Nitrofurazone is a well known sensitizer and is widely used particularly in surgical department for the treatment of secondary infection, but the reports of all ergic contact dermatitis to nitrofurazone are rare in Korean literature. We experienced a case of allergic eontact dermatitis to 0.2% nitrofurazone in 31-year-old female after dressing the grafted wound on the left index finger with the gauze embedded with 0.2% nitrofurazone olintmnt. The patch test results revealed a strong positve reaction to 0.2% nitrofurazone ointment after 48 hours.
Adult ; Bandages ; Coinfection ; Dermatitis ; Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Female ; Fingers ; Humans ; Nitrofurazone* ; Patch Tests ; Transplants ; Wounds and Injuries

BACKGROUND: Transradial coronary intervention was introduced recently. It has less bleeding and vascular complications and advantage of early ambulation. METHODS: We compared 142 transradial coronary interventions (101 stents, 56 balloon angioplasty and 18 rotablation) with 120 transfemoral interventions in 230 patients from January to August 1998. RESULTS: Overall success rate was not different between two approaches (92% vs 89%), but smaller sized sheath and less amount of contrast agent were required in transradial interventions compared to transfemoral interventions. Conventional guiding catheters which are used in transfemoral approach were used in most cases (94%) of transradial interventions. Judkins left 3.5 (in stead of JL4.0 in femoral approach) and Judkins right 4.0 were the most frequently used guiding catheters in transradial approach. Stent implantation was successfully done in 99 out of 101 lesions (98%) in transradial intervention and 76 out of 78 lesions (97%) in transfemoral intervention. Rotational atherectomy and primary balloon angioplasty or stenting were done successfully in 10 - 20% of the patients in both groups. All procedures were done successfully without any major procedure-related complications (myocardial infarction, death, bypass surgery) or major vascular complications in both groups. During the clinical follow-up of transradial group, punctured arteries showed 10% incidence of radial artery pulse weakness with 3% of pulse loss. CONCLUSION: Transradial approach is useful another feasible route for coronary interventions. The feasibility of primary balloon angioplasty or stenting and rotational atherectomy by transradial approach should be evaluated in the future.
Angioplasty, Balloon ; Arteries ; Atherectomy, Coronary ; Catheters ; Coronary Artery Disease* ; Coronary Vessels* ; Early Ambulation ; Follow-Up Studies ; Hemorrhage ; Humans ; Incidence ; Infarction ; Radial Artery ; Stents

Dermatomyofibroma, first described by Kamino et al in 1992, is a rare plaque-like proliferation of fibroblasts and myofibroblasts of the skin. The lesion is a solitary plaque resembling a keloid or scar and is usually located on the shoulder and axilla. Histologically, the lesion is characterized by a proliferation of uniform spindle-shaped cells arranged as fascicles with a parallel arrangement to the skin surface. We report a case of dermatomyofibroma in a 47-year-old woman who had multiple, red papules and plaques on the left upper arm, left hand and right foot. The biopsy specimen obtained from the lesion of left upper arm showed fascicles of proliferations of uniform spindle-shaped cells and thin collagen fibers in the upper half of the dermis, which were arranged parallelly to the skin surface. Immunohistochemically, spindle-shaped cells stained positively for vimentin and smooth muscle actin, but were unstained for Keratin, S-100 protein, Factor VIII-R Ag and desmin.
Actins ; Arm ; Axilla ; Biopsy ; Cicatrix ; Collagen ; Dermis ; Desmin ; Female ; Fibroblasts ; Foot ; Hand ; Humans ; Keloid ; Middle Aged ; Muscle, Smooth ; Myofibroblasts ; S100 Proteins ; Shoulder ; Skin ; Vimentin

BACKGROUND: The differentiation between basal cell carcinoma(BCC) and trichoepithelioma(TE) is sometimes difficult clinically and histologically, and their differentiation is important since their treatment and prognosis are sometimes different. OBJECTIVE: Our purpose was to investigate whether there was a difference in CD34 staining patterns in the stromas (immediate and distant stromas from the tumor lobules) of BCC and TE, since the histopathologic characteristics of the stromas are one of the most important features to differentiate the two tumor. METHOD: We perfomed immunoperoxidase staining(modified ABC technique) by using a monoclonal anti CD34 antibody(QBEND10, IgG1) on the formalin-fixed, paraffin-embedded biopsy specimens of 11 BCC as and 10 TEs. RESULTS: 1. In the immediate strcimas, spindle-shaped cells were stained in 4 out of ll cases of BCC and in 9 out of 10 cases of TE. However, the staining patterns observed in the 4 cases of BCC were all loosely scattered, week staining, while those of the 9 cases of TE were all densely compact, strong staining. CD34 was not expressed in one case of TE. 2. In the distant stromas, all cases of BCC and TE showed staining of loosely scattered spindle-shaped cells, and there was no difference in staining patterns of the two tumors. 3. Papillary mesenchymed bodies were observed in 8 cases of TE and in none of BCC, and they expressed CD34 focally. CONCLUSION: CD34 sta ining patterns of the immediate peritumoral stromas of BCCs and TEs were different and could differentiate the two tumors.
Biopsy ; Carcinoma, Basal Cell* ; Prognosis

