Trichost.asis Spinulosa consists of several fasciles of reta ned vellus hairs in the hyperkeratotic sebaceous follicles, resulting in a dark slightly raied horny follicular spines, resembling comedones on the trunk and face. The condition is relatively common, particulary among the age, but is usually overlooked on routine skin examination as the patient is rarely aware of it.. We report 6 cases of trichostasis spinulosa, which showed numerous asymptomatic tiny black comedo-like dots on their backs. We obtained the follicular material by tweezer, which consised of several vellus hairs surrounded by a keratinous plug. Histologic examination was done in 3 patients, one of whom showed a rarely reproted double follicle and double papilla. With scanning electron microscopy, we observed multiple vellu hairs embedded in a keratotic plug, emerging from a hair follicle opening.
Hair ; Hair Follicle ; Humans ; Microscopy, Electron, Scanning ; Skin ; Spine

Melanoacanthoma is an extremely rare pigmented benign mixed epithelial tumor of both melanocytes and keratinocytes. A 52-year-old female presented an asymptomatic, slightly elevated, 1. 2 cm x 0. 8 cm, dark black-colored plaque on her right buttock of 2 years' duration. Histopathologic finding of the plaque shows hyperkeratosis, focal parakeratosis, follicular plugging, acanthosih, papillomatosis and pseudo-horn cyst in the epidermis. The tumor is composed of basaloid and squarnous cells with many foci of clusters and whorls of melanin pigment-laden cells. Electron microscopic finding reveals many scattered melanocytes in the entire epidermis. Melanin granules are found mostly in the melanocytes but can also be found in a few keratinocytes.
Buttocks ; Epidermis ; Female ; Humans ; Keratinocytes ; Melanins ; Melanocytes ; Middle Aged ; Papilloma ; Parakeratosis

Clear cell sarcoma of tendon and aponeuroses is slow growing and painless. It occur chiefIy in young adults, predominates in women and is most common in the region of the foot and knee. It is intimately bound to tendons or aponeuroses and is composed of srnall nest or aggregates of round or fusiform, pale staining cells showing prominent nucleoli. And it is tend to recur and to resuIt in eventual development of metastatic growth after a protracted clinical ccurs. Herein, we report a case of clear cell sarcorna of tendon anu aponeuross of metatarsophalangeal joint area between 2nd and 3rd light of left foot. The patient, 50-year-old female had a slow groving, asymptomatic, slightly eevated, emooth surfaced and normal skin colored mass for 2 years. Histopatholcigic tindings in dermis revealed nests of atypical polygonal or monotonous cells. Each cell had vesicular or hyperchrornatic nucleus with prominent nucleoli, occcasionally mitotic figure and abundant eosinophilic cytoplasm. For. treatment, transmetatarsal amputation was done.
Amputation ; Cytoplasm ; Dermis ; Eosinophils ; Female ; Foot* ; Humans ; Knee ; Metatarsophalangeal Joint ; Middle Aged ; Sarcoma, Clear Cell* ; Skin ; Tendons ; Young Adult

BACKGROUND: Patient-controlled analgesia (PCA) is a widely used method of postoperative analgesia with the advantage of tailored dosing for each individual. In spite of its popularity, there have been few reports on the current state of PCA in Korea. In this study, the data on PCA management and PCA regimens of medical institutions in Korea were collected and analyzed. METHODS: Members of the Korean Society for Anesthetic Pharmacology were questioned as to the state of postoperative PCA management, such as acute pain services (APS) and pain assessment. A list of PCA regimens for each institution was also requested and analyzed. RESULTS: Among 65 hospitals, APS was run in 30 and the severity of postoperative pain was assessed in 60. The safety and efficacy of PCA was evaluated only in 9 hospitals. A total 518 PCA regimens were reported (414, 95 and 9 regimens for intravenous, epidural and other routes, respectively). For intravenous PCA, fentanyl only and fentanyl-ketorolac regimens comprised 33.8 and 30.9% of treatments, respectively. In 95.9% of the regimens, background infusion was used. For epidural PCA, fentanyl-ropivacaine or fentanyl-levobupivacaine regimens made up the majority (47.4 and 13.7%, respectively). CONCLUSIONS: In Korea, APS was used in less than 50% of the hospitals and the evaluation of the safety and efficacy of PCA is not carried out in the majority. Background infusion, known to have little advantage in most cases, was widely used in intravenous PCA.
Analgesia ; Analgesia, Patient-Controlled* ; Fentanyl ; Korea* ; Pain Clinics ; Pain Measurement ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Pharmacology

