Trichilemmal carcinoma is a rare tumor that is located predominantly on sun-exposed skin of the elderly. It is thought to be related to the external root sheath of the hair follicle and the malignant counterpart of a trichilemmoma. We report a case of trichilemmal carcinoma in a 88-year-old woman who had a 10 year history of a single, dark brown tumor on the right preauricular region. In her past medical history, it had been excised twice at a private clinic without a histopathological evaluation and recurred 2 years later. Histopathological findings showed atypical clear cells resembling those of the outer root sheath. Tumor cells showed PAS-positive cytoplasm. Immunohistochemistry revealed positive high molecular weight cytokeratin expression. To our knowledge, this is the second case of trichilemmal carcinoma in the Korean literature. (Ann Dermatol 100) 175178, 1998).
Aged ; Aged, 80 and over ; Cytoplasm ; Female ; Hair Follicle ; Humans ; Immunohistochemistry ; Keratins ; Molecular Weight ; Skin

We report two cases of linear focal elastosis. They are a 16-year-old girl and a 14-year-old boy who had had asymptomatic, several, yellow-red, slightly elevated, palpable, striae-like lesions on their middle and lower back since their early childhood. Light microscopic examinations of skin biopsy specimens demonstrated dermal thickening and focal increases of thin wavy fibers in the upper and mid-dermis but no changes in the epidermis. Verhoeff-van Gieson stains for elastic fiber revealed aggregated, clumped, curled, or fragmented elastic fibers.
Adolescent ; Biopsy ; Coloring Agents ; Elastic Tissue ; Epidermis ; Female ; Humans ; Male ; Skin

BACKGROUND: Cellulitis is a suppurative inflammation involving particularly the subcutaneous tissue. There has been no data about its clinicopathologic features in Korea. OBJECTIVES: The purpose of this study was to investigate the clinicopathologic characteristics of cellulitis and to assess the yield rate of special stainings (Brown-Brenn, Gram) for organisms. METHODS: We reviewed the medical records and histologic sections of 45 patients who had been diagnosed as cellulitis in the Department of Dermatology, Chungbuk National University Hospital from January 1992 to August 1998. RESULTS: The results were as follows. 1. The sex ratio of male to female was 1.5:1 and average age was 43 years old. 2. The lower extremity was the most frequently involved site of cellulitis with a frequency of 53.4%. 3. Erythema, tenderness, local heating, swelling, and pain were almost always presenting clinical manifestations. 4. Diabetes mellitus was the most frequent underlying systemic disease. 5. The route of infection was suspected in 25 cases(55.6%). Tinea pedis was strongly suspected in 7 cases(28.0%), and followed by insect bite in 5 cases(20.0%), herpes zoster in 4 cases(16.0%), and trauma in 2 cases(8.0%). 6. The main complications were orthopedic problems including bursitis, osteomyelitis, and septic arthritis. 7. Microorganisms were isolated in 20 of 43 tissue cultures(46.5%). 8. It is important to suspect Escherichia coli as a causative organism if blistering cellulitis occurs, especially in patients with underlying systemic disease. 9. The most frequent histopathologic findings were perivascular lymphohistiocytic infiltrations in both dermis and subcutaneous fat simultaneously without vasculitis. 10. Special stainings(Brown-Brenn or Gram) were worthy to try, especially in the neutrophilic dominant cellulitis. 11. First-generation cephalosporin was chosen as primary antibiotics in 31 cases, and there was no difference in clinical course between its monotherapy and combined therapy. 12. Twenty percent of cases experienced recurrences. Lower extremity was most common site of recurrence(63.6%). CONCLUSION: Diabetes mellitus and tinea pedis were so closely bound up with cellulitis that control of those diseases is important in view of the clinical course of cellulitis. Special stainings(Brown-Brenn or Gram) were worthy to try, especially in the neutrophilic dominant cellulitis.
Adult ; Anti-Bacterial Agents ; Arthritis, Infectious ; Blister ; Bursitis ; Cellulitis* ; Chungcheongbuk-do ; Dermatology ; Dermis ; Diabetes Mellitus ; Erythema ; Escherichia coli ; Female ; Heating ; Herpes Zoster ; Hot Temperature ; Humans ; Inflammation ; Insect Bites and Stings ; Korea ; Lower Extremity ; Male ; Medical Records ; Neutrophils ; Orthopedics ; Osteomyelitis ; Recurrence ; Sex Ratio ; Subcutaneous Fat ; Subcutaneous Tissue ; Tinea Pedis ; Vasculitis

