Background: Keloids can occur anywhere in the human body. They are difficult to remove and can cause distress in patients. Although many options are available to treat keloids, no single method is considered the optimal treatment of choice. The authors encountered cases where an umbilical keloid developed at the trocar site after laparoscopic surgery and managed the keloid using a transposition flap. Methods: A total of 10 umbilical keloid patients treated from 2013 to 2020 were included in this study. All patients developed a keloid due to the placement of a laparoscopic trocar incision port, and their major complaints varied from an asymptomatic nodule to pruritus or pain. All excisions were performed under local anesthesia, and transposition flaps were planned afterward. The surrounding tissue was rearranged so that the shape of the umbilicus was deformed to the minimum extent possible. The keloid scars were examined both preoperatively and 6 months postoperatively using the Patient and Observer Scar Assessment Scale (POSAS). Results: All surgical wounds healed well without complications. The average time interval from laparoscopic surgery to keloid scar revision was 4.3 years. The mean postoperative follow-up period was 10.9 months, and no patient underwent reoperation. Four patients were treated with triamcinolone after surgery due to mild hypertrophy or pruritus. The POSAS observer scale showed significantly decreasing scores over time in all patients (P=0.002). Conclusions Cosmetically unfavorable keloids that form in the umbilicus following laparoscopic surgery can be improved with a simple procedure using excision and transposition flaps.

Gastrointestinal tract involvement in undifferentiated pleomorphic sarcoma (UPS) is extremely rare. To the authors' knowledge, only 21 cases of primary small bowel UPS have been reported in the literature available in English. Reported CT findings in primary small bowel UPS have been nonspecific, and MRI findings have been reported in only one case. The present article describes a case involving a 72-year-old male with histologically confirmed primary UPS arising from the ileum, focusing on both CT and magnetic resonance enterography findings. On CT, primary small bowel UPS was noted as a heterogeneously enhanced small bowel mass without obstruction. Magnetic resonance enterography revealed heterogeneous intermediate T1 and T2 signal intensity, with hemorrhagic or necrotic foci within the mass and heterogeneous enhancement. The differential diagnosis included malignant gastrointestinal tumor; however, the prognosis of UPS is worse, with higher incidences of extra-abdominal metastasis.

Various types of tumor can occur in the subungual space, including glomus tumors, subungual exostosis, hemangioma, epidermal cysts, and malignant tumors. While fibromatosis can occur at various sites throughout the body, it is very rarely seen in the toe. Here, we are the first to report a case of superficial fibromatosis mimicking a glomus tumor in the subungual space of the second toe. The presentation of this condition shows the possibility of encountering uncommon superficial fibromatosis in the distal phalanx of the toe, and suggests that superficial fibromatosis should be included in the differential diagnosis of a glomus tumor in the toe.
Adult ; *Fibroma ; *Glomus Tumor ; Humans ; Male ; *Osteochondroma ; *Toes/pathology/surgery

PURPOSE: The glutathione-S-transferase (GST)P1, GSTM1, and GSTT1 genotypes have been associated with an increased risk of prostate, bladder, and lung cancers. The aim of this study was to investigate the association between the GSTP1, GSTM1, and GSTT1 genotypes and the risk of prostate cancer in Korean men. MATERIALS AND METHODS: The study group consisted of 166 patients with histologically confirmed prostate cancer. The control group consisted of 327 healthy, cancer-free individuals. The diagnosis of prostate cancer was made by transrectal ultrasound-guided biopsy. Patients with prostatic adenocarcinoma were divided into organ-confined (< or =pT2) and non-organ-confined (> or =pT3) subgroups. The histological grades were subdivided according to the Gleason score. The GSTP1, GSTM1, and GSTT1 genotypes were determined by using polymerase chain reaction-based methods. The relationship among GSTP1, GSTM1, and GSTT1 polymorphisms and prostate cancer in a case-control study was investigated. RESULTS: The frequency of the GSTM1 null genotype in the prostate cancer group (54.2%) was higher than in the control group (odds ratio=1.53, 95% confidence interval=1.20-1.96). The comparison of the GSTP1, GSTM1, and GSTT1 genotypes and cancer prognostic factors, such as staging and grading, showed no statistical significance. CONCLUSIONS: An increased risk for prostate cancer may be associated with the GSTM1 null genotype in Korean men, but no association was found with the GSTT1 or GSTP1 genotypes.
Adenocarcinoma ; Biopsy ; Case-Control Studies ; Genotype ; Glutathione Transferase ; Humans ; Lung Neoplasms ; Male ; Neoplasm Grading ; Prostate ; Prostatic Neoplasms ; Urinary Bladder

