Aplasia cutie congenita is a rare congenital disease showing focal abscence of skin. In the msjority of instances it is limited ta the scalp especially on the vertex although other areas of the body may also be involved. Other congenital malformation have been reported to ccur with ACC odcasionally. Diagnosis depends on primarily clinical findings. The histologic finding virious from an absence of appendages to the involvement of varying layers of skin, occasionally extending to the bane or dura. Healed lesions often demonstrate a flattened epidermis, a proliferation of fibrobasts in a loose connective tissue stroma, newly formed capillaries, and a complete absence of adnexa stuctures. We observed a newborn infant with aplssia cutis congenita. The akir, defect was found on the posterior fontanelle. No associating cangenital anomalies were found in this case.
Capillaries ; Connective Tissue ; Cranial Fontanelles ; Diagnosis ; Ectodermal Dysplasia* ; Epidermis ; Humans ; Infant, Newborn ; Scalp ; Skin

Phakomatosis pigmentovascularis is characterized by the coexistence of pigmentary nevus and hemangioma. Since the term was first described by Ota et al in 1947, about 80 cases have been reported in the literature. In 1979, Hasegawa et al subclsssified the disorder into eight types : type I, nevus flammeus and nevus pigmentosus et verrucosus, type II, nevus flamme is and dermal melanocytosis, type III nevus flammeus and nev.us spilus, type IV, nevus flammeus, dermal melanocytosis and nevus spilus. Each type is subdivided into localized(a) and systemic(b) types, A 25-year-old male had brown papules on the left knee and thigh and purple patches on the left leg that had been present for approximately 7 years. He had no concon ittant systemic disease. The histopathologic findings on brown papules and purple patches are compatible with epidermal nevus and nevus flammeus respectively. We herein report a case of phakomatosis pigmentovascularis type I a.
Adult ; Down Syndrome ; Hemangioma ; Humans ; Knee ; Leg ; Male ; Neurocutaneous Syndromes* ; Nevus ; Port-Wine Stain ; Thigh

BACKGROUND: In TIVA, it was controversy which was more appropriate to increase the concentration of the analgesic or of the hypnotic according to the intensity of the surgical stimulus. We used preset infusion dose of propofol and fentanyl mixed with pancuronium through a single syringe for expected better control of hemodynamics. METHODS: Vital signs and recovery scores were observed in thirty patients undergoing total abdominal hysterectomy using one-syringe TIVA in which we used premixed fentanyl(150mcg), propofol(450mg) and pancuronium(2 mg) in one syringe. Induction of anesthesia was performed by injection of propofol 1.5~2 mg/kg, fentanyl 1.5~2 mcg/kg, pancuronium 0.1 mg/kg and ventilated with 100% oxygen after endotracheal intubation. Infusion was started by 1 ml/kg/hr of mixed solution immediately after intubation. If the vital sign changed more than 15% compared with preoperative value, flow rate either increased or decreased by 50%. If stable vital signs were maintained for more than 15 minutes, the flow rate decreased by 20% every 15 min, but were maintained above 0.5 ml/kg/hr. Two to four minutes before skin incision and peritoneal traction, an additional 10 ml of mixed solution was infused. Solution without fentanyl and pancuronium was infused after peritoneal closure for early recovery. Ten to fifteen minutes before the operation was completed, infusion was discontinued and neuromuscular block was reversed. RESULTS: Blood pressure and pulse rate were stable and did not significantly change even after intubation or peritoneal traction compared with preoperative value. And, recovery from anesthesia was prompt 15 min after extubation except 2 cases of respiratory depression. CONCLUSIONS: One-syringe TIVA may be an feasible alternative method to replace conventional multi-syringe TIVA.
Anesthesia ; Anesthesia, Intravenous* ; Blood Pressure ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Hysterectomy ; Intubation ; Intubation, Intratracheal ; Neuromuscular Blockade ; Oxygen ; Pancuronium ; Propofol ; Respiratory Insufficiency ; Skin ; Syringes* ; Traction ; Vital Signs

