Keratosis punctata of the palmar creases (KPPC) is rare skin condition characterized by punctiform hyperkeratotic pits confined to the palmar and digital creases. Although this condition has been regarded as a variant of classical punctate keratoses, there are some differences between classical punctate keratosis and KPPC. We herein report a case of KPPC in a 22-year-old man who had numerous, tiny, hyperkeratotic pits limited to the palmar creases of both hands with typical histologic findings.
Hand ; Humans ; Keratosis* ; Skin ; Young Adult

Lentigo maligna melanoma(LMM) is the least common type of melanoma. LMM is almost exclusively located on sun-exposed skin of the head and neck. We describe a case of lentigo maligna melanoma evolved from lentigo maligna in 82-year-old man. Five years ago, the patient developed a brownish pigmented lesion on the left cheek. The lesion progressed slowly, and several months ago, a black pigmented patch was developed in the periphery of the brownish pigmented patch. Histopathologic examination of the lesions revealed findings consistent with lentigo maligna and lentigo maligna melanoma.
Aged, 80 and over ; Cheek ; Head ; Humans ; Hutchinson's Melanotic Freckle* ; Lentigo* ; Melanoma* ; Neck ; Skin

No abstract available.
Anti-Bacterial Agents* ; Dysentery, Bacillary*

Bacterial vaginosis (BV) and complicated vulvovaginal candidiasis (VVC) are frequently occurring vaginal infections in postmenopausal women, caused by an imbalance in vaginal microflora. Postmenopausal women suffer from decreased ovarian hormones estrogen and progesterone. A normal, healthy vaginal microflora mainly comprises Lactobacillus species (spp.), which act beneficially as a bacterial barrier in the vagina, interfering with uropathogens. During premenopausal period, estrogen promotes vaginal colonization by lactobacilli that metabolizing glycogen and producing lactic acid, and maintains intravaginal health by lowering the intravaginal pH level. A lower vaginal pH inhibits uropathogen growth, preventing vaginal infections. Decreased estrogen secretion in postmenopausal women depletes lactobacilli and increases intravaginal pH, resulting in increased vaginal colonization by harmful microorganisms (e.g., Enterobacter, Escherichia coli, Candida, and Gardnerella). Probiotics positively effects on vaginal microflora composition by promoting the proliferation of beneficial microorganisms, alters the intravaginal microbiota composition, prevents vaginal infections in postmenopausal. Probiotics also reduce the symptoms of vaginal infections (e.g., vaginal discharge, odor, etc.), and are thus helpful for the treatment and prevention of BV and VVC. In this review article, we provide information on the intravaginal mechanism of postmenopausal vaginal infections, and describes the effectiveness of probiotics in the treatment and prevention of BV and VVC.
Candida ; Candidiasis, Vulvovaginal ; Colon ; Enterobacter ; Escherichia coli ; Estrogens ; Female ; Glycogen ; Humans ; Hydrogen-Ion Concentration ; Lactic Acid ; Lactobacillus ; Microbiota ; Odors ; Postmenopause ; Premenopause ; Probiotics* ; Progesterone ; Vagina ; Vaginal Discharge ; Vaginal Diseases ; Vaginosis, Bacterial

We report a case of cutaneous metastasis of thymic carcinoma in Korean. A 44-year-old female, who had been diagnosed as thymic carcinoma and treated with total thymectomy and post-operative radiation therapy, presented grouped erythematous papules on the left chest. CT scans revealed metastatic lesions in the left pleura and abdominal cavity. Histopathologic examination of skin biopsy showed extensive infiltration of malignant cells in dermis and subcutis. The morphology of infiltrating cells was similar to that of tumor cells from primary thymic carcinoma specimen. The results of immunohistochemical study for skin biopsy were consistent with the features of non-neuroendocrine thymic carcinoma. Histopathologic and immunohistopathologic similarity between cutaneous lesion and previous tumor suggested that malignant cells in the skin lesion could originate from progressing thymic carcinoma.
Abdominal Cavity ; Adult ; Biopsy ; Dermis ; Female ; Humans ; Neoplasm Metastasis ; Pleura ; Skin ; Thorax ; Thymectomy ; Thymoma* ; Tomography, X-Ray Computed

Pigmented fungiform papillae of the tongue(PFPT) is a rare benign pigmentary disorder of the tongue. In dark-skinned individuals, PFPT appears to be relatively common, whereas this entity is seldom reported in fair-skinned people and Asians. Although the relevance to systemic conditions has been suggested in several reported cases, the etiology and pathogenesis of this entity are not yet clearly defined. We report two cases of PFPT in young Korean females. Clinically both patients presented with asymptomatic pigmentary lesions confined to fungiform papillae of the tongue, which had been detected several months ago. Histopathologic findings revealed increased melanophages in the subepidermal area within the fungiform papillae.
Asian Continental Ancestry Group ; Female ; Humans ; Tongue*

Objective To investigate the differences in the safety of the operation of different hepatic vascular exclusion for liver surgery. Methods Sixty patients with liver resection were grouped by different hepatic blood flow blocking methods, and given pre-operative assessment prior to surgery. Results On the first day after surgery, the average levels of ALT and AST were (395.0 ± 220.2) U/L and (415.3±311.0) U/L in patients who received Pringle’s method (110.2±53.0) U/L and (125.6±78.5) U/L in patients who received regional hepatic vascular exclusion, (98.9±32.2) U/L and (96.2 ±66.5) U/L in patients who didn't receive hepatic vascular exclusion, respectively. Postoperative liver function damage was more serious in patients who received Pringle's method than patients who received regional hepatic vascular exclusion or patients who didn't receive hepatic vascular exclusion, the difference was statistically significant (P<0.05) .Conclusion Regional hepatic vascular exclusion or not can not only reduce the incidence of postoperative complications, but also expand the indications for liver resection.

