A 10-year-old boy had a recurrence of cutaneous lesions 1 week after only one exposure to jellyfish on the lower extremity. The recurring lesion was charaeterized by pruritic several linear or whiplash-like erythematous and some edematous papuloplaques. The histopathologic findings showed focal hyperkeratosis, acanthosis in epidermis and mild perivascular infiltration of inflammatory cells, capillary proliferations in dermis.
Capillaries ; Child ; Dermis ; Epidermis ; Humans ; Lower Extremity ; Male ; Recurrence

We report herein a case of smooth muscle hamartoma associated with Beckers nevus in a 5-year-old female. The child presented with a slight.ly brownish. 2 x 3 cm sized, pigmentecl patch with follicular accentuation on the right forearm, witch had been observecl since age of 2. Histopathologic findings showed the epidermal changes most consistent with Becker's nevus and the presence of irregularly arranged hyperplastic smooth muscle hundless in the dermis.
Child ; Child, Preschool ; Dermis ; Female ; Forearm ; Hamartoma* ; Humans ; Muscle, Smooth* ; Nevus*

Agenesis of the dorsal pancreas is one of the rare congenital anomalies of the pancreas. Six cases of them have been reported. We have experienced an autopsy case of agenesis of the dorsal pancreas associated with fetal death in the uterus. Grossly, the body and tail of the pancreas and uncinate process were not found and those were partially replaced by adipose tissue. No abnormality was noted in the other organs. Microscopically, pancreatic tissue with autolytic change was identified only in the head portion of the pancreas.

The injured skull bone may be contaminated in compound frontal skull fracture, so definitely left out for the prevention of infectious complications in the classic concept. The efficacy of primary replacement and resection of the injured bony fragments in the treatment of compound depressed frontal skull fractures was studied in 33 patients who could be followed up over one year during a recent 5-year period. The patients was divided into a group I which took a primary replacement of injured bony fragments and group II which left out the injured bony fragments in immediate operation. The results are summarized as follows : 1) The age incidence was more frequent in the 3th and 4th decades. The sex distribution was more frequent in male(87%). 2) The motor vehicle accident was most frequent in the injury mechanism. 3) The conscious level on admission was 53% in 13~15 GCS group, 12% in 9~12 group, 26.6% in 6~8 group and 8.4% in 3~5 group. 4) The incidence of an extending fractures was 42% to orbital roof, 35% into frontal sinus, 25% into cribriform plate and 16% into nasal bone. 5) The incidence of intracranial injury was 65% in dural laceration and 51% in cerebral laceration. Of cases of dural laceration the cerebral laceration was associated in 78%. 6) The time duration from injury to operation was under 12 hours in most cases(84%). 7) The incidence of a complication was 36.1% in total group, 27.7% in group I and 47.2% in group II. The infectious complication was not a significant difference between group I(14.9%) and group II(16.7%). In conclusion the infectious morbidity of which were most dangerous complications due to compound depressed frontal skull fractures was not a significant difference in two compared group. The author believe that immediate bone replacement for compound depressed frontal fractures with or without extension to frontal sinus, orbit, or cribriform plate os both practical and safe procesures.
Ethmoid Bone ; Frontal Sinus ; Humans ; Incidence ; Lacerations ; Motor Vehicles ; Nasal Bone ; Orbit ; Sex Distribution ; Skull Fractures* ; Skull*

