We present a 40-year-old woman who had a well circumscribed, pea sized red-brown glistening erosive papule on the foreskin of clitoris for four months which had been resistant to various forms of treatment. Histopathologic examination revealed flattened epidermis with lozenge keratinocytes and watery spongiosis, In the upper dermis, dense bandlike infiltration of plasma cells, endothelial proliferation, and capillary dilatation were noted. Peroxidase-antiperoxidase stain showed polyclonal pattern of reaction in the cytoplasm of plasma cells.
Adult ; Capillaries ; Clitoris ; Cytoplasm ; Dermis ; Dilatation ; Epidermis ; Female ; Foreskin ; Humans ; Keratinocytes ; Peas ; Plasma Cells ; Vulvitis*

Stratum corneum was obtained from 10 healthy individuals aged 23 and 24 years, in order to observe morphological differences in a three-dimensionsl structure of stratum corneum from 3 anatomical sites, i. e., flexor surface of the forearm, abdomen, and palm. The stratum corneum obtained by the skin surface biopsy was ohserved under a scanning electron microscope(SME). The surfaces of stratum eorneum obtained by the replice, technique were observed under a stereomicrascope(SM). The results were as follows : 1) SEM observation of the posterior surfaces of the stratum corneum from the skin surface biopsies of the flexor surface of the forearm and abdomen showed divisions with folding lines which were elliptic in the forearm and squere in the abdomen. But there were no similar folding linea in the palm. Among the 3 anatomiral sites, overlapping corneocytes on the palm were most prominent. On a higher magnification, small pits and fine wrinklings in the forearm, fine wrinklings in the abdomen, and villous projections in the palm were observed respeeti vely. 2) SM observation of the stratum corneum from the negative replica of the flexor surface of the forearm, abdomen, and palm showed divisions with folding lines which were X-shape a.t the site of their crossinga in the forearm, *-shape in the abdomen, and linear shape in the palm, Among the 3 snatomical sites, tiny holes on the palm were most prominent. Follicular openings were observed on the pa1m, and abdomen,
Abdomen ; Biopsy ; Forearm ; Skin

A case of 39-year-old male with keratosis palmoplantaria nummularis was reported. The skin lesions were characterized by the presence of painful focal keratoses on the plantar pressure points. Biopsy of a keratotic plantar lesion revealed excessive hyperkerstosis, hypergranulosis, focal hypogranulosis, and acanthosis in the epidermis. We could observe aymptomatic relief of this patient who was treated with mixture of corticosteroid, 25% urea and 2.5% salicylic acid.
Adult ; Biopsy ; Epidermis ; Humans ; Keratosis* ; Male ; Salicylic Acid ; Skin ; Urea

No abstract available.
Biopsy* ; Hematuria*

The transforaminal epidural injection (TFEI) has been preferred in many cases because it can deliver the injected dose of medication closer to the nerve root and better facilitate ventral epidural flow compared to other methods. However, in patients with deformities not demonstrated on fluoroscopic imaging, the needle may enter unwanted locations. We treated two cases of intradiscal injection of contrast dye, during the TFEI, in patients with lumbar disc herniation.
Congenital Abnormalities ; Discitis ; Humans ; Injections, Epidural ; Needles

Group G beta-hemolytic Streptococcus is a normal flora of skin, pharynx, female genital tract, and intestine. Group G beta-hemolytic Streptococcus has been reported to cause a variety of human infections, such as pharyngitis, soft tissue infection, arthritis, osteomyelitis, respiratory infection, endocarditis, meningitis, puerperal infection, neonatal sepsis and peritonitis. But liver abscess caused by group G beta-hemolytic Streptococcus has not been reported to date. We report two cases of liver abscess caused by group G beta-hemolytic Streptococcus. One patient with underlying neurofibromatosis presented with fever and diarrhea; the other patient presented with fever and pain on the right upper quadrant of abdomen. Hepatic abscess was diagnosed by computerized tomography and confirmed by percutaneous needle aspiration. Cultures of pus obtained by aspiration revealed group G beta-hemolytic Streptococcus, which were susceptible all tested antibiotics, including penicillin.
Abdomen ; Anti-Bacterial Agents ; Arthritis ; Diarrhea ; Endocarditis ; Female ; Fever ; Humans ; Intestines ; Liver Abscess* ; Liver* ; Meningitis ; Needles ; Neurofibromatoses ; Osteomyelitis ; Penicillins ; Peritonitis ; Pharyngitis ; Pharynx ; Puerperal Infection ; Sepsis ; Skin ; Soft Tissue Infections ; Streptococcus* ; Suppuration

