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

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

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

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 33-year-old male visited the emergency room with abdominal pain which developed after a vomiting episode. Based on the pneumomediastinum findings from a chest radiograph and a contrast-enhanced chest and abdominal computed tomography scan, the patient was diagnosed with Boerhaave's syndrome. Preoperative radiologic findings showed no pneumothorax or pleural effusion. Once anesthesia was administered, the patient developed near complete cardiopulmonary collapse due to a bilateral tension pneumothorax, which was treated by bilateral thoracentesis, followed by chest tube insertion. Despite a left side rupture, the damaged right lung was unable to overcome single right ventilation, so the surgery was completed via right thoracotomy. The ruptured site was treated, and the patient was transferred to the intensive care unit. We discuss the anesthetic implications of this disease and how to prevent fatal complications.
Abdominal Pain ; Adult ; Anesthesia* ; Anesthesia, General ; Chest Tubes ; Emergency Service, Hospital ; Humans ; Intensive Care Units ; Lung ; Male ; Mediastinal Emphysema ; Pleural Effusion ; Pneumothorax* ; Positive-Pressure Respiration ; Radiography, Thoracic ; Rupture ; Thoracotomy ; Thorax ; Ventilation ; Vomiting

Gold therapy of rheumatoid arthritis is effective, but adverse reactions are also common. There are some cutaneous, hematologic, renal, and pulmonary side effects which have been associated with immunologic abnormalities. Also, hypersensitivity pneumonitis induced by gold therapy was rarely reported in literature. But, the mechanism for the induction of the pulmonary disease is not blown. We report a case of seropositive rheumatoid arthritis presented as gold induced hypersensitivity pneumonitis which was confirmed by the peripheral blood lymphocyte stimulation test with gold.
Alveolitis, Extrinsic Allergic* ; Arthritis, Rheumatoid ; Hypersensitivity* ; Lung Diseases ; Lymphocyte Activation* ; Lymphocytes*

OBJECTIVES: The purpose of this preliminary study is to evaluate the effectiveness of a customized, three-dimensional, preformed titanium mesh as a barrier membrane for peri-implant alveolar bone regeneration. MATERIALS AND METHODS: Ten patients were recruited for this study. At the time of implant placement, all patients had fenestration or a dehiscence defect around the implant fixture. A mixture of particulate intraoral autologous bone and freeze-dried bone allograft was applied to the defect in a 1 : 1 volume ratio and covered by the preformed titanium mesh. A core biopsy specimen was taken from the regenerated bone four months postoperatively. Patients were followed for 12 months after the definitive prosthesis was placed. RESULTS: Satisfactory bone regeneration with limited fibrous tissue was detected beneath the preformed titanium mesh. Histologic findings revealed that newly formed bones were well-incorporated into the allografts and connective tissue. New growth was composed of approximately 80% vital bone, 5% fibrous marrow tissue, and 15% remaining allograft. All implants were functional without any significant complications. CONCLUSION: The use of preformed titanium mesh may support bone regeneration by maintaining space for new bone growth through its macro-pores. This preliminary study presents the efficacy of a preformed titanium mesh as a ready-to-use barrier membrane around peri-implant alveolar bone defect. This preformed mesh is also convenient to apply and to remove.
Allografts ; Alveolar Bone Loss ; Biopsy ; Bone Development ; Bone Marrow ; Bone Regeneration* ; Connective Tissue ; Humans ; Membranes ; Prostheses and Implants ; Surgical Mesh ; Titanium*