Vascular leak syndrome(VLS) is characterized by endothelial damage, which causes extravasation of plasma proteins and fluid from capillaries into the extravascular space. It has been suggested that the increased vascular permeability is the result of an IL-2-induced suppression of endothelin-1 secretion by endothelial cells, an IL-2-induced activation of the complement cascade or TNF-alpha release from IL-2-activated T-cells. A 13-year-old male patient visited our hospital with abdominal pain. He was diagnosed with acute lymphoblastic leukemia(T cell type) by bone marrow study on his 2 nd day in hospital. On the 3 rd day of induction chemotherapy(prednisone, L-asparaginase, vincristine, intrathecal methotrexate), pulmonary edema and pleural effusion, ascites and generalized edema developed and lasted for 53 days without responding to supportive care. The laboratoy finding was that TNF-alpha was increased without evidence of infection and hypoalbuminemia was noted. It was suggested that the patient's clinical feature was induced by VLS.
Abdominal Pain ; Adolescent ; Ascites ; Blood Proteins ; Bone Marrow ; Capillaries ; Capillary Permeability ; Complement System Proteins ; Edema ; Endothelial Cells ; Endothelin-1 ; Humans ; Hypoalbuminemia ; Induction Chemotherapy* ; Male ; Pleural Effusion ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Pulmonary Edema ; T-Lymphocytes ; Tumor Necrosis Factor-alpha ; Vincristine

BACKGROUND: Troponin T(TnT), a 37 kDa polypeptide subunit of contractile protein, is part of the troponin complect in striated muscle, where it binds to tropomyosin. TnT is not usually found in circulating blood, but increase in serum by cytoplasmic damage. Because the amino acid sequence is unique to cardiac muscle, one can immunologically differentiate skeletal muscle and cardiac protein isoforms. METHODS: We evaluated serum cardiac TnT (ELISA, Troponin-T, Boehringer Mannheim, Germany) versos CK-MB mass (IMX CK-MB, Abbott Laboratories, USA) in 46 cases (173 samples) of acute myocardial infarction, 28 cases (94 samples) of ansi na pectoris, 23 cases (62 samples) of other cardiac disease, and 32 cases of non-cardiac disease from September 1994-June 1996. RESULTS: TnT was detected in serum(cutoff value 0.20 ng/ml) within 6 hours after onset of chest pain, slightly earlier than CK-MB mass (cutoff value 5.0 ng/ml). Sensitivity of TnT (81%) is not statistically different from CK-MB mass (84%) within 24 hour of cutest pain but more sensitive after 24-72 hours of symptom, Specificity (79.5%) and positive predictive value (70.7%) of TnT were superior to that of CK-MB mass within 24 fours of cutest pain, and persistent to 6 days, which was longer than that of Cl4-MB mass. More patients show increment of TnT in unstable angina pectoris(40.0%) than stable angina pectoris(15.4%), No difference in detection rate of TnT between angina pectoris(28.6%) and other cardiac disease patients(34.8%). Only 3.1 % of non-cardiac disease patients show TnT increment. CONCLUSIONS: We concluded that TnT Is not detected In most of non-cardiac disease patients, and is an early and later marker with very wide diagnostic time win-dow. Also, TnT can be used as a valuable masker for ischemic myocardial damage in any underlying causes.
Amino Acid Sequence ; Angina, Stable ; Angina, Unstable ; Chest Pain ; Cytoplasm ; Heart Diseases ; Humans ; Muscle, Skeletal ; Muscle, Striated ; Myocardial Infarction* ; Myocardial Ischemia* ; Myocardium ; Protein Isoforms ; Sensitivity and Specificity ; Trinitrotoluene ; Tropomyosin ; Troponin T* ; Troponin*

