The cliniopathological analysis was done on the 104 cases of malignant melanoma diagnosed at the Seoul National University Hospital (SNUH) from 1984 to 1993. The basic clinical data and the pathological items were based on the New Mexico Melanoma Registry Worksheet. The results were as follows. The male to female ratio was 1 : 0.79. Primary cutaneous melanoma was more common in the male (M : F=1 : 0.56) but primary extracutaneous melanoma with slight female dominancy (M : F=1 : 1.25). The peak age was the 6th decade in both cutaneous and extracutaneous malignant melanoma. In 66% (35 cases) of primary cutaneous malignant melanoma, the primary site was located in the acral area (including cases of acral lentiginous and nodular type), of which 63% (41% of total cutaneous melanoma) was acral lentiginous type. Major components of tumor cells were epithelioid. Clark's level of tumor was III or more at the time of the first visit in the majority of the cases (85%). The incidence rate of extracutaneous melanoma was 34.6% (36 cases) among the primary melanoma, and the eyeball (17.3%) was the most prevalent organ. All these features suggest that the racial difference between the Korean and the Caucasian is evident and also that etiologic role of sun damage is not quite marked in the Korean. We also suggest that an early detection program is very important to cure this malignant tumor.
Female ; Humans ; Incidence ; Male ; Melanoma* ; New Mexico ; Seoul ; Solar System

Thirty two cases of nevus sebaceus were studied by immunohistochemical staining employing three anticytokeratin antibodies(34bE, 34bB, CAM 5.2) and anti-involucrin antibody in order to clarify the biochemical characteristics of the covering epidermis of nevus sebaceus. An attempt was made to compare the expression pattern of these proteins in the epidermis of nevus sebaceus with that in normal skin and in epidermal nevus. Serial sections in all cases were also stained with PAS in attempt to correlate these protein expression with the amount of glycogen in the epidermis of nevus sebaceus. The following results are obtained. 1. The expression of cytokeratin and involucrin in the epidermis of nevus sebaceus was changed as the age of the lesions increased, but we could not identify a uniform pattern according to the age of lesions. 2. Several CAM 5.2 positive cells were found in the basal layer of the epidermis of nevus sebaceus lesion obtained from patients over 10 years of age. 3. The expression of cytokeratin and involucrin did not show any correlation with glycogen content. These results suggest that the covering epidermis of the lesion of nevus sebaceus may not be nevoid proliferation of epidermal nevus.
Epidermis* ; Glycogen ; Humans ; Keratins* ; Nevus* ; Skin

No abstract available.
Keratinocytes* ; Transplants*

A umbilical omphalomesenteric duct polyp is the result of incomplete closure of the omphalomesenteric duct, which connects the midgut with the yolk sac of the embryo. It may be associated with underlying embryologic anomalies such as Meckels diverticulum and umbilical enteric fistula, the complications of which may at times be fatal. This rare malformation should be clinically discerned from persistent granulation tissue or pyogenic granuloma. Histologically, it shows a polypoid lesion consisting of ectopic gastrointestinal epithelium with the appearance of gastric, intestinal, or colonic mucosa. We report a case of an umbilical omphalomesenteric duct polyp in an 8-year-old male patient, who had had a bright-red polyp on the umbilicus from the age of 1 month and had not had any other types of underlying abnormalities.
Child ; Colon ; Diverticulum ; Embryonic Structures ; Epithelium ; Fistula ; Granulation Tissue ; Granuloma, Pyogenic ; Humans ; Male ; Mucous Membrane ; Polyps* ; Umbilicus ; Vitelline Duct* ; Yolk Sac