PURPOSE: Polychlorinated biphenyls (PCBs, Aroclor 1254), synthetic chlorinated organic compounds, are known to decrease thyroid function, sperm count, and fertility, and increase the risk of testicular cancer; they may have serious effects on male reproduction. The aim of this study was to investigate the possible protective role of palmiwon on PCB-induced spermiotoxicity in rats. MATERIALS AND METHODS: 90-day-old male Sprague Dawley rats were randomly divided into three groups, each consisting of ten animals. The control group (Group I) received corn oil, the second group of rats (Group II) was administered 2 mg/kg body weight/day of Aroclor 1254+corn oil intraperitoneally for 30 days. The third group of rats (Group III) was treated with 2 mg/kg body weight/day of Aroclor 1254+corn oil intraperitoneally plus palmiwon (300 mg/day) orally for 30 days. Twenty-four hours after the last treatment, the animals were killed by decapitation. Their serum testosterone levels was measured before and after the experimental medication was taken, and the number and motility of sperm, which had been collected from the cauda epididymal region, were evaluated. RESULTS: The results of this experiment show that treatment with palmiwon significantly improved sperm motility and number in rats that had been exposed to PCBs. There was no marked difference in body weight, testis weight, or epididymis weight among the groups. Nor were there any significant pathological differences in the testes among the groups. CONCLUSIONS: Palmiwon has the potential for treating PCB-induced spermiotoxicity. More experiments with larger samples and a longer period of treatment are needed.
Animals ; Aroclors ; Biphenyl Compounds ; Body Weight ; Corn Oil ; Decapitation ; Epididymis ; Fertility ; Humans ; Male ; Polychlorinated Biphenyls ; Rats ; Rats, Sprague-Dawley ; Reproduction ; Sperm Count ; Sperm Motility ; Spermatozoa ; Testis ; Testosterone ; Thyroid Gland

PURPOSE: Piezolith 3000(R) is one of the 3rd generation lithotriptors that uses double layered piezoelectric shock waves for the treatment of urinary stone. We evaluated the safety and effectiveness of the Piezolith 3000(R) lithotriptor and we compared it with the previous Piezolith 2300(R) lithotriptor. MATERIALS AND METHODS: We reviewed the records of 500 patients with urinary calculi who had been treated with extracorporeal shock wave lithotripsy (ESWL) from January 2002 to December 2003, but complete follow up data was available for only 385 cases. The distribution of stones, the success rate and the number of ESWL sessions according to the size and location of the stones, the auxiliary procedures and their complications were analyzed. RESULTS: There were 172 cases with renal stone and 213 cases with ureteral calculi. The success rate, defined as being stone-free or having asymptomatic residual fragments measuring 3mm or less, was 82.0% for the renal stones and 93.0% for the ureteral calculi. The overall success rate for all the calculi was 88.1%. The mean number of sessions was 3.6 for the renal stones and 2.3 for the ureteral calculi. The overall mean number of sessions was 2.8. All the treatments were performed without analgesia or sedation except for one child (5 years old) who was given oral sedation. Any serious complications or side effects such as renal hematoma were not observed. CONCLUSIONS: The Piezolith 3000(R) lithotriptor allows shorter treatment sessions and it has more comfortable positioning tools to focus on the stone. It also has the advantage of being anesthesia free and a lower morbidity rate (e.g. pain). Yet we couldn't find any difference of the success rate between the previous standard piezo-system and the Piezolith 3000 .
Analgesia ; Anesthesia ; Calculi* ; Child ; Follow-Up Studies ; Hematoma ; Humans ; Lithotripsy ; Shock* ; Ureteral Calculi ; Urinary Calculi ; Urinary Tract*

