A 67-year-old man noted a 4×6cm sized, erythematous, erosive, oozing patch on the penile shaft, which resisted conservative therapy for three years. Histopathologic examination revealed typical findings of extramammary Paget's disease. Interestingly, nests of Paget's cells in some hair follicular structures were shown in the middermis. The lesion was excised by microscopically controlled excision, using the fresh-tissue technique. There were histologically involved areas extending to quite a distance beyond the clinically normal appearing skin. Mohs micrographic surgery might offer the unique advantage of effective surgical treatment with microscopically controlled tumor free borders in the extramammary Paget's disease.
Aged ; Hair ; Humans ; Mohs Surgery ; Paget Disease, Extramammary* ; Skin

Malignant small round cell tumor (SRCT) of the thoracopulmonary region appears to originate in the soft tissues of the chest wall or the peripheral lung. A differential diagnosis of poorly differentiated small round cell tumors which include Ewing's sarcoma of bone and soft tissue, embryonal rhabdomyosarcoma, Askin tumor, neuroblastoma, peripheral neuroectodermal tumor, small cell osteogenic sarcoma and lymphoma are after difficult by light microscopy alone. In recent, by the extensive studies electron microscopic examination, histochemical study, immunochemical study, cytogenetics and gene analysis, these tumors may be derived from the primitive and pluripotential cells, differentiating into mesenchymal, epithelial and neural features in variable proportions. Treatment for SRCT of thoracopulmonary regin is not determined because of massive involvement of the lung, pleura or soft tissues of the chest wall resulted in a dismal outcome despite aggressive surgery, irradiation and chemotherapy.
Cytogenetics ; Diagnosis, Differential* ; Drug Therapy ; Lung ; Lymphoma ; Microscopy ; Neuroblastoma ; Neuroectodermal Tumors, Primitive, Peripheral ; Osteosarcoma ; Pleura ; Rhabdomyosarcoma, Embryonal ; Sarcoma, Ewing ; Thoracic Wall

No abstract available.
Inhalation* ; Lung Injury* ; Lung*

No abstract available.
Drug Therapy, Combination* ; Humans ; Leukemia, Myeloid, Acute*

Twenty cases of polypoid lesions of the gallbladder were reviewed. Seven were benign lesions. Among them, there were 4 (20%) adenomas and 3 (15%) adenomatous hyperplasias. All of the benign lesions were less than 1 cm in diameter. Thirteen cases involved a carcinoma of the gallbladder, of which 92% were more than 1 cm in diameter, 76.9% were over 60 years of age, and 38.5% were associated with gallstones. The accuracy of the preoperative ultrasonographic diagnosis of the polypoid lesions of the gallbladder was 80%. The spread and the size of the tumor showed a close correlation. Therefore, the size of the tumor is a vital indicator for the treatment of polypoid lesions of the gallbladder; lesions between 0.6~1 cm in diameter should be followed up by ultrasonography. An operation may be considered if stones are present. Lesions bigger than 1 cm should be resected since malignancy can not be excluded.
Adenoma ; Diagnosis ; Gallbladder Neoplasms ; Gallbladder* ; Gallstones ; Hyperplasia ; Polyps ; Ultrasonography

The effects of topical Betoptic(R) 0.5% and Mikelan(R) 2% on the ophthalmic artery blood pressure and perfusion pressure were investigated in 30 healthy subjects using ophthalmodynamometer and Goldmann applanation tonometer. The subjects were divided into two groups and each has 15 healthy subjects. In a randomized, double-blind study, one eye of each subject received one drop of Betoptic(R) 0.5% or Mikelan(R) 2%, and fellow eye was received a drop of placebo. Diastolic ophthalmic artery blood pressure (OABPd), systolic artery blood pressure (OPBPs), and intraocular pressure (lOP) were measured just before and 2 hours after the instillation of the drugs. Mean ophthalmic arery blood pressure (OABPm) was calculated as OABPm = OABPd + 1/3 (OABPs - OABPd) and the perfusion pressure (PP) was calculated as PP = OABPm - lOP. The perfusion pressure (pp) was Betoptic(R)-treated group was increased by 9%, and that of Mikelan(R)-treated group was increased by 13%, these increasement were statistically significant (Both group P<0.01).
Arteries ; Blood Pressure ; Double-Blind Method ; Intraocular Pressure ; Ophthalmic Artery ; Perfusion*

