• Tuberculosis and Respiratory Diseases
• /
• v.81 no.4
• /
• pp.330-338
• /
• 2018

Background: We developed an additional laser guidance system to improve the efficacy and safety of conventional computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB), and we conducted this study to evaluate the efficacy and safety of our system. Methods: We retrospectively analyzed the medical records of 244 patients who underwent CT-guided PTNB using our additional laser guidance system from July 1, 2015, to January 20, 2016. Results: There were nine false-negative results among the 238 total cases. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of our system for diagnosing malignancy were 94.4% (152/161), 100% (77/77), 100% (152/152), 89.5% (77/86), and 96.2% (229/238), respectively. The results of univariate analysis showed that the risk factors for a false-negative result were male sex (p=0.029), a final diagnosis of malignancy (p=0.033), a lesion in the lower lobe (p=0.035), shorter distance from the skin to the target lesion (p=0.003), and shorter distance from the pleura to the target lesion (p=0.006). The overall complication rate was 30.5% (74/243). Pneumothorax, hemoptysis, and hemothorax occurred in 21.8% (53/243), 9.1% (22/243), and 1.6% (4/243) of cases, respectively. Conclusion: The additional laser guidance system might be a highly economical and efficient method to improve the diagnostic efficacy and safety of conventional CT-guided PTNB even if performed by inexperienced pulmonologists.

• Childhood Kidney Diseases
• /
• v.12 no.1
• /
• pp.99-104
• /
• 2008

Microscopic polyangiitis(MPA) is a systemic necrotizing vasculitis that involves many organ systems including the skin, joint, kidneys, and lungs. In spite of early diagnosis and intensive care, the five-year actuarial patient and kidney survival rates are 65% and 55%. We experienced a case in 7-year-old girl of microscopic polyangiitis presenting with rapidly progressive glomerulonephritis which was confirmed by renal biopsy and positive serum perinuclear antineutrophil cytoplasmic autoantibodies(p-ANCA). The diagnosis of patients first renal biopsy was MPA, p-ANCA-associated crescentic glomerulonephritis. The patients second renal biopsy was done 5 years 6 months later since first renal biopsy, and pathologic diagnosis was chronic sclerosing glomerulonephritis, advanced, due to MPA. We began methylprednisolone pulse therapy, combined with a low dose of cyclophosphamide and plasmapheresis therapy. ACE inhibitor, angiotensin II receptor blocker, and cyclophosphamide were used until now and the patients current age is 14 years old. On admission, the patients laboratory findings showed BUN 117 mg/dL and Cr 2.3 mg/dL, while on the hospital day BUN and Cr values fell to 20.8 mg/dL and 1.6 mg/dL. But renal function was progressed to chronic failure with latest laboratory data BUN 51.7 mg/dL and Cr 3.2 mg/dL. ACE inhibitor, angiotensin II receptor blocker and small dose of immunosuppressant with close observation is the key to maintain the patient survival.

• Clinics in Shoulder and Elbow
• /
• v.1 no.1
• /
• pp.139-145
• /
• 1998

This report describes a rare, congenital hypertrophy of the left upper extremity that appeared after compressive bandage of right arm at the age of two. He is eighteen years old, and hypertrophy was aggravated for about 2 years since he started weight training exercise. Recently, skin turgor changed and he visited the Dermatology department. Skin biopsy revealed increased thickness of the dermis. On Orthopaedic examination, the left arm showed non­specific neuro-muscular changes other than easy fatigability a.nd increased skin consistency after exercise, compared to the right arm. The differences of circumference were 2.5 to 4cm according to the level of the upper limb. But the relative proportion of hypertrophy of the limb was balanced., On X-ray examination, bony changes were not shown. Through the MRI, we could find edematous changes of subcutaneous fatty tissue. Muscular structures showed unremarkable changes. Through the endurance test of both arms, we could find a decrease in endurance of the left upper arm musculatures. On histologic examination, infrequent focal necrosis and peri fascicular degeneration of the muscle fiber were present.

