Chronic postirradiation changes of skin reflect the injury of dermal structures particularly the vasculature and connective tissue. The clinical signs include atrophy, partial or complete destruc tion of cutaneous appendatges, telangiectasis, sclerosis of underlying tissue, pigrnentary changes, and in rare instances, ulceration with or without var ious premalignant and malignant neoplasms. The patient, was a 65-year-old man, who had been exposed to a large amount. of X-ray irradi- ation on his hands incidentally or accidentally for a long time. The skin changes of his hand were thickening and hardening of all digits loss or focal consttict,ion of digits, and keratotic papules. Epidermal hyperplasia and fibrous thickening of collagen bundles were found on skin biopsy. Gradual narrowingal of the bony caliber with eventual resorption was noticed on radiologic examination. It has been rarely reported in the literature that chronic radiation dermatitis develops severe and unusal manifestions such as acrosclerosis and loss of digit due to osteoradionecrosis.
Aged ; Atrophy ; Biopsy ; Collagen ; Connective Tissue ; Dermatitis* ; Hand ; Humans ; Hyperplasia ; Osteoradionecrosis* ; Sclerosis ; Skin ; Telangiectasis ; Ulcer

BACKGROUND: The sunburn cell is an abnormal keratinocyte of the skin induced by ultraviolet (UV) irradiation, and is used as an indicator of cell damage. The sunburn cell is consideredas an apoptotic cell which has been caused by UV irradiation, and many studies have been performed to understand the mechanism of photodamage in relation to apoptosis. The mechanism of photodamage by UV irradiation is still unclear. However, it is suggested that oxygen stress by reactive oxygen species produced by the UV rays may play an important role. OBJECTIVE: This study was a med at evaluating whether various antioxidants and sunscreen can prevent sunburn cell formation. In addition, we studied whether or not the sunburn cell is identical to an apoptotic cell stained using the TUNEL method. METHODS: White mice (ICR strain) were used to test the potency of various topical agents which are used in the prevention of sunburn cell formation; the agents were various antioxidants of L-ascorbic acid, tocopherol, catalase, a reduced form of glutathione (GSH), and sunscreen PABA (para-amino benzoic acid). Each agent was topically applied daily for 5 consecutive days on the dorsal skin of the ears. 300 mJ/cm of UV-B was irradiated on the ears 30 mins after the final applicaion, and skin samples were taken 24 hrs after that. The sunburn cells in the H & E stain were counted per 1 mm under the microscope. Also, the same sections for the sunburn cell study were stained by the TUNEL method using the ApopTag In Situ Apoptosis Detection Kit (Oncor, Inc.). RESULTS: The number of sunburn cells increased in a UV-B dosage-dependent. manner up to 300 mJ/cm2. The potency in the reduction of sunburn cell formation was as follows in order,PABA (0.37 +/- 0,5), GSH (0.87 +/- 0.5), ascorbic acid (1.62 +/- 0.85) and tocopherol (1.75 +/- 1.12). However catalase (2.93 +/- 1.56) did not show any protective effect. Also, the finding that sunburn cells were the same as TUNEL-positive cells confirmed the notion that the sunburn cell is a kind of apototic cell. CONCLUSION: A sunburn cell is a kind of apoptotic cell that may be caused by reactive oxygen species induced by UV-B irradiation, in view of the fact that sunburn cell formation was inhibited by the topical application of various antioxidants. But the result that physical protection by PABA has the most potent protective effect in relation to sun damage suggests that protection using a combined physical and biochemical approach is important in the development of new topical agents which will inhibit sundamage to the skin.
4-Aminobenzoic Acid ; Animals ; Antioxidants ; Apoptosis ; Ascorbic Acid ; Catalase ; Ear ; Glutathione ; In Situ Nick-End Labeling ; Keratinocytes ; Mice ; Oxygen ; Reactive Oxygen Species ; Skin ; Solar System ; Sunburn* ; Tocopherols

Basal cell epithelioma is a common neoplasm that rarely metastasizes. The majority of metastatic BCE originates from chronic large, ulcerated tumors which have been refractory to several modalities of therapy. It usually metastasizes to regional lymph nodes, lung, bone, skin and liuer but any other organs may b~e also involved. We report a case of metastatic basal cell carcinoma in a 73-year-old male who had a large ulcerated tumor mass on the left orbital and periorbital area for 13 years. He received radiation therapy 4 years ago, which seemed to cause exaggeration of the ulcerative mass ensuing left side eyeball destruction. About 1 year ago, he first noticed an 1 x 1cm sized hard palpable mass on the left side of neck. Cervicil CT shows 1 x 1cm sized central necrotic tumor mass on the left cervical lymph node. Biopsy specimens taken from the left periorbital area and the left cervical mass revealed typical histopathologic findings of the basal cell carcinoma. The diagnosis of metastatic basal cell carcinoma wa,, finally made on clinical, radiological and histopathological findings. The occurence of MBCC has been reported rarely in Korean literature, so we report, this case of the MBCC of cervical lymph node after radiation therapy.
Aged ; Biopsy ; Carcinoma, Basal Cell* ; Diagnosis ; Humans ; Lung ; Lymph Nodes ; Male ; Neck ; Orbit ; Skin ; Ulcer