BACKGROUND: In the course of the study of keratin expression in the epidermis of nevus sebaceus, several cells in the epidermis of nevus sebaceus were positively stained with CAM 5.2 antibody, which is known to be specific for the lower molecular weight cytokeratin and used as a marker of Merkel cell. OBJECTIVE: This study was intended to verify that CAM 5.2 positive cells found in the epidermis of nevus sebaceus are Merkel cells and to understand the meaning of CAM 5.2 positive j cells in the epidermis of nevus sebaceus. METHODS: The immunohistochemical stainings with CAM 5.2 and antibody to epithelial membrane antigen (EMA) performed on specimens of normal skin, epidermal nevus, nevus sebaceus and some appendage tumors. In order to confirm the nature of CAM 5.2 positive cells, the distribution of those were compared to that of Merkel cells and double labeling with CAM 5.2 and neurofilament was performed. RESULTS: CAM 5.2 positive cells were also found in trichilemmoma developed associated with nevus sebaceus and the epidermis of normal paimoplantar skin. CAM 5.2 positive cells were also stained with antibody to EMA on serial sections cut from the same tissue blocks. The association of CAM 5.2 positive cell and nerve fiber was also demonstrated. CONCLUSION: CAM 5.2 positive cells are seemed to be Merkel cells and their presence in the covering epidermis of nevus sebaceus suggests to the epidermis of nevus sebaceus may not be nevoid proliferation of epidermal keratinocytes.
Epidermis* ; Intermediate Filaments ; Keratinocytes ; Keratins ; Merkel Cells ; Molecular Weight ; Mucin-1 ; Nerve Fibers ; Nevus* ; Skin

BACKGROUND: In the course of the study of keratin expression in the epidermis of nevus sebaceus, several cells in the epidermis of nevus sebaceus were positively stained with CAM 5.2 antibody, which is known to be specific for the lower molecular weight cytokeratin and used as a marker of Merkel cell. OBJECTIVE: This study was intended to verify that CAM 5.2 positive cells found in the epidermis of nevus sebaceus are Merkel cells and to understand the meaning of CAM 5.2 positive j cells in the epidermis of nevus sebaceus. METHODS: The immunohistochemical stainings with CAM 5.2 and antibody to epithelial membrane antigen (EMA) performed on specimens of normal skin, epidermal nevus, nevus sebaceus and some appendage tumors. In order to confirm the nature of CAM 5.2 positive cells, the distribution of those were compared to that of Merkel cells and double labeling with CAM 5.2 and neurofilament was performed. RESULTS: CAM 5.2 positive cells were also found in trichilemmoma developed associated with nevus sebaceus and the epidermis of normal paimoplantar skin. CAM 5.2 positive cells were also stained with antibody to EMA on serial sections cut from the same tissue blocks. The association of CAM 5.2 positive cell and nerve fiber was also demonstrated. CONCLUSION: CAM 5.2 positive cells are seemed to be Merkel cells and their presence in the covering epidermis of nevus sebaceus suggests to the epidermis of nevus sebaceus may not be nevoid proliferation of epidermal keratinocytes.
Epidermis* ; Intermediate Filaments ; Keratinocytes ; Keratins ; Merkel Cells ; Molecular Weight ; Mucin-1 ; Nerve Fibers ; Nevus* ; Skin

BACKGROUND: It has been reported that in 62.5% of cases of incurable cancer pain, the complaint is due to myofascial pain syndrome. Trigger point injections using dibucaine hydrochloride help patients with such cancer pain. This study evaluated the efficacy of trigger point injections for alleviating pain in patients with advanced cancer. METHODS: Twenty patients with advanced cancer who had a life expectancy of 6 months or less and had been diagnosed with myofascial pain syndrome were treated with trigger point injections. Prior to treatment, a Visual Analog Scale (VAS) was used to measure the resting pain level and discomfort upon application of pressure on the site of pain. These values were compared with last treatment measurements. RESULTS: The mean pre-treatment VAS scores for pain at rest and upon application of pressure on the pain site were 7.3 and 9.0, respectively. These scores decreased significantly to 1.95 and 3.2, respectively, after the treatment (P<0.05). CONCLUSION: Trigger point injection is an alternative and effective pain control modality for advanced cancer patients with myofascial pain syndrome.
Dibucaine ; Humans ; Life Expectancy ; Myofascial Pain Syndromes ; Trigger Points ; Visual Analog Scale