STUDY DESIGN: This study analyzes the results of selective thoracic fusion by segmental pedicle screw fixation in King type II adolescent idiopathic scoliosis(AIS). OBJECTIVES: To verify the efficacy of selective thoracic fusion by segmental pedicle screw fixation in King type II adolescent idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: Decompensations following selective thoracic fusion in King type II adolescent idipathic scoliosis have been attributed to relative inability of the lumbar curves to accommodate correction of the thoracic curves. However, with segmental pedicle screw fixation, selective thoracic fusions yielded satisfactory results in most of the patients regardless of the lumbar curve characteristics. MATERIALS AND METHODS: Eighty patients subjected to selective thoracic fusion by segmental pedicle screw fixation were analyzed after a minimum follow-up of 2 years for deformity correction and spinal balance. Deformity correction was performed by derotation of rod contoured to the normal sagittal curve without additional compression or distraction. RESULTS: Mean preoperative thoracic curve of 53.3 was corrected to 20.3 showing a correction of 63.2%. The mean preoperative lumbar curve was 34.4 with a flexibility of 97.2% and mean lumboapical distance(LAD)of 18.0mm, L4 tilt of 8.0, and lumbar apical rotation (LAR) of 10.9. It was corrected to 16.5 showing a correction of 55.5%. All the patients were balanced clinically and radiologically. CONCLUSIONS: Selective thoracic fusion with segmental pedicle screw fixation and rod rotation offers a satisfactory correction of the deformity and maintenance of spinal balance in King type g AIS regardless of lumbar curve magnitude, LAD, L4 tilt or LAR.
Adolescent* ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Pliability ; Scoliosis*

The employment of segmental pedicle screw instrumentation has greatly enhanced the correction of scoliotic deformity. However there is still much controversy on the ability of the system to correct the rotational deformity. This prospective study with 12 idiopathic throacic scoliosis patients subjected to segmental pedicle screw instrumentation was performed to determine the effect of the system on the rotational deformity of idiopathic throacic scoliosis. In addition to the standing films to measure the magnitude of scoliotic curvatures, preand postoperative CT were utilized for the measurement and comparison of angle of rotation relative to the sagittal plane(RAsag.), relative rotation with reference to the upper and lower end vertebrae(RAend), relative rotation with reference to the sacrum(RAsac.), frontal translation(TF) and sagittal translation(TS) for the apical vertebrae. Despite the high correction rate obtained in the frontal plane(average 71.1%) and normalization of sagittal contour, the rotational corrections were statistically insignificant in all parameters and showed no significant correlation to the correction of the curvatures nor horizontal plane displacement as represented by the frontal and sagittal displacement. In conclusions, the segmental pedicle screw instrumentation with rod derotation does not produce significant derotation by itself.
Congenital Abnormalities ; Employment ; Humans ; Prospective Studies ; Scoliosis* ; Spine

OBJECTIVE: To evaluate the components for vocational rehabilitation program including the strengths and job simulation, and to provide the data of the upper extremity strengths for a successful return to work. METHOD: Sixty normal untrained subjects(male 30, female 30) were examined for the grip and pinch strengths using Jamar dynamometer and Preston pinch gauge, and the strengths of five simulated tasks using work simulation of Cybex 6000 Testing and Rehabilitation System(Cybex, Division of Lumex, inc., USA). RESULTS: The values during the tasks were significantly different in males compared to females(p<0.01). Strengths of the right upper extremity by Jamar dynamometer, Preston pinch gauge, gripping device, T-handle(radial direction), and flutted knob(radial direction) were significantly different compared to the left(p<0.01). Grip strengths between Jamar dynamometer and gripping device of Cybex were highly correlated(p<0.01). All the measured values were significantly correlated with both weight and height(p<0.01). CONCLUSION: The results of this study can be used as a baseline data for the vocational rehabilitation in patients with a disability of upper extremity.
Female ; Hand Strength ; Humans ; Male ; Pinch Strength ; Rehabilitation ; Rehabilitation, Vocational ; Return to Work ; Upper Extremity*

PURPOSE: Without a specific diagnostic method, the clinical diagnostic criteria for atypical Kawasaki disease is known as the presence of coronary artery changes in a patient who did not meet the already estabilished clinical criteria. With this criteria, we are put into dilemma because atypical Kawasaki disease should exhibit coronary artery disease. So, we demonstrated the rate of coronary artery involvement in atypical Kawasaki disease by another diagnostic criteria. METHODS: This diagnostic criteria for atypical Kawasaki disease is "the clinical symptoms which fulfilled four out of six diagnostic criteria below of typical Kawasaki disease with or without the presence of coronary artery changes, and were inconsistent under a through clinical investigation with any other illness similar to Kawasaki disease." RESULTS: The incidence of coronary artery involvement in atypical Kawasaki disease during the acute phase (analysis of 30 cases who were admitted before the 15th day of illness), on the 30th day of illness (26 cases) and on the 60th day of illness(26 cases) were 20.0% (dilatation : 13.3%, aneurysm : 6.7%), 19.2% (dilatation : 19.2%, aneurysm : 0.0%), 7.7%(dilatation : 7.7%, aneurysm : 0.0%), respectively. CONCLUSOIN: Kawasaki disease may occur in atypical type, ranging over many severe involvements of vital organs including the coronary artery. Up to the present, there are no infallible diagnostic tests for Kawasaki disease and it is advisable to deemphasize the rigid adherence to the current already proposed diagnostic criteria for Kawasaki disease.
Aneurysm ; Coronary Artery Disease ; Coronary Vessels* ; Diagnostic Tests, Routine ; Humans ; Incidence ; Mucocutaneous Lymph Node Syndrome*