BACKGROUND: Carotid artery stenosis is not infrequently associated with coronary artery disease. However, the technique performing selective carotid angiography is not established during right transradial coronary angiography. We investigated the reliability and safety of selective carotid angiography from the right transradial approach. MATERIALS AND METHODS: Following right transradial coronary angiography, selective carotid angio-graphy was performed using a 5 Fr Simmons-2 catheter in 103 patients (59+/-8 years [range, 18-80], 78 males). Ninety five (92%) patients had significant coronary artery disease. Subclavian and innominate arteries were moderately tortuous in 25 (24%) patients and aortic arch was elongated, more vertically oriented in 20 (19%). After forming a loop in ascending (n=65, 63%) or descending (n=38, 37%) aorta, the catheter was withdrawn and rotated counterclockwise to engage its tip in left carotid artery and innominate artery subsequently. After the catheter tip was adjusted at each ostia of carotid arteries, contrast material was delivered. In 63 (61%) patients, the procedures were performed on outpatient basis. RESULTS: Bilateral selective carotid angiography was successfully performed in 101 (98%) patients. In two patients with severely tortuous subclavian artery, the catheter was not engaged selectively in left carotid artery. The image quality of the angiograms performed by manual injection was determined satisfactory. Significant carotid stenosis was found in 17 (17%) patients. There were no complications, including thromboembolism and arterial dissection. CONCLUSION: Selective carotid angiography can be performed reliably and safely using a 5 Fr Simmons catheter from the right transradial approach. This technique is useful for evaluation of isolated or associated carotid artery stenosis from the right transradial approach.
Angiography* ; Aorta ; Aorta, Thoracic ; Brachiocephalic Trunk ; Carotid Arteries ; Carotid Stenosis ; Catheters ; Coronary Angiography ; Coronary Artery Disease ; Humans ; Outpatients ; Radial Artery ; Subclavian Artery ; Thromboembolism

We report a case of eosinophilic pustular folliculitis in a 6-month-old male infant who had pruritic, tiny, erythematous papulopustules on his scalp and eosinophilia in the peripheral blood. Histopathologic examination revealed an acute follicu1ar and perifollicular inflammatory infiltrate with abundant eosinophils. The patient responded to systemic and topical corticosteroid and dapsone.
Dapsone ; Eosinophilia ; Eosinophils* ; Folliculitis* ; Humans ; Infant ; Male ; Scalp

No abstract available.
Korea* ; Mercury Poisoning*

No abstract available.

Reconstruction of extensive soft tissue defects of the lower extremity, especially when complicated by open fracture and bone loss, is usually a difficult problem for the plastic surgeon. Many methods have been devised to treat these conditions Musculocutaneous flaps add a valuable surgical alternative that bring vascularized cover to the defects, and the free microvascular transfer of these flaps gives the surgeon an added dimension of versatility. The latissimus dorsi is an extremly reliable musculocutaneous flap with a long, large-caliber vascular pedicle, so that dissection of the muscle can be performed with relative ease. The size of the latissimus dorsi muscle lends itself to coverage of large defects. While these characteristics appear to make the free latissimus dorsi musculocutaneous transfer ideal in many circumstances, it has some disadvantages. At the recipient site, the flap is ofter too bulky, and donor-site closure requires skin grafts if the flap is wider than 10cm. These skin grafts on the posterior thorax seriously detract from the final appearance of the donor site. The authors have experienced 12 cases of reconstruction of extensive lower extremity soft tissue defect in which the latissimus dorsi muscle alone was transferred and covered with a split-thickness skin graft. This method improves the recipient-site contour by decreasing the bulk of the flap and it also improves the donor-site appearance. We described technical considerations in each case and the advantages of free latissimus dorsi muscle flap and skin graft for the reconstruction of extensive soft tissue defect in the lower extremity.
Fractures, Open ; Humans ; Lower Extremity ; Myocutaneous Flap ; Skin ; Superficial Back Muscles* ; Thorax ; Tissue Donors ; Transplants

No abstract available.
Atrial Fibrillation* ; Mitral Valve*