Plexiform neurilemmoma is a relatively rare, benign peripheral nerve sheath tumor, whieh usually arises in either the dermis or subcutaneous tissue. These tumors may occur singly or as multiple lesions (plexiform neurilemmomatosis), We report an unusual case of plexiform neurilemmomatosis associated with cafe au lait spots reminiscent of neurofibromatosis clinically and another case of plexiform neurilemmoma on the finger. A Biopsy revealed the characteristic palisaded arrangement of spindle cells within well circumscribed elongated nodules, The skin lesions were completely excised without recurrence thereafter.
Biopsy ; Cafe-au-Lait Spots ; Dermis ; Fingers ; Neurilemmoma* ; Neurofibromatoses ; Peripheral Nerves ; Recurrence ; Skin ; Subcutaneous Tissue

BACKGROUND: Lupus erythematosus profundus (LEP) is an unusual clinical variant of lupus erythematosus (LE). It is unclear which part LEP occupied in the disease spectrum of LE. OBJECTIVE: Clinical and histopathological studies were performed on 19 patients with LEP in order to further define the clinical patterns, know the various serological findings, and review the histopathological features. METHODS: A retrospective review was carried out of the clinical records and histopathological specimens of 19 patients with LEP. RESULTS: The most common clinical features were indurated nodules or plaques on the cheek. There was a 37% positivity in the ANA test. Histopathogically epidermal changes as well as subcutaneous involvements were common. There were no cases of newly developed SLE during the follow up period of 41 months. CONCLUSION: Most patients with LEP have a relatively benign disease course, although a few develop systemic abnormalities and have abnormal laboratory findings.
Cheek ; Follow-Up Studies ; Humans ; Panniculitis, Lupus Erythematosus ; Retrospective Studies

Dermatofibrosarcoma protuberans is a rare, slowly growing, locally invasive spindle-cell tumor characterized by a protuberant cutaneous mass with a pronounced tendency to recur and by a prominent storiform histopathologic pattern'-'. We present a case of dermatofibrosarcoma protuberans with myxoid area on the chest of a 57-year-old man. The histopathological study showed a dermal tumor of uniform spindle-shaped cells with storiform pattern. Immunohistochemically, the tumor was stained positively to anti-CD34 antibody and negatively to anti-factor XIIIa antibody.
Dermatofibrosarcoma* ; Factor XIIIa ; Humans ; Middle Aged ; Thorax

BACKGROUND: Pseudo-Kaposi sarcoma mimicks Kaposi sarcoma, both clinically and histopathologically. These conditions are due to congenital (Stewart-Bluefarb syndrome) or acquired (Mali) vascular malformations. OBJECTIVES: The purposes of this study were aimed at evaluating the clinical and histopathological characteristics of pseudo-Kaposi sarcoma and finding differential diagnostic tools from Kaposi sarcoma. METHODS: Clinical information of 7 patients with pseudo-Kaposi sarcoma diagnosed in Asan Medical Center from 1989 to 1999 was obtained from the medical records and clinical follow-ups. We re-evaluated 10 biopsy specimens obtained from them and immunohistochemical studies for cutaneous lymphocyte antigen (CLA), CD34, vimentin, and factor VIII were performed with the standard streptavidin-biotin method using paraffin-embedded tissue specimens of 7 pseudo-Kaposi sarcomas and 3 Kaposi sarcomas. In addition, we examined whether human herpesvirus 8 (HHV8) was detected in 3 patients by polymerase chain reaction (PCR). RESULTS: Six male and one female patients were included. Mean age was 36.3 years. Three patients were classified into Mali type and the other four patients were into Stewart-Bludfarb type. Histopathological examinations revealed capillary proliferation in the upper dermis, perivascular infiltrate of inflammatory cells, extravasated red blood cells, and fibrosis of dermis. Anti-factor VIII and CD34 stained endothelial cells only. CLA was expressed in lymphocytic infiltrate in the epidermis and dermis of pseudo-Kaposi sarcoma, whereas it was negative in Kaposi sarcoma. PCR for HHV 8 showed negative results. CONCLUSIONS: Pseudo-Kaposi sarcoma is an uncommon entity with characteristic clinical and histopathological features. Differential diagnosis between Pseudo-Kaopsi sarcoma and Kaposi sarcoma is important. We suggest that detection of HHV 8 by PCR and imunohistochemical study for CLA may be effective tools in the differential diagnosis between them.
Biopsy ; Capillaries ; Chungcheongnam-do ; Dermis ; Diagnosis* ; Diagnosis, Differential ; Endothelial Cells ; Epidermis ; Erythrocytes ; Factor VIII ; Female ; Fibrosis ; Follow-Up Studies ; Herpesvirus 8, Human ; Humans ; Lymphocytes ; Male ; Mali ; Medical Records ; Polymerase Chain Reaction ; Sarcoma ; Sarcoma, Kaposi* ; Vascular Malformations ; Vimentin