BACKGROUND: Since up to 90% of a theophylline dose is biotransformed, probably by interaction with one or more the variants of the cytochrome P-450 drug metabolism system, anti-tuberculosis agents including drugs influencing microsomal enzyme systems, such as isoniazid and rifampicin, may be affect the elimination of theophylline. METHODS: The effect of combination therapy with isoniazid(INH), rifampicin(RFP), ethambutol(EMB) and pyrazinamide(PZA) on the pharmacokinetics of theophylline was evaluated by a computer program using Bayesian method. Three group were divided as follows. Group lis control, Group II is treated with INH, RFP, EMB and PZA and Group lll is treated with INH, RFP and EMB. All of them were non-smoker who were normal in liver and renal functions, and not administered drugs affecting on the clearance of theophylline with exception of anti-tuberculous agents. RESULTS: When it compared control with test groups, the clearance of theophylline in Group ll and Group lll was significantly decreased(p<0.001), and half life in Group ll and Group lll showed significant elevation(p<0.001). However there were no significant differences in clearance and half life between the Group ll and Group lll. CONCLUSION: These results suggest that theophylline dose may be need of readjustment in concurrent medica fion of anti-tuberculous agents including INH, RFP, and EMB.
Bayes Theorem ; Cytochrome P-450 Enzyme System ; Ethambutol* ; Half-Life ; Isoniazid* ; Liver ; Metabolism ; Pharmacokinetics* ; Pyrazinamide ; Rifampin* ; Theophylline*

Since Virchow first introduced the term myxoma to describe a tumor that recapitulates the structure of the umbilical cord, it has been increasingly recognized that many diverse neoplasms may acquire a similar myxoid appearance. Myxoma have evolved within the pathology literature from tumors often described in practically all sites to the currently recognized subtypes restricted to the heart, skin, soft tissue, and bone. Pulmonary myxoma is extraordinary rare. We experienced pulmonary myxoma in a 63 year old man. The pulmonary radiology showed mass in right upper lung field, and percutaneous transthoracic needle lung biopsy was performed to confirm the myxoma.
Biopsy ; Heart ; Humans ; Lung* ; Middle Aged ; Myxoma* ; Needles ; Pathology ; Skin ; Umbilical Cord

BACKGROUND: The skin has many important functions such as protection, preservation, temperature regulation, and vitamin D synthesis. It is composed of a variety of cell types including keratinocytes, melanocytes and fibroblasts. OBJECTIVE: We attempted to compare the gene expression profiles between keratinocytes, melanocytes and fibroblast, using cDNA microarray. METHODS: Keratinocytes, melanocytes and fibroblasts were primary cultured from five foreskin specimens. Total RNAs were extracted and pooled to reduce the individual variations, and then used for cDNA microarray. RESULTS: Total 12,028 genes were selected as the reliable genes whose expression was detected in at least one of the three cell types. By comparing the relative expression levels with cutoff limitation as a fourfold change, we obtained 126 fibroblast-specific, 179 keratinocyte-specific and 173 melanocyte-specific genes, many of which are known to be characteristically expressed in each cell type. In addition, we identified many genes whose skin-specific functions have not yet been determined. CONCLUSION: Our data provide important information on which to base further investigation into the specification of skin cell types.
DNA, Complementary ; Fibroblasts ; Foreskin ; Gene Expression ; Keratinocytes ; Melanocytes ; Oligonucleotide Array Sequence Analysis ; RNA ; Skin ; Transcriptome ; Vitamin D

