Most of malignant melanoma of skin had occurred in transformation from benign nevi(Webster, 1944), especially most frequently from junctional nevi of them. which was characterized by flat surface, dark-brown color and hairlessness(Ackermen, 1948) Blumberg (1972) introduced five levels of hietologic invasion of malignant melanoma described by Clark et al. Morton(1970) reported various measures of treatment such as surgery combined with radiotherapy or with chemotherapy or with recent immunotherapy with good result. The authors recently experienced 24-yeas old male soldier patient with malignant melanoma on hypothenar region of right palm. The pathologic investigation including electronmicroscopical aspect was carried out and are presented. Treatment consisted of the resections of right axillary lymph nodes and the lesion in situ on the hypotherar region of right hand, pedicle skin graft to right hand from abdomen, and immediate postoperative immunotherapy with intradermal injection of 1.0 cc. of B.C.G. daily on extensor surface of both thighs in turn, which lasted for about 3 months duration to find good result.
Abdomen ; Drug Therapy ; Hand ; Humans ; Immunotherapy ; Injections, Intradermal ; Lymph Nodes ; Male ; Melanoma ; Military Personnel ; Nevus ; Radiotherapy ; Skin ; Thigh ; Transplants

PURPOSE: We estimated the incidence of retinal lesions at preoperative evaluation of retina for LASIK and investigate its clinical importance. METHODS: We estimated retrospectively the incidence of retinal lesions of the patients who visited our hospital with the purpose of correction of refractive error. The examination of retina upto periphery was done preoperatively. RESULTS: The mean spherical value and axial length were -6.5 +/- 3.4 diopters (range -26.0 ~ +17.0) and 25.4 +/- 2.0mm (range 15.7 ~ 34.5), respectively. The retinal lesions were found in 189 eyes of 139 persons (12.4%). Among them degenerative changes were found in 48 eyes of 34 persons, chorioretinal scars in 7 eyes of 7 persons, pigmented lesions in 28 eyes of 24 persons, and miscellaneous lesions in 106 eyes of 74 persons. There was a significant increase of spherical value and axial length in the group with retinal lesions -7.9 +/- 4.5 diopters (range -26.00 ~ -2.25), 26.5 +/- 2.3mm (range 23.1 ~ 34.5) compared to that without retinal lesions -6.1 +/- 3.4 diopters (range -25.00 ~ 17.00), 25.4 +/- 2.1mm (range 15.7 ~ 35.4). And the incidence of degenerative change and retinal tear was significantly increased in moderate myopes more than -4 diopters. CONCLUSIONS: LASIK is relatively a kind of safe refractive surgery, but to prevent the unexpected postoperative retinal complications, it is essential to thoroughly examine the retina upto periphery before surgery.
Cicatrix ; Humans ; Incidence ; Keratomileusis, Laser In Situ* ; Refractive Errors ; Refractive Surgical Procedures ; Retina ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde* ; Retrospective Studies

To determine if the residual corneal stromal bed of 250 micrometer is enough to prevent iatrogenic keratectasia in laser in situ keratomileusis (LASIK), we studied 958 patients who underwent LASIK from April 2000 to October 2003 retrospectively. The estimated probabilities of the residual stromal bed, that was less than 250 micrometer, were calculated using the published flap thickness data of Moria C&B microkeratome. Then we calculated the ratio of the real incidence of keratectasia to the expected the percentage of the patients with less than 250 micrometer residual stromal bed in our study. Using the LASIK flap thickness data of Miranda, Kezirian and Nagy, the expected probabilities that the residual stroma would be less than 250 micrometer were 8.8%, 4.3% and 1.5% of the 1,916 eyes respectively, while keratectasia developed in both eyes (0.1%) of 1 patient in our study. The estimated ratio of the keratectatic eyes to eyes with less than 250 micrometer stromal bed were 1.2-6.9%. Compared to the number of eyes with residual stromal thickness less than 250 micrometer, the incidence of keratectasia was relatively low. The residual stromal bed thickness of more than 250 micrometer may possibly be safe, but further observations for long period are necessary.
Postoperative Complications/*prevention & control ; Middle Aged ; Keratomileusis, Laser In Situ/*adverse effects ; Iatrogenic Disease/*prevention & control ; Humans ; Dilatation, Pathologic ; Corneal Stroma/*pathology ; Corneal Diseases/etiology/*prevention & control ; Adult

Proliferating trichilemmal tumor is a rare benign tumor of skin appendage. It is usually solitary, more common in women after the fourth decade of life, and almost exclusively confined to the scalp and back of the neck. We report herein an unusual case of proliferating trchilemmal tumor which occurred on the knee.
Bursitis ; Female ; Humans ; Knee ; Neck ; Scalp ; Skin

The infestation caused by itch mite, Sarcoptes scabiei brings about very severe itching aggravated at night, and has a very high transmissibility. The lesions are commonly found on lower abdomen, thigh, axilla, interdigital area, buttocks, and genitalia. But it is rare to find the mite on eye lid. We have experienced a 33 year-old female patient who complained of persistent itching and foreign body sense in upper eyelid, and found a mite there. Then it was removed mechaincally, and the symptoms disappeared without any particular treatment. So we report a case of eye lid infestation by S.scabiei with the review of literatures.
Abdomen ; Adult ; Axilla ; Buttocks ; Eyelids ; Female ; Foreign Bodies ; Genitalia ; Humans ; Mites ; Pruritus ; Sarcoptes scabiei* ; Thigh