Peripheral eosinophilia is perpetually associated with many disease conditions like asthma, parasitic disease, IL-2 therapy, hypereosinophilic syndrome and eosinophilia/myalgia syndrome. Furthermore, peripheral eosinophilia may also be linked with Graves' disease, which is induced by thyroid-stimulating anti-TSH receptor antibodies and is related to type 2 helper T cell(Th2) predominant condition that is dependent on humoral immunity. In some of the cases of Graves' disease, thyrotoxicosis may induce peripheral eosinophilia associated with relative cortisol deficiency. In our present study, we present a case of two patients who were suffering from Graves' disease without any thyrotoxic symptoms and exhibited increased levels of peripheral eosinophil count. But, the count was observed to decreas in euthyroid state.
Antibodies ; Asthma ; Eosinophilia* ; Eosinophils ; Graves Disease ; Humans ; Hydrocortisone ; Hypereosinophilic Syndrome ; Hyperthyroidism* ; Immunity, Humoral ; Interleukin-2 ; Parasitic Diseases ; Thyrotoxicosis

PURPOSE: The aim of this study was to investigate effect of specimen preparation method on the microtensile bond strength of veneering ceramic to zirconia core. MATERIALS AND METHODS: Cylindrical Lava zirconia block (3M ESPE, Seefeld, Germany) was cut into discs using a diamond disc. After sintering, the core specimens were placed in an adjustable mold and veneered with Lava ceram (3M ESPE, Seefeld, Germany). The disc shaped specimen of group 1 was cut into microbars (1x1x7 mm3) using a low speed diamond disc under water cooling (n = 15). The specimen of group 2 was cut into microbars (1.2x1.2x7 mm3) in the same way. Whereafter the microbars were trimmed (1x1x7 mm3) using a thick diamond disc under water cooling (n = 15). The microtensile bond strength was tested in a microtensile tester (Instron 8848, Instro(R) Co., Norwood, USA). Fractured microtensile specimens were analyzed under a stereomicroscope (MZ6, Leica Microsystems GmbH, Wetzlar, Germany) at magnification x30. RESULTS: The microtensile bond strength of group 1 (28.8 +/- 7.0 MPa) was significantly higher than group 2 (11.0 +/- 3.3 MPa) (P=.00). CONCLUSION: It appears advisable to avoid the trimming action, especially high strength ceramic specimens.
Ceramics ; Diamond ; Fungi ; Water ; Zirconium

Differential diagnoses showing Verocay body-like formation include schwannoma, palisading myofibroblastoma, palisading cutaneous fibrous histiocytoma, dermatofibroma with myofibroblastic differentiation, leiomyoma, palisaded encapsulated neuroma, and neuroma. A 60-year-old Korean man presented with a 10-year-history of an asymptomatic nodule on the right forearm. Histopathological examination revealed well-circumscribed multi-micronodules with prominent Verocay body-like formation consisted of spindle cells and extensive infiltrate of mutinous materials. The spindle cells were negative for S-100 protein and desmin, but positive for vimentin and a-smooth muscle actin by immunohistochemical staining. The micronodules were lined by CD34 and factor VIII positive endothelial cells. The mutinous materials were stained with alcian blue at pH 2.5, but not at pH 0.5. We diagnose it as myxoid myofibromatosis-type perivascular myoma showing Verocay body-like formation.
Actins ; Alcian Blue ; Desmin ; Diagnosis, Differential ; Endothelial Cells ; Factor VIII ; Forearm ; Histiocytoma, Benign Fibrous ; Humans ; Hydrogen-Ion Concentration ; Leiomyoma ; Middle Aged ; Myofibroblasts ; Myoma* ; Neoplasms, Muscle Tissue ; Neurilemmoma ; Neuroma ; S100 Proteins ; Vimentin