Objective To evaluate the clinical outcome of transesophageal echocardiography(TEE) in guiding and monitoring min-invasive transthoracic hybrid procedure for intracristal ventricular septal defects (VSD) using eccentric occluders.Methods 13 patients with intacristal VSD successfully underwent the min-invasive hybrid procedure using eccentric occluders were analyzed retrospectively.They were all carefully examined by transthoracic echocardiography (TTE) preoperatively and were diagnosed as intracristal VSD.There were no obvious aortic valve prolapse and no severe regurgitation.The entire process was guided and monitored by TEE.The condition of VSD occlusion was assessed by immediate postoperative TEE.Results All cases were occluded successfully.The results of postoperative TEE showed that the occluder was coincided closely with the edge of VSD,no aortic valve regurgitation worsen.2 had tiny residual left-to-right shunt (＜1.5 mm),which disappeared 1 and 3 months respectively after operation.No occluder dislocated followed-up at 6 months to 2 years postoperatively,and no major complications occurred.Conclusions The min-invasive hybrid procedure for intracristal VSD using eccentric occluders guided and monitored by TEE is easy to manipulate,which is safe,less invasive,and has excellent early-term results.

Fractures of the tibial pilon are the severe injuries to the ankle joint resulted from axial compression, shear and/or rotational forces. The mangement has been notoriously difficult due to the comminution of the distal tibia, articular incongruity and soft tissue trauma. The advocated treatment sequence of fibular reconstruction, restoration of the articular suface, bone grafting of defects and the use of an anterior or medial neutralization plate, early movement and delayed weight bearing, were performed recently and the best results have been obtained. The results of treatment of 18 cases were analysed at the Department of Orthopedic Surgery, Chonbuk National University Hospital and Chong ju Lee Rha Hospital from Mar. 1982 to Aug. 1989. The results were as follows. 1. The most frequent type of fracture was type III according to Ruedi and Allgower's classification. 2. The operative treatment was performed with plates and screws in fourteen cases. 3. The overall good and fair results were 72%.
Ankle Joint ; Bone Transplantation ; Classification ; Clinical Study ; Jeollabuk-do ; Orthopedics ; Tibia ; Weight-Bearing

Posterior lumbar apophyseal fracture characterized by osteochondral fragments from posterior rim of a lumbar vertebral body, has often been misdiagnosed as herniated disc or spinal stenosis due to its similarity of symptoms. But recent use of CT scan facilitated the diagnosis of the lesion as a separate entity. This study was performed to verify the clinical characteristics, to find out the mechanism of injury and to determine the most effective method of diagnosis and treatment. Authors reviewed 17 patients(14 male, 3 female) who were subjected to surgical treatment at Department of Orthopaedic Surgery, Seoul National University Hospital for posterior lumbar spophyseal fracture during the period of 1990-1992, and followed up for average of 1 year and 6 months(range 1 to 3 years). Thirteen patients (76%) were related to a history of trauma or strenuous physical activity prior to the onset of symptoms. The mechanism of injury was the rapid flexion with axial compression in 7, hyperextension in 4, and pure axial compression in 2 patients. The mean age at the time of injury was 20 years(range 10 to 31 years). All patients presented low-back pain radiating to lower extremities and 11 patients showed neurogenic intermittent claudication. The mean age at the time of surgical intervention was 23 years and 10 months(range 15 to 31 years), and the mean duration of symptoms was 3 years(range 2 months to 13 years). Simple X-ray revealed the lesion in only 3 cases but CT scan demonstrated the characteristic osteochondral fragment displaced posteriorly into the spinal canal and the corresponding defect with degenerative changes in all patients. The fracture occured through the superior apophyseal rim of L5 in 9 superior rim of L4 in 3, inferior rim of L4 in 2, inferior rim of L5 in, superior rim of L2 in 1, and superior rim of L1 in 2 patients. Two patients had concomitant fractures at two levels. All patients except one were treated with posterior decompression including the removal of the displaced fragment and posterolateral fusion with pedicular screws was carried out to prevent further degenerative change and instablilty. One patient with the lesion at the superior rim of L1 was treated by anterior decompression and fusion. All patients showed relief of pain and claudication with satisfactory results. One patient had partial tear of L4 root with slight weakness of greater toe dorsiflexion, but it recovered in 4 months. In conclusion, posterior lumbar spophyseal fracture predominantly affected young males and the most common causative mechanism was rapid flexion with axial compression. The CT scan facilitated identification of the lesion. The most frequently affected site was the superior rim of L5. Satisfactory results could be achieved bvy adequate posteriior decompression with the removal of the fragment and posterolateral fusion with pedicular screws.
Decompression ; Diagnosis ; Humans ; Intermittent Claudication ; Intervertebral Disc Displacement ; Lower Extremity ; Male ; Methods ; Motor Activity ; Seoul ; Spinal Canal ; Spinal Stenosis ; Tears ; Toes ; Tomography, X-Ray Computed