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

We report two cases of type V hyperlipoproteinemia and eruptive xanthomas associated with diabetes mellitus in a 44-year-old woman and a 25-year-old woman. They had asymptomatic, diffuse, erythematous yellowish papules on the extremities and buttocks. The laboratory studies showed increased serum blood glucose, total cholesterol, triglyceride, increasing pre-β and chylomicron bands on electrophoresis of lipoprotein. Histopathologic findings of erythematous yellowish papules on the thigh and buttock revealed aggregation of foam cells in the dermis. They have been treated with diet control, hypoglycemic agent (gliclazide) and hypolipidemic drug (gemfibrozil), and are under continued supervision.
Adult ; Blood Glucose ; Buttocks ; Cholesterol ; Dermis ; Diabetes Mellitus* ; Diet ; Electrophoresis ; Extremities ; Female ; Foam Cells ; Humans ; Hyperlipoproteinemia Type V* ; Lipoproteins ; Organization and Administration ; Thigh ; Triglycerides ; Xanthomatosis*

Chondroblastoma is a rare primary bone tumor which originates from cartilage, and represents approximate 1% af all bone tumor. The chondroblastoma arises most frequently from the epiphysis of the long bones with the humerus being the commonest site. It afflicts usually the young under 25 years with greater incidence in male. As there is no cartilage cell on craniofacial bone which is mainly fromed by intramembranous ossification, the chondroblastoma on the craniofacial bone is extremely rare. But the chondroblastoma recurred frequently in craniofacial bone when the mass is excised incompletely or curretted and, as the tumor has the outstanding ability of local invasiveness, it destructs the adjacent bone. In addition, it is difficult to diagnose differentially from sarcoma or giant cell tumor histopathologically. Due to the entities described above, it is necessary to remove the entire tumor mass as complete as possible, to treat with radiation pre or postoperatively for preventing from recurrence, and to observe for a long time. The chondroblastoma on temporal bone is rare and is difficult to diagnose and treat successfully. So we'd like to present a case of chondroblastoma which was originated from temporal side of TMJ with literatural review.
Cartilage ; Chondroblastoma ; Epiphyses ; Giant Cell Tumors ; Humans ; Humerus ; Incidence ; Male ; Recurrence ; Sarcoma ; Temporal Bone ; Temporomandibular Joint*

No abstract available.
Cryptococcosis*

Aplasia cutis congenita(ACC) is a rare skin condition in which localized or widespread areas of skin are absent at birth. Clinically, lesions usually appear circular or oval, sharply outlined ulcer, resulting in healing with scarring. The most common site of this condition is scalp, especially on the vertex although other areas of the body may also be involved. Other congenital malformations have been associated with aplasia cutis congenita. Herein we report a 6-year-old male infant with round, well-marginated, smooth surfaced, brownish scar about 2 cm diameter on the vertex of scalp. The lesion was erythematous, crusted ulcer at the time of birth. Histopathologic finding of the lesion showed flattening and thinning of epidermis, fibrosis in the dermis and the absence of adnexal structures except single immature hair follicle.
Child ; Cicatrix ; Dermis ; Ectodermal Dysplasia* ; Epidermis ; Fibrosis ; Hair Follicle ; Humans ; Infant ; Male ; Parturition ; Scalp ; Skin ; Ulcer

Fibrofolliculoma is a rare benign follicular neoplasm histopathologically characterized by central dilated follicular infundibulum surrounded by well-circumscribed, thick mantle of fibrotic tissue, with anastomosing strands of follicular epithelium extending into the stroma. This condition usually occurs in multiple and rarely solitarily. Herein we report on a 34-year-old man with a solitary, skin colored, bean sized nodule on his chin which histopathologically shows a typical fibrofolliculoma.
Adult ; Chin ; Epithelium ; Humans ; Skin

