• Archives of Plastic Surgery
• /
• v.50 no.1
• /
• pp.101-105
• /
• 2023

Benign cartilaginous tumors, known as chondrogenic tumors, show cartilage components in the microscopic diagnosis. We present two clinical cases with cartilaginous tumors of the toes showing distinctive clinical manifestations. Two juvenile patients visited our outpatient clinic due to tumors with toenail deformities. A 10-year-old girl presented with a palpable mass with a nail deformity on the left third toe. The initial pathology report was soft tissue chondroma until complete resection. Another 15-year-old male patient visited the dermatology department with a toenail deformity and underwent a punch biopsy. The pathology report was fibrosis with myxoid degeneration. Excisional biopsies were performed for both patients. In the operative field, we observed exophytic tumors connected to the distal phalangeal bones. The final pathology reports were subungual osteochondroma on both patients. The specimen exhibited mature bone trabeculae with a focal cartilaginous cap. Benign cartilaginous tumors have a slow, progressive course and do not show significant symptoms. However, tumors in subungual areas are accompanied by toenail deformities and they can cause pain. Their clinical characteristics lead to a delayed diagnosis. Surgeons can be confused between soft tissue and chondrogenic tumors. When they conduct physical examinations, these categories should be considered in the differential diagnosis.

• Clinical Psychopharmacology and Neuroscience
• /
• v.16 no.4
• /
• pp.505-507
• /
• 2018

Clozapine may be associated with cardiovascular adverse effects including QTc prolongation and, more rarely, with myocarditis and pericarditis. Although rare, these latter cardiovascular adverse effects may be life-threatening and must be immediately recognized and treated. Several cases of clozapine related-pericarditis have been described and often it has a subtle and insidious onset with symptoms that may be often misdiagnosed with psychiatric manifestations (e.g. anxiety, panic or somatization) leading to a delayed correct diagnosis with potential fatal consequences. In the present report we describe the case of a 27-year-old girl with schizoaffective disorder taking long acting aripiprazole and valproate who developed a sudden onset clozapine-related pericarditis during titration phase that resolved with immediate clozapine discontinuation and indomethacin administration. We underline the importance of an early diagnosis of clozapine-related pericarditis and the need to have monitoring protocols to prevent this potentially fatal adverse effect especially when polypharmacy is administered to patients taking clozapine.

• Investigative Magnetic Resonance Imaging
• /
• v.1 no.1
• /
• pp.154-161
• /
• 1997

Purpose: Traumatic rupture of the diaphragm is not easy to diagnose and often delayed. Delayed diagnosis of diaphragmatic rupture accompanied by higher chances of strangulation of herniated viscera which may result in higher morbility and mortality. The purpose of this study was to evaluate diagnostic accuracy of spiral CT, MRI and US for the diagnosis of diaphragmatic rupture in an animal model. Materials and Methods: Small, medium, and large sized transabdominal diaphragmatic ruptures were surgically made in experimental rabbits and then followed up with spiral CT, MR!, and US at 1 day, 3 day, and 1 week after operation. Results: US was superior to MR! or spiral CT in diagnosis of diaphragmatic rupture(P(0.05). The sensitivity and specificity were 94.4% and 92.9% for US, 54.0% and 85.7% for MRI, and 46.0% and 78.6% for spiral CT, respectively. The size of laceration was not related to diagnostic sensitivity in US. Sensitivity of MRI and spiral CT increased as the size of laceration were larger, but no statistical significance was present(P>0.05). All experimental animals developed pleural effusion or hemothorax one day after operation. In acute phase, US and MRI were more sensitive than spiral CT in detecting diaphragmatic rupture. Spiral CT was more sensitive than US and MRI in delayed phase but without statistical significance(P>0.05). In the experimental rabbits with accompanying visceral hernia through the diaphragmatic defect, diagnostic accuracy was found equally high among three image modalities(P>0.05). Conclusion: This study indicates that US is the most accurate diagnostic method in detecting injury to the diaphragm in a rabbit model. The findings obtained in this experimental study can be applied to the diaphragmatic rupture of human being.

