Primary leiomyosarcomas are extremely rare. Its clinical configuration is a round to oval, more or less hemispherical elevation of the skin, but the appearance of these lesion is not distinctive so that the diagnosis is established by the histopathologic findings. Microscopically the cutaneous leiornyosarcomas consist of a poorly delineated proliferation of spindle shaped atypical myomatous cells arranged in interlacing fascicles which merge into collagenous stroma. We experienced a case of primary cutaneous leiornyosarcoma which developed as a hen egg sized tumor on the left shin in a 71-year-old woman and present this case with the review of literatures.
Aged ; Collagen ; Diagnosis ; Female ; Humans ; Leiomyosarcoma* ; Ovum ; Skin

PURPOSE: To analyze the imaging features of brain abscess. MATERIALS AND METHODS: MR studies of nine patients with surgically verified brain abscess were retrospectively reviewed. RESULTS: The shape of abscesses were round(n=6), multilobulated(n=2) or triangular(n=1). All lesions were located in corticomedullary junction and extended into white matter. On gadolinium-DTPA enhanced images, smooth rim-like(n=6) or irregular thick enhancement(n=3) of abscess wall was noted. Budlike projection from the abscess capsule was found in 4 cases. The signal intensity of abscess capsule was either hyperintense (n=5) or isointense(n=4) relative to white matter on Tl-weighted images, and hypointense(n=6), isointense (n=2) or mixed hypo and isointense(n=l) on T2-weighted images. Satellite nodules were found in 2 cases. PNS inflammation(n=2), meningitis(n=1), ventriculitis(=2) and subdural empyema(n=1) were associated CONCLUSION: The MR features of brain abscess included characteristic intensity of abscess capsule, budlike projection from the abscess wall, moderate amount of peripheral edema, satellite nodules, and associated meningitis, ventriculitis or PNS infection. The morphology of abscess wall was not specific for the diagnosis of brain abscess.
Abscess ; Brain Abscess* ; Brain* ; Diagnosis ; Edema ; Humans ; Meningitis ; Retrospective Studies

Vulva syringomas are rare in reviewing literature. In our case, a 29-year-old had multiple papular lesions involving both sides of the vulva. Microscopically the lesion showed dilated cystic sweat ducts some of which have small comma like tails resembling tadpoles. It is the purpose of this report to present a rare case of syringoma which was limited to the vulva without involvement of other sites.
Adult ; Humans ; Larva ; Sweat ; Syringoma* ; Vulva*

No abstract available.
Urokinase-Type Plasminogen Activator*

The malar bones are major determinants of mid-facial shape. In an oriental population, malar prominences are considered an unpleasing and undesirable feature because they give the face a triangular shape and may produce an emaciated and sunken appearance. There are two main operative approaches to malarplasty. One is a coronal approach and the other is a intraoral approach. The former possess advantages of symmetricity, accuracy and superiorly, medially and posteriorly aesthetical transposition of the malar bone. However, it has drawbacks such as a long visible scar on the scalp and extensive operation. Though the latter is a simple method avoiding a visible scar, it has some problems of asymmetricity, cheekdrooping, partial transposition of the malar complex and difficulty of aesthetic transposition. The authors intended to perform intraoral malarplasty for symmetrically aesthetic transposition of the whole malar bone without cheekdrooping. From February 1996 to January 1999, 9 female patients with prominent malar complex, in whom the coronal incision was objectionable, had intraoral malarplasty performed with 2-point fixation after L-shaped osteotomy involving the zygomatic process of maxilla, resulting in symmetric and aesthetically desirable three dimensional transposition of the malar bone.
Cicatrix ; Female ; Humans ; Maxilla* ; Osteotomy ; Scalp ; Zygoma

BACKGROUND: The use of prednisone in the treatment of myasthenia gravis (MG) has been required circumspection because of its tendency to produce exacerbations of weakness in the early stages of treatment, often requiring critical management. However, factors influencing the exacerbation has not been defined well. The purpose of this study was to evaluate the clinical factors predicting the exacerbation by prednisone in the early stage of treatment in MG. METHODS: Fifty five patients, first-ever prescribed high dose prednsone (40-80 mg) during hospitalization in Samsung Medical Center were included. Prednisone induced exacerbation was defined as significant exacerbation of objective neurologic signs of MG within 4 weeks after prednisone addition by utilizing Myasthnia gravis Severity Scale (MSS). We investigate the differences between the exacerbated and nonexacerbated groups in the clinical, laboratory and electrophysiological features. RESULTS: Twenty three patients (42%) experienced definite exacerbation after prednisone treatment. Old age, presence of bulbar symptom, and severe neurologic finding reflected by MSS score were significant predictors of prednisone induced exacerbation in multivariate logistic regression analysis. Higher prednisone dosage per body weight (Kg) was neither a significant predictor of exacerbation nor related with the early improvement in bivariate correlation. CONCLUSIONS: Prednisone induced exacerbation in MG is a frequent challenging problem to clinician. Clinicans should keep in mind the possibility of exacerbation of MG when prescribing prednisone especially, to old, bulbar dominant, severe and disable myasthenic patients.
Body Weight ; Hospitalization ; Humans ; Logistic Models ; Myasthenia Gravis* ; Neurologic Manifestations ; Prednisone