We performed an epidemiologic survey to investigate the dermatologic problems from cutting oils in metal workers. The personal questionnaires and dermatologic examinations were performed on 360 metal workers who were working at 50 metal industries. The pH meter (HANNA 8520) and the atomic absorption spectrometer(G.B.C. 902) were employed to measure the pH values of cutting oil and the concentration of heavy metals contained in cutting oil respeetively. The results were as follows : 1. The prevalence rates of the dermatologic disorders from cutting oil were 46.0% of eontact dermatitis, 10.9% of black comedone, and 7.1% of paronychia in orders. The dermatologic disorders that seemed to be not directly associsted with cutting oil were callosity(19.1%), burn by metal chips(9.8%), and mechanical injury(5.7%). 2. The localizations of the contact dermatitis and the black cemedone from cutting oil were 84% of hands, 6.6% of face, and 5% af forearms. More detailed localizations of the contact dermatitis and black comedone that developed in hand were 29.6% if finger tip, 27.6% of palm and palm finger, and 19.1% of palm finger only in orders. 3. The prevalence rates of the dermatologic disorders by the of cutting oil were 51.5% of soluble oil, 68.8% of insoluble oil, and 80.8% of mixed cutting oil which containing both soluble and insoluble oil. 4. The mean pH value of aoluble cutting oil was 8.0 and that of insoluble cutting oil was 7.0. 5. The concentrations of heavy metals contained in soluble oil were 32.2 mg/m3 of chrome, 6.42 mg/m3 of nickel, and 4.85 mg/m3 of cobalt. The concentrations of heavy metals contained in inspluble oil were 24.11 mg/m of chrome, 4.63 mg/m3 of nickel, and 2.30 mg/m3 of cobalt.
Absorption ; Burns ; Cobalt ; Dermatitis ; Dermatitis, Contact ; Epidemiologic Studies* ; Fingers ; Forearm ; Hand ; Humans ; Hydrogen-Ion Concentration ; Metals, Heavy ; Nickel ; Oils ; Paronychia ; Prevalence ; Surveys and Questionnaires

Glomangiosarcoma is a histopathologically defined extremely rare malignant tumor that accompanies a glomus tumor usually, but its has benign clinical course characteristically. It shares common ultrastructural and immunohistochemical features with glomus tumor, and transformed possibly from glomus tumor". Glomangiosarcoma shows more sarcomatous appearance histologically than glomus tumor, however with no malignant behavior(i.e. recurrence or metastasis) was expressed. We experienced a case of glomangiosarcoma form subungual region treated by marginal excision and no recurrence or metastasis was developed untill 1 year and 6 months postoperatively.
Glomus Tumor ; Neoplasm Metastasis ; Recurrence

Several reports on burst fractures of the thoracolumbar spine have noted that the neural canal encroachment caused by bone in the canal did not correlate with the neurologic status of the patient. But in the thoracolumbar spine the average percent compromise was significantly higher in those patients with complete and incomplete lesions, compared with those patients with no neural deficits. In this study, we evaluated 38 patients with unstable thoracolumbar fractures, operated from March 1989 to February 1993 to know the amount of neural canal compromise, demonstrated on computed tomography scans with neurologic status, level of injury and type of fractures. Among them 22 patients had neurologic deficit and 16 did not neurologic deficit. The results were as follows; 1. 19(76%) of 22 patients with disruption of the posterior spinal elements had neurologic defictis. 2. In the group with neurologic deficits, the stenotic ratio was 44% at the epiconus level, 55% at the conus medullaris, level and 63% at the cauda equna level. 3. The average A-P diameter of the bony fragments retropulsed into the spinal canal was 4.5mm at the epiconus level, 5.2mm at the conus medullaris level and 6.0mm at the cauda equina level. 4. Unstable bursting fracture and fracture dislocation showed higher incidence of neurologic injury and percentage of spinal stenotic ratio than those of flexion distraction and wedge compression fracture. In conclusion, the higher the level of the injured vertebrae, the smaller the size of the retropulsed fragment needed compromise the neural tissues. We suggest that it is necessary to get enough decompression for restoration of spinal canal and recovery of neurological function and computed tomography was more sensitive than any other modality in detection the reduction of the retropulsed bony fragment into spinal canal.
Cauda Equina ; Decompression ; Dislocations ; Fractures, Compression ; Humans ; Incidence ; Neural Tube ; Neurologic Manifestations ; Spinal Canal ; Spinal Cord ; Spine ; Tomography, X-Ray Computed

