We present a case of eccrine spiradenoma occurring on the trunk in a 33 year old woman. She developed a pea sized, pinkish tender nodule on the anterior chest 8 years ago. On histologic examination, there were several lobules surrounded by thin connective tissue septa in dermis. The lobules themselves consisted of small dark staining cells and large pale-staining cells, forming solid cords or ducts.
Adult ; Connective Tissue ; Dermis ; Female ; Humans ; Peas ; Thorax

No abstract available.
Capillaries* ; Ischemia* ; Muscle, Skeletal* ; Tourniquets*

About half of all burst fractures at the thoracolumbar junction lead to neurological impairment and several clinical series have demonstrated a statistically significant correlation between canal encroachment and neurologic impairment, but not directly related. Spontaneous canal remodelling over time due to bone resorption has been observed in conservatively treated burst fractures. The aim of this study was to measure spinal canal remodelling after stabilization of burst fractures. So, we evaluated 22 cases of surgically stabilized burst fractures of thoracolumbar junction about pre and postoperative spinal canal stenotic ratio and canal remodelling by bone resorption over time. The results were as follows; l. Pedicle splaying increases the spinal canal area and necessitates correction. 2. Patients with neurological deficits had average 53% encroachment and the neurological normal patient had a canal compromise of 33.9%. 3. Postoperatively canal encroachment had decreased to a mean of 17.4% and further reduced by resorption of bony fragment to a mean of 8.3% within 14 months. In conclusions, remodelling of the spinal canal by resorption of encroaching bone fragments is a consistent feature in surgically stabilized thoracolumbar burst fractures and most patients regain their prefracture canal demensions within 14 months.
Bone Resorption ; Humans ; Spinal Canal*

The use of lower extremity tourniquets for procedures of the lower leg is considered routine in orthopedic surgery, but, lower extremity tourniquets do harm occasionally. While the tourniquet is inflated, metabolic changes such as increased PaCO2 , lactic acid, and serum potassium and decreased level of PaO2 and pH occur in the ischemic limb. Deflation of tourniquet results in release of anaerobic metabolic products during ischemia into systemic circulation. In this ischemia/reperfusion situation, oxygen free radicals could potentially be produced during the reperfusion period by several mechanisms. One of these mechanisms is release of intracellular superoxide or hydrogen peroxide by activated neutrophils in the area. These reactive oxygen species(ROS) could be a causative factor for the postreperfusion no-flow, lung injury, induction of tourniquet shock, etc. The purpose of this clinical study was to investigate the effect of tourniquet deflation on the hemodynamic changes, changes of blood gas analysis, and hydrogen peroxide production using flow cytometric analysis of fluorescent DCF(Dichlorofluorescein). Quantitative analysis of fluorescent DCF was performed in resting and fMLP(N-formyl-methyonyl-leucyl-phenylalanine) or PMA(phorbol myristate acetate) stimulated neutrophils. Also differences of these factors between two groups of tourniquet time, one is less than one hour and the other more than one to two hours, were analysed. The hemodynamics(blood pressure, pulse rate), arterial PO2, bicarbonate, base excess, and hydrogen peroxide production showed no significant change before and after tourniquet release(p>0.05). Arterial pH and PaCO2 decreased significantly until 10 and 5 minutes after tourniquet release, respectively(p>0.05). Tourniquet time didn’t reveal any significances differences. These results indicate that tourniquet application with400mmHg pressure and less than 2 hours does not release significant hydrogen peroxide into systemic circulation during reperfusion period after tourniquet release.
Blood Gas Analysis ; Blood Pressure ; Clinical Study ; Extremities ; Flow Cytometry ; Free Radicals ; Hemodynamics ; Hydrogen Peroxide ; Hydrogen ; Hydrogen-Ion Concentration ; Ischemia ; Lactic Acid ; Leg ; Lower Extremity ; Lung Injury ; Myristic Acid ; Neutrophils ; Orthopedics ; Oxygen ; Potassium ; Reperfusion ; Shock ; Superoxides ; Tourniquets

Surgical stabilization using instrumentation for thoracolumbar injuries offers several advantages such as nearly anatomic reduction of fractures, protection of neurologic structures and most importantly early ambulation of the patient. The treatment of fracture-dislocation of the thoracolumbar spine has been progressively improved over the past decades and recently a lot of new device have been introduced to improve fixability of the involved vertebrae three dimensionally and short segmental fixation as possible. The authors have treated 17 cases of unstable thoracolumbar fracture using Cotrel-Dubousset instrumentation in the Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital from Jan. 1988 to Jan. 1989 with the following results: 1. Bursting fractures are the most common type(52.9%) of mechanism of injury. 2. Excellent anatomic reductions were obtained and compression, wedging and local kyphotic deformities were nicely corrected. 3. Short segmental fixation can preserve the maximal spinal mobility. 4. No significant loss of reduction or loosening of implant was found. 5. Remarkable neurologic recoveries were observed in cases of incomplete cord lesion. 6. Significant neurologic recovery was found in patients treated with laminectomy and Cotrel-Dubousset instrumentation.
Congenital Abnormalities ; Early Ambulation ; Heart ; Humans ; Laminectomy ; Orthopedics ; Spine