Barbiturates* ; Brain* ; Cholesterol* ; Membranes* ; Phospholipids*

Pheochromocytoma is the cause of hypertension in 0.1% of the hypertencive patits, and in 10% of these cases, the tumor is bilateral. Therefore bilateral pheochromocytoma is very rare. The following is a report of the anesthetic methods employed in the surgical management of a case of bilateral pheochromocytoma which was performed in stages at PNUH, between June 4th and June 12, 1986. The staged operation reduced the instability of the vital signs caused by concurrent manipulation of the bilateral pheochromoytoma and facilitated tumor removal.
Hypertension ; Pheochromocytoma* ; Vital Signs

Pheochromocytoma is the cause of hypertension in 0.1% of the hypertencive patits, and in 10% of these cases, the tumor is bilateral. Therefore bilateral pheochromocytoma is very rare. The following is a report of the anesthetic methods employed in the surgical management of a case of bilateral pheochromocytoma which was performed in stages at PNUH, between June 4th and June 12, 1986. The staged operation reduced the instability of the vital signs caused by concurrent manipulation of the bilateral pheochromoytoma and facilitated tumor removal.
Hypertension ; Pheochromocytoma* ; Vital Signs

This study was undertaken to evaluate the result of intensive respiratery care for 36 patients who developed acute respiratory insufficiency and pulmonary comlications after operation in Busan National University Hospital, and to compare the any difference between the survivors and nonsurvivors. The results were as follows : 1) 20 patients survived (55.6%) . 2) In 19 patients(52.8%) , were received prolonged cancer operation and upper abdominal surgery. 3) 30 patients had abnormal physilogic conditions before operation, in which the COPD was the most oommon problems. 4) 55% of aurvirors had mean operation time less than 5 hrs and 75% of non survivers had mean operation time greater than 5 hrs. 5) In 83.3% of patients, acute respiratory Compiication was developed within 10 hours from the opration, 6) Majority of the Patients (25/69.4%) required less than 24 hrs of ventilatory support. 7) 29 patients, receive the PEEP therapy and the level of PEEP was 6~15 cmH2O. 8) The survivors showed fair general conditions during respiratory care, such as normal range of blood preasure, more improved pulmonary function, more improved atterial blood gases and CVP, and adequate hourly urine output. But the nonsurvlvors had poor general conditions, such as unstable blood pressure, poor pulmonary function, abnormal arterial blood gases in spite of ventilatory support, low urine output, high CVP, and elctrolyte i mbalances.
Blood Pressure ; Busan ; Gases ; Humans ; Pulmonary Disease, Chronic Obstructive ; Reference Values ; Respiratory Insufficiency* ; Survivors

After analyzing the electrocardiographic findings during anesthesia, we estimated the difference in the incidence of the operative arrhythmia according to preoperative electrocardiographic findings and compared the influence on the occurrence of the operative arrhythmia according to the type of anesthesia(general and spinal) and major inhalational anesthetics. The results were as follows: 1) On the preanesthetic electrocardiographic findings, the number of patients with only normal rhythm was 15 cases. 2) During anesthesia arrhythmias appeared in 15 patients(305) and the most frquent arrhythymis was premsture ventricular contraction. 3) Between the patients with normal presnesthetic electrocardiographic findings and abnormal electrocardiographic finedings, the incidences of operative arrythmias were not significantly different. 4) Thirty percent of patients developed the arrhythmia both in general and spinal anesthesia. 5) The incidence of arrhythmia in halothane and enflurane aneshtesia was respectively 32% and 28% but the difference was not significant.
Anesthesia* ; Anesthesia, Spinal ; Anesthetics ; Arrhythmias, Cardiac* ; Electrocardiography* ; Enflurane ; Halothane ; Humans ; Incidence

The clinical observation was done on 9 patients of incontinentia pigmenti(I,P.) who were seen at the Department of Dermatology, Chonnam University Hospital from January, 1970 through December, 1982. The incidence of I.P. patients among the population of Chonnam province was higher than 1/142,000 whereas the frequency of I.P. among the outpatients was 0.016% The sex of I.P. patients was all female and there was no cases showing faiailial occurrence. The onset of the cases were within 4 months after birth, 44%, being at birth and 89% being within 2 weeks after birth. The durations of first, second and third stages of I.P. patients were respectively 14 days, 15 days to 2 months, and 2 months to 10 months. The trunk and extremities were involved in 4 cases, and the extremities only were involved in 4 cases while the trunk only was involved in J case. The blood eosinophilia was observed in 2 cases among 7 cases, with their results being 18%, and 11% respectively. The biopsy examinations done in 7 cases at the time of their first visits revealed that 3 cases, 2 cases and 1 case respectively conformed to first, second and third stages with 1 case having first and second stages simu 1taneously. There was no I.P. patient showing the associated congenital abnorma- lity.
Biopsy ; Dermatology ; Eosinophilia ; Extremities ; Female ; Humans ; Incidence ; Incontinentia Pigmenti* ; Jeollanam-do ; Outpatients ; Parturition

Epithelioma cuniculatum or plantar verrucous carcinoma shows a great tendency toward deep penetrating growth, resulting in numerous crypts filled with horny material and pus. We herein described a 44 year-old female who showed a warty, relatively round, brown to yellow colored protruding mass with many crypts filled with pus-like exudates, measuring 2.3 X 2.5 X 1.5 cm in size, and of 5 years duration. The biopsy specimen taken from the tumor mass revealed a deeply penetrating, well-differentiated squarnous cell carcinoma without nuclear anaplasia and individual cell keratinization.
Adult ; Anaplasia ; Biopsy ; Carcinoma* ; Carcinoma, Verrucous ; Exudates and Transudates ; Female ; Humans ; Suppuration