• 제목/요약/키워드: A case report

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Multiple Cutaneous Leiomyoma Derived from the Mutation in Fumarate Hydratase Gene: A Case Report (푸마르산 수산화효소 유전자 결함에 따른 다발성 피부 평활근종의 치험례)

  • Kim, Yoong Soo;Tak, Kyoung Seok;Cho, Chung Nam;Chung, Chan Min;Oh, Suk Joon;Lee, Min Jin
    • Archives of Plastic Surgery
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    • v.34 no.5
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    • pp.659-662
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    • 2007
  • Purpose: Multiple skin leiomyoma and uterine myoma bearing autosomal dominant traits are benign smooth muscle tumors which originate in skin or female uterus. Skin leiomyoma occurs after gene mutation originating from arrector pili muscle of hair follicle where its clinical manifestations vary significantly from person to person. Our department hereby reports the histological findings and genetic evaluations of this very rare disease. Methods: A 57-year-old woman presented in our institute with multiple tumors in the left and central parts of her back that started to appear since 19 years ago. The patient was diagnosed as having uterine myoma 15 years ago and underwent hysterectomy. Biopsy has been done on the specimen, and genomic DNA was separated from Fumarate hydratase gene for it to go through PCR amplification. The results of PCR amplification were aligned by sequencer. Results: According to the results of biopsy, tumor cells were spindle-shaped and were aligned in a bundle where there was no dysplasia or mitosis. Moreover, these cells had abundant eosinophilic cytoplasm with elongated nucleus, and benign leiomyoma that showed positive reactions to SMA stain were found. In genetic examination, mutations such as heterozygous single nucleotide substitutions were found in alignments of amplified DNA. Conclusion: Multiple skin leiomyoma and uterine myoma are relatively uncommon diseases that are transmitted through autosomally dominant traits from genetic mutations. When a patient's chief complaint lies upon skin-colored or brown masses that occur in multiples appearing in the trunk or extremities with characteristic clinical symptoms and histological findings, and when the patient's family history is acknowledged such as skin or uterine leiomyoma or renal tumor, necessary genetic examination on multiple skin leiomyoma and uterine myoma could be done, and thereby precise diagnosis could also be made.

Analysis of Loop-Rating Curve in a Gravel and Rock-bed Mountain Stream (자갈 및 암반 하상 산지하천의 고리형 수위-유량 관계 분석)

  • Kim, Dong-Su;Yang, Sung-Kee;Yu, Kwon-Kyu
    • Journal of Korea Water Resources Association
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    • v.45 no.9
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    • pp.853-860
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    • 2012
  • It is well-known that loop effect of the stage-discharge relationship is formulated based on many field observations especially for the sand rivers. Theoretical understandings of the loop effect for the sand rivers have been widely provided, based on the facts that it is driven by the flood wave propagation and bed form changes over the given flood period. However, very few theoretical studies or field observations associated with loop-rating curves in the gravel or rock-bed mountain streams have been attempted so far, due particularly to the difficulties in the accurate discharge measurement during the flood in such field conditions. The present paper aims to report a unique loop-rating curve measured at a gravel and rock-bed mountain stream based on the flood discharge observation acquired during the typhoon, Muifa that passed nearby Jeju Island in summer of 2011. As velocity instrumentation, a non-intrusive Surface Velocity Doppler Radar to be suitable for the flood discharge measurement was utilized, and discharges were consecutively measured for every hour. Interestingly, the authors found that the hysteresis of the loop-rating curve was adverse compared to the typical trend of the sand bed streams, which means that the discharge of the rising limb is smaller than the falling limb at the same stage. We carefully speculate that the adverse trend of the loop-rating curve in the gravel bed was caused by the bed resistance change that works differently from the sand bed case.

