Paget's disease is classified, according to location, as mammary or extramammary disease. Extramammary Paget's disease especially in the vulva is extremely rare. Several hundred cases have been described worldwide. Patients with Paget's disease of the vulva are usually white and postmenopausal. The cause of which remains elusive. A case of vulva Paget's disease is presented with brief review of literature.
Humans ; Paget Disease, Extramammary ; Vulva

No abstract available.
Fournier Gangrene* ; Scrotum* ; Sparganosis*

PURPOSE: Lipiodol CT is a important modality for the diagnosis of hepatocellular carcinoma and compared is usually performed at 2-3 week after Lipiodol injection. Therefore, we assessed and the diagnostic value and merits of immediate CT after chemoembolization from there of 2-3 week delayed Lipiodol CT. MATERIALS AND METHODS: Thirty three cases of chemoembolization which were performed both immediate CT after chemoembolization and 2-3 week delayed Lipiodol CT were reviewed retrospectively. They were divided into four grades according to pattern of lipiodol uptake by three radiologists. The diagnostic value of immediate Lipiiodol CT was compared to delayed Lipiodol CT. RESULTS: Grade 0 was two cases(3.0%) and Grade 1 was seven cases(21.2%). In the cases of Grade 2(23/33, 69.7%) tumor uptake could be dishng wished from parenchymal uptake of Lipiodol by its density and pattern. Tumor uptake showed dense and homogeneous pattern, but parenchymal uptake revealed less dense and hepatoram-like wedge shaped pattern. Lipiodol uptake of tumor in Grade 3(1/24, 3.0%) was equal to that in delayed Lipiodrl CT. Grade 3 and 2(72.7%) of the immediate Lipiodol CT were not inferior to delayed Lipiodol CT in its diagnostic value. CONCLUSION: The immediate Lipiodol CT could make rapid establishment of treatment plan and are expected to be more convenient than delayed CT for the patients.
Carcinoma, Hepatocellular* ; Diagnosis ; Ethiodized Oil ; Humans ; Retrospective Studies

No abstract available.
Decompression, Surgical* ; Exophthalmos*

BACKGROUND: The management of penetrating neck injuries presents a difficult problem. Although many authors have stated that surgical exploration should be mandatory for all neck injuries that penetrate platysma, recent reports from many centers now claim selective exploration. The aim of this study was to review a policy of selective neck exploration based on clinical presentation, anatomic location, and the result of diagnostic studies. METHOD: We reviewed retrospectively medical records of 66 patients who were admitted and managed at Yongdong Severance hospital, Yonsei university college of medicine due to penetrating neck injuries from Jan. 1990 to Dec. 1996. RESULTS: Forty-one patients(62%) were underwent immediate neck exploration, while the remaining 25 patients(38%) were admitted and observed. Three had esophagoscopy, four had esophagogram, and three had direct laryngoscopy, all of which revealed normal result except one patient had blood tinged larynx on laryngoscopy. Results of 12 neck explorations(29%) were negative. There was no delayed diagnosis during conservative treatment. There was no mortality. CONCLUSION: We concluded that selective exploration of penetrating neck injuries is both safe and resonable.
Delayed Diagnosis ; Esophagoscopy ; Humans ; Laryngoscopy ; Larynx ; Medical Records ; Mortality ; Neck Injuries* ; Neck* ; Retrospective Studies ; Tolnaftate

Complications after a median sternotomy incision, which is used currently in most open heart surgery, are serious, although it is infrequent. Reconstruction of the sternal defect resulting from dehiscence of median sternotomy is still big challenge to the most plastic surgeons. Since vascularized greater omentum was transposed to eliminate mediastinal wound problems, many vascularized regional muscle flaps became mainstay in reconstruction of median sternotomy wound. We treated 13 patients with median sternotomy dehiscence between October of 1993 and March of 1998. In two patients, the wound problems were so confined to superficial tissue that debrided and closed primarily. Eleven patients with deep wound infection were managed with vigorous debridement of all necrotic tissues and resultant defects were covered with regional muscle flaps: rectus myocutaneous flap(3) and bilateral pectoralis advancement flap(8). We used the pectoralis major advancement flaps without counter incision at humeral insertion site and the dissections were limited only medial to the anterior axillary line to preserve the axillary fold. In five patients with larger defects, we elevated muscle and cutaneous flaps separately to make these flaps more mobile. Large portion of two rectus abdominis flaps could not survive, whereas pectoralis advancement flaps had mo special wound problems. Only one patient developed fistula due to remained wire, regardless to flap surgery.
Debridement ; Fistula ; Humans ; Omentum ; Rectus Abdominis ; Sternotomy* ; Thoracic Surgery ; Wound Infection ; Wounds and Injuries

