Congenital smooth musele hamartomas appear at birth as hypertrichotic patches or plaques with or without hyperpigmentation. Histologic characteristic is hyperplasia of dermal smooth muscle bundles. We report a case of congenital smooth muscle harnartoma in 5-year-old female, who showed localized excessive-hairy, skin-colored patch on the lateral surface of left. elbow, which were found at birth. Biopsy specimen showed hyperpigmentation of the basal layers of epidermis, melanophages in upper dermis, and hyperplasia of smooth muscle bundles in lower dermis.
Biopsy ; Child, Preschool ; Dermis ; Elbow ; Epidermis ; Female ; Hamartoma* ; Humans ; Hyperpigmentation ; Hyperplasia ; Hypertrichosis ; Muscle, Smooth* ; Parturition

BACKGROUND: The purpose of this study was to evaluate the usefulness and safety of the anterosuperior deltoid splitting approach for fixation of displaced proximal humeral fractures by analyzing the surgical outcomes. METHODS: Twenty-three patients who could be followed-up for at least 8 months after the treatment of displaced proximal humeral fractures through the anterosuperior deltoid splitting approach were enrolled. We evaluated the reduction of the fractures and surgery-related complications at the last follow-up using X-ray results and clinical outcomes comprising the University of California at Los Angeles (UCLA) scoring system and the Korean Shoulder Society (KSS) score. RESULTS: At the last follow-up of patients treated using the anterosuperior deltoid splitting approach for internal fixation of proximal humeral fractures, we found 22 cases (95.6%) of bone union, a mean UCLA score of 28.3 (range, 15 to 34) and a mean KSS score of 82.1 (range, 67 to 95). Various surgery-related complications were noted; a case of varus malunion after fracture displacement, a case of nonunion, a case of delayed union, two cases of impingement, and a case of partial axillary nerve injury, which recovered completely through the follow-up. CONCLUSIONS: Plate fixation using the anterosuperior deltoid splitting approach could be another reliable option for treating displaced proximal humeral fractures.
California ; Follow-Up Studies ; Humans ; Humerus ; Shoulder ; Shoulder Fractures*

BACKGROUND: Radiation has been used in t,he medical field of dragnosis and treatment. There is widely used ionizing radiat:ion such as naturally occuring r-rays or machine-made X-ray. This radiation is able to induce the structural and functional alterations of the mammalian cells. But we have few detailed reports on the effects of radiation on epidermal cells and their immune functions. OBJECTIVE: This study was performed to investigate the effect of radiation on cultured human keratinocytes and melanocytes. MATERIALS AND METHODS: Cultured human keratinocytes and melanocytes were irradiated with 2,6, l0Gy from a Co saurce and stimulated by 100 U/ml of ekratinocyte immediately after irradiation. We investigated cell numbers and morphological changes, DNA synthesis and HLA-DR antigen expression. RESULTS: After exposure to r-ray, the proliferation of keratinocytes and melanocytes decreased in a time and dose dependent fashion to each control group. Tliey showed decreased density, a larger size and a round appearance after radiation exposure and an especially shortened and decreased number of dendrites in the melanocytes. In DNA synthesis counted using [H]-thymidine incorporation, the keratinocvtes decreased values in a dose depen(lent manner at 24 and 72 hours after irradiation but no differense was observed at 168 hours. In melanocytes, there was a greater decrease than that of keratinocytes. The melanin content/cell in all radiation exposed groups increased in a time and dose dependent fashion t,o each contr ol group. HLA-DR antigen expression on keratinocytes after radiat,ion exposure decreased to the control group, but there were no significant differences acccirding to the dose of radiation, And there were no significant diifferences of HLA-DR antigen expression on the melanocytes betweer. controls and the radiation exposed groups. CONCLUSION: Antiproliferative activity was dependent on the exposure time and dose of r-ray exposure. According to the time after radiation exposure, melanogenic activity was stimulated. The expression of HLA-DR, antigen decreased in keratinocyte after radiation exposure but there was no decrease in melanocytes.
Cell Count ; Dendrites ; DNA ; HLA-DR Antigens ; Humans* ; Keratinocytes* ; Melanins ; Melanocytes*

