Reflex sympathetic dystrophy(RSD) defines as a chronic pain syndrome with sympathetic manifestations that afflicts individuals who haute suffered a trauma to the hand. Persistent pain and dysfunctions of the hand are frequently overlooked by the surgeons. The exact pathophysiology of RSD is not known but severity of injury and prolonged immobilization of the joints are considered as resonable causes on the retrospective studies. The diagnosis of reflex sympathetic dystrophy is based on clinical manifestations, simple X-ray and three-phase bone scan. Confirmative diagnosis absolutely depends on the presence of a diffusely abnormal pattern of uptake in phase III in a patient haying pain with underlying cause and strong clinical signs of sympathetic overactivities. As with most disease processes, early diagnosis and treatment is a goal of management of RSD. Surgical restoration of anatomical structures such as tendon, nerve and joint goes ahead of any kind of procedures and it made the VAS pain score decrease from 7.8 to 3.4 in 16 patients. Also, decrease of pain could be achievable with sympathetic or stellate ganglion block with steroid medication. Active physical therapy after surgery is also verb helpful to functional recovery of the hands. Once the appropriate diagnosis is made, combined therapy composed of surgical restoration of anatomical structure, physiotherapy and steroid medication with sympathetic block will be free from pain and produce early functional recovery.
Chronic Pain ; Diagnosis ; Early Diagnosis ; Hand Injuries* ; Hand* ; Humans ; Immobilization ; Joints ; Reflex Sympathetic Dystrophy* ; Reflex* ; Retrospective Studies ; Stellate Ganglion ; Tendons

Atypical fibroxanthoma(AFX) occurs most on sun-exposed area of the head and neck of elderly person. It has an excellent prognosis after conservative, but complete, excision. However, because of its potential, albeit small, for metastasis, it is widely regarded as a low-grade sarcoma. We present herein two cases of atypical fibroxanthoma. The case 1 was a 86-year-old female who had a small egg-sized, dome shaped nodule with eroive surface on the left cheek. The other case was a 60-year-old male who had solitry bean-sized, nodulo-ulcerative lesion on the vertex. Immunohistochemical studies revealed positive reaction for vimntin and a-antichymo trypsin. These patients have received completely total surgical ecis on and remained free of recurrence for a period of about, 2 years follow up.
Aged ; Aged, 80 and over ; Cheek ; Female ; Follow-Up Studies ; Head ; Humans ; Male ; Middle Aged ; Neck ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Sarcoma ; Skin* ; Trypsin

Using immunohistochemical methods, the authors investigated the distribution of tubulin in normal skin and 31 skin tumors, including 11 benign skin tumors and 20 malignant skin tumors, In normal skin, tubulin was strongly expressed in basal cells of the epidermis, sebaceus celis and dermal nerves. Myoepithelial cells, ductalI cells of sveat ducts and outer root sheath cells of hair follicles stained moderat,ely. Lermal fi broblasts showed no staining. In benign tumors including keratoacanthoma, trichoepithelioma, and nevocellular nevus the strornal fibroblast.s were entirely tubulin negative as well as the turnor cells. In basal cell carcinoma, the stromal fibroblasts were negative',whereas tumor cells were weakly positive. In squarnous cell carcinoma(SCC), tumor cells weri, tubulin positive weakly, the degree of tubulin expression of its stroma1 fibroblasts tencied to be in proportional to the grade of malignanr.u. Tumor cells of malignant melanoma and nevocellular nevus were tubulin positive moderately bist the stromal fibrobla.sts were strongly positive only in the cases of malignant melanoma. These results show that the degree of the tubulin; expression in adjacent, stromal cells of epidermal tumors is in proportiona.l to that of their malignancy, These suggest that the expression of tubulin in fibroblasts surrounding tumor cells of malignant melanoma and SCC reflects a stromal alt,eration that might contribute to tumor in vasion, and play a role for cellular motility.
Carcinoma, Basal Cell ; Epidermis ; Fibroblasts ; Hair Follicle ; Keratoacanthoma ; Melanoma ; Nevus ; Skin* ; Stromal Cells ; Tubulin*

No abstract available.
Child* ; Humans ; Seizures, Febrile* ; Spinal Puncture*

Dyschromatosis universalis hereditaria was reported in 1933 by Ichikawa and Hiraga in Japan. This disease is characterized by small pigmented and depigmented mottled macules on the trunk and extremities. We report two cases of dyschromatosis universalis. Case one is a 47-year-old man presented with hypoand hyperpigmented spots on the trunk and extrexities. At about 30 years of age, he started to show pigmentary changes on the back, which became progressively spread to the other parts of the trunk and extremities. Case two is a 27-year-old man with numerous mottled hypo-and hyperpigmented spots on the trunk and extremities. He started to show pigmentary changes on the back about 12 years ago. This pigmentary changes also became progressively spread to the other part of the trunk and extrimities. There were no family history of similar disease. On physical exminations, both patients had hrown rice-grain sized pigmented and depigmented macules without scales and atropy on the trunk and extremites. Fontana-Masson stains revealed decreased and increased melar in granules in the basal cell layers in the hypopigrnented and hyperpigmented lesions respectively.
Adult ; Coloring Agents ; Extremities ; Humans ; Japan ; Middle Aged ; Weights and Measures

The application of fine needle aspiration (FNA) cytology to the soft tissue tumors had been neglected. In recent years, however, FNA has been used increasingly in the preoperative diagnosis of these tumors due to its usefulness and accuracy. We present 3 cases of liposarcoma, myxoid, myxoid with round cell, and pleomorphic, diagnosed by FNA cytology with histologic confirmation. Good correlation between his- tologic and FNA cytologic findings was found. Although the cytologic appearances of liposarcomas varied with histologic type, the main criterion was the presence of atypical multivacuolated lipoblast with characteristically scalloped nuclei.
Biopsy, Fine-Needle ; Child* ; Diagnosis ; Humans ; Hypertension, Renovascular* ; Liposarcoma ; Liposarcoma, Myxoid ; Pectinidae

No abstract available.
Giant Cells* ; Granuloma, Giant Cell*

Papular elastorrhexis is a connective tissue nevus that occurs in the second decade of life as asymptomatic small white-creamy papules scattered over the chest, shoulder, abdomen, or back Histopathologically, there is a decrease in elastic fibers with focal homogenization of collagen. Recognition of this entity is important to prevent use of unnecessary diagnostic procedures and therapy. We present three cases of papular elastorrhexis. All of them occurred in children under the age 10 years.
Abdomen ; Child ; Collagen ; Connective Tissue ; Elastic Tissue ; Humans ; Nevus ; Shoulder ; Thorax

Malignant fibrous histiocytoma is the most common soft tissue sarcoma in adult life and shows a mixed proliferation of both fibroblsstic & histiocytic cells. We report a case of myxoid malignant fibrous histiocytoma involving right lower leg in a 68-year-old male patient, who presented with a childs palm-sized nodular mass of 3 years duration. Histoapthologically, the tumor had varying proportion of myxoid cellular components. The myxoid areas showed spindle and pleomorphic cells arranged in a vague storiform pattern, abrupt transition between a solidly cellular area and a myxoid area, and lipoblast-like cells. The cellular areas showed spindle cells arranged in a storiform pattern characteritic of the typical pleomorphic malignant fibrous histiocytorna.
Adult ; Aged ; Child ; Histiocytoma, Malignant Fibrous* ; Humans ; Leg ; Male ; Sarcoma

No abstract available.
Breast Neoplasms* ; Breast* ; Female ; Mammaplasty* ; Mastectomy*