• Childhood Kidney Diseases
• /
• v.16 no.1
• /
• pp.51-53
• /
• 2012

Henoch-Sch$\ddot{o}$nlein purpura (HSP) is the most common vasculitis in children and is characterized by cutaneous purpura, arthritis, abdominal pain, and nephritis. Bullous skin lesions are rare in children. We report a case involving a 9-year-old female with HSP who displayed rapidly evolving hemorrhagic bullae from the primary purpuric lesions during systemic corticosteroid therapy. The bullae disappeared within 7 days of systemic corticosteroid therapy. Some scar lesions of the skin developed on acute phase recovered completely after 6 months. Bullae should not be considered as a poor prognostic factor of HSP and its renal outcome. Skin biopsy in HSP children with bullae is not necessary if clinical diagnostic criteria of HSP are met. However, further evaluation of more pediatric HSP with bullae is needed to get the clearer conclusions. We report a 9-year-old female with HSP who showed the rapidly evolving hemorrhagic bullae from primary purpuric lesions during systemic corticosteroid therapy.

• Archives of Plastic Surgery
• /
• v.37 no.5
• /
• pp.699-701
• /
• 2010

Purpose: Mondor's disease is a rare benign condition which involves thrombophlebitis of the superficial veins of the breast and anterior chest wall after breast surgery, breast tissue biopsy, inflammatory reaction, breast cancer, trauma. The affected veins include the lateral thoracic, axillary veins, thoracoepigastric veins and superior epigastric veins. Methods: A 49-year-old woman presented to the outpatient department with complaints of the sudden appearance of a subcutaneous cord just under the skin at left lower lateral abdominal wall 1 month later of bilateral mastectomy due to both severe breast paraffinoma. The cord was initially red and tender and subsequently became a painless, tough, fibrous band that was accompanied by tension and skin retraction. Results: On ultrasonographic findings, palpable threadlike structures at both lateral superficial abdominal wall after bilateral mastectomy were noted. Superficial short elongated hypoechoic tubular structures were noted just under the skin at palpable lower lateral abdominal wall. It was compatible to Mondor's disease of thoracoepigastric vein. Conclusion: The increase in breast surgery will give rise to the increase in the frequency of Mondor's disease clinically. Mondor's disease can be diagnosed with clinical symptoms and image findings and the disease has proved to be benign and self-limited.

• Biomedical Science Letters
• /
• v.10 no.4
• /
• pp.361-366
• /
• 2004

The purpose of this study was to determine the effect of high voltage pulsed current (HVPC) stimulation on proliferative activities of basal keratinocytes by measured nucleolar organizer region (NOR) expression and thickness of spinous layer in aged rat skin. Fifty-one weeks old twelve male Sprague-Dawley rats (300∼350g) were divided into control and HVPC stimulation groups. Each animal's hair on the back were removed. The HVPC stimulation group received an negative monophasic twin peak pulsed current stimulation with 50 V, while the control group was given the same treatment without electricity. The rats were sacrificed after 3 weeks. The biopsy specimens were fixed in formalin, embedded in paraffin and stained with hematoxyline-eosin and silver nitrate. The thickness of basal to granular layer of the epidennis were measured using a light microscope and computerized image analysis system. The number of argyrophilic nucleolar organizer region (AgNOR) were counted using a light microscope and computerized image analysis system and calculated as the mean number of AgNOR per nucleus in the basal keratinocyte. By using a Student's t-test, an increase in the thickness of basal-spinous layer (P<0.001) of epidermis can be observed in HVPC stimulation rats as compared with the control rats, whereas the thickness of the granular layer is not affected. A Student's t-test showed a significantly higher mean NOR number per nucleus of the basal keratinocyte in the HVPC stimulation rats than control rats (P<0.001). There was significantly positive correlation between the NOR number and the thickness of basal-spinous layer (r=0.80, P<0.05). These results suggest that the HVPC stimulation may increase the thickness of spinous layer in the epidennis due to increased proliferative activities of basal keratinocytes in epidennis in aged rat skin.