We studied the relationship between dermal mast cell proliferation and pruritus in patients with end stage of renal failure. Skin biopsies were taken from 21 patients undergoing hemodialysis in end stage of renal failure. As a control, 12 pruritic patients without any internai problem were u.d. During the hemodialysis, 13 patient ha<) pruritus. Serum PTH levels were measured by radioimmunoassay. We have thought that the cause of pruritus in patients undergoing hemodialysis is related with dermal mast cell proliferation and a release of histamine. The results were as follows .' 1. Significantly larger numbers of dermal mast cells were found in hemodialysis patients than in the control (p<0.001). 2. Significantly larger mumbers of dermal mast cells were found in prnritic patients than in the non pruritic patients among hemodialysis patients (p<0.01). 3. There was no clear relationship between dermal mast cell proliferation and duration of hemodialysis or seum level of parathyroid hormone.
Biopsy ; Histamine ; Humans ; Mast Cells* ; Parathyroid Hormone ; Pruritus ; Radioimmunoassay ; Renal Dialysis ; Renal Insufficiency* ; Skin

Osteoid Osteoma occurs anywhere in skeleton. They are most common in lower extremity, particularly femur about 40%. Two-thirds of femoral lesions is in the intertrochanter or intracapsular regions of the hip. The lesion is usually cortical and may extend into the periosteal or endosteal surface of the bone. It is rare in the cancellous bone. We experienced a case of osteoid osteoma in intertrochanteric cancellous portion of the femur in 50 year old man. Many complained right hip pain worsend three weeks before his visit. Radiograph shows sclerosis around a lucent nidus in cancellous portion. The lesion did not extend to the endosteal surface. We have removed nidus and surrounding reactive portion completely with curettage. Follow up radiographic results after 20 weeks, showed no evidence of recurrence.
Adult* ; Curettage ; Femur* ; Follow-Up Studies ; Hip ; Humans ; Lower Extremity ; Middle Aged ; Osteoma, Osteoid* ; Recurrence ; Sclerosis ; Skeleton

Injuries to the tarsometatsrsal joint are not common, and the results or treatment are often unsatisfactory. Whatever the severity of the initisl injury, prognosis depends on accurate reduction and its maintenance. 5 cases of fracture and dislocation of the tarsometatarsal joint were treated at Department of Orthopaedic Surgery, Capital Armed Forces General Hospital. The length of follow-up period ranged from 12 months to 18 months, with a mean of 15 months.
Arm ; Dislocations ; Follow-Up Studies ; Hospitals, General ; Joints ; Prognosis

PURPOSE: To evaluate the usefulness of percutaneous catheter drainage (PCD) in patients who have abdominal abscesses or fluid collections. MATERIALS AND METHODS: We performed PCD for 165 abscesses and fluid collections in 148 patients. The follow-up periods in these patients ranged from 15 days to 42 months (mean, 274 days). The lesion sites were subphrenic space in 46 cases, liver in 33, perihepatic space in 20, pancreas or peirpancreatic space in 14, pelvic cavity in 13, and retroperitoneum in 13. We evaluated the success, failure, and recurrence rates, the causes of failure or recurrence, the mean duration of drainage, and the complications of PCD. RESULTS: Of the 165 cases, one hundred-fifty nine(96.5%) were successfully cured, Although a partial success could be achieved, 2(1.2%) cases were failed and 4(2.4%) were recurred. Multiloculation or fistula formation were the main causes of the unsullessful cases. The duration of drainage rainged from 2 to 605 days (mean, 1 days). Complications occured in 12 cases(7%) during or after procedures, which included fever and chill in 7, transgression of pleura in 2, bowel perforation in 2, and bleeding through catheter in 1. CONCLUSION: PCD is an effective and safe method for various abdominal abscesses or fluid collections.
Abdominal Abscess* ; Abscess ; Catheters* ; Drainage* ; Fever ; Fistula ; Follow-Up Studies ; Hemorrhage ; Humans ; Liver ; Pancreas ; Pleura ; Recurrence