The use of lower extremity tourniquets for procedures of the lower leg is considered routine in orthopedic surgery, but, lower extremity tourniquets do harm occasionally. While the tourniquet is inflated, metabolic changes such as increased PaCO2 , lactic acid, and serum potassium and decreased level of PaO2 and pH occur in the ischemic limb. Deflation of tourniquet results in release of anaerobic metabolic products during ischemia into systemic circulation. In this ischemia/reperfusion situation, oxygen free radicals could potentially be produced during the reperfusion period by several mechanisms. One of these mechanisms is release of intracellular superoxide or hydrogen peroxide by activated neutrophils in the area. These reactive oxygen species(ROS) could be a causative factor for the postreperfusion no-flow, lung injury, induction of tourniquet shock, etc. The purpose of this clinical study was to investigate the effect of tourniquet deflation on the hemodynamic changes, changes of blood gas analysis, and hydrogen peroxide production using flow cytometric analysis of fluorescent DCF(Dichlorofluorescein). Quantitative analysis of fluorescent DCF was performed in resting and fMLP(N-formyl-methyonyl-leucyl-phenylalanine) or PMA(phorbol myristate acetate) stimulated neutrophils. Also differences of these factors between two groups of tourniquet time, one is less than one hour and the other more than one to two hours, were analysed. The hemodynamics(blood pressure, pulse rate), arterial PO2, bicarbonate, base excess, and hydrogen peroxide production showed no significant change before and after tourniquet release(p>0.05). Arterial pH and PaCO2 decreased significantly until 10 and 5 minutes after tourniquet release, respectively(p>0.05). Tourniquet time didn’t reveal any significances differences. These results indicate that tourniquet application with400mmHg pressure and less than 2 hours does not release significant hydrogen peroxide into systemic circulation during reperfusion period after tourniquet release.
Blood Gas Analysis ; Blood Pressure ; Clinical Study ; Extremities ; Flow Cytometry ; Free Radicals ; Hemodynamics ; Hydrogen Peroxide ; Hydrogen ; Hydrogen-Ion Concentration ; Ischemia ; Lactic Acid ; Leg ; Lower Extremity ; Lung Injury ; Myristic Acid ; Neutrophils ; Orthopedics ; Oxygen ; Potassium ; Reperfusion ; Shock ; Superoxides ; Tourniquets

No abstract available.

Isometric positioning of the ACL graft is an important consideration in successful reconstruction of the ACL-deficient knee. The purpose of this study is to get a certain guideline in the endoscopic one-tunnel technique of anterior cruciate ligament reconstruction by measuring the skin angle and determine the degree of minimum flexion of the knee joint during femoral tunneling and interference screw fixations. To get the guide lines, first we get the tibial tunnel angle parallel to the Blumensaat's line from fully extended lateral knee joint radiography. Secondly measure the differences between angles of the femur-tibia shaft and anterior thigh-leg skin. Then measure the minimum femur-tibia flexion angle does not perforated the posterior cortex of the distal femur during femoral tunneling. Intraoperative measuring the angle between interference screw guide pin and tibial tunnel to get the parallelism of the femoral tunnel and interference screw. The results were as follows; The average femur-tibia shaft angle with 30degrees anterior thigh-leg skin angle was 30.2+/-1.75degrees, with 45degrees was 45.2+/-1.23degrees, with 60degrees was 61.9+/-4.23degrees, with 75degrees was 78.6+/-2.62degrees, with 90degrees was 97.8+/-3.96degrees. Predetermined sagittal tibial tunnel vector on the 0degrees extension knee joint lateral radiographs were applied to the several knee joint dynamograms. The mean minimum flexion angle of the femur-tibia shaft that doesn't perforate the posterior cortex of the femur was 45+/-1.58degrees (male), 44.5+/-4.97degrees (female). The average angle between interference screw guide pin and tibial tunnel was 23.0+/-2.23degrees. The findings of the present study suggest that anterior thigh-leg skin angle can be used instead of the true femur-tibia shaft angle. Less knee flexion angle makes good arthroscopic view during the tibio-femoral tunneling and interference screw fixation.
Anterior Cruciate Ligament Reconstruction ; Femur ; Knee Joint* ; Knee* ; Radiography ; Skin ; Transplants