BACKGROUND: Protamine sulfate (PS), used to neutralize the anticoagulant effect of heparin, is often associated with systemic hypotension. The present study was aimed to investigate the protective effects of calcium chloride (CaCl2) on adverse hemodynamic reactions to PS in patients undergoing open heart surgery. METHODS: After IRB approval, sixty-one patients undergoing open heart surgery were allocated randomly to receive either saline 10 ml (control group, n = 26), CaCl2 5 mg/kg (CaCl2 5 group, n = 18) or 10 mg/kg (CaCl2 10 group, n = 18), added to PS 3 mg/kg given over 3 min through the right atrium to reverse heparinization. Hemodynamic measurements, including systolic (SAP), diastolic (DAP), and mean arterial pressure (MAP), heart rate, and central venous pressure (CVP) were continuously recorded in a baseline condition and up to 10 minutes after PS infusion. Plasma Ca2+ level and arterial blood gas tension were also measured. RESULTS: PS caused immediate and significant decreases in SAP, DAP, and MAP in all three groups. However, the degree of hypotension was significantly less in the CaCl2 10 group than in the CaCl2 5 and control groups. Heart rate and CVP remained unchanged throughout the study in all groups. Intravenous CaCl2 5 and 10 mg/kg IV caused an increase in plasma Ca2 by 0.13 +/- 0.08 mM and 0.45 0.08 mM at 2 min after its injection, respectively. Arterial oxygen tension did not change significantly throughout the study in any group. CONCLUSIONS: These results suggest that simultaneous administration of 10 mg/kg CaCl2 attenuates the hypotensive effect of PS used to reverse heparin anticoagulation in patients undergoing open heart surgery. However, hypotensive reactions may still occur.
Adult* ; Arterial Pressure ; Calcium Chloride* ; Calcium* ; Central Venous Pressure ; Ethics Committees, Research ; Heart Atria ; Heart Rate ; Hemodynamics ; Heparin ; Humans ; Hypotension* ; Oxygen ; Plasma ; Protamines ; Thoracic Surgery

In cases of meningoencephalocele, brain tissue, which is enveloped by the meninges and cerebrospinal fluid, herniates through the skull defect. Atretic cephalocele, on the other hand, is a congenital malformation in which small meningeal and vestigial glial tissue herniates through this defect; a benign nodular lesion is found near the midline of the scalp. Atretic cephalocele can occur in the parietal or occipital area; in cases involving the latter, the prognosis is poor. We report the radiologic findings of two cases of atretic cephalocele confirmed by surgery and pathologic findings.
Brain ; Cerebrospinal Fluid ; Encephalocele* ; Hand ; Meninges ; Prognosis ; Rabeprazole ; Scalp ; Skull

Primary adenosquamous carcinoma of the liver is a very rare type of cholangiocarcinoma and is defined as a cancer containing both squamous and adenomatous components in the same lesion. Recently, we experienced a primary adenosquamous carcinoma of the liver presented as liver abscess. A 63-year-old man was presented with a 4-day history of fever and chill. The radiologic study showed a 4 cm-sized, central hypoattenuated mass with peripheral rim enhancement in the left lobe of the liver. Ultrasonography-guided aspiration and biopsy suggested an adenocarcinoma with abscess in the liver. At laparotomy, the tumor occupied the left lobe of the liver and invaded the right diaphragm. An extended left lobectomy and a partial excision of the involved diaphragm were done. Grossly, the tumor was 6x5x5 cm in size and had an eccentric necrosis. Microscopically, the tumor was composed of adenocarcinoma and squamous cell carcinoma with a transitional area.
Carcinoma, Adenosquamous/*complications/pathology/surgery ; Case Report ; Human ; Liver Abscess/*etiology ; Liver Neoplasms/*complications/pathology/surgery ; Male ; Middle Age