BACKGROUND: Superoxide disrnutase(SOD) is an essential enzyme oi protective defense mechanism in cellular compartments against the potential cytotoxicity of superoxileinion. It seems SOD activity is increased in psoriasis because of an increase in oxygen intermediates dae to hyperoxia. However SOD activity is decreased paradoxically. OBJECTIVE: In order to understand the pathophysiology of psoriasis and to elucidate the significance of SOD aetivity in keratinocyte proliferution, we measured the SOD activities in psoriatic and in normal skin. METHODS: Authors assayed the level of SOD activities in 16 psoriatie and 16 normal skin specimens, which were obtained from face/neck (1and 4 speeimens), forearm(5 and 4 specimens), trunk(6 and 3 specimens), and lower extremiy(4 and 5 specimens). We also investiga.ed changes of SOD activity by age and regional differences of' SOD sctivities in the psoriatic and normarl skins. RESULT : First, activities of tot,al SOE Mn-SOD and Cu, Zn-SOD were L2.75+8.15, 4.28+ 3.62, 8.48+ 6.37 units/mg protein respect,ively in the psoriatic skin. Activities of toal SOD, Mn-SOD and Cu, Zn- SOD were 17.63+9.10, 3.38+ 1..85, 1.25+8.16 units/mg protein respec,ively in the normal skin. There was a significant differenc between psoriatic and normal skins in C-SOD activity(p<0.05). Second, the changes of total SOD, Mn-FOD and Cu, Zn-SOD activities showed no significant differences between the age groups. Third, in sun exposed area and unexposedire there were no significant differences between the psoriatic and normal skins in SOD activities. Elut in the normal skin, there were significant differences between sun exposed area and unexposed area in total SOD and Cu, Zn-SOD activities. CONCLUSION: There is a signiificant difference between psoriatic and normal skins in Cu, Zn-SOD activity. Namely, the Cu, Zn-SOD activity is significantly decreased in psoriasis.
Epidermal Cyst* ; Humans ; Hyperoxia ; Keratinocytes ; Oxygen ; Psoriasis ; Skin ; Solar System ; Superoxide Dismutase ; Superoxides

BACKGROUND: Androgens stimulate the growth of hair in various are of skin including the pubis, axilla and beard, whereas in the scalp androgens promote baldness in genitically predisposed individuals. Androgens bind to specific intracellular receptors, which modulate saecific gene expression and so affect hair loss. Androgenetic isldness is first apparent on the frontalegion, with recession of the hair line. As this progresses, aloperia also develops on the vertex. But the osterior and lateral scalp area is spared, even in the most advanced eases, and even in old age. OBJECTIVE: The purpose of our study is to find out the difference of androgen receptor expression in lesional and non lesional scailp of androgenetic alopecia patients by iminunohistochemical staining. METHODS: Biopsy specimens were taken from its lesion(vertex) and its non lesion(occiput) of 3 patients with androgenetic alopecia and 4 normal controls. The deteatic n of androgen receptor was performed by an immunohistochemical technique(streptavidin peroxidasc method) using monoclonal antibody against androgen receptor. RESULTS: Androgen receptors were strongly expressed in eccrine land and sebaceous gland, and weakly expressed in epidermal cells, hair infundibulum, hair bulb epith-lium and dermal hair papilla. CONCLUSION: There was no significant difference of the expression if androgen receptors in lesional and non lesional scalp of androgenetic alopecia.
Alopecia* ; Androgens ; Axilla ; Biopsy ; Gene Expression ; Hair ; Humans ; Receptors, Androgen* ; Scalp* ; Sebaceous Glands ; Skin

We report herein a case of the coexistence of linear and placue porokeratosis in a 20-year-old female patient. The patient showed the typical clinical picures of linear and plaque porokeratosis on the right wrist, dorsum of the hand, dorsolater; I aspect of the fingers and axilla, respectively. Histopathologically, these lesions showed the typical cornoid lamella. We tried to remove the lesions with 75 100% trichloroacctic acid but could not gain a sat.isfact.ory effect.
Axilla ; Female ; Fingers ; Hand ; Humans ; Porokeratosis* ; Wrist ; Young Adult

BACKGROUND: Morphine for the intravenous patient controlled analgesia (IV-PCA) provides effective postoperative pain control, but it has side effects such as itching, nausea and vomiting. Meanwhile, butorphanol, a synthetic potent agonist-antagonist narcotic with low incidence of adverse side effects and minimal addiction, produce adequate analgesia for postoperative pain. The purpose of this study was to compare the suitability of butorphanol combining with or without morphine with that of morphine in terms of relieving postoperative pain and incidence of side effects. METHODS: Sixty ASA physical status I or II female patients undergoing total abdominal hysterectomy were randomly allocated into one of three groups according to type of drug used (n=20 for each group). The groups were divided to group M (morphine 100 mg), group M B (morphine 50 mg+butorphanol 10 mg) and group B (butorphanol 20 mg). Drugs for each group mixed with 90 ml of normal saline (total amount: 100 ml) for infusion. Loading dose, PCA dose, lockout interval, mode of infusion was 0.05 ml/kg, 0.02 ml/kg, 8 minute, and PCA only, respectively. In each group, visual analog scale (VAS), pain score, sedation score, degree of satisfaction, total amount of drug used, history of attempt/injetion and incidence of side effects were checked. RESULTS: There were no significant differences in analgesic effects and degree of satisfaction among three groups, but incidence of side effects (especially pruritis) were less in group M+B and B compared with group M (p<0.05). CONCLUSIONS: Butorphanol showed comparable postoperative pain relief and marked less side effects compared with morphine. Butorphanol was considered as a useful drug for postoperative pain relief using IV-PCA.
Analgesia ; Analgesia, Patient-Controlled* ; Analgesics ; Butorphanol* ; Female ; Humans ; Hysterectomy ; Incidence ; Morphine* ; Nausea ; Pain, Postoperative* ; Passive Cutaneous Anaphylaxis ; Pruritus ; Visual Analog Scale ; Vomiting

