PURPOSE: To determine the accuracy of MRI on postoperative pain syndrome (POPS), including early complications such as hematoma or infection. MATERIALS AND METHODS: Of the 54 patients with the POPS, we analyzed pre-operative MRI findings compared with operative findings on 39 patients, excluding nonunion, instability, metal failure and pseudarthrosis, who underwent an operation for POPS from December 1994 to June 1997. There were 25 men (64.1%) and 14 women (35.9%), aged from 16 to 68 years (average 44.5 years). They were divided into 5 subgroups and calculated for sensitivity, specificity and positive predictability. RESULTS: MRI accuracy in recurred disc was 84%, scar adhesion, recurred or developed stenosis, infection and hematoma was 100% for each overall accuracy of MRI was 93%. Average interval of reoperation in POPS was 3.2 years. In 21 cases (53.8%), symptoms persisted without pain-free interval after first operation. CONCLUSIONS: Early complications, including hematoma and infection, are easily detected with MRI. Especially if patient complains of severe leg pain or neurologic deficit, MRI is a good diagnostic tool. MRI is a useful method for evaluation of most cases of POPS, but it is limited in evaluating recurred disc or scar adhesion only in T1, T2 weighted image. Therefore, Gd-DTPA enhancement is necessary for an accurate diagnosis.
Cicatrix ; Constriction, Pathologic ; Diagnosis ; Female ; Gadolinium DTPA ; Hematoma ; Humans ; Leg ; Magnetic Resonance Imaging* ; Male ; Neurologic Manifestations ; Pain, Postoperative* ; Pseudarthrosis ; Reoperation ; Sensitivity and Specificity

BACKGROUND: Pityriasis rubra pilaris (PRP)is a rare papulosquamous disorder of unknown etiology. Although the clinical and histopathologic features of PRP are relatively well known in western patients, there are few available studies in Korea. OBJECTIVE: The purpose of this study was to evaluate the clinical and histopathologic features of pityriasis rubra pilaris(PRP) in Korea METHODS: The clinical charts, photographies and skin biopsy slides of patients clinically diagnosed as PRP at the initial visit were reviewed. Finally 30 patients were diagnosed as PRP. They were classified into 5 groups according to the Griffiths classification. And then the evaluation of age at onset, sex distribution, clinical feature of the skin lesion, associated symptoms, clinical course and histopathologic features were conducted. RESULTS: 1) The male to female ratio was 1:1.14. The age of onset was varied from 1 to 65 years with two peaks in first and fifth decades. The average ages of onset in adult type and juvenile type were 40.1 and 5.1 years respectively. 2) According to the Griffiths classification, 14(47%) of the patients had type I, 4(13%) had type III, 7(23%) had type IV, and 3(10%) had type V. However, 2(7%)patients could not be classified under any of these five types due to atypical clinical feature or insufficient follow-up periods. 3) The common clinical features during the disease course were follicular hyperkeratosis(83%), knee and/or elbow involvement(83%), palm and/or sole hyperkeratosis(80%). Erythroderma was present in 5 patients(17%) during the disease course. 4) There were no specific symptoms in most cases, but 9 patients had ben suffered from mild itching. 5) 3 patients had a positive family history, and were thought to have inherited autosomal dominant trait. 6) The frequent histopathologic findings were alternating parakeratosis and orthokeratosis (100%), superficial perivascular infiltration(100%), broad rete ridge(97%), acanthosis(93%), hypergranulosis (87%), follicular plugging(73%). CONCLUSION: We investigated the clinical and histopathological features of PRP in Korea. In our study, the clinical and histopathological features of PRP were not different from those observed in western patients.
Adult ; Age of Onset ; Biopsy ; Classification ; Dermatitis, Exfoliative ; Elbow ; Female ; Follow-Up Studies ; Humans ; Knee ; Korea ; Male ; Parakeratosis ; Photography ; Pityriasis Rubra Pilaris* ; Pityriasis* ; Pruritus ; Sex Distribution ; Skin ; Skin Diseases, Papulosquamous