Fractures of the tibial condyles, involving as they do weight-bearing articular surfaces and frequently accompanied by soft tissue injuries such as collateral ligaments, cruciate ligaments, and menisci present a variety of problems in treatment and prognosis. Slee, Apley, and others maintained the opinion that most fractures of the tibial condyles could be managed conservatively. On the other hand, Rombold, Schatzker, and others seemed to consider closed treatment to be virtually s form of therapeutic nihilism and adviced open reduction. But recently most authors agree that the method of treatment has to be selected in each individual case, and recommand anatomical reduction of the fracture as possible and early knee motion. The authors have treated 17 cases of tibial condylar fractures with arthroscopic management and extraarticular distal approach in the Department of Orthopedic surpery, Kang Dong Sacred Heart Hospital from Oct. 1986 to Jul. 1989. Of the above cases, 11 cases could be followed for a period of anywhere from 1 year to 31/2 years and analysed according to the cause, classification, treatment, and result. The following results were obtained from the analysis of 11 tibial condylar fractures. l. Of the 11 cases, 7 (63.6%) were male and 4 (36.4%) were female. 2. Of the 11 cases, 7 (63.6%) were due to traffic accident (5 pedestrians, 2 occupants) and 3 (27.3%) were due to fall from height. 3. Among 11 cases, 7 (63.6%) were associated with other injuries. 4. Bone graft was needed in 5 cases. 5. All were treated by arthroscopic management with anatomically and functionally good results. 6. By arthroscopic mangement, it was easy to find and treat the accompanying intraarticular lesion. 7. With early active and C.P.M. exercise, almost full range of motion was obtained in all cases.
Accidents, Traffic ; Classification ; Collateral Ligaments ; Female ; Hand ; Heart ; Humans ; Knee ; Ligaments ; Male ; Methods ; Orthopedics ; Pedestrians ; Prognosis ; Range of Motion, Articular ; Soft Tissue Injuries ; Tibia ; Transplants ; Weight-Bearing

Angiosarcoma is a rare malignant vascular tumor of endothelial cell origin. Most lesions of cutaneous angiosarcoma occur over the face and scalp. We experienced a case of angiosarcoma of the scalp in a 63-year-old man. Multiple pea-sized erythematous papules and nodules developed on the forehead 6 months ago. Thereafter, the lesions have extended to make violaceous, compressible and hemorrhagic plaques. On histologic examination, there were irregular, often anastomosing vascular channels lined by the atypical endothelial cells in the dermis.
Dermis ; Endothelial Cells ; Forehead ; Hemangiosarcoma* ; Humans ; Middle Aged ; Scalp*

We observed the neonatal skin to investigate the incidence and clinical features of birthrnarks. We examined 1791 newborn babies admitted in the nursery of Kangnam Sacred Heart Hospital from July 1987 to July 1989. The results were summarized as follows. 1. Mongolian spots were observed in 1435 neonates (80.1%), occurring most frequently on the lumbosacral area. 2. Salmon patches were observed in 416 neonates (23.2%), the nape of neck being the most common site. 3. Pigmented lesions were observed in 20 neonates (1.1%). 4. Portwine stains were observed in 15 neonates (0.8%). 5. Epidermal nevi were observed in 4 neonates (0.2%) and nevus sebaceus developed in one baby.
Coloring Agents ; Heart ; Humans ; Incidence ; Infant, Newborn* ; Mongolian Spot ; Neck ; Nevus ; Nurseries ; Salmon ; Skin

Recent investigations have revealed that autocrine growth factors and their receptors are closely related and play an important role in controlling cancer cell growth. We performed an immunohistochemical study on the expression of epidermal growth factor (EGF), transforming growth factor-alpha (TGF-alpha), epidermal growth factor receptor (EGF-R), c-erbB-2, and PCNA labelling index in 60 cases of human gastric carcinomas. TGF-alpha was detected in 38 cases (63.3%), EGF in 26 cases (43.3%), EGF-R in 44 cases (73.3%), and c-erbB-2 in 18 cases (30%). These growth factors, EGF-R and c-erbB-2, were found more often in advanced gastric cancers. The PCNA labeling index was significantly higher in tumors with the expression of EGF-R or c-erbB-2. Tumors with simultaneous expression of EGF, TGF-alpha, EGF-R and c-erbB-2 was associated with a high PCNA labeling index. A correlation was observed between the synchronous expression of growth factors and its receptors and histological differentiation. The results suggest that the expression of EGF, TGF-alpha, EGF-R and c-erbB-2 are closely related and plays an important role in the growth and progression of human gastric carcinoma.
Epidermal Growth Factor* ; Humans ; Intercellular Signaling Peptides and Proteins ; Peptides* ; Proliferating Cell Nuclear Antigen ; Receptor, Epidermal Growth Factor ; Stomach Neoplasms ; Transforming Growth Factor alpha

No abstract available.