested to be related with mandibular rotation, inclination of cranial base, and anteroposterior position of the maxilla.
Humans ; Malocclusion* ; Mandible ; Maxilla ; Reference Values ; Skull Base

The purpose of this study was to compare bracket shear bond strengths of th crystal growth solutions wi those of the 37% phosphoric acid etch technique. The 4 crystal growth solutions were made experimentally in th lab, that is (1)30% polyacrylic acid solution containing 0.3 M sulfuric acid (ES 1), (2)30% polyacrylic acid solution containing 0.6 M solution acid (ES 2), (3)30% polyacrylic acid solution containing 0.3 M solution acid and 0.6M lithium sulfate(ES 3), (4)30% polyacrylic acid solution containing 0.3 M solution acid and 5% phosphoric acid (ES 4). The 37% phosphoric acid solution used as a control. Bovine lower incisor tooth enamel was treated by the above solutions for 60 sec, washed out for 20 sec with slow water stream, and bonded lower anterior edgewise bracket with the light curing orthodontic composit resin adhesives. The teeth bonded brackets were stored in the distilled water at room temperature for 24h, and followed to test the bracket shear bond strength. The acid etch technique showed 177.6kg/cm(2) of mean shear bond strength which was the highest among the enamel treatment solutions. ES 1 shown 58.4 kg/cm(2) of mead shear bond strength and the of ES 4 showed 66.5 kg/cm(2). There was no significant difference between the two(p>0.05). Es 2 showed 110.6kg/cm(2) of mean shear bond strength which was 62.3% of that of acid etch technique. ES 3 showed 131.3kg/cm(2) of mead shear bond strength which was the highest among experimental crystal growth solution and which was 74% of that of acid etch technique. The shear bond strengths of the crystal growth solutions and were significantly lower that that of acid etch technique(p<0.05). The results suggest that bracket shear bond strength of 30% polyacrylic acid solution containing 0.3M sulfuric acid and 0.6M lithium sulfate were showed the highest, it is low for the clinical application of this solution.
Adhesives ; Crystallization* ; Dental Enamel ; Incisor ; Lithium ; Rivers ; Sulfur ; Tooth ; Water

Apoptosis ; Bone Regeneration ; Calcium ; Calcium Phosphates ; Cell Cycle ; Cell Proliferation ; Ceramics ; Durapatite ; Gene Expression ; Microarray Analysis ; Oligonucleotide Array Sequence Analysis ; Osteoblasts ; Osteogenesis ; Signal Transduction

Merkel cell carcinoma (MCC) is an aggressive neuroendocrine carcinoma with a high rate of metastasis. MCC is rarely suspected during clinical examination, thus requiring biopsy to establish a pathologic diagnosis. In addition, MCC sometimes occurs in double primary cancers. Although there have been reviews on double primary cancers, only a few cases involving MCC have been described. Herein, we report a case of a 54-year-old female patient who presented to our clinic with a diagnosis of earlobe MCC following an excisional biopsy performed by another clinic. Further evaluation, including chest imaging, revealed a mass in the lung. The patient underwent a wide excision of the right earlobe, and video-assisted thoracic surgery on the lung. Pathology confirmed MCC in the right earlobe and adenocarcinoma in the lung. The patient underwent postoperative adjuvant chemotherapy followed by radiotherapy. Up to this point, 3 years after the surgery, there has been no evidence of recurrence.

A 70-year-old female who was diagnosed as myxoid chondrosarcoma by fine needle aspiration of a pleural mass is described. She presented with left chest discomfort of 4 months' duration and aggravating dyspnea and chest pain for 2 months. Chest X-ray and CT scan revealed a large lobulated low density mass invading chest wall at the left pleural cavity and massive pleural fluid. Fine needle aspiration was done under the impression of mesothelioma or metastatic cancer. The aspirates from the mass were very cellular and composed of isolated or clustered forms of large plump cells. Abundant cytoplasm was bluish opaque and the margin was rounded in the isolated cells, whereas clustered cells show ill-defined cell borders and aggregating tendency. The nuclei were eccentric, round to ovoid, and had fine chromatin pattern and multiple small nucleoli. Cellular pleomorphism or mitotic figure was not definite. These findings were consistent with cytologic features of chondrosarcoma. Final diagnosis was confirmed as myxoid chondrosarcoma by mediastinoscopic biopsy and the tumor showed strong positivity for S-100 protein.
Aged ; Biopsy ; Biopsy, Fine-Needle ; Chest Pain ; Chondrosarcoma ; Chromatin ; Cytoplasm ; Diagnosis ; Dyspnea ; Eosinophils* ; Female ; Humans ; Mesothelioma ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Pleural Cavity ; S100 Proteins ; Thoracic Wall ; Thorax ; Tomography, X-Ray Computed

