We report a case of Becker's nevus associated with smooth muscle hamartoma, in a 21-year-old male patient, which shows clinically match-head sized, flat topped, round to oval, grouped papules with hairs on the outer surface of the right arm, and microscopically reveals numerous bundles of smooth muscle fiber in the dermis.
Arm ; Dermis ; Hair ; Hamartoma* ; Humans ; Male ; Muscle, Smooth* ; Nevus* ; Young Adult

OBJECTIVE: Distance between the active and reference electrodes can affect the waveform configuration and amplitude of sensory nerve action potential (SNAP). This study was purposed to determine the change of SNAP parameters with varying interelectrode distance. METHOD: Median sensory nerve conduction study was performed in the middle finger of 40 young healthy subjects by antidromic method. To ensure firm contact with skin, strip adhesive electrode was used for recording responses. The active electrode was fixed on 1 cm distal to the proximal flexion crease of middle finger and interelectrode separation was increased from 1 to 5 cm by 1.0 cm increments. Bar electrode was fixed 14 cm proximal from active electrode for stimulation in the wrist area. RESULTS: As the interelectrode distance increased from 1 cm to 5 cm, onset latency remained unchanged. The peak latency increased with increasing the distance up to 3 cm but didn't change beyond 3 cm (1 cm: 2.89 0.89 msec, 2 cm: 2.97 0.89 msec, 3 cm: 3.02 0.19 msec, 4 cm: 3.02 0.19 msec, 5 cm: 3.02 0.20 msec). Base-to-peak amplitude significantly increased only up to 3 cm (1 cm: 30.3 6.7 microvolt, 2 cm: 43.7 8.6 microvolt, 3 cm: 50.8 10.4 microvolt, 4 cm: 51.1 10.9 microvolt, 5c m: 51.3 11.4 microvolt) but peak-to-peak amplitude sequentially increased to 5 cm (1 cm: 49.6 12.1 microvolt, 2 cm: 72.8 14.4 microvolt, 3 cm: 83.6 19.4 microvolt, 4 cm: 91.3 22.5 microvolt, 5 cm: 93.4 23.9 microvolt)(p<.05). CONCLUSION: This study showed that changing interelectrode distance altered some parameters of SNAP, especially the peak-to peak amplitude.
Action Potentials* ; Adhesives ; Electrodes ; Fingers ; Neural Conduction ; Skin ; Wrist

Kasabach-Merritt phenomenon does not occur with common hemangioma, rather it is associated with the more aggressive Kaposiform hemangioendothelioma and rarely with other vascular neoplasm. We report the case of an adult who was diagnosed as Kaposiform hemangioendothelioma complicated by Kasabach-Memtt phenomenon. This is the first report in Korea of an adult with Kasabach-Merritt phenomenon who has osteolytic changes of femur, pelvic bone, and lumbar spine.
Adult* ; Femur ; Hemangioendothelioma* ; Hemangioma ; Humans ; Kasabach-Merritt Syndrome ; Korea ; Pelvic Bones ; Spine ; Vascular Neoplasms

PURPOSE: To report a case of bilateral Coats' disease. CASE SUMMARY: A 19-month-old boy presented with esodeviation of his eyes, which started 5 months prior. A fundus exam showed total bullous exudative retinal detachment with retinal vascular telangiectasia in the right eye and localized exudative retinal detachment with vascular telangiectasia at the inferior periphery in the right eye. Fluorescein angiogram of the left eye showed retinal telangiectatic vessels, avascular area and fluorescein leakeage from telangiectatic vessels. The patient received external drainage of subretinal fluid and intravitreal air injection of the right eye and Argon LASER photocoagulation and cryotheraphy of the left eye. A cytologic exam of the subretinal fluid drained from the right eye showed no malignant cells. Forty-four months after the operation, his best corrected visual acuity was no light perception in the right eye and 0.4 in the left eye. Both fundi were flat and stable. No complications, such as glaucoma, recurred retinal detachment, or pain, occurred. CONCLUSIONS: Coats' disease rarely occurs bilaterally and can be involved asymmetrically. The disease presents more severely when bilateral and can progress after long-term observation. Proper treatment and long-term follow-up of both eyes are necessary to prevent visual loss and preserve eyes.
Argon ; Drainage ; Esotropia ; Eye ; Fluorescein ; Follow-Up Studies ; Glaucoma ; Humans ; Infant ; Light ; Light Coagulation ; Retinal Detachment ; Retinaldehyde ; Subretinal Fluid ; Telangiectasis ; Visual Acuity