BACKGROUND: Radiation has been used in t,he medical field of dragnosis and treatment. There is widely used ionizing radiat:ion such as naturally occuring r-rays or machine-made X-ray. This radiation is able to induce the structural and functional alterations of the mammalian cells. But we have few detailed reports on the effects of radiation on epidermal cells and their immune functions. OBJECTIVE: This study was performed to investigate the effect of radiation on cultured human keratinocytes and melanocytes. MATERIALS AND METHODS: Cultured human keratinocytes and melanocytes were irradiated with 2,6, l0Gy from a Co saurce and stimulated by 100 U/ml of ekratinocyte immediately after irradiation. We investigated cell numbers and morphological changes, DNA synthesis and HLA-DR antigen expression. RESULTS: After exposure to r-ray, the proliferation of keratinocytes and melanocytes decreased in a time and dose dependent fashion to each control group. Tliey showed decreased density, a larger size and a round appearance after radiation exposure and an especially shortened and decreased number of dendrites in the melanocytes. In DNA synthesis counted using [H]-thymidine incorporation, the keratinocvtes decreased values in a dose depen(lent manner at 24 and 72 hours after irradiation but no differense was observed at 168 hours. In melanocytes, there was a greater decrease than that of keratinocytes. The melanin content/cell in all radiation exposed groups increased in a time and dose dependent fashion t,o each contr ol group. HLA-DR antigen expression on keratinocytes after radiat,ion exposure decreased to the control group, but there were no significant differences acccirding to the dose of radiation, And there were no significant diifferences of HLA-DR antigen expression on the melanocytes betweer. controls and the radiation exposed groups. CONCLUSION: Antiproliferative activity was dependent on the exposure time and dose of r-ray exposure. According to the time after radiation exposure, melanogenic activity was stimulated. The expression of HLA-DR, antigen decreased in keratinocyte after radiation exposure but there was no decrease in melanocytes.
Cell Count ; Dendrites ; DNA ; HLA-DR Antigens ; Humans* ; Keratinocytes* ; Melanins ; Melanocytes*

We report a case of Becker's nevus associated with smooth muscle hamartoma, in a 21-year-old male patient, which shows clinically match-head sized, flat topped, round to oval, grouped papules with hairs on the outer surface of the right arm, and microscopically reveals numerous bundles of smooth muscle fiber in the dermis.
Arm ; Dermis ; Hair ; Hamartoma* ; Humans ; Male ; Muscle, Smooth* ; Nevus* ; Young Adult

Because of the frequent misdiagnosis of the carpal injury, the orthopedic surgeon must know the mechanism of injury and exact radiological interpretation. We had encountered 114 cases of carpal injury, in which carpal fracture, carpal dislocation and instability were analysed by radiological examination. The following results were obtained: 1. In 75 carpal bone fractures, the most common fracture was scaphoid fracture (64 cases), the next com- mon one was triangular fracture (4 cases). 2. Among the 64 scaphoid fractures, the waist portion was the most frequent site (45 cases) and the least was tubercle fracture (2 cases). 3. Of the carpal bone fractures, the fresh fracture was 48 cases (64%) and old one was 27 cases (36%), these showed sclerosis, cystic change, and degenerative change in radiological examination. 4. In 14 carpal dislocations, perilunar dislocation was 2.5 times move common than lunate dislocation, and the trans-scaphoid perilunar dislocation was the most common dislocation. 5. Carpal instability was 25 cases. These were dorsiflexion instability, navicular rotary subluxation, and pal- mar-flexion instability. The most common instability was dorsiflexion instability.
Carpal Bones ; Classification ; Diagnostic Errors ; Dislocations ; Incidence ; Orthopedics ; Sclerosis ; Wrist

A major problem in the repair of the torn Achilles tendon has been providing the restoration of the anatomic continuity such that virtually normal plantar flexion power and ankle mobility result. Continuity should be restored without subsequent pain, disconfiguration, occupational limitations. If possible, postoperative complications, or tendon-rerupture should be avoided. Surgeons have long advocated the use of strips of facia and other tissues, including the plantaris tendon, to reinforce the repair of the torn Achilles tendon, The repair effected by these methods not infrequently is bulky and not too secure. Non-absorbable suture materials utilizing in the end to end anastomosis of the torn Achilles tendon cause sinus formation and discharge of suture materials. A secure method of repair for the tom Achilles tendon, which decreases sinus formation and is not bulky, should be required. The plantaris tendon, which has been used as a reinforcing material, can be utilized in the end-to-end anastomosis of the torn Achilles tendon by detaching from the muculotendinous junction. The 11 patients with the torn Achilles tendon were treated by end-to-end anastomosis using the plantaris tendon as suture material. The postoperative results were staisfactory without significant functional deficit and complication.
Achilles Tendon ; Ankle ; Humans ; Methods ; Postoperative Complications ; Surgeons ; Sutures ; Tendons