Increased Regulatory T cells in Thyroid Adenocarcinoma in a Mixed Breed Dog (갑상샘 암종을 가진 개에서 조절 T 세포의 증가)

  • Kim, Jun-Hwan;Hong, Yeon-Jung;Kim, Bumseok;Kim, Yunhye;Park, Jin-Ho;Chung, Tae-Ho;Park, Chul
    • Journal of Veterinary Clinics
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    • v.30 no.6
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    • pp.482-485
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    • 2013
  • This case report describes the increment of regulatory T cells in thyroid carcinoma of a mixed breed dog compared with normal dogs. A mixed breed dog was referred for a submandibular mass and hyperthermia. Right cervical mass was detected during the physical examination and radiography identified right cervical mass suspected thyroid gland. Accurate location and size of mass was confirmed using computed tomography and 3D reconstructed images. After confirmation of mass, surgical resection was performed and evaluation of regulatory T cells in blood of this patient was performed using flow cytometric assay. The percentage of regulatory T cells was 38.28% of all CD4 (+)/CD25 (+) T cells. This result was higher than median percentage of regulatory T cells of healthy 8 beagles ($7.66{\pm}1.65%$ (p<0.01) of all CD4 (+)/CD25 (+) T cells). And masses were confirmed as giant cell thyroid carcinoma based on histopathologic examination. After surgical resection of cervical mass was performed, the owner didn't want chemotherapy. Seven days later, cervical mass came out again. And CBC showed severe leukocytosis (WBC $47.6{\times}10^3/{\mu}L$) and non-regenerative anemia (PCV 21%). Suspected pulmonic metastasis regions became more severe. Finally the dog died of severe anemia and respiratory disorder.

Double Bypass of Esophagus and Descending Thoracic Aorta for the Treatment of Esophagapleural and Aortopleural Fistula (식도파열 후 발생한 식도 흉막루와 대동맥루의 수술적 치료: 식도 및 대동맥 이중 우회술)

  • Park, Sung-Joon;Kang, Chang-Hyun;Kim, Kyung-Hwan;Yao, Byung-Su;Kim, Young-Tae;Kim, Joo-Hyun
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.753-757
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    • 2010
  • We report hereon a case of double bypass of the esophagus and descending thoracic aorta for the treatment of esophagopleural fistula and aortopleural fistula due to an infected aortic aneurysm after esophageal rupture. A 48 year old man was diagnosed as having esophageal rupture after an accidental explosion. Although he had been treated by esophageal repair and drainage at another hospital, the esophageal leakage could not be controlled and subsequent empyema developed in the left pleura. Further, bleeding from the descending thoracic aorta had developed and he was managed with endovascular stent insertion to the descending thoracic aorta. He was transferred to our hospital for corrective surgery. We performed esophago - gastrostomy via the substernal route, without exploring posterior mediastinum and we let the empyema resolve spontaneously. While he was being managed postoperatively Without any signs and symptoms of infection, sudden bleeding developed from the left pleural cavity. After evaluation for the bleeding focus, we discovered an Infected aortic aneurysm and an aortospleural fistula at the stent insertion site. We performed a second bypass procedure for the infected descending thoracic aorta from the ascending aorta to the descending abdominal aorta via the right pleural cavity. We found leakage at the distalligation site during the immediate postoperative period, and we occluded the leakage using a vascular plug. He discharged without complications and he is currently doing well without any more bleeding or other complications.

Contemporary Approach to Autotransplantation of Teeth with Complete Roots Using 3D-printing Technology (3D 프린팅 기술을 이용한 치근단 완성 치아의 자가이식에 대한 최신 접근)

  • Park, Jungha;Lee, Sangho;Lee, Nanyoung;Jih, Myoungkwan;Cheong, Hyeran
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.4
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    • pp.461-468
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    • 2017
  • Autotransplantation of teeth with complete roots is being increasingly performed for orthodontic treatment or for replacement of unsalvageable teeth, but this procedure has lower survival and success rates than those obtained following transplantation of teeth with incomplete root formation. While previous autotransplantation procedures used only models of the donor tooth and recipient site, surgical guide templates created using 3D-printing technology are now available. They allow shaping of the recipient site in proper direction and to the correct depth, thereby reducing the treatment time and improving the success and survival rates. Herein, we report a case involving autotransplantation of a tooth with complete roots at the site of a congenitally missing permanent tooth using surgical guide templates generated with 3D-printing technology. The procedure resulted in favorable healing of the transplanted tooth.