PURPOSE: The purpose of this study was to evaluate the CT findings of renal parenchyma infiltrated by pelvocalyceal transitional cell carcinoma. MATERIALS AND METHODS: This study included 28 patients in whom transitional cell carcinoma was dignosed after nephrectomy. CT findings were analyzed for the presence or absence of renal parenchymal infiltration; diagnostic criteria for this included parenchymal inhomogeneous low attenuation, ill-defined margin between the mass and renal parenchyma, or focal calyceal dilatation. To detect renal parenchymal infiltration by transitional cell carcinoma, we evaluated the frequency, sensitivity and specificity of each CT finding. RESULTS: Pathologic reports showed that renal parenchymal infiltration had occurred in 17 of 28 patients, (60.7%) ; on CT scans, renal parenchymal infiltration was seen in 15 of these 28 (53.6%). It two patients who did not show CT findings of renal parenchymal infiltration, pathologic examination revealed parenchymal invasion. All 15 patients who showed renal infiltration on CT had parenchymal inhomogeneous low attenuation (sensitivity: 88.2%, specificity : 100%), 13 showed ill-defined margin of the mass (sensitivity : 76.5%, specificity : 100%), and six showed focal dilatation of the calyx (sensitivity : 35.3%, specificity : 100%). CONCLUSION: In patients with pelvocalyceal transitional cell carcinoma, CT findings of parenchymal inhomogeneous low attenuation, ill-defined margin of mass, and focal calyceal dilatation suggest renal parenchymal infiltration, and these findings may be helpful in preoperative prognosis.
Carcinoma, Transitional Cell* ; Dilatation ; Humans ; Nephrectomy ; Prognosis ; Sensitivity and Specificity ; Tomography, X-Ray Computed

OBJECTIVES: The objective of this study was to evaluate the performance of risk-adjusted mortality models for colorectal cancer surgery. METHODS: We investigated patients (n=652) who had undergone colorectal cancer surgery (colectomy, colectomy of the rectum and sigmoid colon, total colectomy, total proctectomy) at five teaching hospitals during 2008. Mortality was defined as 30-day or in-hospital surgical mortality. Risk-adjusted mortality models were constructed using claims data (basic model) with the addition of TNM staging (TNM model), physiological data (physiological model), surgical data (surgical model), or all clinical data (composite model). Multiple logistic regression analysis was performed to develop the risk-adjustment models. To compare the performance of the models, both c-statistics using Hanley-McNeil pair-wise testing and the ratio of the observed to the expected mortality within quartiles of mortality risk were evaluated to assess the abilities of discrimination and calibration. RESULTS: The physiological model (c=0.92), surgical model (c=0.92), and composite model (c=0.93) displayed a similar improvement in discrimination, whereas the TNM model (c=0.87) displayed little improvement over the basic model (c=0.86). The discriminatory power of the models did not differ by the Hanley-McNeil test (p>0.05). Within each quartile of mortality, the composite and surgical models displayed an expected mortality ratio close to 1. CONCLUSIONS: The addition of clinical data to claims data efficiently enhances the performance of the risk-adjusted postoperative mortality models in colorectal cancer surgery. We recommended that the performance of models should be evaluated through both discrimination and calibration.
Adult ; Aged ; Colorectal Neoplasms/*mortality/surgery ; Databases, Factual ; Female ; Hospital Mortality ; Hospitals, Teaching ; Humans ; Logistic Models ; Male ; Middle Aged ; Models, Psychological ; *Models, Theoretical ; Neoplasm Staging ; Odds Ratio ; Quality of Health Care ; Risk Adjustment

Orofacial pain has various causes, making it challenging to differentiate from dentalrelated diseases based solely on symptoms. Toothache, usually attributed to pathological changes in the pulp and periodontal tissue, is the most common cause of orofacial pain and relatively easy to diagnose. However, distinguishing orofacial pain and nonodontogenic toothache due to myofascial, neuropathic, neurovascular, paranasal sinus and cardiac originating, and psychogenic pain presents diagnostic challenges that may result in incorrect treatment. Therefore, dentists must recognize that orofacial pain can arise from not only dental issues but also other causes. This case report explores the necessary considerations in diagnosing orofacial pain and nonodontogenic toothache by examining the diagnoses of patients presenting at the dental hospital with orofacial pain and nonodontogenic toothache of cardiac origin.

Orofacial pain has various causes, making it challenging to differentiate from dentalrelated diseases based solely on symptoms. Toothache, usually attributed to pathological changes in the pulp and periodontal tissue, is the most common cause of orofacial pain and relatively easy to diagnose. However, distinguishing orofacial pain and nonodontogenic toothache due to myofascial, neuropathic, neurovascular, paranasal sinus and cardiac originating, and psychogenic pain presents diagnostic challenges that may result in incorrect treatment. Therefore, dentists must recognize that orofacial pain can arise from not only dental issues but also other causes. This case report explores the necessary considerations in diagnosing orofacial pain and nonodontogenic toothache by examining the diagnoses of patients presenting at the dental hospital with orofacial pain and nonodontogenic toothache of cardiac origin.