Keratosis punctata of the palmar creases (KPPC) is rare skin condition characterized by punctiform hyperkeratotic pits confined to the palmar and digital creases. Although this condition has been regarded as a variant of classical punctate keratoses, there are some differences between classical punctate keratosis and KPPC. We herein report a case of KPPC in a 22-year-old man who had numerous, tiny, hyperkeratotic pits limited to the palmar creases of both hands with typical histologic findings.
Hand ; Humans ; Keratosis* ; Skin ; Young Adult

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Heart ; Shock

No abstract available.
Diagnosis* ; Magnetic Resonance Imaging* ; Spondylitis*

To investigate the human lung development and the distribution of elastic and reticular fibers during the fetal period proper, lung tissues taken from the periphery of the right lower lobes of Korean fetuses (n=49) of both sex were studied. The fetuses were the prodocts of spontaneous or therapeutic abortions and were found to have no associated lesions or anomalies at autopsy. The fetal age were estimated from crown-rump length or foot length. Paraffin sections, cut at 5-7 µm, were stained with routine hematoxylin and eosin for general structure, acid orcein and a1dehyde fuchsin for elastic fiber, and with Gomori's silver technique for reticular fiber, respectively. The lung development during fetal period proper, could be subdivided into three continuous periods according to the relation between airspaces, surrounding mesenchymal tissue, their structural changes and distribution, i.e., an early stage of the formation of conductive airways (pseudoglandular period, before 16th week of gestation), a middle stage of the development of lung parenchyma and new blood vessels (canalicular period, between 16th and 28th week of gestation), and a late stage of transition of respiratory portion to vascular organ (terminal sac stage, after 28th week of gestation). In places, secondary septa of sac or saccule formed by capillaries, capillary connective tissue, elastic and reticular fuel could be identified by the 33rd week of gestation. Elastic fibers could be noted in pleura, subepithelial areas of bronchioles and the wall of blood vessels in the late stage of pseudoglandular period. By the 28th week of gestation, elastic fibers were seen in the wall of small blood vessels or capillaries in the septal wall among the airspaces. And these fibers were observed in the tip of the secondary septa by the 33rd week of gestation but were not still completely developed in the walls of primary or secondary septa. Reticular fibers were already developed and widely distributed in fetal lung by the 10th week of gestation. These fibers were concentrated particular around the subepithelial area of bronchicoles, the airspaces and the blood vessel wall in the canalicular period. By the late stage of terminal sac period, reticular fibers formed a network along the small blood vessels in the septum of airspaces. These results indicate that primitive alveoli might be formed by the late stage of fetal period proper. The fibrous framework could partially formed by collagenous and reticular fibers during the pseudoglandular period, by addition of elastic fiber to the preformed network, and incompletely still finally by the three kinds of connective tissue fiber.
Abortion, Therapeutic ; Autopsy ; Blood Vessels ; Bronchioles ; Capillaries ; Collagen ; Connective Tissue ; Crown-Rump Length ; Elastic Tissue ; Eosine Yellowish-(YS) ; Female ; Fetus ; Foot ; Gestational Age ; Hematoxylin ; Humans ; Lung* ; Paraffin ; Pleura ; Pregnancy ; Reticulin* ; Rosaniline Dyes ; Saccule and Utricle ; Silver

PURPOSE: To determine the accuracy of automated computer aided volumetry for simulated small pulmonary nodules at computed tomography using various types of phantoms MATERIALS AND METHODS: Three sets of synthetic nodules (small, calcified and those adjacent to vessels) were studied. The volume of the nodules in each set was already known, and using multi-slice CT, volumetric data for each nodule was acquired from the three-dimensional reconstructed image. The volume was calculated by applying three different threshold values using Rapidia(R) software (3D-Med, Seoul, Korea). RESULTS: Relative errors in the measured volume of synthetic pulmonary nodules were 17.3, 2.9, and 11.5% at -200, -400, and -600 HU, respectively, and there was good correlation between true volume and measured volume at -400 HU (r=0.96, p<0.001). For calcified nodules, relative errors in measured volume were 10.9, 5.3, and 16.5% at -200, -400, and -600 HU, respectively, and there was good correlation between true volume and measured volume at -400 HU (r=1.03, p<0.001). In cases involving synthetic nodules adjacent to vessels, relative errors were 4.6, 16.3, and 31.2 % at -200, -400, and -600 HU, respectively. There was good correlation between true volume and measured volume at -200 HU (r=1.1, p<0.001). CONCLUSION: Using computer-aided volumetry, the measured volumes of synthetic nodules correlated closely with their true volume. Measured volumes were the same at each threshold level, regardless of window setting.
Cone-Beam Computed Tomography ; Seoul

