BACKGROUND: Hair casts(HGs) is a disorder of asymptomatic, firm yellowish white, freely movable accretions which encircles but is not attatched to the hairs. There are two types of HC:The first type, parakeratotic HC, is frequently associated with parakeratotic scalp disorders;the second type, the peripilar keratin casts, in an uncommon type not usually associated with diseases of the scalp and has only been reported in female children. The pathophysiology and origin of HC is poorly understood with only 37 cases reported in the literature. @ ES OBJECTIVE: our pupose was to establish the prevalence of hair cast in schoold children and to determine the predisposing factors of hair casts in Korea. METHODS: Five hundred and thirty-seven students of elementary schools(274male, 263female) were examined. Samples of plucked hair were stained with 4-dimethylaminocinnamaldehyde and examined under light microscopes. RESULTS: There were 182 patients with HC;Peripilar keratin casts:174(CRSC 165, ERSC 7, IRSC 2); paakeratotic HC:8. In a total of 182 patients with HC, 181 were girls and the incidence of HC in female children was 68.8%(181/263). In girls who tie up or weave their hair, the incidence of peripilar keratin casts was as high as 81.8%(171/209). CONCLUSIONS: These data suggest that the traction to the hair follicle may play a role in the generation of HC, and that peripilar keratin casts are not rare in Korea.
Causality ; Child* ; Female ; Hair Follicle ; Hair* ; Humans ; Incidence ; Korea ; Prevalence ; Scalp ; Traction

Artichia with papular lesions is a rare congenit,al disease characteriezed by the association of alopecia and papular lesions. We report a case of atrichia with papular lesions in 12-year-old. Alopecia of the scalp and eye brows were present at birth. Nurnerous papular lesions are presentation the trunk, buttock and inguinal area. The histopathologic iinding of a papular lesion showed ker till-filled cyst, and eruptive vellous hair cyst. The patient showed reticulat.ed hyperpigmentation on the hands and feet in addition to the characteristic feature of atriclia with papular lesions.
Alopecia ; Buttocks ; Child ; Foot ; Hair ; Hand ; Humans ; Hyperpigmentation ; Parturition ; Scalp

BACKGROUND: Several reports have demonstrated that TGFalpha and EGF are mitogenic for keratinocytes. Whenther its expression on epithelial tumors is a marker of malignancy or signifies an important step in the development of neoplasia is poorly understood. EGF receptors are also present in normal epidermis and epithelial tumors but their physiological roles are not yet understood. OBJECTIVE: Our purpose was to examine the staining patterns of TGFalpha, EGF and EGF receptors on the npithelial tumors of the skin, and to investigate kinetics of expression of EGF receptors. METHODS: We performed immunoperoxidase staining(ABC technique) with monoclonal anti-TGFalpha antibody, polyclonal anti-EGF antibody and polyclonal anti-EGF receptor antibody on the formalinfixed, paraffin-embedded tissue specimens of benign, premalignant and malignant skin tumors. RESULTS: The density of the expression of TGFalpha and EGF was not correlated with the degree of the malignancy of the epithelial tumors and is neither constant in any kind of the tumors. However the infiltrative type of basal cell carcinoma(BCC) is stronger that its solid type on the expression of TGFalpha and EGF. All benign tumors demonstrated a diffuse pattern within tumor lobules. pression of TGFalpha and EGF. All benign tumors demonstrated a diffuse pattern within tumor lobules. Focal TGFalpha immunostaining was seen in three of 10 squamous cell carcinomas(SCC) and four of 10 BCCs. TGFalpha immunostaining was absent from the outermost one to two layers of tumor lobules of all keratoacanthomas. The specimens which increased the expression of TGFalpha and EGF tended to decrease the expression of EGF receptor. CONCLUSION: These data suggest that the density of immunohistochemical expression of TGFalpha and EGF may be not dependent on the differentiation of tumor cells, and the pattern of immunohistochemical expression of TGFalpha can differentiate SCC from benign tumors such as keratoacanthoma. FGF receptor may be occupied by both of TGFalpha and EGF. With the receptors being occupied, a down regulation of the receptors may occur which results in decreased EGF receptor expression.
Down-Regulation ; Epidermal Growth Factor* ; Epidermis ; Keratinocytes ; Keratoacanthoma ; Kinetics ; Receptor, Epidermal Growth Factor* ; Receptors, Fibroblast Growth Factor ; Skin* ; Transforming Growth Factor alpha*