PURPOSE: The aim of our study was to compare the efficacy and safety of ibuprofen and indomethacin in the prophylaxis of patent ductus arteriosus (PDA) in preterm infants and to determine whether ibuprofen could be an alternative agent in prophylactic use. METHODS: A retrospective study including 37 preterm infants <1,500 g of birth weight, <34 weeks of gestation, whom were administrated indomethacin (n=17; January 2009-December 2009) or ibuprofen (n=20; January 2010-February 2011) within 24 hr after birth was conducted. The rate of ductal closure, need for surgical ligation, clinical outcomes such as necrotizing enterocolitis, intraventricular hemorrhage, bronchopulmonary dysplasia, retinopathy of prematurity (ROP) and death rate were compared. RESULTS: There were no statistically significant differences between the two groups in mean gestational age, mean birth weight, Apgar score, sex, type of delivery, maternal dexamethasone treatment, frequency and duration of ventilator and surfactant treatment. The closure of PDA on day 7 of life was in 19 of 20 infants of the ibuprofen group and 13 of 17 infants of the indomethacin group (P=0.159). Between the two groups, there were no significant differences with respect to clinical outcomes. CONCLUSION: Ibuprofen has similar effects to indomethacin in the rate of PDA closure. Our study demonstrates that prophylactic ibuprofen is relatively effective without significant differences with respect to clinical outcomes compared with indomethacin. Therefore, ibuprofen may be used as an alternative agent in the prophylaxis of PDA in preterm infants.
Apgar Score ; Birth Weight ; Bronchopulmonary Dysplasia ; Dexamethasone ; Ductus Arteriosus, Patent ; Enterocolitis, Necrotizing ; Gestational Age ; Hemorrhage ; Humans ; Ibuprofen ; Indomethacin ; Infant ; Infant, Newborn ; Infant, Premature ; Ligation ; Parturition ; Pregnancy ; Retinopathy of Prematurity ; Retrospective Studies ; Ventilators, Mechanical

A case of infectious mononucleosis was presented. She was admitted to the hospital with the anterior cervical lymphadenopathy. Erythematous skin rashes on both low extermities, and splenomegaly. Her chief complaints were fever and sore throat. She showed atypical lymphocytes in peripheral blood smear with relative lymphocytosis. Mono-spot test was positive. She received symptomatic therapy and discharged without any complications. So, we report this case and review the brief literatures of infectious mononucleosis with the respect to etiology, clinical course, and histological characteristics of the disease.
Exanthema ; Fever ; Infectious Mononucleosis ; Lymphatic Diseases ; Lymphocytes ; Lymphocytosis ; Pharyngitis ; Splenomegaly

Operating Room nurses are required to have special skills and knowledge to do their job. However, because there is no systematic education program, which considers special circumstances in the OR, novice nurses have a great deal of difficulty adapting themselves to the work environment. The purpose of this study is to develope a multimedia education program, which provides the systematic learning environment, so novice nurses can adapt to the OR environment more effectively. This study has been implemented according to Computer Assisted Instruction Design Model(Il-Joo Na and In-Sung Jung, 1990), which goes through the following steps; 1). Education program analysis 2). Development, evaluation 3). CompletionLearning goals, objectives, motive strategy, and analysis of the education program are analyzed by the concepts based on basic education materials for novice surgery nurses of 6 Medical Centers in Seoul and 'Development of the job training program for newly employed nurses in operating rooms. 'written by Ji-Young Yoon(2000). We divided 9 areas of the contents in surgery education; 1. Basic orientation 2. OR nurses' roles and responsibilities 3. Asceptic technique 4. Disinfection and sterilization 5. OR safety 6. OR nursing care 7. Surgical positioning 8. OR Material management 9. Anesthetic care. We selected asceptic technique, which is the most fundamental concept in OR nursing care. The program screens consist of cover screen, screen for guide, mini menu screen, and test screen. We distributed questionnaires to fifteen experts and investigated their opinions to analyze learning contents and effects of the Courseware. The education program was modified based on respones provided by experts. This study offers an educational program, which allows the individuals to choose the areas they want to learn. The program is easy to use, which encourages the individuals to search for additional information more than one area.
Computer-Assisted Instruction ; Disinfection ; Education* ; Learning ; Multimedia* ; Nursing Care ; Operating Rooms* ; Surveys and Questionnaires ; Seoul ; Sterilization

Toxic epidermal necrolysis(TEN) is a severe drug induced life-threatening disease and an acute illness. This disease is characterized by rapid onset of widespread necrosis resulting in sloughing of epidermis. The incidence of TEN is very rare, with approximately 0.5 to 1.4 cases per million per year. but TEN has a high mortality rate of 25-40 percent. Therapy for TEN is primarily aimed at supportive care. Treatment with systemic corticosteroid, immunosuppresive agent such as cyclosporine, cyclophosphamide, pentoxifyllin or plasmapheresis have not been shown to improve outcome. Recently, administration of high dose intravenous immunoglobulin(IVIG) has been shown to result in rapid improvement in patients with TEN. There have been several reports of the benefit of IVIG in adult patients with TEN. However we could not find using IVIG in pediatric patient with TEN in Korea. We have experienced improvement in a 2 years old boy with TEN after using high dose IVIG.
Adult ; Child ; Child, Preschool* ; Cyclophosphamide ; Cyclosporine ; Epidermis ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Incidence ; Korea ; Male* ; Mortality ; Necrosis ; Plasmapheresis ; Stevens-Johnson Syndrome*