Romberg syndrome is a rare disease and characterized by unilaeril atrophy of the skin, subcutaneous tissue and the underlying structure of half the face. The lesion does not usually cross the midline of the scalp. Roriberg syndrome is sometimes mildsnosed as linear scleroderma, although they differ widely in their clinical and histological apperance. A 13-year-old boy was present with a one year history of idefined atrophic patch on the left side of face and neck. We involved skin was not bound down to the underlying structure. The history revealed no prcvious trauma or disease, He had no abnormal neurologic finding. Computerized tomography demonstrated a diminished subcutaneouat volume and also decreased thickness of back muscle is the left side face from cheek to neck.
Adolescent ; Atrophy ; Back Muscles ; Cheek ; Humans ; Male ; Neck ; Neurologic Manifestations ; Rare Diseases ; Scalp ; Scleroderma, Localized ; Skin ; Subcutaneous Tissue

A 63-year-old man had a huge verrucous protruding mass over the suprasternal area. The lesion enlarged rapidly over 3 mooths, and measured about 10×8 cm. The histologic finding of the biopsy specimen showed nests of squamous epithelium with central keratinization, infiltrating the dermis. The neoplasm was treated successfully with surgical excision.
Biopsy ; Dermis ; Epithelium ; Humans ; Keratoacanthoma* ; Middle Aged

Mucormycosis is an infectious disease caused by fungi of the order Mucorales. Almost all patients have a serious uriderlying condition such as diabetes mallitus, imrnunosuppression, starvation, burn, but a few cais have been reported in previously heilthy subjects. In order to successfully treat this infection, diagnosis must be prompt and acior. panied by aggressive debridement and parenteral administration of amphotericin B. We report a case of primary cutaneous mucormycosis in 58-year-old man. The lesion was a well-circumscribed erythematous plaque with central necrcis Histopathologically, a biopsy revealed broad, nonsptate with branches occuring at right anghles.
Amphotericin B ; Biopsy ; Burns ; Communicable Diseases ; Debridement ; Diagnosis ; Fungi ; Humans ; Middle Aged ; Mucorales ; Mucormycosis* ; Starvation

Candidiasis is the most common fungal infection complicating the course of patients with hematologic malignant neoplasms. Although widespread organ involvement is characteristic of disseminated candidiasis, reports of skin are rare. Reports describing typical clinical and histopathological finding of cutaneous lesions are very important since it may enable a diagnosis of disseminated candidiasis to be made and thus antifungal therapy can be initiated earlier. A 50-year-old housewife was admitted with a 5-month history of fatigue and easy bruising. She was diagnosed as ha.ving acute myelocytic leukemia and treatment was begun with daunorubicin and cytosin, arabinoside. Eight days after the start of chemotherapy, she developed a fever and generalized tender well demacated erythematous to purplish papulonodular eruption. A biopsy specimen from the skin lesion showed perivascular mononuclear cell infiltration and spore and pseudohypae v,rere found within the dermis and subcutis in PAS stain. Cultures of one skin biopsy specimen and one of four blood sarnples grew Candida tropicalis. The patient was treated with intravenous amphotericin B for disseminated candidiasis. On the tenth day of antifun gal therapy, she developed cardiopulmonary arrest and died.
Amphotericin B ; Biopsy ; Candida tropicalis ; Candidiasis* ; Daunorubicin ; Dermis ; Diagnosis ; Drug Therapy ; Fatigue ; Fever ; Heart Arrest ; Humans ; Leukemia, Myeloid, Acute ; Middle Aged ; Skin Manifestations* ; Skin* ; Spores

BACKGROUND: Psoriasis is a dynamic process, both clinically and histopathologically. There is wide spectrum of histological change recognizable in psoriatic lesions. OBJECTIVE: We attempted to clarify the histological features in psoriasis by quantitative studies. METHODS: We reviewed the clinical charts, photographs and skin biopsy slides of 106 patients who were diagnosed as psoriasis clinically or histopathologically between March, 1990 and August, 1994 at the Department of Dermatology, Korea University Hospital. The 12 histopathologic fea tures of psoriasis were listed and examined whether these features were seen or not. in each section. And if seen, then the features were scored 0 to 1. The sum of score in ear,h section could range from 0 to 12. RESULTS: 1. 72 of 106 patients were psoriasis vulgaris. In other patients, the clinical forms of psoriasis wer e guttate psoriasis, pustulosis palmoplantaris, and generalized pustular psoriasis. 2. The average score of histopathologic features seen in each section were 8.11+/-2.11. 3. Sections commonly showed club shaped rete ridges, elongation and ederna of the dermal papil- lae, perivascular mononuclear infiltrate in the upper dermis, absent granular layer, parakeratosis, suprapapillary plate thinning, mitosis above basal cell layer, and dilated tortuous blood vessels. The observed frequency of Munro microabscess, spongiform pustule, and dilated tortuous blood vessels were significantly lower in psoriasis vulgaris than in other clinical forms(p<0.05). CONCLUSION: This study showed that the histologic picture of psoriasis varied with the clinical forms. In each section seen, the observed frequncy of Munro microabscess and spongiform pustule was relatively low.
Biopsy ; Blood Vessels ; Dermatology ; Dermis ; Humans ; Korea ; Mitosis ; Parakeratosis ; Psoriasis* ; Skin

