No abstract available.
Rheumatoid Nodule* ; Scalp*

No abstract available.
Pseudohypoaldosteronism*

Approximately 6% of all head and neck skin cancers arise from the external ear, of which squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are the most common. Acquired helical rim defects can be caused by injury or after excision of a tumor. Since many patients feel that the auricle has a functional and cosmetic importance, it is crucial to consider the esthetics. In cases where the defect exposes bare cartilage, second-intention healing is usually not achieved. Therefore, full-thickness skin grafts have been adopted, but the healing time is long and in many cases, mismatch of color between the grafted skin and the surrounding ear has been observed. Alternatively, reconstruction with flaps may provide optimal coverage. Among the many possible flap designs, the rhombic transposition flap has become widely utilized in dermatologic surgery, due to its simplicity and versatility. Herein, we report a case of SCC on the superior helical rim (of which the cartilage was spared) successfully managed with a rhombic transposition flap. The surgical procedure had been relatively simple and the resultant ear helix was free from deformity. In future, we recommend that defects of the ear helix, which have an intact cartilage, should be treated with a rhombic transposition flap to give a successful cosmetic and functional outcome.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell* ; Cartilage ; Congenital Abnormalities ; Dermatologic Surgical Procedures ; Ear* ; Ear, External ; Esthetics ; Head ; Humans ; Neck ; Skin ; Skin Neoplasms ; Transplants

BACKGROUND: Classical surgical treatment of axillary osmidrosis and hyperhidrosis results in many complications such as scarring, hematoma and necrosis, therefore, gentle skin flap cares is needed. OBJECTIVE: In order to lessen the complications and to obtain an improved clinical outcome, a new easy-learn, surgical excision method of treating subcutaneous tissue is required. METHOD: On 16 patients, We carried out a type-1 surgical method to treat axillary osmidrosis and hyperhidrosis. This invoved major removal of the subcutaneous tissue by scissor excision, and partial removal by the subwtaneous shaver method, to minimise trauma. We then analyzed the clinical efficiency, complications, patient satisfaction, and pathologic specimens according to clinical severity. RESULTS: All 16 patients showed an improved odor or sweating pattern, and a good or very good level of satisfaction. One patient also showed that hematoma was improved with proper post- operative care. Hyperactivity of the apocrine glands in osmidrosis and eccrine gland in hyperhidrosis was seen, and various morphologic features of apoeccrine glands were found in both osmidrosis and hyperhidrosis. We observed that apocrine and eccrine glands were completely excised by following the biopsy of 2 patients. CONCLUSION: Our present method of minimal skin incision and major removal of subcutaneous fat with manual scissor excision, in combination with partial excision with the subcutaneous shaver method, showed a good clinical outcome and few complications.
Apocrine Glands ; Biopsy ; Cicatrix ; Eccrine Glands ; Hematoma ; Humans ; Hyperhidrosis* ; Necrosis ; Odors ; Patient Satisfaction ; Skin ; Subcutaneous Fat ; Subcutaneous Tissue* ; Sweat ; Sweating

Leukemia cutis, the specific infiltration of leukemia, can be seen in any leukemia, but, are especially common in the acute myelogenous leukemia M4 and M5 variants. It may clinically mimic many inflammatory dermatoses. We herein report a case of a 59-year-old man with acute monocytic leukemia who concurrently presented with various cutaneous manifestations that clinically resembled benign skin lesions such as rosacea, contact dermatitis, and milium. Histologic study of all the lesions revealed leukemia cutis of the monocytic type. We presented this case to illustrate how leukemia cutis can masquerade as clinically benign-appearing, cutaneous eruptions.
Dermatitis, Contact ; Humans ; Leukemia* ; Leukemia, Monocytic, Acute ; Leukemia, Myeloid, Acute ; Middle Aged ; Rosacea ; Skin ; Skin Diseases

