Trichorrhexis nodosa(TN) denotes small node-like swelling with a loss of cuticle of the hair shaft through which the hair readily fractures. The basic cause of TN is mechanical or chemical trauma, and a contributing factor is an inherent weakness of the hair shaft. We report a case of localized TN in a 37-year-old male. He had an ovoid hair patch with multiple small white-gray dotted and stubby hairs localized to the right occipital scalp. TN is known to be the commonest of all hair shaft anomalies (Price, 1975). However TN is rarely reported, and there have been only four reports in Korean dermatological literature, to our knowledge, which might be due to underdiagnosis of this disorder. We postulated that diagnostic difficulty lies in the discrepancy between terminology and gross morphological findings.
Adult ; Fibrinogen ; Hair ; Humans ; Male ; Scalp

Mucormycosis is an infectious disease caused by fungi of the order Mucorales. Almost all patients have a serious uriderlying condition such as diabetes mallitus, imrnunosuppression, starvation, burn, but a few cais have been reported in previously heilthy subjects. In order to successfully treat this infection, diagnosis must be prompt and acior. panied by aggressive debridement and parenteral administration of amphotericin B. We report a case of primary cutaneous mucormycosis in 58-year-old man. The lesion was a well-circumscribed erythematous plaque with central necrcis Histopathologically, a biopsy revealed broad, nonsptate with branches occuring at right anghles.
Amphotericin B ; Biopsy ; Burns ; Communicable Diseases ; Debridement ; Diagnosis ; Fungi ; Humans ; Middle Aged ; Mucorales ; Mucormycosis* ; Starvation

Candidiasis is the most common fungal infection complicating the course of patients with hematologic malignant neoplasms. Although widespread organ involvement is characteristic of disseminated candidiasis, reports of skin are rare. Reports describing typical clinical and histopathological finding of cutaneous lesions are very important since it may enable a diagnosis of disseminated candidiasis to be made and thus antifungal therapy can be initiated earlier. A 50-year-old housewife was admitted with a 5-month history of fatigue and easy bruising. She was diagnosed as ha.ving acute myelocytic leukemia and treatment was begun with daunorubicin and cytosin, arabinoside. Eight days after the start of chemotherapy, she developed a fever and generalized tender well demacated erythematous to purplish papulonodular eruption. A biopsy specimen from the skin lesion showed perivascular mononuclear cell infiltration and spore and pseudohypae v,rere found within the dermis and subcutis in PAS stain. Cultures of one skin biopsy specimen and one of four blood sarnples grew Candida tropicalis. The patient was treated with intravenous amphotericin B for disseminated candidiasis. On the tenth day of antifun gal therapy, she developed cardiopulmonary arrest and died.
Amphotericin B ; Biopsy ; Candida tropicalis ; Candidiasis* ; Daunorubicin ; Dermis ; Diagnosis ; Drug Therapy ; Fatigue ; Fever ; Heart Arrest ; Humans ; Leukemia, Myeloid, Acute ; Middle Aged ; Skin Manifestations* ; Skin* ; Spores

Heel cord advancement(HCA), which has been applied for the correction of equinus deformity in spastic cerebral palsy, has some theoretical advantages. However, HCA has also theoretical disadvantage that the procedure remove the tensile force exerting to the calcaneal apophysis. In order to evaluate the effect of HCA on the calcaneal growth, we compared the changes of calcaneal and foot lengths between the operated feet and non-operated feet after HCA. Among the 54 patients who had been treated with HCA at Seoul National University Childrens Hospital from March 1990 to August 1995, we excluded the cases who had been treated bilaterally, and also excluded hemiplegic patients in whom the ipsilateral feet were already shortened and the growth rates are different between the ipsilateral and contralateral foot. Seven patients who met the criterior of this study were included for the evaluation. There were 3 diplegics and 4 paraplegics, and average age at operation was 10 years and 6 months(range; 7 year 8 months-16 year 5 months). Average follow-up period was 3 years and 5 months(range; 2 years-4 years 9 mos). Total calcaneal lengths, anterior and posterior part of calcaneal lengths were measured on the standing lateral radiographs of the foot and ankle. Ratios of the operated limb over the non-operated limb were calculated for the three parameters. Ratios of posterior part of calcaneal lengths decreased significantly(P=0.031). Ratios of total calcaneal lengths decreased and ratios of anterior part of calcaneal lengths increased. However, the changes of two ratios were not significant. Ratios of posterior part calcaeal lengths over total calcaneal length decreases significantly(P=0.016). In conclusion, HCA can cause calcaneal growth retardation, especially posterior part of calcaneus, due to removal of physiologic tensile force of Achilles tendon.
Achilles Tendon ; Ankle ; Calcaneus ; Cerebral Palsy* ; Child ; Equinus Deformity ; Extremities ; Follow-Up Studies ; Foot ; Heel* ; Humans ; Muscle Spasticity* ; Seoul

