Epidermal cysts may develop on any part of the body. Most of them are thought to occur following inflammation of the epithelium of the hair follicle. These found on the palm and sole where the hair follicle is absent have been considered to developmant of following a traumatic inclusion of the epidermis into the Dermis. Because only a few cases w re known to be related to preceding trauma, the latter assumption has been questioned. Reerly, the HPV-like virions and papillomavirus genus-speciric antigen were detected in the epicrml cyst of the sole in some reports. 1 our cases of plantar epidermal cyst were studied for the presence of human papillomavirus using conventional histologic and immunohistochemical examinator Histologic examination showed three characteristic findings, that is, intracytoplasmic eosinophil odies in the cyst wall, parakeratosis within the cyst caviti, and vacuolar structures disperse the wall and cavity. In all of the cases, immunohistochernical staining was positive for papule evirus antigen. These findings suggest an etiologic as.iation between the papillomavirus infection and plantar epidermal cyst.
Dermis ; Eosinophils ; Epidermal Cyst* ; Epidermis ; Epithelium ; Hair Follicle ; Humans* ; Inflammation ; Papilloma* ; Papillomavirus Infections ; Parakeratosis ; Virion

Reconstruction of soft tissue defect with exposure of the tendons and bone in the lower third of the leg and the heel represents a challenge to plastic surgeons. The sural artery flap is a fasciocutaneous flap supplied by the sural artery that accompanies the sural nerve and connects with a septocutaneous perforator of the peroneal artery via a suprafascial network of vessels. For the coverage of soft tissue defects, we operated on 10 patients using a distally-based sural artery flap. The sites of the soft tissue defect were the lower third of the leg in 7 cases and the heel in 3 cases. The size of flap varied from 3.5x4cm to 12x18cm. Nine of 10 flaps survived completely. One flap in which the sural nerve was preserved showed partial necrosis but healed spontaneously. Two flaps showed slightly venous congestion which disappeared after a few days. The advantages of the sural flap are a reliable blood supply, easy and quick elevation of the flap, preservation of the major artery and minimal donor site morbidity. The disadvantage of the flap is hypoesthesia at the lateral part of the foot. In conclusion, the distally-based sural artery flap can be used safely for soft tissues coverage in the lower third of the leg and the heel.
Arteries* ; Foot ; Heel ; Humans ; Hyperemia ; Hypesthesia ; Leg ; Necrosis ; Sural Nerve ; Tendons ; Tissue Donors

Bone graft is an important procedure in craniomaxillofacial reconstruction and the success of reconstruction depends on the survival of the grafted bone. In this study, the survival of the membranous inlay bone graft on the mandibles of dogs was investigated with bone scan and histologic examination. The inlay bone graft, 1x2cm critical-sized bone, was completely separated from the lower border of the mandible of dogs and then refixed to the original site. Bone scan and histologic examination were done at 1,2,3 and 4 weeks postoperatively. The bone scan after 1 week showed radioisotope uptake on the margin of the grafted bone and the isotope count was 21% compared to the uptake of the normal bone. After 2 weeks, the radioisotope uptake in the grafted bone increased to 52% of normal bone uptake. After 3 and 4 weeks, the degree of isotope uptake was 111% and 124% respectively. Histological findings after 1 week showed the absence of osteoblastic activity and 6 viable blood vessels in one 200X magnified field, which was 25% compared to the vessels of the normal bone. After 2 weeks, osteoblastic activities were noted and the number of viable blood vessels totalled 15, which was 63% of the vessels of the normal bone. After 3 weeks, osteoblastic activities increased and the number of viable blood vessels totalled 21, which was 88% of the vessels of the normal bone. After 4 weeks, there were markedly increased osteoblastic activities with a total number of 23 vessels, which was 96% of the normal bone. In summary, the revascularization of the membranous inlay bone graft began from the first week after bone graft, and then it gradually increased. After 3 weeks, the revascularization had returned to a nearly normal value compared with the value of the near-by normal mandibular bone.
Animals ; Blood Vessels ; Dogs ; Inlays* ; Mandible* ; Osteoblasts ; Reference Values ; Transplants*