PURPOSE: In spite of curative surgery and early postoperative intraperitoneal chemotherapy, the prognosis of patients with gastric cancer involving the serosal surface is poor. The aim of this study was to analyze p53 protein overexpression in these patients and to clarify the usefulness of p53 mutation as a prognostic indicator. METHODS: p53 protein overexpression was assessed by immunohistochemistry in 123 gastric cancer specimens. The correlation between p53 protein overexpression and clinicopathologic parameters and prognosis of the patients were analyzed. RESULTS: Overexpression of p53 protein was identified in 67 (54.5%) tumors and was more frequent in differentiated tumors than in undifferentiated tumors (67.4% vs. 46.8%; P=0.026). However, there were no statistically significant differences in the frequency of p53 protein overexpression according to age, sex, depth of invasion, lymph node metastasis, distant metastasis, pathologic stage, and Lauren classification. There was no statistically significant difference in 5-year survival rate according to the p53 protein overexpression (P=0.565). CONCLUSION: Overexpression of p53 protein could not predict the effectiveness of early postoperative intraperitoneal chemotherapy. Therefore, it could not be used as a prognostic indicator in patients with advanced gastric cancer who underwent gastrectomy and early postoperative intraperitoneal chemotherapy.
Gastrectomy ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Stomach Neoplasms ; Survival Rate ; Tumor Suppressor Protein p53

We report a case of a 19-year-old female with an elevated plasma B-type natriuretic peptide (BNP) level, but without evidence of heart failure (HF). She presented with non-specific chest pain and a high level of the B-type natriuretic peptide, despite having unremarkable findings on physical examination, laboratory analysis, electrocardiogram, echocardiogram, chest X-ray, chest computed tomography, whole body scan, and coronary angiography. We attribute this finding to a genetic variation in the synthesis and cleavage of the natriuretic peptides.
Chest Pain ; Coronary Angiography ; Electrocardiography ; Female ; Genetic Variation ; Heart ; Heart Failure ; Humans ; Natriuretic Peptide, Brain ; Natriuretic Peptides ; Physical Examination ; Plasma ; Thorax ; Whole Body Imaging ; Young Adult

BACKGROUND: we have evaluated the association of age, smoking, type of anesthesia, type of operation, duration of surgery, previous history of chronic pulmonary diseases with postoperative pulmonary complications and identified which parameter of preoperative spirometry was a predictor of postoperative pulmonary complications. METHOD: In 270 patients older than 60 years, the postoperative pulmonary complications were evaluated according to age, smoking, type of anesthesia, type of operation, duration of surgery, previous history of chronic pulmonary diseases and the parameters of preoperative spirometry were analyzed. RESULTS: The postoperative pulmonary complications rates were significant higher among patients older than 70 years, and among those with previous chronic pulmonary diseases or their smoking history. The pulmonary complications were increased among patients with general anesthesia or duration of surgery more than 2 hours. The pulmonary complications rates did not differ according to sex, type of operation. The patients with hypercarbia(PaCO2> 45mmHg) have more increased postoperative complications. The preoperative FEVl less than 1 liter, FVC, MMEFR & MVV less than 50% of predicted respectively were predictive of complications. CONCLUSION: Age 70, history of smoking,duration of operation more than 2 hours, general anesthesia, previous chronic pulmonary disease and hypercarbia (> or=45mmHg) on preoperative arterial blood gas analysis were predictivd of pulmonary complications. Among the parameters of spirometry, FEV1, FVC, MMEFR and MVV were indicator of predicting postoperative pulmonary complications.
Aged* ; Anesthesia ; Anesthesia, General ; Blood Gas Analysis ; Humans ; Lung Diseases ; Postoperative Complications ; Smoke ; Smoking ; Spirometry

