BACKGROUND: Pilomatricoma is a rare benign follicular tumor in Asians OBJECTIVE: purpose of this study was to assess the clinical and histopathological features of the tumor. METHODS: The hospital charts and slides of 13 patients with pilomatricoma over a 12-year period at Ewha Womans University Tongdaemun Hospital were retrospectively reviewed. RESULTS: The age of patients ranged from 5 to 76 years with a mean of 21.5 years. The maleto-female ratio was 1:3.3. Seventy-seven percent of the tumors were located on the upper and lower extremities, followed by the face and neck. Most tumors appeared as a pea-sized hard movable skin-colored nodule. At histopathologic level, the most common morphological stage was the early regressive stage (stage 3), followed by late regressive (stage 4), fully developed (stage 2), and early (stage 1) stages. Foreign body giant cells, calci6cation, ossification were seen in 69.2%, 84.6%, and 7.7%, respectively; giant cells and inflammatory infiltrate were mostly seen in stage 3 tumors, calcification in stage 3 and 4 tumors, and ossification, only in the sole stage 4 tumor. Anetodermic changes of overlying dermis were seen in 2 cases (15.4%). CONCLUSION: The various histopathologic features of pilomatricoma can be explained by its chronological, morphological stages.Most pilomatricomas present for longer than 6 months are already in stage 3, and one can expect the histopathological features accordingly.
Asian Continental Ancestry Group ; Dermis ; Female ; Giant Cells ; Giant Cells, Foreign-Body ; Humans ; Lower Extremity ; Neck ; Pilomatrixoma* ; Retrospective Studies

BACKGROUND: Nevus sebaceus of Jadassohn is a complex anomaly involving the epidermis, dermis, apocrine glands and hair follicles, as well as the sebaceous glands, and a variety of benign and malignant tumors and neurologic abnormalities may be associated with it; however, only a few studies on it have been reported in the Korean literature. OBJECTIVE: The objectives of this study was to document clinical and histopathologic features of nevus sebaceus in Koreans and compare them to those in the previously reported studies. METHOD: Clinical records and histopathology of 53 cases of nevus sebaceus diagnosed at Ewha Womans University Tongdaemun Hospital during a period of 18 years were reviewed and analyzed. RESULTS: The average incidence rate of nevus sebaceus among new patients was 0.03%. The male-to-female ratio was 1.04 and the average age at visit, 16.5 years. The lesions had been present since birth or had developed before age 10 in 85% of the cases. A11 lesions were situated on the head, and the most common site was the scalp. Linear 1esions (20.8%) were mostly facial lesions. Histopathologically, the incidence of sebaceous and apocrine glandular hyperplasia was most notable in the 13-18 and over-18 age groups. The sebaceous glands showed small punched out defects or "holes" in 24.5%; ectopic apocrine glands were found in 24.5 %. Mature hair follicles were absent or greatly reduced in number in 75.5%. Acanthosis nigricanslike pattern of acanthosis and mild papillomatosis were the dominant changes in the epidermis. Hyperplasias and neoplasms were associated in 15.1%, which included 5 cases of primitive follicular induction and 1 trichoblastoma. CONCLUSION: In this series, no examples of malignant neoplasms were identified; however, an early total excision before age 13 is recommended since a variable "deficit malformation" of the follicles with hyperplasia of the epidermis and sebaceous glands becomes more prominent after that age.
Apocrine Glands ; Dermis ; Epidermis ; Female ; Hair Follicle ; Head ; Humans ; Hyperplasia ; Incidence ; Nevus* ; Nevus, Sebaceous of Jadassohn ; Papilloma ; Parturition ; Scalp ; Sebaceous Glands

A 22-year-old woman with no history of trauma or other diseases presented with a slowly enlarging firm nodule with a central pointed opening on the right chest. An excisional biopsy revealed a pilomatricoma associated with an epidermoid cyst. Histopathologically, an epidermoid cyst located in the deep dermis was lined mostly by keratin-forming stratified squamous epithelium but focally had columns of shadow cells that projected from the epithelial lining of the cyst into the lumen. The lumen also contained masses of shadow cells, unattached to the epithelial lining. In the stroma surrounding the cyst, numerous masses of shadow cells with giant cell reaction and focal calcification were seen, which were in turn surrounded by a connective tissue capsule. These features are similar to those seen in infundibular cysts associated with Gardner's syndrome. Since epidermoid cysts and pilomatricomas originate in common from the pilosebaceous unit and pilomatricomas begin as infundibular matrix cysts, we suggest that they can occur simultaneously, although rarely, in a healthy person.
Biopsy ; Connective Tissue ; Dermis ; Epidermal Cyst* ; Epithelium ; Female ; Gardner Syndrome ; Giant Cells ; Humans ; Pilomatrixoma* ; Thorax ; Young Adult