BACKGROUND: To date, a laparoscopic gastrectomy has been performed by a small number of surgeons around the world, but the laparoscopic approach has been extended to Billroth I and a total gastrectomy. To evaluate the validity of the procedure, we present the results of six patients who underwent a gastrectomy using a laparoscopic technique. METHODS: First, two patients had a totally intra-abdominal laparoscopic B-II gastrectomy, and one of two also had a bilateral truncal vagotomy. The rest had a laparoscopic-assisted gastrectomy. One patient had concurrently an open reduction and an internal fixation with a K-wire for a patellar fracture. Indications were (a) gastric outlet obstruction due to peptic ulcer disease in five patients and (b) duodenal ulcer bleeding in one patient. RESULTS: Except for one patient who had stump leakage, which was solved by conservative therapy, there were no complications or operative mortality. The operating time and the cost were less for the patients who had their operations later in the series and who had laparoscopic-assisted operation. CONCLUSIONS: These forms of laparoscopic gastric surgery for patients with complications of peptic ulcer disease may be useful from the standpoint of minimal access, rapid recovery, less pain, and good cosmesis.
Duodenal Ulcer ; Gastrectomy* ; Gastric Outlet Obstruction ; Gastroenterostomy ; Hemorrhage ; Humans ; Mortality ; Peptic Ulcer ; Stomach Diseases* ; Vagotomy, Truncal

Two cases of malignant histiocytosis, in which skin involvement was a prominent finding at initial clinical presentation, are reported. 1nteresting histopathologic findings, including Langerhans granule in one case and numerous eosinophils in another, were observed. In one case remission was achieved with BACOP chemotherapy (Bleomycin, Adriamycin, Cyclophosphamide, Vincristine, and Prednisone). In the other case, the patient died nine months after the onset of the disease without any treatment.
Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Eosinophils ; Histiocytic Sarcoma* ; Humans ; Skin ; Vincristine

BACKGROUND: To report the radiological and clinical outcomes of internal fixation using distal clavicle hook plates for distal clavicle fractures. METHODS: From April 2008 to December 2012, 32 patients with distal clavicle fractures underwent surgery using an AO hook plate. The reduction was qualified and evaluated according to the radiological findings. The evaluation of the clinical outcomes was performed with the University of California at Los Angeles (UCLA) score, the Korean Shoulder score, and the visual analogue scale (VAS) pain score. RESULTS: By radiological evaluation, we found that 31 of 32 patients showed anatomical reduction and solid bone union. Although we obtained satisfactory UCLA scores, Korean Shoulder Scale scores, and VAS pain scores, 12 cases of complications were present. We found 4 cases of osteolysis of the acromion, 1 case of nonunion, 3 cases of periprosthetic fractures, 3 cases of subacromial pain, and 1 case of skin irritation. We performed re-operations in 2 patients. CONCLUSIONS: To avoid complications associated with clavicle hook plates, choosing the appropriate hook size and bending of the hook according to the slope of the acromion undersurface is critical. Also, we believe that early removal of clavicle plates may help reduce complications.
Acromion ; California ; Clavicle* ; Humans ; Osteolysis ; Periprosthetic Fractures ; Shoulder ; Skin

In order to evaluate the genotoxic hazard among workers potentially exposed to low level petrochemical substances, the analyses of micronuclei (MN) and sister chromatid exchanges (SCEs) in lymphocytes were performed in 46 male workers (as exposed group) and 46 nonexposed subjects (as control group). Mean frequencies of MN and SCEs (respectively, 12.9/1000 cells and 6.5/cell) in exposed group were very significantly higher than those (10.2/1000 cells and 5.4/cell) in control group. And there were also significant differences in mean frequencies of MN and SCEs adjusted for age, employment duration, smoking, and drinking between two groups. Median frequencies of MN and SCEs in exposed group were very significantly higher than those in control group. Frequencies of SCEs were higher in smokers than in non-smoker. Frequencies of MN in smokers, however, were similiar to those of non-smoker. Interaction between exposure and smoking on MN and SCEs induction was not observed. The results suggest that there is genotoxic hazard in high risk group like workers handling carcinogens in petrochemical plants and the analyses of MN and SCEs are useful biomarkers for the exposure to hazard substances even at the level below the exposure limit.
Biological Markers ; Carcinogens ; Drinking ; Employment ; Humans ; Lymphocytes ; Male ; Sister Chromatid Exchange ; Smoke ; Smoking