BACKGROUND: N-methyl-D-aspartate (NMDA) and alpha-amino-3-hydroxy-5-methyl-isoxazole-4-propinoic acid (AMPA) receptors bound to postsynaptic density-95 (PSD-95) and alpha isoform of calcium/calmodulin-dependent protein kinase II (alphaCaMKII) is fundamentally involved in the regulation of working memory. The aim of present study was to investigate the alterations of NMDA and AMPA receptors responsible for hippocampal synaptic dysfunction and selective neuronal cell death after chronic renal failure (CRF) which may be associated with impairment of working memory. METHODS: Altered interactions between NMDA and AMPA receptors and PSD-95 and alphaCaMKII were analyzed in the cornu ammonis (CA) 1 and CA3/dentate gyrus (DG) subfields of the uremic rat hippocampi using the immunoblotting and immunoprecipitation methods. RESULTS: Uremia induced by CRF produced necrotic cell death and decreased neuronal nucleoli protein levels in the hippocampal CA1 subfield, but not in the CA3/DG subfields. The CA1 subfields of CRF rats exhibited significant decreases and increases, respectively, in the expressions of PSD-95/NR2B and alphaCaMKII/NR2A synaptic complex. Moreover, increased phosphorylation of glutamate receptor type 1 (GluR1) AMPA receptor at ser831 was observed in the CA1 subfield after CRF. CONCLUSION: These hippocampal CA1 neuronal vulnerability may be responsible for memory dysfunction after CRF as mediated by an increase in NR2A-containing NMDA receptors bound to alphaCaMKII and subsequent activation of GluR1-containing AMPA receptors caused by the phosphorylation of GluR1 at ser831.
Animals ; Cell Death* ; Hippocampus ; Immunoblotting ; Immunoprecipitation ; Kidney Failure, Chronic* ; Memory ; Memory, Short-Term ; N-Methylaspartate ; Neurons ; Phosphorylation ; Protein Kinases ; Rats* ; Receptors, AMPA* ; Receptors, Glutamate ; Receptors, N-Methyl-D-Aspartate ; Up-Regulation* ; Uremia

OBJECTIVES: This study was conducted to review the diffusion process and factors affecting the adoption of the Health Center Information System (HIS). METHODS: Data were collected from POSDATA (private company), MOHW, other Ministries and local governments. To specify the date of adoption, supplementary information was collected from 40 health centers. The following three kinds of factors were analyzed. Internal factors included type, size, and innovativeness of health centers. Community factors were composed of population size, economic status, and level of education. Organizational environmental factors consisted of information score of the municipalities, financial support of the from central government, and the neighborhoodness of innovator health centers. RESULTS: All health centers in the metropolitan cities of Seoul, Gwangju and Jeju adopted the HIS. The laggards were those in the metropolitan cities of Busan (18.8%), Incheon (20.0%) and Daejun (20.0%), and cities with population more than 300, 000 (54.8%) and counties with health center hospitals (47.1%). Financially supported rural health centers adopted the HIS more rapidly than those not supported. The factors identified as being statistically significant (p< 0.05), from a univariate analysis by Kaplan-Meier method, were: (1) internal factors of the type, size and innovativeness of health centers; (2) community factors of population size and economic status; (3) organizational environmental factors of the central government financial support and the neighborhoodness of innovator health centers. A multivariate analysis, using a Cox proportional hazard method, proved the innovativeness of health centers, central government financial support and the neighborhoodness of innovator health centers, were statistically significant (p< 0.05). CONCLUSIONS: The innovativeness of health centers, financial support from central government and the neighborhoodness of innovator health centers, rather than community factors related to regional socioeconomic status, affected the adoption of the HIS in health centers. Further in-depth studies, modifying the MOHW's strategy to propagate the HIS to the laggard health centers, are recommended.
Busan ; Diffusion of Innovation ; Diffusion* ; Education ; Financial Support ; Gwangju ; Incheon ; Information Systems* ; Methods ; Multivariate Analysis ; Population Density ; Residence Characteristics ; Rural Health Services ; Seoul ; Social Class