To investigate the drug effect of topical Mitomycin C in various concentrations combined with steroid, we used 30 rabbits whose corneal epitheliums were abraded intentionally. They were divided into 5 groups. Using MMC in various concentrations and steroids, we instilled them into right eyes and saline into left eyes as control. We measured the healing rate at a interval of 12 hours. Three months later, we sacrificed one of them and examined the pathological changes from various ocular tissues. We found many complications such as corneal edema, ulcer, opacity and definite delay of wound healing when the concentration higher than 0.04%MMC was used. There were also decreased fibroblast cells in H-E staining. The steroids seemed not to pose any influence on the effect of MMC. In conclusion, we must take the great care in the use of MMC, and the concentration should be low when used. In addition, we still think there ought to be more studies as to the effect of steroids according to MMC levels.
Cornea* ; Corneal Edema ; Epithelium, Corneal ; Fibroblasts ; Intention ; Mitomycin* ; Ophthalmic Solutions* ; Rabbits ; Steroids ; Ulcer ; Wound Healing

To investigate the drug effect of topical Mitomycin C in various concentrations combined with steroid, we used 30 rabbits whose corneal epitheliums were abraded intentionally. They were divided into 5 groups. Using MMC in various concentrations and steroids, we instilled them into right eyes and saline into left eyes as control. We measured the healing rate at a interval of 12 hours. Three months later, we sacrificed one of them and examined the pathological changes from various ocular tissues. We found many complications such as corneal edema, ulcer, opacity and definite delay of wound healing when the concentration higher than 0.04%MMC was used. There were also decreased fibroblast cells in H-E staining. The steroids seemed not to pose any influence on the effect of MMC. In conclusion, we must take the great care in the use of MMC, and the concentration should be low when used. In addition, we still think there ought to be more studies as to the effect of steroids according to MMC levels.
Cornea* ; Corneal Edema ; Epithelium, Corneal ; Fibroblasts ; Intention ; Mitomycin* ; Ophthalmic Solutions* ; Rabbits ; Steroids ; Ulcer ; Wound Healing

PURPOSE: The purpose of this study was to describe the clinical characteristics of neonatal urinary tract infection (UTI) caused by Klebsiella pneumoniae and non- Klebsiella pneumoniae UTI. METHODS: We compared clinical characteristics of 84 neonatal patients with UTI caused by Klebsiella pneumoniae who were hospitalized at the Department of Pediatricsat Han Dong University, Sunlin Hospital during the period between May, 1994 and August, 1998. The cases were divided into two groups depending upon causative organisms' Klebsiella pneumoniae UTI vs non-Klebsiella pneumoniae UTI, and the clinical characteristics of these groups were compared. RESULTS: Escherichia coli was the most common bacterial pathogen causing neonatal UTI, followed by Klebsiella pneumoniae. There was no significant difference in the sex distribution of Klebsiella pneumoniae UTI, but non-Klebsiella pneumoniae UTI showed male predominence. There were no significant differences in the incidences of hematologic, urologic, radiologic findings and perinatal complications in between these 2 groups. CONCLUSION: Klebsiella pneumoniae is the second most common pathogen causing neonatal UTI. There were no specific differences in the laboratory, symptomatologic, and radiologic findings in these two groups.
Escherichia coli ; Humans ; Incidence ; Klebsiella pneumoniae* ; Klebsiella* ; Male ; Pneumonia ; Sex Distribution ; Urinary Tract Infections* ; Urinary Tract*

The villous adenoma of the duodenum is a rare disease and a considerable portion of the cases are known to be associated with malignancy. Although the diagnosis can be made with duodenoscopy, some cases showed false negative rate for malignancy detection with endoscopic biopsy only. So Whipple's operation is preferred than local excision. We experienced a case of tubulovillous adenoma involving ampulla of Vater, which recurred after local excision. So we report a case of tubulovillous adenoma involving ampulla of Vater with relevant literature.
Adenoma* ; Adenoma, Villous ; Ampulla of Vater* ; Biopsy ; Diagnosis ; Duodenoscopy ; Duodenum ; Rare Diseases

Prediction of acetabular development after reduction in treatment of developmental dysplasia of thc hip (DDH) is earlier, the hetter results because it would help ensure optimal timing of additional procedure if necessary. In this respect, authors reviewed retrospectively the radiographs of the hips of 35 children with DDH who had unilateral involvement and treated hy senior author (S.H.Lee) from the heginning with single successful attempt of reduction. The radiographs which were made at the time of initial diagnosis, one, two year nfter reduction und final follow up were assessed of teardrop figures. The results of treatment were classified as satisfactory group(CE > 10degrees ) and unsatisfactory group(CE < 10degrees) judged hy center-edge angle(CE degrees) at final follow-ups. 1. The teardrop figures were classifiable into 4 distinct groups as i)absent. ii)V-shaped, iii)Ushaped, iv) inverted D-shaped. 2. The teardrop figures in normal sides of hip were all U-shaped. 3. In dislocated but with satisfactory result group(24 cases), absent at 2 cases(8%), U-shaped teardrop was seen at 13 cases(54%), V-shaped in 9 cases(38%), and inverted 2-shaped in 0 case at I year after reduction. 4. In dislocated but with unsatisfactory result group( 11 cases), they were mostly of V-shaped(7 cases, 64%). The rest were of ahsent in 4 cases(36%) . hut none of U-shaped and inverted 2-shaped. In conclusions, teardrop figures appeared as significant predictor of future development of hip joint. Teardrop figure which stay as V-shaped at one year after reduction seems suggestive of insufficient reduction of DDH, therehy calls for early additional procedure.
Acetabulum ; Child ; Diagnosis ; Dislocations* ; Dronabinol ; Follow-Up Studies ; Hip Joint ; Hip* ; Humans ; Retrospective Studies