Cardiac output depends on the ability of systolic ejection and diastolic filling of the heart. M-mode echocardiography can provide accurate clinical assessment of left ventricular systolic and diastolic functions. To see whether there are changes of the left ventricular function in asymptomatic hypertensives and if any kind of dysfunction and whether any relationship between the pattern of the ventricular hypertrophy and type of ventricular dysfunction exists, the authors examined the systolic and diastolic function indices of the left ventricle in 50 normotensives and 88 hypertensives composed of 18 patients without left ventricular hypertrophy(group 1), 40 patients with disproportionate septal thickening (group 2) and 30 patients with concentric left ventricular hypertrophy(group 3). Obtained results were as follows : 1) Blood pressure & left ventricular mass index were increased significantly in each hypertensive group compared to normal control. 2) Ejection fraction & fractional shortening in the hypertensive groups were not different from the normotensive control group. 3) Left ventricular isovolumic relaxation time(A2D time) was prolonged in each hypertensive group, especially in group 3. 4) Left atrial emptying index (AEI) was decreased in each hypertensive group. 5) Left ventricular percent ventricular A wave (% VAW) was increased in all hypertensive groups. Above study suggested that the left ventricular diastolic function could be impaired in the hypertensives without associated systolic dysfunction, and the degree of the diastolic dysfunction was not much affected by the type of left ventricular hypertrophy, but the more prolonged A2D time in the concentric hypertrophy group.
Blood Pressure ; Cardiac Output ; Echocardiography ; Heart ; Heart Ventricles ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Relaxation ; Ventricular Dysfunction ; Ventricular Function, Left

Two factors of the ventricular function, systolic contractile and diastolic relaxing functions, cooporate in pumping the adequate blood volumes to suffice bodily demands. In some hypertensive patients with marked left ventricular hypertrophy, the intact systolic function of the ventricle associated with clinical symptom of congestive heart failure(CHF), which is considered to be a consequence of diastolic dysfunction. In this study 10 hypertensive patients(group A) complaining of exertional dyspnea or chest pain with increased left ventricular mass index and normal systolic function and 6 normotensive controls(group B) were examined by cardiac catheterization and echocardiography to assess the left ventricular systolic and diastolic function and ventricular responses to constant infusion of nitroprusside. Various systolic and diastolic function indices were measured by cardiac catheterization and echocardiography. 1) The ejection fraction(EF), fractional fiber shortening, mean velocity of circumferential fiber shortening, left ventricular(LV) peak+dp/dt, change of slope of LV peak systolic pressure-volume and pressure-dimension relations in group A were not different from those of group B in the resting states. 2) Diastolic dysfunction was evidenced by prolonged A2D time, decreased OR slope, decreased peak negative dp/dt and increased diastolic time constant 'T' in group A. 3) Cardiac index by thermodilution method was negatively related to left ventricular mass index(LVMI) measured by echocardiography, whereas time constant T was positively related to LVMI. 4) With constant infusion of nitroprusside, LV systolic pressure, LV end-diastolic pressure and pulmonary arterial pressure were decreased, and left ventricular end-systolic stress and stroke work index(SWI) derived from left ventricular pressure-volume loop area were decreased, EF was increased, but time constant T was prolonged and cardiac output(CO) by thermodilution method was decreased in group A. 5) In group B, with constant infusion of nitroprusside, EF, SWI and CO were pratically unaffected and time constant T was not prolonged significantly. These reults suggest that patients with hypertensive hypertrophic left ventricle is associated with diastolic dysfunction, which could further be exacerbated by a vasodilator such as nitroprusside.
Arterial Pressure ; Blood Pressure ; Blood Volume ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Dyspnea ; Echocardiography ; Estrogens, Conjugated (USP) ; Heart Diseases* ; Heart Ventricles* ; Heart* ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Nitroprusside* ; Stroke ; Theophylline ; Thermodilution ; Ventricular Function