BACKGROUND: Ventricular remodeling after myocardial infarction increase mortality and morbidity. Two-dimensional echocardiography in acute myocardial infarction provides a useful diagnostic tool for evaluation of ventricular remodeling. The aims of this study were to verify whether follow-up two-dimensional echocardiography could detect ventricular enlargement after acute myocardial infarction and to find early echocardiographic predictors and clinical charateristics of ventricular enlargement. METHODS: Two-dimensional echocardiography was done prospectively at 2 week, 3 month, and 6 month after the first Q-wave acute myocardial infarction in 18 patients. The control group was 11 patients of a normal chest roentgenogram and echocardiogram who were studied for chest pain or arrhythmia. The patients were divided by the mean value of the control group left ventricular end-diastolic volume index(LVEDVI) 56.8ml/m2. The group A was more than 60ml/m2(the control group LVEDVI 56.8ml/m2) and the group B was less than 60ml/m2 of LVEDVI at 2 week post myocardial infarction. The left vantricular volume was measured by the modified disk method at the apical four chamber view. The wall motion abnormality of left ventricle was examined by the recommendation of the American Society of Echcardiography. RESULTS: The left vntricular end-diastolic volume and the left ventricular end-systolic volume were enlarged after 3 month of acute myocardial infarction in the group A compare with those of the control group. There was no ventricular enlargement during 6 month after myocardial infarction in the group B. The frequency of ventricular enlargement was increased in anterior myocardial infarction. There was no difference in left ventricular ejection fraction at 2 week post myocardial infarction between the group A(51.4+/-15.7%) and the group B(50.8+/-10.3%). The wall motion score index more than 1.5 at 2 week post myocardial infarction means the enlarged LVEDVI more than 60ml/m2 and the group of ventricular enlargement. CONCLUSION: The left ventricular enlargement could be diagnosed by the follow-up two-dimensional echocardiography in acute myocardial infarction. The echocardiographic early predictors of ventricular enlagement were the left ventricular end-diastolic volume greater than 60ml/m2 and increased wall motion score index more than 1.5 at 2 week post myocardial infarstion. The anterior myocardial infarction was the electrocardiographic predictor of ventricular dilatation. Therefore these early predictors could identify the patients of ventricular enlargement and these patients could be a candidate of follow-up echocardiography and of a specific treatment for limiting ventricular remodeling.
Arrhythmias, Cardiac ; Chest Pain ; Dilatation ; Echocardiography* ; Electrocardiography ; Follow-Up Studies ; Heart Ventricles ; Humans ; Mortality ; Myocardial Infarction* ; Prospective Studies ; Stroke Volume ; Thorax ; Ventricular Remodeling

BACKGROUND AND OBJECTIVES: Diabetes is associated with a unique form of cardiomyopathy in the absence of atherosclerosis. The mechanisms of diabetic cardiomyopathy have not been defined, but is associated with early left ventricular (LV) diastolic dysfunction following an altered LV contractile performance. However, less attention has been paid to the right ventricular (RV) diastolic function in diabetes. Therefore, the changes in the RV ans LV filling dynamics, in patients with early type 2 diabetes, were investigated. SUBJECTS AND METHODS: The transtricuspid and trans-mitral flows were assessed by transthoracic Doppler echocardiography, at maximal inspiration and expiration, in 48 subjects (mean age: 62+/-9 years, M:F=16:32) with type 2 diabetes (Type 2 DM group) and 34 normal subjects (control group ; mean age:59+/-9 years, M:F=15:19, ranging from 45-75 years of age) with normal LV systolic function and ECG at rest. Subjects with diabetic complication, nephropathy (Cr >1.5 mg/dL), LVH and COPD were excluded. RESULTS: The mitral E/A ratio and DT (deceleration time) showed no significant difference between the type 2 DM and control groups. The LV and RV systolic functions also showed no significant difference between the two groups. However, the type 2 DM group had a lower tricuspid E/A ratio (0.98+/-0.25 vs. 1.17+/-0.21, p<0.001) and a longer tricuspid DT (241+/-65 msec vs. 208+/-51 msec, p=0.016) than the control group. CONCLUSION: The right ventricular diastolic function is frequently abnormal in early type 2 diabetes. This suggests that right ventricular diastolic dysfunction may be an important predictor for the early detection of diabetic cardiomyopathy.
Atherosclerosis ; Cardiomyopathies ; Diabetes Complications ; Diabetes Mellitus ; Diabetic Cardiomyopathies ; Diastole ; Echocardiography ; Echocardiography, Doppler ; Electrocardiography ; Heart Ventricles ; Humans ; Pulmonary Disease, Chronic Obstructive