Malignant angioendothelioma is an uncommon malignant vascular tumor featuring endothelial cell, and it occurs most frequently in sixth and seventh decade. Most lesions occur over the face and scalp, and may be solitary or multiple, The lesion usally appears as a localized dark red to purplish nodules or plapue with small satellite nodules. Histopatholgic finding shows a nodule eomposed of irregular vascular spaces lined by plump endothelial cells stroma. We present a case of malignant angioendo thelioma on a 42 year-old woman. The patient had purplish nodule with satellite lesions on the right cheek. This case was confirmed by clinical picture, histologic findings and electron microscopic examination.
Adult ; Cheek ; Endothelial Cells ; Female ; Humans ; Scalp

It is generally accepted that the integrity of posterior cruciate ligament plays a major role in knee stability. The rotatory movement is around a point to the back of center of joint where the posterior cruciate ligament lies, and it is a structure which is just as important as the other ligaments. Methods of reconstruction have been described, using semitendinosus tendon, gracilis tendon, popliteus tendon, patellar tendon, iliotibial band, and medial meniscus. We have successfully used the semitendinosus tendon in two patients who sustained neglected rupture of posterior cruciate ligament.
Humans ; Joints ; Knee ; Ligaments ; Menisci, Tibial ; Patellar Ligament ; Posterior Cruciate Ligament ; Rupture ; Tendons

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

Idiopathic progressive atrophoderma of Pasini and Pierini(IPAPP) is charcterized by sharply dermatcated, atrophic and slate-gray to brownish patches. We report a 17-year-old female with well-defined, atrophic, and brown colored patched on the abdomen, flank, and back. Histologic finding showed marked thining of dermis with thichening of collagen fibers and fragmentation of elastic fibers.
Abdomen ; Adolescent ; Collagen ; Dermis ; Elastic Tissue ; Female ; Humans

To evaluate the detection of HPV DNA according to subtype of lesions of uterine cervix and its clinical applicability, in situ hybridization (ISH) and immunohistochemistry for HPV were performed in 189 cases of uterine cervical lesion, including 23 cases of low grade squamous intraepithelial lesion (SIL), 115 cases of high grade SIL and 51 cases of invasive carcinoma. Positive immunostaining, brown precipitate, was mainly noted in the nucleus of koilocytes in the superficial and intermediate layer. Positivity of immunostaining was 21.7% in low grade SIL, 13.0% in high grade SIL and 9.8% in invasive carcinoma. Positive reaction in ISH, red precipitate, was noted in the nucleus of not only koilocytes but also non-koilocytes in the superficial and intermediate layer, and dot precipitate was rarely identified in the nest of squamous cell carcinoma. Based on HPV subtype, 6/11 was 21.7% in low grade SIL, 16/18 was 32.2% and 39.2% in high grade SIL and invasive carcinoma, respectively. With regard to their associated HPV types, low grade SILs were heterogeneous and high grade SILs and invasive carcinomas were related with the high oncogenic risk group only. The correlation of HPV subtypes with panHPV was 91.3% in low grade SIL, 91.3% in high grade SIL and 98.0% in invasive carcinoma. These results suggest that detection of HPV infection by ISH may be a more useful method than immunohistochemistry and application of the HPV subtype probe with the panHPV probe could improve the sensitivity of ISH.
Carcinoma, Squamous Cell ; Cervix Uteri* ; DNA ; Female ; Humans* ; Immunohistochemistry* ; In Situ Hybridization*