BACKGROUND: When applying pulsed radiofrequency on dorsal root ganglia for treating chronic lower back pain, maximum efficiency can be expected when a needle is placed 1-2 cm peripheral to the dorsal root ganglion. The object of this study is to analyze images taken after adding contrast to transforaminal epidural injection, categorize root ganglia according to anatomical position, and provide a reference for efficient needle positioning in applying pulsed radiofrequency on dorsal root ganglia. METHODS: From January 2008 to January 2009, 457 patients who visited our hospital for root pain or radiculopathy were treated with transforaminal epidural injection on the nerve roots based on the dermatome of the painful area. Anteroposterior views were taken after injection of contrast. A virtual line was made by connecting the internal and external parts of the spinal pedicle from the contrast images. Then the dorsal root ganglia were categorized as intraspinal (IS), intraforaminal (IF), or extraforaminal (EF). RESULTS: In the fourth lumbar spine, dorsal root ganglia positions were 48% IF, 41% IS, and 6% EF. In the fifth lumbar spine, dorsal root ganglia positions were 75% IF, 10% IS, and 6% EF. In the first sacral spine, dorsal root ganglia locations were 8% IF and 83% IS. CONCLUSIONS: Positional categorization of dorsal root ganglia according to contrast images was proven to be good anatomical references for effective radiofrequency or blocking of dorsal root ganglia.
Catheter Ablation ; Ganglia ; Ganglia, Spinal ; Humans ; Injections, Epidural ; Low Back Pain ; Lumbosacral Region ; Needles ; Radiculopathy ; Spinal Nerve Roots ; Spine

Hiccups occur due to sudden glottic closure connected to inspiratory muscle and diaphragm's involuntary spasm. Hiccups have been known to be caused organically, psychologically, and by some unknown causes, yet, their pathophysiologic mechanism is still unknown. There are non-drug treatments such as hyperventilation, drinking water, pharynx and larynx stimulation, and Valsalva maneuver: and drug treatments such as antipsychotics and antiepileptics. Nerve block can be also considered. A 67-year-old man, who was hospitalized due to his months' long hiccup, had begun hiccups 5-6 months after an operation of radical subtotal gastrectomy with Billroth I anastomosis due to his early gastric cancer. During follow-ups of 4 weeks and 12 weeks after one treatment of bilateral SGB, the patient no longer complained hiccups. In conclusion, SGB treatment for intractable hiccup is an alternative method to palliative therapy or pharmacotherapy when either method is ineffective as a cure.
Aged ; Anticonvulsants ; Antipsychotic Agents ; Drinking Water ; Follow-Up Studies ; Gastrectomy ; Gastroenterostomy ; Hiccup ; Humans ; Hyperventilation ; Larynx ; Muscles ; Nerve Block ; Palliative Care ; Pharynx ; Spasm ; Stellate Ganglion ; Stomach Neoplasms

OBJECTIVE: Spontaneous intracranial hemorrhage in children is not common and very different compared to adults. We analyze the etiology, hemorrhagic type, clinical features, and outcome of spontaneous intracranial hemorrhage in children. METHODS: Twenty-nine patients under 17years of age with nontraumatic intracranial hemorrhage were analyzed retrospectively. Neonates were excepted. We reviewed their medical records in regard to their age, symptoms, radiologic findings, treatment, and prognosis. RESULTS: Among 29 patients, there were 17boys and 12girls. The average age was 10.2years. The most common presenting symptom was mental deterioration, and the most common cause was arteriovenous malformation. Spontaneous intracranial hemorrhage in children showed a better prognosis than in adults. CONCLUSION: Spontaneous intracranial hemorrhage in children resulted mainly from vascular malformation and the prognosis is relatively good. More careful follow-up studies and active management are needed for better outcomes.
Adult ; Arteriovenous Malformations ; Child* ; Follow-Up Studies ; Humans ; Infant, Newborn ; Intracranial Hemorrhages* ; Medical Records ; Prognosis ; Retrospective Studies ; Vascular Malformations

Piriformis syndrome consists of pain, tingling sensation, and paresthesia in areas innervated by sciatic nerve and is one of the main causes of low back pain. A 43-year-old male made a visit for continuous left buttock pain and tingling sensation in lower limbs for three years. Medication, epidural block and sacroiliac joint block were performed, but without effect. Sciatic nerve block with local anesthetics and steroid, however, showed some improvement for a short period of time. The patient's symptoms, physical examination, and the fact that sciatic nerve block showed improvement for a while led to the suspicion of piriformis syndrome. Thus, pulsed radiofrequency was performed on sciatic nerve twice. Visual analog scale (VAS) was 8-9 on first visit, which decreased to 1 after treatment and lasted for more than 18 months.
Adult ; Anesthetics, Local ; Buttocks ; Catheter Ablation ; Humans ; Low Back Pain ; Lower Extremity ; Male ; Paresthesia ; Physical Examination ; Piriformis Muscle Syndrome ; Sacroiliac Joint ; Sciatic Nerve ; Sensation