Changes in the number, the immunoreactivities and the ultrastructures of sero- tonin immunoreactive mucosal mast cells[MMCs] in rat gastrointestinal tracts after vagus nerve stimulation were investigated by using light and electron microscopic immunocytochemical methods. The vagus nerves were electrically stimulated with a square wave pulse generator for a duration of 5 minutes each, a total of 8 times at 2 minute intervals. Serotonin immunoreactive cells of the connective tissues of the gastrointestinal tract were mainly located in the lamina propria, and a small number of the cells were also scattered in the submucosa. By using electron microscopic immunocytochemistry and Wright stain, the serotonin immunoreactive cells of the lamina propria and the submucosa were identified to be MMCs. A few large-sized serotonin immunoreactive connective tissue mast cells [CTMCs], showing strong metachromasia with the Wright stain, were located together with the MMCs in the submucosa of the stomach. In most of the gut regions of the control group, the majority of the MMCs did not show any serotonin immunoreactivities and only a few MMCs showed weak serotonin immunoreactivities. After stimulation of the vagus nerves, the number and the immnu- noreactivities of the serotonin immunoreactive MMCs dramatically increased in all gut regions observed, especially in the small intestines. In the samples treated with the electron microscopic immnunocytochemical methods, hardly any serotonin immunoreactivities were detected in the MMCs of the control group. However, the serotonin imrnunoreactivities of the MMCs were significantly increased after vagus nerve stimulation. The serotonin immnunoreactive products were localized, following vagal stimulation, both in the peripheral matrix of the granules and in the cytoplasm. Also, it was confirmed ultrastructurally that the Golgi complexes were expanded in the MMCs of the vagal stimulation group. The above results suggest that vagus nerve stimulation may activate serotonin biosynthesis in MMCs.
Animals ; Connective Tissue ; Cytoplasm ; Gastrointestinal Tract* ; Golgi Apparatus ; Immunohistochemistry ; Intestine, Small ; Mast Cells* ; Mucous Membrane ; Rats* ; Serotonin* ; Stomach ; Vagus Nerve Stimulation* ; Vagus Nerve*

This study was undertaken to investigate the ultrastructure of the neurons, neuroglial cells and capillaries in the area postrema[AP] of the Oriental discolured bat, Vespertilio superans. The AP of the bat was a single midline structure at the most caudal portion of the fourth ventricle. Most neurons in the AP were small cells, but their ultrastructure were similar to the typical neurons located elsewhere in the central nervous system. Astroglial cells and oligodendrocytes were also observed and showed their typical ultrastructure. Ultrastructural features of neurons, astroglial cells and oligodendrocytes were not changed during hibernating cycles. However, microglial cells were only found in the hibernating AP ; these cells were located in the parenchyma and near the blood vessels of the AP. Since the microglial cytoplasm was filled with phagocytotic inclusions, the nuclei of the these cells were eccentrically located. Phagocytotic cytoplasmic inclusions were shown to be composed of a dense irregular peripheral region and the pale round central region. A Large vacant space was often found in the electron lucent central region. Continuous and fenestrated capillaries surrounded by pericytes were found in the bat`s AP. Especially, Phagocytotic inclusions were found in the pericyte cytoplasm of the hibernating AP, and this result supports suggestion that pericytes might be phagocytotic cells. On the basis of the distributions of phagocytotic tells[pericytes and microglial cell], ultrastructure of these cells, morphology of their cytoplasmic inclusions, and the appearance of phagocytotic activity of the pericytes during the hibernating stage when microglial cells were observed, it can be concluded that pericytes may also participates in the formation of rrlicroglial cells. Tanycytes were also found in the bat AP.
Area Postrema* ; Blood Vessels ; Capillaries ; Central Nervous System ; Cytoplasm ; Ependymoglial Cells ; Fourth Ventricle ; Inclusion Bodies ; Microglia ; Neuroglia ; Neurons ; Oligodendroglia ; Pericytes

PURPOSE: The object of this study was to evaluate entrance angle effects on femoral tunnel length and cartilage damage during anteromedial portal drilling using three-dimensional computer simulation. MATERIALS AND METHODS: Data was obtained from an anatomic study performed using 16 cadaveric knees. The anterior cruciate ligament femoral insertion was dissected and the knees were scanned by computer tomography. Tunnels with different of three-dimensional entrance angles were identified using a computer simulation. The effects of different entrance angles on the femoral tunnel length and medial femoral cartilage damage were evaluated. Specifically, tunnel length and distance from the medial femoral condyle to a virtual cylinder of the femoral tunnel were measured. RESULTS: In tunnels drilled at a coronal angle of 45degrees, an axial angle of 45degrees, and a sagittal angle of 45degrees, the mean femoral tunnel length was 39.5+/-3.7 mm and the distance between the virtual cylinder of the femoral tunnel and the medial femoral condyle was 9.4+/-2.6 mm. The tunnel length at a coronal angle of 30degrees, an axial angle of 60degrees, and a sagittal angle of 45degrees, was 34.0+/-2.9 mm and the distance between the virtual cylinder of the tunnel and the medial femoral condyle was 0.7+/-1.3 mm, which was significantly shorter than the standard angle (p<0.001). CONCLUSION: Extremely low and high entrance angles in both of axial plane and coronal plane produced inappropriate tunnel angles, lengths and higher incidence of cartilage damage. We recommend that angles in proximity to standard angles be chosen during femoral tunnel drilling through the anteromedial portal.
Aged ; Anterior Cruciate Ligament/*surgery ; Anterior Cruciate Ligament Reconstruction/instrumentation/*methods ; Cadaver ; Computer Simulation ; Female ; Femur/anatomy & histology/*surgery ; Humans ; Imaging, Three-Dimensional ; Knee Joint/radiography/*surgery ; Male ; Middle Aged ; Osteotomy/*methods ; Outcome and Process Assessment (Health Care) ; Patient Positioning ; Surgical Instruments ; Tomography, X-Ray Computed