PURPOSE: This study was conducted to identify the effectiveness of a preoperative comprehensive geriatric assessment (CGA) for predicting postoperative morbidity in elderly patients who underwent surgery for colorectal cancer. METHODS: Elderly patients (≥70 years old) who underwent surgery for colorectal cancer at a tertiary hospital in Korea were identified, and their cases were analyzed using data from a prospectively collected database to establish an association between major postsurgical complications and 'high-risk' patient as defined by the CGA. RESULTS: A total of 240 patients, with a mean age of 76.7 ± 5.2 years, were enrolled. Ninety-five patients (39.6%) were classified as "high-risk" and 99 patients (41.3%) as having postoperative complications. The univariate analysis indicated that risk factors for postoperative complications were age, American Society of Anesthesiologists physical status classification, serum hemoglobin, carcinoembryonic antigen, cancer stage, and "high-risk" status. The multivariable analyses indicated that "high-risk" status (odds ratio, 2.107; 95% confidence interval, 1.168–3.804; P = 0.013) and elevated preoperative carcinoembryonic antigen (odds ratio, 2.561; 95% confidence interval, 1.346–4.871, P = 0.004) were independently associated with postoperative complications. A multivariable analysis of the individual CGA domains indicated that high comorbidities and low activities of daily living were significantly related with postoperative complications. CONCLUSION: A preoperative CGA indicating "high-risk" was associated with major postoperative complications in elderly patients who underwent surgery for colorectal cancer. Thus, using the CGA to identify elderly colorectal-cancer patients who should be given more care during postoperative management may be clinically beneficial.
Activities of Daily Living ; Aged* ; Carcinoembryonic Antigen ; Classification ; Colorectal Neoplasms* ; Comorbidity ; Geriatric Assessment* ; Humans ; Korea ; Postoperative Complications ; Prospective Studies ; Risk Factors ; Tertiary Care Centers

Tracheal bronchus is an aberrant bronchus that arises most often from the right tracheal bronchial wall above the carina and is the result of an additional tracheal outgrowth early in embryonic life. Its incidence ranges from 0.1 to 5%. This anomaly is usually diagnosed incidentally during bronchoscopy or bronchography in patients with various respiratory problems. Tracheal bronchus may be associated with other bronchopulmonary anomalies such as tracheal stenosis, pulmonary agenesis, pulmonary sequestration, abnormal lobulation, and Down's syndrome. In patients without specific clinical symptoms, a incidentally diagnosed tracheal bronchus does not require any treatment. We report a case of 59-year-old man incidentally detected accessory tracheal bronchus associated with bronchial asthma with review of literatures.
Asthma* ; Bronchi* ; Bronchography ; Bronchopulmonary Sequestration ; Bronchoscopy ; Down Syndrome ; Humans ; Incidence ; Middle Aged ; Tracheal Stenosis

BACKGROUND: Topical 5% minoxidil solution stimulates new hair growth and it helps stop the loss of hair on individuals with androgenetic alopecia (AGA). OBJECTIVE: We wanted to assess the efficacy and safety of topical 5% minoxidil solution for treating Korean men with AGA. METHODS: This was a 24-week, open label, clinical trial that was conducted at 14 university dermatologic centers nationwide throughout South Korea as a multicenter study of the Korean Hair Research Society. The eligible subjects for this study were 18- to 65 year-old men with androgenetic alopecia, as defined by the Norwood scale as type III vertex, IV and IVA. A total of 175 men (20~62 years old) with AGA applied topical 5% minoxidil solution twice daily. Efficacy was evaluated by 1) the total hair count per 1 cm2 and 2) the mean hair diameter and 3) the patient assessment and 4) the investigator assessment of the change in scalp coverage and the benefit of treatment. RESULTS: At week 24 as compared with baseline, there was a statistically significant increase in the total hair counts and the mean hair diameter (p<.0001). Topical 5% minoxidil solution helped improve the investigator and patient assessments. The topical 5% minoxidil solution was well tolerated over a 24-week period. CONCLUSION: We believe that topical 5% minoxidil solution is a safe and effective drug for Korean men with AGA.
Alopecia ; Hair ; Humans ; Male ; Minoxidil ; Republic of Korea ; Research Personnel ; Scalp