The objective of this paper is to introduce the schematic protocol of radiofrequency (RF) ablation for the treatment of varicose veins. Indication: anatomic or pathophysiologic indication includes venous diameter within 2-20 mm, reflux time > or =0.5 seconds and distance from the skin > or =5 mm or subfascial location. Access: it is recommended to access at or above the knee joint for great saphenous vein and above the mid-calf for small saphenous vein. Catheter placement: the catheter tip should be placed 2.0 cm inferior to the saphenofemoral or saphenopopliteal junction. Endovenous heat-induced thrombosis > or =class III should be treated with low-molecular weight heparin. Tumescent solution: the composition of solution can be variable (e.g., 2% lidocaine 20 mL+500 mL normal saline+bicarbonate 2.5 mL with/without epinephrine). Infiltration can be done from each direction. Ablation: two cycles' ablation for the first proximal segment of saphenous vein and the segment with the incompetent perforators is recommended. The other segments should be ablated one time. During RF energy delivery, it is recommended to apply external compression. Concomitant procedure: It is recommended to do simultaneously ambulatory phlebectomy. For sclerotherapy, it is recommended to defer at least 2 weeks. Post-procedural management: post-procedural ambulation is encouraged to reduce the thrombotic complications. Compression stocking should be applied for at least 7 days. Minor daily activity is not limited, but strenuous activities should be avoided for 2 weeks. It is suggested to take showers after 24 hours and tub baths, swimming, or soaking in water after 2 weeks.
Baths ; Catheter Ablation* ; Catheters ; Consensus* ; Heparin ; Knee Joint ; Lidocaine ; Saphenous Vein ; Sclerotherapy ; Skin ; Stockings, Compression ; Swimming ; Thrombosis ; Varicose Veins* ; Walking

Recently, the use of internal fixation device in spine is popular due to several advantages. The advantages are to make short segmental fusion possible, to obtain early stability, and to reduce the needs of external immobilization. But, we can easily observe the hardware failures such as screw breakage and loosening. The purpose of this study is to evaluate the contributing factors to hardware complications through analysis of the problem cases. The authors reviewed complicated 17 (6.7%) cases out of 271 patients who was done posterior decompression and spinal fusion with transpedicular screws for spinal stenosis or spondylolisthesis from Jan. 1986 to Dec. 1994. We reviewed the clinical data, radiograph, and bone mineralo-densitometry. Seventeen patients (6.7%) had hardware complications: breakage of the screw in 5 cases, loosening of the screw in 11 cases, displacement of the rod in 1 case. The duration from the operation to the onset of complications was 1.3 years (4 month-6 years). More complications were occurred in the distal segments (13 cases) than in the proximal segments (4 cases). In 6 cases of 17 cases, we could observe the incomplete spinal fusion. We performed the bone mineralodensitometry (BMD, DEXA) in 30 patients. Among them, 6 cases had hardware complications-5 cases of screw loosening and 1 case of screw breakage. The average BMD (1.048g/cm2) of 24 patients without hardware complications was higher than that (0.890g/cm2) of 6 patients with complications (p<0.05). The duration of wearing the external support after surgery was also checked. Removal of hardware was performed in 5 cases due to pain, but the others were treated conservatively because of no symptom. Hardware complications were found mainly in the distal segment and was related to bone mineral density. Checking the bone mineral density in preoperative state helps to decide on the indication of surgical intervention. Through follow-up X-ray, spinal fusions can be carefully observed, and the duration of external support can be decided.
Bone Density ; Decompression ; Follow-Up Studies ; Humans ; Immobilization ; Internal Fixators ; Spinal Fusion ; Spinal Stenosis ; Spine ; Spondylolisthesis

Background: Cardiac tamponade results in a hemodynamic disorder associated with decreased cardiac output and blood pressure. To improve cardiac output in a subject with cardiac tamponade, cardiotonic drugs and vasodilators with blood volume expander can be used. The purpose of this study was to observe the hemodynamic effects of cardiotonic drugs and vasodilators following administration of plasma expander in the dogs with cardiac tamponade. Method: Three groups of dogs were studied during the induced cardiac tamponade. Following infusion of pentastarch, group I received dobutamine by dripping of 10 microg/kg/min, followed by injection of 20 microg/kg/min, group II received hydralazine (20 mg, 40 mg) and group III received sodium nitroprusside (5 microg/kg/min, 10 microg/kg/min). The heart rate, blood pressure, cardiac output and pulmonary arterial occluded pressure were measured. The atrial transmural pressure was calculated by subtracting intrapericardial pressure from mean atrial pressure. Results: Cardiac output was increased in the groups I and II, but mean arterial pressure was increased in only the group I. Atrial transmural pressure was not changed in all three groups. Conclusion: The most pronounced hemodynamic improvements during the cardiac tamponade is observed in group I with pentastarch-dobutamine combination.
Animals ; Arterial Pressure ; Atrial Pressure ; Blood Pressure ; Blood Volume ; Cardiac Output ; Cardiac Tamponade* ; Cardiotonic Agents ; Dobutamine* ; Dogs* ; Heart Rate ; Hemodynamics* ; Hydralazine* ; Hydroxyethyl Starch Derivatives* ; Nitroprusside* ; Plasma ; Vasodilator Agents

We report a case of cutaneous metastasis of thymic carcinoma in Korean. A 44-year-old female, who had been diagnosed as thymic carcinoma and treated with total thymectomy and post-operative radiation therapy, presented grouped erythematous papules on the left chest. CT scans revealed metastatic lesions in the left pleura and abdominal cavity. Histopathologic examination of skin biopsy showed extensive infiltration of malignant cells in dermis and subcutis. The morphology of infiltrating cells was similar to that of tumor cells from primary thymic carcinoma specimen. The results of immunohistochemical study for skin biopsy were consistent with the features of non-neuroendocrine thymic carcinoma. Histopathologic and immunohistopathologic similarity between cutaneous lesion and previous tumor suggested that malignant cells in the skin lesion could originate from progressing thymic carcinoma.
Abdominal Cavity ; Adult ; Biopsy ; Dermis ; Female ; Humans ; Neoplasm Metastasis ; Pleura ; Skin ; Thorax ; Thymectomy ; Thymoma* ; Tomography, X-Ray Computed