BACKGROUND: Gallstones have been one of the most common gastrointestinal diseases to surgeons which open cholecystectomy has been the standard operation for the past one hundred years. Recently, operations with a laparoscope have become popular and are spreading worldwide. METHODS: A clinical analysis of 200 cases who had been treated by laparoscopic cholecystectomy for gallstone disease in Seoul Red Cross Hospital for 4 years from July 1993 to June 1997 was done according to age, sex, advantage, and complication. RESULTS: The results were as follows. 1) Among the 200 cases, there were 69 male patients and 131 female patients, with a female to male ratio of 1.9:1. The most prevalent age group was the 6th decade with 59 cases (29.5%) and the 7th decade with 43 cases (21.5%), the 5th decade with 41 cases (20.5%) and the 4th decade with 29 cases (14.5%) in order of frequency. 2) The associated diseases were hypertension with 25 cases (12.5%), diabetes mellitus with 12 cases (6.0%), cardiopulmonary disease with 11 cases (5.5%), and hepatitis with 10 cases (5.0%) in order of frequency. 3) The cases of previous abdominal operations were 75 cases (37.5%). The most frequent operations were appendectomy with 33 cases (16.5%), C-section with 12 cases (6.0%), laparoscopic tubal ligation with 11 cases (5.5%), salphingo- oophorectomy with 8 cases (4.0%) and T.A.H with 8 cases (4.0%) in order of frequency. 4) The most frequent pathologic diagnosis was chronic cholecystitis with 187 cases (93.5%). 5) The operation time ranged from 30-180 minutes with an average of 81 minutes. The operation time for the first 10 cases was 77 minutes, but it was been reduced to 58 minutes in the last 10 cases. 6) Conversion to an open cholecystectomy during the operation was done in 6 cases (3.0%), and the cause of conversion were uncontrolled bleeding with 2 cases (1.0%), severe adhesion with 2 cases (1.0%) and GB empyema with 2 cases (1.0%). 7) Postoperative analgesics were needed in 81 cases (40.5%) on the operative day, 71 cases (35.5%) on the 1st postoperative day, 26 cases (12.5%) on the 2nd postoperative day, 6 cases (3.0%) on the 3rd postoperative day, and 3 cases (1.5%) on the 4th postoperative day, and the use of analgesics was reduced as times went by. 8) The length of hospital stay ranged from 2 to 10 day with an average of 4.13 day, and 74 cases (37.0%) experienced a 3 to 6 day hospitalization, which was the most common hospital stay. 9) The total postoperative complication rate was 5.0% (n=10) with 2 cases (1.0%) of wound infection and 2 cases (1.0%) of ileus, and there was no postoperative mortality.
Analgesics ; Appendectomy ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Diabetes Mellitus ; Diagnosis ; Empyema ; Female ; Gallstones ; Gastrointestinal Diseases ; Hemorrhage ; Hepatitis ; Hospitalization ; Humans ; Hypertension ; Ileus ; Laparoscopes ; Length of Stay ; Male ; Mortality ; Ovariectomy ; Postoperative Complications ; Red Cross ; Seoul ; Sterilization, Tubal ; Wound Infection

Hair takes a great role in featuring man's appearance and absence of hair can causes troubles in physical and psychological aspects. Many efforts have been made to treat male pattern baldness, including medical therapy and surgical correction, but there is not a definite and eternal method of treatment. Even though the diagnosis of male pattern baldness can be made with its characteristic clinical manifestations, histopathological study must be done for definite diagnosis. Author obtained biopsy material from the frontal progressive baldness area and the occipital non-baldness area with punch biopsy in 20 patients who were diagnosed to be Type II and III male pattern baldness according to the Norwood classification. A comparative study was done in the basis of histopathology using serial vertical section of the biopsy materia with the aid of light microscope and the results are as follows : 1. The average number of total hair in the frontal area was on third than that of occipital area and the number of anagen hair was less in the frontal area. The number of telogen hair in the frontal area was seven times more than that of occipital area. 2. The thickness of epidermis and dermis in the frontal area was thinner than that of occipital area. 3. The infiltration of inflammatory cells in the periadnexal field like blood vessels, hair follicles, sebaceous glands, eccrine glands was more prominent in the frontal area than in the occipatal area. 4. Perifollicular fibrosis and hypertrophy of arrector pilli muscle were more remarkable in the frontal area compared with that of occipital area. 5. There was no difference between the frontal and occipiral area in the number of lobules of sebaceous glands.
Alopecia* ; Biopsy ; Blood Vessels ; Classification ; Dermis ; Diagnosis ; Eccrine Glands ; Epidermis ; Fibrosis ; Hair ; Hair Follicle ; Humans ; Hypertrophy ; Male* ; Sebaceous Glands