Kirschner Wire Fixation for the Treatment of Comminuted Zygomatic Fractures

  • Kang, Dai-Hun;Jung, Dong-Woo;Kim, Yong-Ha;Kim, Tae-Gon;Lee, JunHo;Chung, Kyu Jin
    • Archives of Craniofacial Surgery
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    • v.16 no.3
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    • pp.119-124
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    • 2015
  • Background: The Kirschner wire (K-wire) technique allows stable fixation of bone fragments without periosteal dissection, which often lead to bone segment scattering and loss. The authors used the K-wire fixation to simplify the treatment of laborious comminuted zygomatic bone fracture and report outcomes following the operation. Methods: A single-institution retrospective review was performed for all patients with comminuted zygomatic bone fractures between January 2010 and December 2013. In each patient, the zygoma was reduced and fixed with K-wire, which was drilled from the cheek bone and into the contralateral nasal cavity. For severely displaced fractures, the zygomaticofrontal suture was first fixated with a microplate and the K-wire was used to increase the stability of fixation. Each wire was removed approximately 4 weeks after surgery. Surgical outcomes were evaluated for malar eminence, cheek symmetry, K-wire site scar, and complications (based on a 4-point scale from 0 to 3, where 0 point is 'poor' and 3 points is 'excellent'). Results: The review identified 25 patients meeting inclusion criteria (21 men and 4 women). The mean age was 52 years (range, 15-73 years). The mean follow up duration was 6.2 months. The mean operation time was 21 minutes for K-wire alone (n=7) and 52 minutes for K-wire and plate fixation (n=18). Patients who had received K-wire only fixation had severe underlying diseases or accompanying injuries. The mean postoperative evaluation scores were 2.8 for malar contour and 2.7 for K-wire site scars. The mean patient satisfaction was 2.7. There was one case of inflammation due to the K-wire. Conclusion: The use of K-wire technique was associated with high patient satisfaction in our review. K-wire fixation technique is useful in patient who require reduction of zygomatic bone fractures in a short operating time.

Diffuse Nodular Interstitial Infiltrations with Bilateral Hilar Lymphadenopathy (양측 폐문 림프절 종대를 동반한 간질성 결절성 폐침윤)

  • Yoon, Jae Ho;Yeo, Chang Dong;Shin, Eun Joong;Song, So Hyang;Kim, Chi Hong;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.294-298
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    • 2006
  • Lymphocytic interstitial pneumonia(LIP) is an uncommon condition in which the alveolar septa and extra-alveolar interstitial space are markedly expanded by small lymphocytes, plasma cells and histiocytes. Chest radiographs generally show nonspecific patterns with the most common pattern showing bibasilar reticular or reticulonodular infiltrates. Hilar or mediastinal lymphadenopathy and pleural effusions are usually absent. We encountered a 42-year-old female patient who was admitted to hospital because of exertional dyspnea and palpitation. The chest X-ray showed an enlarged bilateral hilar shadow and diffusely increased bronchovascular markings in both lung fields. The chest CT showed diffuse nodular infiltrations with mild septal thickening and combined patchy ground glass opacity in both lungs, and conglomerated mediastinal and bilateral hilar lymphadenopathy. A diagnosis of LIP was made from the tissue pathology taken by a thoracoscopic lung biopsy. The patient showed clinical and radiographic improvement after 3 months of treatment with prednisolone. We report a case of LIP presenting as diffuse nodular interstitial infiltrations with multiple mediastinal and bilateral hilar lymphadenopathy.