Aneurysms of the ascending aorta are relatively uncommon disorders which are located in ascending portion of the thoracic aorta. The commenest cause of aneurysms of the ascending aorta is arteriosclerosis, but syphilis, marfan syndrome, cystic medial necrosis, trauma, and aging of the aorta must also be noted as causes. We report a case with a aneurysm of the ascending aorta, 23 years old female, who was performed the open heart surgery because of ventricular septal defect with aortic insufficiency about 10 years ago.
Aging ; Aneurysm* ; Aorta* ; Aorta, Thoracic ; Arteriosclerosis ; Female ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Marfan Syndrome ; Necrosis ; Syphilis ; Thoracic Surgery* ; Young Adult

Benign pigmented lesions derived from dermal melanocytes include the Mongolian spot, the nevi of Ota and Ito, and the blue nevus. The nevus of Ito differs from the nevus of Ota by its location in the supraclavicular, scapular and deltoid regions. It occurs rarely in association with bilateral nevus of Ota. We present a 70 years old male, showing extensive involvement of dermal melanocytic nevi, so called bilateral nevus of Ota associated with bilateral nevus of Ito.
Aged ; Humans ; Male ; Melanocytes ; Mongolian Spot ; Nevus of Ota* ; Nevus* ; Nevus, Blue ; Nevus, Pigmented

Cutis verticis gyrata(CVG) is a descriptive term for a condition of the scalp in which deep furrows and convolutions are seen that resemble the outer surface of the cerebrum. The possible etiologies may be categorized as primary essential, primary nonessential, and secondary cutis verticis gyrata. This is based on history, physical examination, and histologic criteria with or without laboratory examinations. Herein we reported a case of primary essential cutis verticis gyrata with no associated disorders.
Cerebrum ; Physical Examination ; Scalp

Polymerase chain reaction was performed to determine he types of human papillomavirus (HPV) causing condylomata acuminata in frozen tissues and paraffinembedded tissues of condylomata acuminata. HPV DNA was detected in 31 of 32 patients with condylomata aciminata. HPV 6 and/or 11, low-risk types in genital carcinogenesis, were present in all cases in whieh HPV was detected. Both types were present in 5 cases. It is, therefore, supposed that there is not much risk of this disease to transform to the invasive cancer in Korean and polymerase chain reaction can be used to deteet HPV and identify its type from paraffin-embedded tissues.
Carcinogenesis ; Condylomata Acuminata* ; DNA ; Human papillomavirus 6 ; Humans* ; Polymerase Chain Reaction*

Sweet's syndrome, also referred to as acute febrile neutrophilic dermatosis(AFND), is an unusual entity characterized by painful erythematous plaques. Histologically a dense perivascular infiltrate composed predominantly of neutrophils without discernable vascular wall change. Sweet's syndrome can be associated with several disorders, such as inflammatory bowel diseases, various malignant tumors, and autoimmune diseases including rheumatoid arthritis, but the association of Sweet's syndrome with rheumatoid arthritis seems to be uncommon and no case has ever been reported in Korea. Herein we describe a patient who had Sweet's syndrome associated with rheumatoid arthritis.
Arthritis, Rheumatoid* ; Autoimmune Diseases ; Humans ; Inflammatory Bowel Diseases ; Korea ; Neutrophils ; Sweet Syndrome*

Allergic contact dermatitis to topical corticosteroids seems to occur more frequently than previously supposed. But it is not easily recognized because the allergic condition for which the steroid is mostly prescribed masks the sensitization. Moreover, corticosteroids evoke some anti-inflammatory effect, even in case of steroid hypersensitivity. A 40-year-old man visited our department for the evaluation of aggravated skin lesion of trunk. Previously he was treated with Dermovate(R) and Eumovate(R) ointment for chronic dermatitis. He was patch tested to the Korean standard series, with Dermovate(R) and Eumovate(R) ointment as is. Patch test showed positive reactions to both ointments.
Adrenal Cortex Hormones ; Adult ; Dermatitis ; Dermatitis, Allergic Contact* ; Humans ; Hypersensitivity ; Masks ; Ointments ; Patch Tests ; Skin