PURPOSE: The purpose of this study is to investigate the level of pain, gait speed, and ROM (Range of motion) in community-dwelling older adults with knee joint pain. METHODS: A convenience sample of 160 participants living in G city were recruited. Elderly people who suffer from knee joint pain with a pain level ≥5 during the last one year on a visual analogue scale were included in the study. The data were collected from June to August 2016. All statistical analyses were performed using IBM SPSS ver. 22.0. RESULTS: Participants' pain was 6.81 by VAS. The mean gait speed was 13.9 sec/10m. The ROM of left knee and right knee were 54.06° and 56.50°, respectively. The level of pain was different according to gender (t=-4.87, p<.001), economic status (t=3.51, p=.032), diseases (t=5.23, p<.001), diagnosis of arthritis (t=3.86, p<.001), region of knee joint pain (F=9.30, p<.001), duration of pain occurrence (F=13.82, p<.001), and limp (F=3.58, p<.001). The level of knee joint pain and gait speed had significant correlations. CONCLUSION: The gait speed in older adults is an important variable that should be taken into account in the assessment of their level of knee joint pain.
Adult* ; Aged ; Arthritis ; Diagnosis ; Gait* ; Humans ; Knee Joint* ; Knee* ; Range of Motion, Articular

BACKGROUND: Many investigations were done about pulmonary protection in lung transplantation which is the most effective treatment of end-stage pulmonary disease. The objective of this study is to verify the effect of prostacyclin on the ischemia-reperfusion injury in terms of the change of arterial blood gas (ABGA), pulmonary vascular resistance (PVR) and pulmonary water content. METHODS: In twelve mongrel dogs weighing approximately 20 kg, double-lumen endotracheal tube was intubated and Swan-Ganz catheter was inserted. To obtain control data for water content of left lung right postcaval lobe was resected. Left hilum was snared with umbilical tape after collapse of left lung and tightened to clamp. It was maintained for 90 min. Thereafter, ventilation and perfusion of left lung were restored. To control group (n=6), prostacyclin was not given. To prostacyclin group (n=6), prostacyclin was intravenously administered at 250 ng/kg/min for 20 min, just before ischemia and just after reperfusion. We measured hemodynamic variables and analyzed arterial blood gas before and after ischemia and then at every 1 hour interval. At 4 hours after reperfusion, left lung was resected, and water content was measured with wet-dry method. RESULTS: There was no significant difference between control group and prostacyclin group in ABGA, PVR and water content of lung. However, three subjects of prostacyclin group showed higher PaO2 after reperfusion than that of others. CONCLUSION: This study shows that protective effect of prostacyclin is not uniform in severely injured canine ischemia-reperfusion model. We conclude that prostacyclin does not have pulmonary protective effect in severe ischemia-reperfusion injury.
Animals ; Catheters ; Dogs ; Epoprostenol* ; Hemodynamics ; Ischemia ; Lung ; Lung Diseases ; Lung Transplantation ; Perfusion ; Reperfusion ; Reperfusion Injury* ; SNARE Proteins ; Vascular Resistance* ; Ventilation

Animals ; Durapatite ; Fibroins ; Microcomputers ; Osteogenesis ; Parietal Bone ; Rabbits ; Silk ; Skull ; Transplants ; X-Ray Microtomography

BACKGROUND: The accuracy and efficacy of patient-controlled analgesia (PCA) devices are crucial because malfunction of the devices may lead to fatal outcomes. The aim of this study is to evaluate the accuracy and efficacy of Accumate(R) 1100, an electronic PCA pump, in comparison with GemStar(R) infusion system. METHODS: Fifty patients scheduled for gastrectomy or colon resection were assigned to the Accumate or GemStar group (n = 25 in each group). Intraoperatively, backflow, siphonage, autoclamp function, and lockout time were tested. Postoperatively, PCA using either Accumate(R) 1100 or GemStar(R) infusion system according to the assigned group was maintained for 48 hours. For PCA, fentanyl 1,500 ug and ketorolac 180 mg in 100 ml were used (demand bolus 1 ml, background infusion 1 ml/h, lockout time 15 minutes). The accuracy of the total infused dose and the level of satisfaction of the patients and users were assessed. The results were compared between the two groups. RESULTS: Although backflow and auto-clamp backflow were less with GemStar(R) infusion system, their extent was negligible in both groups. Siphonage was not different between both pumps. Autoclamp and lockout time worked without abnormalities. The relative error of total infused volume over 48 hours was -0.26 +/- 1.20% and -0.34 +/- 0.48% in the Accumate group and GemStar group, respectively. The Accumate group showed a higher level of satisfaction in terms of the ease of priming (P < 0.05). CONCLUSIONS: The accuracy and clinical efficacy of Accumate(R) 1100 were comparable to those of GemStar(R) infusion system.
Analgesia, Patient-Controlled* ; Colon ; Equipment Safety ; Fatal Outcome ; Fentanyl ; Gastrectomy ; Humans ; Infusion Pumps* ; Ketorolac ; Passive Cutaneous Anaphylaxis