CORRECTION OF ECTOPIC ERUPTION WITH BILATERAL ANCHORAGE : REPORT OF CASES (양측성 고정원을 이용한 이소 맹출의 치료에 대한 증례 보고)

  • Ahn, Sung-Ihn;Shun, Ye-Kyung;Shim, Youn-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.2
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    • pp.446-452
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    • 1999
  • Ectopic eruption of the first permanent molar means the first permanent molar assumes an atypical path of eruption resulting in premature atypical resorption of the second primary molar. If the reversible eruption does not occur, early loss of the second primary molars results in space loss, mesial tipping of the first permanent molar, impaction of the second premolar, buccal segment crowding and overeruption of opposing tooth. The main objectives of treatment are (1) to prevent loss of the second deciduous molars so it can continue to serve as a space maintainer and (2) to regain lost arch length, allowing the second premolar to erupt into normal position. The optimal treatment approach depends on a number of factors including the clinical eruption status of /6/, the change in position of /6/, the amount of enamel ledge of /E/ entrapping /6/, the mobility of /E/, and the presence of pain or infection. Unilateral appliance to correct the mesial angulation of ectopic permanent first molars, as in the majority of the appliance designs, would produce a resultant force that would further enhance the space loss. A bilateral support similar to the holding arch design is recommended to maximize the anchorage. These case reports present the successful result of preserving space for the second premolar in treatment of ectopic eruption of the first permanent molar using Halterman appliance with bilateral anchorage on patients visiting department of pediatric dentistry in Samsung Medical Center.

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ERUPTION DISTURBANCE ASSOCIATED WITH A SMALL ODONTOMA (작은 치아종으로 인한 맹출 장애)

  • Song, Ji-Hyun;Lee, Kwang-Hee;Ra, Ji-Young;Lee, Dong-Jin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.3
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    • pp.490-497
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    • 2007
  • Odontoma is defined as a benign odontogenic tumor containing enamel, dentin as well as cementum and constitued 22% of all odontogenic tumors. Although the lesions are commonly asymptomatic, they may be discovered routine radiographic examination. Odontomas often cause disturbances in the eruption of teeth such as, impaction or delayed eruption, retention of primary teeth, or abnomalities in the position of the teeth such as tipping or displacement of adjacent teeth. Radiologically, odontomas manifest as a dense radiopaque lesion surrounded by a thin radiotransparent halo. However, in some cases, radiopacity was not quite clear and images of the teeth shadowed very tiny odontomas. And at early development stages of odontoma, calcification remains immature and is difficult to diagnose on radiographs. This suggests that when delayed eruption of the teeth is found, periapical radiographs should be taken to clarify whether any small area of radiopaque material exists. This case report shows tiny odontomas involving an impacted tooth and crowding and we remove the tiny odontoma surgically.

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Adenocarcinoma of the Lung Progressing to Multiple Cystic Lesions in a 29-Year-Old Man (29세 남자에서 다발성 낭종성 병변으로 진행한 폐선암 1예)

  • Lee, Hyun-Seong;Jeon, Jae-Wan;Kim, Jae-Hee;Ju, Hyeong-Uk;Bae, Joong-Gi;Min, Young-Ju;Ahn, Jong-Joon;Seo, Kwang-Won;JeGal, Yang-Jin;Kwon, Woon-Jung;Cha, Hee-Jeong;Ra, Seung-Won
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.2
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    • pp.203-206
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    • 2012
  • Cystic lesions or progressive cystic changes in adenocarcinoma of the lung have rarely been reported. We report a case of lung adenocarcinoma that progressed from ground-glass opacities (GGOs) and consolidations or nodules to extensive cystic lesions during 12 months in a young adult patient. A 29-year-old male was initially diagnosed with primary lung adenocarcinoma by transbronchial lung biopsy of the right lower lobe and lung to lung metastasis in both lungs according to imaging findings. The initial chest computed tomography (CT) scans showed multifocal GGOs, consolidations, and nodules in both lungs. Despite treatment with palliative chemotherapy, the patient's follow-up CT scans showed multiple, cystic changes in both lungs and that the lesions had progressed more extensively. He died of hypoxic respiratory failure one year after his diagnosis.