BACKGROUND: Pilomatricoma is a cystic neoplasm with differentiation toward hair cortex cells. Although it is characterized by several features such as cellular constitiuents, stromal change and inflammation, it is difficult to interpret the histopathogenesis of the lesions, and there is no comprehensive understanding about the evolution of the tumor. OBJECT: The purpose of this study was to characterize the clinical and histopathologic feature of pilomatricoma and to suggest the growth pattern and evolutional stage of this tumor. METHOD: Thirty-eight cases with pilomatricoma in 34 patients who had visited Korea University Hospital during the last 10 years have been collected. We studied the clinical and histopathological characteristics of the cases and tried to classify evolutional stages of them and to elucidate the growth pattern. RESULTS: Most of the tumors were solitary lesions except four patients, who showed two lesions simultaneously. The male to female ratio was 1:1.1. The average age was 16.25 years (9months to 43 years) and 35 cases(92%) were developed in the patients younger than 30 years old. The predilection sites were arm(61%), face(18.2%), neck(13%), thigh(5.2%), shoulder(2.6%) in order. The duration of lesions was from 10 days to 3 years in known cases, with mean duration of 9.8months. Histopathologically tumor size was from 0.3cm to 1.9cm in diameter, with average value of 0.89cm. 29 cases showed inflammatory reaction variably in its severity involving giant cells. Calcification was observed in 22 cases and two of them showed ossification. According to four stage system of previous study, we categorized our cases into the 3 early stage, 8 fully developed stage, 15 early regressive stage, and 12 late regressive stage. Peripheral basaloid epithelium surrounding the tumor was found in 17 cases. 3 cases were surrounded by epithelium perfectly, and 5cases were surrounded by half or more. CONCLUSION: Pilomatricoma is not a cyst but a cystic neoplasm that consists principally of rapidly growing basaloid cells that form well-defined lobular aggregations of diverse sizes and shapes. It shows variable features with differentiation. Since previous four staging system were not clearly differentiated in each stage, we divided pilomatricoma into three phases, developing phase, proliferative phase and regressive phase, according to the constituents of basaloid cells in the periphery.
Adult ; Epithelium ; Female ; Giant Cells ; Hair ; Humans ; Inflammation ; Korea ; Male ; Pilomatrixoma*

Basal cell carcinomas(BCCs) are the most common skin cancers in Korea and a proportion of BCCs contain pigment. Pigmented basal cell carcinomas(PBCCs) are included in the differential diagnosis of invasive melanoma and other benign pigmented skin lesions(PSLs) because of their growth patterns and asymmetry of pigmentation. Epiluminescence microscopy(ELM) describes the non-invasive in vivo examination of skin lesions with a microscope using incident light delivered from an acute angle and oil immersion. Many studies have shown that epiluminescence microscopy can improve the diagnostic accuracy of PSLs. Menzies et al analyzed the morphologic features of a large set of 142 pigmented BCCs and produced a simple ELM method for diagnosis that would allow differentiation from melanomas and benign pigmented lesions. We observed morphologic features of two PSLs with a handheld 10 epiluminescence microscopy (Episcope, Welch Allyn Inc, Skaneateles Falls, NY). After the ELM examination, two PSLs were excised and processed for histopathology. The ELM findings and histopathologic diagnosis were compared for each lesion. ELM permits the recognition of two PBCCs and the fact that it is a non-invasive in vivo method makes it even more attractive as a diagnostic tool in clinical practice.
Carcinoma, Basal Cell* ; Dermoscopy* ; Diagnosis ; Diagnosis, Differential ; Immersion ; Korea ; Melanoma ; Pigmentation ; Skin ; Skin Neoplasms