To evaluate the hypertensive effect of guanbenz acetate, we performed a prospective clinical study for 10 weeks or more in 27 patients with essential hypertension(mean age: 51, mean supine blood pressure: 176/105mmHg). The daily dose of guanabenz acetate was 8-49 mg. The results were as follows; 1) After 2, 4, 6 and 8 weeks of treatment, average supine systolic and diastolic blood pressures reduced to 156/94, 150/94, 149/93 and 144/93mmHg respectively(all P<0.05). 2) Pulse rate decreased slightly from pre-treatment average of 75 beats per minute to 71 beats per minute at the end of the study(P<0.05). 3) Average body weight, serum levels of total cholesterol, AST, ALT, BUN, creatinine, sodium and potassium were not significantly changed from pre-treatment values. 4) A few side effects in order of frequency were dry mouth, dizziness, sedation, weakness, etc. We conclude that guanabenz acetate may be used as an effective first line antihypertensive agent in essential hypertension.
Blood Pressure ; Body Weight ; Cholesterol ; Creatinine ; Dizziness ; Guanabenz* ; Heart Rate ; Humans ; Hypertension ; Mouth ; Potassium ; Prospective Studies ; Sodium

This study was made to evaluate the effect of oral atenolol, a cardioselective beta-adrenergic blocking agent without intrinsic sympathomimetic activity, on left ventricular function in patient with essential hypertension. Atenolol, 100mg/day, was given to 11 hypertensive patients for 4 weeks, and its effects on arterial pressure, pulse rate, left ventricular dimensions and ejection phase indices of myocardial performance were examined by echocardiography. Echocardiographic studies were performed before treatment and after 4 weeks of atenolol therapy. Arterial pressure fell form 145/90 mmHg to 138/84mmHg after 4 weeks. Pulse rate fell significantly from 69/min to 58/min(p<0.05). Left ventricular end-diastolic and end-systolic dimensions and mean rate of circumferential fiber shortening(mVcf) did not change significantly. Ejection fraction increased significantly from 0.66 to 0.72(p=0.01). This results indicate that atenolol in the resting state has no depressant effect on left ventricular function in patients with essential hypertension.
Arterial Pressure ; Atenolol* ; Echocardiography ; Heart Rate ; Humans ; Hypertension* ; Ventricular Function, Left*

Congenital self-healing reticulohistiocytosis (CSHRH) is a rare Langerhans cell disorder usually showing spontaneous resolution within 3-4 months. By electron microscopy, the identification of Birbeck granules and laminated dense bodies in the infiltrated cells is mandatory for the diagnosis of CSHRH. However, in some reported cases, Birbeck granules could not be demonstrated and only cytoplasmic dense bodies were seen. If the lesion is more advanced, Birbeck granules are transformed to lysosomes, i.e., 'unique phagosomes', in which they are degraded. A 2-month-old Korean girl presented with congenital, numerous red-brown pigmented papules on the left side of trunk and upper extremity without systemic symptoms. A biopsy specimen demonstrated papillary dermis containing epidermotropic infiltrates of histiocytes with abundant eosinophilic cytoplasm. Some had kidney-shaped nuclei and PAS-positive cytoplasmic inclusions. Immunohistochemically, infiltrating cells expressed S-100 protein and ultrastructurally, no Birbeck granules but many dense laminated bodies and unique phagosomes were found. It was ten months since the skin lesions developed that they have started resolving.
Biopsy ; Cytoplasm ; Dermis ; Diagnosis ; Eosinophils ; Female ; Histiocytes ; Humans ; Inclusion Bodies ; Infant ; Lysosomes ; Microscopy, Electron ; Phagosomes ; S100 Proteins ; Skin ; Upper Extremity

Mucoepidermoid carcinoma occurs commonly in salivary gland, but rarely in lacrimal gland. In literature about ten or more cases of mucoepidermoid carcinoma of the lacrimal gland have been described. A 73-year-old woman had noted upper lid swelling and lacrimation of the left eye for 2 months. Computed tomographic scan demonstrated a large homogenous mass on superotemporal portion of the left orbit. The mass extended into the left temporal fossa, middle cranial fossa, and ethmoidal sinus with bone destruction. Histopathologically, the mass was proved to be a intermediate grade mucoepidermoid carcinoma of the lacrimal gland.
Aged ; Carcinoma, Mucoepidermoid* ; Cranial Fossa, Middle ; Female ; Humans ; Lacrimal Apparatus* ; Orbit ; Salivary Glands

No Abstract Available.
Churg-Strauss Syndrome*