Whiplash injury in low-speed traffic accidents are not objectively verified by medical equipment, thereby creating scope for misuse, which has resulted in huge social losses worldwide. The aim of this study was to examine the influence of low-speed vehicular rear-impact collisions on middle-aged men, and to analyze the head and neck injury criteria for the symptomatic human volunteers. Data was examined from the results of 50 dynamic sled tests, originally performed by Hong et al. (2012). In the previous tests, 50 men aged 30~50 years were exposed to an impulse equivalent to a bumper-to-bumper rear collision under medical supervision, and no resulting whiplash injury was identified. In this study, for 6 subjects who experienced dull aches over their bodies, head injury criteria (HIC15) and neck injury criteria (N(km)) were calculated according to the accelerations, forces, and moments at the occipital condyle measured by motion capture system. Although there were no changes in magnetic resonance imaging findings in all subjects at the pre-/post-test orthopedic examination, 6 subjects revealed mild aches around the shoulder, back, or lumbar area, and their symptoms disappeared within 2 days. The head and neck injury criteria, HIC15 (3.086 +/- 2.942) and N(km) (0.077 +/- 0.064) were obtained, and the maximum HIC15 and N(km) were found to be significantly lower than the critical injury assessment reference values (HIC15: 700, N(km): 0.3). Moreover, even though 2 subjects were exposed to the same level of change of velocity (7.9 km/h), each N(km) was significantly different (0.179, 0.057). One can therefore conclude that N(km) can vary according to voluntary movements in the human subject.
Acceleration ; Accidents, Traffic ; Aged ; Automobiles ; Craniocerebral Trauma ; Head ; Human Experimentation ; Humans ; Magnetic Resonance Imaging ; Male ; Neck ; Neck Injuries ; Organization and Administration ; Orthopedics ; Reference Values ; Shoulder ; Whiplash Injuries

We analyzed ERCP findings of 15 patients with clonorchiasis, that were confirmed by stool examination and operation from May, 1976 to September, 1980. The results were as follows. 1) Filling defects due to adult worm of clonorchis sinensis were significant direct findings of clonorchiasis. 2) Irregular stenosis, fuzziness, raggedness, peripheral dilation and disturbance of peripheral filling of intrahepatic bile ducts were significant indirect findings of clonorchiasis. 3) ERCP was excellent method to evaluate biliary tree in patients with clonorchiasis, who showed obstructive jaundice.
Adult ; Bile Ducts, Intrahepatic ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Clonorchiasis* ; Clonorchis sinensis ; Constriction, Pathologic ; Humans ; Jaundice, Obstructive

BACGROUND: After amendment of the national health insurance law to enforce and reform primary health care, the number of family medicine out-patients was increased. Some patients requested referral. Therefore, this study was made to reveal family medicine residents'perception of attitude towards request for referral. METHODS: The self-administered questionnaires were collected by post mailing (July 1 to July 30, 2002) and by e-mailing (July 25 to August 10, 2002). The questionnaire contained the followings: general characteristics, issues of referral request, influence of referral request in training, and influence in private family clinics. RESULTS: The overall response rate was 22.2% (93/418). Patients need was the most common cause of referral (62.0%). Among the total, 46.2% of respondents gave answers that increasing number of patients at the family medicine out-patient clinic was beneficial in increasing their experience. Also, 55% of respondents replied that the present state of family medicine out-patient system influenced lowering of motivation in training. Overall, 63.4% of respondents replied that the present state of family medicine out-patient system led a trend of distrust to private family clinics. CONCLUSION: Patients request was the most common cause of referral in family medicine out-patient clinic. The present state of referral system in family medicine out-patient clinic influenced lowering of motivation in training and a trend of distrust to private family clinics.
Surveys and Questionnaires ; Electronic Mail ; Humans ; Jurisprudence ; Motivation ; National Health Programs ; Outpatients* ; Postal Service ; Primary Health Care ; Referral and Consultation*