The purpose of this study was to investigate the possibility of distraction osteogenesis in membranous onlay bone graft on the mandible and to clarify the histology of bone repair during distraction osteogenesis in the membranous onlay bone in a dog model. Four dogs, 5 months of age at the beginning of the experiment, were used for this study. The zygomatic arch was exposed in the subperiosteal plane and the full-thickness zygomatic arch was harvested to 3 centimeters in length. The lateral surface of the mandibular body was exposed in the subperiosteal plane and the membranous onlay bone graft was performed with firm contact using screws. The osteotomy on the membranous onlay bone graft and underlying mandibular body was carried down week 1 in dog 1, week 2 in dog 2, week 3 in dog 3, and week 4 in dog 4 after membranous onlay bone graft. The external distraction device was applied to the mandibular body. Mandibular distraction was started 7 days after the operation at a rate of 1mm per day for a total of 10 mm distraction over 10 days. After completion of distraction, the distraction device was left in place for 6 weeks bony consolidation of the distracted area. Radiographs were carried out at 2 weeks, 4 weeks and 6 weeks after distraction. New bone between the native underlying mandibular segments was generated in the distracted zone in all dogs. The new bone between the native underlying mandibular segments was generated in the distracted zone in all dogs. The new bone between segments of membranous onlay bone graft was not generated in dog 1, but it was generated in dogs 2, 3 and 4. However, in dog 2 and 3, the new bone between segments of the distracted membranous onlay bone graft presented less firmness with fibrous tissue than that of the native underlying mandibular segment. Histologically, the distracted gap between segments of the membranous onlay bone graft was composed of much fibrous tissue in the central zone while activated osteoblastic cells formed new bone in the margins of the distracted gap in dogs 2 and 3. In dog 4, there were abundant osteoblastic activities in the distracted gap and the new bone appeared as nearly-normal cortical bone. In conclusion, these findings suggested that membranous onlay bone graft had an osteogenic capacity and that distraction osteogenesis was possible in membranous onlay bone graft.
Animals ; Dogs* ; Inlays* ; Mandible ; Osteoblasts ; Osteogenesis, Distraction* ; Osteotomy ; Transplants* ; Zygoma

No abstract available.
Infectious Mononucleosis*

Sudoriparous angioma is an unusual form of angioma with pain and hyperhidrosis. We present two cases of typical sudoriparous angioma. Case 1: 9-year-old female showed 0. 8 to 2. 0cm multiple dark brownish tender palpable hypertrichotic masses on the right lower leg after birth. Muscular atrophy and flexion contracture was also developed on the right lower leg for 2 years. Case 2: 4-year-old rnale showed 3 * 3cm tender elevated mass on the left shin after birth. Marked hyperhidrosis was developed when even slight pressure applied on the lesion in these cases. On histologic examination, these two cases showed proliferation of varible sized blood veasels hyperplasia and dilated hyperplastic eccrine glandular and ectopic adipose tissue on the mid and deep dermis. Muscular biopsy from case 1 showed fibrotic and degenerative change. Electromicroscopic examination done from case 1. The secretory epithelial cell of eccrine gland showed cytoplastic degradation and slight dilated intercellular canaliculi (Fig. 11). The lumen of subepithelial capillaries were dilated and some of endothelial cells showed degenerative changes evidenced by RER dilation, mitochondrial swelling and detachment from underlying tissue(Fig. l2). The cutaneous nerve showed many non-myelinated axons enclosed in cytoplasm of Schwann cells.
Adipose Tissue ; Axons ; Biopsy ; Capillaries ; Child ; Child, Preschool ; Contracture ; Cytoplasm ; Dermis ; Eccrine Glands ; Endothelial Cells ; Epithelial Cells ; Female ; Hemangioma* ; Humans ; Hyperhidrosis ; Hyperplasia ; Leg ; Mitochondrial Swelling ; Muscular Atrophy ; Parturition ; Schwann Cells