• Allergy, Asthma & Respiratory Disease
• /
• v.6 no.6
• /
• pp.303-309
• /
• 2018

Purpose: Foreign body aspiration in children is emergent and can cause serious complications. This study aims to show the clinical characteristics of foreign body aspiration and to analyze the clinical cases of delayed diagnosis to predict and prevent complications. Methods: We retrospectively reviewed the medical records of 63 children (48 in Inha University Hospital and 15 in Gachon University Gil Medical Center) who were diagnosed with foreign body aspiration through bronchoscopy from 1996 to 2017 in Incheon City, and analyzed clinical characteristics. Patients were divided into 3 groups: those were diagnosed within 24 hours, delayed after 24 hours, or delayed more than 7 days according to time elapse from the time of foreign body aspiration, and clinical characteristics of each group were compared. Results: Aspiration occurred in 58.7% at 1 year and 15.9% at 2 years. Cough (65.1%) and coarse breathing sound (41.3%) were most common, and radiologic findings were commonly presented as emphysema on the affected side (41.3%). Nuts were most common (42.9%), and there was no difference in the frequency between the right and left main bronchi. The documented history of foreign body aspiration was more frequently found in the early diagnosed group; however, sputum, fever, and complications were more frequent in the delayed diagnosed group. Conclusion: If a patient with respiratory disease has persistent fever or sputum, foreign body aspiration should be suspected.

• Journal of Trauma and Injury
• /
• v.31 no.1
• /
• pp.24-28
• /
• 2018

Ascending aortic injury after blunt chest trauma is an emergency condition that requires urgent diagnosis and treatment. The authors report the case of a patient with traumatic ascending aortic injury who received ascending aorta replacement under cardiopulmonary bypass after failure of primary repair.

• Journal of Trauma and Injury
• /
• v.25 no.3
• /
• pp.94-96
• /
• 2012

Duodenal injuries following a blunt or penetrating trauma are uncommon and account for just 3% to 5% of all abdominal injuries. About 22% of all duodenal injuries are caused by blunt trauma. An overlooked injury or delayed diagnosis of duodenal injury may lead to increased mortality and morbidity. We report two cases of a duodenal injury following blunt abdominal trauma.

• Journal of Chest Surgery
• /
• v.28 no.5
• /
• pp.513-517
• /
• 1995

The injuries to the bronchi have been reported with increasing frequencies. The most common cause of such injuries is compression or crushing chest trauma. Early diagnosis and emergent repair should be done for the good prognosis. We report 3 cases who had bronchial injuries after traffic accident. Our operative procedures were a primary bronchial repair for 17 months old boy, a pneumonectomy for delayed recognition and a bronchoplasty procedure 63 days after trauma. All these bronchial ruptures were successfully treated and discharged.

• Journal of Chest Surgery
• /
• v.23 no.5
• /
• pp.1040-1046
• /
• 1990

Despite the improved diagnostic and treatment modalities recently introduced for a variety of esophageal disorders, a perforation or leak from the esophagus remains a sources of morbidity and mortality regardless of the cause of leak. After the perforation of esophagus, the contamination of mediastinum and pleural cavity with food, bacteria and corrosive gastric juice leads to sepsis and cardiopulmonary dysfunction. The early diagnosis and early treatment are very important, and the delayed treatment leads to high risk of morbidity and mortality. We experienced one case of esophageal perforation, after forced vomiting in 48 years old male patient. We used omentum on the treatment of ruptured esophagus, and it was successfully managed.

• Journal of Chest Surgery
• /
• v.22 no.2
• /
• pp.342-347
• /
• 1989

A 4-year-old male developed the esophageal perforation after air-gun shut injury in the thorax. The esophageal perforation was found on esophagogram at the next day after the accident. Because of delayed diagnosis, mediastinitis and pyopneumothorax were developed. The general conditions of the patient were very critical with sepsis on admission. Therefore, two staged operation was planned. At the first stage, exclusion and diversion of the esophagus was carried out to treat chemical pneumonitis due to gastric contents through the esophago-bronchial fistula by gastroesophageal reflux. Clinical conditions of the patient were improved after the first stage operation. At the second stage, the esophageal reconstruction with right colon was performed.

• Journal of Oral Medicine and Pain
• /
• v.23 no.3
• /
• pp.235-239
• /
• 1998

In Sjogren syndrome, abruptly decreased salivation and delayed lag time reveal that many acini cells are destructed and Lymphocytes infiltration is supposed as the main cause that makes dysfunction of salivation. In this case report, the biopsy of minor salivary glands is very useful diagnostic method of Sjogren's syndrome with sialometry,sialography, salivary gland scan.