Fibrous hamartoma of infancy is an uncommon benign soft tissue tumor, characterized by three different tissue components histologically; 1)intersecting trabeculae of fibrous tissue, 2)immature cells with mucoid matrix, and 3)mature fat. The majority of fibrous hamartoma of infancy occur within the first year of life as a painless nodule and a few cases have overlying skin changes, including alteration in pigmentaion, eccrine gland hyperplasia and increased hair. We report a case of fibrous hamartoma of infancy on the buttock with overlying hypertrichosis in an 8-month-old male patient.
Buttocks ; Eccrine Glands ; Hair ; Hamartoma* ; Humans ; Hyperplasia ; Hypertrichosis* ; Infant ; Male ; Skin

OBJECTIVE: Thoracoscopic T2 sympathicotomy had been performed as a simple and effective method in treating palmar hyperhidrosis, but some patients are not satisfied with the result of sympathicotomy due to compensatory hyperhidrosis. Therefore, a more limited T2 sympathicotomy using 2mm endoscope was introduced. We made a comparison between conventional T2 sympathicotomy and limited T2 sympathicotomy on operative results and compensatory hyperhidrosis. MATERIAL AND METHOD: From January 1998 to April 2000, 56 patients were treated by video assisted endoscopic thoracic sympathicotomy. Thirty patients of these underwent T2 sympathicotomy(Group A), and the remainders underwent limited T2 sympathicotomy(Group B). The limited T2 sympathicotomy is coagulation of the interganglionic fibers of T2 sympathetic ganglion on T2 rib head. The comparative analysis between two groups was based on the medical records and telephone interview results. RESULT: All patients were treated for excessive sweating on palms with 2mm endoscopic sympathicotmy. There were no mortalities, life-threatening complications except one recurrent patient who was treated successfully with re-operation(endoscopic sympathicotomy). Compensatory hyperhidrosis was common in group A. An individual satisfactory rate for the operations was higher in group B than in group A. CONCLUSION: The limited T2 sympathicotomy considered to be a more effective and less complicated method than the T2 sympathicotomy for the treatment of palmar hyperhidrosis.
Endoscopes* ; Ganglia, Sympathetic ; Head ; Humans ; Hyperhidrosis* ; Interviews as Topic ; Medical Records ; Mortality ; Ribs ; Sweat ; Sweating

The mortality of patients with brain abscess has decreased significaltly. This has been attributed to improved diagnostic imaging, the evolution of neurosurgical techniques and understanding of intracranial pressure pathophysiology, greater critical care understanding, and newer antibiotics. However, the mortality associated with intraventricular rupture of brain abscess remained consistently high at or above 80% once identified. A case of intraventicular rupture of thalamic abscess with good quality of survival is presented based on aggressive 4-component therapeutic plan used. The four components are 1) extraventricular drainage for 6 weeks, 2) lavage of the ventricular system using closed irrigation system, 3) intravenous antibiotics, 4) intraventricular gentamicin and vancomycin, twice and once daily, respectively.
Abscess* ; Anti-Bacterial Agents ; Brain Abscess ; Critical Care ; Diagnostic Imaging ; Drainage ; Gentamicins ; Humans ; Intracranial Pressure ; Mortality ; Rupture* ; Thalamus ; Therapeutic Irrigation ; Vancomycin

Although it is known that hypothyroidism can cause cardiac dysfunction, it is very hard to find a case report on sudden death due to hypothyroidism. There are only two reported cases on medline; one is about a 15-year-old girl who died suddenly of Hashimoto's thyroiditis and the other is about a 31-year-old man who also died suddenly of hypothyroidism associated with chronic lymphocytic thyroiditis. Recently we found a young woman who unexpectedly died while she was sleeping. She was diagnosed as hypothyroidism when she went to hospital about a month before she died. At autopsy there were roughly four abnormal findings; Hashimoto's thyroiditis, mild chronic active hepatitis, diverticulosis and accessory spleen. Trace of chlorpheniramine was detected in gastric remains and blood alcohol level was 0.37 percent. To our knowledge, this is the first case reporting sudden and unexpected natural death associated with hypothyroidism in Korea.
Adolescent ; Adult ; Autopsy ; Chlorpheniramine ; Death, Sudden* ; Diverticulum ; Female ; Hashimoto Disease ; Hepatitis, Chronic ; Humans ; Hypothyroidism* ; Korea ; Spleen ; Thyroid Gland ; Thyroiditis