Soft tissue expansion technique has been a very useful method for the reconstruction of scalp defects and alopecia since the scalp is an unyielding tissue allowing minimal distension in traditional local flap surgery. As a result, there has been wide use of the tissue expansion method in the reconstruction of scalp defect and treatment of alopecia in the plastic surgery. There have been many concerns about histomorphologic changes of the overlying skin and the underlying structure resulting from tissue expansion. We also know that progressive tissue expansion induces increased mitotic activity of the epidermis and thining of the dermis in the overlying skin, as well as significant gross, histologic bony erosion in the underlying structure. However, little informations have been reported about the changes of the hair and pilocebaceus units in scalp expansion. We compared the horizontal sections of the expanded scalp and its longterm histologic changes with a normal unexpanded scalp specimen as a control. The terminal hair proportions to the vellus hair both increased. There was a 32% decrease in follicular units, a 24% decrease in terminal hair, and a 23% decrease in total hairs 8 week after scalp expansion compared to the normal unexpanded scalp. The perifollicular inflammatory changes and fibrosis observed in the full expanded scalp specimen disappeared within 12 weeks after removal of the expander and the flap transposition. In our observation, tissue expansion at the hair-bearing scalp did not precipitate any adverse changes on the hair follicles. On the contrary, we observed that secondary scalp expasion could be safetly performed 3 months after the first scalp expansion.
Alopecia ; Dermis ; Epidermis ; Fibrosis ; Hair Follicle* ; Hair* ; Humans* ; Scalp* ; Skin ; Surgery, Plastic ; Tissue Expansion*

Purpose: To report a case of both ocular perforation due to periocular acupuncture therapy with vitrectomy in the right eye andbarrier laser photocoagulation without vitrectomy in the left eye.Case summary: A 58-year-old female presented with ocular pain and decreased visual acuity in both eye. She had received periocularacupuncture therapy 4 days earlier. Dilated fundoscopy revealed vitreous hemorrhage. B-scan ultrasonography revealedvitreous opacity. Thus, at the request of the patient, vitrectomy was performed in only the right eye, and did not performed in theleft eye. Intraoperatively, we identified retinal laceration in the temporal and inferior retina. In the left eye, the sites of retinal hemorrhagewere observed in the temporal and inferior retina in the fundus examination, and a barrier laser photocoagulation wasperformed around the lesion. At the three-month postoperative follow-up, the patient’s visual acuity was 0.5 in the right eye withoutmacular edema. In the left eye, visual acuity was 0.01 with macular edema observed on optical coherence tomography. Conclusions Authors present a case of a patient with vitreous hemorrhage and ocular perforations caused by periocular acupuncturetherapy in both eye, able to compare the results of eyes that performed vitrectomy and that did not performed vitrectomyin a same patient. The recovery of visual acuity in eye that performed vitrectomy was better than eye that did not performedvitrectomy. Therefore, we consider performing vitrectomy in patients with eye perforation.

Trichinellosis is a parasitic zoonosis of public health importance. It is caused by Trichinella spiralis which has a wide host range including humans. In the present communication, the ELISA technique was employed on a total of 803 blood samples from 7 selected pig breeding farms in 1996 for diagnosis and surveillance of trichinellosis. Out of the entire 803 samples, nine were found to be suspected while one was positive by ELISA. But western blot analyses employed for further confirmation have shown that all of 10 samples did not react to larval excretory-secretory product antigens. These results indicate that pig breeding farms included in the present study are free from trichinellosis. However, it does not mean Korea is free from trichinellosis since human trichinellosis has recently been reported. The necessity of continued surveillance for trichinellosis in both pigs and wild animals was discussed.
Animals ; *Animals, Domestic ; Antibodies, Helminth/*blood ; Biological Markers/blood ; Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; Human ; Korea/epidemiology ; Swine ; Swine Diseases/*diagnosis/epidemiology ; Trichinella spiralis/*immunology ; Trichinosis/*diagnosis/epidemiology/*veterinary

Eczema herpeticum is a herpes simplex virus infection with disseminated skin involvement superimposed on a pre-existing dermatosis. Dariers disease has been reported to be among the dermatoses susceptible to the sudden onset of a widespread vesicular eruption accompanied by high fever known as Kaposis varicelliform eruption. We report a case of eczema herpeticum in a 46-year-old woman associated with Dariers disease.
Darier Disease* ; Eczema* ; Female ; Fever ; Humans ; Kaposi Varicelliform Eruption* ; Middle Aged ; Simplexvirus ; Skin ; Skin Diseases

