Recurrent infantile digital fibroma is a peculiar fibrous tumiir that may be single or multiple on fingers and toes of infants and children. We report a 5-year-old gril with recurrent infantile digital fiber oma which was recurrent on the left 5th toe. The lesion had noted at the age of 6 months. and was excised surgically when the child was 3 year old. 2 years after operation, the lesion was recurred in operation site. Microscopically, nodular fibrous mass is attached to flattened,pidermis. The underlying nodule is composed of proliferating fibroblasts surrounded by derse collagenous tissue. We could find eosinophilic inclusion bodies in the cytoplasm of fibro ilast. It was stained pink with H&E, bright red with Massons trichrome and purple with PTAH.
Child ; Child, Preschool ; Collagen ; Cytoplasm ; Eosinophils ; Fibroblasts ; Fibroma* ; Fingers ; Humans ; Inclusion Bodies ; Infant ; Toes

Giant cell tumor of tendon sheath(GCTTS) is a benign mesenchymal lesion composed of cytologically bland mononuclear cells admixed with multinucleated giant cells. Our report describes the clinical and pathologic features of a 36-year-old female's tumor with a two years history over the lateral side of the left little finger, Especially, we could observe the characteristic thre types of cells in an electromicroscopic study, histiocyte-like cells, fibroblast-like cells and multinucleated giant cells. In lmmunohistochemical studies, we demonstrated that the tumor cells of GCTTS exhibit a phenotype consistent with histiocyte differentiated to Langerhan's cell.
Adult ; Fingers ; Giant Cell Tumors* ; Giant Cells* ; Histiocytes ; Humans ; Phenotype ; Tendons*

Postherpetic neuralgia(PHN) is a common complication of herpes zoster and one of most common intractable conditions in pain clinics. The PHN is defined solely by the persistence of pain after the herpes zoster. There has been no known pathophysiology for the PHN and the role of scars, local muscles, tendons and ligaments has not been addressed. The characteristics, duration, and location of the referred pain were evaluated along with the electromyographic(EMG) examination of involved muscles. Then treatment was given under the concept of a myofascial pain syndrome till the pain was completely resolved. Most of the patients with acute or chronic pain were relieved from the pain. This study revealed a practical and important new concept on herpes zoster related pains. In some cases of herpes zoster, acute herpes zoster seems to be an initiating factor to form an acute trigger point in the muscles of the related area. And uncomplicated trigger points neglected in an acute stage become chronic intractable problems, when they were neglected. In conclusion, myofascial pain syndrome should be taken into account when a postherpetic neuralgia is diagnosed. The recognition of this possible relationship between PHN and myofascial pain syndrome and an early proper care can greatly reduce the suffering of patents from chronic pain.
Chronic Pain ; Cicatrix ; Herpes Zoster ; Humans ; Ligaments ; Muscles ; Myofascial Pain Syndromes* ; Neuralgia, Postherpetic* ; Pain Clinics ; Pain, Referred ; Tendons ; Trigger Points

Basal cell carcinomas(BCCs) are the most common skin cancers in Korea and a proportion of BCCs contain pigment. Pigmented basal cell carcinomas(PBCCs) are included in the differential diagnosis of invasive melanoma and other benign pigmented skin lesions(PSLs) because of their growth patterns and asymmetry of pigmentation. Epiluminescence microscopy(ELM) describes the non-invasive in vivo examination of skin lesions with a microscope using incident light delivered from an acute angle and oil immersion. Many studies have shown that epiluminescence microscopy can improve the diagnostic accuracy of PSLs. Menzies et al analyzed the morphologic features of a large set of 142 pigmented BCCs and produced a simple ELM method for diagnosis that would allow differentiation from melanomas and benign pigmented lesions. We observed morphologic features of two PSLs with a handheld 10 epiluminescence microscopy (Episcope, Welch Allyn Inc, Skaneateles Falls, NY). After the ELM examination, two PSLs were excised and processed for histopathology. The ELM findings and histopathologic diagnosis were compared for each lesion. ELM permits the recognition of two PBCCs and the fact that it is a non-invasive in vivo method makes it even more attractive as a diagnostic tool in clinical practice.
Carcinoma, Basal Cell* ; Dermoscopy* ; Diagnosis ; Diagnosis, Differential ; Immersion ; Korea ; Melanoma ; Pigmentation ; Skin ; Skin Neoplasms

BACKGROUND: Although recent studies have demonstrated that infusion of L-arginine reduces myocardial necrotic area during prolonged ischemia, its effects on transient postischemic myocardial dysfunction(myocardial stunning) and microvascular dyfunction(vascular stunning) are not well known. To investigate whether intravenous administration of L-arginine, physiological nitric oxide(NO) precursor, during reperfusion would attenuate postischemic myocardial dysfunction and microvascular dysfunction, 15 open-chest dogs were studied. METHODS: In 15 pentobarbital anesthesized open-chest dogs, left circumflex coronary artery was occluded for 20 minutes and was followed by a reperfusion for 60 minutes. L-Arginine(30mg/kg)(L-arginine group, n=8) or saline(control group, n=7) was given intravenously by a bolus 1 minute before reperfusion and was followed by a continuous infusion(10mg/kg/min) for 30 minutes during reperfusion. Before coronary occlusion and 60 minutes after reperfusion, coronary blood flow(CBF) and coronary vascular resistance(CVR) wre measured after intracoronary injection of each of acetylcholine(0.01/kg) and adenosine(1.5/kg), and reactive hyperemia with coronary occlusion(RH20) for 20 seconds was measured. Myocardial segment thickening in the area of ischemia-reperfusion was measured using 2D-echocardiography. The echocardiographic images were digitized and analyzed by cardiac image analyzer. RESULTS: The results obtained 60 minutes after reperfusion were as follows. 1) CBF was decreased by 41% in L-arginine group vs 30.1% in control group(p < 0.05) and CVR was increased by 83.9% in L-arginine group vs 19.3% in control group after 60 minutes of reperfusion, compared with pre-occlusion baseline values. 2) Percent change of CBF was decreased in control group(acetylcholine by 25.8%, adenosine by 29.2%, RH20 by 39.8%), while it was increased in L-arginine group(acetylcholine by 60%, adenosine by 22%, RH20 by 26.7%). Percent change of CVR was increased in control group(acetylcholine by 10.5%, adenosine by 6.9%, RH20 by 21%), but it was decreased in L-arginine group(acetylcholine by 10%, adenosine by 6.6%, RH20 by 1.6%). Increase of CBF and decrease of CVR were significant on acetylcholine and RH20 between control group and L-arginine group. 3) Fraction of myocardial segment thickening was significantly decreased in L-arginine group(by 80%) compared with control group(by 61.7%, p < 0.05). CONCLUSIONS: The finding that L-arginine depressed post-ischemic myocardial contractil function suggests that systemic infusion of L-arginine has unfavorable effect on myocardial stunning. In contrast, the finding that L-arginine improved CBF and CVR with acetylcholine and adenosine and reactive hyperemia indicates that L-arginine may exert a beneficial effect on vascular stunning. These results suggest that L-arginine may have independent effects on myocardial stunning and vascular stunning.
Acetylcholine ; Adenosine ; Administration, Intravenous ; Animals ; Arginine* ; Coronary Occlusion ; Coronary Vessels ; Dogs* ; Echocardiography ; Hyperemia ; Ischemia ; Myocardial Reperfusion ; Myocardial Stunning ; Nitric Oxide ; Pentobarbital ; Reperfusion