No abstract available.
Echocardiography, Transesophageal*

BACKGROUND: Psoriasis is a dynamic process, both clinically and histopathologically. There is wide spectrum of histological change recognizable in psoriatic lesions. OBJECTIVE: We attempted to clarify the histological features in psoriasis by quantitative studies. METHODS: We reviewed the clinical charts, photographs and skin biopsy slides of 106 patients who were diagnosed as psoriasis clinically or histopathologically between March, 1990 and August, 1994 at the Department of Dermatology, Korea University Hospital. The 12 histopathologic fea tures of psoriasis were listed and examined whether these features were seen or not. in each section. And if seen, then the features were scored 0 to 1. The sum of score in ear,h section could range from 0 to 12. RESULTS: 1. 72 of 106 patients were psoriasis vulgaris. In other patients, the clinical forms of psoriasis wer e guttate psoriasis, pustulosis palmoplantaris, and generalized pustular psoriasis. 2. The average score of histopathologic features seen in each section were 8.11+/-2.11. 3. Sections commonly showed club shaped rete ridges, elongation and ederna of the dermal papil- lae, perivascular mononuclear infiltrate in the upper dermis, absent granular layer, parakeratosis, suprapapillary plate thinning, mitosis above basal cell layer, and dilated tortuous blood vessels. The observed frequency of Munro microabscess, spongiform pustule, and dilated tortuous blood vessels were significantly lower in psoriasis vulgaris than in other clinical forms(p<0.05). CONCLUSION: This study showed that the histologic picture of psoriasis varied with the clinical forms. In each section seen, the observed frequncy of Munro microabscess and spongiform pustule was relatively low.
Biopsy ; Blood Vessels ; Dermatology ; Dermis ; Humans ; Korea ; Mitosis ; Parakeratosis ; Psoriasis* ; Skin

BACKGROUND: Ventricular remodeling after myocardial infarction increase mortality and morbidity. Two-dimensional echocardiography in acute myocardial infarction provides a useful diagnostic tool for evaluation of ventricular remodeling. The aims of this study were to verify whether follow-up two-dimensional echocardiography could detect ventricular enlargement after acute myocardial infarction and to find early echocardiographic predictors and clinical charateristics of ventricular enlargement. METHODS: Two-dimensional echocardiography was done prospectively at 2 week, 3 month, and 6 month after the first Q-wave acute myocardial infarction in 18 patients. The control group was 11 patients of a normal chest roentgenogram and echocardiogram who were studied for chest pain or arrhythmia. The patients were divided by the mean value of the control group left ventricular end-diastolic volume index(LVEDVI) 56.8ml/m2. The group A was more than 60ml/m2(the control group LVEDVI 56.8ml/m2) and the group B was less than 60ml/m2 of LVEDVI at 2 week post myocardial infarction. The left vantricular volume was measured by the modified disk method at the apical four chamber view. The wall motion abnormality of left ventricle was examined by the recommendation of the American Society of Echcardiography. RESULTS: The left vntricular end-diastolic volume and the left ventricular end-systolic volume were enlarged after 3 month of acute myocardial infarction in the group A compare with those of the control group. There was no ventricular enlargement during 6 month after myocardial infarction in the group B. The frequency of ventricular enlargement was increased in anterior myocardial infarction. There was no difference in left ventricular ejection fraction at 2 week post myocardial infarction between the group A(51.4+/-15.7%) and the group B(50.8+/-10.3%). The wall motion score index more than 1.5 at 2 week post myocardial infarction means the enlarged LVEDVI more than 60ml/m2 and the group of ventricular enlargement. CONCLUSION: The left ventricular enlargement could be diagnosed by the follow-up two-dimensional echocardiography in acute myocardial infarction. The echocardiographic early predictors of ventricular enlagement were the left ventricular end-diastolic volume greater than 60ml/m2 and increased wall motion score index more than 1.5 at 2 week post myocardial infarstion. The anterior myocardial infarction was the electrocardiographic predictor of ventricular dilatation. Therefore these early predictors could identify the patients of ventricular enlargement and these patients could be a candidate of follow-up echocardiography and of a specific treatment for limiting ventricular remodeling.
Arrhythmias, Cardiac ; Chest Pain ; Dilatation ; Echocardiography* ; Electrocardiography ; Follow-Up Studies ; Heart Ventricles ; Humans ; Mortality ; Myocardial Infarction* ; Prospective Studies ; Stroke Volume ; Thorax ; Ventricular Remodeling