Nevus sebaceus is well-known for its potential to develop both benign and malignant neoplasms of epidermal and adnexal origin. We found 5 tumors including syringocystadenoma papilliferum, a basal cell carcinoma-like tumor, sebaceous epithelioma, a tumor of follicular infundibulum and apocrine adenoma within a single nevus sebaceus lesion in a 37-year-old man. This is a rarely reported case of a nevus sebaceus lesion containing a basal carcinoma-like, trichoblastoma-like skin tumor and tumors of follicular infundibulum. The lesion was treated by wide excision and repaired with subgaleal-periosteal fixation which resulted in good wound healing.
Adenoma* ; Adult ; Carcinoma* ; Carcinoma, Basal Cell ; Humans ; Nevus* ; Skin ; Wound Healing

Malignant melanoma is a tumor arising from melanocytes which originate in the neural crest. According to several reports, about 20-30% of all melanoma are associated with pre-existing nevi. Because early detection and intervention of aquired and congenital nevi is the only way to increase survival, the important risk factors should be carefully observed, especially if there are changes of to the number, size, and characteristic of the nevi. We present a 41 year-old man who has a superficial, spreading type of malignant melanoma, which arose from an acquired nevus following trauma to the right malleolar area. This case is interesting because of the clinical type and accompanying pathologic condition of the benign nevus.
Adult ; Humans ; Melanocytes ; Melanoma* ; Neural Crest ; Nevus* ; Risk Factors

BACKGROUND: Actinic keratosis is one of the most common precancerous lesions, and its incidence in Western society has been reported to be up to 40%. However, few clinical and histopathologcial studies of actinic keratosis have been conducted in Korea. OBJECTIVE: The purpose of this study was to investigate clinical and histopathological features of actinic keratosis in Koreans. METHODS: We reviewed the medical records and biopsy specimens of 63 cases previously diagnosed as actinic keratosis at St.Vincents hospital of Catholic Medical Center from January 1999 to June 2003. RESULTS: We were able to compile clinical data and histologic information on 63 cases of actinic keratosis 1. The mean age at diagnosis was 72.6 years, and all the patients were over 50 years old. Actinic kerotosis developed predominantly in females at the sex ratio of 1: 3.8. 2. The disease duration was more than 1 year in 69.8% of patients, and there were few associated cutaneous malignancies, except two basal cell carcinoma. 3. Half of the patients was asymptomatic, however, 34.9% and 15.9% of the patients complained of pruritus and pain, respectively. The lesions were usually solitary, less than 1cm, and erythematous. 4. Actinic keratosis was involved mostly in face, especially cheek, forehead, chin, and nose by decreasing order. 5. Histopathologically, hypertrophic type was noted in 30.2% of the cases, atrophic type in 44.4%, bowenoid type in 19.0%, acantholytic type in 3.2%, and pigmented type in 3.2%. The histopathological scores according to subtype were 5.00(1.76) in hypertrophic type, 3.54(1.82) in atrophic type, and 6.83(1.03) in Bowenoid type. 6. The most common treatment modality was cryotherapy with liquid nitrogen, and surgical resection, electrodessication, and CO2 Laser were also used for the treatment of actinic keratosis. The recurrence was observed in one patient treated by cryotherapy and two patients by electodessication. CONCLUSION: Actinic keratosis in Koreans was precancerous lesion usually present on the face of female patients over 50 years old. Various histopathologic types including hypertrophic, atrophic, Bowenoid, acantholytic and pigmented type were noted, and the most common type was atrophic type. Actinic keratosis could be treated by cryotherapy with liquid nitrogen, surgical resection, eletrodessication and CO2 laser. However, because of the possibility of recurrence, close follow-up is needed.
Actins* ; Biopsy ; Carcinoma, Basal Cell ; Cheek ; Chin ; Cryotherapy ; Diagnosis ; Female ; Follow-Up Studies ; Forehead ; Humans ; Incidence ; Keratosis, Actinic* ; Korea* ; Lasers, Gas ; Medical Records ; Middle Aged ; Nitrogen ; Nose ; Pruritus ; Recurrence ; Sex Ratio