PURPOSE: The aim of this study was to evaluate the utility of contrast-enhanced MRI with first-pass and delayed images in prediction of myocardial viability after acute myocardial infarction. MATERIALS AND METHODS: Ten patients (M:F=:4, mean age =6 5 years) with acute myocardial infarction underwent first-pass image after bolus injection of gadolinium (one image/sec for 120sec)and delayed image (7 2 minutes later). According to 60 segments on midventricular level, the assessment of MRI were concerned about location of lesion, depth of lesion, enhancement on first-pass image and enhancement pattern on delayed image. MRI findings were compared with wall motion on resting echocardiography and stress or follow-up echocardiography. RESULTS: 1) MRI findings were classified into 4 types: normal enhancement on first-pass and delayed images (type 1), normal enhancement on first-pass image and nontransmural hyperenhancement on delayed image (type 2), non-transmural enhancing defect on first-pass image and transmural enhancement with endocardial non-enhancing defect on delayed image (type 3), and transmural enhancing defect on first-pass image and transmural hyperenhancement on delayed image (type 4).2) Type 2 suggested viable myocardium and type 3 had high porbability of viability. Type was compatible with non-viable myocardium. CONCLUSION: Enhancing defect on first-pass image and involving thickness on both the first-pass image and delayed image in contrast enhanced MRI may predict myocardial viability.
Echocardiography ; Follow-Up Studies ; Gadolinium ; Humans ; Magnetic Resonance Imaging* ; Myocardial Infarction* ; Myocardium

OBJECTIVE: The purpose of this study was to compare the skeletal, dental, and soft-tissue treatment effects of nonextraction therapy using the modified C-palatal plate (MCPP) to those of premolar extraction (PE) treatment in adult patients with Class II malocclusion. METHODS: Pretreatment and posttreatment lateral cephalographs of 40 adult patients with Class II malocclusion were retrospectively analyzed. The MCPP group comprised 20 patients treated with total arch distalization of the maxillary arch while the PE group comprised 20 patients treated with four PE. Fifty-eight linear and angular measurements were analyzed to assess the changes before and after treatment. Descriptive statistics, paired t-test, and multivariate analysis of variance were performed to evaluate the treatment effects within and between the two groups. RESULTS: The MCPP group presented 3.4 mm of retraction, 1.0 mm of extrusion, and 7.3° lingual inclination of the maxillary central incisor. In comparison, the PE group displayed greater amount of maxillary central incisor retraction and retroclination, mandibular incisor retraction, and upper lip retraction (5.3 mm, 14.8°, 5.1 mm, and 2.0 mm, respectively; p < 0.001 for all). In addition, the MCPP group showed 4.0 mm of distalization and 1.3 mm of intrusion with 2.9° distal tipping of the maxillary first molars. CONCLUSIONS: These findings suggest the MCPP is an effective distalization appliance in the maxillary arch. The amount of incisor retraction, however, was significantly higher in the PE group. Therefore, four PE may be recommended when greater improvement of incisor position and soft-tissue profile is required.
Adult ; Bicuspid* ; Humans ; Incisor ; Lip ; Malocclusion ; Molar ; Multivariate Analysis ; Retrospective Studies

BACKGROUND: Skin tags are benign fleshy or darker colored papillomatous dermal tumors locatei mostly in the neck, axill or groin. Recent reports on a possible association between skin tags and colonic polyps, however, caused interest in these henign tumors of the dermis, especially wite regarding to their frequercy. OBJECTIVE: The purpose rate this study was to explore the clinical profiles of skin tags, the effect of obesity on the frequeny of skin tags and the association between skin tags and obesity in the normal population. We also tried to evaluate the usefulness of skin tags as a general marker for the presence of colonic piyps. METHODS: The first, 524 unselected patients were examined. The patient material comprised of 240 males and 284 females. Each patient was inspected with regard to skin tags by a clermatolgist. 334 patients were classified into obese groups and nonobese groups and then we evaluated the relationship between skin tags and the degree of obesity. The second, ninety consecutive patients referred for coloniscopic evaluation were examined to determine the association between skin tags and colonic polps. RESULTS: We found 22.9% of the males and 22.5% of the females to be skin tag carriers in the general population. We also noticed a steady increase of the frequency according to age eccept for the third decads. Of the skin tags found 51% were in the axillar region, 40% around the neck and 8% in the inguinal region. In the study for the relationship between skin tags and obesity, 44.9% of the obise patients and 23% of the nonobese patients were skin tag carriers(relative risk=1.95, p<0.05). In the study for the association between skin tags and colonic polyps in patients undergoing colonoscopic examination, 18 of patients with skin tags(45%) hnd colonic polyps and 11 of patients without skin tags(22%) had colonic polyps(relative risk=2.05, p<0.05). CONCLUSION: This study identified an obese group that are at risk of the developing skin tags. Consideration of skin tags as a marker for colonic polyps is likely to prove helpful.
Colon* ; Colonic Polyps* ; Dermis ; Female ; Groin ; Humans ; Male ; Neck ; Obesity ; Skin*