The purpose of this study was to analyze and evaluate therapeutic results of stereotactic evacuation of hematoma, urokinase irrigation and external ventricular drainage(EVD) in comatose patients who had hypertensive supratentorial intracerebral hemorrhage. The authors carried out stereotactic evacuation of hematoma and external ventricular drainage in the consecutive 45 cases who were admitted to the Department of Neurosurgery, Chosun University Hospital. from Sep. 1990 to Jun. 1993. The therapeutic results were as follows : 1) The peak age incidences were 6th to 7th decades. The incidence was higher in female than male. The age was not related to the prognosis. 2) The hematoma was located at the basal ganglia in 37 cases, and the thalamic area in 8 cases. The prognosis was poorer as the area of hematoma extended more wider and deeper. 3) The volume of hematoma ranged from 8 to 155 ml. The prognosis of the patient was unfavorable in large volume of hematoma. 4) Intraventricular hemorrhage(IVH) occured in forty cases(89.9%) and mortality rate was 45%. The mortality rate was increased in cases with IVH than in case without it. 5) The mortality rates based on the Glasgow coma scale(GCS) on admission were 50% in GCS score 4 group, 50% in GCS score 5 group, 40% in GCS score 6 group, 27% in GCS score 7 group. Cases of low Glasgow coma scale on admission showed high mortality rate. 6) The overall mortality rate was 42%. These results suggest that stereotactic evacuation of hematoma and EVD decreased the mortality rate when compared with conservative treatment and conventional craniotomy in the literatures.
Basal Ganglia ; Cerebral Hemorrhage* ; Coma* ; Craniotomy ; Drainage* ; Female ; Glasgow Coma Scale ; Hematoma* ; Humans ; Incidence ; Intracranial Hemorrhage, Hypertensive ; Male ; Mortality ; Neurosurgery ; Prognosis ; Urokinase-Type Plasminogen Activator

Among the 98 patients who underwent operations for thoracolumbar spinal lesions from May 1989 to September 1994, the authors performed clinical analysis of 72 patients who were followed-up for more than 12 months. There were 52 cases of trauma, 18 cases of tuberculous spondylitis, and 2 cases of metastatic tumor. After partial or toal vertebrectomy, interbody fusion was performed using autogenous iliac bone or autogenous ribs which were taken while approaching the thoracic spine, and stabilized using Kaneda devices. Complete neural decompression was possible under direct vision in all cases. Neurologic deficits improved to an average of 1.7 grades using a modified Frankel scale. Patients with tuberculous spondylitis did not show recurrence or any evidence of increased risk of secondary infection caused by instrumentation. Loosening or breakdown of instruments occurred in 4 patients, and spinal deformity in 7 patients, but reoperation was not needed in any of these patients. By anterior decompression, interbody fusion and stabilization using Kaneda device in thoracolumbar spinal lesions, we could obtain satisfactory neurologic improvement as well as immediate firm stability and high fusion rate involving only a minimum(usually two) number of motion segments as compared with the posterior approach.
Coinfection ; Congenital Abnormalities ; Decompression ; Humans ; Neurologic Manifestations ; Recurrence ; Reoperation ; Ribs ; Spine ; Spondylitis

Infantile acne is a much less common disease than adolescent and postadolescent acne. It occurs in children approximately at 3 to 6 months of age. An 8 month-old male infant, accompanied by his mother, visited our clinic with a history of erythematous skin lesions on both cheeks, which started 5 months ago. Physical examination revealed closed comedones, several relatively well demarcated, erythematous papules, nodules and pustules. Inflammatory lesions left scars scattered over the face. For further evaluation of endocrinologic abnormalities or other systemic diseases, an additional abdominal ultrasound was done after a visit to the pediatrician. A skin biopsy revealed findings compatible with acne. Skin lesions were improved by treatment with oral and topical antibiotics, adapalene and isotretinoin. We report herein a case of infantile acne which has not been reported in Korean dermatological literature.
Acne Vulgaris* ; Adolescent ; Anti-Bacterial Agents ; Biopsy ; Cheek ; Child ; Cicatrix ; Humans ; Infant ; Isotretinoin ; Male ; Mothers ; Physical Examination ; Skin ; Ultrasonography ; Adapalene