• Journal of the Society of Cosmetic Scientists of Korea
• /
• v.40 no.3
• /
• pp.259-268
• /
• 2014

Non-invasive technologies in skin research have enabled to use a live image of living skin without a biopsy or histologic processing of tissue. Confocal scanning laser microscope (CSLM) operated at a near-infrared wavelength of 830 nm allows visualization of inner structure of skin as a non-invasive manner. According to previous researches using CSLM, melanin cap and papillary ring were clearly observed in pigmented areas between stratum basale and papillary dermis. In this study, conversional analysis of CSLM digital images into numerical estimation using scanning probe image processor (SPIP) software was attempted for the first time. It is concluded that a quantification of CSLM images can pave way to expand the field of applications of CSLM.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.27 no.6
• /
• pp.570-574
• /
• 2005

Keratoacanthoma is a benign, self-limited epithelial lesion that closely resembles Squamous cell carcinoma(SCC). Keratoacanthoma occur primarily exposed skin in male patients over 45 years of ages. although etiology is unknown, sunlight, genetic, and human papillomavirus factor have been considered. in clinical feature, rapid enlargement occurs over 4$\sim$8 weeks, resulting ultimately in a hemispheric, firm, elevated, asymptomatic nodule that contains a central plug of keratin. When fully developed, the keratoacanthoma contains a core of keratin surrounded by a concentric collar of raised skin. Over the next 4$\sim$8 weeks, static lesion persists. Then undergoes spontaneous regression over the next 6$\sim$8weeks period by expulsion of the keratin core with resorption of the mass. In histologic feature, Keratoacanthoma consists of hyperplastic squamous epithelium growing into the underlying connective tissue. The surface is covered by a thickened layer of parakeratin with central plugging. Epithelium cell shows dysplastic features and the margins the normal adjacent epithelium is elevated. The differential diagnosis includes SCC. Keratoacanthoma present as a exophytic lesion with horny keratin occupying a depression on the top of the lesion, persists static period and undergoes rapid growth compared with SCC. Keratoacanthoma is usually treated by surgical excision or curettage of the base, spontaneous regression does not occur in every case. A 60 years old male who present facial lesion visit our hospital and surgical excision was done. Biopsy result was keratoacanthoma. We report case with review of literatures.

• Journal of Embryo Transfer
• /
• v.31 no.1
• /
• pp.89-95
• /
• 2016

The present study was conduct to examine the $H_2O_2$ expression level and apoptosis-related gene expression levels inporcineskin-derived stem cell-like cells (pSSCs) after adipogenic, chondrogenic, and osteogenic differentiation induction. The pSSCs were obtained by digestion of porcine ear skin biopsy and cultured in each induction medium for 21 to 26 days to induce adipogenic, chondrogenic, and osteogenic differentiation, respectively. The $H_2O_2$ levels of pSSCs after induction culture were evaluated by staining with 2'7'-dichlorodihydrofluorescein diacetate ($H_2DCFDA$). The apoptotic gene expression of pSSCs after induction culture was also estimated by RT-PCR. The pSSCs have a potential to differentiate into three mesodermal cell types (adipocytes, chondrocytes, and osteoblasts). Non-induced control and chondrogenic-induced cells were showed higher $H_2DCFDA$ intensity (P<0.05) than adipogenic- and osteogenic-induced cells. The relative expression of Bax/Bcl-2 level was significantly low (P<0.05) in adipogenic- and osteogenic-induced cells compared to non-induced control. However, there was no difference in the relative expression of Bax/Bcl-2 level among differentiation induction groups. The result of the present study shows that the apoptosis of pSSCs is not detrimentally increased by differentiation induction culture, although chondrogenic-induced pSSCs showed high ROS generation level and apoptotic index similarly to those of non-induced cells.

• Archives of Reconstructive Microsurgery
• /
• v.19 no.2
• /
• pp.81-87
• /
• 2010

In surgical treatment of the malignant melanoma, radical resection and a sentinel lymph node biopsy are essential procedures to eradicate the tumor and to minimize the risk of local recurrence. For the reconstruction of skin defect after tumor resection, a skin graft has been generally performed procedure. However, if tendon or bone is exposed after tumor resection, simple skin graft is not enough for the coverage of the defect and additional procedure is mandatory. In this study, we reviewed the clinical results of 16 patients, who had been diagnosed with malignant melanoma of the limb and underwent surgical resection and reconstruction of the defect with various methods. The sentinel lymph node dissection was performed in all patients combined with radical excision of the tumor. In 11 cases of positive sentinel lymph nodes, further elective lymph node dissections were performed. The mean tumor invasion depth was 4.54 mm (2~10 mm), and AJCC stage II was most common (9 cases). The pedicled flaps were performed in 10 cases for the reconstruction of defects. All flaps were successfully survived without significant complications until the last follow up. In conclusion, a pedicled flap coverage is very useful reconstruction strategy for the soft tissue defects after radical resection of malignant melanoma.