The HUMACTBP2 locus was investigated to collect population genetic data in the Korean population and to evaluate the applicability for the forensic field. An Automatic fluorescent-based sequencer (377 automatic DNA sequencer, ABI) was used to detect amplified fragments of the HUMACTBP2 locus electrophoresed on 4% denaturing polyacrylamide sequencing gels. ACTBP2 allelic ladder consisting of different sizes of 18 alleles was constructed and employed as an internal size standard in combination with a GS-350 size standard for precision of allele-band sizing. By utilizing different fluorescent dyes, both the allelic ladders and samples were able to be analyzed in the same lane by 99% orecision of allele-band sizing. Among the Korean population (n=224), 26 alleles in the range of 239-313 bp are determined. allele No. 6 is found 45 times (0.100) which is mostly frequent, and the rest of allele is distributed with their relative frequency of 0.002-0.100. The comparison between observed and expected numbers of homozygous and heterozygous individuals confirms that ACTBP2 locus is in the state of Hardy-Weinberg equilibrium among the Korean population. The heterozygosity is 0.9389+/-0.0034(93.89%), and the power of discrimination(PD) and power of exclusion(PEX) are calculated to be 0.991(99.1%)and 0.890(89.0%), respectively, showing the high informativeness for individual identification. Thus, these results mean that the HUMACTBP2 locus can effectively be used for the forensic application.
Alleles ; DNA ; Fluorescent Dyes ; Gels ; Genetic Variation*

Ancient (degenerated) schwannomas are benign tumors that display pronounced degenerative changes including cyst formation, calcification, hemorrhage, and hyalinization. The tumors are usually infiltrated by large numbers of inflammatory cells such as neutrophils, lymphocytes, siderophages, and histiocytes. They are located in deep locations such as the retroperitoneum and must be differentiated from malignant soft tissue tumors because spindle cells with nuclear atypia may be present in the fine needle aspiration biopsy. The cytologic findings of two cases of ancient schwannoma occurring in posterior mediastinum and retroperitoneum, respectively, are described. Computerized tomographic findings of both cases showed changes of cystic degeneration or necrosis. A case occurred in retroperitoneum revealed features of destruction of vertebral body to suggest a malignant soft tussue tumor radiologically. The cytologic findings of aspiration biopsy of both tumors revealed that the tumor cells were spindle in shape with elongated nuclei. Some of tumor cells were arranged in a palisading fashion. Cell structures that resemble the Verocay bodies were observed. Some of the tumor cells showed pleomorphic bizarre nuclei, but no mitotic activity or chromatin clumping was seen. Inflammatory cells, siderophages and histiocytes were scattered in fibrillar material. These cytologic findings are important in the diagnosis of ancient schwannoma and in the differentiation of this tumor from the malignant spindle cell tumor.
Biopsy* ; Biopsy, Fine-Needle* ; Biopsy, Needle ; Chromatin ; Diagnosis ; Hemorrhage ; Histiocytes ; Hyalin ; Lymphocytes ; Mediastinum ; Necrosis ; Neurilemmoma* ; Neutrophils

Eosinophilic granuloma of the cervical spine is an uncommon disease. A 20-year old male patient noticed cervical pain, restricted range of movement, torticollis and tenderness. On computed tomographic scan, myelographic imaging and plain radiographic imaging demonstated a bony destruction in the left side of the third cervical vertebral body and a part of the pedicle. Preoperative radioisotope bone scan demonstrated an hot uptake in the third cervical vertebral body. Gross total removal of the lesion and radiation therapy were performed. Postoperative course was favorable. The lesion is readily curable and should be considered in the diferential diagnosis of pain or neurological deficit in association with a lytic defect in the cervical spine. Occasionally, a solitary lesion characteristic of eosinophillic granuloma in found in cases of otherwise classic Hand-Schuller-Christian. So, close chinical and radiologic follow-up sholuld be obtained.
Diagnosis ; Eosinophilic Granuloma* ; Eosinophils* ; Follow-Up Studies ; Granuloma ; Humans ; Male ; Neck Pain ; Spine* ; Torticollis ; Young Adult