PURPOSE: This study was aimed to determine the relationship between osteopontin(OPN) and osteoclast, especially focused on whether ostecolast could produce osteopontin or not. MATERIALS AND METHODS: Osteoclasts were isolated from the giant cell tumor of proximal tibia and seeded on the 13 mm round cover slip resided in 24 multi-well plates for culture. After 2 days, osteclasts on the cover slip were fixed with cold acetone for 3 minutes and immunocytochemistry was done with rabbit osteopontin antibody. For in situ RT-PCR, osteoclasts on the cover-slips were fixed with 4% paraformaldehyde for 4 hours and were treated to pepsin. PR-PCR was done and the PCR producst were stained with anti-digoxigenin-AP. RESULTS: Osteopontins were found on the surface of the osteoclast by immunocytochemistry, and intense osteopontin mRNAs were found by in situ RT-PCR. CONCLUSION: We have identified that osteoclast could synthesize the osteopontin, and confirmed that in situ RT-PCR was a very useful method in expressing small amount of mRNA in case of mixed cell culture. Further study was needed to identify the action of the osteopontin produced by the osteoclast.
Acetone ; Cell Culture Techniques ; Giant Cell Tumors ; Immunohistochemistry ; Osteoclasts* ; Osteopontin* ; Pepsin A ; Polymerase Chain Reaction ; RNA, Messenger ; Tibia

BACKGROUND: We observed fentanyl known as centrally-acting antitussive agents provoke a cough response in some patients at induction of anesthesia. This may be of clinical importance. METHOD: 121 patients (ASA class I) were assigned randomly to 4 groups. Each group was given different doses of fentanyll Group 1 (n=30); 0.5ug/kg, Group 2 (n=30); 1ug/kg, Group 3 (n=33); 2ug/kg, Group 4 (n=28); 4 g/kgl, within 1 second through a peripheral venous cannula before induction of anesthesia. All patients were observed carefully in order to detect a cough response and any side effects. RESULT: The incidences of FCR (Fentanyl Cough Response) were 0% in Group 1, 10.0% in Group 2, 30.3% in Group 3, and 39.3% in Group 4. The ED50 of FCR was 4.25ug/kg. The mean onset-time from the end of fentanyl administration to the beginning of coughing was 12.5 seconds. FCR was decreased with aging, but not affected by weight, height, or smoking. Other serious side effects were not accompanied. CONCLUSION: Fentanyl can evoke the pulmonary chemoreflex dose-dependently and the ED50 was 4.25 g/kg.
Aging ; Anesthesia ; Antitussive Agents ; Catheters* ; Cough* ; Fentanyl* ; Humans ; Incidence ; Reflex* ; Smoke ; Smoking

No abstract available.
Axilla ; Syringoma

Relapsing polychondritis is a rare inflammatory disorder affecting the cartilaginous structures throughout the body. Although there is no pathognomonic laboratory tests, clinical features, when coupled with histopathologic findings, enable one to make a diagnosis of relapsing polychondritis. A 26-year-old man presented with purplish, swollen, and tender auricles and injected eyes. His symptoms had developed eight months ago and fluctuated irrespective of various medications such as corticosteroids and antibiotics. Histopathologic examination revealed loss of basophilic staining of the cartilage with some dissolution of its structures. Treatment was initiated with dapsone, However, the remission was too immediate to be considered as a effect of dapsone.
Adrenal Cortex Hormones ; Adult ; Anti-Bacterial Agents ; Basophils ; Cartilage ; Dapsone ; Diagnosis ; Humans ; Polychondritis, Relapsing*