Melanoacanthoma is an extremely rare pigmented benign mixed epithelial tumor of both melanocytes and keratinocytes. A 52-year-old female presented an asymptomatic, slightly elevated, 1. 2 cm x 0. 8 cm, dark black-colored plaque on her right buttock of 2 years' duration. Histopathologic finding of the plaque shows hyperkeratosis, focal parakeratosis, follicular plugging, acanthosih, papillomatosis and pseudo-horn cyst in the epidermis. The tumor is composed of basaloid and squarnous cells with many foci of clusters and whorls of melanin pigment-laden cells. Electron microscopic finding reveals many scattered melanocytes in the entire epidermis. Melanin granules are found mostly in the melanocytes but can also be found in a few keratinocytes.
Buttocks ; Epidermis ; Female ; Humans ; Keratinocytes ; Melanins ; Melanocytes ; Middle Aged ; Papilloma ; Parakeratosis

OBJECTIVE: The aim of this study was to evaluate the prognostic value of the selective nerve root block prior to the surgery. METHODS: Between January 2007 and December 2009, 52 cases of selective nerve root block prior to the spine surgery were performed. Three cervical lesions and 49 lumbar spinal lesions were selected. All selected patients had multilevel spine lesions or poorly defined radiologic findings with significant symptoms of neural foramen stenosis. RESULTS: In total of the 52 patients, 41 had positive and 11 had negative results with the nerve root block. Out of the 41 patients with positive results, 40 patients had good surgical outcome. From the 11 patients with negative results, 6 patients had good surgical outcome. All surgeries were performed at the positive level at the selective nerve root block and the most suspected lesion. CONCLUSION: Selective nerve root block can be used to evaluate the location generating the most serious radiating pain. Results of selective nerve root block corresponded with the results of the surgical outcome in the most cases. We can predict the outcome of the surgery, especially in case of multilevel spine problems or poorly defined radiologic findings, by performing preoperative selective nerve root block.
Humans ; Spine

We present a case of tuberculous spondylitis in which diagnosis was masked by a concomitant pyogenic infection. The patient had undergone percutaneous needle aspiration of an abscess in the cavity of the psoas muscle. Early results from the culture regimen showed isolation of methicillin-resistant Staphylococcus aureus. After eight weeks, mycobacterium tuberculosis was grown at regimen which was cultured at the same site. Initial isolation of pyogenic bacteria, considered to be highly virulent organisms, led to delayed diagnosis and treatment of the tuberculosis.
Abscess ; Bacteria ; Delayed Diagnosis ; Humans ; Masks ; Methicillin ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Mycobacterium tuberculosis ; Needles ; Psoas Muscles ; Spondylitis ; Staphylococcus ; Staphylococcus aureus ; Tuberculosis

No abstract available.
Animals ; Embryonic Development* ; Embryonic Structures* ; Endometriosis* ; Female ; Humans ; Mice* ; Pregnancy

Warfarin-induced skin necrosis is a rare complication caused by transient hypercoagulable state. This state is a result of rapid decline of the protein C activity relative to that of coagulation factor II, IX, and X during initiation of oral anticoagulant therapy. We experienced a case of warfarin-induced skin necrosis involving both breasts in a patient who underwent double valve replacement 1 month before. Warfarin was replaced to a low- molecular weight heparin and the necrotic breast lesion was healed spontaneously. Low-dose warfarin was restarted and gradually increased, after which a low molecular weight heparin discontinued.
Breast ; Heparin ; Heparin, Low-Molecular-Weight ; Humans ; Molecular Weight ; Necrosis* ; Protein C ; Prothrombin ; Skin* ; Warfarin

No abstract available.
Biopsy, Fine-Needle*

Rotatory fixation of the atlantoaxial joint is relatively rare in adults but somewhat more common in children. Most of them are reduced spontaneously or after traction. However, combined rotatory injury of atlantoaxial joint and unilateral occipitoatlantal subluxation is a rare disease, and it is often difficult to diagnose accurately. Because the craniovertebral junction is complex and patients with combined atlantoaxial rotatory fixation (AARF) and occipitoatlantal subluxation has a less rotated head than patients with pure AARF. And injury of the occipitoatlantal and atlantoaxial joint can often result upper cervical instability, so early diagnosis is very important. We present a case of the combined AARF and unilateral counter occipitoatlantal subluxation after minor trauma.
Adult ; Arthrodesis ; Atlanto-Axial Joint ; Child ; Early Diagnosis ; Head ; Humans ; Organothiophosphorus Compounds ; Rare Diseases ; Traction