BACKGROUND: Erythema multiforme is an inflammatory disorder of the skin which may be characterized by erythematous papules, plaques, vesicles, and 'target-like' annular lesions. Mucosal lesions may occur. Symmetric irivolvement of the extrernities, especially the dorsurn of the hands and feet, and face is the classic pattern of cutaneous distribution. Palmoplantar lesions of erythema multiforme are relatively uricornmon. OBJECTIVE: Our purpose was to investigate the clinical and histopathological characteristics of erythema multiforme involving the palm and sole. METHODS: Thirty one cases of erythema multiforme involving the palm and sole, and thirty cases involving other sites wer collected and analysed with particular reference to epidemiological data, type and distribution of the skin lesion and histopathological characteristics. RESULTS: 1. The median ages of both groups were the early thirties. There were no sexual predominances. 2. The clinical features of erythema multiforme involving the palm and sole were relatively mild and showed atypical skin lesions including macules and papules compared with erythema multiforme involving the other sites. 3. The histopathological changes of the palmoplantar group were also mild, especially the epidermal changes which included keratinocytes necrosis, subepidermal blisters, focal parakeratosis, extensive epidermal necrosis and xocytosis etc. 4. The most important and consistent histopathological finding of the palmoplantar erythema multiforme group was lymphocyte tagging along the basernent membrane, which was found consistently apart from one case. CONCLUSION: We investigated the clinical and histopathological features of erythema multiforme involving the palm and sole. They showed mild clinical features and atypical skin lesions cornpared with other group. The histopathological spectrum of this group was diverse, and reflected the early stage of pathomecha nisms of erythema multiforme. Among them, lyrnphocyte tagging was the most important and censistent finding in palmoplantar erythema multiforme.
Blister ; Erythema Multiforme* ; Erythema* ; Foot ; Hand ; Keratinocytes ; Lymphocytes ; Membranes ; Necrosis ; Parakeratosis ; Skin

The laparoscopic cholecystectomy has been rapidly accepted as the standard treatment for gallbladder stones because its minimally invasive nature offers a significant advantage over an open cholecystectomy in terms of postoperative morbidity & recovery. The endoscopic sphinterotomy has become the primary treatment for common bile duct stones, yielding a duct clearance rate of approximately 90%. The laparoscopic cholecystectomy combined with the preoperative endoscopic sphinterotomy is becoming more widely employed as a therapeutic option for the management of gallbladder stones & common bile-duct stones. The authors retrospectively analyzed 71 patients who had been treated by an open cholecystectomy and a common bile-duct exploration (group A) and 35 patients who had been treated by a laparoscopic cholecystectomy plus endoscopic sphinterotomy (group B) at the Department of Surgery, Jungang Gil Hospital, from March 1993 to January 1996. The diagnotic procedures performed were ultrasonography ERC and DISIDA scan, and abdominal computed tomography. Intraoperative cholangiograms were successfully performed in 59 cases from group A and in 5 cases from group B. Successful duct clearance was achieved in 87.3% of the group A cases and in 87.5% of the group B cases. The operation time, the postoperative hospital stay, and postoperative complications were significantly lower for group B than for group A. The major postoperative complication was wound pain & infection for both groups. We conclude that in comparison with group A, group B appeared to have a similar clearance rate, a much lower morbidity, a shorter hospital stay, an earlier return to working fitness, and a better cosmetic result.
Cholecystectomy ; Cholecystectomy, Laparoscopic ; Choledocholithiasis* ; Cholelithiasis* ; Common Bile Duct ; Gallbladder ; Humans ; Length of Stay ; Postoperative Complications ; Retrospective Studies ; Return to Work ; Ultrasonography ; Wounds and Injuries

We describe a case of fine needle aspiration cytologyof renal angiomyolipoma which was not associated with the clinical complex of tuberous sclerosis and was incidentally found. It was a solitary lesion and the clinical impression before needle aspiration was renal cell carcinoma. The aspirated specimen showed mature fat cells, clusters of renal tubular epithelial cells and sheets of pleomorphic smooth muscle cells with fibrillary cytoplasm. The nuclei of smooth muscle cells varied in size and shape. Since the treatment of renal angiomyolipoma differs from that of renal cell carcinoma, the preoperative cytological diagnosis is of great value.
Adipocytes ; Angiomyolipoma* ; Biopsy, Fine-Needle* ; Carcinoma, Renal Cell ; Cytoplasm ; Diagnosis ; Epithelial Cells ; Kidney ; Myocytes, Smooth Muscle ; Needles ; Tuberous Sclerosis