PURPOSE: The present study was aimed to evaluate the level of cortical bone strain during the placement of an implant. The primary concern was to investigate if the extent of overloading area near the marginal bone could be affected by microthread fabricated at the cervical 1/3 of an implant. MATERIALS AND METHODS: Three dimensional finite element analysis was used to simulate the insertion of 3 implants. Control model was 4.1 x 10 mm implant (Submerged model, Dentis Co,, Daegu, Korea) equipped with a main thread only. Type I was with main thread and microthread, and Type II had similar thread pattern but was of tapered body. A PC-based finite element software (DEFORM 3D ver 5, SFTC, Columbus, OH, USA) was used to calculate a total of 3,600 steps of analysis, which simulated the whole insertion. RESULTS: Results showed that the strain field in the marginal bone within 1 mm of the implant wall was higher than 4,000 micro-strain in the control model. The size of bone overloading was 1-1.5 mm in Type I, and greater than 2 mm in Type II implants. CONCLUSION: These results indicate that the marginal bone may be at the risk of resorption on receiving the implant for all 3 implant models studied. Yet, the risk was greater for Type I and Type II implants, which had microthread at the cervical 1/3.
Finite Element Analysis ; Sprains and Strains

Intracavernous papaverine injection may be the first step in the assessment of the impotent patient Since measurement of the rigidity requires a sophisticated procedures that may not be available to the majority of the practitioners, we attempted to find an objective method to evaluate the results or this common test. We tested 44 patients complaining of impotence and 2 normal potent men with intracavernous injection of 30mg. papaverine and measured the angle between the penis and the legs with the patient in the standing position and obtained radioisotope erection penogram. Various penogram indexes were calculated from the time activity curve and their usefulness was evaluated and was compared with the findings of nocturnal penile tumescence. The papaverine test can distinguish between the vasculogenic and psychogenic impotent patients. Measurement of the erectile angle after intracavernous injection of papaverine is a simple, objective and reliable method to evaluate patients with vascular impotence. The penogram indexes were significantly correlated with the penile arterial inflow and venous outflow during erection. but not significantly correlated with nocturnal penile tumescence test.
Erectile Dysfunction ; Humans ; Leg ; Male ; Papaverine ; Penile Erection* ; Penis

PURPOSE: The purpose of this study was to evaluate the utility of two-phase dynamic CT, early and equilibrium pahse, in the preoperative staging of rectal cancers. MATERIALS AND METHODS: We performed incremental dynamic CT after rectal infusion of water in 34 patients with pathologically proved rectal cancers. Two-phase dynamic CT findings were prospectively analyzed and correlated with surgical and histopathologic findings. A total of 150ml of nonionic contrast medium was intravenously administered with a power injector at a flow rate of 5ml/sec for 30 sec, and two-phase images were obtained at 30 sec(early phase) and 2 min (equilibrium phase) after bolus injection. Local tumor staging and regional lymph node were classified by TNM staging. RESULTS: All 34 rectal cancers showed a moderate to marked enhancement in the early phase and a homogeneous and prolonged enhancement of the entire lesion in the equilibrium phase. T-staging of primary tumors were 85.3%(29/34) in early phase and 70.6%(24/34) in equilibrium phase. The accuracy in determining the perirectal fat invasion of rectal cancer was 92%(23/25) in early phase, and 72%(18/25) in equilibrium phase. The sensitivity & specificity of the regional lymph node metastasis were 63.6% and 79.1% in early phase, and 54.5% and 65.2% in equilibrium phase, respectively. CONCLUSION: Early phase dynamic CT was more accurate for the preoperative staging of rectal cancer than that at equilibrium phase.
Humans ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Staging ; Prospective Studies ; Rectal Neoplasms* ; Sensitivity and Specificity ; Water