A total of 127 cases of seborrheic keratosis examind at the Dept. of Pathology, Yonsei University School of Medicine during 1980~1986 was reviewed. The results were as follow; 1) Sex distribution showed without preponderance with male; Female ratio of 1.05:1. 2) Age distrubution were 10~19 years 0.8%, 20~29 years 4.7%, 30~39 years 14.2%, 40-49 years 25.2%, 50~59 years 29.1%, 60~69 years 17.3%, 70~79 years 6.3% and neck (3.7%). 3) The most common site was face (44.8%), followed by trunk (29.8), lower extremities (10.4%), scalp (6.7%) and neck (3.7%). 4) The clinical diagnoses were sebrorrheic keratosis (47%), nevus (15.4%), verruca (12%), malignant melanoma (7.7%), actinic keratosis (3.4%), pyogenic granuloma (2.6%), mass (2.6%), basal cell epithelioma (0.9%), corn (0.9%), leproy (0.9%), and angiokeratoma (0.9%). 5) The distributions of the light microscopic diagnosis were acanthotic 52 cases (42.9%), hyperkeratotic 33 cases (30%), irritated 17 cases (13.4%), adenoid 15 cases (11.8%), clonal 3 cases (2.4%), melanoacanthoma 1 case (0.8%) and mixed 6 cases (4.7%). 6) The lesions measured from 0.2 cm to 3 cm in maximum diameter and its color was light brown to black with sharply demarcated papule, pladque or nodule.
Female ; Male ; Humans

Nevus flammeus is a benign but cosmetically devascating congenital inalformation involving mature capillaries. The copper vapor laser is a therapeutic device which had been newly applied to this. Yellow copper vapor light is absorbed by the intraluminal oxyhemoglobulin mo ecules, leading to the destruction of blood vessels. This study was undertaken to evaluate the histobigic findings in a patient with nevus flammeus according to the sequential time after copper vapor laser therapy. The results were as followed, One hour after treatment, nonspecific damages to the epidermis and upper part of the dermis were observed. The specific damage to the vessels which showed thrombi formations and partial disruption of the vessel walls was prominent. One cay after treatment, degeneration of the epidermis and sepaiation of the dermoepidermal junction were apparent. Three days after treatment, extravasations of a small amount of erythrocytes and inflanimatory cell infiltrations were present, especially around the vessels. Seven days after treatment, the capillaries showed a deposition of fiorinoid material around themselves. Partial disappearance of the vessel walls was seen. There was hisi ologic evidence of the replacement of abnormal ectatic vessels by normal appearing vessels with small uminal diameters, surrounded by endothelial cells.
Blood Vessels ; Capillaries ; Copper* ; Dermis ; Endothelial Cells ; Epidermis ; Erythrocytes ; Humans ; Lasers, Gas* ; Nevus* ; Port-Wine Stain*

BACKGROUND: Hydration, the water content of the stratum corneum, is an important factor in both the appearance and the barrier function of the skin. Many non-invasive methods have been developed in order to assesa the hydration state of the skin and the effect of various moisturizers. The hydrometer and carneometer are commercially available instruments which are widely used in dermatologic research. OBJECTIVE: Our purpose was to compare the measuring usefulnes of both instruments on normal subjects with a wide range of hydration states of the hornylayer. METHODS: We measured the conductance with the hydrometer and the capacitance with the corneometer in various hydrating eonditions and compared both insruments. RESULTS: Conductance had a non linear correlation with capacita ice. Capacitance measured with the corneometer had a high sensitivity to moisture in a wide range of hydration levels. On the other hand, conductance guaged with the hydrometer showed a few sensitivity to moisture at a low level. When the hydretion level was measured after a moiturizer was added, 10 % urea cream showed a sharp increase by 256% in terms of conductanae, and H-base by 97.8%. Mineral oil decreased by 41.5% and petrolatum by 62% respectively. On the other hand, when measured in terms of capacitance under the same conditions as above, 38.9 increase in 10% urea cream, 19.3% increase in H-base, 20% decrease in mineral oil, and 43.5 % decrease in petrolatum were reported. Conductance showed a higher hygroscopicity and a lower water holding capacity than capacitance did. When the measurement of the moisture level iri virious parts of the human body is performed, the corneometer provided us with more stable alies than the hydrometer. While the hydrometer can not the available and appropriate under the condition of insulation, the corneometer can measure moisture levels even down at the depth of 250mm. When measured after the oily surface of the forehead was cleansed with soft tissue, conductance and capacitance revealed higher values of moisture levels than before the eleanin. However, there is no statistical significance in these values. CONCLUSION: The hydrometer is a more appropriate tool for the measurement of moisture at a high level, and the corneometer at a low moisture level. The hydrcmeter is a more sensitive method of measuring the increase and the decrease in the moisture level.
Forehead ; Hand ; Human Body ; Ice ; Lasers, Gas ; Mineral Oil ; Petrolatum ; Skin* ; Urea ; Water ; Wettability