INTRODUCTION: Understanding the normal distribution of the tracheal diameter and crross- sectional area is one of the key elements in the management of various tracheal pathologies or tracheal reconstruction for the patients in growing age. However, data for Korean standard has been lacking. This study was designed to analyze retrospectively the distribution of tracheal diameter and cross-sectional area in young Koreans, which can afford fundamental data for the management of tracheal diseases. MATERIAL AND METHOD: Of the patients who underwent computerized tomogram of the chest between May 1996 and August 1998, one hundred six young patients(age range: 0-20 years) were included. Patients with any conditions which might affect the tracheal cross-sectional area or diameter, such as tracheal disease, previous operation, mediastinal tumor, or obstructive lung disease were excluded from the study. Gender distribution was 69 males and 37 females. Tracheal diameters, anterior-posterior and transverse, were measured at the level of the thoracic inlet(level I) and the aortic arch(level II). Types of the trachea were divided into round, oval, or horseshoe shaped on cross-sectional view, and the dimension was calculated by using the equation of A=1/4(pi)ab(A; area, (pi); 3.14, a; anterior-posterior diameter, b; transverse diameter). We analyzed the distribution of the diameter at each level and compared the cross-sectional area with respect to age and gender. A p-value lower than 0.05 wa considered significant. RESULT: The trachea of patients less than 5 years old were round in shape at both of level I and II, and no differences in cross-sectional area was observed between the levels(p=NS). As the age increased, the trachea become oval in shape at level I while it remained round in shape at level II(p=0.020). The tracheal diameter and cross-sectional area increased as the age increased with a linear correlation(r>0.9). In patients less than 5 years of age, female patients showed larger cross-sectional area than male patients (p=0.020), and it was reversed in patients older than 15 years of age(p=0.002). CONCLUSION: From the above results, we suggest chest computerized tomogram as a safe and reliable tool in measuring the tracheal diameter and cross-sectional area. We also provide the data as a standard for distribution of the tracheal diameter and cross-sectional area in young Korean population.
Age Factors ; Child, Preschool ; Female ; Humans ; Lung Diseases, Obstructive ; Male ; Pathology ; Retrospective Studies ; Thorax ; Trachea ; Tracheal Diseases

Pains derived from the temporomandibular joint are not treated easily. Recently, an arthroscopic surgical management has been reported, but its efficacy has not been proven yet. In this case report, we introduce an effective non-surgical treatment technique for the temporomandibular joint using a specially designed dry needle under ultrasonography guidance. Since the patient has pain related to mouth movement, accompanying decreased mouth opening, clicking sound or crepitus on physical examination, this approach will be helpful for pain relief and for functional recovery of the temporomandibular joint.
Humans ; Mouth ; Needles ; Physical Examination ; Temporomandibular Joint ; Temporomandibular Joint Disorders

BACKGROUND: Cervical facet joint needling and stimulation is useful for the management of cervical facet arthropathy, but a direct needling of the joint may injure the capsule and cause post-needling pain.We developed a new approaching technique for cervical facet joint needling and stimulation. METHODS: We retrospectively reviewed medical records of 24 patients with cervical facet arthropathy who underwent facet joint needling and stimulation through oblique posterior approach.Under ultrasonographic guidance, a specially designed dry needle (Ahn's needle) was inserted at midline of posterior neck and advanced obliquely to posterior and lateral side of facet joint.The procedure was completed when a marked reduction in resistance was felt at the tip of the needle.Follow-ups using the numeric rating pain scale (NRS) and the rate of self-rated improvement were conducted at three weeks and about three months after last treatment by telephone interview. RESULTS: Among them, 23 patients were enrolled.The average of NRS decreased from 6.8 +/- 3.0 to 2.7 +/- 3.0 at 3 weeks and to 2.9 +/- 2.0 at 3 months after the last treatment (P < 0.05).The average rate of self-rated improvement was 63.7 +/- 7.2 and 61.6 +/- 3.0% at 3 weeks and 3 months after the last treatment respectively. CONCLUSIONS: Our result suggested that this technique for dry needling around cervical facet joint under ultrasound guidance is one of the successful options to treat neck pain derived from facet joint.
Humans ; Interviews as Topic ; Joints ; Medical Records ; Neck ; Neck Pain ; Needles ; Retrospective Studies ; Zygapophyseal Joint